FNP:(Family Nurse Practitioner) Exam
Study Guide
Trauma to Kiesselbachs plexus:
(Ans- Will result in an anterior nosebleed
The diagnostic or gold standard test for sickle cell anemia, G6PD anemia,
and alpha or beta thalassemia:
(Ans- Hemoglobin electrophoresis
Erythromycin "allergy" vs adverse reaction:
(Ans- Adverse reaction-symptoms of nausea or GI upset allergy -hives, angioedema
Acute mononucleosis:
(Ans- Pt will most likely be a teen presenting w classic triad of sore throat, prolonged fatigue, and enlarged cervical nodes.
Alpha thalassemia:
(Ans- More common among Southeast Asians such as, Indian, Chinese, or Filipino descent
Lupus (Ans- Malar rash(butterfly rash)Pts need to avoid or to minimize sunlight exposure(photosensitivity)
Tx polymyalgic rheumatica(PMR) (Ans- 1st line tx for PMR includes long-term steroids. Long term steroids are commonly used to control symptoms(pain, stiffness on shoulders, and hip girdle). PMR pts have higher risk for temporal arteritis.
Gold standard exam for temporal arteritis:
(Ans- Biopsy of the temporal artery. refer pt to opthalmologist for mgt 1 / 4
Finkelstein's test:
(Ans- Positive in De Quervains tenosynovitis
Anterior Drawer maneuver and Lachman maneuver:
(Ans- Positive if anterior cruciate ligament (ACL) of knee damaged. The knee may also be unstable
McMurray's sign:
(Ans- Positive in meniscus injuries of the knee
Damaged Joints:
(Ans- Order X-ray first, but MRI is the Gold Standard
Diabetic retinopathy:
(Ans- Neovascularization, hard exudates, cotton wool spots, and micoaneurysms
Hypertensive retinopathy:
(Ans- AV nicking, silver and or copper wire arterioles
Checking deep tendon reflexes:
(Ans- absent(0), hypoactive (1) normal(2) hyperactive(3) clonus(4)
Clonus:
(Ans- Clonus is typically seen in patients with stroke, multiple sclerosis, spinal cord damage and hepatic encephalopathy. 2 / 4
Clonus has also appeared after ingesting potent serotonergic drugs, where ingestion strongly predicts imminent serotonin toxicity (serotonin syndrome).Clonus is a series of involuntary, rhythmic, muscular contractions and relaxations.Clonus is a sign of certain neurological conditions, particularly associated with upper motor neuron lesions involving descending motor pathways, and in many cases is, accompanied by spasticity (another form of hyperexcitability).Unlike small, spontaneous twitches known as fasciculations (usually caused by lower motor neuron pathology), clonus causes large motions that are usually initiated by a reflex.
A rare but serious adverse effect of ACE inhibitors is:
(Ans- Angioedema
A common side effect of ACE inhibitors is a (Ans- Dry cough(10%)
1st line drug to tx htn in DM & pts w mild renal dz bc of their renal
protective properties:
(Ans- ACE inhibitors or ARBS
Penicillin:
(Ans- Amoxicillin(broad-spectrum PCN) Penicillin VK
Macrolide:
(Ans- Erythromycin, azithromycin(Z-Pack), or clarithromycin(Biaxin)
Cephalosporins:
(Ans- 1st generation(Keflex), 2nd generation(Cefaclor, Ceftin, Cefzil)3rd generation(Rocephin, Suprax, Omnicef)
Quinolones w gram positive coverage:
(Ans- Levofloxacin(Levaquin), moxifloxacin(Avelox), gatifloxacin(Tequin)
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Quinolones:
(Ans- Ciprofloxacin(Cipro), ofloxacin(Floxin)
Sulfa:
(Ans- Trimethoprim/sulfamethazole(Bactrim, Septra), nitrofurantoin(Macrobid),
Tetracyclines:
(Ans- Tetracycline, doxycycline, minocycline(Minocin)
NSAID:
(Ans- Ibuprofen, naproxen(aleve, Anaprox)
Cox-2 inhibitors:
(Ans- Celecoxib (celebrex)
Antitussives:
(Ans- Dextromorphan(Robitussin), benzonate(Tessalon Perles)
Drugs allowed for pregnant or lactating women:
(Ans- Category B
Pregnancy in pain:
(Ans- Tylenol instead of Ibuprofen
Avoid nitrofurantoin & sulfa drugs during 3rd trimester:
(Ans- Increase the risk of hyperbilirubinemia
Best way method of spreading viruses or bacteria:
(Ans- Making them airborne or nebulized
Tx cutaneous anthrax:
(Ans- Ciprofloxacin 500mg orally BID for 60 days or 8 weeks. If pt allergic to ciprofloxacin , use doxycycline 100mg BID
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