FNP (boards study review)
Nurse Practitioner Process Correct Answer: 1. History
2. Assessments
3. Labs/Diagnostic
4. Diagnosis
5. Least invasive, least expensive
6. First Line treatment
Nurse Practitioner Process Continues Correct Answer: 1. Introduction
2. CC
3. ROS
4. Physical Exam
5. Plan
6. First line tx
Infection Markers
Erythrocyte Sedimentation rate (ESR)
Antinuclear antibodies (ANA)
C-Reactive Protein Correct Answer: Rheumatic Fever- (ESR), (C-reactive)
Lupus- (ESR), C-reactive, ANA
Rheumatoid Arthritis - ESR, ANA
Lymph Nodes Correct Answer: Located throughout the body, but visible and palpable when they are
enlarged or swollen.
Epitrochlear Lymph Nodes Correct Answer: Epitrochlear lymph nodes- drains from the hand and
forearm proximally via epitrochlear lymph node
High Potency Steroids Correct Answer: causes atrophy, telangiecatasia (spider veins), purport, and
striae if used on the face
Fundoscope Exam Correct Answer: The examiner
a. Uses right hand for ophthalmoscope, uses right eye for pts right eye
b. Start with wheel at 0
c. Starts about 12'' from the patient with both eyes open
d. Moves in to within 1-2'' from the patient's eye
e. Should function as one with ophthalmoscope
2. After obtaining a red reflex, exam should proceed from the optic disc and end with fovea of each eye
Inspection of the Optic Disc
1. Shape: Doughnut-like with an orange/pink neuroretinal rim and a central white depression
(physiological cup)
,2. Cup disk ratio: Cup should not be more
than 1/2 the size of the diameter of disk diameter, the optic disk is area where optic nerve and blood
vessels enter the retina (if larger, consider glaucoma)
Retinal vessels
1. Arteries are brighter and narrower than veins; A:V ratio = 2:3 or 4:5, if raised area where a artery and
a vein meet
- Hypertension (AV Nickling)
Glaucoma optic disk Correct Answer:
Macula Correct Answer: 1. Creamy yellow Centered: 2-2.5 disc diameter temporal to the optic disk and
is avascular
- Have the pt look directly in the scope if macula is difficult to visualize, or have the patient look directly
into the light
2. The fovea centralis is a 2.5 mm-diameter reflective area that looks slightly darker and lies in the
center of the macular region
- The fovea is composed of closely packed cones on the eye
-located in the center of the macula
-responsible for sharp central vision
3. Patient should look directly into the light of the ophthalmoscope, if the macula is difficult to visualize
Cones of the eye Correct Answer: Responsible of color
Visual Acuity
-Snellen Chart Correct Answer: 1. Snellen eye chart: 20/20 means that "the patient can see at 20 feet
what the normal person can see at 20 feet" (the larger the denominator, the poorer the patient's vision)
-20/40 = a person can see at 20 feet what the normal person (without impairment) can see at 40 ft
-If 20/30 = Referral stage
CN II = Snellen chart
Hyperopia Correct Answer: "Farsightedness" (on freeway and can't see the signs)
Myopia Correct Answer: Nearsightedness
Presbyopia Correct Answer: Common after age 40; results in greater difficulty maintaining a clear focus
at a near distance die to a lessening of flexibility of the crystalline lens and weakening of the ciliary
muscles which control lens focusing
Arcus Senilis Correct Answer: 5. Arcus senilis: cloudy appearance of the cornea with a gray/white arc or
circle around the limbus due to deposition of the lipid material; the arcus has no effect on vision-
permanent change, need to make sure they are taking their statins
Pterygium Correct Answer: Raised wedge-shaped growth of thin, noncancerous tissue over the
conjunctiva (conjunctiva is transparent and sits over the sclera)
,Hordeolum (Stye) Correct Answer: (Stye-this hurts)
Acute inflammation of the eyelid, usually caused by (staph aureus)
Signs/symptoms
Abrupt onset with pain and erythema of the eyelid (tender painful mass) (chalazion = painless)
Management
1. *Warm compressor*
2. Topical bacitracin or erythromycin opthalmic ointment
3. Refer to opthamalogist if not better x 2 days
Chalazion Correct Answer: (No Pain)
Beady nodule on the eyelid, infection or retention cyst usually on upper eyelid
Signs/symptoms
-painless
-swelling
-tenderness to eyelid
-tearing
Management
1. Warm compresses
2. Refer for surgical removal
Blepharitis Correct Answer: Staphylococcus infection or seborrheic dermatitis of the eyelid
Signs/symptoms
-red, scaly, greasy flakes (classic)
-thickened, crusted lid margins
-burning
-itching
-tearing
Management
1. Hot compressed
2. Topical abx (bacitracin or erythromycin)
3. Vigrously scrub & rinse lashes, may use an old toothbrush
Conjunctivitis
Bacterial
, Gonococcal or
Chlamydial
Allergic
Viral Correct Answer: (There is no pain, if there is pain it may be a corneal abrasion)
Most common infection of the conjunctiva (pink eye) painless
S/s- Prulent drainage = evidence to use Abx
Treatment
1. Self limiting-2 hr max
2. Antibiotic drops
Levofloxacin
Ofloxacin
Ciprofloxacin
Tobbramycin
Gentamycin ophthalmic solution
Nurse Practitioner Process Correct Answer: 1. History
2. Assessments
3. Labs/Diagnostic
4. Diagnosis
5. Least invasive, least expensive
6. First Line treatment
Nurse Practitioner Process Continues Correct Answer: 1. Introduction
2. CC
3. ROS
4. Physical Exam
5. Plan
6. First line tx
Infection Markers
Erythrocyte Sedimentation rate (ESR)
Antinuclear antibodies (ANA)
C-Reactive Protein Correct Answer: Rheumatic Fever- (ESR), (C-reactive)
Lupus- (ESR), C-reactive, ANA
Rheumatoid Arthritis - ESR, ANA
Lymph Nodes Correct Answer: Located throughout the body, but visible and palpable when they are
enlarged or swollen.
Epitrochlear Lymph Nodes Correct Answer: Epitrochlear lymph nodes- drains from the hand and
forearm proximally via epitrochlear lymph node
High Potency Steroids Correct Answer: causes atrophy, telangiecatasia (spider veins), purport, and
striae if used on the face
Fundoscope Exam Correct Answer: The examiner
a. Uses right hand for ophthalmoscope, uses right eye for pts right eye
b. Start with wheel at 0
c. Starts about 12'' from the patient with both eyes open
d. Moves in to within 1-2'' from the patient's eye
e. Should function as one with ophthalmoscope
2. After obtaining a red reflex, exam should proceed from the optic disc and end with fovea of each eye
Inspection of the Optic Disc
1. Shape: Doughnut-like with an orange/pink neuroretinal rim and a central white depression
(physiological cup)
,2. Cup disk ratio: Cup should not be more
than 1/2 the size of the diameter of disk diameter, the optic disk is area where optic nerve and blood
vessels enter the retina (if larger, consider glaucoma)
Retinal vessels
1. Arteries are brighter and narrower than veins; A:V ratio = 2:3 or 4:5, if raised area where a artery and
a vein meet
- Hypertension (AV Nickling)
Glaucoma optic disk Correct Answer:
Macula Correct Answer: 1. Creamy yellow Centered: 2-2.5 disc diameter temporal to the optic disk and
is avascular
- Have the pt look directly in the scope if macula is difficult to visualize, or have the patient look directly
into the light
2. The fovea centralis is a 2.5 mm-diameter reflective area that looks slightly darker and lies in the
center of the macular region
- The fovea is composed of closely packed cones on the eye
-located in the center of the macula
-responsible for sharp central vision
3. Patient should look directly into the light of the ophthalmoscope, if the macula is difficult to visualize
Cones of the eye Correct Answer: Responsible of color
Visual Acuity
-Snellen Chart Correct Answer: 1. Snellen eye chart: 20/20 means that "the patient can see at 20 feet
what the normal person can see at 20 feet" (the larger the denominator, the poorer the patient's vision)
-20/40 = a person can see at 20 feet what the normal person (without impairment) can see at 40 ft
-If 20/30 = Referral stage
CN II = Snellen chart
Hyperopia Correct Answer: "Farsightedness" (on freeway and can't see the signs)
Myopia Correct Answer: Nearsightedness
Presbyopia Correct Answer: Common after age 40; results in greater difficulty maintaining a clear focus
at a near distance die to a lessening of flexibility of the crystalline lens and weakening of the ciliary
muscles which control lens focusing
Arcus Senilis Correct Answer: 5. Arcus senilis: cloudy appearance of the cornea with a gray/white arc or
circle around the limbus due to deposition of the lipid material; the arcus has no effect on vision-
permanent change, need to make sure they are taking their statins
Pterygium Correct Answer: Raised wedge-shaped growth of thin, noncancerous tissue over the
conjunctiva (conjunctiva is transparent and sits over the sclera)
,Hordeolum (Stye) Correct Answer: (Stye-this hurts)
Acute inflammation of the eyelid, usually caused by (staph aureus)
Signs/symptoms
Abrupt onset with pain and erythema of the eyelid (tender painful mass) (chalazion = painless)
Management
1. *Warm compressor*
2. Topical bacitracin or erythromycin opthalmic ointment
3. Refer to opthamalogist if not better x 2 days
Chalazion Correct Answer: (No Pain)
Beady nodule on the eyelid, infection or retention cyst usually on upper eyelid
Signs/symptoms
-painless
-swelling
-tenderness to eyelid
-tearing
Management
1. Warm compresses
2. Refer for surgical removal
Blepharitis Correct Answer: Staphylococcus infection or seborrheic dermatitis of the eyelid
Signs/symptoms
-red, scaly, greasy flakes (classic)
-thickened, crusted lid margins
-burning
-itching
-tearing
Management
1. Hot compressed
2. Topical abx (bacitracin or erythromycin)
3. Vigrously scrub & rinse lashes, may use an old toothbrush
Conjunctivitis
Bacterial
, Gonococcal or
Chlamydial
Allergic
Viral Correct Answer: (There is no pain, if there is pain it may be a corneal abrasion)
Most common infection of the conjunctiva (pink eye) painless
S/s- Prulent drainage = evidence to use Abx
Treatment
1. Self limiting-2 hr max
2. Antibiotic drops
Levofloxacin
Ofloxacin
Ciprofloxacin
Tobbramycin
Gentamycin ophthalmic solution
