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Family Nurse practitioner Exam|306 Q’s and A’s A+ Rated
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Family Nurse practitioner Exam|306 Q’s andA’s A+ Rated
Sensitivity - -defined as the ability of a test to detect a person who has the
disease.
-Specificity - -defined as the ability of a test to detect a person who is
healthy or to detect the person without the disease.
-Trauma to Kiesselbachs plexus - -will result in an anterior nosebleed
-The diagnostic or gold standard test for sickle cell anemia, G6PD anemia,
and alpha or beta thalassemia - -hemoglobin electrophoresis
-questions asking for "action" - -the initial action might be to interview and
gather subjective data or the history
-erythromycin "allergy" vs adverse reaction - -adverse reactio-symptoms of
nausea or GI upset
allergy -hives, angioedema
-acute mononucleosis - -the patient will most likely be a teen presenting
with the classic triad of sore throat, prolonged fatigue, and enlarged cervical
nodes.
-Alpha thalassemia - -more common among Southeast Asians such as
filipinos
-Lupus - -present with malar rash(butterfly rash)Pts need to avoid or to
minimize sunlight exposure(photosensitivity)
-treatment for polymyalgic rheumatica(PMR) - -first line treatment 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 - -biopsy of the temporal artery.
refer pt to opthalmologist for mgt
-Finkelstein's test - -Positive in De Quervains tenosynovitis
-Anterior Drawer maneuver and Lachman maneuver - -Positive if anterior
cruciate ligament (ACL) of knee damaged. The knee may also be unstable
-McMurray's sign - -Positive in meniscus injuries of the knee
,-Damaged Joints - -order X-ray first, but MRI is the Gold Standard
-Diabetic retinopathy - -neovascularization, hard exudates, cotton wool
spots, and micoaneurysms
-Hypertensive retinopathy - -AV nicking, silver and or copper wire arterioles
-Checking deep tendon reflexes - -absent(0),
hypoactive (1)
normal(2)
hyperactive(3)
clonus(4)
-define clonus - -Clonus is typically seen in patients with stroke, multiple
sclerosis, spinal cord damage and hepatic encephalopathy. Clonus has also
appeared after ingesting potent serotonergic drugs, where 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 - -angioedema
-A common side effect of ACE inhibitors is a - -dry cough(10%)
-First line drug to treat hypertension in diabetics and patients with mild
renal disease because of their renal protective properties - -ACE inhibitors or
ARBS
-Penicillin - -amoxicillin(broad-spectrum PCN) Penicillin VK
-Macrolide - -erythromycin, azithromycin(Z-Pack), or clarithromycin(Biaxin)
-Cephalosporins: - -1st generation(Keflex), 2nd generation(Cefaclor, Ceftin,
Cefzil)3rd generation(Rocephin, Suprax, Omnicef)
-Quinolones with gram positive coverage - -levofloxacin(Levaquin),
moxifloxacin(Avelox), gatifloxacin(Tequin)
-Quinolones - -ciprofloxacin(Cipro), ofloxacin(Floxin)
, -Sulfa - -trimethoprim/sulfamethazole(Bactrim, Septra),
nitrofurantoin(Macrobid),
-Tetracyclines - -tetracycline, doxycycline, minocycline(Minocin)
-NSAID - -ibuprofen, naproxen(aleve, Anaprox)
-Cox-2 inhibitors - -celecoxib (celebrex)
-Antitussives - -dextromorphan(Robitussin), benzonate(Tessalon Perles)
-Drugs allowed for pregnant or lactating women - -Category B
-Pregnancy in pain - -order Tylenol instead of Ibuprofen
-Avoid nitrofurantoin and sulfa drugs during 3rd trimester - -increase the
risk of hyperbilirubinemia
-best way method of spreading viruses or bacteria is - -making them
airborne or nebulized
-treatment of cutaneous anthrax - -Ciprofloxacin 500mg orally BID for 60
days or 8 weeks. If pt allergic to ciprofloxacin , use doxycycline 100mg BID
-Good communication rules - -Ask open ended questions, do not reassure
patients, avoid angering the patient, and respect the patients culture.
-Eriksons Stages of Psychosocial Development - -Stage 1: Infancy -- Age 0
to 1
Crisis: Trust vs. Mistrust
Stage 2: Toddler -- Age 1 to 2
Crisis: Autonomy (Independence) vs. Doubt (or Shame)
Stage 3: Early Childhood -- Age 2 to 6
Crisis: Initiative vs. Guilt
Stage 4: Elementary and Middle School Years -- Age 6 to 12
Crisis: Competence (aka. "Industry") vs. Inferiority
Stage 5: Adolescence -- Age 12 to 18
Crisis: Identity vs. Role Confusion
Stage 6: Young Adulthood -- Age 19 to 40
Crisis: Intimacy vs. Isolation
Stage 7: Middle Adulthood -- Age 40 to 65
Crisis: Generativity vs. Stagnation Stage 8: Late Adulthood -- Age 65 to death
Crisis: Integrity vs. Despair Important
, -primary vs secondary - -"Will performing this action prevent the disease or
the social condition from happening? If it does, then it is considered as
primary prevention(if it doesn, then it is secondary)
-breast self exam and genital self exam - -considered secondary prevention
-tertiary prevention - -involves not only rehabilitation, but also includes
actiivities that will help to prevent complications from disease treatment,
such as patient education about medication side effects or the proper use of
equipment such as cane. Support groups for a disease /condition are all
considered as part of a tertiary prevention activity.
-Primary prevention - -(prevent disease.injury/condition)-youth violence
prevention, bullying prevention, presonal safety promotion, disease
prevention-immunization, using suncreen, healthy lifestyle promotion,
promotion of OSHA lawas-workplace safety, EPA laws-clean water,
anipollution laws
-secondary prevention - -(Detect disease.condition as Early as Possible)
any lab test to screen disease, US preventive Services Task Force-screening
rec-mammograms, PSA, PPD, screening for high risk behaviour-suicide,
depression, personal action to detect cancer
-Tertiary prevention - -(Limiting Further harm and disability)
All types of rehabilitation-cardiac, pt/ot, speech therapy , addition/drug
rehab, support groups, exercise for an obese person
-clue cells - -mature squamous epithelial cells with numerous bacteria
noted on the cell borders(bacterial vaginosis)
-Bacterial Vaginosis - -has a alkaline pH(vagina normally has an acidic pH of
4.0) BV is the only vaginal condition with the only alkaline pH for the exam.
BV is not considered an STD(it is imbalance of vaginal bacteria-sex partner
does not need to be treated. The microscopy slide will have very few WBC
and large number clue cells.
-Candida vaginal discharge - -white in color with a thick and curd like
consistency. it frequently causes redness and itching in the vulvovagina due
to inflammation
-microscopy in candidiasis - -will show a large number of WBC,
pseudohyphae, and spores(saghetti and meatballs
-candida yeast - -normal flora of gastrointestinal tract and in some womens
vaginas
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