ANCC FNP Board Exam Study Guide
Key Concepts in Common Medical
Conditions and Treatments
1. Chronic Bronchitis
Definition: A type of Chronic Obstructive Pulmonary Disease (COPD)
characterized by inflammation of the bronchi, leading to excess mucus
production.
Key Characteristics:
o Diagnosis typically after age 35.
o Often associated with obesity.
o Production of copious amounts of purulent sputum.
o Possible elevated Hematocrit (Hct) level.
Treatment:
o Short-Acting Beta Agonists (SABA): Example: Albuterol.
o Inhaled Anticholinergics: Example: Ipratropium.
Normal Lung Auscultation Findings:
o Lower Lobes: Vesicular breath sounds (soft and low).
o Upper Lobes: Bronchial breath sounds (louder).
2. Actinic Keratosis
Patient Profile: Typically affects older to elderly fair-skinned adults.
Lesion Characteristics: Numerous dry, round, pink to red-colored, slow-
growing lesions that do not heal.
Common Locations: Sun-exposed areas such as cheeks, nose, face, arms,
and back.
Significance: Precancerous precursor of squamous cell carcinoma.
Risk Factor: History of frequent sunburns as a child increases risk.
Diagnosis: Confirmed with biopsy.
Treatment:
o Cryotherapy: For a small number of lesions.
o 5-FU (5% Fluorouracil) Cream: For a large number of lesions.
Follow-up: Essential with a dermatologist.
,3. Seborrheic Keratosis
Lesion Characteristics: Soft, round, wart-like fleshy growths
predominantly on the trunk (mostly on the back).
Appearance: Can range in color from light tan to black and appear to be
"pasted on".
Symptoms: Generally asymptomatic.
Nature: Benign.
4. Fingernail Hematoma Treatment
Procedure: Trephination - creating a hole in the nail (through drilling or
piercing) to allow blood to drain.
5. Hypothyroidism
Primary Hypothyroidism:
o Elevated TSH (Thyroid-Stimulating Hormone).
o Low T4 (Thyroxine).
o Low or normal T3 (Triiodothyronine).
Subclinical Hypothyroidism:
o Elevated TSH.
o Normal T4.
o Normal T3.
Common Cause: Hashimoto's thyroiditis (autoimmune).
Symptoms: Variable, may include fatigue.
Treatment: Levothyroxine (Synthroid) daily in the AM on an empty
stomach.
Starting Dose: Typically 25-50 mcg.
Monitoring: Check TSH every 6-8 weeks to assess treatment effectiveness.
6. Hyperthyroidism
Primary Hyperthyroidism:
o Low TSH.
o High T4.
o Normal or high T3.
Subclinical Hyperthyroidism:
o Low TSH.
, o Normal T4.
o Normal T3.
Most Common Cause: Grave's Disease (autoimmune).
Common Symptoms: More prevalent in females, rapid weight loss,
increased heart rate, tremors, sweating, irritability, anxiety,
hyperactivity, insomnia, diarrhea, amenorrhea, hypertension,
exophthalmos (protruding eyeballs), heat intolerance, goiter (enlarged
thyroid gland).
Treatment:
o Propylthiouracil (PTU).
o Methimazole (Tapazole).
o Radioactive Iodine: Often leads to lifelong hypothyroidism and is
contraindicated in pregnancy.
Thyroid Storm (Thyrotoxicosis):
o Acute worsening of symptoms.
o May be triggered by stress or infection.
o Look for altered level of consciousness (LOC), fever, abdominal
pain.
o Life-threatening condition requiring immediate hospitalization.
7. Increased Risk of Ectopic Pregnancy
Risk Factors: Previous ectopic pregnancy, salpingitis (inflammation of
the fallopian tubes), tubal surgery, current Intrauterine Device (IUD)
use, previous cervicitis, history of Pelvic Inflammatory Disease (PID).
Symptoms: Abdominal pain (worsens when supine or with jarring),
vaginal bleeding, amenorrhea, low-grade fever, pain referred to the
right shoulder (may indicate rupture).
8. Hypertension Medications Part 1
African-American Patients (with or without diabetes): Initial treatment
options include thiazide diuretic or Calcium Channel Blocker (CCB).
Non-Black Patients (with or without diabetes): Initial treatment options
include thiazide diuretic, CCB, ACE inhibitor, or Angiotensin Receptor
Blocker (ARB).
Thiazide Diuretics ("-ide"):
o Excellent synergist when used with other antihypertensives.
o Avoid in sulfa allergy.
Key Concepts in Common Medical
Conditions and Treatments
1. Chronic Bronchitis
Definition: A type of Chronic Obstructive Pulmonary Disease (COPD)
characterized by inflammation of the bronchi, leading to excess mucus
production.
Key Characteristics:
o Diagnosis typically after age 35.
o Often associated with obesity.
o Production of copious amounts of purulent sputum.
o Possible elevated Hematocrit (Hct) level.
Treatment:
o Short-Acting Beta Agonists (SABA): Example: Albuterol.
o Inhaled Anticholinergics: Example: Ipratropium.
Normal Lung Auscultation Findings:
o Lower Lobes: Vesicular breath sounds (soft and low).
o Upper Lobes: Bronchial breath sounds (louder).
2. Actinic Keratosis
Patient Profile: Typically affects older to elderly fair-skinned adults.
Lesion Characteristics: Numerous dry, round, pink to red-colored, slow-
growing lesions that do not heal.
Common Locations: Sun-exposed areas such as cheeks, nose, face, arms,
and back.
Significance: Precancerous precursor of squamous cell carcinoma.
Risk Factor: History of frequent sunburns as a child increases risk.
Diagnosis: Confirmed with biopsy.
Treatment:
o Cryotherapy: For a small number of lesions.
o 5-FU (5% Fluorouracil) Cream: For a large number of lesions.
Follow-up: Essential with a dermatologist.
,3. Seborrheic Keratosis
Lesion Characteristics: Soft, round, wart-like fleshy growths
predominantly on the trunk (mostly on the back).
Appearance: Can range in color from light tan to black and appear to be
"pasted on".
Symptoms: Generally asymptomatic.
Nature: Benign.
4. Fingernail Hematoma Treatment
Procedure: Trephination - creating a hole in the nail (through drilling or
piercing) to allow blood to drain.
5. Hypothyroidism
Primary Hypothyroidism:
o Elevated TSH (Thyroid-Stimulating Hormone).
o Low T4 (Thyroxine).
o Low or normal T3 (Triiodothyronine).
Subclinical Hypothyroidism:
o Elevated TSH.
o Normal T4.
o Normal T3.
Common Cause: Hashimoto's thyroiditis (autoimmune).
Symptoms: Variable, may include fatigue.
Treatment: Levothyroxine (Synthroid) daily in the AM on an empty
stomach.
Starting Dose: Typically 25-50 mcg.
Monitoring: Check TSH every 6-8 weeks to assess treatment effectiveness.
6. Hyperthyroidism
Primary Hyperthyroidism:
o Low TSH.
o High T4.
o Normal or high T3.
Subclinical Hyperthyroidism:
o Low TSH.
, o Normal T4.
o Normal T3.
Most Common Cause: Grave's Disease (autoimmune).
Common Symptoms: More prevalent in females, rapid weight loss,
increased heart rate, tremors, sweating, irritability, anxiety,
hyperactivity, insomnia, diarrhea, amenorrhea, hypertension,
exophthalmos (protruding eyeballs), heat intolerance, goiter (enlarged
thyroid gland).
Treatment:
o Propylthiouracil (PTU).
o Methimazole (Tapazole).
o Radioactive Iodine: Often leads to lifelong hypothyroidism and is
contraindicated in pregnancy.
Thyroid Storm (Thyrotoxicosis):
o Acute worsening of symptoms.
o May be triggered by stress or infection.
o Look for altered level of consciousness (LOC), fever, abdominal
pain.
o Life-threatening condition requiring immediate hospitalization.
7. Increased Risk of Ectopic Pregnancy
Risk Factors: Previous ectopic pregnancy, salpingitis (inflammation of
the fallopian tubes), tubal surgery, current Intrauterine Device (IUD)
use, previous cervicitis, history of Pelvic Inflammatory Disease (PID).
Symptoms: Abdominal pain (worsens when supine or with jarring),
vaginal bleeding, amenorrhea, low-grade fever, pain referred to the
right shoulder (may indicate rupture).
8. Hypertension Medications Part 1
African-American Patients (with or without diabetes): Initial treatment
options include thiazide diuretic or Calcium Channel Blocker (CCB).
Non-Black Patients (with or without diabetes): Initial treatment options
include thiazide diuretic, CCB, ACE inhibitor, or Angiotensin Receptor
Blocker (ARB).
Thiazide Diuretics ("-ide"):
o Excellent synergist when used with other antihypertensives.
o Avoid in sulfa allergy.
