FAMILY NURSE PRACTITIONER CERTIFICATION INTENSIVE REVIEW,
11TH EDITION LATEST VERSION 2024/2025 QUESTIONS AND
ANSWERS ALL CHAPTERS |GRADE A+
_____________________________________________________________________________
A 5-year-old patient is in the office for a school physical. The child is up to date on
immunizations, and the mother denies a history of chickenpox infection. Which
immunizations are indicated at this visit?
DTaP, IPV, MMR, varicella
The Tdap
is reserved for patients older than 11 years of age.
A 5-year-old
requires a booster for varicella, as well as the fifth DTaP, the second MMR, and the fourth
IPV
Employee health clinic protocols for needlesticks
recommend ordering an ELISA test as soon as possible to establish baseline blood work for
the employee.
A 14-month-old child
should developmentally be able to say "mama" and "dada," know his own name, and know
at least two to four words.
A 2-year-old
is able to understand simple commands.
Which of the following viral infections is associated with occasional abnormal forms of
lymphocytes during an acute infection?
Epstein-Barr virus (EBV)
,EBV
is a member of the herpesvirus family and one of the most common viruses.
During adolescence, EBV
causes infectious mononucleosis.
In most cases of infectious mononucleosis,
the clinical diagnosis can be made from the triad of fever, pharyngitis, and
lymphadenopathy lasting 1 to 4 weeks.
Serology tests for Epstein-Barr virus (EBV)
show normal to moderately elevated white blood cells and increased numbers of
lymphocytes, >10% atypical lymphocytes, and a positive reaction to a mono spot test.
The antibody response in primary EBV infection
appears to be quite rapid.
Acute lymphoblastic leukemia,
a malignancy of the bone marrow, is the most common type of cancer in children.
Acute lymphoblastic leukemia
is more common in boys and in children between the ages of 2 and 4 years.
Aplastic anemia
is bone marrow suppression (not cancer) usually caused by medications or a viral infection.
Multiple myeloma and non-Hodgkin's lymphoma
are more common in older adults.
The ELISA (enzyme-linked immunosorbent assay) and Western blot tests
detect only HIV antibodies. That is why there is a "window period" with HIV infection. If the
test is performed too early in the infection, it will be falsely negative because there may not
yet be enough antibodies against HIV to trigger a positive result.
,gestational diabetes indication
mother of the infant weighing 9.5 lb
Other risk factors for diabetes
include impaired glucose tolerance test, sedentary lifestyle, polycystic ovary syndrome
(PCOS), and hypertension.
Fever
is most likely due to the pertussis component of the diphtheria, tetanus, acellular pertussis
(DTaP) vaccine.
A 10-year-old female student complains of pain and decreased hearing in her left ear that
is getting steadily worse. She has a history of allergic rhinitis and is allergic to dust mites.
On physical exam, the left tympanic membrane is bulging and red with displaced
landmarks. The tympanogram exam reveals a flat line. The student denies frequent ear
infections, and the last antibiotic she took was 8 months ago for a urinary tract infection.
She is allergic to sulfa and tells the NP that she will not take any erythromycin because it
makes her very nauseated. Which is the best choice of treatment for this patient?
Amoxicillin 500 mg PO three times a day for 7 days
Last antibiotic taken was 8 months ago and ear infections were infrequent is important in
AOM ABx selection because
Lack of risk factors for beta-lactamase-resistant bacteria (The ideal patient is someone who
has not been on any antibiotics in the past 3 months and/or does not live in an area with
high rates of beta-lactam-resistant bacteria.)
NSAIDs (increase bleeding risk) examples
Ketorolac (Toradol); do not exceed 5 days of use; Naproxen (Aleve, Naprosyn), ibuprofen
(Advil, Motrin), indomethacin (Indocin), and Mefenamic acid (Ponstel) are indicated for
dysmenorrhea
Second-Generation Cephalosporins
, Considered to be "broad-spectrum" antibiotics; used to treat infections caused by both
gram-positive cocci (S. pneumoniae) and gram-negative bacilli (e.g., Haemophilus
influenzae, Moraxella catarrhalis), such as rhinosinusitis and otitis media.
In the United States, the typical patient living w/ G6PD deficiency anemia
is a person of African American (10%) descent. This patient is usually asymptomatic, but
may present with hemolysis/jaundice secondary to being treated with a sulfa drug or after
eating fava beans. Look for a low hemoglobin and hematocrit (H...H) and jaundice. ____ is
also seen with Mediterranean ancestry.
Drugs That Require Eye Examination
Digoxin (yellow-to-green vision, blurred vision, halos if blood level too high); Ethambutol
and linezolid (optic neuropathy); Corticosteroids (cataracts, glaucoma, optic neuritis);
Fluoroquinolones (retinal detachment); Viagra, Cialis, Levitra (cataracts, blurred vision,
ischemic optic neuropathy, others); Accutane (cataracts, decreased night vision, others);
Topamax (acute angle-closure glaucoma, increased ICP, mydriasis); Plaquenil (neuropathy
and permanent loss of vision)
Cisapride (Propulsid)
Available only by limited-access protocol in the United States; Numerous drug
contraindications (e.g., macrolides, antifungals, TCAs); Black box warning: Serious cardiac
arrhythmias (ventricular fibrillation/tachycardia, torsades de pointes, prolongation of QT
interval); check 12-lead EKG at baseline; check serum electrolytes and creatinine
Theophylline Drug interactions:
Cimetidine, alprazolam, macrolides, fluvoxamine, others; avoid combining with other
stimulants (theophylline, pseudoephedrine, caffeine, Ritalin)
USPSTF Recommendations: Prostate Cancer (May 2018)
Discuss potential harms (erectile dysfunction, urinary incontinence, prostate biopsy, false-
positive results) versus the benefits. Do not screen cis-AMAB who do not express preference
for screening. Aged 70 years or older: Do not screen.
Grade D: Routine screening is not recommended. High-risk cis-AFAB:
11TH EDITION LATEST VERSION 2024/2025 QUESTIONS AND
ANSWERS ALL CHAPTERS |GRADE A+
_____________________________________________________________________________
A 5-year-old patient is in the office for a school physical. The child is up to date on
immunizations, and the mother denies a history of chickenpox infection. Which
immunizations are indicated at this visit?
DTaP, IPV, MMR, varicella
The Tdap
is reserved for patients older than 11 years of age.
A 5-year-old
requires a booster for varicella, as well as the fifth DTaP, the second MMR, and the fourth
IPV
Employee health clinic protocols for needlesticks
recommend ordering an ELISA test as soon as possible to establish baseline blood work for
the employee.
A 14-month-old child
should developmentally be able to say "mama" and "dada," know his own name, and know
at least two to four words.
A 2-year-old
is able to understand simple commands.
Which of the following viral infections is associated with occasional abnormal forms of
lymphocytes during an acute infection?
Epstein-Barr virus (EBV)
,EBV
is a member of the herpesvirus family and one of the most common viruses.
During adolescence, EBV
causes infectious mononucleosis.
In most cases of infectious mononucleosis,
the clinical diagnosis can be made from the triad of fever, pharyngitis, and
lymphadenopathy lasting 1 to 4 weeks.
Serology tests for Epstein-Barr virus (EBV)
show normal to moderately elevated white blood cells and increased numbers of
lymphocytes, >10% atypical lymphocytes, and a positive reaction to a mono spot test.
The antibody response in primary EBV infection
appears to be quite rapid.
Acute lymphoblastic leukemia,
a malignancy of the bone marrow, is the most common type of cancer in children.
Acute lymphoblastic leukemia
is more common in boys and in children between the ages of 2 and 4 years.
Aplastic anemia
is bone marrow suppression (not cancer) usually caused by medications or a viral infection.
Multiple myeloma and non-Hodgkin's lymphoma
are more common in older adults.
The ELISA (enzyme-linked immunosorbent assay) and Western blot tests
detect only HIV antibodies. That is why there is a "window period" with HIV infection. If the
test is performed too early in the infection, it will be falsely negative because there may not
yet be enough antibodies against HIV to trigger a positive result.
,gestational diabetes indication
mother of the infant weighing 9.5 lb
Other risk factors for diabetes
include impaired glucose tolerance test, sedentary lifestyle, polycystic ovary syndrome
(PCOS), and hypertension.
Fever
is most likely due to the pertussis component of the diphtheria, tetanus, acellular pertussis
(DTaP) vaccine.
A 10-year-old female student complains of pain and decreased hearing in her left ear that
is getting steadily worse. She has a history of allergic rhinitis and is allergic to dust mites.
On physical exam, the left tympanic membrane is bulging and red with displaced
landmarks. The tympanogram exam reveals a flat line. The student denies frequent ear
infections, and the last antibiotic she took was 8 months ago for a urinary tract infection.
She is allergic to sulfa and tells the NP that she will not take any erythromycin because it
makes her very nauseated. Which is the best choice of treatment for this patient?
Amoxicillin 500 mg PO three times a day for 7 days
Last antibiotic taken was 8 months ago and ear infections were infrequent is important in
AOM ABx selection because
Lack of risk factors for beta-lactamase-resistant bacteria (The ideal patient is someone who
has not been on any antibiotics in the past 3 months and/or does not live in an area with
high rates of beta-lactam-resistant bacteria.)
NSAIDs (increase bleeding risk) examples
Ketorolac (Toradol); do not exceed 5 days of use; Naproxen (Aleve, Naprosyn), ibuprofen
(Advil, Motrin), indomethacin (Indocin), and Mefenamic acid (Ponstel) are indicated for
dysmenorrhea
Second-Generation Cephalosporins
, Considered to be "broad-spectrum" antibiotics; used to treat infections caused by both
gram-positive cocci (S. pneumoniae) and gram-negative bacilli (e.g., Haemophilus
influenzae, Moraxella catarrhalis), such as rhinosinusitis and otitis media.
In the United States, the typical patient living w/ G6PD deficiency anemia
is a person of African American (10%) descent. This patient is usually asymptomatic, but
may present with hemolysis/jaundice secondary to being treated with a sulfa drug or after
eating fava beans. Look for a low hemoglobin and hematocrit (H...H) and jaundice. ____ is
also seen with Mediterranean ancestry.
Drugs That Require Eye Examination
Digoxin (yellow-to-green vision, blurred vision, halos if blood level too high); Ethambutol
and linezolid (optic neuropathy); Corticosteroids (cataracts, glaucoma, optic neuritis);
Fluoroquinolones (retinal detachment); Viagra, Cialis, Levitra (cataracts, blurred vision,
ischemic optic neuropathy, others); Accutane (cataracts, decreased night vision, others);
Topamax (acute angle-closure glaucoma, increased ICP, mydriasis); Plaquenil (neuropathy
and permanent loss of vision)
Cisapride (Propulsid)
Available only by limited-access protocol in the United States; Numerous drug
contraindications (e.g., macrolides, antifungals, TCAs); Black box warning: Serious cardiac
arrhythmias (ventricular fibrillation/tachycardia, torsades de pointes, prolongation of QT
interval); check 12-lead EKG at baseline; check serum electrolytes and creatinine
Theophylline Drug interactions:
Cimetidine, alprazolam, macrolides, fluvoxamine, others; avoid combining with other
stimulants (theophylline, pseudoephedrine, caffeine, Ritalin)
USPSTF Recommendations: Prostate Cancer (May 2018)
Discuss potential harms (erectile dysfunction, urinary incontinence, prostate biopsy, false-
positive results) versus the benefits. Do not screen cis-AMAB who do not express preference
for screening. Aged 70 years or older: Do not screen.
Grade D: Routine screening is not recommended. High-risk cis-AFAB:
