OMG...AANP Certification Sample Questions are horrible

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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.

any opinions?

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. tetorifice prophylaxis and wound scraping for culture

2. irrigate and apply topical abx

3. administer tetorifice 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 tetorifice 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!

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Seriously, I just passed the AANP ANP exam and those questions did me the EXACT same way! Continue to study the Fitzgerald and you will be fine. Those sample questions were ridiculous! Good Luck!:D

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If you took the GRE and made it through NP school successfully, I think you'll find the certification exam very anticlimactic. No one from my cohort failed. Don't worry, really!!

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Specializes in Emergency, MCCU, Surgical/ENT, Hep Trans.

Your intution is correct. These questions are not made for you to dig, don't have time for that. First impressions mean a lot. So,

1. The tetorifice is throwing you off. See, you questioned it's validity. Look at what they included w/tetorifice, culture??? oral Abx??? nah...irrigation always, topical abx for the skin puncture.

2. Look at WHAT the question is asking you. Don't get thrown by the ankle/temp, this is NOT follow-up information. He's been on a high dose thiazide and is still hypertensive, so that should clue you to possible renal disease. While it is important to know if his Na/K are up, the most important would be to evaluate his kidneys, hence, Cr/BUN would be the most useful.

3. Kegels a 100x/day? No, try half that.

4. Again, your barking up the right tree. Obstruction? a stretch, stay with the more conservative "dysfunction."

You are doing fine! BTW, these questions seem very acute to me (as in ACNP). The AANP is far more clinically based vs the ANCC. I took/passed both. Good luck!

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Did they give you the answers too?

Those are weird questions. I'm sure Margaret Fitzgerald would agree...

:lol2:

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Kay, I'm going to have a stab at these questions:

1. I'd go with tetorifice and culture. If it's a deep wound I wouldn't put topical abx on it. I wouldn't automatically prophylax with abx since there have been studies that show I&D without abx in a primary care setting is often preferred. In addition to tetorifice and culture, I would irrigate. I'd probably get this question wrong.

2. I think checking cholesterol and glucose is the best answer. HCTZ can have a negative impact on both (and it's a good idea to check these anyway). I don't see any reason to suspect kidney disease in this patient since he's young and has no significant history. Then I'd either decrease the dose of HCTZ (which is about as effective at 12.5 or 25mg) and start another med, or just get rid of the HCTZ and start an ACEI. At which point I would want a baseline kidney function...

3. I'd go with the assumption that 100x/day of anything is too much. :)

4. I'm with you on biliary obstruction. Don't think PUD has effect on alk-phos, amy would be up with pancreatitis, and with both liver and pancreatits I imagine the patient would be sicker and there would be more abnormals on exam.

I just graduated and have NOT taken the exam yet (ANCC this summer). So, wonder if I pass?

()_()

(*.*)

(") (")

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Specializes in ER; CCT.
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.

any opinions?

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. tetorifice prophylaxis and wound scraping for culture

2. irrigate and apply topical abx

3. administer tetorifice 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 tetorifice 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)."

http://www.nlm.nih.gov/medlineplus/ency/article/003975.htm

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!

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Thanks for all your encouragement/advice.

I think the 2nd question is throwing me off the most right now. He appears to have HTN, not well controlled, but treatment with HCTZ has exacerbated a gout attack. The pain in his ankle could certainly elevate the BP. So I am not sure if the question is asking the obvious...BUN/Creatnine for HTN, or wanting you to detect the gout which would lead mre more towards CBC/Uric Acid to evaluate the ankle.

I could practically recite the Fitzgerald course from memory at this point. Unfortunately I struggle to consistently get a 70 in Hollier's practice question book. I am comfortable with my knowledge base, but not so much with my ability to choose the correct answer!

Good luck to you Tammy79. I test 7/8 so I will keep you posted!

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I was wondering how long you waited to hear from the AANP certification program. I applied back in March expecting to have received information by now. Every time I call or email I get the same answer, my application is in professional review. When I ask if there is anything else they need or have to do I get no answer. I have even asked why it is still in professional review and I receive no answer, just that I will get the information within 1-2 weeks. I am nervous about taking the exam, if I knew when I was taking it I would feel better.

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I sent my application at just about the last minute around March 25th. I got authorization to test June 24th (though they had not yet gotten my final transcript with degree conferred). Good luck to you...I have heard horror stories of people waiting months to hear. Hopefully it won't be much longer since the testing window ends in August!

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Thank you for answering so soon. It makes me feel alittle better. I was beginning to think it was just me.

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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 tetorifice 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?

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