Best Study Tips for FNP Boards Exam

Cardiac

•        Know S3 what does it mean.

•        Know S4 it is a sign of what? They describe a patient. Sounds like Tennessee.

•        A murmur that is loud and heard with your scope plus thrill is 4. A loud murmur that you don’t need a scope for is 6

•        They tell you a systolic murmur one that radiates to the neck and one the radiates to the axilla- what are they called

•        How do you rule out AAA -US gold standard in 65 and older especially if they smoke

•        You have a pt with HTN and osteoporosis what medication do you put them on for HTN- thiazides

•        HTN drug for DM with neuropathy- ACE or ARB

•        You have a patient that on eye exam you notice copper and silver artioles AV nicking what else do you assess them for – HTN

•        You have an elderly patient with ISH BP log what medication do you start? CCB

•        PAD pt what is treatment- exercise

•        PAD what test- brachial index

•        Know chronic venous insuff- edema, thick skin discolored  Test you do for stable angina – stress test.

•        Know Systolic and Diastolic Murmur was asked about heart murmur with high pitch holosystolic and the other one is mid systolic.

•        Question about Grade III/VI Murmur: (Loud murmur easily heard)

•        Know the difference between Peripheral Arterial Disease and Chronic Venous Insufficiency.

•        Question about JVD causes?

•        Know Bacterial endocarditis (There was a pt. with gradual onset of fever, hemorrhages on nail beds, painful raised red nodules) Osler’s nodes

•        Questions about carotid bruit signs can signifies what- narrowing of the carotid

GI

•        High triglycerides increase the risk of – pancreatitis

•        You have a pt with chronic Hep C what will be high the AST or ALT or Both  First line tx GERD H2 blocker

•        Hep serology you have to tell them what they have see Hollier notes

•        You have a positive psoas maneuver and it is positive. What does this mean?  Rovsing sign

•        Pt. with GERD and Barrett’s esophagus: Refer to Oncologist  Question about Hepatitis B active Immunology.

•        Question about pyloric stenosis (Hint is non bilious vomiting, olive like firm mass palpated on right upper quadrant)

•        Common causes of GERD. Options are (Histamine blocker, BB, CCB, cant remember the last one)

•        Increase in triglyceride can cause pancreatitis

First line treatment for Zollinger is PPI

Skin

•        What is honey crusted lesions how do you treat

•        Actinic keratosis precursor to SCC look up in Leik how it presents

•        Rosacea tx with metronidazole gel

•        How do you treat shingles – acyclovir

•        Older induration that has been there awhile what do you do? Bx it

•        Basal Cell Cancer: Question description and the fact that it doesn’t have any tx: Waxy, pearly, telangiectasia, ulcer center lesion

•        Actinic Keratosis: Question about description (Scaly red to yellow located in sun exposed area

•        Melanoma question: Know ABCDE

•        Subungual Hematoma tx: Make a hole and drain the blood

•        Tx for moderate acne

•        Review your skin issues for adult and kids. Question about Rubeola (Koplick),  How do you treat a skin fungal infection

Peds

•        What puts a new born at high risk for hyperbilirubinemia the answer is cephalohematoma  Tanner stage III female

•        14 yo boy cc of bony mass on anterior tibial tubercle-osgood-schlatter

•        They describe a weak baby, doesn’t feed well sleeps a lot- it has congenital heart defect

•        Least likely signs of child abuse, bruise in buttocks, retinal hemorrhage or bruises on shin

•        ADHA question- answer is neurobiological

•        First line tx of ADHD

•        Coarctation of Aorta: Know that systolic BP on lower extremities is supposed to be equal compared to upper extremities. In COA it will be lower. Look for weak radial and bounding femoral pulse

•        ADHD is a behavior disease

•        Most common cause of death in children (Options are poisoning, Motor vehicle accident, drowning, and can’t remember the fourth one)

•        Question about molliscum tx none

•        Peds pt has sausage like mass this is what-

•        If you have a both parents with a genetic defect what is the percentage the child will have it.

25%

•        Baby is 6 days old. Has eye discharge. What is it. STD

Psy

•        Know how an anorexia presents

•        Antipsychotics lead to risk of obesity, DM2 hyperlipidemia

•        You put a patient on zyprexa what do you monitor- BMI -wt check every 3 months

•        The most common side effect of Paxil – erectile dysfunction

You will get a young female with depression what med do you start? SSRI

You have an elderly female with depression what med do you start SSRI if they list celexa chose it. Has the shortest list of interactions

•        Kava Kava  question- something about what not to mix it with- benzo, CNS depressants or hypnotic

•        Which medication causes low sperm count for a patient (SSRI)

•        Question about grandiosity (Bipolar)

•        They will ask you what is MME and then they will give you a question like you are asking an elderly patient to repeat three words. What test are you doing? MME

•        A patient 77 yo is on benzo’s how do you get them off- wean them

•        Zyprexa (What lab and intervention to put in place) such as weight check, DM,)  Question about what’s the common bug in children with diarrhea.

•        What drug do you give in an ACUTE anxiety attack Gero

•        You have an elderly patient that has new rapid onset of confusion what are labs to check for reversible causes? CBC, TSH, BMP and UA- the main medication that causes this is Benadryl

•        Sensorineural (Presbyacusis)

•        Know types of Alzheimer’s: Question about a pt. experiencing 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). 

Neuro

•        Your patient has essential/familial tremor what is first line treatment- propranolol  How do abort migraines drug?

•        Prophylactic tx migraines? Drug

•        They describe a pt with Trigeminal neuralgia how do you treat?

•        Treatment of cluster HA high dose O2

•        Teen with dizziness and lateral gaze and returns to normal- this means what? Normal  Pappiledema is a SS of ICP

•        Question about Pt. complaining of headache after trauma: (Options include  post concussion headache, subarachnoid hemorrhage and Subdural hemorrhage). I am confident the answer is subdural hemorrhage

•        Question about Migraine headache: Know the description and duration of headaches as well

•        Question about CN 3,4,6 (EOM)

•        Question about Romberg test and how it’s done

•        Question about a pt. complaining about upper arm tremor that seems to be hereditary. What’s the treatment? options include (Xanax, lorazepam, topolol and cant rember the last one)

Legal

•        I did have a question about HIPPA. Something like sharing info to a boyfriend is an example of HIPPA violation, they throw out like beneficence and non- maleficence

Heme

Your pt has as big beefy tongue they have- B12 anemia

You have a pt on coumadin INR is 1.4 hx of DVT what do you do? Increase it

•        Your pt t-score is 1.5. what does that mean -osteopenia

•        How do pt present for temporal arteritis and they ask for the gold standard BX of artery  Anemia question, Vitamin B12 deficiency, Folate.

Men’s Health

•        What is the first line treatment in BPH- Hytrin

•        Look up how acute prostatitis presents they ask you how to treat it. 35 yo male doxi 100mg BID X 10 days and Rocephin 250mg.

STD

•        If the patient is older than 35 its not likely STD but LUTS cipro BID or Levo 4-6 weeks

•        They describe a patient with BV “look it up” treat with Flagyl 500mg Bid X 7 days. Do not drink ETOH

•        They tell you your patient has strawberry cervix with green discharge. How do you treat? It Trich and 2gm of flagyl

•        If you treat gonorrhea you also treat what? And how? Chlamydia (Rocephin and Azith)

•        If you have an HIV pt with a TB test that reads 5mm they ARE considered positive

•        They describe a pt with syphilis what lab do you draw RPR

•        How to tx genital warts TCA trichloroacetic if prego

•        Question about chlamydia what drug you give

•        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 he is qualified to be diagnosed with AIDS according to CDC

Women’s Health

•        Know the difference between probable, possible and positive signs of pregnancy. Leik book  Naegeles rule

•        I had a pregnant patient in her 3rd trimester painless vaginal bleeding- what is that how do you treat

•        Same as above but painful dark red blood. What is it and how to tx

•        What abx do you give a preg pt for UTI answer is nitrofuration/Macrobid

•        Question about contraceptive pills mini pill is ok for smoker??? If under 35 no other risks

•        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?

referring for colposcopy,

•        Question about NP palpating right ovaries on a 1-year postmenopausal woman. Answer is to r/o ovarian cancer start with US

•        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:  PID r/o STDs, abortions or past trauma like surgery- Anything that causes scarring 

Preeclampsia tx  bed rest, laying on her side and

Question about a pregnant female at slightly above symphysis pubic   and Fundal height is

23cm (above the umbilical. What should be done (I picked to have Ultrasound done to)

•        Coombs test=  Detects  presence of  RH antibodies 

•        Ovarian CA risk. options are (multipara, family history and cant remember the rest).

•        What test needed to differentiate lesion/cyst found on a breast (Options include Screening mammogram, Ultrasound, Need aspiration)

Pulm

•        Asthma first line treatment.

•        They describe a pt with TB- fatigue fever  on Xray

•        What causes the greatest increase in RR- hypercapnia

•        You suspect sleep apnea which includes everything but -obesity, enlarge tonsils, macrognathia or microglossia

•        RML CXR

•        Chronic bronchitis description and treatment

•        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.

•        Question about CURBS: Which of the options does not require hospitalization for pneumonia Review CURBS: It’s a criteria for pneumonia hospital admission

•        Which among the list can cause increase in respiration. Options include (low oxygen, high oxygen, hypercapnia, hypocapnia)

HEENT

•        What is the most common pathogen of otitis externa and how to treat

•        Weber test- lateralization to only one ear is abnormal

•        They describe a bilateral allergic conjunctivitis

•        Retinoblastoma- look up all SS of this and what it means.  Google it for an advance search they do not give you basis info

•        Question about AV nicking (Arterioles pressing on vein of the eye): Its HTN retinopathy  Question causes of IOP

•        Question about horizontal nystagmus that stops when eye is close to midline in a college student its normal

•        Weber/Rhinne Test

•        Question about someone eating, painful lump noted on the jaw that comes and go. Options include , sialolithiasis – also Caculi or salivary stones”, is a condition where a calcified mass or silaolith forms within a salivary gland usually in the duct of the sub mandibular gland also term  Wharton’s DUCT -

Orthopedic

•        Treatment for mild ankle sprain RICE

•        Treatment for medial tibial stress syndrome- shin splint RICE

•        A lot of Musculoskeletal questions: (Anteriorly ligament which is for ACL; Apprehension test positive,

•        lateral epicondylitis Tx,

Morton’s Neuroma description as someone has a mass or nodule on the 4th/5th toe)

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

•        Question about osteoporosis risk factors. Options include (low estrogen level, obesity, sedimentary lifestyle, cant remember the last one)

•        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 don’t remember…..

•        Navicular fx don’t show up on Xray right away they will in 2 weeks Leik 251 second add…  Pageants disease first line treatment- I picked surgical

Renal

•        How do you dx a kidney stone- US not CT

•        Old lady with new onset of incontinence- you do what. UA and culture  Know your urinalysis result

ENDO

•        Hyper and Hypothyroidism

•        Question about FRUCTOSESAMINE TEST. Test for how long sugar storage in system. Options include (2-4 week, 3-8 weeks 4-6 weeks and cant remember the rest). The answer is 2-3 or 4 weeks



Cancer

•        Question about pencil like stool, descending colon CA is the answer

Updates:

 My COA question was about a younger male with no hx of htn whos BP was 200’s/100’s in his left arm with an audible abdominal bruit –what was his dx?

Dacryocystitis-how it presents

Know how mortons neuroma presents

I had to choose the best prophylactic antibiotic for a geriatric patient who is fairly healthy, undergoing knee surgery-options were vanco, a tetracycline a cephalosporin and something else. I think it’s the cephalosporin.

Know S&S of CHF-particularly breathing difficulties (orthopnea, etc)

Causes of tachycardia

6 day old infant with conjunctivitis—STD (I think chlamydia was the only STD option)

Intussusception

Atypical antipsychotics-adverse affects(lab wise)

How nasal polyps present

Addisons disease—they give a question about how they present without telling you that’s what it is and ask you what labs you expect to see-high cortisol levels, hyperkalemia, low sodium, etc Lichen sclerosis-how it presents (white streaks)