FNP PEDIATRICS EXAM 3 LATEST VERSIONS (VERSION A, B & C) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+
Asthma categories - (ANSWER)Classified according to :
(1) Frequency of symptoms: night or early morning
(2) FEV1: forced expiratory volume in 1 second
(3) PEFR: Peak expiratory flow rate
(4) Frequency of medication use
Least to most severe: Intermittent, mild persistent, moderate persistent, severe persistent
Spirometry - (ANSWER)should not diagnose or manage asthma without it
FEV1/FVC ratio: should be 70%+ age 65+ with symptoms or smoking hx (GOLD STANDARD) or >lower
limit of normal for <65 years or 65+ nonsmokers (AMERICAN THORACIC SOCIETY); lower of this indicates
obstructive disease; test again after bronchodilator use to determine if it is reversibles
Asthma control test - (ANSWER)5 question test to identify the current level of asthma control, reflected
from a patient's memory over the past 4 weeks. The ACT covers the impact of asthma on productivity, at
work, home or school, shortness of breath, all asthma symptoms (including coughing, wheezing,
dyspnea and chest tightness) impact at night (either during sleep or early morning awakenings), use of
rescue meds (from 3+ times per day, 1-2 times per day, 2-3 times per week or less than once a week (or
not at all), and your own perception of your asthma control.
The ACT is scored from 5 (poorly controlled) to 25 (completely controlled) by ranking each question's
response as a 1-5 score (1 being indicative of increased asthma symptoms or impact of asthma
symptoms, 5 being indicative of no impact on daily life per the patient's perspective) and totalling these
points.1
Asthma action plan - (ANSWER)Every patient with asthma needs one
Green Zone actions
Yellow Zone actions
Red Zone actions
,FNP PEDIATRICS EXAM 3 LATEST VERSIONS (VERSION A, B & C) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+
Status asthmaticus - (ANSWER)severe airway obstruction and asthmatic symptoms persist despite the
administration of standard acute asthma therapy
severe bronchospasm, with mucus plugging leading to asphyxia
hyperinflation on CXR
usually occurs @ sleep when inflammation and hyperresponsiveness are at their peak
Angioedema - (ANSWER)Localized areas of swelling beneath the skin, often around the eyes and lips, but
it can also involve other body areas as well.
Anaphylaxis - (ANSWER)rapid, severe onset allergic reaction that can result in death
involves more than one organ system
Allergies - (ANSWER)An allergy occurs when your body's immune system sees a certain substance as
harmful. It reacts by causing an allergic reaction. Substances that cause allergic reactions are allergens.
Allergic Reaction I - (ANSWER)IgE mediated
Immediate reaction (minutes)
Most allergic reactions are this type
First exposure: sensitization
Hives, eczema, allergic rhinitis, asthma, anaphylaxis (airway constriction and increased vascular
permeability)
Tx: antihistamines, corticosteroids, epinephrine
Allergic Reaction II - (ANSWER)IgG or IgM
,FNP PEDIATRICS EXAM 3 LATEST VERSIONS (VERSION A, B & C) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+
Blood transfusion reaction, erythroblastosis fetalis, autoimmune hemolytic anemia
Allergic Reaction III - (ANSWER)Immune complex mediated
arthrus reactions, serum sickness, necrotizing vasculitis, glomerulonephritis, SLE, rheumatoid arthritis
Allergic Reaction IV - (ANSWER)cell mediated
contact dermatitis, graft rejection
Atopy - (ANSWER)predisposition toward developing certain allergic hypersensitivity reactions. Atopy
may have a hereditary component, although contact with the allergen or irritant must occur before the
hypersensitivity reaction can develop
Atopic triad - (ANSWER)Asthma
Atopic dermatitis
Allergic rhinitis
Regulated by type 2 helper T cells/eosinophils (less severe) or neutrophils (more severe)
Insect allergy - (ANSWER)Stinging insects: venom can cause allergic reaction
Biting insects: less commonly cause allergic reaction
s/s: pain, redness, itching, minor swelling (normal)
s/s anaphylaxis: rash, itching, hives, swelling of mouth/throat, SOB, wheezing, dizziness, syncope, N/V/D,
bloating, feeling of impending doom
Atopic dermatitis - (ANSWER)Chronic inflammatory skin disease
, FNP PEDIATRICS EXAM 3 LATEST VERSIONS (VERSION A, B & C) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+
Common in the first year of life; often clears by adolescents
Dry scaly patches on cheeks, scalp, forehead and face
Less common adult onset
Older children and adults: in creases of neck, flexor areas
Frequently itchy --> scratch --> infection
Remissions and exacerbations
Erythematous papules --> erythematous plaques; may weep/crust/scale
Xerosis: abnormally dry skin
Can disrupt sleep
Lichenification can occur from years of itching
50-80% of children that have atopic dermatitis will also have or develope another atopic disease
(asthma, allergic rhinitis-think atopic triad)
Thought be caused by (1) genetics (2) skin barrier dysfunction (3) impaired immune response (3)
environment
Food allergy as a cause of or exacerbating factor for AD is uncommon; testing should be reserved for
severe refractive cases
Eczema - (ANSWER)Nonspecific term that refers to group of inflammatory skin conditions characterized
by (1) pruritis (2) erythema (3) scale
NOT THE SAME AS ATOPIC DERMATITIS, which is a specific type of exzema
Urticaria - (ANSWER)intensely pruritic, well-circumscribed, raised wheals ranging from several
millimeters to several centimeters or larger in size. Urticaria can occur with angioedema, which is
localized nonpitting edema of the subcutaneous or interstitial tissue that may be painful and warm
If in one spot for > 24 hours, likely NOT urticaria
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+
Asthma categories - (ANSWER)Classified according to :
(1) Frequency of symptoms: night or early morning
(2) FEV1: forced expiratory volume in 1 second
(3) PEFR: Peak expiratory flow rate
(4) Frequency of medication use
Least to most severe: Intermittent, mild persistent, moderate persistent, severe persistent
Spirometry - (ANSWER)should not diagnose or manage asthma without it
FEV1/FVC ratio: should be 70%+ age 65+ with symptoms or smoking hx (GOLD STANDARD) or >lower
limit of normal for <65 years or 65+ nonsmokers (AMERICAN THORACIC SOCIETY); lower of this indicates
obstructive disease; test again after bronchodilator use to determine if it is reversibles
Asthma control test - (ANSWER)5 question test to identify the current level of asthma control, reflected
from a patient's memory over the past 4 weeks. The ACT covers the impact of asthma on productivity, at
work, home or school, shortness of breath, all asthma symptoms (including coughing, wheezing,
dyspnea and chest tightness) impact at night (either during sleep or early morning awakenings), use of
rescue meds (from 3+ times per day, 1-2 times per day, 2-3 times per week or less than once a week (or
not at all), and your own perception of your asthma control.
The ACT is scored from 5 (poorly controlled) to 25 (completely controlled) by ranking each question's
response as a 1-5 score (1 being indicative of increased asthma symptoms or impact of asthma
symptoms, 5 being indicative of no impact on daily life per the patient's perspective) and totalling these
points.1
Asthma action plan - (ANSWER)Every patient with asthma needs one
Green Zone actions
Yellow Zone actions
Red Zone actions
,FNP PEDIATRICS EXAM 3 LATEST VERSIONS (VERSION A, B & C) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+
Status asthmaticus - (ANSWER)severe airway obstruction and asthmatic symptoms persist despite the
administration of standard acute asthma therapy
severe bronchospasm, with mucus plugging leading to asphyxia
hyperinflation on CXR
usually occurs @ sleep when inflammation and hyperresponsiveness are at their peak
Angioedema - (ANSWER)Localized areas of swelling beneath the skin, often around the eyes and lips, but
it can also involve other body areas as well.
Anaphylaxis - (ANSWER)rapid, severe onset allergic reaction that can result in death
involves more than one organ system
Allergies - (ANSWER)An allergy occurs when your body's immune system sees a certain substance as
harmful. It reacts by causing an allergic reaction. Substances that cause allergic reactions are allergens.
Allergic Reaction I - (ANSWER)IgE mediated
Immediate reaction (minutes)
Most allergic reactions are this type
First exposure: sensitization
Hives, eczema, allergic rhinitis, asthma, anaphylaxis (airway constriction and increased vascular
permeability)
Tx: antihistamines, corticosteroids, epinephrine
Allergic Reaction II - (ANSWER)IgG or IgM
,FNP PEDIATRICS EXAM 3 LATEST VERSIONS (VERSION A, B & C) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+
Blood transfusion reaction, erythroblastosis fetalis, autoimmune hemolytic anemia
Allergic Reaction III - (ANSWER)Immune complex mediated
arthrus reactions, serum sickness, necrotizing vasculitis, glomerulonephritis, SLE, rheumatoid arthritis
Allergic Reaction IV - (ANSWER)cell mediated
contact dermatitis, graft rejection
Atopy - (ANSWER)predisposition toward developing certain allergic hypersensitivity reactions. Atopy
may have a hereditary component, although contact with the allergen or irritant must occur before the
hypersensitivity reaction can develop
Atopic triad - (ANSWER)Asthma
Atopic dermatitis
Allergic rhinitis
Regulated by type 2 helper T cells/eosinophils (less severe) or neutrophils (more severe)
Insect allergy - (ANSWER)Stinging insects: venom can cause allergic reaction
Biting insects: less commonly cause allergic reaction
s/s: pain, redness, itching, minor swelling (normal)
s/s anaphylaxis: rash, itching, hives, swelling of mouth/throat, SOB, wheezing, dizziness, syncope, N/V/D,
bloating, feeling of impending doom
Atopic dermatitis - (ANSWER)Chronic inflammatory skin disease
, FNP PEDIATRICS EXAM 3 LATEST VERSIONS (VERSION A, B & C) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+
Common in the first year of life; often clears by adolescents
Dry scaly patches on cheeks, scalp, forehead and face
Less common adult onset
Older children and adults: in creases of neck, flexor areas
Frequently itchy --> scratch --> infection
Remissions and exacerbations
Erythematous papules --> erythematous plaques; may weep/crust/scale
Xerosis: abnormally dry skin
Can disrupt sleep
Lichenification can occur from years of itching
50-80% of children that have atopic dermatitis will also have or develope another atopic disease
(asthma, allergic rhinitis-think atopic triad)
Thought be caused by (1) genetics (2) skin barrier dysfunction (3) impaired immune response (3)
environment
Food allergy as a cause of or exacerbating factor for AD is uncommon; testing should be reserved for
severe refractive cases
Eczema - (ANSWER)Nonspecific term that refers to group of inflammatory skin conditions characterized
by (1) pruritis (2) erythema (3) scale
NOT THE SAME AS ATOPIC DERMATITIS, which is a specific type of exzema
Urticaria - (ANSWER)intensely pruritic, well-circumscribed, raised wheals ranging from several
millimeters to several centimeters or larger in size. Urticaria can occur with angioedema, which is
localized nonpitting edema of the subcutaneous or interstitial tissue that may be painful and warm
If in one spot for > 24 hours, likely NOT urticaria
