ANCC Exam Questions And Correct Answers
Types of prevention - ANSWER primary- car restraints, bicycle helmets, immunizations
secondary- prevent for those with RF-pap, mammo
tertiary-mgmt of established disease- meds, lifestyle
Primary - ANSWER Preventing the health problem, most cost effective form of
healthcare **IMMUNIZATIONS, ensuring adequate illumination at home (preventing
falls)
Secondary - ANSWER Detecting disease in early asymptomatic stages, screenings
-Early cause finding of asymptomatic disease via the use of a screening test
Ex. highly abnormal mammo not final word
Tertiary- ANSWER Decreasing negative disease induced outcomes, could be
considered failure of primary prevention
Ex- rehab, PT, OT
Who should not receive influenza vaccine- ANSWER 4 mon old born at 32 weeks
gestation
receive flu- 6 mon and older
can give during pregnancy/lactation
give children 2x- 4 months apart
MMR- ANSWER preggers can't receive (no varicella, or zoster, smallpox, flu mist,
rotavirus), but lactation OK!
its live but weakened
give again to those born after 1957
,Give to 6-11 month who are travelling outside US
May treat and have an innocent flat pink rash
2 doses ( at 12-15 mon and 4-6 years)
Tetanus - ANSWER can get from soil, a depth of the wound is important
Preggers- get a tdap in her thirst trimester to pass onto the unborn child pertusis is a
bad outcome, family members need to be up to date- can cause lockjaw
T-dap- 1 at 11-64 and then booster every 10
dTap-five doses
Pertussis- uncontrollable cough, vomiting, fatigue, dx: nasopharyngeal culture and PCR
testing
tx: Azithromycin
No pap smear - ANSWER prior to 21 or in elderly
Benadryl - ANSWER older, cross BBB, can cause sedation, urinary retention (bad for
BPH)
herpes zoster - ANSWER stronger chickenpox vaccine-zoster vaccine
post-herpetic neuralgia- persists after 1 month
Herpes keratitis refers to an infection of the corneal epithelium caused by the herpes
virus, and most commonly shingles. The patient usually presents with acute onset of eye
pain, photophobia, and blurred vision in the affected eye.
,primary open angle glaucoma - ANSWER peripheral vision loss, elevated intraocular
pressure, deep-cupping of optic disc, tx with beta-adrenergic antag (Timolol), alpha
agonists, prostaglandin analogues
Glaucoma screening test- Tonometry
Normative aging - ANSWER Need for increased illumination
Macular degeneration - ANSWER central vision loss, common cause of new onset
blindness in elderly
More females
Screening tests- Amsler grid test
-Meniere's disease (idio) vs. Meniere's syndrome (secondary)-ANSWER: dizziness,
tinnitius, nystagmus, vertigo RF: ototoxic drugs, tx: benzos for rest and corticosteroids
for anti-inflam
oral cancer-ANSWER ulcerated lesion with indurated margins, most common SCC, RF:
HPV 16, screening at dental visits
beta lacatams with allergic reactions-ANSWER penecillins, cephalosporins,
carbapenems
rashes with Epstein Barr
Otitis externa-ANSWER Caused by fungus- Candidia or Aspergillus/P. aeruginosa
hallmark is pain on palpating tragus
Tx--> fluoroquinolone
AOM - ANSWER S.penumoniae (gram pos)-40-50%, tx with amox/cephalo, macrolides,
resistance protein binding sites
H.influenza (gram neg)- can produce beta-lactamase
, M.catarrhalis (gram neg)- also produces beta-lactamase, can get better w/o antibiotic
Need abnormal ear drum (bulging TM) + pain (otalgia)/rubbing/tugging ear
tx- Acetaminophen and otic drops help with ST
Watchful waiting- 6 months or older, with non-severe illness, unilateral, fever <102.2,
otalgia <48
<6 months-begin antibiotic!! if allergy-Cefdinir], RF: pacifier use for 10 months, feedings
in the supine, smoke exposure, day care,
<2- 10 days
2-6 yrs- 7 days
>6 yrs- 5 days
1st line- Amox 90 BID, Amox clav BID
With PCN allergy- **Cefdinir (Cephlosporins)
Group A strep
(GABHS) - ANSWER Streptococcus pyogenes, risk for rheumatic fever and Glomerulo.,
peritonsillar abscess,
tx- amox then try macrolide if doesnt't improve
GOLD STANDARD IS THROAT CULTURE
Indoor allergen - ANSWER dust mites (perennial), pets, cockroaches, mold spores
Acute Bacterial rhinosinusitis - ANSWER S.penumoniae**, RF-viral infection, allergies,
tobacco use, 1st line is Augmentin, penicillin allergy-Cefdinir