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ANCC Exam Study Guide Solutions
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✔✔-Minimizing negative disease induced outcomes, potentially viewed as a 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
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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, vomitting, fatigue, dx: nasopharyngeal culture and PCR testing
tx: Azithromycin
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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 is damage to the corneal epithelium caused by the herpes virus, commonly shingles. The
patient usually has 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
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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 without 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,
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