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AANP FNP Latest Exam (TEST BANK) 2025 - 2026
With 800+ Verified Questions and Correct
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Increased rugae of scrotum, testes enlarge. Breast bud. Straight sparse hair. - correct answer>>Tanner Stage 2 Penis elongates. Pencil penis. Scrotal color darkens. Breast tissue and areola are one mound. Darkened hair, starts to curl. - correct answer>>Tanner Stage 3 Penis thickens and increases in size. Areola/nipple separate for secondary mound. Curly hair, not on medial thigh. - correct answer>>Tanner 4 After Tanner stage 2, within 1-2 years. Delayed puberty if no secondary sexual characteristics by 12-13 in girls and 14 in boys. - correct answer>>When does menarche begin? Down Syndrome. Risk with advanced maternal age. Microcephaly, flat nose, hypotonia, simian crease. - correct answer>>Trisomy 21 Pectus excavatum. Tall, wide arm span. Risk of MVP, aneurysm, aortic regurgitation. Do not clear for sports. - correct answer>>Marfan's Syndrome FEMALE. Lymphedema in utero, webbed neck, LD, widely spaced nipples, HTN coarctation of aorta. - correct answer>>Turner's Syndrome Extra X in males. More feminine. Will see in puberty. Infertile, hypogonadism, low testosterone. Tall, lanky, underdeveloped sexually. - correct answer>>Klienfelter's Syndrome Sutures cross midline, spreads. - correct answer>>Caput succadeum Sutures do not cross midline, more significant. - correct answer>>Caphalohematoma 18 months - correct answer>>When does anterior fontanelle close? 2 - 3 months - correct answer>>When does posterior fontanelle close?
Black or white. Retinoblastoma, cataracts, osteogenesis perfecta. White specks in down syndrome. - correct answer>>Abrnomal red reflex Trisomy 18. Small mouth. High pitched cry. - correct answer>>Edward's Syndrome PKU (phenylalanine), can lead to hyperactivity and mental retardation. Hypothyroid. If not treated, mental retardation. Sickle cell. Galactessemia, maple smell to urine, septic.
- correct answer>>Newborn screening tests Stye. Pain, edema. Bacitracin ophthalmic ointment. - correct answer>>Hordeolum Emergency. Rocephin for gonorrhea. - correct answer>>STD conjunctivitis. 2 - 4 days after birth. Red eye, purulent discharge, swollen eyelids. GC culture, Thayer Martin, ROCEPHIN. - correct answer>>Gonococcola Ophthamlia Neonatorum 4 - 10 days after birth. Edematous, red, profuse WATERY discharge that becomes purulent. Azithromycin, erythmocycin. - correct answer>>Chalmydial Ophthalmia Trachoma Fungal. Odor, black specks. Clotramizole. Pain with tragus/pinna. Corticosporin - correct answer>>Otitis externa Syphilis, acoustic neuroma, aminoglycoside (gentamycin) - correct answer>>Sensorineuro hearing loss in PEDS Bacterial. Thumb sign on x-ray. - correct answer>>Epiglottitis Viral. Steeple sign on x-ray. - correct answer>>Croup RSV, adenovirus. Under 3. Lower respi. URI, fever, nasal flaring, stridor.If a preemie, synegis. - correct answer>>Bronchioloitis SABA, 2 puffs q 4-6 hours. Peak 30 min-2 hours, lasts 4-6. - correct answer>>Intermittent Asthma peds Lobar consolidation. Tx with penicillin. - correct answer>>S. pneumonia (CAP) peds Lobar consolidation. Amoxicillin or cephalosporin. - correct answer>>H. influenza pneumonia peds
Osteogenesis imperfecta or Mongolian spot - correct answer>>What can be confused as child abuse in younger children? Thrill sometimes felt at LL sternal border. Most common heart defect in babies. Opening between septum. Holosystolic murmur. - correct answer>>VSD RVH. L. lower sternal border. Egg on a string on x-ray. - correct answer>>Transposition of great arteries VSD. Pulmonary stenosis. Overriding aorta. R. sided hypertrophy. Systolic ejection murmur and thrill. Squat to slow return of blood to heart. - correct answer>>Tetralogy of fallot Systolic thrill. R. upper sternal border. Ejection click heard at apex. LVH. X-ray, severe HF. More common in boys than girls, common to see mild exercise intolerance - correct answer>>Aortic stenosis Ejection murmur heard best at LUSB and L interscapular area. RVH to LVH. Rib notching. Pressures different in upper and lower extremities. OFten seen with mitral regurgitation and Aortic stenosis - correct answer>>Coarctation of aorta 1 - 3/6, early systolic ejection murmur. Musical / vibratory (buzz). Left lower sternal border. Turbulence in left ventricle. Innocents. Softens with standing, Valsalva, sitting. Age 2-6 years - correct answer>>Still's Murmur Mild systolic ejection murmur, high-pitched, pulmonic & aortic areas. Only heard in increased cardiac output. - correct answer>>Hemic murmur Heard best while sitting, disappears while supine. R and L upper sternal border, continuous humming murmur. innocent. Disappears in supine position or when jugular vein compressed. > 3yo - correct answer>>Venous hum 2 - 4/6 continuous heard best over LUSB. Full pulses. Most common congenital heart defect. More common in girls - correct answer>>PDA (patent ductus arteriosus) 1 - 3/6 mid-systolic click w/ late systolic murmur. Heard best at apex. Louder with standing/squatting. Often seen with pectus excavatum - correct answer>>MVP
2 - 5/6 best at LUSB, ejection click @ 2nd L ICS. Radiates to back. May involve wide S2. Usually d/t fusion of valves - correct answer>>Pulmonic valve stenosis Organ problem or aldosterone. Cushings. Refer to cards - correct answer>>HTN in peds Joints, CNS, post infectious group a strep. affects mitral valve. Jones criteria (carditis, chorea, erythema marginatum, esr elevated, arthralgia, fever, prolonged PR interval) - correct answer>>Rheumatic heart disease Toxic vasculitis. Fever several days, rash, swelling, peeling, strawberry tongue, prolonged PR or QT. ASA, refer. - correct answer>>Kawasaki's Surgical emergency. Lethargy, vomiting, jelly stool, mass in RUQ. Can be from rotavirus?
- correct answer>>Intusucception Adrenal gland tumor, before age 5. Mass in abdomen. Catecholamines elevated. Painful, fixed, crosses midline. - correct answer>>Neuroblastoma Small head, shortened palpebral fissures (narrow eyes), flat nasal bridge. Thin upper lip.
- correct answer>>Fetal alcohol syndrome Trigeminal nerve, refer to opthlamology to rule out congeital glaucoma. Can be a sign of Sturge-Weber syndrome. - correct answer>>Port wine stain Corneal light reflex, tests for strabismus. - correct answer>>Hirschberg Test Absence is indicitave of spina bifida - correct answer>>Anal wink Fencing - correct answer>>Tonic neck 12 months and 4-6 years ol.d - correct answer>>When do you get MMR? Follows objects past midline, coos, lifts head, smiles - correct answer>>2 month development Palmar grasp, reaches, bring things to mouth, pass things from one hand to another, sits up on own, turns belly-back-belly - correct answer>>6 month development
Enlarged, painless cervical and supraclavicular adenopathy, fever a nd night sweats. Common 15-19. - correct answer>>Hodgkin's Lymphoma normally elevated in puberty due to growth spurts. - correct answer>>ALK phos Lack of menarche before age 15. - correct answer>>Primary amenorrhea Most common cause pregnancy, anorexia, PCOS. - correct answer>>Secondary amenorrhea Screening for adolescent substance abuse. Car, relax, alone, forget, friends, trouble - correct answer>>CRAFFT questions Overweight (BMI >85th percentile), plus 2 risk factors. Family hx, race, signs of diabetes, maternal history of DM or gestational - correct answer>>When to screen for type 2 diabetes in children? Symptoms present before age 12, impairment present in 2 settings, functional interference - correct answer>>Diagnosing ADD Bacterial, hot potato voice, lock jaw (trismus) - correct answer>>Peritonsillar abscess Budesonide, fluticasone - correct answer>>ICS for children 0- 4 budeonide, beclomethasone, fluticasone - correct answer>>ICS 5- 11 Children younger than 6 months, severe with unilateral or bilateral, non severe with bilateral in children 6-23 months - correct answer>>When to tx AOM? Amoxicillin or if PCN allergic, cefdinir/cefuroxine - correct answer>>Abx for AOM 50 - 100 ml/kg over 3-4 hours, frequent small volumes - correct answer>>Moderate dehydration Oral rehydration therapy Common: Amoxillin or augmentin, atypical: azithromycin - correct answer>>CAP in children less than 5 Amoxicillin, atypical" azithromycin/clarithyromycin. Doxy for children over 7 - correct answer>>CAP in children older than 5
7 - 14 days. Amoxicillin, bactrim, ceficime, cephalexin, cefpodoxine - correct answer>>UTI treatment in children 2-24 months Abdominal pain, dark, tarry bleeding. Get HCG. Tender adnexa, positive CMT - correct answer>>Ectopic pregnancy softening of cervix - correct answer>>Goodell's sign blue color to cervix - correct answer>>Chadwick's sign Softening of cervical uterine junction - correct answer>>Hager's sign Should not be elevated in single uterine pregnancy - correct answer>>Alpha Fetal Protein 24 weeks - correct answer>>When is viability? Rest, fetal surveillance, kick counts, left lateral position - correct answer>>Treatment for PIH sudden weight gain, hands/feet swelling, protein in urine, htn - correct answer>>Signs of preeclampsia late 2nd-3rd trimester, bleeding preciptated by intercourse, painless, no tenderness. Nothing in vagina. - correct answer>>Signs of placental previa Severe pain, bleeding, cocaine use,smoking, alcohol - correct answer>>Signs of placental abruptio DVt, bleeding disorder, major surgery, smoker over 35, migraines with focal neuro changes, CAD or CVA, undiagnosed bleeding, pregnancy, liver tumor, estrogen depednet tumor. MYCUPLETS - correct answer>>Absolute contraindications of combination BC Migraines, smoke >15 cigarettes under 35, fracture on lower extremities, severe depression, hyperlipidemia - correct answer>>Relative contraindications for BC Decreased risk of ovarian and endometrial cancer, cramps, PID, IDA< acne, cysts, heavy periods - correct answer>>Advantages of BC pill
Destroys fetal Rh-positive RBCs that have crossed the placenta - correct answer>>What does rhogam do? Always treat. Nitrofurantoin, Amoxicillin. - correct answer>>Tx for asymptomatic bacteruria in pregnancy tetracyclines, nitrofurantoin (very end/also do not use in G^PD anemia)), sulfa drugs. - correct answer>>Abx to avoid late in pregnancy Non-MRSA: Dicloxacillin MRSA: Bactrim, clinda - correct answer>>How to treat mastitis? Cup should not be more than 1/2 the size of diameter of disc. If it is, glaucoma. - correct answer>>Normal cup to disc ratio in eye Order lipid panel. - correct answer>>Arcus stenosis Wedge shaped growth of non cancerous skin - correct answer>>Ptergyum Staph infection, stye. Warm compresses. - correct answer>>Hordeoleum Beady nodule, painless. - correct answer>>Chalazion Staph. Sebhorreic dermatitis of lid edge. Hot compresses, topical, scrub. - correct answer>>Blepharitis Increased ICP. Cupping of disc - correct answer>>Signs of glaucoma Peripheral vision loss. Alpha 2 adrenergic. Tinolol, pilocarpine. - correct answer>>Open angle glaucoma Immediate referral. Eye pain when closed, halos around lights. Mannitol, xolimide. - correct answer>>Closed angle glaucoma Cataracts. Painless, clouded, blurred vision. Diplopia, opacity of lens. - correct answer>>What is leading cause of treatable blindness? Chronic OM, scaling, erode middle ear, deafness. Squamous epithelial lining. TM perforates.Cauliflower like. - correct answer>>Cholesteatoma
Meneire's disease, acoustic trauma, ototoxic drugs. Can be identified with Weber test (louder sound lateralizes to better-hearing ear) Rinne test will be normal in both ears - correct answer>>Sensorineural hearing loss Herpes keratitis. severe eye pain, photophobia, blurred vision. Refer immediately - correct answer>>Fernlike lines on corneal surface Battle's sign. clear, golden serous discharge. sign of basilar skull fracture - correct answer>>Bruise behind ear Color perception, 20/20 vision - correct answer>>Cones in eyes Detects lights and shadows, depth perception - correct answer>>Rods in eyes Normal changes in vision after age 40. - correct answer>>Presbyopia 2:3, veins larger than arteries in eyes - correct answer>>AV ratio Copper and silver wire arterioles, arteries larger than veins - correct answer>>Signs of hypertensive retinopathy Cotton wool spots, microaneurysms. - correct answer>>Signs of diabetic retinopathy Normal-no lateralization. Conductive-lateralizes to affected side. Sensorineural- unaffected side - correct answer>>Weber test Acute onset of severe eye pain, foreign body sensation. Linear lines. Use topical antibiotic ointment - correct answer>>Corneal abrasion Timolol drops, careful in asthma or HF - correct answer>>Treatment for open angle glaucoma Lacrimal and salivary gland dysfunction. Dryr eyes and dry mouth. - correct answer>>Sjogren's syndrome Pseudomonas (gram negative) staph (gram positive). Treat with cortisporin drugs. Prophylactic vingegar and alcohol - correct answer>>Common causes of otitis externa Doxycycline, respiratory fluoroquinolones. (Levo, moxi) - correct answer>>Tx for sinus infection if allergic to amoxicillin
ALL - correct answer>>Differential to consider if child complains of bone pain all day while playing? MMR, varicella - correct answer>>Vaccines to avoid if gelatin allergy Head larger than chest up to 18 months old - correct answer>>Chest/head difference in babies Atorvastatin 40-80, Rosuvastatin 20-40. For patients with ASCVD, younger than 75, or 190 or higher LDL - correct answer>>Examples of high intensity statins Atorvastatin 10-20, Rosuvastatin 5-10, Simvastatin 20-40, Pravastatin 40- 80 - correct answer>>Examples of moderate intensity statins Younger adults, H. pylori, food improves symptoms--gnawing pain - correct answer>>Signs of duodenal ulcer Older patients, food makes it worse - correct answer>>Signs of gastric ulcer 2 antibiotics, PPI, pepto. MOC. AOC. - correct answer>>How to treat h. pylori Anti-HAV, IgM (IgM--immediate). Fecal/oral - correct answer>>Active Hep. A. Anti-HAV, IgG (IgG-gone) - correct answer>>Recoveredhep. a HBsAg, HBeAg, Anti-HCc, IgM - correct answer>>Active hep. B HBsAg, Anti-HBc, Anti-Hbe, Igm, IgG - correct answer>>Chronic Hep B Anti-HBc, Anti-HBsAg - correct answer>>Recovered Hep. B Anti-HCV, HCV RNA - correct answer>>Acute Hep. C Anti-HCV, HCV RNA - correct answer>>Chronic Hep. C HBsab, Anti-HBs - correct answer>>Immune from Hep. B Low fiber diet, women, LLQ pain. Plain films to check for air. Broad spectrum abx. - correct answer>>Diverticulitis
High pitched, hyperactive in some quadrants w/ absent in other - correct answer>>Bowel sounds with obstruction Quiet, ominous - correct answer>>Bowel sounds with perforation Decreased thirst-risk for dehydration, delayed gastric emptying, dysphagia - correct answer>>Changes with older adults GI PPI once a day before first meal - correct answer>>Treatment for presumptive gerd Anti-HAV+, IgG - correct answer>>Immune to Hep. A Gastrinoma located on pancreas, serum fasting gastrin, tarry colorled stool, severe ulcers in stomach - correct answer>>Zollinger-Ellison Syndrome Clinda, fluoroquinolones, cephaolosproins - correct answer>>What meds can cause C. dif? Palpate on left, pain on right - correct answer>>Rovsings sign Increase fiber - correct answer>>How to treat IBS Stimulates pancreas to release more insulin. Glipizide - correct answer>>How do sulfonyureas work? Rebound, hypoglycemia at night that flips and cause high fasting blood sugars. Treat by decreasing night insulin - correct answer>>What is somogyi effect? Nervous, tremors, bug eyes, TSH low, T3 High. Manage: Propanolol for symptoms, PTU, tapazole, radioactive iodine, surgery. - correct answer>>Hyperthyroidism TSH High, T4 low. Synthroid. 50-100 average, lower for gero/cardiac patients. - correct answer>>Hypothyroidism Thirst, labile mood, diabetes symptoms, too much steroids. Hypertensive. Hyperglycemic, hypernatremic, HYPOkalemic. - correct answer>>Cushing's disease Deficiencies in cortisol, androgen, aldosterone. Tanning, freckles, hypotensive. Hypoglycemia, hyponatremia, HYPERkalemia. - correct answer>>Addison's Disease
serotonin - correct answer>>Which neurotransmitter is believed to be most responsible for sensation of satiety? 1 hour. Onset is 15 min. Lasts 4 hours - correct answer>>Peak of short acting insulin (aspart, lispro, glulisine) HyperK+ Hyponatremia polycythemia elevated CK - correct answer>>lab abnormalities occurring with heatstroke A nocturnal release of growth hormone, leading to increased cortisol secretion, which may cause blood glucose level elevations before breakfast in the client with diabetes mellitus. Treatment includes administering an evening dose of intermediate acting insulin at 10 pm. - correct answer>>Dawn phenomenon
- subnorm effect of insulin on glucose metabolism --> hyperglycemia --> increased insulin production --> euglycemia w/ hyperinsulinemia
- pancreatic beta cell deficiency occurs over years of IR
- decreased urinary clearance of uric acid --> gout
- anovulation in PCOS
- prothrombitic effect
- increased r/o atherosclerosis - correct answer>>Sequelae of insulin resistance greater responsiveness to angiotensin II - correct answer>>cardiovascular effects of hyperinsulinemia Increase by 4 units daily - correct answer>>Increasing long-acting insulin dose Peaks 2-3 hours, onset 30 min, lasts 3-6 hours - correct answer>>Short acting insulin (regular) Peak --no peak, onset - 2 hours, lasts 24 hours - correct answer>>Peak of long acting, lantus, determir, glargine Onset 1-2 hours, peak 6-14 hours, lasts 16-24 hours - correct answer>>Intermediate acting insulin Partner with patient. Empathy, self-efficacy, change talk, open-ended, affirming statements. Ask-provide-ask - correct answer>>What is motivational interviewing?
PTU - correct answer>>What med for hyperthyroidism is preferred in pregnant women? Metformin, Byetta - correct answer>>What diabetes meds cause weight loss? TZD, sulfonyureas, insulin - correct answer>>What diabetes meds cause weight gain? Microcytic, hypochromic elevated RDW.Blood loss, inadequate intake, absorption problem. PICA. Ferritin LOW, TIBC High - correct answer>>IDA Microcytic, hypochromic NORMAL rdw. Medeterranian, Asian. Ferritin and TIBC normal.
- correct answer>>Thalassemia MCV HIGH. Beefy red tongue, no neuro symptoms. Common in alcoholic. Tx by diet changes, 1 mg PO folate - correct answer>>Folate deficiency MCV high. Beefy red tongue and neuro signs (parasthesias, fine motor, tremors). B injections (cyanacobalmin) daily for 1 week then monthly. - correct answer>>B deficiency Normocytic. Hemolytic. Worse in high altitudes, stress, dehydration, joint pain. - correct answer>>Sickle Cell Normocytic. Ferritin High, TIBC low. - correct answer>>Anemia of chronic disease Most common acute leukemia - correct answer>>AML Pacytopenia with circulating blasts, all lab values down. - correct answer>>ALL Most common leukemia in adults, lymphocytosis, 10 year survival. - correct answer>>CLL 40 years and over, 3-4 year survival, philadelphia chromosome. - correct answer>>CML Stage 1-1 node. Stage 2-more than one place but on one side of diaphragm. stage 3 both sides of diaphragm. Stage 4 everywhere - correct answer>>Staging of lymphoma Young adults 32. Cervical adenopathy then spreads down. Reed Sternberg cells. Night sweats. - correct answer>>Hodgkin's Lymphoma
Tanner 3 - correct answer>>When does masturbation start? Ceftriaxone plus doxy - correct answer>>Tx for epididymitis in men under 35 bactrim plus cipro - correct answer>>Tx epididymitis in men over 35 Pain relief when scrotum is lifted. Positive in epid....negative in torsion - correct answer>>Positive phren's sign STD. Frequency, dribbling, fever, chills. DRE, painful, boggy. Bactrim, levaquin - correct answer>>Acute bacterial prostatitis Enlarged, non-tender, smooth, rubbery. - correct answer>>BPH Adenopathy, prostate harder than normal, nodules, obscure borders - correct answer>>Prostate cancer Under 4 - correct answer>>Normal PSA ELISA-early screening. Confirmatory: Western Blot. If positive--CD4, Viral load. - correct answer>>HIV tests T cells over 800, CD4 less than 200, viral load high. - correct answer>>AIDS Bactrim daily - correct answer>>Prophylaxis for Pneumocysitis jarin... Single, painful ulcer. Swollen lymph node.Tx: azithro/ceftriaxone - correct answer>>Chancroid Asymptomatic. If sx: thick, cloudy dicharge, dysuria. Tx with azithro or doxy - correct answer>>Chlamydia Report to health department. Also treat for chlamydia. Green/yellow discharge, dysuria. Ceftriaxone - correct answer>>Gonorrhea Condyloma acumilata. painless growth. Tx: podophylin, TCA, BCA< cautery - correct answer>>HPV
painless vesicle, adenopathy. doxycycline 21 days bid - correct answer>>Lymphogranuloma verenium greater than 90. Renal failure: less than 15. - correct answer>>Normal GFR Males, pregnant women, diabetics, children/elderly, recurrent UTIs, immunocompromised, structure changes - correct answer>>What is a complicated uti? Avoid with stones: rhubarb, spinach, beets, chocolate, tea, meat. - correct answer>>High oxalate foods Terazosin, tamsulosin--A.A.A. Finasteride shrinks prostate. Avoid cold meds. Saw Palmetto can help symptoms. - correct answer>>Meds for BPH Elderly, perineal discomfort, voiding symptoms. Boggy, non-tender. UA normla. Treat with bactrim or oflaxin for 4-6 weeks - correct answer>>How to treat chronic bacterial prostatitsi Candida of penis. Topic OTC azole. - correct answer>>Balanitis Untreated gonorrhea. petechial rash, arthritis, pharyngitis, signs of std - correct answer>>Disseminated gonoccocal disease Infection of liver capsule, STD, violin strings. Complication of GC - correct answer>>Fitz- hugh-curtis syndrome Febrile reaction 24 hours after treatment for STD - correct answer>>Jarish-Herxheimer Reaction Screening test for Syphylis. FTA-ABS confirmatory - correct answer>>What is RPR and VDRL Second trimester - correct answer>>When do you start antivirals in pregnant women? Amitriptyline, propanolol, topamax - correct answer>>Prophylaxis for migraines Sumatriptan, triptans, NSAIDS. - correct answer>>Acute tx for migraine Classic with aura, common without aura - correct answer>>Class and common migraine
