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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mild hidradenitis suppurativa after topical therapies failed.Which first-line
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treatment is recommended?
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Answer>>> Tetracycline
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Twelveweeksoforaltetracycline(Sumycin)istherecommendedfirst-linetreatmentfor
r hidradenitis suppurativa.
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Hidradenitissuppurativaisadisorderoftheterminalfollicularepitheliuminapocrine
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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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,cludesnodules and sinus tracts (inflamed ornoninflamed), 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
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doxycycline.Forpatientswhodonotrespondtodoxycycline,thenextrecommendedstep
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r 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 beconsidered bya dermatologist.In patients withmoderateto
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severehidradenitissuppurativa,adalimumab(Humira)maypossiblybeconsidered.
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2. When providing culturally competent health care services to an American
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r Indian elder,the nurse practitioner understands which is traditionally true?
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r Answer>>>-The "MedicineWheel" is used by many for the purpose of health and
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healing
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The"MedicineWheel" istraditionally usedandcontains fourdirections;north, south,east r r r r
r and west.Traditionally each tribe has different meanings for each direction andthey may
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r represent the season of the year or stage of life. It is aimed at providing aholistic view
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r of life.
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An understanding of different cultural preferences leads to cultural competence in
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r healthcare.Somepatientsmayvaluetraditionalcultureandpreferencesasitrelates
, to healthcare.These individual preferences should be included in the interview and
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r treatment plan for patients. r r r
Traditionally, the American Indian culture values a holistic approach to health care
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r integrating the person, lifestyle, environment, family, and religion.Patients adheringto
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r thesetraditionalculturalpracticesoftenfeelthatillnessisduetoalackofharmonywith r
r the physical body, mind, spirit, and emotions. Patients may seek care from western
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r medicine for specific ailments while also consulting with traditional healersfor
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r spiritual guidance. r
Healthcareprovidersshouldseektounderstandrelevantculturalfactorsandassesseach
r 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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r primary report of hearing loss and a sensation of fullness in the right ear.The
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r nurse practitioner suspects conductive hearing loss. Which could contributeto
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r this?
Answer>>> Cerumen, commonly called earwax, is a combination of secretions and
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r 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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r self-cleaningprocessfails,cerumen canbecomeimpacted.Cerumenimpactionoccludes r r
r the ear canal and can press against the tympanic membrane, resulting inconductive
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r hearing loss. r
Conductive hearing is the transition of sound from the external and middle earto
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