ANCC FNP Board Questions & Answers
A middle-age female patient presents to the clinic with a recurrence of mild
hidradenitis suppurativa after topical therapies failed. Which first-line
treatment is recommended?
(Ans- Tetracycline
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line
treatment for hidradenitis suppurativa.
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in
apocrine gland-bearing skin. It is a chronic, disabling disorder that
progresses, often causing keloids, contractures, and immobility. It is
characterized by comedone-like follicular occlusion, chronic and relapsing
inflammation, mucopurulent discharge, and progressive scarring.
Arthropathy associated with hidradenitis may be present. Typical
presentation includes nodules and sinus tracts (inflamed or noninflamed),
abscesses, and scarring found in the axilla, genitofemoral area, perineum,
gluteal area, and inframammary area in women.
Recommended treatments include antibiotics, steroids, retinoids, dapsone,
and anti-tumor necrosis factor agents. A dermatology consultation should
also be considered.
First-line treatment is a 12-week course of an oral tetracycline (Sumycin)
such as doxycycline. For patients who do not respond to doxycycline, the
next recommended step is a combination of twice-daily clindamycin
(Cleocin) and rifampicin (Rifadin) for 10-12 weeks. If treatment fails,
acitretin (Soriatane, for males and nonfertile females) or dapsone (Aczone)
may be considered by a dermatologist. In patients with moderate to severe
hidradenitis suppurativa, adalimumab (Humira) may possibly be
considered.<\/p>\n\n\n\n
When providing culturally competent health care services to an American
Indian elder, the nurse practitioner understands which is traditionally true?
(AnsThe “Medicine Wheel” is used by many for the purpose of health and
healing
The “Medicine Wheel” is traditionally used and contains four directions;
north, south, east, and west. Traditionally each tribe has different meanings
for each direction and they may represent the season of the year or stage
of life. It is aimed at providing a holistic view of life.
An understanding of different cultural preferences leads to cultural
competence in healthcare. Some patients may value traditional culture and
preferences as it relates to healthcare. These individual preferences should
be included in the interview and treatment plan for patients.
Traditionally, the American Indian culture values a holistic approach to
health care integrating the person, lifestyle, environment, family, and
religion. Patients adhering to these traditional cultural practices often feel
that illness is due to a lack of harmony with the physical body, mind, spirit,
and emotions. Patients may seek care from western medicine for specific
ailments while also consulting with traditional healers for spiritual guidance.
Healthcare providers should seek to understand relevant cultural factors
and assess each individual’s healthcare literacy in order to provide
culturally competent care.
The nurse practitioner sees an older adult patient in the clinic with the
primary report of hearing loss and a sensation of fullness in the right ear.
The nurse practitioner suspects conductive hearing loss. Which could
contribute to this?
(Ans- Cerumen, commonly called earwax, is a combination of secretions
and sloughed epithelial cells that protects the ears from infection, water,
and insects. It is normally expelled from the ear canal through natural jaw
movement. When this self-cleaning process fails, cerumen can become
impacted. Cerumen impaction occludes the ear canal and can press
against the tympanic membrane, resulting in conductive hearing loss.<\/p>\n\n\n\n
Conductive hearing is the transition of sound from the external and middle
ear to the inner ear. Conductive hearing loss is caused by problems in the
external and middle ear that interfere with the transmission of sound and its
conversion to mechanical vibration. Causes of conductive hearing loss
include obstruction of the external auditory canal by cerumen, foreign
bodies, debris from otitis externa, and large exocytosis and osteomas.
Sensorineural hearing loss involves difficulty converting mechanical
vibrations to electrical potential in the cochlea or in auditory nerve
transmission to the brain. It is mostly caused by permanent damage in the
organ of Corti. It can be caused by age-related hearing loss, noise trauma,
medications, autoimmune diseases, mechanical trauma, Meniere disease,
infection, and neoplasm (acoustic neuroma).
Approximately one-third of older adults between the ages of 61 and 70
years have hearing loss. More than 90% of adults older than 85 years of
age have hearing loss. The most common type of hearing loss is agerelated and sensorineural. All adults older than 60 years of age should be
screened for hearing loss at periodic health examinations.
An otherwise healthy adult patient presents to the clinic with a diagnosis of
community-acquired pneumonia and no recent antibiotic therapy. Which is
the best option for treatment?
(Ans- Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as firstline therapy for adults without comorbidities.
Community-acquired pneumonia (CAP) is pneumonia not acquired in a
hospital or long-term care facility. Patients with suspected CAP should
receive a chest X-ray for diagnosis. The Pneumonia Severity Index should
be used to assist in decisions regarding the need for hospitalization in
patients with CAP.
According to the American Thoracic Society (ATS) and the Infectious
Diseases Society of America (IDSA) 2019 guidelines, the initial treatment of<\/p>\n\n\n\n
FNP Boards Review: Questions &
Answers
combined hormonal contraceptives examples
(Ans- Pill, Patch (Ortho Evra, Xulane) and Ring (NuvaRing)
Which birth control improves acne and hirsutism?
(Ans- CHC
The most common reasons for d\/c COC use is BTB and
(Ans- Inconvenience of use
BTB can be minimized by
(Ans- Taking the pill within the same 4hr period everyday
Birth control nausea can be reduced by
(Ans- Taking the pill with food or at bedtime
When should you retake birth control?
(Ans- If vomiting occurs within 2 hrs
Roux-en-Y gastric bypass is contraindicated for with contraceptive
measure?
(Ans- COC
Examples of progestin only contraceptives
(Ans- POP & DMPA
What birth control option is best for nursing mothers?
(Ans- Progestin- POP & DMPA
When should DMPA be started?
(Ans- Within the first few days of menses<\/p>\n\n\n\n
Max use for DMPA FNP:(Family Nurse Practitioner) Exam Finkelstein’s test: Clonus has also appeared after ingesting potent serotonergic drugs, where Quinolones: ANCC FNP Boards Study Guide Target BG after eating ANCC FNP Exam Review questions LEIK D: ARB ANCC FNP Board Exam Study Guide -benign Increased risk of ectopic pregnancy ANCC FNP Exam Review Questions D: A normal finding ANCC FNP Exam Questions & Answers a difficult aspect of determining occupational exposure to disease is the:<\/p>\n\n\n\n AANP FNP Certification Exam: Questions & Cranial nerves responsible for extraocular eye movements GERD treatment AANP FNP certification Exam Questions Abnormal cells on PAP, what do you do next? Definitive diagnosis of acute bacterial prostatitis AANP FNP Practice Questions & The nurse practitioner prescribes amitriptyline (Elavil) for a patient with FNP Certification Exam Questions & FEV1 (forced expiratory volume at 1 second) (>- Ans: Arrange for additional blood pressure measurements within the Case reports _Meta-analysis __Randomized controlled trials __Expert opinion 1-Case reports 2-Meta-analysis 3-Randomized controlled trials 4-Expert opinion 2-Case reports 1-Meta-analysis 3-Randomized controlled trials 4-Expert opinion 3-Case reports 1-Meta-analysis 2-Randomized controlled trials 4-Expert opinion 4-Case reports 3-Meta-analysis 2-Randomized controlled trials 1-Expert opinion (>- Ans: 3-Case reports 1-Meta-analysis 2-Randomized controlled trials 4-Expert opinion In a 46-year-old woman with hypertension and dyslipidemia, choose the correct prevention: Primary prevention Secondary prevention Tertiary prevention Counseling about reducing risk for sexually transmitted infection <\/em><\/strong> AANP FNP TEST REVIEW initial evaluation of symptoms of acute prostatitis The most commonly prescribed medication for mild systemic lupus FNP CERTIFICATION REVIEW: QUESTIONS To evaluate a child for esotropia, which one of the following is a rapid and c. overflow incontinence FNP Board review Questions& Answers What antibiotics are avoided in CAP caused by atypical pathogens? F) Tuberculosis Family Nurse Practitioner-questions for d. gastric ulcer A 39 year old migrant worker presents to the clinic 2.5 days after a PPD ANCC FNP Board Questions & AnswersA middle-age female patient presents to the clinic with a recurrence of mildhidradenitis suppurativa after topical therapies failed. Which first-linetreatment is recommended?(Ans- TetracyclineTwelve weeks of oral tetracycline (Sumycin) is the recommended first-linetreatment for hidradenitis suppurativa.Hidradenitis suppurativa is a disorder of the terminal follicular epithelium inapocrine gland-bearing skin. It is a […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-117227","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117227","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=117227"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117227\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=117227"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=117227"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=117227"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
(Ans- 2 yrs- decreased bone density
DMPA can cause infertility for up to _ years (Ans- 1 year COC- missed 1 pill in a day (Ans- Take today’s pill ASAP COC- missed more than 1 pill (Ans- Take today’s pill & last forgotten pill Women with chronic conditions should use__<\/strong> contraceptive
(Ans- POP
Which of following is a clinical condition in which Cu-IUD should be
approached with caution?
(Ans- PID or STI
Safe HORMONAL contraceptive option for women taking Phenytoin
(Ans- POP
Progestin-only EC (Plan B) should be taken within _ hrs of unprotected sex. (Ans- 72 hrs Which EC requires a prescription? (Ans- Ulipristal acetate (Ella) Ulipristal acetate (Ella) can be take up to _<\/strong> days after unprotected sex.
(Ans- 5 Days<\/p>\n\n\n\n
Study Guide
Trauma to Kiesselbachs plexus:
(Ans- Will result in an anterior nosebleed
The diagnostic or gold standard test for sickle cell anemia, G6PD anemia,
and alpha or beta thalassemia:
(Ans- Hemoglobin electrophoresis
Erythromycin “allergy” vs adverse reaction:
(Ans- Adverse reaction-symptoms of nausea or GI upset
allergy -hives, angioedema
Acute mononucleosis:
(Ans- Pt will most likely be a teen presenting w classic triad of sore throat,
prolonged fatigue, and enlarged cervical nodes.
Alpha thalassemia:
(Ans- More common among Southeast Asians such as, Indian, Chinese, or
Filipino descent
Lupus
(Ans- Malar rash(butterfly rash)Pts need to avoid or to minimize sunlight
exposure(photosensitivity)
Tx polymyalgic rheumatica(PMR)
(Ans- 1st line tx for PMR includes long-term steroids. Long term steroids
are commonly used to control symptoms(pain, stiffness on shoulders, and
hip girdle). PMR pts have higher risk for temporal arteritis.
Gold standard exam for temporal arteritis:
(Ans- Biopsy of the temporal artery. refer pt to opthalmologist for mgt<\/p>\n\n\n\n
(Ans- Positive in De Quervains tenosynovitis
Anterior Drawer maneuver and Lachman maneuver:
(Ans- Positive if anterior cruciate ligament (ACL) of knee damaged. The
knee may also be unstable
McMurray’s sign:
(Ans- Positive in meniscus injuries of the knee
Damaged Joints:
(Ans- Order X-ray first, but MRI is the Gold Standard
Diabetic retinopathy:
(Ans- Neovascularization, hard exudates, cotton wool spots, and
micoaneurysms
Hypertensive retinopathy:
(Ans- AV nicking, silver and or copper wire arterioles
Checking deep tendon reflexes:
(Ansabsent(0),
hypoactive (1)
normal(2)
hyperactive(3)
clonus(4)
Clonus:
(Ans- Clonus is typically seen in patients with stroke, multiple sclerosis,
spinal cord damage and hepatic encephalopathy.<\/p>\n\n\n\n
ingestion strongly predicts imminent serotonin toxicity (serotonin
syndrome).
Clonus is a series of involuntary, rhythmic, muscular contractions and
relaxations.
Clonus is a sign of certain neurological conditions, particularly associated
with upper motor neuron lesions involving descending motor pathways, and
in many cases is, accompanied by spasticity (another form of
hyperexcitability).Unlike small, spontaneous twitches known as
fasciculations (usually caused by lower motor neuron pathology), clonus
causes large motions that are usually initiated by a reflex.
A rare but serious adverse effect of ACE inhibitors is:
(Ans- Angioedema
A common side effect of ACE inhibitors is a
(Ans- Dry cough(10%)
1st line drug to tx htn in DM & pts w mild renal dz bc of their renal
protective properties:
(Ans- ACE inhibitors or ARBS
Penicillin:
(Ans- Amoxicillin(broad-spectrum PCN) Penicillin VK
Macrolide:
(Ans- Erythromycin, azithromycin(Z-Pack), or clarithromycin(Biaxin)
Cephalosporins:
(Ans- 1st generation(Keflex), 2nd generation(Cefaclor, Ceftin, Cefzil)3rd
generation(Rocephin, Suprax, Omnicef)
Quinolones w gram positive coverage:
(Ans- Levofloxacin(Levaquin), moxifloxacin(Avelox), gatifloxacin(Tequin)<\/p>\n\n\n\n
(Ans- Ciprofloxacin(Cipro), ofloxacin(Floxin)
Sulfa:
(Ans- Trimethoprim\/sulfamethazole(Bactrim, Septra),
nitrofurantoin(Macrobid),
Tetracyclines:
(Ans- Tetracycline, doxycycline, minocycline(Minocin)
NSAID:
(Ans- Ibuprofen, naproxen(aleve, Anaprox)
Cox-2 inhibitors:
(Ans- Celecoxib (celebrex)
Antitussives:
(Ans- Dextromorphan(Robitussin), benzonate(Tessalon Perles)
Drugs allowed for pregnant or lactating women:
(Ans- Category B
Pregnancy in pain:
(Ans- Tylenol instead of Ibuprofen
Avoid nitrofurantoin & sulfa drugs during 3rd trimester:
(Ans- Increase the risk of hyperbilirubinemia
Best way method of spreading viruses or bacteria:
(Ans- Making them airborne or nebulized
Tx cutaneous anthrax:
(Ans- Ciprofloxacin 500mg orally BID for 60 days or 8 weeks. If pt allergic
to ciprofloxacin , use doxycycline 100mg BID<\/p>\n\n\n\n
Type 2 Diabetes
(Ans- insulin resistance
Screening for Type 2 Diabetes
(Ans- every 3 years starting at age 45
A1C for Type 2 Diabetes
(Ans- > 6.5%
FPG for Type 2 Diabetes
(Ans- > 126
2 hour plasma glucose for Type 2 Diabetes
(Ans- > 200
Random glucose for Type 2 Diabetes
(Ans- > 200
A1C for Prediabetes
(Ans- 5.7-6.4%
1st drug or choice for Type 2 Diabetes
(Ans- Metformin
Contraindication for Metformin
(Ans- liver cirrhosis or alcohol use disorder; increased serum creatinine
Two most common side effects of Metformin
(Ans- Diarrhea and Flatulence
4 Meds for All Diabetics
(Ans- Aspirin, Metformin, BP, and Statin<\/p>\n\n\n\n
(Ans- < 180 Fasting BG Target (Ans- 70-130 Biguanides (Ans- Metformin (Glucophage) Sulfonylureas (-ide) (Ans- Secrete insulin; can cause hypoglycemia and wt gain; for pt’s on a fixed budget (-Ride Price) DPP-4 inhibitors (-gliptin) (Ans- Reduces A1C by 0.7% GLP-1 agonists (-tide) (Ans- Helps ppl lose weight (-Tide of the wt); Not for fixed budget When should you consider basal insulin? (Ans- A1C > 9% & Fasting glucose > 250
Basal insulin (Lantus)
(Ans- Once a day at the same time
NPH insulin (Humulin N, Novolin N)
(Ans- Lasts from breakfast to dinner; Covers the postprandial spike after
lunch
Regular insulin (Humulin R, Novolin R)
(Ans- Lasts from meal to meal
Rapid-acting insulin (Humalog- Lispro)
(Ans- Covers one meal at a time<\/p>\n\n\n\n
part 2
The posterior fontanel should be completely closed by:
(Ans- 3 months
On auscultation of the chest, a split s2 is best heard at:
A: 2 ICS, right sternal border
B: 2 ICS, Left sternal border
C: 5th ICS, midclavicular line
D: 4 ICS, left sternal border
(Ans- 2nd ICS left sternal border
The most common type of skin malignancy in the united states is:
A: squamous cell skin cancer
B: Basal cell carcinoma
C: Melanoma
D: dysplastic nevi
(Ans- Basal Cell Carcinoma
All of the following patients have an increased risk of developing adverse
effects from metformin (Glucophage) except:
A: pts with renal disease
B: pts with hypoxia
C: Obese pts
D: pts who are alcoholics
(Ans- obese patients
Which of the following classes of drugs is implicated with blunting the signs
and symptoms of hypoglycemia in diabetics?
A; CCB
B: Diuretics
C: Beta Blockers<\/p>\n\n\n\n
(Ans- Beta blockers
All of the following factors increase the risk of mortality for patients
diagnosed w\/ bacterial pneumonia except:
A: alcoholism
B: very young\/old
C: Multiple lobar involvement
D: hypertension
(Ans- Hypertension
The bacterium responsible for the highest mortality for pts with communityacquired pneumonia is:
A: streptococcus pneumoniae
B: mycoplasma pneumoniae
C: Moraxella catarrhalis
D: Haemophilus influenzae
(Ans- Streptococcus pneumoniae
What is the least common pathogen found in CAP?
A: moraxella catarrhalis
B: Streptococcus pneumoniae
C: pseudomonas aeruginosa
D: mycoplasma pneumonia
(Ans- Pseudomonas Aeruginosa
The following statements are true about Wilms’ tumor EXCEPT:
A: the most frequent clinical sign is a palpable abdominal mass
B: it is a congenital tumor of the kidneys
C: microscopic or gross hematuria is sometimes present
D: the tumor commonly crosses the midline of the abdomen when it is
discovered.
(Ans- the tumor commonly crosses the midline of the abdomen when it is
discovered.<\/p>\n\n\n\n
Part 1: FNP Study Guide
Treatment for chronic bronchitis
(Ans-
-Chronic bronchitis is a type of COPD that is characterized by inflammation
of the bronchi, causing excess mucus; characteristics of chronic bronchitis
include diagnosis after age 35, obesity, copious amounts of purulent
sputum, elevated Hct level
-Treat with SABA (albuterol), inhaled anticholinergics (ipratropium)
-Normal Findings of Lungs: Lower lobes vesicular breath sounds (soft and
low)
Upper lobes; Bronchial breath sounds louder
Actinic keratosis
(Ans-
-Older to elderly fair-skinned adults
-numerous dry, round, pink to red-colored, slow-growing lesions that do not
heal
-lesions common on sun-exposed areas (cheeks, nose, face, arms, back)
-precancerous precursor of squamous cell carcinoma
-frequent sunburns as child places person at higher risk
-diagnosed with biopsy
-treat with cryotherapy (small number) or 5-FU(5% fluorouracil) cream
(large number)
follow up with derm.
Seborrheic keratosis
(Ans-
-soft, round, wart-like fleshy growths on trunk (mostly on back)
-can range in color from light tan to black
-appear to be pasted on
-asymptomatic<\/p>\n\n\n\n
Fingernail hematoma treatment
(Ans-
-Trephination – make hole in nail through drilling or piercing and allow blood
to drain
Hypothyroid
(Ans-
-Primary – elevated TSH; low T4; low or normal T3
-Subclinical – elevated TSH; normal T4; normal T3
-Common cause is Hashimoto’s (autoimmune) – Hashimoto and Hypo both
have O
-Symptoms are variable – may include fatigue
-Treatment – levothyroxine (Synthroid) daily in AM on empty stomach
-Starting dose of levothyroxine (Synthroid) is 25-50mcg
-Check TSH every 6-8 weeks to monitor treatment
Hyperthyroid
(Ans-
-Primary – low TSH; high T4; normal or high T3
-Subclinical – low TSH; normal T4; normal T3
-Most common cause is Grave’s Disease (autoimmune) – Grave and Hyper
both have R
-Common symptoms – female; rapid weight loss; increased heart rate;
tremors; sweating; irritability; anxiety; hyperactivity; insomnia; diarrhea;
amenorrhea; hypertension; exophthalmos; heat intolerance; goiter
-Treatment – Propylthiouracil (PTU); Methimazole (Tapazole); Radioactive
iodine (causes hypothyroid for life, contraindicated in pregnancy)
-Thyroid Storm (thyrotoxicosis) – acute worsening of symptoms; may be
caused by stress or infection; look for LOC, fever, abdominal pain; lifethreatening; immediate hospitalization needed<\/p>\n\n\n\n
(Ans-
-Risk factors – previous ectopic, salpingitis, tubal surgery, current IUD use,
previous cervicitis, history of PID
-Symptoms – abdominal pain (worsens when supine or with jarring), vaginal
bleeding, amenorrhea, low grade fever, pain referred to right shoulder (may
indicate rupture)
Hypertension Meds Part 1
(Ans-
-African-American with or without diabetes – initial choices include thiazide
diuretic or CCB
-Non-Black with or without diabetes – initial choices include thiazide
diuretic, CCB, ACE, or ARB
-Thiazide diuretic – “ide”; excellent synergist; avoid in sulfa allergy;
favorable in osteopenia\/osteoporosis; side effects include hyperglycemia
(caution in diabetics), hyperuricemia (gout attack), hypertriglyceridemia and
hypercholesteremia (check lipid profile), hypokalemia (potentiates digoxin
toxicity and increases risk for arrhythmia), hyponatremia (hold diuretic,
restrict fluid, replace K+); lowers BP only 2-8 points
-ACE inhibitor – “pril” and ARB – “sartan” – use in high renin states; drug of
choice in diabetics (protects kidneys); pregnancy category C\/D; side effects
include dry\/hacking cough (more with ACE), hyperkalemia, angioedema
(rare, life-threatening); contraindicated in moderate to severe kidney
disease; do not use ACE and ARB together.
Hypertension Meds Part 2
(Ans-
-Beta blocker – “lol”; good as add-on medication, not uncomplicated HTN;
avoid abrupt discontinuation, wean slowly to avoid rebound HTN;
contraindications include asthma, COPD, chronic bronchitis, emphysema,
second and third-degree heart block (okay with 1st degree), sinus
bradycardia; do not use Propranolol for HTN
-Calcium channel blocker – “pine”; first choice for ISH (isolated systolic
HTN); side effects include headaches (vasodilation), ankle edema<\/p>\n\n\n\n
LEIK part 1
The Lachman Maneuver is used to detect which of the following?
A: Instability of the knee
B: Nerve Damage of the knee due to past knee injuries
C: Integrity of the patellar tendon
D: Tears of the meniscus
(Ans- instability of the knee
A 28-year old multipara who is at 32 weeks gestation presents to your
office complaining of a sudden onset of small amounts of bright-red vaginal
bleeding. She has had several episodes and appears anxious.
On exam, her uterus is soft to palpation.
Which of the following is most likely?
A: placenta abruptio
B: placenta previa
C: acute cervicitis
D: Molar Pregnancy (hydatidiform mole)
(Ans- Placental previa
A 30 year old woman who is sexually active complains of a large amount of
milk-like vaginal discharge for several weeks. A microscopy slide reveals a
large number of cells that have BLURRED margins. Very few white blood
cells are seen. The vaginal pH is 6.0.
What is most likely?
A: Trichomonas infections
B: Bacterial Vaginosis
C: Candidal infection<\/p>\n\n\n\n
(Ans- Bacterial Vaginosis
Signs and symptoms of depression include all of the following except:
A: anhedonia
B: Low Self-esteem
C: Apathy
D: Apraxia
(Ans- apraxia
All of the following are cover under Medicare part B except:
A: person aged 65 years or older
B: Durable medical equipment
C: Mammograms annually starting at age 50
D: outpatient anesthesiologists services
(Ans- Outpatient Anesthesiologist services
All of the following are complications of severe preeclampsia except:
A: Liver Failure
B: Hypertensive Encephalopathy
C: Pulmonary Edema
D: Placenta Previa
(Ans- Placenta Previa
Koplik’s spots are associated with:
A: poxvirus infections
B: Rubeola
C: Kawasaki’s disease
D: Rubella
(Ans- Rubeola<\/p>\n\n\n\n
which drug is associated with increased lipoprotein levels?<\/p>\n\n\n\n\n
(Ans- hydrochlorothiazide (HCTZ)
what is the main reason for giving a progestational medication to
perimenopausal women who use estrogen?<\/li>\n\n\n\n
(Ans- 4. decrease the risk of endometrial hyperplasia
The FNP asks a patient to perform rapid, alternating movements of the
hands to evaluate:<\/li>\n\n\n\n
(Ans- 1. cerebellar function
A 38 yo Vietnamese patient tells the FNP that his parent died in her 40s
from liver cancer. That patient is at risk for:<\/li>\n\n\n\n
(Ans- 1. hepatitis B
ANCC FNP<\/li>\n<\/ol>\n\n\n\n\n
3.long latency period between exposure and disease development<\/li>\n\n\n\n
(Ans- 3. long latency period between exposure and disease development
To comply with regulations for third-party payor reimbursement and
documentation, a family nurse practitioner correlates:<\/li>\n\n\n\n
decision making.<\/li>\n\n\n\n
3.medication orders and treatment plan with electronic billing.<\/li>\n\n\n\n
(Ans- 1. evaluation and management code with history, examination and
medical decision making.
The family nurse practitioner examines a patient who has sustained a nonwork-related injury that interferes with the patient’s ability to perform his or
her job. The patient does not qualify for medical disability and has a
reasonable chance of engaging in a suitable occupation with proper
therapy. The nurse practitioner recommends that the patient apply for:<\/li>\n\n\n\n
4.vocational rehabilitation services.
(Ans- 4.vocational rehabilitation services.
A 45-year-old patient who is an opera singer reports progressive
hoarseness for the last four weeks. The hoarseness began after a threehour opera performance. The patient does not smoke and reports no
weight loss, upper respiratory infection, dysphagia, or shortness of breath.
The family nurse practitioner manages this patient by:<\/li>\n\n\n\n
ANCC FNP<\/li>\n\n\n\n
(Ans- 4. requesting a referral for evaluation of the larynx.
Routine immunization guidelines recommend administering the hepatitis B
vaccine at birth and repeating doses at:<\/li>\n\n\n\n
(Ans- 1. one month and six months.
A patient who sustained a myocardial infarction comes to the clinic for a
refill of atorvastatin (Lipitor). The family nurse practitioner explains that the
medication is prescribed for:
1.cancer prevention.<\/li>\n\n\n\n
(Ans- 4. tertiary prevention.
Which health promotion strategy is most appropriate for adolescents who
are obese?<\/li>\n\n\n\n
(Ans- 2. Motivational interviewing.
Treatment of viral conjunctivitis includes the use of:<\/li>\n\n\n\n
(Ans- 3. cold compresses.
ANCC FNP<\/li>\n<\/ol>\n\n\n\n
Answers
3 month old infant with down syndrome, due to milk intolerance,
mom started on goats milk; now has pale conjunctiva but
otherwise healthy. Low HCT. What additional test would you
order?
(Ans- Iron, TIBC
3 months of synthroid, TSH increased, T4 normal, what do you
do?
(Ans- Increase Medication
3 ways to assess cognitive function in patient with
signs\/symptoms of memory loss
(Ans- Mini mental exam
4 month old with strabismus, mom is worried\u2026\u2026
(Ans- tell her it is normal.
AANP FNP certification
4 month old wont keep anything down, what is the main thing you
look at?
(Ans- Growth chart
6 month old closed anterior fontanel.
(Ans- XRAY
Abnormal cells on PAP, what do you do next?
(Ans- Refer for Colposcopy
CAGE ACRONYM
(AnsCut down
Annoyed by criticism
Guilty about drinking
Eye opener drink
Causes of tachycardia
(AnsFever
Anemia
Hypotension<\/p>\n\n\n\n
(Ans- CN 3,4,6
Definition of metabolic syndrome
(Ans- cluster of conditions that increase risk of heart disease,
stroke, diabetes.
diagnose trichomoniasis
(Ans- wet prep
Elderly presents with atrophic vaginitis, small uterus, palpable 4×5
ovary, what do you do next?
(Ans- Pelvic US
Epistaxis is most common in the area of the nose known as
kiesselbachs triangle, where is this located?
(Ans- Anterior septum
Definitive diagnosis of acute bacterial prostatitis
(Ans- urinalysis and culture<\/p>\n\n\n\n
(Ans- H2 is first line, give hs
Grade 3 cells on Pap, treatment?
(AnsLEEP
excision
Fingernail hematoma treatment?
(Ans- drill hole and drain blood?
Increased risk of ectopic pregnancy
(Ans- Salpingitis, or history of abortion, PID,
Koplick spots
(Ans- Measles (rubeola). Grains of salt lesions inside mouth in
Measles
Koplick spots<\/p>\n\n\n\n
All diastolic murmurs are pathological. Murmurs Grades I-barely II-audible
III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM
(Ans- III first time audible, IV first time thrill
Fundal height 12 weeks
(Ans- Fundal Height 12 weeks above symphysis pubis. EXAM
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks is at umbilicus.
2 cm more of less from # of wk gestation is normal if more or less order US
3 month old infant with down syndrome, due to milk intolerance, mom
started on goats milk; now has pale conjunctiva but otherwise healthy. Low
HCT. What additional test would you order?
(Ans- Iron, TIBC
3 months of synthroid, TSH increased, T4 normal, what do you do?
(Ans- Increase Medication
3 ways to assess cognitive function in patient with signs\/symptoms of
memory loss
(Ans- Mini mental exam
4 month old with strabismus, mom is worried\u2026\u2026
(Ans- tell her it is normal.
4 month old wont keep anything down, what is the main thing you look at?
(Ans- Growth chart
6 month old closed anterior fontanel.
(Ans- XRAY<\/p>\n\n\n\n
(Ans- Refer for Colposcopy
CAGE ACRONYM
(AnsCut down
Annoyed by criticism
Guilty about drinking
Eye opener drink
Causes of tachycardia
(AnsFever
Anemia
Hypotension
Cranial nerves responsible for extraocular eye movements
(Ans- CN 3,4,6
Definition of metabolic syndrome
(Ans- cluster of conditions that increase risk of heart disease, stroke,
diabetes.
diagnose trichomoniasis
(Ans- wet prep
Elderly presents with atrophic vaginitis, small uterus, palpable 4×5 ovary,
what do you do next?
(Ans- Pelvic US
Epistaxis is most common in the area of the nose known as kiesselbachs
triangle, where is this located?
(Ans- Anterior septum<\/p>\n\n\n\n
(Ans- urinalysis and culture
GERD treatment
(Ans- H2 is first line, give hs
Grade 3 cells on Pap, treatment?
(Ans- LEEP
excision
Fingernail hematoma treatment?
(Ans- drill hole and drain blood?
Increased risk of ectopic pregnancy
(Ans- Salpingitis, or history of abortion, PID,
Koplick spots
(Ans- Measles (rubeola). Grains of salt lesions inside mouth in Measles
Koplick spots
(Ans- Measles (rubeola). Grains of salt lesions inside mouth in Measles
Legg-Calve-Perthes Disease
(Ans- Avascular necrosis of the proximal femoral head
Lipid level of 1500, increased risk for?
(Ans- Pancreatitis
Low HGB, Low HCT, High MCV indicates what?
(Ans- Macrocytic anemia, B12 Def
Man with BPH, prostate feels on digital exam?
(Ans- Enlarged, symmetrical, smooth<\/p>\n\n\n\n
Answers
A 65-year-old woman presents for a follow-up examination after a new
patient visit. She has not seen a healthcare provider for several years. She
is a smoker and her hypertension is now adequately controlled with
medication. Her mother died at age 40 from a heart attack. The fasting lipid
profile shows cholesterol = 240 mg\/dL, HDL = 30, and LDL = 200. In
addition to starting Therapeutic Lifestyle Changes, the nurse practitioner
should start the patient on:
1.bile acid sequestrant.<\/p>\n\n\n\n\n
(Ans- A statin drug
The most commonly prescribed medication for mild systemic lupus
erythematosus (SLE) is:<\/li>\n\n\n\n
(Ans- ibuprofen (advil)
The most common sign of cervical cancer is:<\/li>\n\n\n\n
(Ans- postcoital bleeding<\/li>\n<\/ol>\n\n\n\n
neuropathic pain secondary to diabetes mellitus. On follow-up, the patient
complains of urine retention and dry mouth. The practitioner would:<\/p>\n\n\n\n\n
(Ans- discontinue amitriptyline and begin gabapentin (neurontin)
A 17-year-old male with rheumatoid arthritis is being treated with an NSAID
and omeprazole (Prilosec). The patient complains of headache, abdominal
pain, and gas. These symptoms are most likely:<\/li>\n\n\n\n
(Ans- associated with the omeprazole
The medication of choice for the initial treatment of juvenile rheumatoid
arthritis is:<\/li>\n\n\n\n
(Ans- ibuprofen
A 12-year-old with sickle cell anemia has recently experienced a sickle cell
crisis and presents for a follow-up examination after a recent
hospitalization. It is most important to continue monitoring growth,
development, and:<\/li>\n\n\n\n
(Ans- hemoglobin levels
A 90-year-old female is brought to the clinic by her neighbor. She states
that everything is fine, but the nurse practitioner notes that she has poor
hygiene and bruises on her trunk. The neighbor is concerned that the
patient often has no money to buy food, despite income from social security
and a coal miner’s pension. The nurse practitioner suspects abuse. Which
of the following is the nurse practitioner obligated to do next?<\/li>\n\n\n\n
(Ans- report the case to proper authorities
In most cases, the first manifestation of Alzheimer’s disease is:<\/li>\n\n\n\n
(Ans- decrease in short-term memory
The optimal treatment for latent tuberculosis is:<\/li>\n\n\n\n
(Ans- osioniazid (nydrazid) for 9 months<\/li>\n<\/ol>\n\n\n\n
Answers
Assessment of the optic disc is a component of the evaluation of cranial
nerve:
I.
II.
III.
.IV
(>- Cranial II
You examine a 62-year-old woman with a 20-year history of hypertension.
She reports intermittent use of antihypertensive medications, stating, “I feel
better without the medications.” Today she presents for a “check-up.”On
physical examination, you note the following: PMI with a downward and
lateral shift as well as a Gr II\/VI holosystolic murmur with radiation to the
axilla.
This patient’s health history is most likely to include a report of:
Syncopal episodes.
Episodes of chest pain at rest.
Dyspnea with exertion.
Vertigo.
(>- Ans: dyspnea on exertion
Of the following, which should be performed first in assessing a 48-year-old
woman who has a 25-year history of moderate persistent asthma and who
now presents with an acute asthma flare?
Oxygen saturation
Arterial blood gas<\/p>\n\n\n\n
Chest x-ray
(>- Ans: FEV (force expiratory volume)
You are setting up a healthcare clinic for migrant farm workers. Which of
the following sites is most desirable?
Community hall of a local church
Local hospital ambulatory care center
Mobile van
Space in a shopping center
(>- Ans: Mobile van
A 58-year-old woman presents for an initial examination in order to become
a patient in your primary care practice. She is a nonsmoker, drinks 1 to 2, 5
oz (0.15 L) glasses of wine per week, and works as an administrative
assistant in a law office. She is without complaint and reports that she is
generally in good health. Physical exam reveals BMI=34 kg\/m2 and
BP=144\/98 mm Hg bilaterally.
The rest of her examination is unremarkable.
Prescribe a low-dose thiazide diuretic.
Arrange for additional blood pressure measurements within the next four
weeks.
Order a serum creatinine, urea nitrogen and urinalysis.
Advise restricting sodium intake and limiting alcohol intake to no more than
1 glass of wine per week.<\/p>\n\n\n\n
next four weeks.
The NP demonstrates fulfillment of the advanced practice nursing
leadership role by participating in which of the following activities?
Teaching a 56-year-old man with newly-diagnosed type 2 diabetes mellitus
about the importance of self-glucose monitoring
Volunteering to teach a class on contraceptive methods to a group of teen
mothers
Discussing barriers to achieving blood pressure control with a 65-year-old
woman with hypertension who “does not want to take any medicine”
Collaborating with the regional public health department on an initiative to
combat obesity through a community-based exercise program
(>- Ans: Collaborating with the regional public health department on an
initiative to combat obesity through a community-based exercise program
You are asked to speak to a group of healthcare executives on the NP role.
Which of the following provides the strongest support for NP practice?
Number of academic credits earned during the NP program
Evidence of NP practice outcomes
The quantity of clinical hours and type of clinical rotations in the NP
program
The professional experience of the person prior to entering the NP program
(>- Ans: Evidence of NP practice outcomes
Rank the following from highest (1) to lowest (4) level of research design.<\/p>\n\n\n\n
Skin survey for precancerous lesions _<\/em>
1-Primary prevention 2-Secondary prevention
1-Secondary prevention 2-Primary prevention<\/p>\n\n\n\n
ADA screening for DM in Children
(Ans-
-symptomatic children (polyuria, polydipsia, polyphagia, blurred vision)
regardless of risk factors
-asymptomatic children after puberty or 10 years of age or older if
overweight or obese (>85th percentile). Plus 1 of the following:
*T2DM in 1st or 2nd degree relative
*high risk racial\/ethnic group
*signs of insulin resistance (HTN, dyslipidemia, acanthosis nigricans,
PCOS, SGA)
*maternal hx of DM or GDM during the child’s gestation
Statistics
(Ans-<\/p>\n\n\n\n\n
suicide: males more successful, women more attempts. highest rate is
older white males.
Osgood-Schlatter:
(Ans- knee pain in young adults, overuse. Repetitive stress pain,
tenderness, swelling at the tendon’s insertion site. The tibial tuberosity.
Rule out avulsion fracture if there is an acute onset and order a lateral xray.
RICE. Usually stops when the growth stops.
If patient has right sided weakness, etc. the CVA occurred where
(Ans- left side<\/li>\n<\/ul>\n\n\n\n
(Ans- Urinalysis and urine culture
A 65-year-old woman presents for a follow-up examination after a new
patient visit. She has not seen a healthcare provider for several years. She
is a smoker and her hypertension is now adequately controlled with
medication. Her mother died at age 40 from a heart attack. The fasting lipid
profile shows cholesterol = 240 mg\/dL, HDL = 30, and LDL = 200. In
addition to starting Therapeutic Lifestyle Changes, the nurse practitioner
should start the patient on:<\/p>\n\n\n\n\n
(Ans- A statin drug
Ortolani’s Click
(Ans- a click is heard or felt as dislocation is reduced (developmental
dysplasia of hip) (good until one year)
Which of the following laboratory tests should a nurse practitioner order
when the suspected diagnosis is temporal arteritis?
(Ans- Erythrocyte sedimentation rate (ESR)
What are narrow therapeutic index drugs?
(Ans1. Warfarin sodium (Coumadin): monitor INR<\/li>\n\n\n\n
magnesium, calcium)<\/li>\n\n\n\n
levels<\/li>\n\n\n\n
Otitis Externa tx
(Ans- Fluoroquinolone & Polymyxin B cortisporin drops
An elderly male patient complains of a new-onset, left-sided temporal
headache accompanied by scalp tenderness and indurated temporal
artery. The NP suspects temporal arteritis. What screening test would you
order to assist with diagnosis?
(Ans- sedimentation rate (expect to be very elevated)
Basal Cell Carcinoma
(AnsPearly domed nodule with overlaying telangiectatic vessels. Could be
plaque, papule, possible central ulceration and crusting. Dx: Biopsy Tx:
Normal, healthy woman of reproductive age
(Answhite, clear, flocculent(physiologic leukorrhea), no complaints, pH 3.8-4.2
(toward acidic), no odor, microscopic shows lactobacilli (gram+bacteria)
Multiple infections from bacteria and fungus?
(Ans- Screen for HIV
Screening Tests
(Ans-<\/li>\n<\/ol>\n\n\n\n\n
the false positives<\/li>\n\n\n\n
to assess pts ability to think abstractly a nurse pract could ask the patient
(Ans- the meaning of a common proverb<\/li>\n<\/ul>\n\n\n\n
erythematosus (SLE) is:
1.
azathioprine (AZA).
2.
belimumab (Benlysta).
3.
ibuprofen (Advil).
4.
cyclophosphamide (Cytoxan).
(Ans- ibuprofen (advil)
A 17-year-old female is suspected of having polycystic ovary syndrome. In
addition to testosterone, the most appropriate diagnostic tests to order
would be:
(Ans- follicle-stimulating hormone (FSH), luteinizing hormone (LH),
prolactin, and thyroid-stimulating hormone (TSH).
Barlow’s Maneuver
(Ans- Feeling of a slip as the femoral head slips away from the acetabulum
(toward the butt) (good until 6 mo)
Candida vulvovaginitis
(Ans- etiology: candida albican (80-90%)
white, curdy, “cottage-cheese” like, sometimes increased, itching\/burning
discharge, pH <4.5, odor is usually absent, microscopic shows mycelia,
budding yeast, pseudohyphae w\/KOH prep. Treatment: oral diflucan or
vaginal miconazole or terconazole
PSEUDOHYPHAE, CLOTRIMAZOLE CREAM
Proton Inhibitors
(Ans- Increased risk of fractures(postmenopausal women),<\/p>\n\n\n\n
& Answers
An adult patient needs treatment for Chlamydia trachomatis urethritis.
Which one of the following drugs is useful as a single-dose regimen?
a. Ceftriaxone intramuscularly
b. Levofloxacin
c. Azithromycin
d. Doxycycline
(Ans- c
A patient who gave birth to an infant two months previously seems
disengaged and withdrawn. The family nurse practitioner is concerned that
the patient may have postpartum depression. Which three of the following
symptoms are characteristic of postpartum depressions?
a. Insomnia or hypersomnia
b. Disorientation and confusion
c. Feeling of worthlessness or inadequacy
d. Poor concentration and inability to make decisions
e. Delusions associated with the infant
(Ans- a, c & d
A child with fetal alcohol syndrome [FAS] is likely to exhibit which of the
following findings?
a. Growth deficiency
b. Normal IQ
c. Thickened upper lip
d. Macrocephaly
(Ans- a<\/p>\n\n\n\n
convenient diagnostic screening test?
a. Slit lamp examination
b. Corneal light reflex test
c. Snellen test
d. Fluorescein test
(Ans- b
According to Dr. Elisabeth Kubler-Ross, dying patients experience several
emotional stages during terminal illness. Which one of these emotions
persists throughout all the stages of terminal illness?
a. Anger
b. Hope
c. Denial
d. Bargaining
(Ans- b
A family nurse practitioner is assessing an 11-month-old African-American
child who was brought in by his mother for concerns about swelling in both
hands and both feet. On examination, the nurse practitioner finds
tenderness and obvious swelling of the hands and feet. Vital signs,
including temperature and blood pressure, are normal The most likely
diagnosis is:
a. osteomyelitis
b. hand-foot-mouth disease
c. glomerulonephritis
d. sickle cell disease
(Ans- d
(hand-foot syndrome) dactylitis due to sickle cell disease
A 65-year-old woman complains of urinary incontinence. She is
experiencing leakage of urine when she coughs, sneezes, or laughs. This
form of urinary incontinence is called:
a. stress incontinence
b. urge incontinence<\/p>\n\n\n\n
d. functional incontinence
(Ans- a
A full-term newborn weighed 7 pounds, 9 ounces at birth. Three days after
hospital discharge, the family nurse practitioner is seeing the baby for his
first checkup. he now weighs 7 pounds, 4 ounces. This level of weight loss
is:
a. worrisome because it is below birth weight
b Indicative of inadequate nutrition
c. A sign of dehydration
d. Normal at this age
(Ans- d
Which of the following drugs is NOT associated with human teratogenicity?
a. Valproic acid
b. Warfarin
c. Phenytoin
d. Amoxicillin
(Ans- d
Valproic acid – neural tube defects (spina bifida, meningocele)
Phenytoin (Dilantin) – developmental defects (cleft palate, mental
deficiency, cleft lip)
Warfarin (Coumadin) – nasal deformities, brain abnormalities and stillbirth
The family nurse practitioner is assessing an infant for indications of
developmental hip dysplasia utilizing the Ortolani-Barlow maneuver. The
maneuver begins by placing the infant on the back and includes the
following steps:<\/p>\n\n\n\n\n
resistance, or an abnormal “clunk” sound.<\/li>\n\n\n\n
femur at a time, observing for dislocation
(Ans1
3
4
2
The study of individual genes and their impact on relatively rare singlegene disorders
(Ans- Genetics
The study of all the genes in the human genome together, including their
interactions with one another, the environment, and the influence of
psychosocial and cultural factors
(Ans- Genomics
A transaction between the sender and the receiver. Both parties participate
simultaneously
(Ans- Therapeutic communication
Requirements for therapeutic relationships
(AnsRapport
Trust
Respect
Honesty
Empathy
Are social systems that form interdependent and independent relationships,
referred to as subsystems both within and outside.
(Ans- Families<\/li>\n\n\n\n
A 24-year old, otherwise healthy college student presents with c\/o cough x
6 weeks. She has tried several OTC cough meds with no improvement.
What is the most important information to consider when building your
differential diagnoses?
A) Her age
B) Family hx
C) Ineffectiveness of OTC cough medicines
D) Length of time she has been coughing
(AnsD) Length of time she has been coughing
Why? This information helps you build your ddx
Acute cough < 3 weeks: bronchitis, sinusitis, PND, exacerbation of COPD\/asthma, pneumonia, pulmonary embolism Chronic cough (>8 weeks) GERD and Asthma are most common causes,
also consider infection (e.g. pertussis, atypical pneumonia), ACE inhibitors,
chronic bronchitis, bronchiectasis, lung ca)
According to the CDC, what drug class is considered first-line treatment for
pertussis?
A) Sulfonamide
B) Tetracycline
C) Macrolide
D) Beta-lactam
(Ans- C) Macrolide antiobitic (e.g. Azithromycin, clarithromycin
Sulfonamides are second-line
Match the antibiotics with the correct drug class:<\/p>\n\n\n\n\n
A. Doxycyline
B. Azithromycin
C. Penicillins
D.Trimethoprim-Sulfamethoxazole
E. Cephalosporin
F. Clarithromycin
(Ans1. Sulfonamide – D.Trimethoprim-Sulfamethoxazole (Bactrim)<\/li>\n\n\n\n
What are the three most common bugs in community-acquired pneumonia?
(AnsStreptococcus pneumoniae
Mycoplasma pneuomiae (atypical pathogen)
Chlamydophila pneumoniae (atypical pathogen)
What is the treatment for CAP caused by Strep pneumo?
(Ans- Respiratory quinolone (e.g. Levofloxacin, moxifloxacin, gemifloxacin)
OR high-dose amoxicillin OR amoxicillin with clavulanate
What antibiotics are avoided in CAP caused by Strep pneumo due to high
rates of resistance?
(Ans- Macrolides
What is the treatment for CAP caused by Mycoplasma pneumoniae?
(Ans- Macrolide OR doxycycline<\/li>\n<\/ol>\n\n\n\n
(Ans- Beta-lactams (ineffective)
A 38-year old mother of two teenagers recently recovered from
Mycoplasma pneumonia a couple of weeks ago. She asks if she should get
the “pneumonia shot.” She takes levothyroxine 88 mcg daily for
hypothyroidism, but is otherwise healthy. How do you respond?
A) No, it’s too soon after your infection
B) No, it’s not indicated
C) Yes, you can get it in about a month
D) Yes you can get it today
(Ans- B) No, it’s not indicated
An otherwise healthy adult without immunocompromise or multiple
comorbid conditions is not a “vulnerable population”
The pneumonia vaccine does not prevent mycoplasma pneumonia
According to GOLD, what is required to establish the diagnosis of COPD?
(Ans- Spirometry (FEV1\/FVC ratio < 70%)
A 70-year old house painter reports a 4-week history of exertional dyspnea,
chest tightness, and cough for the past 3 months. He has never smoked.
What diagnoses are included in your differential? Select 4.
A) Asthma
B) Angina
C) COPD
D) GERD
E) Pneumonia
F) Tuberculosis
G) Heart Failure
(AnsB) Angina
C) COPD<\/p>\n\n\n\n
G) Heart failure
How do inhaled anticholinergics work to treat shortness of breath in
COPD?
A) They cause bronchodilation in the lungs
B) They block the action of acetylcholine and prevent bronchoconstriction
(AnsB) They block the action of acetylcholine and prevent bronchconstriction
Name a short-acting inhaled anticholinergic: (Ans- Ipratropium (Atrovent)
Name a long-acting inhaled anticholinergic: (Ans- Tiotropium (Spiriva)
How do inhaled bet\u00e1-agonists work to treat shortness of breath in COPD?
A) They cause bronchodilation in the lungs
B) They block the action of acetylcholine and prevent bronchoconstriction
(AnsA) They cause bronchodilation in the lungs
What are the only 2 inhaled short-acting beta agonists (SABAs):
(Ans- Albuterol and levalbuterol
Name an inhaled long-acting beta agonists (LABAs):
(Ans- Salmeterol (Serevent)
What are the side effects associated with anticholinergic medications?
(Ans- Cognitive impairment, confusion, hallucinations, dry mouth, blurry
vision, urinary retention, constipation, tachycardia, acute angle glaucoma
“Can’t see, can’t pee, can’t spit, can’t shit.”
Name a inhaled combined short-acting anticholinergic\/short-acting beta
agonist:
(Ans- Ipratropium\/albuterol (Combivent)<\/p>\n\n\n\n
FNP review
A 72 year old woman has been on hydrochlorthiazide 12.5 mg for many
years to control her Stage II hypertension. Her BP at this visit is 168\/96.
She is currently complaining of pain in her right hip and both knees. She
has increased her dose of ibuprofen from 400 mg TID to 800 mg TID. She
is still in pain and would like something stronger. Which of the following
statements is the best explanation of the effects of ibuprofen on her
disease.
a. It increases the chances of adverse effects to her health
b. it inhibits the effect of renal prostaglandins and blunts the effectiveness
of the diuretic
c. it prolongs the therapeutic effects of HCTZ and other diuretics
d. none of the above
(Ans – b
All of the following are infections that affect mostly the labia and vagina
except?
a. Bacterial vaginosis
b. candidiasis
c. trichomoniasis
d. chlamydia trachomatis
(Ans – d
The nurse practitioner would test the obturator and iliopsoas muscle to
evaluate for?
a. cholecystitis
b. acute appendicitis
c. inguinal hernia<\/p>\n\n\n\n
(Ans – b
Treatment for mild preeclampsia includes all of the following except?
a. bedrest except for bathroom privileges
b. close monitoring of weight and blood pressure
c. close follow-up of urinary protein, serum creatinine, and platelet count
d. a prescription of methyldopa to control BP
(Ans – d
All of the following services are covered under Medicare Part A except?
a. inpatient hospitalization
b. medicines administered to a patient while hospitalized
c. nursing home care
d. surgeons
(Ans – c
A 28 year old student is seen in the school health clinic with complaints of a
hacking cough that is productive of small amounts of sputum and a runny
nose. He does not take medications, denies any allergies, and has no
significant medical history. Physical exam reveals low-grade temperature of
99.9 degrees, respirations of 16 per minute, heart rate of 90 beats per
minute, and diffuse fine crackles in the base of the lungs. A chest xray
shows diffuse infiltrates on the lower lobe of the right lung. The total WBC
is 10,000. What is the most likely diagnosis?
a. streptococcal pneumonia
b. mycoplasma pneumonia
c. acute bronchitis
d. legionnaire’s disease
(Ans – b<\/p>\n\n\n\n
skin test. The minimum size of induration would be considered positive in
this patient?
a. 3 mm
b. 5 mm
c. 10 mm
d. 15 mm
(Ans – c
All of the following are correct statements regarding a durable power of
attorney’s role except?
a. their decisions are legally binding
b. it can be used in other areas of a patient’s life such as financial issues
c. they can decide for the patient who is on life support when it can be
terminated
d. the patient’s spouse has the right to override a durable power of attorney
(Ans – d
All of the following are true statements regarding Munchausen syndrome
except:
a. it is considered a mental illness
b. the patient has a medical illness that causes an anxiety reaction and
denial
c. the patient fakes an illness in order to gain attention from health care
providers
d. the patient has an inconsistent medical history along with a past history
of frequent hospitalizations
(Ans – b<\/p>\n","protected":false},"excerpt":{"rendered":"