ANCC FNP BOARD EXAM STUDY GUIDE PART 1 2023-2024
100 QUESTIONS WITH VERIFIED SOLUTIONS GRADED A+
1. Treatment for chronic bronchitis: -Chronic bronchitis is a type of COPD that is
characterized by inflammation of the bronchi, causing excess mucus; characteristics of chronic
bronchitis include diagnosis after age 35, obesity, copious amounts of purulent sputum,
elevated Hct level
-Treat with SABA (albuterol), inhaled anticholinergics (ipratropium)
-Normal Findings of Lungs: Lower lobes vesicular breath sounds (soft and low) Upper lobes;
Bronchial breath sounds louder
2. Actinic keratosis: -Older to elderly fair-skinned adults
-numerous dry, round, pink to red-colored, slow-growing lesions that do not heal
-lesions common on sun-exposed areas (cheeks, nose, face, arms, back)
-precancerous precursor of squamous cell carcinoma
-frequent sunburns as child places person at higher risk
-diagnosed with biopsy
-treat with cryotherapy (small number) or 5-FU(5% fluorouracil) cream (large num- ber)
follow up with derm.
3. Seborrheic keratosis: -soft, round, wart-like fleshy growths on trunk (mostly on back)
-can range in color from light tan to black
-appear to be pasted on
-asymptomatic
-benign
4. Fingernail hematoma treatment: -Trephination - make hole in nail through
,ANCC FNP BOARD EXAM STUDY GUIDE PART 1 2023-2024
100 QUESTIONS WITH VERIFIED SOLUTIONS GRADED A+
drilling or piercing and allow blood to drain
5. Hypothyroid: -Primary - elevated TSH; low T4; low or normal T3
-Subclinical - elevated TSH; normal T4; normal T3
-Common cause is Hashimoto's (autoimmune) - Hashimoto and Hypo both have O
-Symptoms are variable - may include fatigue
-Treatment - levothyroxine (Synthroid) daily in AM on empty stomach
-Starting dose of levothyroxine (Synthroid) is 25-50mcg
-Check TSH every 6-8 weeks to monitor treatment
6. Hyperthyroid: -Primary - low TSH; high T4; normal or high T3
-Subclinical - low TSH; normal T4; normal T3
-Most common cause is Grave's Disease (autoimmune) - Grave and Hyper both have R
-Common symptoms - female; rapid weight loss; increased heart rate; tremors; sweating;
irritability; anxiety; hyperactivity; insomnia; diarrhea; amenorrhea; hyper- tension;
exophthalmos; heat intolerance; goiter
-Treatment - Propylthiouracil (PTU); Methimazole (Tapazole); Radioactive iodine
,ANCC FNP BOARD EXAM STUDY GUIDE PART 1 2023-2024
100 QUESTIONS WITH VERIFIED SOLUTIONS GRADED A+
(causes hypothyroid for life, contraindicated in pregnancy)
-Thyroid Storm (thyrotoxicosis) - acute worsening of symptoms; may be caused by stress or
infection; look for LOC, fever, abdominal pain; life-threatening; immediate hospitalization
needed
7. Increased risk of ectopic pregnancy: -Risk factors - previous ectopic, salpingi- tis,
tubal surgery, current IUD use, previous cervicitis, history of PID
-Symptoms - abdominal pain (worsens when supine or with jarring), vaginal bleed- ing,
amenorrhea, low grade fever, pain referred to right shoulder (may indicate rupture)
8. Hypertension Meds Part 1: -African-American with or without diabetes - initial
choices include thiazide diuretic or CCB
-Non-Black with or without diabetes - initial choices include thiazide diuretic, CCB, ACE, or
ARB
-Thiazide diuretic - "ide"; excellent synergist; avoid in sulfa allergy; favorable in
osteopenia/osteoporosis; side effects include hyperglycemia (caution in diabetics),
hyperuricemia (gout attack), hypertriglyceridemia and hypercholesteremia (check lipid profile)
hypokalemia (potentiates digoxin toxicity and increases risk for arrhyth- mia), hyponatremia
(hold diuretic, restrict fluid, replace K+); lowers BP only 2-8 points
-ACE inhibitor - "pril" and ARB - "sartan" - use in high renin states; drug of choice in diabetics
(protects kidneys); pregnancy category C/D; side effects include dry/hack- ing cough (more with
ACE), hyperkalemia, angioedema (rare, life-threatening); contraindicated in moderate to
, ANCC FNP BOARD EXAM STUDY GUIDE PART 1 2023-2024
100 QUESTIONS WITH VERIFIED SOLUTIONS GRADED A+
severe kidney disease; do not use ACE and ARB together.
9. Hypertension Meds Part 2: -Beta blocker - "lol"; good as add-on medication, not
uncomplicated HTN; avoid abrupt discontinuation, wean slowly to avoid rebound HTN;
contraindications include asthma, COPD, chronic bronchitis, emphysema, second and third-
degree heart block (okay with 1st degree), sinus bradycardia; do not use Propranolol for HTN
-Calcium channel blocker - "pine"; first choice for ISH (isolated systolic HTN); side effects
include headaches (vasodilation), ankle edema (vasodilation, benign), heart block/bradycardia
(depresses cardiac muscle and AV node), reflex tachycardia (nifedipine); contraindicated in
2nd and 3rd degree heart block, bradycardia, CHF
10. Hypertension Meds Part 3: -Heart Failure: ACEI or ARB as first-line, plus BB, plus
diuretic
-DM: ACE/ARB first line, IF African American, can start with CCB or Thiazide
-CKD: ACE/ARB first line, can add CCB or Thiazide
-Stroke Hx: ACE/ARB first line, add CCb or Thiazide as second-line drugs.
-African American even with DM Thiazides and CCBs.
