ANCC FNP BOARD EXAM LATEST REAL EXAM 150 QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES|ALREDY GRADED
A+
1. A middle-age female patient presents to the clinic with a recurrence of
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f mild hidradenitis suppurativa after topical therapies failed.Which first-line
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treatment is recommended?
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Answer>>> Tetracycline ff
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line treatmentfor
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hidradenitis suppurativa.
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Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in apocrine
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gland-bearing skin. It is a chronic, disabling disorder that progresses, often causing
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keloids, contractures, and immobility. It is characterized by comedone-like follicular
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occlusion, chronic and relapsing inflammation, mucopurulent discharge, and pro-
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gressive scarring.
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Arthropathy associated with hidradenitis may be present. Typical presentation in-
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,cludes nodules and sinus tracts (inflamed or noninflamed), abscesses, and scarring
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found in the axilla, genitofemoral area, perineum, gluteal area, and inframammary
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area in women.
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Recommended treatments include antibiotics, steroids, retinoids, dapsone, and anti-
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tumor necrosis factor agents. A dermatology consultation should also be con-sidered.
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First-line treatment is a 12 f f f f week course of an oral tetracycline (Sumycin) such as
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doxycycline.For patients who do not respond to doxycycline, the next recommendedstep
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is a combination of twice-daily clindamycin (Cleocin) and rifampicin (Rifadin) for 10-
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12 weeks. If treatment fails, acitretin (Soriatane, for males and nonfertile fe- males) or
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dapsone (Aczone) may be considered by a dermatologist.In patients withmoderate to
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severe hidradenitis suppurativa, adalimumab (Humira) may possibly beconsidered.
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2. When providing culturally competent health care services to an American
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f Indian elder, the nurse practitioner understands which is traditionally true?
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Answer>>> -The "Medicine Wheel" is used by many for the purpose of health and
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healing
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The "Medicine Wheel" is traditionally used and contains four directions;north, south,east,
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and west.Traditionally each tribe has different meanings for each direction andthey may
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represent the season of the year or stage of life. It is aimed at providing aholistic view
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of life.
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An understanding of different cultural preferences leads to cultural competence in
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healthcare.Some patients may value traditional culture and preferences as it relates
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,to healthcare.These individual preferences should be included in the interview and
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treatment plan for patients.
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Traditionally, the American Indian culture values a holistic approach to health care
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integrating the person, lifestyle, environment, family, and religion. Patients adheringto
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these traditional cultural practices often feel that illness is due to a lack of harmonywith
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the physical body, mind, spirit, and emotions. Patients may seek care from western
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medicine for specific ailments while also consulting with traditional healersfor
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spiritual guidance.
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Healthcare providers should seek to understand relevant cultural factors and assesseach
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individual's healthcare literacy in order to provide culturally competent care.
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3. The nurse practitioner sees an older adult patient in the clinic with the
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f primary report of hearing loss and a sensation of fullness in the right ear.The
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nurse practitioner suspects conductive hearing loss. Which could contributeto
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f this?
Answer>>> Cerumen, commonly called earwax, is a combination of secretions and
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sloughed epithelial cells that protects the ears from infection, water, and insects.
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It is normally expelled from the ear canal through natural jaw movement. When this
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self-cleaning process fails, cerumen can become impacted.Cerumen impactionoccludes
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the ear canal and can press against the tympanic membrane, resulting inconductive
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hearing loss.
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Conductive hearing is the transition of sound from the external and middle earto
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, f the inner ear. Conductive hearing loss is caused by problems in the external
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and middle ear that interfere with the transmission of sound and its conversion to
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f mechanical vibration. Causes of conductive hearing loss include obstruction of the
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external auditory canal by cerumen, foreign bodies, debris from otitis externa, and
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large exocytosis and osteomas.
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Sensorineural hearing loss involves difficulty converting mechanical vibrations to
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electrical potential in the cochlea or in auditory nerve transmission to the brain. Itis
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f mostly caused by permanent damage in the organ of Corti. It can be caused by age-
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related hearing loss, noise trauma, medications, autoimmune diseases,
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mechanical trauma, Meniere disease, infection, and neoplasm (acoustic neuroma).
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Approximately one-third of older adults between the ages of 61 and 70 years have
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hearing loss.More than 90% of adults older than 85 years of age have hearing loss.The
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f most common type of hearing loss is age-related and sensorineural. All adultsolder
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f than 60 years of age should be screened for hearing loss at periodic health
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f examinations.
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