{"id":111217,"date":"2023-07-31T00:30:03","date_gmt":"2023-07-31T00:30:03","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=111217"},"modified":"2023-07-31T00:30:08","modified_gmt":"2023-07-31T00:30:08","slug":"aanp-exam-pearls","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/07\/31\/aanp-exam-pearls\/","title":{"rendered":"AANP EXAM PEARLS"},"content":{"rendered":"\n<p>m Format \u2022 AANP FNP exam contains very few nonclinical questions<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Certification tests are designed for entry-level practice<\/li>\n\n\n\n<li>AANP has 15 pilot questions which are not graded [there is NO WAY to identify the pilot test<br>questions from the graded questions]<\/li>\n\n\n\n<li>New clinical info [treatment and\/or guidelines] released in the last 10 months won\u2019t be on the<br>exam<\/li>\n\n\n\n<li>Questions will be on primary care disorders \u2013 if you are guessing, AVOID PICKING EXOTIC<br>DIAGNOSIS AS AN ANSWER<br>Labs\u2022 Normal lab results pertinent to a question WILL ONLY BE LISTED ONCE. Use your scratch<br>sheet of paper to jot down these values if given.<\/li>\n\n\n\n<li>Follow the LAB NORMS GIVEN BY AANP not what you learned in NP school<\/li>\n\n\n\n<li>Learn the significance of abnormal lab values AND type of follow-up needed [i.e. elderly<br>gentleman with c\/o scalp tenderness + indurated temporal artery, NP suspects temporal<br>arteritis. Screening test is sed rate \u2013 which is expected to be MUCH HIGHER than normal<br>value]<br>Good to Know \u2022 Expect one question related to dental injury [i.e. completely avulsed permanent tooth<br>should be reimplanted ASAP! It can be transported to dentist in cold milk (not frozen milk)<\/li>\n\n\n\n<li>May be a question on epidemiologic terms (i.e. sensitivity is defined as the ability of a test to<br>detect a person who has the disease. Specificity is defined as the ability of a test to detect a<br>person who is healthy or detect the person without the disease)<\/li>\n\n\n\n<li>Learn definition of some research study designs: cohort follows a group of people who<br>share some common characteristics to observe the development of a disease over time \u2013<br>Framingham nurses health study<\/li>\n\n\n\n<li>Emergent conditions that will present in primary care clinics will be on the exam: navicular<br>fracture, MI, cauda equina syndrome, anaphylaxis, angioedema, meningococcal meningitis<\/li>\n\n\n\n<li>Know some anatomic areas: trauma to Kiesselbach\u2019s plexus = anterior nosebleed<\/li>\n\n\n\n<li>Some questions ask about \u201cgold-standard test\u201d or the \u201cdiagnostic test for the condition\u201d:<br>sickle cell anemia, G6PD anemia, and alpha\/beta thalassemia = hgb electrophoresis<\/li>\n\n\n\n<li>Disease states are usually presented in their \u201cfull-blown classic\u201d textbook presentation:<br>acute mononucleosis, teen will have classic triad of sore throat, prolonged fatigue, and<br>enlarged cervical nodes. If patient is older with same signs\/symptoms, it is still mononucleosis<br>reactivated type<\/li>\n\n\n\n<li>Ethic background may provide clues to disease: alpha thal = southeast Asia \/ Filipinos; beta<br>thal = Mediterranean<\/li>\n\n\n\n<li>NO ASYMPTOMATIC or BORDERLINE CASES OF DISEASE STATES WILL BE ON THE<br>EXAM: IDA in \u201creal life\u201d don\u2019t present often with pica or spoon-shaped nails, on the exam they<br>will have these clinical findings<\/li>\n\n\n\n<li>Be familiar with lupus and SLE: malar rash (butterfly) = lupus. Instruct patient to avoid \/<br>minimize sun exposure r\/t photosensitivity.<\/li>\n\n\n\n<li>Be familiar with polymyalgia rheumatica (PRM): 1st line tx is long-term steroids. Long-term,<br>low-dose steroids are commonly used to control symptoms (pain, severe stiffness in shoulders<br>\/ hip girdle). PMR patients are at HIGH RISK FOR TEMPORAL ARTERITIS.<br>AANP EXAM PEARLS<br>1 \/ 4<\/li>\n\n\n\n<li>Gold standard exam for temporal arteritis: biopsy + refer patient to optho for management.<\/li>\n\n\n\n<li>Learn the disorders for which maneuvers are used and what a positive report means:<br>o Finkelstein\u2019s test\u2014positive in De Quervain\u2019s tenosynovitis<br>o Anterior drawer maneuver and Lachman maneuver\u2014positive if anterior cruciate<br>ligament (ACL) of the knee is damaged. The knee may also be unstable.<br>o McMurray\u2019s sign\u2014positive in meniscus injuries of the knee<\/li>\n\n\n\n<li>Conditions that NEED a radiologic test: damaged joints \u2013 order Xray 1st (but MRI is the gold<br>standard)<\/li>\n\n\n\n<li>Abnormal eye findings in DM (diabetic retinopathy) and HTN (hypertensive retinopathy)<br>should be MEMORIZED and learn to distinguish each one:<br>o Diabetic retinopathy = neovascularization, cotton wool spots, microaneurysms<br>o Hypertensive retinopathy = AV nicking, silver and\/or copper wire arterioles<\/li>\n\n\n\n<li>Become knowledgeable about physical exam \u201cnormal\u201d and \u201cabnormal\u201d findings:<br>o Checking DTRs in patient w\/severe sciatica or diabetic peripheral neuropathy: ankle<br>jerk reflex (Achilles reflex) may be absent or hypoactive. Scoring absent (0), hypoactive<br>(1), normal (2), hyperactive (3), and clonus (4).<\/li>\n\n\n\n<li>ONLY A FEW QUESTIONS WILL BE ON BENIGN or PHYSIOLOGIC VARIANTS: benign S4<br>heart sounds may be auscultated in some elderly pt. Torus palantinus and fishtail uvula may be<br>seen during the oral exam in a few patients.<\/li>\n\n\n\n<li>If the question is asking for the initial or screening lab test, it will probably be a \u201ccheap\u201d and<br>readily available test: CBC (complete blood count (CBC) to screen for anemia<\/li>\n\n\n\n<li>There are some questions on theories and conceptual models: Stages of change or<br>\u201cdecision\u201d theory (Prochaska) includes concepts such as precontemplation, contemplation,<br>preparation, action, and maintenance.<\/li>\n\n\n\n<li>Other health theorists who have been included on the exams in the past are (not inclusive):<br>o Alfred Bandura (self-efficacy), Erik Erikson, Sigmund Freud, Elisabeth K\u00fcbler-Ross<br>(grieving), and others<br>o If a small child expresses a desire to marry a parent of the opposite sex: the child is<br>in the oedipal stage (Freud). Child\u2019s age is about 5 to 6 years (preschool to<br>kindergarten).<br>o Starting at the age of about 11 years, most children can understand abstract<br>concepts (early abstract thinking) and are better at logical thinking.<br>o When performing the Mini-Mental State Exam, when the NP is asking about<br>\u201cproverbs,\u201d the nurse is assessing the patient\u2019s ability to understand abstract concepts.<\/li>\n\n\n\n<li>Keep these good communication rules in mind: Ask open-ended questions, do not reassure<br>patients, avoid angering the patient, and respect the patient\u2019s culture.<\/li>\n\n\n\n<li>There may be two to three questions relating to abuse: child abuse, domestic abuse, elderly<br>abuse<br>Antibiotics &amp; Medications \u2022 Know the difference between 1st and 2nd line abx: AOM in 7 yr old treated with amoxicillin<br>returns in 48hr without improvement (continued ear pain, bulging TM). Next step is to d\/c<br>amox and start child on 2nd line abx Augmentin BID x10 days<\/li>\n\n\n\n<li>Be familiar with alternative abx for PCN-allergic patients: If patient has gram+ infection,<br>prescribe macrolides, clinda, quinolones = levo or moxi<\/li>\n\n\n\n<li>Patient responds well to macrolides but thinks they\u2019re allergic to erythromycin (nausea,<br>GI upset): inform patient she had an adverse rx, not a true allergic (hives\/angioedema): switch<br>pt from erythromycin to azithromycin (z-pack)<\/li>\n\n\n\n<li>Fails to respond to initial medication: add another medication per treatment guidelines (i.e.<br>COPD pt prescribed Atrovent for dyspnea. On follow-up, patient complains symptoms are not<br>relieved. Next step is to prescribe albuterol (Ventolin) or combo inhaler)<\/li>\n\n\n\n<li>Commonly used drugs with rare (potentially fatal) adverse effects: ACE-I = angioedema.<br>Common side effect of ACEIs = dry cough (up to 10%)<br>2 \/ 4<\/li>\n\n\n\n<li>Learn the preferred and\/or 1st line drug to tx some diseases: ACEI\/ARB is preferred for HTN<br>in DM and patients with mild-mod renal disease = renal protective properties<\/li>\n\n\n\n<li>When meds are used in answer options, they will be listed either by name (generic and brand<br>name) or by drug class alone: ipratropium (Atrovent) or an anticholinergic<\/li>\n\n\n\n<li>Most of the drugs mentioned in the exam are the well-recognized drugs:<br>o Penicillin: Amoxicillin (broad-spectrum penicillin), penicillin VK<br>o Macrolide: Erythromycin, azithromycin (Z-Pack), or clarithromycin (Biaxin)<br>o Cephalosporins: First-generation (Keflex), second-generation (Cefaclor, Ceftin, Cefzil),<br>third generation (Rocephin, Suprax, Omnicef)<br>o Quinolones: Ciprofloxacin (Cipro), ofloxacin (Floxin)<br>o Quinolones with gram-positive coverage: Levofloxacin (Levaquin), moxifloxacin<br>(Avelox), gatifloxacin (Tequin)<br>o Sulfa: Trimethoprim-sulfamethoxazole (Bactrim, Septra), nitrofurantoin (Macrobid)<br>o Tetracyclines: Tetracycline, doxycycline, minocycline (Minocin)<br>o Nonsteroidal anti-inflammatory drug (NSAID): Ibuprofen, naproxen (Aleve,<br>Anaprox)<br>o COX-2 inhibitor: Celecoxib (Celebrex)<\/li>\n\n\n\n<li>Category B drugs are ALLOWED for pregnant or lactating women: Pain relief, pick<br>acetaminophen (Tylenol) instead of NSAIDs such as ibuprofen (Advil) or naproxen (Aleve,<br>Anaprox). Avoid nitrofurantoin and sulfa drugs during the third trimester (these increase risk of<br>hyperbilirubinemia).<\/li>\n\n\n\n<li>Preferred tx for cutaneous anthrax: ciprofloxacin 500 mg orally BID for 60 days or for 8<br>weeks. If the patient is allergic to ciprofloxacin, use doxycycline 100 mg BID. Cutaneous<br>anthrax is not contagious; it comes from touching fur or animal skins that are contaminated<br>with anthrax spores.<br>Follow national treatment guidelines for certain disorders: \u2022 Asthma: National Asthma Education and Prevention Program (NAEPP)<\/li>\n\n\n\n<li>COPD: Global Initiative for Chronic Obstructive Lung Disease (GOLD Guidelines)<\/li>\n\n\n\n<li>Diabetes: American Diabetes Association Clinical Practice Recommendations (ADA)<\/li>\n\n\n\n<li>Ethics: Guide to the Code of Ethics for Nurses with Interpretive Statements: Development,<br>Interpretation, and Application<\/li>\n\n\n\n<li>Healthy People: Office of Disease Promotion and Health Prevention<\/li>\n\n\n\n<li>Health Promotion: The Guide to Clinical Preventive Services 2014: Recommendations of the<br>U.S. Preventive Services Task Force (USPSTF)<\/li>\n\n\n\n<li>Hyperlipidemia: (ACC\/AHA)<\/li>\n\n\n\n<li>Hypertension: (JNC 8)<\/li>\n\n\n\n<li>Mental Health: American Psychiatric Association. Diagnostic and Statistical Manual of Mental<br>Disorders (APA)<\/li>\n\n\n\n<li>Pediatrics: American Academy of Pediatrics. (AAP \u2013 Bright Futures)<\/li>\n\n\n\n<li>Sexually Transmitted Diseases (CDC)<br>3 \/ 4<br>Maximize Your Score<\/li>\n<\/ul>\n\n\n\n<ol class=\"wp-block-list\">\n<li>The FIRST ANSWER that pops in your head: it\u2019s usually the correct answer<\/li>\n\n\n\n<li>If you are GUESSING: pick an answer at random and DO NOT CHANGE IT unless you are sure.<br>a. Click mark command: this will allow you to return to the question later when you complete the<br>exam.<br>b. AVOID changing too many answers (no more than 3): If you are not sure, then leave the<br>answer alone.<br>c. AVOID choosing exotic diseases as answers if you are guessing: Remember, these are tests<br>for primary care conditions.<br>d. Methods of Guessing<br>i. Look for a pattern and pick the answer that does not fit the pattern.<br>ii. Pick the answer that you are most \u201cattracted\u201d to \u2013 go with your gut and DO NOT<br>CHANGE the answer unless you are very sure.<\/li>\n\n\n\n<li>READ SLOWLY and carefully throughout the test: Make sure that you understand the stem of the<br>question (usually the last sentence of a question)<\/li>\n\n\n\n<li>If you are having issues choosing \/ understanding the answer options: try to read them from the<br>bottom up (from option D to A, or from 4 to 1).<\/li>\n\n\n\n<li>Only eliminate wrong answers AFTER you read all the answer choices<\/li>\n\n\n\n<li>If an answer option contains all-inclusive words \u201call,\u201d \u201cnone,\u201d \u201cevery,\u201d \u201cnever,\u201d \u201cnone\u201d: IT IS<br>PROBABLY WRONG. Be careful with certain words such as \u201calways,\u201d \u201cexactly,\u201d \u201coften,\u201d \u201csometimes,\u201d and<br>\u201cmostly.\u201d<\/li>\n\n\n\n<li>Assume each question has enough information to answer it correctly: Questions and answers are<br>carefully designed. Take the facts at face value.<\/li>\n\n\n\n<li>The first few questions are usually harder to solve: This is a common test design. Do not let it shake<br>your confidence. (Guess the answer and \u201cmark\u201d it so that you can return to it later.)<\/li>\n\n\n\n<li>Read the last sentence or stem of long questions and case scenarios first: this saves you time and mental<br>strain. Then, read the question again from the beginning. This \u201cbackwards technique\u201d allows you to know<br>ahead of time what the question is asking for so when you read it again, it becomes easier to recognize<br>important clues that will help you answer the question.<\/li>\n\n\n\n<li>Just because a statement or an answer is true does not mean that it is the correct answer: If it does<br>not answer the stem of the question, then it is the wrong answer.<\/li>\n\n\n\n<li>Design and memorize your \u201cscratch paper\u201d BEFORE YOU TAKE THE EXAM: Choose what you want<br>on it wisely. Remember to keep it brief.<br>a. Use the \u201cfree\u201d computer tutorial time to write down the facts you memorized for your scratch<br>paper (If you run out of time, skip this step)<br>b. Suggested facts to write down: lab results (hemoglobin, hematocrit, MCV, platelets, WBC<br>count, neutrophil percentage, potassium, urinalysis, etc.). Other popular choices are the<br>murmurs, mnemonics, and cranial nerves.<\/li>\n\n\n\n<li>NEVER LEAVE QUESTIONS UNANSWERED: there is NO penalty for guessing. Questions that are left<br>blank are marked as errors (0 points). If you have only 30 minutes left and you are not done, quickly<br>answer the remaining questions at random.<\/li>\n\n\n\n<li>DO NOT SPEND MORE THAN 60 SECONDS ON A QUESTION: doing so, wastes time. Answer it at<br>random and then \u201cmark\u201d it so that you can return to it later (after you finish the entire test).<\/li>\n\n\n\n<li>Consider a quick break (if you have enough time) if you get too mentally fatigued: Solving 200<br>questions is pretty intense. If you feel \u201cfuzzy\u201d or tired, go to the bathroom and get a drink of water, and<br>splash cold water on your face. This can take less than 5 minutes. You can bring bottled water, but you<br>have to leave it outside the testing area.<\/li>\n\n\n\n<li>COUNTDOWN CLOCK does NOT stop for breaks: Do not use more than 5 mins for your quick<br>bathroom break.<\/li>\n\n\n\n<li>Do not panic or let your anxiety take over: Learn to use a calming technique (controlled breathing) to<br>calm yourself quickly before you take the exam.<\/li>\n\n\n\n<li>MOST IMPORTANT ADVICE: Aim for at least 7 to 8 hours of sleep the night before the exam!<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>m Format \u2022 AANP FNP exam contains very few nonclinical questions<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[],"tags":[],"class_list":["post-111217","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/111217","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=111217"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/111217\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=111217"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=111217"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=111217"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}