⦁ AANP FNP exam contains very few nonclinical questions
⦁ Certification tests are designed for entry-level practice
⦁ AANP has 15 pilot
... [Show More] questions which are not graded [there is NO WAY to identify the pilot test questions from the graded questions]
⦁ New clinical info [treatment and/or guidelines] released in the last 10 months won’t be on the
exam
⦁ Questions will be on primary care disorders – if you are guessing, AVOID PICKING EXOTIC DIAGNOSIS AS AN ANSWER
Labs
⦁ Normal lab results pertinent to a question WILL ONLY BE LISTED ONCE. Use your scratch sheet of paper to jot down these values if given.
⦁ Follow the LAB NORMS GIVEN BY AANP not what you learned in NP school
⦁ Learn the significance of abnormal lab values AND type of follow-up needed [i.e. elderly gentleman with c/o scalp tenderness + indurated temporal artery, NP suspects temporal arteritis. Screening test is sed rate – which is expected to be MUCH HIGHER than normal value]
Good to Know
⦁ Expect one question related to dental injury [i.e. completely avulsed permanent tooth should be reimplanted ASAP! It can be transported to dentist in cold milk (not frozen milk)
⦁ May be a question on epidemiologic terms (i.e. sensitivity is defined as the ability of a test to detect a person who has the disease. Specificity is defined as the ability of a test to detect a person who is healthy or detect the person without the disease)
⦁ Learn definition of some research study designs : cohort follows a group of people who
share some common characteristics to observe the development of a disease over time – Framingham nurses health study
⦁ Emergent conditions that will present in primary care clinics will be on the exam: navicular
fracture, MI, cauda equina syndrome, anaphylaxis, angioedema, meningococcal meningitis
⦁ Know some anatomic areas : trauma to Kiesselbach’s plexus = anterior nosebleed
⦁ Some questions ask about “gold-standard test” or the “diagnostic test for the condition”: sickle cell anemia, G6PD anemia, and alpha/beta thalassemia = hgb electrophoresis
⦁ Disease states are usually presented in their “full-blown classic” textbook presentation:
acute mononucleosis, teen will have classic triad of sore throat, prolonged fatigue, and enlarged cervical nodes. If patient is older with same signs/symptoms, it is still mononucleosis reactivated type
⦁ Ethic background may provide clues to disease: alpha thal = southeast Asia / Filipinos; beta thal = Mediterranean
⦁ NO ASYMPTOMATIC or BORDERLINE CASES OF DISEASE STATES WILL BE ON THE
EXAM: IDA in “real life” don’t present often with pica or spoon-shaped nails, on the exam they
will have these clinical findings
⦁ Be familiar with lupus and SLE: malar rash (butterfly) = lupus. Instruct patient to avoid / minimize sun exposure r/t photosensitivity.
⦁ Be familiar with polymyalgia rheumatica (PRM): 1st line tx is long-term steroids. Long-term,
low-dose steroids are commonly used to control symptoms (pain, severe stiffness in shoulders
/ hip girdle). PMR patients are at HIGH RISK FOR TEMPORAL ARTERITIS.
⦁ Gold standard exam for temporal arteritis: biopsy + refer patient to optho for management.
⦁ Learn the disorders for which maneuvers are used and what a positive report means :
⦁ Finkelstein’s test—positive in De Quervain’s tenosynovitis
⦁ Anterior drawer maneuver and Lachman maneuver—positive if anterior cruciate ligament (ACL) of the knee is damaged. The knee may also be unstable.
⦁ McMurray’s sign—positive in meniscus injuries of the knee
⦁ Conditions that NEED a radiologic test : damaged joints – order Xray 1 st (but MRI is the gold standard)
⦁ Abnormal eye findings in DM (diabetic retinopathy) and HTN (hypertensive retinopathy)
should be MEMORIZED and learn to distinguish each one:
⦁ Diabetic retinopathy = neovascularization, cotton wool spots, microaneurysms
⦁ Hypertensive retinopathy = AV nicking, silver and/or copper wire arterioles
⦁ Become knowledgeable about physical exam “normal” and “abnormal” findings:
o Checking DTRs in patient w/severe sciatica or diabetic peripheral neuropathy: ankle jerk reflex (Achilles reflex) may be absent or hypoactive. Scoring absent (0), hypoactive (1), normal (2), hyperactive (3), and clonus (4).
⦁ ONLY A FEW QUESTIONS WILL BE ON BENIGN or PHYSIOLOGIC VARIANTS: benign S4
heart sounds may be auscultated in some elderly pt. Torus palantinus and fishtail uvula may be seen during the oral exam in a few patients.
⦁ If the question is asking for the initial or screening lab test , it will probably be a “ cheap ” and
readily available test : CBC (complete blood count (CBC) to screen for anemia
⦁ There are some questions on theories and conceptual models : Stages of change or “decision” theory (Prochaska) includes concepts such as precontemplation, contemplation, preparation, action, and maintenance.
⦁ Other health theorists who have been included on the exams in the past are ( not inclusive ): [Show Less]