Final Exam: NR 577 (NR577) |Latest 2023/
2024| Primary Care Management of
Adolescents and Adults Final Exam Review|
Guide with Verified Answers
Q: Signs and symptoms of concussion
Answer:
headache drowsiness
dizziness sensitivity to light memory difficulties difficulty concentrating feeling slowed down
Q: When is a CT scan warranted for concussions
Answer:
CT scan to evaluate for hemorrhage is recommended for patients who are over 60, patients who
are on anticoagulants, or patients with:
vomiting
persistent short-term memory loss drug/alcohol intoxication
post-injury seizure persistent headache
Q: What should you observe patients for who have a concussion
Answer:
loss of consciousness
increasing headache repeated vomiting slurred speech confusion
unusual behaviors seizures
limb weakness or numbness
The presence of any worsening symptoms requires emergency care.
Q: Immediately after injury (for concussions)
Answer:
Conduct serial assessments since signs and symptoms may not appear for minutes to hours after
the injury or may evolve over time.
Apply guidelines for assessment and management that support the use of a multi- disciplinary
approach including qualified sports medicine specialists.
Use the Balance Error Scoring System (BESS) assessment tool at the sideline to objectively
assess balance after a concussion.
Q: How do you grade a TBI
Answer:
Glasgow coma scale (GCS)
Q: Mild injury on GCS
Answer:
Mild injury: GCS 13-15
Q: Moderate injury on GCS
Answer:
Moderate injury: GCS 9-12
Q: Severe injury on GCS
Answer:
Severe injury: 3-9
Q: Chronic Traumatic Encephalopathy (CTE)
Answer:
a degenerative brain disease caused by repeated head trauma. CTE is seen in athletes, such as
boxers and football players, and veterans
Q: s/s of Chronic traumatic encephalopathy
Answer:
depression confusion
irritability impulsivity aggression memory problems attention problems
poor decision-making
Q: Impetigo
Answer:
begins as a small, erythematous macule (commonly the face) that evolves into a vesicle beneath
the stratum corneum. The thin-roofed collection of fluid ruptures easily, leaving denuded, oozing
areas. A honey-colored crust forms as the fluid dries and collects. Intense erythema at the base of
the pustule. New lesions appear in the same location, and they coalesce. When the honey-colored
crusts are removed, the skin appears raw and glistening. Individual lesions usually do not exceed
2 cm in size. Impetigo is seen most frequently in children, but it also occurs in adults, especially
those with poor hygiene.
Q: Tx of imeptigo
Answer:
The crusts of impetigo should be debrided to expose the skin surface where bacteria are present.
The use of a washcloth for this purpose is rec- ommended. Furuncles and carbuncles are treated
with hot compresses to enhance drainage. Fluctuant lesions with abscess formation usually
require incision and drainage. Sometimes, packing of the wound is necessary. With exudative
lesions, drying compresses are required to remove detritus and desiccate the lesion. Saline
solution, tap water, or Burow solution (aluminum acetate) may be applied for 10 to
20 minutes three to four times a day.
Q: Scabies
Answer:
Transmission is through close personal contact, either sexual or non- sexual. Patients usually
present with intense pruritus, which is often more severe during the night. Eighty-five percent of
infested persons have burrows on the fingers, interdigital areas, and wrists; these appear as linear
marks a few millimeters in length.
Q: Dx of scabies
Answer:
A skin scraping is performed by placing a drop of mineral oil on a suspicious lesion, shaving off
the roof of the burrow with a scalpel, scraping the base to remove the contents, and placing the
material on a microscope slide with cover slip.
Q: tx of scabies
Answer:
Permethrin 5% cream, which is synthetically derived from the chrysanthemum flower, is the
FDA-approved and first-line treatment for scabies for patients aged 2 months and older.
Q: Head lice
Answer:
The diagnosis is made by direct examination of the involved areas. Few adult lice are found at
the bases of the hairs, but many nits are typically seen. Both are usually visible to the naked eye,
but a hand lens and bright light may help. Nits appear as gray or white specks attached to the hair
shafts.
Q: Lice tx
Answer:
Permethrin 1% cream rinse shampoo is the first-line treatment for pedicu- losis and can be
obtained over the counter. Only permethrin has activity against eggs because it retains residual
activity for 2 weeks and remains on the hair for 14 days after treatment, thereby killing hatched
eggs. Some physicians still recommend that a second permethrin treatment be given 1 week after
the first, for maximum cure rate.
Midterm Exam: NR 577 (NR577) |Latest
2023/ 2024| Primary Care Management of
Adolescents and Adults Final Exam Review|
Guide with Verified Answers
Q: Breast lumps masses or pain
Answer:
A breast lump or mass, or breast pain, may be a symptom of breast cancer or a benign (noncancerous) condition
Q: Dx tests for breast lumps
Answer:
Mammogram, Ultrasound, MRI
Q: Mammogram
Answer:
A mammogram is an X-ray of the breast used to detect breast cancer. It is usually the first test
recommended for women who have breast symp- toms or who are at increased risk of breast
cancer.
Q: Ultrasound for breast
Answer:
An ultrasound uses high-frequency sound waves to create images of the breast, which can be
used to help determine whether a breast lump is solid or fluid-filled.
Q: MRI for breast
Answer:
An MRI uses a strong magnetic field and radio waves to produce detailed images of the breast
and is often used in conjunction with a mammogram for women with a high risk of breast cancer.
It is important to consult a healthcare provider for proper evaluation and diagnosis of any breast
symptoms and to deter- mine the best course of action, which may include additional testing
and/or biopsy. Early detection is crucial for the successful treatment of breast cancer
Q: Presumptive signs of preggancy
Answer:
Amenorrhea, N/V, breast tenderness, fa- tigue, urianry frequency, Quickening,
Q: Probably signs of pregnancy
Answer:
Pregnancy test
Q: Positive signs of pregnancy
Answer:
Palpation of the fetus by the health care provider
- Ultrasound and visualization of the fetus • Fetal Heart Tones (FHT) auscultated by the health
care provider
Q: Positive signs pregnancy
Answer:
Fetal heart rate auscultated by fetoscope at 17-20 weeks or by Doppler at 10-12 weeks Palpable
fetal outline and fetal movement after
20 weeks Visualization of fetus with cardiac activity by ultrasound (fetal parts visible by 8
weeks)
Q: Vaccines in pregnancy
Answer:
IM Flu, Tdap, Hep B,
Q: Vaccines contraindicated in pregancy
Answer:
MMR, Varicella, Live flu vaccine
Q: Benefits of combined estrogen oral contraceptive
Answer:
decrease blood loss, decrease cramps, can manipulate timing of cycle, decrease ovarain and
endometrial cancer, decreases risk for ectopic pregancny, Effective to treat acne, hirsutism
and other androgen excess/sensitivity states Reduced vasomotorsymptoms and effective
contraception in perimenopausal women Increased bone mineral density Decreased pain and
frequency of sickle cell disease crises
Q: Disadvantage of combined oral contraceptives
Answer:
Decreased libido and anor- gasmia is unusual, but possible Mood changes, depression, anxiety,
irritability No protection against STDs or HIV Nausea & vomiting, especially in the first few
cycles Breast tenderness or pain Headaches may increase
Q: When to use combined oral contraceptives
Answer:
Endometriosis-continuous use are most effective in reducing severe symptoms(skip placebo
week); must use monophasic pills Functional ovarian cysts-higher dose estrogen COCs may be
slightly more effective
Q: Which oral contraceptive should be used in breast feeding women
Answer:
Prog- estin only
Q: Tier 1 contraception
Answer:
IUD o Depo o Progestin Implants o Sterilization (tubal/va- sectomy)
Q: Tier 2 methods of contraception
Answer:
Combined oral contraceptive (COC) pills- estrogen and progesterone o Oral contraceptive pillprogestin only “Minipill” o Emergency contraception o Transdermal patch o Ring
Q: Tier 3 methods of contraception
Answer:
Tier 3 methods include all of your barrier methods, natural family planning and coitus
interruptus. o These methods are the least effective in terms of preventing pregnancy with
variable rates between them which are outlined in your textbook
Q: Amenorrhea
Answer:
simply means absence of menses and is part of the spectrum of ovulatory disorders classified as
AUB-O
Q: common causes of amenorrhea