AANP FNP CERTIFICATION/2024-2025 AANP FNP
CERTIFICATION LATEST EXAM QUESTIONS AND
CORRECT ANSWERS
Must check LFT before starting Statin. Know when to start statins and what to check for to decide
mod-high dose statins. ON EXAM - ANSWER-Statin
Pulsus paradox Apical pulse can still be heard even though the radial pulse is no longer palpable.
Certain issues cause impairment with diastolic filling, 10 or greater drop in the SYSTOLIC pressure. I
think her patient had asthma and their pressure dropped by 10 etc. ON EXAM - ANSWER-Pulses
paradoxus
Emphysema Lungs- Percussion-HYPERENNOSANCE tactile frem + egophony- dec. CXR- flattened
diaphragms with hyperinflation. Inc. AP diameter, accessory muscles, pursed-lip breathing, weight
loss. ON EXAM - ANSWER-Emphysema
middle lobe. ON EXAM - ANSWER-Acute Bacterial Pneumonia- CXR
does not include Microglossia which is an absent tongue congenital. EXAM - ANSWER-OSA
fatigue, fever, cough. Never do fewer than 3-4 drugs initially if positive, then u can narrow it down.
Latent TB usually treated with INH. If u suspect ACTIVE TB order, NAAT, C&S, AFB. The AFB is not
diagnostic. SPUTUM FOR C & S if gold standard. Deep morning cough collected for three
"consecutive days". TB is usually upper lobes. - ANSWER-TB
TPO- this lab is off MEANING ELEVATED in BOTH hyper/hypo thyroidism. TPO is GOLD stand for
diagnosis in Hashimotos. But you always want to order a TSH first, THEN ur thyroid panel do not get
ahead of yourself. Check ur TSH lab on both in 6-8 weeks but never sooner than 6 weeks that is how
long these meds take to work. TOPIC ON EXAM - ANSWER-TPO
Hyperthyroid- Low TSH, high "FREE" T4/T3. ALWAYS DO FREEs. Graves disease-autoimmune. Lid lag,
exophthalmos, everything is hyper (body wise). Treatment: PTU/Tapazole. PTU PREFER IN
PREGNANCY
,RAIU-no w/ prego. Destroys thyroid, lifelong treatment for hypo then. - ANSWER-hyperthyroid
If you are already on TWO oral drugs for diabetes and A1c is 9 or higher, start BASAL insulin. If you
cannot tolerate metformin and your A1c is 9 or higher start BASAL insulin. ON EXAM - ANSWER-A1C
>9
For parathyroid- dx blood test. You will have elevated calcium because your parathyroid is releasing
too much from bones and this will just cause it to float around and not help ur bones. TX:
BIPHOSPHANATES FOR SECONDARY HYPERPARATHY. EXAM - ANSWER-Parathyroid
Central obesity, moon face, purple striae, hairy, hypertension, elevated plasma CORTISOL in AM. "INC
BS, SODIUM" Dec K. You must draw cortisol levels in the morning. - ANSWER-cushings
checks sugar for past 2-4 weeks. - ANSWER-Fructosamine test
causes pancreatitis >500. If >500 treat with Niacin or Fibrate or Niaspan. If your patient is already on
NIACIN you can add a fibrate like (LOPID/TRICOR). Apparently an insulin infusion works also. ON
EXAM - ANSWER-triglycerides
diagnosed with amylase / lipase draw. Amylase beings 2-12 h. Lipase 4-8 hours. Lipase however is
MORE specific and sensitive to alcoholic pancreatitis. ACUTE: Grey Turner/ Cullen sign. Abd pain that
rates to midback "boring" epigastric pain. Fever, n/v. EXAM TOPICS - ANSWER-Pancreatitis
Metformin - monitor BUN, Creatinine.
contraindicated renal and liver disease
ARF creatinine up and GFR down.
affects liver enzymes, weight loss, avoid in alcohol drinkers, lactic acidosis, diarrhea flatulence
CT: hold 24 hr before and 48hr after - ANSWER-Metformin
slow growing blood cancer. blood too thick, clots. bone marrow to many RBC. risk bleed , anemia,
CBC - ANSWER-Polycythemia vera
BLE edema- walk around - ANSWER-CCB
, III first time audible, IV first time thrill - ANSWER-All diastolic murmurs are pathological. Murmurs
Grades I-barely II-audible III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM
Fundal Height 12 weeks above symphysis pubis. EXAM
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks is at umbilicus.
2 cm more of less from # of wk gestation is normal if more or less order US - ANSWER-Fundal height
12 weeks
Iron, TIBC - ANSWER-3 month old infant with down syndrome, due to milk intolerance, mom started
on goats milk; now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would
you order?
Increase Medication - ANSWER-3 months of synthroid, TSH increased, T4 normal, what do you do?
Mini mental exam - ANSWER-3 ways to assess cognitive function in patient with signs/symptoms of
memory loss
tell her it is normal. - ANSWER-4 month old with strabismus, mom is worried......
Growth chart - ANSWER-4 month old wont keep anything down, what is the main thing you look at?
XRAY - ANSWER-6 month old closed anterior fontanel.
Refer for Colposcopy - ANSWER-Abnormal cells on PAP, what do you do next?
Cut down
Annoyed by criticism
Guilty about drinking
Eye opener drink - ANSWER-CAGE ACRONYM
Fever
CERTIFICATION LATEST EXAM QUESTIONS AND
CORRECT ANSWERS
Must check LFT before starting Statin. Know when to start statins and what to check for to decide
mod-high dose statins. ON EXAM - ANSWER-Statin
Pulsus paradox Apical pulse can still be heard even though the radial pulse is no longer palpable.
Certain issues cause impairment with diastolic filling, 10 or greater drop in the SYSTOLIC pressure. I
think her patient had asthma and their pressure dropped by 10 etc. ON EXAM - ANSWER-Pulses
paradoxus
Emphysema Lungs- Percussion-HYPERENNOSANCE tactile frem + egophony- dec. CXR- flattened
diaphragms with hyperinflation. Inc. AP diameter, accessory muscles, pursed-lip breathing, weight
loss. ON EXAM - ANSWER-Emphysema
middle lobe. ON EXAM - ANSWER-Acute Bacterial Pneumonia- CXR
does not include Microglossia which is an absent tongue congenital. EXAM - ANSWER-OSA
fatigue, fever, cough. Never do fewer than 3-4 drugs initially if positive, then u can narrow it down.
Latent TB usually treated with INH. If u suspect ACTIVE TB order, NAAT, C&S, AFB. The AFB is not
diagnostic. SPUTUM FOR C & S if gold standard. Deep morning cough collected for three
"consecutive days". TB is usually upper lobes. - ANSWER-TB
TPO- this lab is off MEANING ELEVATED in BOTH hyper/hypo thyroidism. TPO is GOLD stand for
diagnosis in Hashimotos. But you always want to order a TSH first, THEN ur thyroid panel do not get
ahead of yourself. Check ur TSH lab on both in 6-8 weeks but never sooner than 6 weeks that is how
long these meds take to work. TOPIC ON EXAM - ANSWER-TPO
Hyperthyroid- Low TSH, high "FREE" T4/T3. ALWAYS DO FREEs. Graves disease-autoimmune. Lid lag,
exophthalmos, everything is hyper (body wise). Treatment: PTU/Tapazole. PTU PREFER IN
PREGNANCY
,RAIU-no w/ prego. Destroys thyroid, lifelong treatment for hypo then. - ANSWER-hyperthyroid
If you are already on TWO oral drugs for diabetes and A1c is 9 or higher, start BASAL insulin. If you
cannot tolerate metformin and your A1c is 9 or higher start BASAL insulin. ON EXAM - ANSWER-A1C
>9
For parathyroid- dx blood test. You will have elevated calcium because your parathyroid is releasing
too much from bones and this will just cause it to float around and not help ur bones. TX:
BIPHOSPHANATES FOR SECONDARY HYPERPARATHY. EXAM - ANSWER-Parathyroid
Central obesity, moon face, purple striae, hairy, hypertension, elevated plasma CORTISOL in AM. "INC
BS, SODIUM" Dec K. You must draw cortisol levels in the morning. - ANSWER-cushings
checks sugar for past 2-4 weeks. - ANSWER-Fructosamine test
causes pancreatitis >500. If >500 treat with Niacin or Fibrate or Niaspan. If your patient is already on
NIACIN you can add a fibrate like (LOPID/TRICOR). Apparently an insulin infusion works also. ON
EXAM - ANSWER-triglycerides
diagnosed with amylase / lipase draw. Amylase beings 2-12 h. Lipase 4-8 hours. Lipase however is
MORE specific and sensitive to alcoholic pancreatitis. ACUTE: Grey Turner/ Cullen sign. Abd pain that
rates to midback "boring" epigastric pain. Fever, n/v. EXAM TOPICS - ANSWER-Pancreatitis
Metformin - monitor BUN, Creatinine.
contraindicated renal and liver disease
ARF creatinine up and GFR down.
affects liver enzymes, weight loss, avoid in alcohol drinkers, lactic acidosis, diarrhea flatulence
CT: hold 24 hr before and 48hr after - ANSWER-Metformin
slow growing blood cancer. blood too thick, clots. bone marrow to many RBC. risk bleed , anemia,
CBC - ANSWER-Polycythemia vera
BLE edema- walk around - ANSWER-CCB
, III first time audible, IV first time thrill - ANSWER-All diastolic murmurs are pathological. Murmurs
Grades I-barely II-audible III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM
Fundal Height 12 weeks above symphysis pubis. EXAM
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks is at umbilicus.
2 cm more of less from # of wk gestation is normal if more or less order US - ANSWER-Fundal height
12 weeks
Iron, TIBC - ANSWER-3 month old infant with down syndrome, due to milk intolerance, mom started
on goats milk; now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would
you order?
Increase Medication - ANSWER-3 months of synthroid, TSH increased, T4 normal, what do you do?
Mini mental exam - ANSWER-3 ways to assess cognitive function in patient with signs/symptoms of
memory loss
tell her it is normal. - ANSWER-4 month old with strabismus, mom is worried......
Growth chart - ANSWER-4 month old wont keep anything down, what is the main thing you look at?
XRAY - ANSWER-6 month old closed anterior fontanel.
Refer for Colposcopy - ANSWER-Abnormal cells on PAP, what do you do next?
Cut down
Annoyed by criticism
Guilty about drinking
Eye opener drink - ANSWER-CAGE ACRONYM
Fever
