2024 FNP LEIK SYSTEM REVIEW
EXAM WITH 1,000 TERMS AND
ANSWERS
Specificity - CORRECT-ANSWERS(SPIN) Positive results rules in the disease.
Which anti-HTN med would be avoided in a pt with emphysema? - CORRECT-
ANSWERSbeta-blockers
Sensitivity - CORRECT-ANSWERS(SNOUT) Negative results rules out the
disease.
What is the 1st line tx for essential tremor? - CORRECT-ANSWERSPropanolol
What is the Cullen's sign? - CORRECT-ANSWERSA bluish discoloration or
bruising that is located on the umbilical area. It's a sign of severe
pancreatitis.
What is the Grey-Turner sign? - CORRECT-ANSWERSbluish discoloration on
the flank area (think...turner/side/flank). It's a sign of severe pancreatitis.
For a compound fracture that has broken through the skin, what treatment
plan is necessary? - CORRECT-ANSWERS- surgical repair
- tetanus vaccine
- systemic abx
American Academy of Pediatrics recommends what vitamin within the first
few days of life? - CORRECT-ANSWERSvitamin D
Drug(s) of choice to treat OCD? - CORRECT-ANSWERSSSRIs (paxil, zoloft,
prozac)
Which anti-HTN med has beneficial effects for an elderly white female w
osteoporosis? - CORRECT-ANSWERScalcium channel blocker (keeps more
calcium in the bones)
What is Phren's sign? - CORRECT-ANSWERSrelief of pain with scrotal
elevation
,A ____ relationship is a formal process of sharing responsibility for treating a
pt together (sharing a progress report); for example, referring a pt to a
specialist or for rehab - CORRECT-ANSWERScollaborative
Employee health protocols for needlesticks recommend ordering a ____ test
as soon as possible to establish baseline bloodwork for the employee -
CORRECT-ANSWERSELISA
A ___ relationship is an informal process btw 2 or more providers who
exchange info about a pt occasionally. Ex: a new NP asks an experienced NP
a question about a complicated pt in their clinic. - CORRECT-
ANSWERSConsultative
According to HIPAA, do pts have a right to view their mental health and
psychotherapy-related health information? - CORRECT-ANSWERSNo. Mental
health records do not have to be released to pts, even if they request them.
Medicare Part B covers: - CORRECT-ANSWERS- outpt physician visits, labs, x-
rays
- durable medical equipment
- mammograms/colonoscopy after age 50 and annually
- rehab
The earliest age an MMR can be administered is: - CORRECT-ANSWERS12
months
Licensure for a NP... - CORRECT-ANSWERS- ensures a minimum level of
professional competency
- grants permission for an individual to practice in a profession
- requires verification of educational training from an accredited graduate
program
Primary Prevention - CORRECT-ANSWERSPrevent the disease in its entirety.
Examples include healthy diet, exercise, safety (helmets/seatbelts),
immunizations, and job safety
Secondary Prevention - CORRECT-ANSWERSEarly detection of a disease.
Examples include screening tests
Tertiary Prevention - CORRECT-ANSWERSRehabilitation of a disease.
Examples include support groups, education for pts with pre-existing
disease, drug side effect safety, medical equipment safety, any type of rehab
like PT or OT
,Breast Cancer Screening Guidelines (USPSTF) - CORRECT-ANSWERSOnset =
50yo. Biannual. Stop at age 74yo. No SBE.
Breast Cancer Screening Guidelines (ACA) - CORRECT-ANSWERSOnset =
40yo. Annual. No stop age.
Cervical cancer screening guidelines - CORRECT-ANSWERSOnset=21yo
(immunocompromised individuals start at onset of sexual activity). Every 3
years Pap w/ no HPV test until 30yo. Pap and HPV test after 30 yo and can
begin screening every 5 years. Stop at age 65yo. Complete hysterectomy
means no Pap unless pt has history of cervical cancer or high grade lesion.
Colorectal cancer - CORRECT-ANSWERSOnset 50yo. 1) colonoscopy q 10
years if wnl, 2) sigmoidoscopy q 5 years if wnl, 3) annual FOBT with 3 stool
samples. Stop age 75 yo.
Prostate cancer - CORRECT-ANSWERSUSPSTF does not recommend
screening with PSA but it based on individual pt.
Lipid screening - CORRECT-ANSWERSOnset 18-35/45yo screen if at increased
risk of heart disease. Males >35yo and Females >45yo
Flu vaccine - CORRECT-ANSWERSLAIV - Live virus can only be given to
healthy non-pregnant 2 -49 yo w/o recent hx of asthma (Peds). Cautioned or
C/I in pts with egg, gentamicin or gelatin allergy and kids receiving aspirin
therapy (Reye's syndrome). TIV (trivalent inactivated vaccine) is approved
for >6months.
Tetanus vaccine - CORRECT-ANSWERSQ 10 years. Booster for dirty wounds if
last TDAP/Td is > 5 years old. >7yo receive Td/TDAP. Avoid in egg allergy
and Gullian Barre. 5 doses of DTAP aka Pediarix (2,4,6,15 months and 5 yo)
First TDAP is at age 11-12yo. Td is the booster every 10 years or if someone
has never had TDAP (came out in 2005) then they should have a one time
dose of TDAP and then continue with Td boosters.
Pneumococcal vaccine - CORRECT-ANSWERSPCV 23 given one time at age
65 yo in healthy adults and for persons who are 2 years and older and at
high risk for pneumococcal disease (e.g., those with sickle cell disease, HIV
infection, or other immunocompromising conditions). PPSV23 is also
recommended for use in adults 19 through 64 years of age who smoke
cigarettes or who have asthma. One time booster given 5 years after first
dose (So non-healthy pts will receive 2 doses of PSV23 over their lifetime).
PCV 13 is for <5 yo. When both PCV13 and PPSV23 are indicated, PCV13
should be administered first; PCV13 and PPSV23 should not be administered
during the same visit. When indicated, PCV13 and PPSV23 should be
, administered to adults whose pneumococcal vaccination history is
incomplete or unknown.
Varicella Vaccine - CORRECT-ANSWERS60 yo. May be given to pts who have
previously had shingles. May be given earlier at age 50yo. Live virus so c/I
include pregnancy and immunocompromised.
Herpes Keratitis - CORRECT-ANSWERSInflammation of the cornea. C/O abrupt
severe eye pain, photophobia and blurred vision. Diagnose with fluorescein
dye and black lamp. Look for fernlike lines (corneal abrasions appear more
linear). Infection permanently damages corneal epithelium which may result
in blindness.
Acute angle closure - CORRECT-ANSWERSGlaucoma (Increased ICP r/t
blocked drainage duct). Elderly pt c/o abrupt onset of severe eye pain, HA,
N/V, halos around eyes, and decreased vision. Exam reveals mid-dilated
pupil that is oval shaped, cloudy cornea, and fundoscopic exam shows
cupping of the optic nerve. Tx = keep pt supine, trx to ED for acetazolamide,
B blockers, and topical steroids. Sx may be required
Cholesteatoma - CORRECT-ANSWERSCauliflower like growth in the middle
ear. Pt c/o foul smelling discharge and hearing loss. On exam, no TM or
ossicles visible. PMhx of chronic OM. The mass is not cancerous but it can
erode in to the bones of the face and damage CN7. Tx = ENT referral for sx,
abx. Mass is usually made of epithelium and cholesterol. AKA pearl tumor.
Battle's sign - CORRECT-ANSWERSBruise behind the ear over the mastoid
process. Hx of trauma, and indicates a fracture of the basilar skull. Golden
serous discharge from ear or nose. Refer to ED for abx and imaging (CSF will
be + for glucose. Mucous will be - for glucose).
Cavernous sinus thrombosis - CORRECT-ANSWERSBlood clot in w/I cavernous
sinus. This cavity houses internal carotid artery and CN III, IV, V and VI).
PmHx of sinus or facial infection. Pt c/o severe HA, high fever, decreased
LOC, unilateral periorbital edema, photophobia, proptosis and inability to
move eye appropriately.
Peritonsillar abcess - CORRECT-ANSWERSPt c/o severe sore throat, difficult
and painful swallowing (odonophagia) and LOCKJAW (trimus), and a hot
potato voice. Unilateral swelling peritonsillar area and soft palate with
displaced uvula. Tx = I&D in ED or needle aspiration
Diptheria - CORRECT-ANSWERSBull neck, dysphagia, and gray/yellow
psuedomembrane that is not to displace (stuff is like concrete) and may
obstruct airway