Family Nurse Practitioner Test Questions And
Answers Verified 100% Correct
1st line tx for depression: - ANSWER SSRI. Second line tx TCAs. TCAs are also used
as prophylactic treatment of migraine headaches, chronic pain, and neuropathic pain
such as post herpatic neuralgia.
Ex: amitriptyline(elavil), nortriptyline(Pamelor)
do not give suicidal pt TCAs because of high risk of hoarding and overdosing.
Overdose of TCAs can be fatal(cardiac and CNS toxicity)
SSRI: - ANSWER SSRI are firrst line treatment for OCD, generalized anxiety
discorder, panic disorder, social anxiety disorder(extreme shyness) and premenstrual
mood disorder(fluoxetine or Prozac) Examples of SSRI: citalopram(Celexa),
ecitalopram(lexapro), fluoxetine(Prozac, sertraline (Zoloft), paroxetine (Paxil)
CAGE mnemonic: - ANSWER A screening tool used to screen patients for possible
alcohol abuse. Scoring two out of 4 is highly suggestive of alcohol abuse.
Thizide diuretics: - ANSWER Prefered for hypertension patients with osteopenia or
osteoporosis. The mechanism of action of thiazide on the bone is that it decreases
calcium excretion by the kidneys and it stimulates osteoclast activity that helps with
bone formation
Beta blockers: - ANSWER Are contraindicated in asthmatics or patients with chronic
lung diseases such as astma , COPD, emphysema, or chonic bronchitis.
Acute diverticulitis: - ANSWER Tx outpt w ciprofloxacin 500mg PO BID plus
metronidazole PO TID for 10 to 14 days
Rocky Mountain Spotted fever: - ANSWER South central US, classsic rash (red rash
on both wrists and ankles that spread centrally with involvement of the palms and the
soles) systemic symptoms-high fever, headache, myalgia, nausea. can cause death if
not treated with the first 8 days of symptoms
Rocky Mountain spotted fever (RMSF) - ANSWER Dog/wood tick bite, spirochete
called Rickettsia rickettsia. Treatment with doxycycline 100mg PO/IV for minimum of 7
days
Early lyme disease (erythema migrans rash stage): - ANSWER Oxodes(deer) tick
bite, spirochete called Borrelia burgdorferi of the cases are in the Mid Atri. treatment
with doxycycline x 21 days. Majority of the cases are in theMid Atlantic and New
England states(CT, MA, NY, NJ, PA)
,ITP(Idiopathic thrombocytopenic purpura - ANSWER Severity ranges from mild to
severe(platelet count less than 30,000/) Platelets are broken down by the spleen,
causing thrombocytopenia. Look for easy bruising, petechiae, purpura, epistxis, and
gingival bleeding. Initial treatment for ITP is glucocorticoids(prednisone) based on
platelet response.
Estimated GFR: - ANSWER Better test of renal function compared with the serum
creatinine concentration. A GFR value fo 60 or less is a sign of kidney damage(refer to
nephrologist) The GFR is an estimated alue, it is not measured directly and is
computed using the serum creatinine value in the Cockcroft-Gault(or MDRD study)
equations.
Serum creatinine: - ANSWER Is affected by age(less sensitive in elderly) gender
(higher in males), ethnicity (higher with African American background) and other factors.
BUN: - ANSWER Is a waste product of the protein from foods that you have eaten. If
you eat more protein before the test, it will increase(or decrease with low protein
intake) Dehydration will elevate the BUN value.
Liver(cytochrome P450 enzyme system): - ANSWER Most active organ.
Drug excretion: - ANSWER Almost all drugs chemicals are broken down by the liver
and excreted from the body in the bile, urine, feces, respiratory gas(Co2) and as sweat.
Trough: - ANSWER The lowest concentration fo a drug after a dose
Potent inhibitors of the cytochrome P450 system: - ANSWER These drugs are
respnsible for a large number of drug -drug interactions
Macrolides(erythromycin, clarithromycin, pediazole)
Antifungals(ketoconazole, fluconazole)
Cisapride(Proulsid)
Cimetidine(Tagament)
Citaprolam(Celexa)
Coumadin: - ANSWER For A fib the target INR is from 2.0 to 3.0.
INR values below 2.0 increase stroke risk sixfold
Vitamin K: - ANSWER Mayonnaise, canola oil, and soybean oil has Vitamin K
Adverse effects of thiazide dieuretics: - ANSWER Hyperglycemia, elevated
triglycerides and LDL, elevattes uric acid, hypokalemia.
,Thiazide diuretics: - ANSWER Pt with both htn and osteoporosis have an extra benefit
from thiazides. thiazide diuretics decrease calcium excretion by the kidneys and
stimulate osteoclasts formation. Patients with serious sulfa allergies should avoid
thiazide diuretics. Potassium sparing diuretics can be used as alternative.
Potassium sparing diuretics: - ANSWER Hypertension alternative dieuretics with
severe sulfa allergy.
Loop diuretics: - ANSWER Edema from heart failure, cirrhosis , renal disease,
hypertension. Loop diuretics are excreted via loop of Henle of the kidneys and are
more motent than Hctz. Ex: Lasix, Gumetanide. Loop diuretics are more potent tha
thiazides , but shorter duration of action
Adverse effect of loop diuretics: - ANSWER Electrolytes imblance, hypocolemia,
pancreatitis, juandice, rash. ototoxicity.
Aldosterone Antagonists: - ANSWER Hirsuitism, htn, sever heart failure. exp
spironolactone. Adverse effects are galactorrhea and hyperkalemia. Spironolactone is
rarely used to treat htn in primary care due to adverse effects and higher risk of certain
cancer.
Beta Blockers: - ANSWER HTN, post myocardial infarction(first line),
angina,
arrhythmias, migraine prophylaxis. Adjunct tretment-
hyperthyroidism/thyrotoxicosis
(decrease HR, anxiety). Migrain prophylaxis-non-cardioselective(blocks beta 1 and
beta
2).
Cardio selective(blocks beta 1 only)-atenolol(tenormin), metoprolol
(lopressor)
Adverse effects of beta blockers: - ANSWER Bronchospasm, bradycardia, depression,
fatigue, erectile dysfunction, blunts hypoglycemic resonse
Contraindications of beta blockers: - ANSWER Asthma (causes bronchospasm)
COPD (causes bronchospasm)
Chronic bronchitis (causes bronchoconstriction)
Emphysema (casues bronchoconstriction)
Bradycardia and AV block (second to third degree block)
Ace inhibitors: - ANSWER Lisinopril(Zestril)
Captopril(Capoten)
Benazepril(lotensin)
, Combination: lisinopril and HCTZ (Zestoretic)
ENalapril(Vasotec)
Angiotensin II Receptor Blockers (ARBs) - ANSWER Valsartan(Diovan)
Losartan(Cozar)
Irbesartan(Avapro)
Potassium sparing diuretics: - ANSWER Triamterene(Dyrenium)
Triamterne + HCTZ(Dyazide)
Amiloride(Midamor)
Beta blockers: - ANSWER Propranolol(Inderal)
atenolol(Tenormin)
metoprolol(Lopressor)
pindolol(Visken)
Due not discontinue beta blockers a
Ace inhibitors and ARBS: - ANSWER Cat C (first trimestor) cat D (second and third
trimestor)
ACEI blocks conversion of angiotensin I to angiotensin II(potent vasocontrictor). ARBs
blocks angiotensin II(less aldonsteron). ACEI suffix "pril" ARBS suffix sartan"
Calcium Channel Blockers: - ANSWER HTN, Raynauds phenomenon(first line)
Amlodipine(Nirvasc)
Diltiazem(Cardizem)
Nifedipine(Procardia)
Verapamil(Calan. Do not mix with erythromycin and clarithromycin(drug interaction)
Contraindications:AV-block(second to third degree), bradycardia, CHF
Adverse effects of CCB: - ANSWER Headache
Periperhal edema(not due to fluid overload)
Bradycardia
HF, heart block
Hypotension, QT prologation
Constipation is the most commonly reported side effect
Alpha blockers: - ANSWER HTN with coexisting BPH
Terazosin(Hytrin) at bedtime-potent vasodilator
Macrolides(cat B): - ANSWER Erythromycin PO QID
Azithromycin (Z-pack)
Clarithromycin PO BID
Answers Verified 100% Correct
1st line tx for depression: - ANSWER SSRI. Second line tx TCAs. TCAs are also used
as prophylactic treatment of migraine headaches, chronic pain, and neuropathic pain
such as post herpatic neuralgia.
Ex: amitriptyline(elavil), nortriptyline(Pamelor)
do not give suicidal pt TCAs because of high risk of hoarding and overdosing.
Overdose of TCAs can be fatal(cardiac and CNS toxicity)
SSRI: - ANSWER SSRI are firrst line treatment for OCD, generalized anxiety
discorder, panic disorder, social anxiety disorder(extreme shyness) and premenstrual
mood disorder(fluoxetine or Prozac) Examples of SSRI: citalopram(Celexa),
ecitalopram(lexapro), fluoxetine(Prozac, sertraline (Zoloft), paroxetine (Paxil)
CAGE mnemonic: - ANSWER A screening tool used to screen patients for possible
alcohol abuse. Scoring two out of 4 is highly suggestive of alcohol abuse.
Thizide diuretics: - ANSWER Prefered for hypertension patients with osteopenia or
osteoporosis. The mechanism of action of thiazide on the bone is that it decreases
calcium excretion by the kidneys and it stimulates osteoclast activity that helps with
bone formation
Beta blockers: - ANSWER Are contraindicated in asthmatics or patients with chronic
lung diseases such as astma , COPD, emphysema, or chonic bronchitis.
Acute diverticulitis: - ANSWER Tx outpt w ciprofloxacin 500mg PO BID plus
metronidazole PO TID for 10 to 14 days
Rocky Mountain Spotted fever: - ANSWER South central US, classsic rash (red rash
on both wrists and ankles that spread centrally with involvement of the palms and the
soles) systemic symptoms-high fever, headache, myalgia, nausea. can cause death if
not treated with the first 8 days of symptoms
Rocky Mountain spotted fever (RMSF) - ANSWER Dog/wood tick bite, spirochete
called Rickettsia rickettsia. Treatment with doxycycline 100mg PO/IV for minimum of 7
days
Early lyme disease (erythema migrans rash stage): - ANSWER Oxodes(deer) tick
bite, spirochete called Borrelia burgdorferi of the cases are in the Mid Atri. treatment
with doxycycline x 21 days. Majority of the cases are in theMid Atlantic and New
England states(CT, MA, NY, NJ, PA)
,ITP(Idiopathic thrombocytopenic purpura - ANSWER Severity ranges from mild to
severe(platelet count less than 30,000/) Platelets are broken down by the spleen,
causing thrombocytopenia. Look for easy bruising, petechiae, purpura, epistxis, and
gingival bleeding. Initial treatment for ITP is glucocorticoids(prednisone) based on
platelet response.
Estimated GFR: - ANSWER Better test of renal function compared with the serum
creatinine concentration. A GFR value fo 60 or less is a sign of kidney damage(refer to
nephrologist) The GFR is an estimated alue, it is not measured directly and is
computed using the serum creatinine value in the Cockcroft-Gault(or MDRD study)
equations.
Serum creatinine: - ANSWER Is affected by age(less sensitive in elderly) gender
(higher in males), ethnicity (higher with African American background) and other factors.
BUN: - ANSWER Is a waste product of the protein from foods that you have eaten. If
you eat more protein before the test, it will increase(or decrease with low protein
intake) Dehydration will elevate the BUN value.
Liver(cytochrome P450 enzyme system): - ANSWER Most active organ.
Drug excretion: - ANSWER Almost all drugs chemicals are broken down by the liver
and excreted from the body in the bile, urine, feces, respiratory gas(Co2) and as sweat.
Trough: - ANSWER The lowest concentration fo a drug after a dose
Potent inhibitors of the cytochrome P450 system: - ANSWER These drugs are
respnsible for a large number of drug -drug interactions
Macrolides(erythromycin, clarithromycin, pediazole)
Antifungals(ketoconazole, fluconazole)
Cisapride(Proulsid)
Cimetidine(Tagament)
Citaprolam(Celexa)
Coumadin: - ANSWER For A fib the target INR is from 2.0 to 3.0.
INR values below 2.0 increase stroke risk sixfold
Vitamin K: - ANSWER Mayonnaise, canola oil, and soybean oil has Vitamin K
Adverse effects of thiazide dieuretics: - ANSWER Hyperglycemia, elevated
triglycerides and LDL, elevattes uric acid, hypokalemia.
,Thiazide diuretics: - ANSWER Pt with both htn and osteoporosis have an extra benefit
from thiazides. thiazide diuretics decrease calcium excretion by the kidneys and
stimulate osteoclasts formation. Patients with serious sulfa allergies should avoid
thiazide diuretics. Potassium sparing diuretics can be used as alternative.
Potassium sparing diuretics: - ANSWER Hypertension alternative dieuretics with
severe sulfa allergy.
Loop diuretics: - ANSWER Edema from heart failure, cirrhosis , renal disease,
hypertension. Loop diuretics are excreted via loop of Henle of the kidneys and are
more motent than Hctz. Ex: Lasix, Gumetanide. Loop diuretics are more potent tha
thiazides , but shorter duration of action
Adverse effect of loop diuretics: - ANSWER Electrolytes imblance, hypocolemia,
pancreatitis, juandice, rash. ototoxicity.
Aldosterone Antagonists: - ANSWER Hirsuitism, htn, sever heart failure. exp
spironolactone. Adverse effects are galactorrhea and hyperkalemia. Spironolactone is
rarely used to treat htn in primary care due to adverse effects and higher risk of certain
cancer.
Beta Blockers: - ANSWER HTN, post myocardial infarction(first line),
angina,
arrhythmias, migraine prophylaxis. Adjunct tretment-
hyperthyroidism/thyrotoxicosis
(decrease HR, anxiety). Migrain prophylaxis-non-cardioselective(blocks beta 1 and
beta
2).
Cardio selective(blocks beta 1 only)-atenolol(tenormin), metoprolol
(lopressor)
Adverse effects of beta blockers: - ANSWER Bronchospasm, bradycardia, depression,
fatigue, erectile dysfunction, blunts hypoglycemic resonse
Contraindications of beta blockers: - ANSWER Asthma (causes bronchospasm)
COPD (causes bronchospasm)
Chronic bronchitis (causes bronchoconstriction)
Emphysema (casues bronchoconstriction)
Bradycardia and AV block (second to third degree block)
Ace inhibitors: - ANSWER Lisinopril(Zestril)
Captopril(Capoten)
Benazepril(lotensin)
, Combination: lisinopril and HCTZ (Zestoretic)
ENalapril(Vasotec)
Angiotensin II Receptor Blockers (ARBs) - ANSWER Valsartan(Diovan)
Losartan(Cozar)
Irbesartan(Avapro)
Potassium sparing diuretics: - ANSWER Triamterene(Dyrenium)
Triamterne + HCTZ(Dyazide)
Amiloride(Midamor)
Beta blockers: - ANSWER Propranolol(Inderal)
atenolol(Tenormin)
metoprolol(Lopressor)
pindolol(Visken)
Due not discontinue beta blockers a
Ace inhibitors and ARBS: - ANSWER Cat C (first trimestor) cat D (second and third
trimestor)
ACEI blocks conversion of angiotensin I to angiotensin II(potent vasocontrictor). ARBs
blocks angiotensin II(less aldonsteron). ACEI suffix "pril" ARBS suffix sartan"
Calcium Channel Blockers: - ANSWER HTN, Raynauds phenomenon(first line)
Amlodipine(Nirvasc)
Diltiazem(Cardizem)
Nifedipine(Procardia)
Verapamil(Calan. Do not mix with erythromycin and clarithromycin(drug interaction)
Contraindications:AV-block(second to third degree), bradycardia, CHF
Adverse effects of CCB: - ANSWER Headache
Periperhal edema(not due to fluid overload)
Bradycardia
HF, heart block
Hypotension, QT prologation
Constipation is the most commonly reported side effect
Alpha blockers: - ANSWER HTN with coexisting BPH
Terazosin(Hytrin) at bedtime-potent vasodilator
Macrolides(cat B): - ANSWER Erythromycin PO QID
Azithromycin (Z-pack)
Clarithromycin PO BID
