ok, i just got my approval letter to take the aanp certification exam along with a candidate handbook with 11 sample questions. i was almost a straight a student and have been studying the fitzgerald cds for weeks. imagine my surprise when, even when searching the internet and books, i cannot find the answer to some questions.
a 16 year old female patient presents with an edematous ankle. your exam reveals a pinpoint wound at the lateral aspect of the ankle ans x-rays show a distal fib faracture. in addition to managing the fracture which intervention is appropriate?
1. tetanus prophylaxis and wound scraping for culture
2. irrigate and apply topical abx
3. administer tetanus prophylaxis and prescribe oral abx
4. apply topial abx and cover wound with sterile dressing
i would pick 3 since this should technically be considered an open fx, however at age 16 she shouldn't need a tetanus vax so i am not 100% sure. plus i feel like an open fx would get an ortho referral.
a 37 year old male dx with htn has been tx with low na+ diet and hctz 50mg x2mos. no fam hx cardiac disease. today's bp 150/90 and temp 100 f. pe reveals no bruit, clear cest, no atrial gallop, edema and tenderness of left ankle, intact neuro system. which lab values will provide the most useful follow up information?
1. serum sodium and potassium
2. total serus cholesterol and serum glucose
3. serum uric acid and cbc
4. bun and creatinine
i would pick 3 b/c i guess i want the cbc more than the kidney function, but really i want to order both. i don't think uric acid is necessary since this is an acute gout attack and right now i would not be following chronic hyperuricemia.
a 70 year old female with urinary stress incontinence should be instructed to:
1. perform abdominal strengthening exercises bid
2. perform kegels 100x/day
3. perform kegels 35-40x/day
4. void frequently
i know the answer is kegels, but couldn't find any guidelines regarding how many kegels. so is it 2 or 3????
a 65 year old patietn presents with a history of recurrent right upper quadrant pain associated with intermittent nausea and vomiting. lab tests reveal isolated elevations of serus alk phos and normal amylase. pe nl. the tentative dx is:
1. biliary obstruction
2. peptic ulcer
3. chronic pancreatitis
4. hepatic dysfunction
i want to say biliary obstruction, but i don't think there is enough info to rule out hepatic dysfunction.
so in a matter of hours i have gone from completely confident to sure i am going to fail. please help!
i think you have picked the right answers.
1. i think it is 4. I would want to keep it moist and covered until they take her
to surgery. ortho consult for sure. her tetanus should be ok
if she had it when she was older ...if 5 yrs out ...would still give her a Td
2. HCTZ can exacerbate gout. the ? is ...is it gout or an infection? so uric acid and a CBC will help you differentiate
3. i am guessing the lower reps of kegels here
4. biliary obstruction for sure ...that is why alk phos is up....that is why i always order
alk ph as part of a workup for ruq pain
let us know what the right answers are?
Last edit by globalRN on Jul 7, '09