FNP 2 Study Material/guide with Complete
Verified Answers
Fragile x - ANSWER Fragile X syndrome is the most common form of inherited
intellectual disability. The disorder is associated with a higher incidence of autism
(especially boys). Males are affected more severely than females. The facial features can
vary. The classic facie is a long, narrow face with a prominent forehead and chin and
large ears. Other features include hyperlaxity of the joints, flat feet, high arched palate,
and others. Definitive diagnosis is by genetic
Down's syndrome - ANSWER People with Down syndrome (trisomy 21) develop a
syndrome of dementia that has the same characteristics of Alzheimer's disease that
occurs in individuals without Down syndrome. The only difference is that Alzheimer's
disease occurs much earlier in people with Down syndrome; patients with Down
syndrome begin to have symptoms in their late 40s or early 50s. In the United States,
atlantoaxial instability (AAI) with or without subluxation has been reported in as many
as 10%-30% of individuals with Down syndrome. Children with Down syndrome are at a
much higher risk for congenital heart disease. Types of defects include atrioventricular
septal defects (most common), ventricular septal defects, atrial septal defects, patent
ductus arteriosus, and tetralogy of Fallot.
Breath sounds - ANSWER There are two normal breath sounds. Breath sounds heard
over the tracheobronchial tree are called bronchial breathing and breath sounds heard
over the lower lobes of lung tissue are called vesicular breathing.
- ANSWER Skin cancer is the most common type of cancer overall, but the most
common type of skin cancer is basal cell carcinoma of the skin. Regarding mortality, the
skin cancer that causes the most deaths (from skin cancer) is melanomas (65% of skin
cancer deaths).
Hpv lesions - ANSWER Lesions of HPV infection will turn white with application of acetic
acid.
,Aids diagnosis criteria - ANSWER Criteria used to diagnose AIDS include hairly
leukoplakia of the tongue, Kaposi's sarcoma, and thrush.
SLE - ANSWER The ANA is usually positive in lupus patients. Other types of autoantibody
testing recommended for these patients, in addition to antinuclear antibody (ANA)
tests, are antiphospholipid antibodies, antibodies to double-stranded DNA, and anti-
Smith (Sm) antibodies. Patient with suspected lupus should be referred to a
rheumatologist. The sedimentation rate and the C-reactive protein are nonspecific
findings of inflammation and are present in autoimmune diseases, infections, and
others.
S1,s2 hear sound motivated apples - ANSWER S1 motivated - mitral, tricuspid , av
S2 apples - aortic , pulmonic , semilunar
Murmur - ANSWER Systolic murmurs use the MR TRAS mnemonic Diastolic murmurs use
the MS. PRAR mnemonic
"MR TRAS" (use for all systolic murmurs) Systole or S1 murmurs are also described as
holosystolic, pansystolic, early systolic, mid-systolic, or late systolic murmurs. - ANSWER
MR- mitral regurgitate
pansystolic (or holosystolic) murmur heard best at the apex or the apical area radiates
to axilla loud-blowing and high-pitched murmur (use the diaphragm of the stethoscope)
Tricuspid Regurgitation not on the test at present
Aortic Stenosis a mid-systolic ejection murmur best heard at the second ICS at the right
side of the sternum radiates to the neck a harsh and noisy murmur (use the diaphragm
of the stethoscope) Patients with aortic stenosis should avoid physical overexertion.
, These patients are at risk for sudden death. Monitored by serial cardiac sonograms with
Doppler flow studies. Surgical valve replacement if moderately
"MS. PRAR" Diastole or S2 is also decribed as early diastole, late diastole, or mid-
diastole. Diastolic murmurs are always indicative of heart disease - ANSWER MS (Mitral
Stenosis) A low-pitched diastolic rumbling murmur heard best at the apex of the heart
or the apical area also called an "opening snap" (use bell of the stethoscope)
PR (Pulmonic Regurgitation) not on the test at present
AR (Aortic Regurgitation) A high-pitched diastolic murmur best heard at the second ICS
at the right side of the sternum high-pitched blowing murmur (use diaphragm of the
stethoscope)
Mitral location
Aortic location - ANSWER Mitral area fifth ICS on the left side of sternum medial to the
midclavicular line apical murmur or the apex of the heart Pulmonic area second ICS on
the left side of the sternum left side of the upper sternum at the base of the heart Aortic
area second ICS to the right side of the sternum right side of the upper sternum at the
base of the heart
Mitral valve prolapse - ANSWER Mitral Valve Prolapse (MVP) Normal sinus rhythm
associated with an S2 "click" followed by a systolic murmur. More common in tall and
thin adult females. Higher risk of thromboemboli and infective endocarditis. Diagnosed
by cardiac ultrasound. IE prophylaxis is no longer recommended by the AHA for MVP.
Classic Case Female adult patient may complain of fatigue, palpitations,
lightheadedness.
Prolapsed hemorrhoid - ANSWER With chronically protruding or prolapsing
hemorrhoids, the patient often reports itch, mucus leaking, and staining of the
undergarments with streaks of stool. Manual reduction of a protruding hemorrhoid
after evacuation can be helpful.
Verified Answers
Fragile x - ANSWER Fragile X syndrome is the most common form of inherited
intellectual disability. The disorder is associated with a higher incidence of autism
(especially boys). Males are affected more severely than females. The facial features can
vary. The classic facie is a long, narrow face with a prominent forehead and chin and
large ears. Other features include hyperlaxity of the joints, flat feet, high arched palate,
and others. Definitive diagnosis is by genetic
Down's syndrome - ANSWER People with Down syndrome (trisomy 21) develop a
syndrome of dementia that has the same characteristics of Alzheimer's disease that
occurs in individuals without Down syndrome. The only difference is that Alzheimer's
disease occurs much earlier in people with Down syndrome; patients with Down
syndrome begin to have symptoms in their late 40s or early 50s. In the United States,
atlantoaxial instability (AAI) with or without subluxation has been reported in as many
as 10%-30% of individuals with Down syndrome. Children with Down syndrome are at a
much higher risk for congenital heart disease. Types of defects include atrioventricular
septal defects (most common), ventricular septal defects, atrial septal defects, patent
ductus arteriosus, and tetralogy of Fallot.
Breath sounds - ANSWER There are two normal breath sounds. Breath sounds heard
over the tracheobronchial tree are called bronchial breathing and breath sounds heard
over the lower lobes of lung tissue are called vesicular breathing.
- ANSWER Skin cancer is the most common type of cancer overall, but the most
common type of skin cancer is basal cell carcinoma of the skin. Regarding mortality, the
skin cancer that causes the most deaths (from skin cancer) is melanomas (65% of skin
cancer deaths).
Hpv lesions - ANSWER Lesions of HPV infection will turn white with application of acetic
acid.
,Aids diagnosis criteria - ANSWER Criteria used to diagnose AIDS include hairly
leukoplakia of the tongue, Kaposi's sarcoma, and thrush.
SLE - ANSWER The ANA is usually positive in lupus patients. Other types of autoantibody
testing recommended for these patients, in addition to antinuclear antibody (ANA)
tests, are antiphospholipid antibodies, antibodies to double-stranded DNA, and anti-
Smith (Sm) antibodies. Patient with suspected lupus should be referred to a
rheumatologist. The sedimentation rate and the C-reactive protein are nonspecific
findings of inflammation and are present in autoimmune diseases, infections, and
others.
S1,s2 hear sound motivated apples - ANSWER S1 motivated - mitral, tricuspid , av
S2 apples - aortic , pulmonic , semilunar
Murmur - ANSWER Systolic murmurs use the MR TRAS mnemonic Diastolic murmurs use
the MS. PRAR mnemonic
"MR TRAS" (use for all systolic murmurs) Systole or S1 murmurs are also described as
holosystolic, pansystolic, early systolic, mid-systolic, or late systolic murmurs. - ANSWER
MR- mitral regurgitate
pansystolic (or holosystolic) murmur heard best at the apex or the apical area radiates
to axilla loud-blowing and high-pitched murmur (use the diaphragm of the stethoscope)
Tricuspid Regurgitation not on the test at present
Aortic Stenosis a mid-systolic ejection murmur best heard at the second ICS at the right
side of the sternum radiates to the neck a harsh and noisy murmur (use the diaphragm
of the stethoscope) Patients with aortic stenosis should avoid physical overexertion.
, These patients are at risk for sudden death. Monitored by serial cardiac sonograms with
Doppler flow studies. Surgical valve replacement if moderately
"MS. PRAR" Diastole or S2 is also decribed as early diastole, late diastole, or mid-
diastole. Diastolic murmurs are always indicative of heart disease - ANSWER MS (Mitral
Stenosis) A low-pitched diastolic rumbling murmur heard best at the apex of the heart
or the apical area also called an "opening snap" (use bell of the stethoscope)
PR (Pulmonic Regurgitation) not on the test at present
AR (Aortic Regurgitation) A high-pitched diastolic murmur best heard at the second ICS
at the right side of the sternum high-pitched blowing murmur (use diaphragm of the
stethoscope)
Mitral location
Aortic location - ANSWER Mitral area fifth ICS on the left side of sternum medial to the
midclavicular line apical murmur or the apex of the heart Pulmonic area second ICS on
the left side of the sternum left side of the upper sternum at the base of the heart Aortic
area second ICS to the right side of the sternum right side of the upper sternum at the
base of the heart
Mitral valve prolapse - ANSWER Mitral Valve Prolapse (MVP) Normal sinus rhythm
associated with an S2 "click" followed by a systolic murmur. More common in tall and
thin adult females. Higher risk of thromboemboli and infective endocarditis. Diagnosed
by cardiac ultrasound. IE prophylaxis is no longer recommended by the AHA for MVP.
Classic Case Female adult patient may complain of fatigue, palpitations,
lightheadedness.
Prolapsed hemorrhoid - ANSWER With chronically protruding or prolapsing
hemorrhoids, the patient often reports itch, mucus leaking, and staining of the
undergarments with streaks of stool. Manual reduction of a protruding hemorrhoid
after evacuation can be helpful.
