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AANP FNP CERTIFICATION EXAM NEWEST
VERSION 202 5 - 2026 WITH CORRECT DETAILED
ANSWERS GRADED A+
3 month old infant with down syndrome, due to milk intolerance, mom started on goats milk; now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would you order? - correct answer>>Iron, TIBC 3 months of synthroid, TSH increased, T4 normal, what do you do? - correct answer>>Increase Medication 3 ways to assess cognitive function in patient with signs/symptoms of memory loss - correct answer>>Mini mental exam 4 month old with strabismus, mom is worried...... - correct answer>>tell her it is normal. 4 month old wont keep anything down, what is the main thing you look at? - correct answer>>Growth chart 6 month old closed anterior fontanel. - correct answer>>XRAY Abnormal cells on PAP, what do you do next? - correct answer>>Refer for Colposcopy CAGE ACRONYM - correct answer>>Cut down Annoyed by criticism Guilty about drinking Eye opener drink Causes of tachycardia - correct answer>>Fever Anemia Hypotension Cranial nerves responsible for extraocular eye movements - correct answer>>CN 3,4, Definition of metabolic syndrome - correct answer>>cluster of conditions that increase risk of heart disease, stroke, diabetes. diagnose trichomoniasis - correct answer>>wet prep
Elderly presents with atrophic vaginitis, small uterus, palpable 4x5 ovary, what do you do next? - correct answer>>Pelvic US Epistaxis is most common in the area of the nose known as kiesselbachs triangle, where is this located? - correct answer>>Anterior septum Definitive diagnosis of acute bacterial prostatitis - correct answer>>urinalysis and culture GERD treatment - correct answer>>H2 is first line, give hs Grade 3 cells on Pap, treatment? - correct answer>>LEEP excision Fingernail hematoma treatment? - correct answer>>drill hole and drain blood? Increased risk of ectopic pregnancy - correct answer>>Salpingitis, or history of abortion, PID, Koplick spots - correct answer>>Measles (rubeola). Grains of salt lesions inside mouth in Measles Koplick spots - correct answer>>Measles (rubeola). Grains of salt lesions inside mouth in Measles Legg-Calve-Perthes Disease - correct answer>>Avascular necrosis of the proximal femoral head Lipid level of 1500, increased risk for? - correct answer>>Pancreatitis Low HGB, Low HCT, High MCV indicates what? - correct answer>>Macrocytic anemia, B12 Def Man with BPH, prostate feels on digital exam? - correct answer>>Enlarged, symmetrical, smooth Man with HTN, CAD, present femoral pulses but absent pedal - correct answer>>Arterial Insufficiency McMurray's Sign
Quick assessment of patients fall risk? Timed Get up and Go - correct answer>>Timed Get up and Go Red beefy tongue? - correct answer>>pernicious anemia Rotator cuff injury presentation - correct answer>>disturbs sleep, arm weakness, dull ache Shingles near eye - correct answer>>immediate referral to ophthalmology Signs and symptoms of Roseola (6ths disease)? - correct answer>>Viral infection Can result in a maculopapular rash, but up to 70% of cases proceed without the rash stage
- Usually accompanied by a high fever (41°C or 105°F) that comes on quickly and lasts up to 3 days followed by rash
- Seizures may occur during this period.
- On the fourth day, the fever disappears and the rash appears, first on chest and trunk, then less prominently on the face and limbs.
- High fever, pink flat or raised rash Treatment for chronic alcoholism: - correct answer>>12 step program Treatment for Gonorrhea? - correct answer>>Rocephin 250mg IMx1 plus Azithromycin 1 gm orally x1 to cover chlamydia. , or doxy 100 mg BID x7d. Green colored vaginal discharge, friable cervix. EXAM Report to health department Young female want birth control, forgets to take pills, does not want to get pregnant for at least 5 years: - correct answer>>IUD Basal cell cancer - correct answer>>Waxy, pearly, telangiectasia, ulcer center lesion
- most common type of skin cancer caused by UV exposure. Metastatic is rare Actinic Keratosis - correct answer>>Scaly red to yellow located in sun exposed area
- a precancerous skin growth that occurs on sun-damaged skin Actinic Keratosis - correct answer>>Numerous round dry pink to red areas. Scaly red to yellow located in sun exposed area
- a pre squamous cell carcinoma occurs on sun-damaged skin biopsy
cryo or 5fu cream subungual hematoma tx - correct answer>>Make a hole and drain the blood Moderate acne treatment - correct answer>>Without inflammation: Topical retinoid Moderate inflammation: Topical Retinoid or benzoyl peroxide or Azaleic acic ( very expensive and hard to get covered) PLUS ADD Oral antibiotics: doxycycline or tetracycline or minocycline- (tetracyclines has been proven most affective for inflammatory acne) Minocycline- long term use has been linked with pseudotumor cerebri Oral contraceptives for hormone related Spironolactone heart murmur with holosystolic or pan systolic Heart mumur with mid systolic - correct answer>>MR - radiate axilla, 5th ICS MCL, apex, AS - radiate neck, 2ICS right sternal border MR ASSH Coarctation of Aorta - correct answer>>COA: bounding radial and weak femoral pulse increase blood pressure in arms, and lower pressure in lower legs.
- congenital cardiac condition characterized by a narrowing of the aorta
Murmur Grade III - VI - correct answer>>Loud murmur easily heard JVD caused by - correct answer>>-tension pneumothorax,
- Rt. sided heart failure,
- cardiac tamponade,
- traumatic axphysia from Increase in portal pressure(LIVER) in venous side or cor pulmonale
headache after trauma - correct answer>>SDH migraine headache - correct answer>>-paroxysmal (sudden, periodic) attacks of mostly unilateral headache, often accompanied by disordered vision, nausea, or vomiting, lasting hours or days and caused by dilation of arteries. 4 - 12 hours, abortive triptans prophylaxis propranolol, TCA amitriptyline, anticonvulsants topiramate Vitamin B12 - correct answer>>Folate shares a close relationship with this other B Vitamin. Vitamin B12 - correct answer>>Cognitive deficits, glossitis, pernicious anemia, Folate shares a close relationship with this other B Vitamin. 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. - correct answer>>be changed to NSAID, SED rate is a sign of inflammation Which medication causes low sperm count for a patient - correct answer>>SSRI grandiosity - correct answer>>Exaggerated belief in or claims about one's importance or identity. Bipolor ADHD - correct answer>>A behavioral problem characterized by short attention span, restless movement, and impaired learning capacity. 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? - correct answer>>HPV test if not done. Refer for colposcopy Chlamydia trachomatis - correct answer>>Doxycycline (+ ceftriaxone for gonorrhea coinfection) Genital warts treatment - correct answer>>Cryotherapy
OR
Podophyllotoxin cream - OR Imiquimod (Aldara cream) HIV pt. with antiviral and CD4 count still less than 200. What should NP tell the pt. - correct answer>>tell the pt. that he is qualified to be diagnosed with AIDS according to CDC Most common cause of death in children - correct answer>>motor vehicle Tanner 2 - correct answer>>Tanner 2- female breast bud areola develops Male testes scrotum start to enlarge, scrotum gets darker Tanner 4 - correct answer>>Tanner 4- female nipples and areola become elevated from breast, secondary mound Male penis grows wider grows in length, darker scrotum pt. expericieng memory loss, and increase in confusion and she has a history of stroke, HTN, What type of Alzheimer. - correct answer>>vascular dementia presbycusis - correct answer>>a gradual loss of sensorineural hearing that occurs as the body ages a pregnant female at slightly above symphysis pubic and Fundal height is 32cm (above the umbilical). What should be done - correct answer>>Ultrasound Romberg test - correct answer>>cerebellar
- ask client to stand with feet at comfortable distance apart, arms at sides, and eyes closed
- expected finding: client should be able to stand with minimal swaying for at least 5 seconds Direct Coombs test - correct answer>>r/o bilirubin preeclampsia treatment - correct answer>>bed rest, laying on her side Molluscum contagiosum treatment - correct answer>>Currettage, liquid nitrogen pyloric stenosis - correct answer>>non bilious vomiting, olive like firm mass palpated on right upper quadrant
LOW TSH= Hyperthyroidism- BONE DEMINERALIZATION. NEED CALCIUM for BONE GROWTH Carotid bruit - correct answer>>abnormal flow of blood through the carotid artery Carotid bruit - correct answer>>abnormal flow of blood through the carotid artery due to atherosclerotic disease Common causes of GERD - correct answer>>risk factors- alcohol, anticholinergic, CCB, chocolate peppermint, fatty, spicy, citrus foods, hormones, obesity, pregnancy, smoking, theophylline, exacerbated by CCB verapamil Common causes of GERD - correct answer>>risk factors- alcohol, anticholinergic, CCB, BB chocolate peppermint, fatty, spicy, citrus foods, hormones, obesity, pregnancy, smoking, theophylline Zeprexa. What lab and intervention to put in place - correct answer>>CAUSES ELEVATED LIPDS, GLUCOSE, WEIGHT monitor CBC for low WBC weight- BMI q 3m b/p, mental status, lips, prolactin, glucose Weber test - correct answer>>Sensorineural loss Weber test(top of head) no laterization, normal finding, does not lateralize to either ear, bilateral hearing loss, if hear better in left ear, right sensorineural loss Weber test - correct answer>>Sensorineural loss Weber test (top of head) no laterization- normal, does not lateralize to either ear- bilateral hearing loss, if hear better in left ear, right sensorineural loss. SUN- sensorial lateralize unaffected ear CAFFE- Conductive lateralize to affected ear Assessment on patient with ascites - correct answer>>Dullness
Assessment on patient with ascites - correct answer>>Dullness to percussion Varus Stress Test - correct answer>>application of a lateral force to the medial aspect of a joint in an attempt to create a gap in the lateral joint line, thereby testing the stability of the lateral aspect of the joint LCL Varus Stress Test - correct answer>>TEST LCL (lateral-vaRus) McMurrays- Meniscus CLICK application of a lateral force to the medial aspect of a joint in an attempt to create a gap in the lateral joint line, thereby testing the stability of the lateral aspect of the joint LCL German Measles (Rubella) - correct answer>>Pink, papular rash (similar to measles but paler) first appears on face, then spreads. Distinguished from measles by presence of neck lymphadenopathy and absence of Koplik spots. patient with IOP of 32mmHg, what do you expect during fundoscopic exam - correct answer>> patient with IOP of 32mmHg, what do you expect during fundoscopic exam - correct answer>>increase cup-to-disc ratio retinal hemorrhage optic nerve asymmetry and pallor measured w tonometry BPH and urge incontinence - correct answer>>anticholinergics/oxybutynin, impamine/tricyclic/antidepressant Anticholinergic- can't think or blink, can't see (Increase eye pressure) or pee, can't spit or shit, SADCCUB sedation, anorexia, dry mouth confusion, constipation, urinary retention, BPH BPH and urge incontinence - correct answer>>TX anticholinergics/oxybutynin, impamine/tricyclic antidepressant seasonal affective disorder (SAD) - correct answer>>a mood disorder caused by the body's reaction to low levels of sunlight in the winter months
BONE DENSITY >2.
Retinoblastoma - correct answer>>white reflection in child's pupil for staph aureus infection (skin) with pus - correct answer>>MRSA- TX Bactrim or tetracyclines? hyperparathyroidism - correct answer>>high calcium Hyperthyroidism treatment - correct answer>>methimazole, PTU-propylthiouracil (preferred in pregnancy) Radioactive iodine, Beta blockers Mammography Screening - correct answer>>-Age 45 - 54 yearly mammogram
- 55 and older every 2 years Fifth's Disease (Erythema Infectiosum) - correct answer>>B19: lytic infection, respiratory transmission Sx: flushed rash/fever in kids Px: fever, get better in a week pt has AOM but has hives on Amoxicillin and N/V with erythromycin, what meds to give
- correct answer>>TREATMENT: Amoxicillin (first line), then Augmentin, Omnicef, Ceftin, Levaquin. If your patient is only PCN allergic do azithromycin or clarithromycin. chlamydia in pregnancy - correct answer>>Azithromycin 1 gm PO x1 or Amoxicillin 500 mg PO TID x7d. Test of cure 3 weeks after completion of treatment (PREGO). EXAM papilledema - correct answer>>optic disc swollen w/ blurred edges due to increased ICP EXAM actinic keratoses - correct answer>>Precursor to squamous cell carcinoma. "numerous dry round and pink to red lesions" with a rough and scaly texture. Does not heal. Slow growing in sun exposed areas. Diagnosis: BIOPSY Golden Standard. Treatment: Sm. (cryotherapy), Lrg. (5-FU cream)- which causes ur skin to ooze, crust, scab, redness EXAM Allergic Conjunctivitis - correct answer>>"stringy; increased tearing" PO antihistamines. Type I sensitivity. Typically bilateral. Rhinitis and allergic shiner.
COPD - correct answer>>COPD- Gold 1- 2 - SABA or SAMA ON EXAM.BASCIALLY ANTICHOLINERGIC FIRST LINE FOR COPD ON EXAM Gold 1-2 that are poor controlled- LAMA or LABA. May use SABA for rescue. Gold 3-4 LAMA first line. If poor use LAMA plus LABA. Alternative is LABA + ICS. Gold 3- 4 - refer SABA- Albuterol, levoalbuterol (terol) LABA- Formeterol, salmeterol (Terol) SAMA- Atrovent Ipatropium (tropium) LAMA- Spiriva Tiotroium (tropium) COPD long term is OXYGEN CN IX Glossopharyngeal - correct answer>>- Shoulder shrug/ ROMBERG test EXAM CN V Trigeminal - correct answer>>Herpes. CORNEAL ABRASION. EXAM CN VIII Vestibulocochlear - correct answer>>ears 8 EXAM CN VII Facial - correct answer>>BELLS EXAM ACEI contraindicated - correct answer>>pregnancy Safe to give varicella/MMR - correct answer>>Do not give <12 mo. EXAM QUESTION Acne Vulgaris - correct answer>>common acne. Retin-A, acne worsens 4-6 weeks if no improvement in 8-12 weeks increase dose or add erythromycin, benzoyl peroxide. Acne Rosacea - correct answer>>- chronic small acne like papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. Clindamycin. EXAM Cataracts - correct answer>>is on EXAM in elderly night vision issues. Opaque Kawasaki disease - correct answer>>- acute high fever, enlarged lymph. BRIGHT RED RASH, conjunctivitis, dry cracked lips, strawberry tongue, Swollen hands, feet, AFTER the fever resides the rash PEELS on hands/feet. Treated with high dose aspirin and gamma globulin. This is TOXIC and VASCULAR, think blood clots, heart problems etc. Treat: high dose aspirin. EXAM Erythema migrans - correct answer>>Erythema Migraines- (stage 1 Lyme) Target bulls- eye, usually appears in 7-14 days POST bitten tick. Rash is hot to touch with rough
Psoriasis - correct answer>>Psoriasis- Inherited. Pruritic erythematous plaques, fine silvery-white scales with pitted fingernails. Scalp, elbows, knees, sacrum, intergluteal folds. (Koebner phenomenon- new psoriatic plaques form over skin trauma) (Auspitz sign- pinpoint bleeding when plaques are removed). TREATMENT: Topical steroids, Tar preps (mild). For (severe) do anti-TNF, or immunologic. D Dacrocystitis - correct answer>>Darcryotosis lacrimal sac, rub down towards mouth. If think secondary infection abx. EXAM how it presents. Acne Rosacea - correct answer>>Acne Rosacea- chronic small acne like papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. EXAM Parathyroid hormone - correct answer>>PTH is responsible for calcium loss or gain from bones, kidneys, and GI tract. EXAM Diabetic Retinopathy - correct answer>>Diabetic Retinopathy-Cotton wool spots (moderate retinopathy), micro-aneurysms. ALSO RETINAL HEMORRHAGES ON CENTER OF EYE APPEAR ORANGE RED HTN Retinopathy - correct answer>>Hypertensive Retinopathy- Copper/silver wire arterioles. AV nicking(mild retinopathy). Retinal Hemorrhages. EXAM Wilms Tumor - correct answer>>Wilms tumor (Nephroblastoma)- Not painful. Asymptomatic abd mass does NOT cross the midline. 2-3 y. o.d. do not palpate. Do ABD US. PUNT. Think Nephro doesn't cross. Stays where kidney is. EXAM Primary Amenorrhea - correct answer>>Primary amenorrhea: NO menarche by 15 y. with or w/o secondary sex characteristics. Aphthous stomatitis - correct answer>>Cancer sores. Aphthous stomatitis: painful shallow ulcers heal 7-10 days. Magic mouthwash. Temporal arteritis - correct answer>>Temporal arteritis- one temple indurated cord like gold stand. Biopsy. Abrupt visual changes blindness, inc. ESR. CPR. Most have POLYMYALGIA RHEUMATICA. Treat high dose steroids.
Atopic Dermatitis (eczema) - correct answer>>Inherited. Extremely itchy. On flexural folds, neck, hands. Inc. IgE. "small vesicles that rupture leaving painful, bright-red, weepy lesions" they become lichenified from itching. First line: Topical steroids. Avoid hot water/soaps. PO antihistamines. EXAM Tinea Corporis - correct answer>>ring like itchy rash, slowly enlarge central clearing"- Treatment: most respond to topical antifungals, if severe do oral Lamisil. EXAM AZOLE ending Cellulitis - correct answer>>Deep dermis poor demarcated low legs. EXAM/ MULTIPLE QUESTIONS. DVT RISK, DM WITH CELLULITIS WATCH FOR OSTEOMYLITIS. Erysipelas - correct answer>>Group A strep, painful, Upper dermis, clear demarcated, cheeks, shins. TREATMENT- Dicloxacillin QID x10d. Cephalexin, Clinda. PCN ALLERGY? Do Azithro x5d. MRSA TREATMENT: Bactrim, doxy, mino, clinda. If sulfa allergy do not use Bactrim. Varicella Zoster - correct answer>>"contagious 48 h. before, until all lesions crusted over" low grade fever, generalized lymphadenopathy, intense itching, erythematous macules, papules develop over macules, then vesicles erupt. "initially on trunk, then scalp and face" TREATMENT supportive, antihistamines, acyclovir 20mg/kg 5xd. If given first 24 hours works best. EXAM Impetigo - correct answer>>Impetigo-Gram positive. Itchy pink-red lesions, evolve into vesiculopustules that rupture. If bullous-large blisters. Severe- Keflex, dicloxacillin. PCN Allergic-Azithro, clinda. If NO BULLAE- Bactroban. EXAM Scarlet fever- scarlantina - correct answer>>"sandpaper textured-pink rash with sore throat" strawberry tongue, rash starts on head and neck, spreads to trunk. The skin THEN desquamates. EXAM Lichen planus - correct answer>>LICHEN PLANUS: SMALL FLAT TOPPED, RED TO PURPLE BUMPS THAT MAY HAVE WHITE SCALES/FLAKES.. WHISPY GREY WHITE STREAKS CALLED WICHHAMS STRIAE. INNER WRISTS FOREARMS, AND ANKLES. IF ON SCALP CAUSE HAIR LOSS. Causes hep C, medications, contact with chemicals. EXAM Spider bite - correct answer>>fever chills, n/v, located arms, upper legs, or the trunk. Biten area becomes swollen, red, and tender, and blisters appear within 24-48 hours. Necrotic in center, which kills the tissue. Ice packs to wound and cold inactivates the toxin, tx like cellulitis of the skin, abx ointment at first, watch etc. Exam
MR. ASS - correct answer>>(Systolic Murmur) Only systolic murmurs will radiate to a location on the exam. Mitral Regurg - correct answer>>(Holo/pansystolic)- radiates to axilla. Think Mitral area 5th ics MCL. Aortic Stenosis (mid systolic ejection) radiates to neck. Think 2ics rsb. All diastolic murmurs are pathological. Grades Murmurs - correct answer>>I-barely II- audible III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM MVP - correct answer>>MVP- S2 click, followed by systolic murmur. Asymptomatic. MVP with palpitations is treated with BB. LATE SYSTOLIC. S3- HF, S4-LVH stiffening, - correct answer>>S3- HF, Kentucky, early diastole. Abn >35. Bell EXAM S4-LVH stiffening, Tennesse, late diastole. "Atrial kick/gallop" EXAM Isolated Systolic HTN - correct answer>>CCB PAD/ PVD - correct answer>>PAD/ PVD (same)- Nocturnal pain relieved by lowering legs, poor pulses, dependent rubor, intermittent claudication, atrophy, shiny, hairless, cold feet. Initial do a pulse check, ABI 0.9 or less is PAD. Ateriography is the most DEFINITIVE test. Try to develop collateral circulation. Otherwise- Trental, Pletal. EXAM CVI - correct answer>>CVI- Impaired venous return. Achy legs relieved by elevation, edema after prolonged standing, night cramps, brownish discoloration, cold, ulcers. Etc. do support stockings. EXAM blood pressure - correct answer>>BP - ST 1 (140-159/ 90-99), if you know this you will get the rest!! Normal is <120/80. ELERGLY OVER 60 150/90 IS OK. ISH WILL INCREASE SYSTOLIC NOT DIASTOLIC. ON EXAM. Thiazide diuretics - correct answer>>no sulfa allergies, hyperuricemia, hypokalemia, hypomagnesia, hyponatremia, hyperglycemia, hypertriglycerides. ON EXAM Statin - correct answer>>Must check LFT before starting Statin. Know when to start statins and what to check for to decide mod-high dose statins. ON EXAM
Pulses paradoxus - correct answer>>Pulsus paradox Apical pulse can still be heard even though the radial pulse is no longer palpable. Certain issues cause impairment with diastolic filling, 10 or greater drop in the SYSTOLIC pressure. I think her patient had asthma and their pressure dropped by 10 etc. ON EXAM Emphysema - correct answer>>Emphysema Lungs- Percussion-HYPERENNOSANCE tactile frem + egophony- dec. CXR- flattened diaphragms with hyperinflation. Inc. AP diameter, accessory muscles, pursed-lip breathing, weight loss. ON EXAM Acute Bacterial Pneumonia- CXR - correct answer>>middle lobe. ON EXAM OSA - correct answer>>does not include Microglossia which is an absent tongue congenital. EXAM TB - correct answer>>fatigue, fever, cough. Never do fewer than 3-4 drugs initially if positive, then u can narrow it down. Latent TB usually treated with INH. If u suspect ACTIVE TB order, NAAT, C&S, AFB. The AFB is not diagnostic. SPUTUM FOR C & S if gold standard. Deep morning cough collected for three "consecutive days". TB is usually upper lobes. TPO - correct answer>>TPO- this lab is off MEANING ELEVATED in BOTH hyper/hypo thyroidism. TPO is GOLD stand for diagnosis in Hashimotos. But you always want to order a TSH first, THEN ur thyroid panel do not get ahead of yourself. Check ur TSH lab on both in 6-8 weeks but never sooner than 6 weeks that is how long these meds take to work. TOPIC ON EXAM hyperthyroid - correct answer>>Hyperthyroid- Low TSH, high "FREE" T4/T3. ALWAYS DO FREEs. Graves disease-autoimmune. Lid lag, exophthalmos, everything is hyper (body wise). Treatment: PTU/Tapazole. PTU PREFER IN PREGNANCY RAIU-no w/ prego. Destroys thyroid, lifelong treatment for hypo then. A1C > 9 - correct answer>>If you are already on TWO oral drugs for diabetes and A1c is 9 or higher, start BASAL insulin. If you cannot tolerate metformin and your A1c is 9 or higher start BASAL insulin. ON EXAM Parathyroid - correct answer>>For parathyroid- dx blood test. You will have elevated calcium because your parathyroid is releasing too much from bones and this will just cause it to float around and not help ur bones. TX: BIPHOSPHANATES FOR SECONDARY HYPERPARATHY. EXAM
