NR 506 Exam tips for Clinical question AANP revised.docx

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NR 506 Exam tips for Clinical question AANP revised.docx Thank you all for your support and I a grateful for this page. Keep in mind this is just a resource, you do have to know your content. I studi ... ed for 6 week and took the AANP. My strength is in doing tons of questions. Find what your strength is and focus on your weakness as well. 1. Leik App questions do it twice and read rationale 2. Leik Book read your areas of weakness including cardiovascular, musculoskeletal, respiratory heme/onc, peds. The rest you can read the summary. 3. I also did FNP mastery App fo $30 or so. I thought it was better for ANCC exam but still helped a lot. I did all the questions twice 4. I also did 3 Barkley questions posted on our Facebook page . I got some questions on the exam similar to this https://lookaside.fbsbx.com/file/barkley%20questions%20with%20answer179.pdf?token=AWzaJjIuAADWW3PGOaDDo24L8KsVV5usj34EGReV_jt5OK2Y2L_nhVV16OFZ9bdWuVsW0K1yzpArQCvG8Qy8di-E6jSSCnt8AqrT--P3SyxTL5sazoxtKzlRwYoXtYRXWwdYAzS_gj2B5rrfOLgIm3 https://lookaside.fbsbx.com/file/barkley%20questions%202nd%20side178.pdf? token=AWxUXeGkYsmolSSFkpipsZb5qvD9xMmknZFvkUXG8P0VzCEmOeDmLWU208vBRzXXhFMJBnEsZ94WWx5I0cbqK0dUHmvnObOZFLbHI80x3A7t0LdalLBTxidJrelVxb8FhYT4kCDa4LVpO-WX_3RpSa https://lookaside.fbsbx.com/file/barkley%20questions%20one%20side177.pdf? token=AWx7_Pq8kql7-QCeCviYm33ieuxKBuERoHcTXWjGhnOCoer9Q2CKc2Qf7Rbvf3nb0K18acqRYI2tzJUsFHz88xPNO0vvf6sNLuSB6vTLyti9WgcvBH WXAf82ZEK3z1KrJncjvLuUtIh-Dia2KFrJFK2 5. I am attaching a file from a lightning round 6. I also attached 3 PSI questions. You will see at least 3 of these questions in your exam file:///C:/Users/Kingsley/Documents/PSI%20adult%20gerontology%20(1).pdf file:///C:/Users/Kingsley/Documents/PSI%20predictor%20test-2.pdf file:///C:/Users/Kingsley/Documents/PSIpracticetestFNP.pdf 7. Lastly. Check out the file called Summarization of previous test takers. I have it pasted on here. You will see a lot of those questions on your exam.  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? Iron, TIBC 3 months of synthroid, TSH increased, T4 normal, what do you do? Increase Medication  3 ways to assess cognitive function in patient with signs/symptoms of memory loss…. Mini mental exam  4 month old with strabismus, mom is worried…… tell her it is normal.  4 month old wont keep anything down, what is the main thing you look at? Growth chart  6 month old closed anterior fontanel. XRAY  Abnormal cells on PAP, what do you do next? Refer for Colposcopy  CAGE ACRONYM  Causes of tachycardia  Cranial nerves responsible for extraocular eye movements… 3,4,6  Definition of metabolic syndrome- cluster of conditions that increase risk of heart disease, stroke, diabetes.  Definitive diagnosis of acute bacterial prostatitis: urinalysis and culture!  Diagnose Trich: wet prep  Elederly presents with atrophic vaginitis, small uterus, palpable 4x5 ovary, what do you do next? Pelvic US  Elder presents with atrophic vaginitis-add estrogen cream  Epistaxis is most common in the area of the nose known as kiesselbachs triangle, where is this located? Anterior septum  Fingernail hematoma treatment… drill hole, drain blood  GERD treatment: H2 is first line  Grade 3 cells on pap, treatment? Excision  Growth Plate fracture/Salter Harris Fx  Increased risk of ectopic pregnancy…. Salpingitis  Koplick Spots… Measles  Legg-Calve Perthes disease: avascular necrosis of the proximal femoral head  Lipid level of 1500, increased risk for? Pancreatitis  Low HGB, Low HCT, High MCV indicates what? Macrocytic anemia, B12 Def  Man with high BPH, prostate feels on digital exam? Enlarged, symmetrical, smooth  Man with HTN, CAD, present femoral pulses but absent pedal…. Arterial Insufficiency  McMurrays Sign- Meniscus tears  Lachmans- ACL  Know heart murmors!!!! MrPASS MVP MsARD  Newborn with foot turned in, what do you do? Refer to orthopedist  Osgood Schlatter disease- Knee pain  Patient forgot to start Thanksgiving dinner and husband states she has trouble remembering tasks and trouble with organization. What is this indicative of? Alzheimers  Pt has Barretts Esophagus, insurance no longer covers GI who was treating condition. Pt at FNP office wanting refill prescriptions. What do you do? Refer to oncologist  Know labs for diagnosing Hepatitis  Pt presents with rash on shoulder, erythematous maculopapular rash with center clearing and scaling? Tinea Corporis  Pt presents with “bag of worms:, indicates? Varicocele Pt with atopic dermatitis, look for what other diseases? Asthma  Pt with bleeding after menopause- endometrial biopsy  Pt with hx of PID, increased rick for? Infertility  Bacterial vaginosis does not cause PID- trich, gonorrhea, and chlamidia can cause it  Pt with HIV took high potency anti viral treatments and CD4 is >400, what does this indicate? This is good. Want higher than 350  Pt with hx of htn and stroke, now having memory loss. What does this indicate? Vascular dementia  Pregnant teacher with exposure to 5ths disease, what risk is there to the fetus? Fetal death and birth defects  Quick assessment of patients fall risk? Timed Get up and Go  Red beefy tongue? Pernicious anemia  Rotator cuff injury presentation: disturbs sleep, arm weakness, dull ache  Shingles near eye- immediate referral to ophthalmology  Signs and symptoms of Roseola? High fever, pink flat or raised rash  Treatment for chronic alcoholism: 12 step program  Treatment for Gonorrhea? Rocpehin IM and Zithromax PO  Young female want birth control, forgets to take pills, does not want to get pregnant for at least 5 years: IUD Questions: few questions about T2DM and appropriate treatment, including insulin. Know the reason for doing a PSA When to give a pregnant woman with negative rubella titer the rubella vaccine Treatment for gonorrhea, and syphilis, including during pregnancy What meds you can't take while ingesting grapefruit juice Bells palsy s/S S/s of serotonin syndrome Kawasaki disease presentation Lab test for "slapped face" Treatment for shin splints What to do with thyroid meds based on lab values What heart sound would be expected in CHF What antihypertensive meds to avoid in GERD Who gets hep C screening Definition of AIDS No hepatitis a or b on mine The cheapest treatment of shingles -acyclovir T2DM has foot laceration, what would u monitor them for- osteomylitis Acute GAD treatment-ssri Know which murmurs are diastolic and where they're locatedWhat pts would need to go to ED with pneumonia... CURB65 Presentation of allergic conjunctivitis- bilateral eye symptoms Treatment of mild persistent asthma Parents have heterozygous disorder, what % of children are homozygous-25% Weber and Rinne No CN questions for me Darcosytosis s/s Cotton wool on fundoscopic exam means?? Chronic use of afrin causes...medicamentosa Vascular dementia most commonly occurs with people who had stroke and htn S/s of strep a pharyngitis Questions: Some of the questions I still remember from this morning exam: Signs and symptoms of definitive HF Description of Molluscum contagiosum Management of fall with extended arm but no fracture seen on the xray 2 questions about Hepatitis Dacryocystitis Evaluation of fall for the elderly Know your labs for anemia, hypo & hyperthyroidism, hyperparathyroidism Systolic murmurs Carotid bruits Primary amenorrhea Acquired hypothyroidism Drugs for OM and alternatives Drugs for gono and chlamydia and alternatives Autosomal recessive and dominant AV nicking Pediatric asthma management Infant dehydration assessment Trichomonas Grades of HF, bruits and thrills A lot of questions about Weber and Rinnes test Erysipelas 12 weeks just above SP IntussuceptionWilms tumor Antipsychotic drug that causes hyperglycemia Management of TG if niacin does not work When to prescribe insulin... that’s all I remember. And I’m sure all of you know these stuf � but some variations like titration of levothyxine based on labs as well as coumadi at least 4 or 5 questions . Grapefruit affects what meds? On the review class from Barkley, some comments about the least expensive treatment for severe shingles. His questions are not the same format as AANP. TB diagnosis and PPD readings. No cranial nerves. Xray interpretation of knee fx. No pictures. What kind of pain on MI, ekg interpretation. Read in detail about the 3 recent posts about the new test, they helped me a lot . Good luck Questions: genetics, a few on sexually transmitted disease and the medications (mostly gonorrhea), I had several questions about the elderly and medications that were safe and meds that were not. I had several questions on Derm, Basal cell carcinoma and seborrheic keratosis, I had a lot of questions of what labs to order, and they gave the situation of the patient. I had several questions on monon, anemia ,and sinusitis. I had PNA when to send to ER, Glaucoma, Hep B, 2 murmurs, one asthma, One on Marijuana s/s, 2 on BV, one on Alzheimer's, one on hypothyroidism, one on symptoms of a person with Myasthenia Gravis, menopause, woman had bleeding what to do, Glaucoma, also shingles around the eyes, treatment of Bells Palsy, also how to diagnose Temperal arthritis, OA and RA. Questions: anemias and RA vs OA, two murmurs, 2-3 Hepatitis serological, picking which Abx is appropriate for a named infection, PTSD, lots of frail elderly, STIs, PUD, GERD, Adolescents, who’s at risk for suicide, Myesthenia Gravis, Parkinson’s, appropriate tests for poss diagnoses, HTN meds, proteinuria, gastroenteritis dx, tests for appendicitis, expected labs changes in cholecystitis, dx hepatitis from pt symptoms. Questions: hep b and C, hypercalcemia, fibromyalgia, Alzheimer's, fifth disease, MCL, Pagets. Questions: I had a couple of questions on genetics, a few on sexually transmitted disease and the medications (mostly gonorrhea), I had several questions about the elderly and medications thatwere safe and meds that were not. I had several questions on Rocky Mountain spotted fever. I had a lot of questions of what labs to order, and they gave the situation of the patient. I had several questions on mononucleosis, anemia ,and sinusitis. I want to thank everyone for all the questions that were posted, they helped a lot. Questions: Here’s some additional details on my AANP FNP exam from Jan 12, 2018. I suspect my exam was the “new version” (it was expected to be updated this January). [Edit: I have no idea if/when the test is updated - lots of people posted conflicting information about it; you can search the group for posts on the subject to see the whole gamut.] NOTE: I will not give out any questions or any specifics. This is just a vague description of some of the topics covered. � I feel like I had multiple musculoskeletal questions - from RA to pediatric conditions to tendonitis to grade 3 muscle strains. I had a lot of endocrine on my exam too - particularly hypothyroid, hyperthyroid, Hypoparathyroidism vs hyperparathyroidism - the type of questions ranged from from s/s, to meds, to scan, test and lab results. Quite a few derm questions, from lichen planus to tinea to BCC to shingles. One question about what in-office procedure is best for a specified derm finding. Only 1-2 questions were right off the PSI predictor. Only a few were like the questions from this group or from Leik. Difficulty level of the AANP exam felt more in line with the difficulty of the APEA practice exam. 2 murmurs. One hepatitis serology. 2 asthma. 1 or 2 anemia questions. Also: EKG finding description for bradyarrythmia Otitis externa and media Varus vs. valgus in knee exam Presentation of HTN 2* to renal dx Tendonitis progressing into tear s/s Palpable ovary in elderly female Palpable abdominal mass in a child Headaches Hyperlipidemia Calcium dosage Meds that may worsen GERD s/s Diltiazem Acute renal conditions Concussion Pain meds for geriatric pt Venous and arterial insufficiency Top cause of mortality in a specific population group Post menopausal abnormal gyne findings and how to respond Antibiotics Newborn/infant GI disordersQuestions: Fair amount of derm and Peds derm dx and treatment, Peds ortho dx and reg ortho dx and tests, elderly women's health issues, some pregnancy. 2 murmurs, one asthma, one asked about prolonged PR on EKG strip what kind of block!!, UAs, thyroid and parathyroid, one anemia, one hep serology, one asthma tx, infant emergent conditions. passed AANP yesterday!! yayy! This group was so much help! Thank you for everyone posting tips and questions! I strongly recommend going through the tips that people have been giving in the past few weeks. My test had many of the topics they gave! Some of the questions I had no clue at all, but most of them I could come down to two answers and choose from there. It was very nerve wracking and I am so happy to be done! One thing that really helped me every day for a couple weeks for my test was I reread this bible verse over and over and told myself it was okay if I failed! It put less pressure on me :) Here are some of the topics I specifically remember! (also read the old psi test because I had a couple from there on the test) I started studying hard about 3-4 weeks before the test and I studied most week days at least 5-8 hrs because I felt very behind and like I needed it. I went to a fitzgerald live review a couple of months ago, I watched and took notes on all of the hollier videos (which really helped me get an initial knowledge for the topics) then I read the leik book (which had almost every topic that was on my exam!) then I made note cards and spent the last week reviewing those and the topics that were given by the people in this group. Probably overkill but I'm glad I did it! On my scratch paper I wrote: Deuteronomy 31:6, heart murmurs, cranial nerve picture, S/S of anticholinergics (SAD CUB) and SSRI (BAD SSRI), weber and Rinne and hepatitis panel. - Dacrocytsis -ruptured tympanic membrane -Rosacea -thyroid and parathyroid -Treatment for gonorrhea and chlamydia while pregnant -I had about 3 cranial nerves which I wasn't expecting -2-3 Rinne and Weber -aquired hypothyroidism -know what fundoscopic exam will look like from HTN and DM-I got one about AV nicking -Fundal height at 12 weeks -Wilms tumor -Carotid bruits -Primary amenorrhea -Apthous stomatitis- a little kid with sores in his mouth -Hypertension medications - like which one you would give or not give for specific patient- which one causes GERD CCB. -Fibromyalgia diagnosis-11/18 -Gold standard for temporal lobe arthritis- biopsy, give sterids, associated with Temporal arteritis -I had one hepatitis question- IGm was positive -Cause for ectopic pregnancy That's all I can remember specifically! Good luck everyone!Question that I was able to remember • Basal Cell Cancer: Question description and the fact that it doesn’t have any tx (Hints: Waxy, pearly, telangiectasia, ulcer center lesion • Actinic Keratosis: Question about description (Scaly red to yellow located in sun exposed area • Melanoma question: Know ABCDE • Subungal Hematoma tx: Make a hole and drain the blood • Tx for moderate acne- I got one about Retin A • Know Systolic and Diastolic Murmur (MR. ASS & MS. ARD). Mr. ASS question was asked about heart murmur with high pitch holosystolic and the other one is mid systolic. Got one about a low rumbling diastolic murmur • Question about Grade III/VI Murmur: (Loud murmur easily heard) • Coarctation of Aorta: Know that systolic BP on lower extremities is supposed to be higher compare to upper extremities. In COA case its vise versa. Look for weak radial and bounding femoral pulse • Know the difference between Peripheral Arterial Disease and Chronic Venous Insufficiency. There was question about PAD and the answer was exercise by walking (Tx)- chronic venous insufficiency you elevate it • Question about JVD causes? HF right side to be specific • Know Bacterial endocarditis (There was a pt. with gradual onset of fever, hemorrhages on nail beds, painful raised red nodules) Osler’s nodes • RML CXR • Chronic bronchitis description and treatment • Hiv pt. PPD + (5mm) • Croup/Epiglottitis: Question about what condition would make you order Lateral X-ray of the neck. Options include: Drooling, Unable to do ROM of the neck / stiff neck. • Hyper and Hypothyroidism • Question about AV nicking (Arterioles pressing on vein of the eye): Its HTN retinopathy • Question causes of IOP-Papilledema • Rovsing sign Mcmurray sign • Pt. with GERD and Barrett’s esophagus: Refer to Oncologist • Question about pencil like stool: Options include problem with ascending colon, descending colon. Descending colon Question about a thin narrow stool and possible causes include colon cancer, diarrhea, IBS. Refer for GI colonoscopy • Question about Hepatitis B active Immunology. • Know your urinalysis result • Question about Pt. complaining of headache after trauma: (Options include post concussion headache, subarachnoid hemorrhage and Subdural hemorrhage). I think the answer is subdural hemorrhage • Question about Migraine headache: Know the description and duration of headaches as well- nausea vomitting • Question about CN 3,4,6 (EOM) • Anemia question, Vitamin B12 deficiency-beefy red tongue, tingling • A lot of Musculoskeletal questions: (Anteriorly ligament which is for ACL; Apprehensiontest positive, lateral epicondylitis Tx, Morton’s Neuroma description as someone with high heels and has a mass or nodule on the 4th/5th toe) • Osgood Schlatter Disease: Hint tibia tuberosity • Question about an 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. (Do nothing, Increase Tylenol, change to NSAID, and pt. is expected to have a high SED rate due to age). I think it should be changed to NSAID cuz SED rate is a sign of inflammation, • Question about medial Tibia Stress • ADHD is a behavior disease • Which medication causes low sperm count for a patient (SSRI) • Question about grandiosity (Bipolar) • Question about contraceptive pills • Question about, Trichomonas test wet mount was mentioned on the exam • Question about a 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? (Options are referring for colposcopy, repeat in 12 month and can’t remember other options. My review book stated to order HPV test if not done. Refer for colposcopy. • Question about NP palpating right ovaries on a 1-year postmenopausal woman. Options include (To refer for endocerviacal test, for ovarian cancer something, couldn’t remember other options). Answer is to r/o ovarian cancer • Another question about who is at high risk for ovarian cancer (Options include Family history, previous abortion and cant remember the rest) • High risk for ectopic pregnancy: (Options include: Infertile, and cant remember the rest of the options) • Question about chlamydia • Question about CURBS: Which of the options does not require hospitalization for pneumonia (Options are all except 1; all include one that’s not part of it) Review CURBS: It’s a criteria for pneumonia hospital admission • Question about genital wart tx • Question about treating HIV pt. with antiviral and CD4 count still less than 200. What should NP tell the pt. (Different option but the best option is to tell the pt. that he is qualified to be diagnosed with AIDS according to CDC • Most common cause of death in children (Options are poisoning, Motor vehicle accident, drowning, and cant remember the fourth one) • Tanner stage questions • Sensorineural (Presbyacus) • Know types of Alzheimer’s: Question about a pt. expericieng memory loss, and increase in confusion and she has a history of stroke, HTN, What type of Alzheimer. Options include (Dementia with lewy bodies, Vascular dementia, frontotemporal dementia). I think the answer is vascular dementia. • Question about Romberg test and how its done • Question about sensitivity • Question about Coombs test r/o bilirubin • Hyperbiliribubin question risk• Preeclampsia tx (bed rest, laying on her side and • Question about a pregnant female at slightly above symphysis pubic and Fundal height is 32cm (above the umbilical. What should be done (I picked to have Ultrasound done to) • Question about molloscum contagiosum- umbilicated, • Question about pyloric stenosis (Hint is non bilious vomiting, olive like firm mass palpated on right upper quadrant) • Review your skin issues for adult and kids. Question about Rubeola (Koplick)- measles • Question about horizontal nystagmus that stops when eye is close to midline in a college student (options include messinere, BBPV, normal and cant remember the forth one) • Question about someone eating, painful lump noted on the jaw that comes and go. Options include (Cancer of Wharton, sialolithiasis). The answer is sialolithiasis • Question about ADHD (options include are solely a behavior disorder, panic, personality disorder) • Question about a pt. complaining about upper arm tremor that seems to be hereditary. What’s the treatment? options include (Xanax, lorazepam, metoprolol and cant rember the last one) • Which among the list can cause increase in respiration. Options include (low oxygen, high oxygen, hypercapnia, hypocapnia) • Question about osteoporosis risk factors. Options include (low estrogen level, obesity, sedimentary lifestyle, cant remember the last one) Osteoporosis exercise- walking (weight bearing exercise) • Tx to prevent fracture in a pt. with low vitamin d hydroxyl, high TSH and low Hct (Option include Calcium carbonate 600mg, vitamin d 800 IU, cant remember the remaining 2 options) • Questions about carotid bruit signs can signifies what. Options include (Pulmonary HTN, carotid problem, cant remember the remaining two options0 • Ovarian CA risk. options are (multipara, family history and cant remember the rest). • Question about ectopic risk factor. Options include (abnormality, exposure to some chemicals, previous abortion) • Common causes of GERD. Options are (Histamine blocker, BB, CCB, cant remember the last one) • Zeprexa (What lab and intervention to put in place) such as weigh check, DM,) • Question about what’s the common bug in children with diarrhea. • What test needed to differentiate lesion/cyst found on a breast (Options include Screening mammogram, Ultrasound, Need aspiration) • Increase in triglyceride can cause pancreatitis • Weber/Rinne Test know this by heart multiple questions about it –WUS and WAC Lung sound on a pt with emphysema- I put hyperresonance? 2/15/18: Things I remembered that I marked: - Assessment for dullness on patient with ascites -INR goal on patient with DVT less than a month ago 2-3If INR not therapeutic increase the dose -know pneumoconiosis (so you know which one you can eliminate) -Varus/Valgus test -know the difference of measles (Rubeola)vs german measles(Rubella) -patient with IOP of 32mmHg, what do you expect during fundoscopic exam-Cupping -1st line tx for Chronic bronchitis -significant risk factor for ovarian CA -meds for patient with BPH and urge incontinence-flomax -causes of hyperbilirubinemia in newborn [Show More]

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