ANCC FNP flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Sensitivity

Proportion of people with disease who test positive. A highly sensitive test has few false negatives, so a negative result is useful for ruling out a condition.

Specificity

Proportion of people without disease who test negative. High specificity means few false positives, so a positive result helps rule in the diagnosis.

Positive likelihood ratio

Sensitivity divided by one minus specificity. Values above 10 substantially raise the probability of disease and support ruling in a diagnosis at the bedside.

Number needed to treat

The reciprocal of absolute risk reduction. It estimates how many patients must receive a therapy for one additional person to benefit over the study period.

Anion gap

Sodium minus the sum of chloride and bicarbonate. Normal is roughly 8 to 12 mEq/L, and an elevated gap suggests a high-anion-gap metabolic acidosis.

Corrected sodium in hyperglycemia

Add 1.6 mEq/L to measured sodium for every 100 mg/dL that glucose exceeds 100. Severe hyperglycemia dilutes sodium and can mask true hyponatremia.

PHQ-9 scoring threshold

Scores of 5, 10, 15, and 20 mark mild, moderate, moderately severe, and severe depression. A score of 10 or higher generally warrants treatment or close follow-up.

CAGE questionnaire

Four yes-or-no items about cutting down, annoyance at criticism, guilt, and morning eye-openers. Two or more affirmative answers suggest an alcohol use disorder needing further assessment.

A1c diagnostic threshold

Diabetes is diagnosed when hemoglobin A1c is 6.5 percent or higher. Values from 5.7 to 6.4 percent define prediabetes and prompt lifestyle counseling with annual rescreening.

Stage 1 hypertension

Systolic 130 to 139 or diastolic 80 to 89 mmHg by ACC/AHA criteria. Management begins with lifestyle change, with medication guided by 10-year cardiovascular risk.

Metabolic syndrome criteria

Three of five findings: elevated waist circumference, triglycerides 150 mg/dL or higher, low HDL, blood pressure 130/85 or higher, and fasting glucose 100 mg/dL or higher.

CKD definition

eGFR below 60 mL/min/1.73 m2 or a kidney damage marker such as albumin-to-creatinine ratio of 30 mg/g or more, persisting for at least three months.

Chronic bronchitis definition

Productive cough on most days for at least three months in each of two consecutive years. In a patient with airflow obstruction it supports a COPD diagnosis.

Ottawa ankle rules

Ankle radiography is indicated when there is malleolar pain plus bone tenderness at the posterior edge or tip of either malleolus, or inability to bear weight four steps.

Subclinical hypothyroidism

An elevated TSH with a normal free T4. Levothyroxine is usually considered when TSH exceeds 10 mIU/L or when symptoms and cardiovascular risk are present.

BNP interpretation

B-type natriuretic peptide below 100 pg/mL makes heart failure unlikely, while values above 400 pg/mL strongly support the diagnosis in an adult with dyspnea.

Uncomplicated cystitis first line

Nitrofurantoin for five days, or trimethoprim-sulfamethoxazole for three days when local E. coli resistance is below 20 percent. Fluoroquinolones are reserved for resistant cases.

Aspirin for acute coronary syndrome

Give 162 to 325 mg of chewed non-enteric aspirin immediately unless contraindicated, with reperfusion targeted within 90 minutes of first medical contact at a PCI center.

A1c goal for most adults

Target hemoglobin A1c below 7 percent for most nonpregnant adults with diabetes, with higher individualized goals for limited life expectancy or high hypoglycemia risk.

Blood pressure goal

ACC/AHA recommends below 130/80 mmHg for most adults with hypertension, including those with diabetes, chronic kidney disease, or established cardiovascular disease.

Shingles vaccine

Recombinant zoster vaccine is given as two doses two to six months apart to adults aged 50 and older and is preferred over the older live zoster vaccine.

Statin initiation threshold

Moderate-intensity statin for adults 40 to 75 with diabetes or a 10-year ASCVD risk of 7.5 percent or greater after a clinician-patient risk discussion.

Warfarin INR target in AF

Atrial fibrillation anticoagulation with warfarin targets an INR of 2.0 to 3.0. Direct oral anticoagulants are preferred for most eligible patients without mechanical valves.

Asthma controller therapy

Guidelines recommend inhaled corticosteroid-containing therapy at every asthma severity level. A short-acting beta agonist used alone is no longer a preferred treatment strategy.

ACE inhibitor follow-up labs

Check a basic metabolic panel one to two weeks after starting or titrating. A creatinine rise up to 30 percent is acceptable; potassium above 5.5 warrants holding the drug.

Levothyroxine recheck interval

Measure TSH six to eight weeks after any dose change because the pituitary requires that long to equilibrate. Retesting earlier produces misleading results and inappropriate adjustments.

Metformin and eGFR

Metformin is contraindicated when eGFR falls below 30 and should be held around iodinated contrast when eGFR is under 30, resuming after renal function is confirmed.

A1c monitoring frequency

Check hemoglobin A1c every three months when therapy changes or goals are unmet, and every six months once control is stable at the individualized goal.

Antibiotic reassessment for otitis media

If symptoms persist 48 to 72 hours after starting amoxicillin for acute otitis media, reassess the ear and consider switching to amoxicillin-clavulanate rather than repeating the same drug.

SSRI response assessment

Reassess depressive symptoms four to six weeks after starting or adjusting an SSRI. An adequate trial is six to eight weeks at a therapeutic dose before changing agents.

Stage 1 hypertension follow-up

Recheck blood pressure within three to six months after lifestyle counseling for stage 1 hypertension, starting medication if the 130/80 mmHg goal is not met.

Warfarin INR monitoring frequency

Check INR at least weekly during initiation and after dose changes, extending to every four weeks once values are stable, aiming for time in therapeutic range of 70 percent or more.