Free AANP FNP-C Exam Flashcards

Around 6-8 weeks (about 2 months) of age. Absence of a social smile by 2-3 months warrants developmental follow-up and vision/hearing screening.

The Ortolani maneuver (reduces a dislocated hip back into the acetabulum) and the Barlow maneuver (attempts to provoke dislocation of an unstable hip). A positive result warrants hip ultrasound referral before 6 months of age.

Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide/depression, and Safety - a structured psychosocial risk screen conducted confidentially, one-on-one with the adolescent.

Age 40, per the 2024 USPSTF update (grade B), continuing biennially through age 74. This lowered the prior 2016 threshold of age 50.

Age 45 (lowered from 50), continuing through age 75, with individualized/shared decision-making for ages 76-85.

Ages 21-29: cytology (Pap) alone every 3 years. Ages 30-65: cytology plus HPV co-testing every 5 years, or cytology alone every 3 years if co-testing is unavailable.

All sexually active women under age 25, and older women with risk factors such as new or multiple partners. Screening uses a urine- or swab-based NAAT.

PHQ-9 for depression severity and GAD-7 for anxiety severity. Both are validated, self-administered, and reused at follow-up visits to track treatment response.

Stage 1: 130-139/80-89 mmHg. Stage 2: 140/90 mmHg or higher. Normal is under 120/80; Elevated is 120-129 systolic with diastolic under 80.

Adults ages 35-70 who are overweight or obese (BMI 25 or higher, or 23+ in some Asian populations). Rescreen every 3 years if the result is normal.

Ideally at 6-8 weeks gestation, including CBC, blood type/Rh antibody screen, rubella/varicella immunity, HIV/syphilis/hepatitis B screening, urinalysis with culture, and a Pap test if due.

Men aged 65-75 who have ever smoked. Routine screening is not recommended for women or for men who have never smoked (USPSTF).

All women age 65 and older, regardless of risk factors. Postmenopausal women under 65 are screened if their fracture risk (by FRAX) equals or exceeds that of a 65-year-old white woman.

Ages 50-80, at least a 20 pack-year smoking history, and currently smoking or having quit within the past 15 years (USPSTF 2021 update).

The Timed Up and Go (TUG) test - time to rise from a chair, walk 10 feet, turn, return, and sit. A time over 12 seconds signals elevated fall risk and need for further workup.

The Mini-Cog (3-item recall plus a clock-draw test), or the MoCA/MMSE for a more detailed evaluation. Abnormal results warrant further dementia workup rather than reassurance about normal aging.

Moderate-to-severe bulging of the tympanic membrane, OR new-onset otorrhea not caused by otitis externa, OR mild bulging plus recent onset of ear pain or erythema (AAP criteria).

Add 1 point for ages 3-14, add 0 points for ages 15-44, and subtract 1 point for age 45 and older, on top of points for fever, tonsillar exudate, tender anterior nodes, and absent cough - higher totals raise the pretest probability of strep pharyngitis.

Heterophile antibodies often have not risen yet during the first week of illness; sensitivity peaks around weeks 2-5. A negative test in week 1 with a classic triad of fever, pharyngitis, and adenopathy should be repeated rather than used to rule out mono.

A1C 6.5% or higher, fasting plasma glucose 126 mg/dL or higher, or 2-hour OGTT 200 mg/dL or higher - each needs confirmatory repeat testing unless the patient has clear hyperglycemia symptoms with a random glucose of 200 mg/dL or higher.

IFG uses a fasting glucose of 100-125 mg/dL. IGT uses a 2-hour OGTT of 140-199 mg/dL. Both define prediabetes; an A1C of 5.7-6.4% is the third prediabetes criterion.

Pyelonephritis adds fever, flank pain, and systemic illness (nausea, malaise) to the dysuria and frequency seen in cystitis, and may require imaging or IV therapy if the patient appears toxic.

Pneumonia severity and mortality risk. One point each for Confusion, Urea over 19 mg/dL (7 mmol/L), Respiratory rate 30 or higher, Blood pressure under 90/60 mmHg, and age 65 or older. A score of 2 or more suggests hospitalization.

Low ferritin (most specific), low serum iron, high total iron-binding capacity (TIBC)/transferrin, elevated RDW, and microcytic (low MCV) red cells. Anemia of chronic disease typically shows low-to-normal TIBC with normal-to-high ferritin.

Primary hypothyroidism: TSH high, free T4 low. Subclinical hypothyroidism: TSH high, free T4 normal. Subclinical disease is often monitored rather than immediately treated unless TSH is markedly elevated or the patient is symptomatic or pregnant.

Delirium has an acute onset, a fluctuating course, and impaired attention, and is often reversible once an underlying cause (infection, medication, metabolic derangement) is treated. Dementia has a gradual onset, is progressive, and spares attention until late stages.

Osteoporosis: T-score of -2.5 or lower. Osteopenia (low bone mass): T-score between -1.0 and -2.5. Normal: T-score of -1.0 or higher. The T-score compares the patient to a healthy young-adult reference population.

Stage 3a: eGFR 45-59 mL/min/1.73m2. Stage 3b: eGFR 30-44. Stage 4 is 15-29, and Stage 5 (kidney failure) is under 15. Staging also requires findings to persist at least 3 months to confirm chronicity.

It identifies potentially inappropriate medications for older adults - such as benzodiazepines, first-generation antihistamines, and anticholinergics - because of increased risk for falls, sedation, and cognitive impairment.

DTaP, inactivated poliovirus (IPV), Hib, and pneumococcal conjugate vaccine (PCV) at each visit, plus rotavirus vaccine doses at 2 and 4 months (a 6-month dose may apply depending on the rotavirus brand used).

High-dose amoxicillin, 80-90 mg/kg/day divided twice daily, for most children. Amoxicillin-clavulanate is preferred if the child took amoxicillin in the last 30 days, has concurrent purulent conjunctivitis, or has recurrent AOM unresponsive to amoxicillin.

2 doses, given 6-12 months apart, if the series starts before age 15. 3 doses (0, 1-2, and 6 months) if the series starts at age 15 or later, or in an immunocompromised patient.

Thiazide diuretics or calcium channel blockers (CCBs), per ACC/AHA guidance - this population shows a stronger response to these classes as monotherapy than to ACE inhibitors or ARBs.

Metformin is first-line unless contraindicated (eGFR under 30, acute illness risk). Add a GLP-1 receptor agonist or SGLT2 inhibitor regardless of A1C when the patient has established ASCVD, heart failure, or CKD, per ADA Standards of Care.

Nitrofurantoin 100 mg twice daily for 5 days, or TMP-SMX DS twice daily for 3 days where local resistance is under 20%, or a single 3 g dose of fosfomycin.

Penicillin V or amoxicillin for 10 days. For penicillin allergy, use a first-generation cephalosporin (if the allergy is non-severe) or azithromycin/clindamycin.

Ages 40-75 with one or more cardiovascular risk factors (dyslipidemia, diabetes, hypertension, smoking) and an estimated 10-year ASCVD risk of about 7.5-10% or higher, using shared decision-making.

Safe: labetalol, nifedipine, and methyldopa. Contraindicated: ACE inhibitors, ARBs, and direct renin inhibitors, due to fetal renal toxicity and teratogenicity risk.

All adults age 50 and older (and immunocompromised adults 19 and older), given as 2 doses spaced 2-6 months apart, regardless of prior shingles history or earlier Zostavax vaccination.

A single dose of a pneumococcal conjugate vaccine (PCV15, PCV20, or PCV21) for all adults age 50 and older who are unvaccinated or have unknown vaccination history - replacing the prior age-65 threshold. If PCV15 is used, follow it with PPSV23 at least 1 year later (or 8 weeks later if immunocompromised).

Older adults, especially those with cardiac disease, start at a lower dose (about 25-50 mcg/day) and are titrated slowly with TSH rechecks every 6-8 weeks, to avoid precipitating angina or arrhythmia from rapid thyroid hormone correction.

A T-score of -2.5 or lower at the hip or spine, a history of hip or vertebral fragility fracture, or osteopenia combined with a FRAX 10-year risk of 3% or higher for hip fracture (or 20% or higher for major osteoporotic fracture).

Referral to a pediatric subspecialist (GI, endocrinology, or a feeding team) for further workup, along with a focused dietary/feeding history and screening labs - growth faltering should not simply be reassured away.

At 48-72 hours. Lack of improvement by then should prompt reassessment of the diagnosis and adherence, and consideration of a broader-spectrum or alternate agent.

In 2-4 weeks. Faster follow-up, within days, is needed for hypertensive urgency/emergency or when starting a drug with meaningful early risk, such as an ACE inhibitor in a patient with borderline renal function.

Every 3 months if uncontrolled or therapy was just changed; every 6 months if the patient is stable and consistently at goal.

In 4-12 weeks, to assess response and tolerability, then periodically (for example, annually) once the patient is stable at goal.

4-6 weeks at an adequate dose. Partial response at 2-4 weeks supports staying the course, while no response by 6-8 weeks warrants a dose increase or a medication change.

Referral to nephrology, along with confirming the finding using a urine albumin-to-creatinine ratio and reviewing/optimizing ACE inhibitor or ARB dosing, since persistent proteinuria signals kidney damage and higher cardiovascular risk.

Perform a fall risk assessment such as the Timed Up and Go test, review medications for fall-risk contributors (sedatives, orthostatic agents), check orthostatic vital signs, and consider physical therapy or a home safety evaluation rather than dismissing it as normal aging.