Quote from sheristudentfnp
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 feel your pain. i just got my letter and scheduled for july 17. funny they didn't come with the answers. perhaps they don't know either.
on number one, any answer without a tet is not right, but then again she is 16, presumably with iz utd, therefore it opens the field up the most appropriate. the wound, coupled with the proximation of the fx makes you consider a compound fracture, therefore probably a bit beyond the tripple antibiotic ointment. i would go with number 3.
on the second one, a bit more clear--think target organ damage and what could evidence that. bun & cr come to mind as the number one cause of death of hypertension before htn meds which was renal failure (learned that one from the fitz cd's)
the third one i had trouble with too. the answer is 3.
"4. do 10 exercises, 3 times a day (morning, afternoon, and night)."
the last one is biliary obstruction. check out your pcp book for same and jive with your lab handbook.
remember what fitz said on her cd's
all questions are valid...don't get caught up in the "but theres not enough info" review the stuff on track 2 and 3 of the first fnp cd. i'm on my fourth run through now.
good luck to us both!