ANCC Family Nurse Practitioner Exam 350Questions & Answers all answers 100%Verified: Updat, Exams of Nursing

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Karposi Sarcoma - correct answers Characteristic purple areas on the nose in an HIV-positive female. A type of cancer that can form in the skin, lymph nodes, or other organs. The skin lesions are usually purple in color. Malodorous single nare - correct answers Foreign body Retinal Detachment - correct answers the retina separates from the layer underneath. Symptoms include an increase in the number of floaters, flashes of light, and worsening of the outer part of the visual field. Adolescent with friable nasal turbinates - correct answers Cocaine use Aphthous ulcer - correct answers a recurrent round or oval sore or ulcer inside the mouth on an area where the skin is not tightly bound to the underlying bone, such as on the inside of the lips and cheeks or underneath the tongue. Aphthous ulcers can also affect the genitalia in males and females. GERD first line tx - correct answers h2 then ppi if doesnt work

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Maxillary Sinusitis - correct answers Dental pain Kasmaul Triangle - correct answers Anterior epitaxis Roseola infantum - correct answers H. fever => small pink dots pink or raised body rash => arms Acne Roscaca - correct answers "adult acne." most often in adults (30-50 years of age). Unlike acne vulgaris, rosacea is devoid of blackheads and characteristically does not resolve after puberty. Rosacea strikes both sexes and potentially all ages. It tends to be more frequent in women but more severe in men. It is very uncommon in children, and it is less frequent in people with dark skin. Tx with Flagyl AV Nicking - correct answers HTN, arteries crossing veins Blepharitis - correct answers commonly occurs when the tiny oil glands of the inner eyelid become inflamed. It often occurs along with other skin conditions or allergies. Symptoms include red, itchy eyelids that may look greasy and crusted. Dry eyes also are a symptom.

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Treatments include cleaning the eyelids, antibiotic or steroid eye drops and treating underlying conditions. However, blepharitis tends to come back. Hordelum - correct answers Painful stye it hurts chalazion - correct answers Non painful lesion to eyelid Cotton Wool - correct answers Cotton wool spots are an abnormal finding on funduscopic exam of the retina of the eye. They appear as fluffy white patches on the retina. They are caused by damage to nerve fibers and are a result of accumulations of axoplasmic material within the nerve fiber layer. Systemic HTN, DM Herpes Zoster - correct answers Early signs of shingles include a burning sensation or stabbing pain and tingling or itching on the skin. After a few days, a rash or blisters appear usually on one side of the body or face. When the rash is at its peak, symptoms can range from mild itching to extreme and debilitating pain. Tx within 72 hours Aclovir Retinoblastoma (Rb) - correct answers Absence of light reflex, it is a rare form of cancer that rapidly develops

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from the immature cells of a retina, the light-detecting tissue of the eye. It is the most common primary malignant intraocular cancer in children, and it is almost exclusively found in young children. Seborrheic dermatitis (Dandruff) - correct answers commonly involves portions of the scalp, brows, mid-face, ears, mid-chest, and mid-back. It is not unusual for it to affect the skin of infants and young children where it often involves the scalp (cradle cap) and the diaper area. Seborrheic dermatitis is also known as seborrhea. Seborrheic Keratosis - correct answers A seborrhoeic keratosis is a harmless warty spot that appears during adult life as a common sign of skin aging. ... Seborrhoeic keratosis (or seborrheic keratosis, using American spelling) is also called SK, basal cell papilloma, senile wart, brown wart or barnacle. Cupping of disc - correct answers Intracranial pressure subconjunctival haemorrhage - correct answers is bleeding underneath the conjunctiva. It can occur after a sudden or severe sneeze or cough, heavy lifting, straining, vomiting or even rubbing one's eyes too

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roughly. It can also occur as a side effect of eye surgery or blood thinners. The main symptom is a bright red patch in the eye that may spread and then become green or yellow, much like a bruise. Usually it disappears within two weeks. In most cases, no treatment is required for this condition. Sialolithiasis (also termed salivary calculi, or salivary stones) - correct answers A condition where a calcified mass or sialolith forms within a salivary gland, usually in the duct of the submandibular gland (also termed "Wharton's duct"). Honey Crusted lesions - correct answers Impetigo is a bacterial infection that involves the superficial skin.The most common presentation is yellowish crusts on the face, arms, or legs.Less commonly there may be large blisters which affect the groin or armpits. The lesions may be painful or itchy. Fever is uncommon. It is typically due to either Staphylococcus aureus or Streptococcus pyogenes. Risk factors include attending day care, crowding, poor nutrition, diabetes mellitus, contact sports, and breaks in the skin such as from mosquito bites, eczema, scabies, or herpes. With contact

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it can spread around or between people.Diagnosis is typically based on the symptoms. Prevention is by hand washing, avoiding people who are infected, and cleaning injuries. Treatment is typically with antibiotic creams such as mupirocin or fusidic acid. Antibiotics by mouth, such as cephalexin, may be used if large areas are affected. Antibiotic-resistant forms have been found. Mild acne - correct answers Skin wash retinol benzol moderate acne - correct answers retinol plus tetracylines oral abx Retinol reaction - correct answers decrease to 3 times a day Well demarcated cellulitis - correct answers erysipelas affects the dermis, most commonly on the legs, and tends to be sharply demarcated. Cellulitis, which typically affects the lower legs, involves the subcutaneous fat and is often less well demarcated. ... The diagnosis of cellulitis or erysipelas is usually clinical.

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polymyalgia rheumatica - correct answers you feel pain and stiffness in the muscles in your shoulders and upper arms (shoulder girdle) and hips (pelvic girdle). This feeling often comes after you've spent time resting, and is most severe upon wakening from sleep. Fibromyalgia - correct answers can also cause muscle pain in the same parts of the body. But it's more wide- spread and the pain is more severe. People with fibromyalgia tend to experience other symptoms as well, including: tiredness trouble sleeping memory problems bowel and bladder problems Temporal arteritis - correct answers is a condition in which the temporal arteries, which supply blood to the head and brain, become inflamed or damaged. It is also known as cranial arteritis or giant cell arteritis. Although this condition usually occurs in the temporal arteries, it can occur in almost any medium to large artery in the body.

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Temporal arteritis - correct answers ESR CRP Biopsy Temporal arteritis - correct answers S/SX double vision sudden, permanent loss of vision in one eye a throbbing headache that's usually in the temples fatigue weakness loss of appetite jaw pain, which sometimes can occur with chewing fever unintentional weight loss shoulder pain, hip pain, and stiffness tenderness in the scalp and temple areas Basal Cell carcinoma - correct answers Most common form herpes keratosis - correct answers acute onset, photophobia, blurred vision refer to ophthalmologist

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Pinworms - correct answers itching at rectum, worst at noc, scotch tape, also known as enterobiasis Cellulitis worsening - correct answers Suspect DVD Millia - correct answers white spots on mouth w/ infants Kawasaki Disease - correct answers Redeye, strawberry pharnyx, rash on body, edema hands and feet t's most common in infants and young children. Early stages include a rash and fever. Symptoms include high fever and peeling skin. In late stages, there may be inflammation of medium-sized blood vessels (vasculitis). It also affects lymph nodes, skin and mucous membranes, such as inside the mouth. Kawasaki disease is usually treatable. Initial treatments include aspirin and intravenous immunoglobulin therapy given in a medical facility. Critical: consult a doctor for medical advice varicella - correct answers chicken pox rash crusted "vesicles"

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Herald Patch - correct answers Pityriasis rosea is a viral rash which lasts about 6-12 weeks. It is characterised by a herald patch followed by similar, smaller oval red patches that are located mainly on the chest and back. 3 types of hand rashes - correct answers FHand mouth, sypillis, RMSD Bulls eye lesion - correct answers Lymes Disease, Doxy x 21 days Hand Foot Mouth - correct answers cocsacki virus Syphillis - correct answers palm of hand, RPR test, tx w/ penicillin Rash on shoulder(body) - correct answers Tinea Corpius Ringworm - correct answers azole antifungal Parvola lab - correct answers slap face, 5ths disease, stay away from pregnant women

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Koplik spots - correct answers Measels, Rubeola, The disease spreads through the air by respiratory droplets produced from coughing or sneezing. Measles symptoms don't appear until 10 to 14 days after exposure. They include cough, runny nose, inflamed eyes, sore throat, fever and a red, blotchy skin rash. There's no treatment to get rid of an established measles infection, but over-the-counter fever reducers or vitamin A may help with symptoms. Waxy pearly domeshaped lesion - correct answers Basal cell carcinoma Actinic keratosis - correct answers flat scaly rash, precurser to SCC Addison Disease - correct answers Cortisol is low, hyperkalemia, low sodium, cravings thirsty primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Symptoms generally come on slowly and may include abdominal pain, weakness, and weight loss. Causes: Problems with the adrenal gland

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Treatment: Corticosteroid such as hydrocortiso... Symptoms: Abdominal pain, weakness, weight CD4 counts <200 - correct answers HIV bad CD4 counts 350 - correct answers HIV meds working CD4 count >400 - correct answers ideal goal for HIV TB 5mm - correct answers exposed to TB, HIV TB >10mm - correct answers exposure health workers immigrants Subungual hematomas - correct answers are common nail bed injuries caused by blunt or sharp trauma to the fingers or toes. [1] Bleeding from the rich vascular nail bed results in increased pressure under the nail and can cause significant discomfort. [2] Subungual hematoma drainage, also known as nail bed trephination, can be performed to relieve this discomfort. [3]

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Molluscum - correct answers is a common viral skin infection that causes small, harmless, raised dome- shaped spots to appear on the skin. It is caused by the molluscum contagiosum virus. Once infected, your child can easily spread molluscum to other people, or to different areas on their own body. It is spread by touching the molluscum spots Acanthosis nigricans - correct answers is usually the result of obesity. This is known as obesity-associated acanthosis nigricans. It occurs because obesity can cause insulin resistance (when the body is unable to properly use the hormone insulin), which may lead to high levels of insulin in the blood, affecting the skin cells. fibromyalgia - correct answers 18 points (9 pairs) tend to be painful when pressed, and may spread pain to other body parts. American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of these tender points when a doctor applies a certain amount of pressure fibromyalgia definition - correct answers Fibromyalgia is a chronic condition that causes pain in the muscles and bones. Other common symptoms are feeling tired and sleeping poorly.

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Some people also feel vague and even confused at times. Fibromyalgia is common and affects around 2-5% of the population, mainly young to middle-aged women. The most common symptoms of fibromyalgia are: pain in many different muscles and bones tenderness or stiffness in the muscles or bones, lasting for at least 3 months tiredness difficulties in sleeping. Orthopnea - correct answers often a symptom of left ventricular heart failure and/or pulmonary edema. It can also occur in those with asthma and chronic bronchitis, as well as those with sleep apnea or panic disorder Pulmonic area heart sound - correct answers split S Carotid Stenosis - correct answers CVA, Stroke

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Arterial insufficiency, Peripheral vascular disease - correct answers lack pedal pulses, pain in calf, red feet, common in elderly, blood cant go down. DX w/ brachial index test, encourage exercise Venous insufficiency - correct answers Edema, no feeling, blood cant go up S4 indicates - correct answers Left ventricular hypertrophy Pulsus Paradoxus - correct answers BP decreases with inspiration Prolonged PR interval - correct answers 1st degree heart block Absent P wave - correct answers AFIB STEMI - correct answers ST elevated MI AAA - correct answers diagnosed with US

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Apical Murmurs - correct answers systolic at base, Mitral Regurgitation Aortic Murmurs - correct answers to neck, aortic stenosis Acute OM - correct answers 1st line tx Penicillin- Amoxicillin- if allergic PCN reaction go to Macrolide. ("Mycin") If nausea etc change to different Macrolide ie. Azith, Errith, Clarithomycin Acute External Ottitis - correct answers chief pathogen Pseudo monas Augina tx w/ 1st Cipro, 2nd cephlosporin Swimmers Ear - correct answers Gm-ve, foul smell pseudo auginas Herbal alternatives post menopausal hormonal replacement - correct answers Isoflavins= soybeans, blackbeans, black cohash Preferred ABO Anthrax - correct answers Cipro 500mg

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Meds to wean off slowly, never stop abruptly - correct answers Benzos SSRI's + Effexor Prednisone after 7 days Cava Cava - correct answers natural Tx for anxiety, never with benzos Med causing sexual dysfunction - correct answers Paxil especially, but any SSRI will decrease sexual function Lithium - correct answers Bipolar treatment of grandiosity dont give with a MOAI or TCA Monitor TSH levels SIGECAPS - correct answers S leep changes: increase during day or decreased sleep at night I nterest (loss): of interest in activities that used to interest them G uilt (worthless): depressed elderly tend to devalue themselves

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E nergy (lack): common presenting symptom (fatigue) C ognition/C oncentration: reduced cognition &/or difficulty concentrating A ppetite (wt. loss); usually declined, occasionally increased P sychomotor: agitation (anxiety) or retardations (lethargic) S uicide/death preocp. Best BP Med for African Americans - correct answers CCB Metformin contraindications - correct answers Decr. renal function Hepatic disease Lympatic - causes lacticacidosis Surgery w/ metformin - correct answers hold 24o a/ and 48o p/

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Increased Creatin and decreased GFR - correct answers Renal effects= renal failure If meds are invacana and metformin and creatine elevated which one to dc? - correct answers Metformin Which BP med not given with CHF - correct answers CCB d/t increased edema If PT on CCB and gets peripheral edema what do you tell them? - correct answers Move around often, don't be sedentary Elderly PT's on Thiazides are risk for? - correct answers Dehydration and kidney stones, holds calcium Symptoms of serratonin syndrome - correct answers fevers muscle rigidity Seasonal depressive disorder - correct answers Depression no tx due to symrtomatic, get a sun lamp

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Effects of NSAIDS on cardiac - correct answers inhibitsprostaglandins reaction in blood vessels, makes BP increase Synthroid - correct answers increased is hypo decreased is hyper parathyroid - correct answers calcium higher than 13 = hyperparathyroid High trigyleride levels - correct answers normal 150 150-280 + lifestyle mods, diet wt loss

350 + niacin plus diet 900 fibrates CYP40 w/ grapefruit - correct answers avoid if on

statins CCB Flagyl (Metronidazole) what to avoid when taking it? - correct answers ETOH d/t metallic taste

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TCA's with elderly - correct answers can cause arrithmias 1st line tx for anxiety - correct answers Benzos, ativan or buspar can you give SSRI's to elderly - correct answers yes monitor for falls Avoid CCB and NSAIDS in CHF patients, why? - correct answers CCB = fluid buildup NSAIDS will increase fluids GERD - correct answers never give a ccb or a statin Anticholinergic reactions - correct answers Hot as a hare: increased body temperature Blind as a bat: mydriasis (dilated pupils) Dry as a bone: dry mouth, dry eyes, decreased sweat Red as a beet: flushed face Mad as a hatter: delirium

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Cant see cant pee, cant spit cant shit What effects of anticholinergic in elderly - correct answers BPH urinary retention, increased confusion Metabolic syndrome - correct answers is a collection of conditions that often occur together and increase your risk of diabetes, stroke and heart disease. The main components of metabolic syndrome include obesity, high blood pressure, high blood triglycerides, low levels of HDL cholesterol and insulin resistance. What causes Metabolic syndrome to increase? - correct answers DM HTN heart disese stroke BP med decreases blood sugar - correct answers beta blocker ase's of HCTZ - correct answers hyperuremia hyperglycemia

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hypercalcemia never give hctz to who? - correct answers diabetic and gout patients green nasal discharge - correct answers sinusitis Curtain over eye - correct answers retinal detachment peripheral vision loss - correct answers open angle glaucoma Mononucleosis - correct answers spleenectomy- 4- 6wks no body contact never give amoxiciilin d/t rash fever, fatigue posterial lympathothy anterioral lymp nodes - correct answers strep strep points Centor score - correct answers Age Group A streptococcus (GAS) rare under 3 3-14 years

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15-44 years 0 ≥45 years -1 Exudate or swelling on tonsils No 0 Yes +1 Tender/swollen anterior cervical lymph nodes No 0 Yes +1 Temp >38°C (100.4°F) No 0 Yes +1 Cough

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Cough present 0 Cough absent +1 centor score - correct answers The Centor Score correlates directly with risk of positive throat culture for GAS (Group A Streptococcus). New 2012 guidelines from the IDSA (Infectious Disease Society of America) no longer recommend empiric treatment for patients alone; they recommend testing patients that are at higher risk for strep pharyngitis, but not giving antibiotics until a rapid test is positive or a throat culture is positive. Strep throat - correct answers The modified criteria by McIsaac et al include an age component, along with tonsillar swelling, as part of the rule. GAS is incredibly rare in patients under 3 and less common in older adults, so this can help clinicians risk stratify patients. Most cases of pharyngitis are viral in origin, and with the rare incidence of rheumatic fever, along with the questionable benefits of early antibiotics to prevent sequelae like peritonsillar abscess, antibiotics are prescribed much less often. Steroids (like