FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2, Exams of Nursing

Download FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2 and more Exams Nursing in PDF only on Docsity! FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Alpha thalassemia - CORRECT ANSWERS more common among Southeast Asians such as filipinos Lupus - CORRECT ANSWERS present with malar rash(butterfly rash)Pts need to avoid or to minimize sunlight exposure(photosensitivity) treatment for polymyalgic rheumatica(PMR) - CORRECT ANSWERS 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 - CORRECT ANSWERS biopsy of the temporal artery. refer pt to opthalmologist for mgt Finkelstein's test - CORRECT ANSWERS Positive in De Quervains tenosynovitis Anterior Drawer maneuver and Lachman maneuver - CORRECT ANSWERS Positive if anterior cruciate ligament (ACL) of knee damaged. The knee may also be unstable McMurray's sign - CORRECT ANSWERS Positive in meniscus injuries of the knee Damaged Joints - CORRECT ANSWERS order X-ray first, but MRI is the Gold Standard Diabetic retinopathy - CORRECT ANSWERS neovascularization, hard exudates, cotton wool spots, and micoaneurysms Hypertensive retinopathy - CORRECT ANSWERS AV nicking, silver and or copper wire arterioles FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Checking deep tendon reflexes - CORRECT ANSWERS absent(0), hypoactive (1) normal(2) hyperactive(3) clonus(4) define clonus - CORRECT ANSWERS 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 - CORRECT ANSWERS angioedema A common side effect of ACE inhibitors is a - CORRECT ANSWERS dry cough(10%) First line drug to treat hypertension in diabetics and patients with mild renal disease because of their renal protective properties - CORRECT ANSWERS ACE inhibitors or ARBS Penicillin - CORRECT ANSWERS amoxicillin(broad-spectrum PCN) Penicillin VK Macrolide - CORRECT ANSWERS erythromycin, azithromycin(Z-Pack), or clarithromycin(Biaxin) Cephalosporins: - CORRECT ANSWERS 1st generation(Keflex), 2nd generation(Cefaclor, Ceftin, Cefzil)3rd generation(Rocephin, Suprax, Omnicef) FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS 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 - CORRECT ANSWERS "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 - CORRECT ANSWERS considered secondary prevention tertiary prevention - CORRECT ANSWERS 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 - CORRECT ANSWERS (prevent disease.injury/condition)-youth violence prevention, bullying prevention, presonal safety promotion, disease prevention- FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS immunization, using suncreen, healthy lifestyle promotion, promotion of OSHA lawas- workplace safety, EPA laws-clean water, anipollution laws secondary prevention - CORRECT ANSWERS (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 - CORRECT ANSWERS (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 - CORRECT ANSWERS mature squamous epithelial cells with numerous bacteria noted on the cell borders(bacterial vaginosis) Bacterial Vaginosis - CORRECT ANSWERS 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 - CORRECT ANSWERS 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 - CORRECT ANSWERS will show a large number of WBC, pseudohyphae, and spores(saghetti and meatballs candida yeast - CORRECT ANSWERS normal flora of gastrointestinal tract and in some womens vaginas FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS trichomonas infection - CORRECT ANSWERS vaginal discharge is copious, bubbly, and green in color. It causes a lot of inflammation resulting in itching and redness of the vulvvagina. It is considered a sexually transmitted infection. The sex partner needs treatment. Gold standard of diagnosis for BV, candida vaginitis, and trichomoniasis for the exam - CORRECT ANSWERS microscopy is the gold standard. treatment for strep throat - CORRECT ANSWERS penicillin VK PO for 10 days. If pt is PCN allergy, macrolides can be used instead. mortality - CORRECT ANSWERS most common cause of death prevalence - CORRECT ANSWERS most common cause of a certain disease in a population torus palatinus - CORRECT ANSWERS is a benign growth of bone(an exostosis) located midline on the hard palate and covered with normal oral skin. It is painless and does not interfere with function. geographic tongue - CORRECT ANSWERS has multiple fissures and irrecgular smoother areas on its surface that makes it look like a topographic map. The paitent may complain of soreness on the tongue after eating or drinking acidic or hot foods leukoplakia - CORRECT ANSWERS is a benign variant. It appears as a slow growing white plaque that has a firm to hard surface that is slightly raised on the tongue or inside the mouth. It is considered a precancerous lesion. It is due to chrnoic irritation of the skin or to precancerous changes on the tongue and inside the cheeks. It causes include poorly fitting dentures, chewing tobacco, and using other types of tobacco. refer for biopsy oral hairy leukoplakia(OHL) - CORRECT ANSWERS of the tongue is a painless white patch that appears corrugated. It is located on the lateral aspects of the tongue and is associated with HIV and AIDS infection. It is caused by Epstein-Barr virus infection of the tongue. It is considered a premalignant lesion. FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Ex: amitriptyline(elavil), nortriptyline(Pamelor) do not give suicidal pt TCAs because of high risk of hoarding and overdosing. Overdose of TCAs can be fatal(cardiac and CNS toxicity) SSRI - CORRECT ANSWERS SSRI are firrst line treatment for OCD, generalized anxiety discorder, panic disorder, social anxiety disorder(extreme shyness) and premenstrual mood disorder(fluoxetine or Prozac) Examples of SSRI: citalopram(Celexa), ecitalopram(lexapro), fluoxetine(Prozac, sertraline (Zoloft), paroxetine (Paxil) CAGE mnemonic - CORRECT ANSWERS is a creening tool used to screen patients for possible alcohol abuse. Scoring two out of 4 is highly suggestive of alcohol abuse. Thizide diuretics - CORRECT ANSWERS prefered for hypertension patients with osteopenia or osteoporosis. The mechanism of action of thiazide on the bone is that it decreases calcium excretion by the kidneys and it stimulates osteoclast activity that helps with bone formation Beta blockers - CORRECT ANSWERS are contraindicated in asthmatics or patients with chronic lung diseases such as astma , COPD, emphysema, or chonic bronchitis. ACute diverticulitis - CORRECT ANSWERS can be treated outpatient with ciprofloxacin 500mg PO BID plus metronidazole PO TID for 10 to 14 days Rocky Mountain Spotted fever - CORRECT ANSWERS South central US, classsic rash (red rash on both wrists and ankles that spread centrally with involvement of the palms and the soles) systemic symptoms-high fever, headache, myalgia, nausea. can cause death if not treated with the first 8 days of symptoms RMSF - CORRECT ANSWERS Dog/wood tick bite, spirochete called Rickettsia rickettsia. Treatment with doxycycline 100mg PO/IV for minimum of 7 days FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Early lyme disease(erythema migrans rash stage) - CORRECT ANSWERS Oxodes(deer) tick bite, spirochete called Borrelia burgdorferi of the cases are in the Mid Atri. treatment with doxycycline x 21 days. Majority of the cases are in theMid Atlantic and New England states(CT, MA, NY, NJ, PA) ITP(Idiopathic thrombocytopenic purpura - CORRECT ANSWERS severity ranges from mild to severe(platelet count less than 30,000/) Platelets are broken down by the spleen, causing thrombocytopenia. Look for easy bruising, petechiae, purpura, epistxis, and gingival bleeding. Initial treatment for ITP is glucocorticoids(prednisone) based on platelet response. Emancipated minors - CORRECT ANSWERS a person under the age of 18 years who has a full legal right of an adult such as signing legal contracts and consents. Minors who are parents are not considred emancipated unless they are legally married. Minors who are single parents may give consent for the care of their children, but not for their own medical care. Criteria for emancipated minor (United States) - CORRECT ANSWERS Any minor who is legally married, any minor who is enlisted on active duty in the US military, a minor who has obtained emanipation through the court or a "Declaration of Emancipation" Estimated GFR - CORRECT ANSWERS better test of renal function compared with the serum creatinine concentration. A GFR value fo 60 or less is a sign of kidney damage(refer to nephrologist) The GFR is an estimated alue, it is not measured directly and is computed using the serum creatinine value in the Cockcroft-Gault(or MDRD study) equations. serum creatinine - CORRECT ANSWERS is affected by age(less sensitive in elderly) gender (higher in males), ethnicity (higher with African American background) and other factors. BUN - CORRECT ANSWERS is a waste product of the protein from foods that you have eaten. If you eat more protein before the test, it will increase(or decrease with low protein intake) Dehydration will elevate the BUN value. Liver(cytochrome P450 enzyme system) - CORRECT ANSWERS most active organ. FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Drug excretion - CORRECT ANSWERS almost all drugs chemicals are broken down by the liver and excreted from the body in the bile, urine, feces, respiratory gas(Co2) and as sweat. trough - CORRECT ANSWERS the lowest concentration fo a drug after a dose Potent inhibitors of the cytochrome P450 system. - CORRECT ANSWERS These drugs are respnsible for a large number of drug -drug interactions Macrolides(erythromycin, clarithromycin, pediazole) Antifungals(ketoconazole, fluconazole) Cisapride(Proulsid) Cimetidine(Tagament) Citaprolam(Celexa) coumadin - CORRECT ANSWERS for A fib the target INR is from 2.0 to 3.0. INR values below 2.0 increase stroke risk sixfold vitamin K - CORRECT ANSWERS mayonnaise, canola oil, and soybean oil has Vitamin K Adverse effects of thiazide dieuretics - CORRECT ANSWERS hyperglycemia, elevated triglycerides and LDL, elevattes uric acid, hypokalemia. thiazide diuretics - CORRECT ANSWERS pt with both htn and osteoporosis have an extra benefit from thiazides. thiazide diuretics decrease calcium excretion by the kidneys and stimulate osteoclasts formation. Patients with serious sulfa allergies should avoid thiazide diuretics. Potassium sparing diuretics can be used as alternative. Potassium sparing diuretics - CORRECT ANSWERS hypertension alternative dieuretics with severe sulfa allergy. FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Contraindications:AV-block(second to third degree), bradycardia, CHF Adverse effects of CCB - CORRECT ANSWERS headache periperhal edema(not due to fluid overload) bradycardia HF, heart block hypotension, QT prologation constipation is the most commonly reported side effect Alpha blockers - CORRECT ANSWERS HTN with coexisting BPH Terazosin(Hytrin) at bedtime-potent vasodilator Macrolides(cat B) - CORRECT ANSWERS Erythromycin PO QID Azithromycin (Z-pack) Clarithromycin PO BID Many side effects: careful with myasthenia gravis, coumadin, QT prolongation/bradyarrhythmias GI distress(especially erythromyicin) Ototoxicity, cholestatic juandice QTCprolongation(risk of torsades de pointes) Cephalosporins (CAT B) - CORRECT ANSWERS Cephalosporins and penicillins belong to the beta-lactam family of ABX. FIRST GENERATION Cephalosporins -Activity against gram-positive bacteria. Used to treat infections caused mainly by gram positive bacteria(cellulitis, mastitis) Exp: Cephalaxin(Keflex) PO QID FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Pregnancy: UTI(if sensitive)pregnancy Skin:Cellulitis (not caused by MRSA) impetigo Second generation Cephalosporins - CORRECT ANSWERS Considered as "broad spectrum" antibiotics. Used to treat infections caused by gram positive bacteria . (sinusitis, otitis media) Cefuroxime axetil(Ceftin) PO BID ENT:Sinusitis, OM Cefprozil(Cefzil) PO BID Resp: CAP, exac chronic Bronchitis Cefaclor (Ceclor) PO BID others: AOM, sinusitis, skin infections Third generation Cephalosporins - CORRECT ANSWERS Less activity against gram positive infections compared to the first generation cephalosporins. Better covereage for gram negative bacteria(Neisseria gonorrheae infections) and against enteric bacteria 3rd gen Ceph Ceftriaxone (Rocephine)IM STD:Gonorrhea cervicitis, urethritis, PID Cefixime (Suprax) daily to BID ENT: AOM in children, acute sinusitis, OM Cefdinir(Omnicef) daily to BID GU: pyelonephritis, CAP Penicillins (CAT B) - CORRECT ANSWERS There is a chance of cross reactivity, especially with firrst gen cephalosporins. Amoxicillin and ampicillin are extended spectrum penicillins. They are effective against gram positive bacteria andsome gram negative bacteria(Haemophilius influenza, Escherichia coli, Proteus mirabilis) Examples: Penicillin V PO QID Amoxicillin PO BID to TID Amoxicillin plus clavulanic acid (Augmentin) PO BID Benzathine PCN G IM FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Dicloxacillin PO QID Adverse reactions of PCNs - CORRECT ANSWERS diarrhea, c difficile, vaginitis(usualy candida) First line treatment for gonorrheal infection - CORRECT ANSWERS Rocephine(ceftriaxone) IM first line TX for MRSA skin infections(boils , abscesses) - CORRECT ANSWERS do not use cephalosporins. First line tx is either trimethoprim-sulfa(Bactrim DS) BID r clindamycin TID treat for 5 to 10 days. if pt have true allergy to PCN - CORRECT ANSWERS they are more likely to have allergic reaction to cephalosporins(esecially 1st gen) Use PCN VK - CORRECT ANSWERS for mononucleosis, not amoxicillin(causes generalized rash not related to allergy) Dicloxacillin - CORRECT ANSWERS is for pencilinase-producing staph skin infections(mastitis and impetigo) Fluoroquinolones (Quinolones) - CORRECT ANSWERS effective against gram negative bacteria and some atypical bacteria(chlamydia, Mycoplasma, Legionella) Newer generation quinolones (levofloxacin , moxifloxacin, gatifloxacin) are also active against gram positve bacteria. respiratory quinolones - CORRECT ANSWERS Levoflaxacin and moxifloxacin -due to their excellent activity against strep pneumonia Quinolones - CORRECT ANSWERS Norfloxacin(Noroxin) BID FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Topical Nasal Decongestants - CORRECT ANSWERS Oxymetazoline Nasal Spray(Afrin), Phenylephrine(Neo-Synephrine) short term use i considered safe (BID PRN x 3), rhinitis medicamentosa is due to chronic use(greater than 3 days) of nasal decongestants) Antihistamines - CORRECT ANSWERS Diphenhydramine(Benadryl) Loratadine(cclaritin) Cetrizine(Zyrtec)-more potent and long acting. Sulfonamides - CORRECT ANSWERS Trimethoprim-sulfamethoxazole (TMP-SMX) Bactrim DS BID- prophylaxis treatment of PCP, MRSA cellulitis, UTIs, pyelonephritis aspirin toxicity - CORRECT ANSWERS if pt c/o tinnitus(possible asa toxicity), asa given post MI or after stroke is considered tertiary prevention. Tylenol - CORRECT ANSWERS max dose up to 4 gm, considered 1st line drug for pain from osteoarthritis, the antidote for tylenol overdose is acetylcysteine oral steroids - CORRECT ANSWERS prednisone 40 to 60 for 3-4 days , does not need to be weaned. Methylprednisolone(Medrol Dose Pack) x 7 days. Does not need to be weaned Topical steroids - CORRECT ANSWERS Classification (class 1 (superpotent) to class 7(least potent) -superpotent(class 1)-clobetasol(Temovate) -Potent-halocinonide (Halog) -Moderate-triamcinolone(Kenalog) FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS -Least potent (Class 7)-hydrocortisone Acutely inflamed joints(knee/hip/shoulders/elbows) - CORRECT ANSWERS cn be treated with intra-articular triamcinolone(Kenolog) injections up to 3 times per year. poison ivy or poison oak - CORRECT ANSWERS severe case of poison ivy case or poison oak rash may require 14 to 21 days of an oral steroid to clear Tapering weaning drugs - CORRECT ANSWERS beta-clockers(rebound htn, or htn crisis)benzodiazepines(severe anxiety, insomnia, seizures, tremors) Oral Steroids Anticonvulstants Antipsychotics Antiarrythmics Paroxetine or Paxil Controled substance act-US FDA DEA - CORRECT ANSWERS Schedule I drugs(heroin, ecstasy/MDMA, PCP, -illegal to prescribe Schedule 2(Demerol, Dilaudid, Oxycontin, cocaine, amphetamines)-only the original prescription with the physicians signature acceptable Schedule 3(Tylenol with codein, Vicodin, nabolic steroids, testosterone, ) Schedule4(benzodiazepines, ambien, lunesta, Soma) Schedule 5(cough medicine with less than 200mg codeine, Lomotil,Lyrica) Schedule 4,5 acn be mailed to the matient. some states allow NPs to prescribe lower level controlled substance For all controlled substance: Must have the prescribers and the supervising physicians name/DEA number with the clinic address on the pad. Some states do not require supervising physician. FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS List of Category X drugs - CORRECT ANSWERS Finasteride(proscar, propecia)-reproductive aged or pregnant women should not handle crushed finasteride tablets Isotretinoin(Accutane) Warfarin sodium(coumadin) Misoprostol(Cytotec) Androgenic hormones: birth control pills, HRT, testosterone Live virus vaccines(measles, mumps, rubella, varicella, rotavirus, flumist) Thalidomide, DES, methimazole FDA category classification - CORRECT ANSWERS Category A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters). Category B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. Category C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Category D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Category X FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Acute angle glaucoma - CORRECT ANSWERS elderly pt with onset of severe eye pain accompanied by headache, nausea/vomiting, halos around lights, and decreased vision examination reveals:mid dilated pupil that is oval shaped, cornea is cloudy, fundoscopics exam reveals cupping of optic nerve. cholesteatoma - CORRECT ANSWERS "cauliflowerlike" groth accompanied by foul smelling ear discharge. Hearing loss on affected ear. refer to ENT MD, can cause face and damage to fcaial nerve VII Battle sign - CORRECT ANSWERS acute onset of bruise behind the ear over the mastoid area after recent hx of trauma. Indicated fracture of the basilar skull Clear golden fluid discharge from the nose/ear - CORRECT ANSWERS indicative of basilar skull fx. CSF slowly leaking through fx Peritonsillar abscess - CORRECT ANSWERS severe sore throat and difficulty swallowing, odonophagia, trsmus, and a "hot potato" voice. refer to ED for incision and drainiage Diptheria - CORRECT ANSWERS sore throat, fever, and swollen neck"bull neck". eyes normal finding - CORRECT ANSWERS fundi:the veins are larger than arteries cones:for color perception, 20/20 vision rods: for detecting light and shadow, depth perception, night vision Macula:the macula is the area responsible for central vision. The fovea which contains large number of cones is set in the middle. This area of the eye determines 20/20 vision. Cobblestoning: inner conjunctiva with mildly elevated lymphoid tissue resembling "cobblestone" may be seen in atopic pt, allergic rhinitis, allergic conjunctivitis Presbyopia:age realted visual change due to a decreaswe ability of the eye to accommodat3e and stiffening of the lense. Usually start at age 40, FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS normal finding ears - CORRECT ANSWERS Tympanic membrame(TM) translucent off white to gray color with the "cone of light" intact Tympanogram:most objects measure for presence of fluid inside middle ear(results in a straight line vs a peaked shape) External portion of ear: has large amount of cartilage. Cartilage: des not regenerate leukoplakia - CORRECT ANSWERS appear on the surface and under the tongue. may be cancerous. pt with hx of chewing tobacco are high risk of oral cancer apthous stomatitis(canker sores) - CORRECT ANSWERS painful and look like shallow ulcers of soft tissue. avulsed tooth - CORRECT ANSWERS store in cool milk torus palatinus - CORRECT ANSWERS painless bony protuberance midline of the hard palate(roof of mouth). May be asymmetrical. papiledema - CORRECT ANSWERS optic disc swollen with blurred edges due to ICP HTN retinopathy - CORRECT ANSWERS microaneurysm cause by neovascularization cataract - CORRECT ANSWERS opacity of the corneas. Chronic steroid use can cause cataract Allergic rhinitis - CORRECT ANSWERS blue tinged or pale and swollen nasal turbinates kopliks spots - CORRECT ANSWERS small sized red paples with blue white centers inside the cheeks by the lower molars FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Hairy leukoplakia - CORRECT ANSWERS elongated pailla on the lateral aspects of the tongue that are pathognomic for HIV infection. Caused by epstein barr virus hyperopia - CORRECT ANSWERS farsightedness nystagmus - CORRECT ANSWERS abnormal for color blindness - CORRECT ANSWERS use ishihara chart fluorescein dye strips - CORRECT ANSWERS herpes keratitis appears as fernlike lines. cornial abrasion usually appear more linear hordeolum(stye) - CORRECT ANSWERS a painful acute bacterial infection of a hair follicle on the eyelid treatment:abx drops(sulfa, erythromycin gtts) warm packs BID to TID until pustules drains chlazion - CORRECT ANSWERS a chronic inflammation fo the meibomian gland(specialized sweat gland)of the eyelid-t c/o gradual onset of a small superficial nodule that is discrete and movable on the upper eyelid that feels like a bead. i fnodule enlarges or does not resolve in a few weeks. biopsy to r/o SCC. primary open angle glaucoma - CORRECT ANSWERS gradual onset of increased intraocular pressure grater than 22mmdue to blockage of the drainage of aqueos humor inside the eye. If untreated permanent damage. Most common type of glaucoma (60-70%) CHeck IOP+normal 1- to 22 FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS levoflaxacin(levaquin) or moxifloxacinif 18 years or older Trimethoprim/sulfamethazole(bactrim ds Otitis MEdia with effusion - CORRECT ANSWERS TM may bulge or retract. treatment:oral decongestants, steroid nasal spray, oral antihistamine Organism: Pseudomonas aeruginosa(gram negative) Staph aureus(gram positive) Infectious Mononuleosis - CORRECT ANSWERS peak ages 15 to 24 classic triad:fatigue, acute pharyngitis, lymphadenopathy Objective:cbc, heterophile antibody test(Monospot)Positive order abd u/s if splenomegaly/hepatomegaly Cheilosis - CORRECT ANSWERS skin fissures and maceration at the corners of the mouth. Multiple etiologies-iron def anemia, secondary bact infection, vitamin def Treatment for Otitis Externa - CORRECT ANSWERS Cortisporin Otic gtts most common pathogen:pseudomonas rocky mountain spotted fever - CORRECT ANSWERS classic rash look like small red spots(petechiae) and starts to erupt on both the hands and feet. (reapidly progressing toward the trunk until it becomes generalized. the rash appears on 3rd day after the abrupt onset of high fever. Erythema Migrans(early lyme disease) - CORRECT ANSWERS the classic lesion is an expanding red rash with central clearing that resembles a target. (bulls eye) rash usually appears within 7 to 14 days. after deer tick bite. between 3 to 30 days. FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS melanomawith a diameter of 6 mm or larger. - CORRECT ANSWERS dark colored moles with eneven texture, variegated colors, and irregular borders basal cell carcinoma - CORRECT ANSWERS suerficial form of BCC looks like a pearly white waxy skin lesion with an atropic or ulcerated center that does not heal. steven johnsons syndrome(erythema multiforme major) - CORRECT ANSWERS the classic lesions appear target like or (bulls eye). the drug classes associated with SJS are the PCN, sulfas, barbiturates and Dilantin. Anatomy of skin - CORRECT ANSWERS epidermis-no blood vessels, gets nourished from the dermis, consists of : top layer:consists of keratinized cells(dead swuamous epitheal cells) bottom level-is where melanocytes reside and vitmin D synthesis occurs Dermis-blood vessels, sebaceous glnds, and hair follicles subcutaneous layer-fat , sweat glands, and hair follicles Screening for melanoma - CORRECT ANSWERS A-asymmetry B-border irregular C-color varies in the same region D-diameter>6mm E-enlargment or change in size skin lesion review - CORRECT ANSWERS bulla-elevated superficial blister filled with serous fluid and >1 cm in size exp:impetigo, second degree burn, SJS vesicle-elevated superficial skin lesion <1 cm in diameter and filled with serous fluid. exp: herpetic lesion FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Pustuel:elevated superficial skin lsion <1 cm diameter dilled with purulent fluid Exp: acne pustules Macule:flat nonpalapable lesion <1cm in diameterEx freckles, lentigenes, small cherry angiomoas Papule:palpable solid lesion up to 0.5 cm ex: nevi(moles), acne Plaque: flattened elavated lesion with variable shape that is >1 cm in diameter ex: psoriatic lesion melasma(mask of pregnancy) - CORRECT ANSWERS brown to tan colored stains locaated on the upper cheeks and foehead in some women, stains are usually permanenet but can lighten over time. vitiligo - CORRECT ANSWERS hypopigmented patches of skin with irregular shapes. acanthosis Nigricans - CORRECT ANSWERS Diffuse velvety thickening of the skin that is usually located behind the nexk and on axilla. It is associated with DM, metabolic syndrome, obesity, and cancer of the GI tract xerosis - CORRECT ANSWERS inherited skin disorder that results in extremely dry skin and may involve mucosal surfaces and conjuctiva Psoriasis - CORRECT ANSWERS inherited skin disorder in which squamous epitheal cells undergo rapid mitotic division and abnormal maturation Koebner phenomenon- new psoriatic plaques form over areas of skin trauma Auspitz sign-pinpoint aras of bleeding reamin in the skin when a plaqu is removed. tinea versicolor - CORRECT ANSWERS superficial skin infection caused by yeeasts labs-potassium hydroxide(Koh) slide-hyphae and spores(Spaghetti and meatballs FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS scabies - CORRECT ANSWERS very pruruitic , especially at night. Serpenginous rash on interdigitial webs, waist, axilla, penis scarlet fever - CORRECT ANSWERS "sandpaper rash with sore throat(strep throat) tinea versicolor - CORRECT ANSWERS hypopigmentated round to oval macular rashes. Most lesions on upper shoulders/back. Not pruritic pityriasis rosea - CORRECT ANSWERS christmas tree pattern rash(rash on cleavage lines. "Herald patch)largest lesion, appears initially molluscm contagiosum - CORRECT ANSWERS smooth papules 5mm size that are dome shaped with central umbilication with a white plug) erythema migrans - CORRECT ANSWERS red target like lesion that grwo in size. Some central clearing. eArly stage of lyme disease meningococcemia - CORRECT ANSWERS purple colored to dark red painful skin lesion allover body. Acute onset high fever, headache, LOC changes. Rifamipine prophylaxis for close contacts Apical impulse - CORRECT ANSWERS located at the 5th intercostal space by the midclavicular line or the left side of the chest Deoxygeated blood - CORRECT ANSWERS enters the heart through superior vena cava and interiour vena cava -right atrium-tricuspid valve-right ventricle-pulmonic valve-pulm artery-the lungs-alveoli (RBC pick up O2 and release Co2) FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Oxygenated blood - CORRECT ANSWERS exits the lungs through pulmonary veins and enters the heart left atrium-mitral valve-left ventricle-aoric valve-aorta-ggeneral circulation MOTIVATED APPLES - CORRECT ANSWERS M(mitral valve) T(tricuspid valve) AV(atrioventricular valves) Apples A)Aortic valve) P(pulmonic valve) S(Semilunar valves) S1(systole) - CORRECT ANSWERS "Lub" of lub-dub closure of the mitral and tricuspid valve atrioventricular (AV) valves (three leaflets) S2(Diastole) - CORRECT ANSWERS the "dub" of lub-dub closure of the aortic and pulmonic valves semilunar valves(two leaflets) S3 - CORRECT ANSWERS CHF occurs during early diastole aka ventricular gallop or s3 gallop sounds like KENTUCKY S4 - CORRECT ANSWERS caused by increased resistance due to a stiff left ventricular, udually indicates LVH. FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS (thickening of left ventricle) sounds like TENNESSEE Best heard at apex or apical area using bell of stethoscope Bell of stethoscope - CORRECT ANSWERS low tones such as extra heart sounds (S3 or S4) mitral stenosis Diaphragm of stethoscope - CORRECT ANSWERS mid to high pitched tones such as lung sounds mitral regurgitation aortic stenosis systolic murmurs - CORRECT ANSWERS use MR. AS Diastolic murmurs - CORRECT ANSWERS use MS. AR Mitral area(aka Apex) - CORRECT ANSWERS fifth left ICS is about 8 to 9 cm from themidsternl line and slightly medial to the midclavicular line PMI or the apical pulse is located in this area Aortic area - CORRECT ANSWERS second ICS to the right side of the upper border of the sternum. the location of the aortic area can also be described as the "second ICS by the right side of the sternum at the base of heart MR.ASH(use for all systolic murmurs) - CORRECT ANSWERS holosystolic, pansystolic, early systolic, late systolic, or midsystolic murmurs. FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Secondary HTN - CORRECT ANSWERS Renal -renal artery stenosis, polycystic kidneys, chronic kidney disease Endocrine -hyperthyroidism, hyperaldosteronism, pheochromocytoma Other causes -obstructive sleep apnea, coarcation of the aorta Coarctation of the Aorta - CORRECT ANSWERS BP of the arms is higher thatn BP of the legs -delayed or diminished femoral pulses(check both radal and femoral pulses at the same time. Side effects of Thiazide Diuretics - CORRECT ANSWERS hyperglycemia, hyperuricemia, hypertriglycermia and hypercholesteremia, hypokalemia, hyonatremia hypertensive retinopathy - CORRECT ANSWERS cooper and silver wire arterioles, AV nicking diabetic retinopathy - CORRECT ANSWERS neovascularization, microaneurysms, hard exudates, cotton wool spots ACE inhibitors - CORRECT ANSWERS precipitate renal artery stenosis Left Ventricular Failure(diminished ventricular systolic emptying - CORRECT ANSWERS -- crackles, bibasilar rales(rales on lower lobes of the lungs) , cough, dyspnea, decreased breath sounds, dullness to percussion --paroxysmal nocturnal dyspnea, othopnea, nocturnal nonproductive cough, and wheezing(cardiac asthma) Right Ventricular Failure - CORRECT ANSWERS Jugular Venous distention(JVD), normal JVD is 4cm or less FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS --enlarged spleen, enlarged liver causes anorexia, nausea, and abd pain --lower extremity edema with cool skin New York Heart Association Functional Capacity Rating( - CORRECT ANSWERS Class I-No limitations on physical activity Class II-Ordinary physical activity results in fatigue, exertional dyspnea Class III-Marked limitation in physical activity Class IV- Symptoms are present at rest, with or without physical activity Homan's sign - CORRECT ANSWERS Lower leg pain on dorsiflexion of the foot Contrast Venography(gold standard) - CORRECT ANSWERS r/o DVT Hospital admission , heparin IV then coumadin PO for 3-6 months(first episode) or longer Bacterial endocarditis - CORRECT ANSWERS Osler's nodes- tender violet colored nodules on the fingers/toes -Janeway lesions-palms and soles amy have tender red spots on the skin Blood cultures x 3(first 24 hours) ABX no longer recommended for -mitral valve prolapse -gu or GI incisions Chlesterol guidelines - CORRECT ANSWERS treat triglycerides first, then LDL. high triglycerides put pt at high risk for acute pancreatitis FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Simvastatin/statin drug interactions(high risk of rhabdomyolysis - CORRECT ANSWERS - grapefruuit juice -other ffibrates(except fenofibrate) -antifungals(intraconazole, ketoconazole) -Macrolides(erythromycin, clarithromycin, telithromycin) -Amiodarone, some CCB(diltiazem, amlodipine, verapamil) Lipid lowering agents - CORRECT ANSWERS Nicotinic Acid and Fibrates -Niacin -Fibrates-genfibrizole Bile Acid Sequestrants - Rhabdomyolysis - CORRECT ANSWERS acute breakdown of skeletal muscle will cause acute reanl failure. Triad of muscle pain, weakness, and dark urine. Look for muscle pain and aches that persist. Labs: order CK-markedly elevated urine-reddish/brown color(myoglubinuria and protenurea. FTS will be elevated. ; Metabolic syndrome - CORRECT ANSWERS a metabolic disorder with a cluster of symptoms. These patients are at higher risk for type 2 DM and CV At least 3 characteristics must be present to diagnose metabolic syndrome --Abd obesity(greater than 40 inches in men and greater than 35 inches in women) --HTN --Hyperlipidemia FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Legionella PNA-found in areas with moisture sch as air conditioners Meds: Macrolides: Azithromycin(Z-pack) x 5 days Clarithromycin(Biaxin) 500mg BID x10-14 days Erythromycin(500mg QID x 10-14days Bordetella pertussis(gram negative) - CORRECT ANSWERS pertussis has three stages: catarrhal-most infectious up to 21 days of cough. paraxysmal-pt may vomit convalescent-cough becomes less frequent and finally resolves. labs -nasopharyngeal swab for culture and polymerase chain reaction. -pertussis antibodies by ELISA chest x rays should be negative. If positive due to secondary bacterial infection TX:Macrolides Bacterial PNA - CORRECT ANSWERS No 1 bacterium in CAP is Streptococous PNA NO 2 is Haemophilus influenza phlemn is rust colored or blood tinged Atypical PNA - CORRECT ANSWERS no 1 bacterium is Mycoplasma PNA FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS acute bronchitis - CORRECT ANSWERS do not pick ABX as first line tx. tx:increase fluids and rest. Military TB AKA disseminated TB disease - CORRECT ANSWERS infects multiple organ systems. More common in younger children<5 age and elderly. CXR will show class milia seed pattern Tuberculosis - CORRECT ANSWERS report to local health dept. all active TB pt should be tested for HIV Initial regimen for suspected TB before C&s results are available. Use four drugs:isonicotinylhydrazine(INH) 300mg daily for adults, rifampine, ethambutal, and pyrazidamide three times a week. Warning: Ethambutal causes optic neuritis. Avoid if patint has abnormal vision(blindness, retinal vein occusion, and so forth. ) asthma - CORRECT ANSWERS reversible airway obstruction by chronic inflammation of the bronchial tree Peak expiratory flow rate :PERF or PEF - CORRECT ANSWERS measures effectiveness of treatment, worsening symptoms , and exacerbations. During expiratioin, patient is instructed to blow hard using the spiroeter(3 times). the highest value is recorded (personal best) PEF is based on height(H), age (A), and gender (G) or HAG Spirometer Parameters - CORRECT ANSWERS Green Zone: 80%-100% of expected volume -maintain or reduce medication Yellow Zone:50% to 80 % of expected volume FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS -Maintenance therapy needs to be increased or patient is having an acute exacerbation. Red Zone: Below 50% of expected -If after treatment patients PEFR is still below 50% expected, call 911. If in resp distress, give epinephrine . First line treatment for severe asthmatic exacerbation or respiratory distress - CORRECT ANSWERS is an adrenaline injection. Severe hypoglycemia - CORRECT ANSWERS blood glucose less than 50. c/o weakness, headache, clammy hands and anxiety. Difficulty concentrating. type 1 DM - CORRECT ANSWERS school aged children, polyuria, losing wt, breath has fruity odor. Large amount of ketones in urine. thyroid cancer - CORRECT ANSWERS a single large nodule(>2.5 cm)on one lobe of the thyroid gland. The 24 hour radioactive iodine uptake(RAIU) test will show a cold nodule pheochromocytoma - CORRECT ANSWERS random episodes of severe hypertensioin(systolic BP grater than 200mm Hg or diastolic BP greater than 110mmHG) associated with abrupt onset of sever headache, tachycardia, and axiety. Episodes resolve spontaneously, but occur random. hyperprlactinemia - CORRECT ANSWERS can be a sign of a pituitary adenoma. Slow onset. Endocrine system - CORRECT ANSWERS works as a "negative feedback"system. If a low level of "active"hormone occurs, it stimulates production. Inversely, if high levels of hormones stop production Endocrine glands - CORRECT ANSWERS Hypothalmus"Master Gland" FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS Thyroid gland test - CORRECT ANSWERS thyroid gland scan-used to detect goiter thyroid cancer: single painless nodule greater than 2.5 cm thyroid scan-(24 hour thyroid scna with RAIU) Shows metabolic activity of thyroid gland -Cold Spot-Not metabolically active(more worrisome:r/o thyroid cancer) -Hot spot-metabolically active nodule with homogenous uptake and is usually benign Lab finding of thyroid disease - CORRECT ANSWERS TSH is used for both screening and monitoring response to treatment. If TSH abnormal order full thyroid panel. Serum free T3 and T4 are high ang TSH is very low(usually <0.05) Check TSH Q6-8 weeks until normal. Drug induced thyroid disease:lithhium, amiodarone, interferon-alfa, dopamine Hypothyroidism - CORRECT ANSWERS The classic lab finding for hypothyroidism is a high TSH with low free T4(no not confuse with total T4). Some of the most common causes are Hashimotos thyroiditis, postpartum thyroiditis, and thyroid ablation with radioactive iodine. Hashimotos thyroiditis is the most common cause of hypothyroiditis in the United States Hashimoto Thyroiditis - CORRECT ANSWERS LABS TSH elevated(greater than 6.0 ) with low levels of serum free T4 -Antimicrosomal antibodies: "elevated(gold standard test for diagnosisng AHshimotodisease) ---work-up: order TSH first. If elevated, order thyroid panel. Next step is to order TSH receptor antibodies to confirm Hashimoto thyroiditis. Treatment plan -starting dose of levothyroxine(synthroid) is 25 to 50 mcg per day -start with lowerst dose(Synthroid 25 mcg) increase by 25mcg every few weeks until TSH normamlized FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS -recheck TSH every 6-8 weeks until TSH is normalized(less than 6 mIU/L) Insulin - CORRECT ANSWERS Rapid Acting insulin (insulin lispro)-covers one meal at a time Regular insulin(Regular) -lasts from meal to meal NPH insulin lasts from breakfast to dinner Lantus is once a day rapid acting insulins(insulin lispro - CORRECT ANSWERS are used mostly by type 1 Diabetics before each meal Antidiabetic medication: effect on weight gain - CORRECT ANSWERS Causes weight loss: metformin and incretin mimetic(Byetta), amylin analog(Symlin) Causes weight gain: Sulfonylureas, TZDs(Actos, Avandia) insulin. Weight neutral: Meglitanides(Starlix, Prandin) bile acid sequestrants(Wellchol) DM pharmacology - CORRECT ANSWERS -Biguanindes:Metformin(glucophage) ---decreases gluconeogenesis and decreases peripheral insulin resistance -Sulfonylureas:Glucotrol XL, Diabeta, Amaryl --stimulates the beta cells of the pancrease to secrete more insulin Thiazolidinediones:Roseglitazone(Avandia), pioglitazone(Actos) -Enhances insulin sensitivity in muscle tissue(decreases peripheral tissue resistance) and reduces hepatic glucagon production(gluconeogenesis) -Bile acid sequestrant: Colesevelam(Welchol) --reduces hepatic glucose production and may reduce intestinal absorption of glucose Meglitinide: Repaglinide(prandin), nateglinide(starlix) --stimulates pancreatic secretion of insulin. Indicated for type 2 diabetes with positive prandial hyperglycemia Incretin mimetic or GLP -1 drug: Byetta BID or Victoza once a day injections (subq) FAMILY NURSE PRACTITIONER QUESTIONS AND CORRECT 100% VERIFIED ANSWERS NEWEST UPDATE 2024/2025 BEST COMPLETE EXAM SOLUTION RANKED A+ FOR PASS -stimulates GLP-1 causing an increase in insulin production and inhibiting postprandial glucagon release(will decrease postprandial hyperglycemia)