AANP FNP CERTIFICATION PRACTICE TEST EXAM(QUESTIONS AND ANSWERS) 2023/2024

AANP FNP CERTIFICATION PRACTICE TEST EXAM(QUESTIONS AND ANSWERS) 2023/2024 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 - CORRECT ANSWER-III first time audible, IV first time thrill Fundal height 12 weeks - CORRECT ANSWER-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 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? - CORRECT ANSWER-Iron, TIBC 3 months of synthroid, TSH increased, T4 normal, what do you do? - CORRECT ANSWER-Increase Medication 3 ways to assess cognitive function in patient with signs/symptoms of memory loss - CORRECT ANSWER-Mini mental exam 4 month old with strabismus, mom is worried...... - CORRECT ANSWER-tell her it is normal. 4 month old wont keep anything down, what is the main thing you look at? - CORRECT ANSWER-Growth chart 6 month old closed anterior fontanel. - CORRECT ANSWER-XRAY Abnormal cells on PAP, what do you do next? - CORRECT ANSWER-Refer for Colposcopy CAGE ACRONYM - CORRECT ANSWER-Cut down Annoyed by criticism Guilty about drinking Eye opener drink Causes of tachycardia - CORRECT ANSWER-Fever Anemia Hypotension Cranial nerves responsible for extraocular eye movements - CORRECT ANSWER-CN 3,4,6 Definition of metabolic syndrome - CORRECT ANSWER-cluster of conditions that increase risk of heart disease, stroke, diabetes. diagnose trichomoniasis - CORRECT ANSWER-wet prep Elderly presents with atrophic vaginitis, small uterus, palpable 4x5 ovary, what do you do next? - CORRECT ANSWER-Pelvic US Epistaxis is most common in the area of the nose known as kiesselbachs triangle, where is this located? - CORRECT ANSWER-Anterior septum Definitive diagnosis of acute bacterial prostatitis - CORRECT ANSWER-urinalysis and culture GERD treatment - CORRECT ANSWER-PPI Grade 3 cells on Pap, treatment? - CORRECT ANSWER-LEEP excision Fingernail hematoma treatment? - CORRECT ANSWER-drill hole and drain blood Increased risk of ectopic pregnancy - CORRECT ANSWER-Salpingitis, or history of abortion, PID, Koplick spots - CORRECT ANSWER-Measles (rubeola). Grains of salt lesions inside mouth in Measles Legg-Calve-Perthes Disease - CORRECT ANSWER-Avascular necrosis of the proximal femoral head Lipid level of 1500, increased risk for? - CORRECT ANSWER-Pancreatitis Low HGB, Low HCT, High MCV indicates what? - CORRECT ANSWER-Macrocytic anemia, B12 Def Man with BPH, prostate feels on digital exam? - CORRECT ANSWER-Enlarged, symmetrical, smooth Man with HTN, CAD, present femoral pulses but absent pedal - CORRECT ANSWERArterial Insufficiency McMurray's Sign (+) palpable or audible click while extending with varus stress - CORRECT ANSWERMeniscus tears Lachman's Test - CORRECT ANSWER-pivot shift test (ACL tear) Newborn with foot turned in, what do you do? - CORRECT ANSWER-refer to orthopedist Osgood-Schlatter disease - CORRECT ANSWER-Knee pain/anterior tibial tubercule inflammation or irritation of the tibia at its point of attachment with the patellar tendon Patient forgot to start Thanksgiving dinner and husband states she has trouble remembering tasks and trouble with organization. What is this indicative of? - CORRECT ANSWER-Alzheimer's Pt has Barretts Esophagus, insurance no longer covers GI who was treating condition. Pt at FNP office wanting refill prescriptions. What do you do? - CORRECT ANSWERRefill med Pt presents with rash on shoulder, erythematous maculopapular rash with center clearing and scaling? - CORRECT ANSWER-Tinea Corporis Pt presents with "bag of worms:, indicates? - CORRECT ANSWER-Varicocele Pt with atopic dermatitis, look for what other diseases? - CORRECT ANSWER-Asthma Pt with bleeding after menopause - CORRECT ANSWER-endometrial biopsy, need to screen for cancer Pt with hx of PID, increased rick for? - CORRECT ANSWER-Infertility Pt with HIV took high potency anti viral treatments and CD4 is >400, what does this indicate? - CORRECT ANSWER-This is good. Want higher than 350 Pt with hx of htn and stroke, now having memory loss. What does this indicate? - CORRECT ANSWER-Vascular dementia Pregnant teacher with exposure to 5ths disease (SLAP CHEEK), what risk is there to the fetus? - CORRECT ANSWER-slap cheek, PVB19, rash hands / feet Fetal death and birth defects Quick assessment of patients fall risk? - CORRECT ANSWER-Timed Get up and Go Red beefy tongue? - CORRECT ANSWER-pernicious anemia Rotator cuff injury presentation - CORRECT ANSWER-disturbs sleep, arm weakness, dull ache pain with overhead activity Shingles near eye - CORRECT ANSWER-immediate referral to ophthalmology Signs and symptoms of Roseola (6ths disease) ? - CORRECT ANSWER-Viral infection Can result in a maculopapular rash, but up to 70% of cases proceed without the rash stage -Usually accompanied by a high fever (41°C or 105°F) that comes on quickly and lasts up to 3 days followed by rash -Seizures may occur during this period. -On the fourth day, the fever disappears and the rash appears, first on chest and trunk, then less prominently on the face and limbs. -High fever, pink flat or raised rash Treatment for chronic alcoholism: - CORRECT ANSWER-12 step program Treatment for Gonorrhea? - CORRECT ANSWER-Rocephin 250mg IMx1 plus Azithromycin 1 gm orally x1 to cover chlamydia. , or doxy 100 mg BID x7d. EXAM: Green colored vaginal discharge, friable cervix. Report to health department Young female want birth control, forgets to take pills, does not want to get pregnant for at least 5 years: - CORRECT ANSWER-IUD Basal cell cancer - CORRECT ANSWER-Waxy, pearly, telangiectasia, ulcer center lesion -most common type of skin cancer caused by UV exposure. Metastatic is rare Actinic Keratosis - CORRECT ANSWER-Numerous round dry pink to red areas. Scaly red to yellow located in sun exposed area -a pre squamous cell carcinoma occurs on sun-damaged skin biopsy. TX: cryo or 5fu cream Moderate acne treatment - CORRECT ANSWER-Without inflammation: Topical retinoid Moderate inflammation: Topical Retinoid or benzoyl peroxide or Azaleic acic ( very expensive and hard to get covered) PLUS ADD Oral antibiotics: doxycycline or tetracycline or minocycline- (tetracyclines has been proven most affective for inflammatory acne) Minocycline- long term use has been linked with pseudotumor cerebri Oral contraceptives for hormone related Spironolactone heart murmur with holosystolic or pan systolic Heart mumur with mid systolic - CORRECT ANSWER-MR - radiate axilla, 5th ICS MCL, apex, AS - radiate neck, 2ICS right sternal border MR ASSH Coarctation of Aorta - CORRECT ANSWER-COA: bounding radial and weak femoral pulse increase blood pressure in arms, and lower pressure in lower legs. -congenital cardiac condition characterized by a narrowing of the aorta Murmur Grade III - VI - CORRECT ANSWER-Loud murmur easily heard JVD caused by - CORRECT ANSWER--tension pneumothorax, -Rt. sided heart failure, -cardiac tamponade, -traumatic axphysia from Increase in portal pressure(LIVER) in venous side or cor pulmonale pt. with gradual onset of fever, hemorrhages on nail beds, painful raised red nodules, rash on palms - CORRECT ANSWER-endocarditis , painful red spots on fingers olser's nodes, janeway legions rash on palms and soles. Know the difference between Peripheral Arterial Disease and Chronic Venous Insufficiency or PVD. - CORRECT ANSWER-PAD: Absence of pulse, decrease blow flowing down, PAIN, Dx doppler or ABI<0.9, TX exercise by walking, smoking cessation PVD: Volume, edema, discoloration, decrease blood going up, Chronic Bronchitis Treatment - CORRECT ANSWER-Smoking cessation Pulmonary rehabilitation Pharmacologic therapy Supplemental oxygen TB... PPD is positive if area of induration is: - CORRECT ANSWER->5 mm in an immunocompromised patient or close contact >10 mm in immigrant, health care workers, drug user >15 mm in a patient who lives in an area where TB is very rare. what condition would make you order Lateral X-ray of the neck. Options include: Drooling, Unable to do ROM of the neck / stiff neck. - CORRECT ANSWERCroup/Epiglottitis AV nicking (Arterioles pressing on vein of the eye) - CORRECT ANSWER-HTN retinopathy intraocular pressure (IOP) - CORRECT ANSWER-Fluid pressure inside the eye; measured with tonometry Rovsing sign - CORRECT ANSWER-pain in the RLQ when the LLQ is palpated (indicative of appendicitis) Pencil-like stools occur in an obstruction of what - CORRECT ANSWER-Sigmoid descending colon possible causes include colon cancer, diarrhea, IBS. Refer for GI colonoscopy headache after trauma - CORRECT ANSWER-SDH migraine headache - CORRECT ANSWER--paroxysmal (sudden, periodic) attacks of mostly unilateral headache, often accompanied by disordered vision, nausea, or vomiting, lasting hours or days and caused by dilation of arteries. 4-72 hours, TX: abortive triptans, prophylaxis propranolol, amitriptyline, topiramate Vitamin B12 - CORRECT ANSWER-Cognitive deficits, glossitis, pernicious anemia, Folate shares a close relationship with this other B Vitamin. 88/yr. old patient in for follow up secondary. She's been treated with Tylenol for Joint arthritis. Her SED rate was checked after 6 weeks of treatment and it was 28. Normal range is from something to 25. How would you treat the pt. - CORRECT ANSWER-be changed to NSAID, SED rate is a sign of inflammation Which medication causes low sperm count for a patient - CORRECT ANSWER-SSRI grandiosity - CORRECT ANSWER-Exaggerated belief in or claims about one's importance or identity. Concern for Bipolar ADHD - CORRECT ANSWER-A behavioral problem characterized by short attention span, restless movement, and impaired learning capacity. pt. pap's smear noted with Low Grade Squamous Intraepithelial Lesions and High Grade Squamous Epithelia Lesion noted on the report, what should NP do? - CORRECT ANSWER-HPV test if not done. Refer for colposcopy Chlamydia trachomatis - CORRECT ANSWER-Azithromycin (+ ceftriaxone for gonorrhea coinfection) Genital warts treatment - CORRECT ANSWER-Cryotherapy OR Podophyllotoxin cream - OR Imiquimod (Aldara cream) HIV pt. with antiviral and CD4 count still less than 200. What should NP tell the pt. - CORRECT ANSWER-tell the pt. that he is qualified to be diagnosed with AIDS according to CDC Most common cause of death in children - CORRECT ANSWER-motor vehicle Tanner 2 - CORRECT ANSWER-Tanner 2- female breast bud areola develops Male testes scrotum start to enlarge, scrotum gets darker Tanner 4 - CORRECT ANSWER-Tanner 4- female nipples and areola become elevated from breast, secondary mound Male penis grows wider grows in length, darker scrotum pt. expericieng memory loss, and increase in confusion and she has a history of stroke, HTN, What type of Alzheimer. - CORRECT ANSWER-vascular dementia presbycusis - CORRECT ANSWER-a gradual loss of sensorineural hearing that occurs as the body ages- effects high pitched sounds Romberg test - CORRECT ANSWER-cerebellarfunction -ask client to stand with feet at comfortable distance apart, arms at sides, and eyes closed -expected finding: client should be able to stand with minimal swaying for at least 5 seconds Direct Coombs test vs Indirect - CORRECT ANSWER-r/o hemolytic anemia r/o RH-/RH+ preeclampsia treatment - CORRECT ANSWER-bed rest, laying on her side