AC-PNP Exam Review
Comprehensive Questions
(Frequently Tested) with
Verified Answers Graded A+
List drug options that will cover a pseudomonas - Answer: Ceftazidime, cefipime,
Pipercillin/ticarcillin, Meropenem, imipenem,aztreonam, Flouroquinolones, Aminoglycosides
Describe the differences in CSF findings between bacterial, viral, & herpes meningitis - Answer:
Bacterial- Decreased glucose and highly Increased WBC, Lactate, protein: Diff- PMN
Viral- Glucose normal and lactate normal or decreased, protein and WBC mildly increased. DIff
PMN first than monos
Herpes- Glucose normal, protein and WBC increased, Diff PMN than monos, RBC >1000 in
absence of traumatic tap.
List signs & symptoms of malaria - Answer: Fever, CNS dysfunction, anemia, hemoglobinuria,
sweats, chills, HA, pulmonary edema, N&V, coagulopathy, myalgia, shock, fatigue, renal failure,
hepatosplenomegaly, metabolic acidosis, tachypnea, hypoglycemia
3rd generation cephalosporins cover which organisms? - Answer: Gram Positive, HENPEK,
Serratia, Ceftazidime also covers pseudomonas
,Review the signs & symptoms, course, and treatment for the 2 organisms causing toxic shock.
Which is worse? - Answer: Early symptoms = pain is the most common initial symptom,
fever/hypothermia, confusion, soft tissue infection, positive blood culture (60%), or rash
S. pyogenes causes hypotension- 2 of the following: renal dysfunction, coagulopathy, ARDS,
tissue necrosis, erythematous rash, skin desquamation 10-14 days after onset, high mortality, Tx
with supportive care, clindamycin and debridement;
S. aureus- fever, hypotention and rash -involvement of 3 or more organ systems, Absence of
rocky mountain spotted fever, leptospirosis, measles, mono, or syphilis. High morbidity. Treat
with supportive care, nafcillin, (vancomycin for MRSA) and debridement
State one major pediatric theorist for each of the following: Psychosocial, cognitive and moral
development - Answer: Psychosocial: Erickson
Cognitive: Piaget
Moral: Kohlberg
At what age should children first be able to combine words? - Answer: 18 months
Erikson's stage of Industry vs. inferiortiy coincides with which Piaget stage? - Answer: Concrete
Operations
What are the adverse effects of ginkgo biloba? - Answer: Bleeding events r/t inhibition of
platelet activating factor, subdural hematoma, cerebral hemorrhage, hyphema and post-op
bleeding complications, increased CBF may result in increased ICP, may potentiate
anticoagulation
What is St. John's Wort used for and what are the adverse effects? - Answer: Used for mild
depresssion, Generally well tolerated, Headache, GI disturbances, Phytophotoxic dermatitis,
Reduces plasma levels of protease inhibitors
Name two classes of medication that can be used as adjuvants to treat pain - Answer:
Antidepressants or anticonvulsants
,Name the 5 cranial nerves important to eating - Answer: V Trigeminal SM, VII facial SM, IX
Glossopharyngeal SM, X Vagus M, XII Hypoglossal M
Describe Epidural Hemmorhages? - Answer: Epidural, between inner table of skull and dura
mater, lenticular shape, do not cross hemispheres, often follow middle meningeal artery tear,
period of lucency followed by decreased LOA, emergent surgical evacuation if symptomatic
Describe Subdural Hemmorhages? - Answer: Subdural, between dura mater and arachnoid, may
be associated with a skull fracture, often bilateral and will cross hemispheres, symptoms may be
acute or insidious ICP- surgical evacuation if symptomatic
Describe subarchnoid hemmorhage? - Answer: Subarachnoid, between arachnoid and pia
mater, severe headache and neck pain, surgical evacuation if symptomatic
"Name and describe the type of migraine typical to adolescence? - Answer: Common migraine
without aura, throbbing or pounding headache that is usually unilateral, may have nausea and
vomiting, often relieved by sleep
Summarize signs and symptoms of depression? - Answer: Usually coherent and clear thinking,
history of deterioration of scoial/school activities, weight gain/loss, lethargic/apatheticvs
anxious with angry outbursts, sleep disturbances, may have suicidal ideation
Describe pertussis... course, diagnosis and treatment? - Answer: Course, catarrhal phase,
paroxysmal phase, convelescent phase. May have co-findings of pneumonia, otits, seizures or
encephalitis
Diagnosis- Lymphocytosis, Bordetella pertussis, a coccobacillus.
Treatment erythromycin
, Review the signs, symptoms , and etiology of Guillain-Barre vs. Botulism - Answer: Guillain-
Barre' -- May follow non specific viral infection or commonly, Campylobacter, Landry's
ascending. Paralysis. CSF in notable for few white cells and high protein. Botulism- Clostridium
botulinum -A gram positive Anaerobe. Rapid descending . Paralysis. CSF is normal. Avoid
antibiotics
" - Answer:
What is transient tachypnea of the newborn? - Answer: Usually follows uneventful deliveries .
May be related to slower absorption of fetal lung fluid resulting. Decreased pulmonary
compliance and increased dead space. Usually resolves in approximately 3 days without
therapy.
Review the criteria for ARDS - Answer: Acute onset of symptoms following, precipitating
infection of insult, frontal chest xray biliateral infiltrates. No clinical evidence of LA HTN, PsO2 to
Fio2 ratio </= 200
What are the radiologic findings for asthma? - Answer: Asthma, flattened diaphragm, narrow
cardiac silhouette, hyperinflation, narrow cardiac silhouette, peribronchial thickening,
subsegmental atelectasis
Describe methods to treat hyperkalemia - Answer: Push K into cells- Albuterol, Insulin/glucose,
Sodium bicarbonate - Remove K- Kayexalate, dialysis; Stabilize cardiac cell membrane- Ca
chloride
What is the equation to calculate creatinine clearance in children? - Answer: K x ht (cm)/serum
creatnine - K equals Preemie 0.33, Term 0.45, 2-21yrs female, 0.55 2-21 yrs male .70
Review the diagnostic criteria, treatment, and followup for urinary tract infection in young
children - Answer: Diagnostic Criteria- Unexplained fever( 2mos- 2yrs), + nitrite test, +
leukoesterase test, 5 WBC's, Colony coutn > 100,000, Culture of 2 or less organisms;
Comprehensive Questions
(Frequently Tested) with
Verified Answers Graded A+
List drug options that will cover a pseudomonas - Answer: Ceftazidime, cefipime,
Pipercillin/ticarcillin, Meropenem, imipenem,aztreonam, Flouroquinolones, Aminoglycosides
Describe the differences in CSF findings between bacterial, viral, & herpes meningitis - Answer:
Bacterial- Decreased glucose and highly Increased WBC, Lactate, protein: Diff- PMN
Viral- Glucose normal and lactate normal or decreased, protein and WBC mildly increased. DIff
PMN first than monos
Herpes- Glucose normal, protein and WBC increased, Diff PMN than monos, RBC >1000 in
absence of traumatic tap.
List signs & symptoms of malaria - Answer: Fever, CNS dysfunction, anemia, hemoglobinuria,
sweats, chills, HA, pulmonary edema, N&V, coagulopathy, myalgia, shock, fatigue, renal failure,
hepatosplenomegaly, metabolic acidosis, tachypnea, hypoglycemia
3rd generation cephalosporins cover which organisms? - Answer: Gram Positive, HENPEK,
Serratia, Ceftazidime also covers pseudomonas
,Review the signs & symptoms, course, and treatment for the 2 organisms causing toxic shock.
Which is worse? - Answer: Early symptoms = pain is the most common initial symptom,
fever/hypothermia, confusion, soft tissue infection, positive blood culture (60%), or rash
S. pyogenes causes hypotension- 2 of the following: renal dysfunction, coagulopathy, ARDS,
tissue necrosis, erythematous rash, skin desquamation 10-14 days after onset, high mortality, Tx
with supportive care, clindamycin and debridement;
S. aureus- fever, hypotention and rash -involvement of 3 or more organ systems, Absence of
rocky mountain spotted fever, leptospirosis, measles, mono, or syphilis. High morbidity. Treat
with supportive care, nafcillin, (vancomycin for MRSA) and debridement
State one major pediatric theorist for each of the following: Psychosocial, cognitive and moral
development - Answer: Psychosocial: Erickson
Cognitive: Piaget
Moral: Kohlberg
At what age should children first be able to combine words? - Answer: 18 months
Erikson's stage of Industry vs. inferiortiy coincides with which Piaget stage? - Answer: Concrete
Operations
What are the adverse effects of ginkgo biloba? - Answer: Bleeding events r/t inhibition of
platelet activating factor, subdural hematoma, cerebral hemorrhage, hyphema and post-op
bleeding complications, increased CBF may result in increased ICP, may potentiate
anticoagulation
What is St. John's Wort used for and what are the adverse effects? - Answer: Used for mild
depresssion, Generally well tolerated, Headache, GI disturbances, Phytophotoxic dermatitis,
Reduces plasma levels of protease inhibitors
Name two classes of medication that can be used as adjuvants to treat pain - Answer:
Antidepressants or anticonvulsants
,Name the 5 cranial nerves important to eating - Answer: V Trigeminal SM, VII facial SM, IX
Glossopharyngeal SM, X Vagus M, XII Hypoglossal M
Describe Epidural Hemmorhages? - Answer: Epidural, between inner table of skull and dura
mater, lenticular shape, do not cross hemispheres, often follow middle meningeal artery tear,
period of lucency followed by decreased LOA, emergent surgical evacuation if symptomatic
Describe Subdural Hemmorhages? - Answer: Subdural, between dura mater and arachnoid, may
be associated with a skull fracture, often bilateral and will cross hemispheres, symptoms may be
acute or insidious ICP- surgical evacuation if symptomatic
Describe subarchnoid hemmorhage? - Answer: Subarachnoid, between arachnoid and pia
mater, severe headache and neck pain, surgical evacuation if symptomatic
"Name and describe the type of migraine typical to adolescence? - Answer: Common migraine
without aura, throbbing or pounding headache that is usually unilateral, may have nausea and
vomiting, often relieved by sleep
Summarize signs and symptoms of depression? - Answer: Usually coherent and clear thinking,
history of deterioration of scoial/school activities, weight gain/loss, lethargic/apatheticvs
anxious with angry outbursts, sleep disturbances, may have suicidal ideation
Describe pertussis... course, diagnosis and treatment? - Answer: Course, catarrhal phase,
paroxysmal phase, convelescent phase. May have co-findings of pneumonia, otits, seizures or
encephalitis
Diagnosis- Lymphocytosis, Bordetella pertussis, a coccobacillus.
Treatment erythromycin
, Review the signs, symptoms , and etiology of Guillain-Barre vs. Botulism - Answer: Guillain-
Barre' -- May follow non specific viral infection or commonly, Campylobacter, Landry's
ascending. Paralysis. CSF in notable for few white cells and high protein. Botulism- Clostridium
botulinum -A gram positive Anaerobe. Rapid descending . Paralysis. CSF is normal. Avoid
antibiotics
" - Answer:
What is transient tachypnea of the newborn? - Answer: Usually follows uneventful deliveries .
May be related to slower absorption of fetal lung fluid resulting. Decreased pulmonary
compliance and increased dead space. Usually resolves in approximately 3 days without
therapy.
Review the criteria for ARDS - Answer: Acute onset of symptoms following, precipitating
infection of insult, frontal chest xray biliateral infiltrates. No clinical evidence of LA HTN, PsO2 to
Fio2 ratio </= 200
What are the radiologic findings for asthma? - Answer: Asthma, flattened diaphragm, narrow
cardiac silhouette, hyperinflation, narrow cardiac silhouette, peribronchial thickening,
subsegmental atelectasis
Describe methods to treat hyperkalemia - Answer: Push K into cells- Albuterol, Insulin/glucose,
Sodium bicarbonate - Remove K- Kayexalate, dialysis; Stabilize cardiac cell membrane- Ca
chloride
What is the equation to calculate creatinine clearance in children? - Answer: K x ht (cm)/serum
creatnine - K equals Preemie 0.33, Term 0.45, 2-21yrs female, 0.55 2-21 yrs male .70
Review the diagnostic criteria, treatment, and followup for urinary tract infection in young
children - Answer: Diagnostic Criteria- Unexplained fever( 2mos- 2yrs), + nitrite test, +
leukoesterase test, 5 WBC's, Colony coutn > 100,000, Culture of 2 or less organisms;
