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NU 577: AANP Exam Pearls STUDY GUIDE/NU 577: AANP Exam Pearls STUDY GUIDE $11.99   Add to cart

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NU 577: AANP Exam Pearls STUDY GUIDE/NU 577: AANP Exam Pearls STUDY GUIDE

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NU 577: AANP Exam Pearls STUDY GUIDE/NU 577: AANP Exam Pearls STUDY GUIDE

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  • October 20, 2022
  • 59
  • 2022/2023
  • Exam (elaborations)
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NU 577:
AANP
Exam
Pearls
STUDY
GUIDE

, AANP: Exam Pearls


Exam Format
 AANP FNP exam contains very few nonclinical questions
 Certification tests are designed for entry-level practice
 AANP has 15 pilot questions which are not graded [there is NO WAY to identify the
pilot test questions from the graded questions]
 New clinical info [treatment and/or guidelines] released in the last 10 months
won’t be on the exam
 Questions will be on primary care disorders – if you are guessing, AVOID PICKING
EXOTIC
DIAGNOSIS AS AN ANSWER


Labs
 Normal lab results pertinent to a question WILL ONLY BE LISTED ONCE. Use your
scratch sheet of paper to jot down these values if given.
 Follow the LAB NORMS GIVEN BY AANP not what you learned in NP school
 Learn the significance of abnormal lab values AND type of follow-up needed
[i.e. elderly gentleman with c/o scalp tenderness + indurated temporal
artery, NP suspects temporal arteritis. Screening test is sed rate – which is
expected to be MUCH HIGHER than normal value]


Good to Know
 Expect one question related to dental injury [i.e. completely avulsed permanent
tooth should be reimplanted ASAP! It can be transported to dentist in cold milk
(not frozen milk)
 May be a question on epidemiologic terms (i.e. sensitivity is defined as the ability
of a test to detect a person who has the disease. Specificity is defined as the
ability of a test to detect a person who is healthy or detect the person without
the disease)
 Learn definition of some research study designs: cohort follows a group of
people who share some common characteristics to observe the
development of a disease over time – Framingham nurses health study
 Emergent conditions that will present in primary care clinics will be on the
exam: navicular fracture, MI, cauda equina syndrome, anaphylaxis,
angioedema, meningococcal meningitis
 Know some anatomic areas: trauma to Kiesselbach’s plexus = anterior nosebleed
 Some questions ask about “gold-standard test” or the “diagnostic test for the
condition”: sickle cell anemia, G6PD anemia, and alpha/beta thalassemia =
hgb electrophoresis
 Disease states are usually presented in their “full-blown classic” textbook
presentation: acute mononucleosis, teen will have classic triad of sore throat,
prolonged fatigue, and enlarged cervical nodes. If patient is older with same
signs/symptoms, it is still mononucleosis reactivated type

, Ethic background may provide clues to disease: alpha thal = southeast Asia /
Filipinos; beta thal = Mediterranean
 NO ASYMPTOMATIC or BORDERLINE CASES OF DISEASE STATES WILL BE ON THE
EXAM: IDA in “real life” don’t present often with pica or spoon-shaped nails, on
the exam they will have these clinical findings
 Be familiar with lupus and SLE: malar rash (butterfly) = lupus. Instruct
patient to avoid / minimize sun exposure r/t photosensitivity.
 Be familiar with polymyalgia rheumatica (PRM): 1st line tx is long-term steroids.
Long-term, low-dose steroids are commonly used to control symptoms (pain,
severe stiffness in shoulders
/ hip girdle). PMR patients are at HIGH RISK FOR TEMPORAL ARTERITIS.

,  Gold standard exam for temporal arteritis: biopsy + refer patient to optho for
management.
 Learn the disorders for which maneuvers are used and what a positive report means:
o Finkelstein’s test—positive in De Quervain’s tenosynovitis
o Anterior drawer maneuver and Lachman maneuver—positive if
anterior cruciate ligament (ACL) of the knee is damaged. The knee
may also be unstable.
o McMurray’s sign—positive in meniscus injuries of the knee
 Conditions that NEED a radiologic test: damaged joints – order Xray 1st (but MRI
is the gold standard)
 Abnormal eye findings in DM (diabetic retinopathy) and HTN (hypertensive
retinopathy)
should be MEMORIZED and learn to distinguish each one:
o Diabetic retinopathy = neovascularization, cotton wool spots,
microaneurysms
o Hypertensive retinopathy = AV nicking, silver and/or copper wire arterioles
 Become knowledgeable about physical exam “normal” and “abnormal” findings:
o Checking DTRs in patient w/severe sciatica or diabetic peripheral
neuropathy: ankle jerk reflex (Achilles reflex) may be absent or hypoactive.
Scoring absent (0), hypoactive (1), normal (2), hyperactive (3), and clonus
(4).
 ONLY A FEW QUESTIONS WILL BE ON BENIGN or PHYSIOLOGIC VARIANTS: benign S4
heart sounds may be auscultated in some elderly pt. Torus palantinus and fishtail
uvula may be seen during the oral exam in a few patients.
 If the question is asking for the initial or screening lab test, it will probably be a
“cheap” and
readily available test: CBC (complete blood count (CBC) to screen for anemia
 There are some questions on theories and conceptual models: Stages of change
or “decision” theory (Prochaska) includes concepts such as precontemplation,
contemplation, preparation, action, and maintenance.
 Other health theorists who have been included on the exams in the past are (not
inclusive):
o Alfred Bandura (self-efficacy), Erik Erikson, Sigmund Freud, Elisabeth
Kübler-Ross (grieving), and others
o If a small child expresses a desire to marry a parent of the opposite sex: the child
is in the oedipal stage (Freud). Child’s age is about 5 to 6 years (preschool
to kindergarten).
o Starting at the age of about 11 years, most children can understand
abstract concepts (early abstract thinking) and are better at logical
thinking.
o When performing the Mini-Mental State Exam, when the NP is asking about
“proverbs,” the nurse is assessing the patient’s ability to understand
abstract concepts.
 Keep these good communication rules in mind: Ask open-ended questions, do not
reassure patients, avoid angering the patient, and respect the patient’s culture.
 There may be two to three questions relating to abuse: child abuse, domestic
abuse, elderly abuse


Antibiotics & Medications
 Know the difference between 1st and 2nd line abx: AOM in 7 yr old treated with
amoxicillin returns in 48hr without improvement (continued ear pain, bulging
TM). Next step is to d/c amox and start child on 2nd line abx Augmentin BID x10
days

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