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A wide range of medical terminology and concepts, including sensitivity, specificity, statistical analysis, ventilator settings, medicare coverage, pain management, infection control, nursing practice, and various medical conditions and their diagnostic tests and treatments. It provides a comprehensive overview of important medical knowledge and decision-making principles that are relevant to healthcare professionals, particularly nurses and physicians. The document could be useful for students studying medicine, nursing, or related healthcare fields, as it covers a diverse set of topics that are fundamental to clinical practice and patient care.
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what disease conditions do you see Telangiectasia in? Differential? Physical Exam? - correct answer rosasea liver dx scleroderma LUPUS steroid use raynauds Basal cell Skin CA PVD Hemosiderans deposition Type 1 error? - correct answer False positive, incorrectly rejecting the true null hypothesis type 2 error? - correct answer False Negative , failing to reject a false null hypothesis national mandate to prevent VAP? - correct answer ELEVATE HOB What is credentialing? - correct answer 1. acceptable level minimal competence
What is credentialing or priviliging? - correct answer granted by hospital credentialing committee to allow NP practice IP Who gives licensure? - correct answer SBON What is sensitivity - correct answer Correctly identifying those with disease, little false positive what is specificity? - correct answer ability to identify those without a disease, little false - What is null hypothesis? what if the null hypothesis is rejected? - correct answer there is no significant relationship between the variables of the study. it means the results of the study could not be due to chance what is p VALUE? - correct answer Probability of error involved in accepting the study results as a valid representation of the population if P<0.05 it? - correct answer rejects null hypothesis if p>0.05? - correct answer fail to reject the null hypothesis what is tx for VAP? - correct answer Cover MRSA+ Double antipseudomonal coverage EX: vanco+pip/taz+levaquin what pain radiating to the back could be? - correct answer pancreatitis what is treatment for cardiac tamponade? - correct answer pericardiocentesis Scope of Practice NP - correct answer What is legally allowable in each state, according to and delineated by the state practice act, provides guideline for nursing practice
Vaccines after splenectomy most important? others? - correct answer meningitis, both PNA (13/23) Flu, Zoster, MMR, HIV, T-DAP, HPV, Varicella Addisons lab findings? what test do you do to diagnose? TX hypotension? - correct answer hyponatremia hypoglycemia hyperkalemia elevated ESR Lymphocytosis plasma cortison is low 0800 cOSYNTROPIN D5 NS Cushings labs? - correct answer Hypernatremia hyperglycemia hypokalemia glucosuria leukocytosis increased serum ACTH increased 0800 cortisol
Dexamethasone suppression test what ethnicity like to have DM not seek tx? - correct answer Hispanics STEPS RESEARCH process - correct answer P- Formulate the problem L- Review the literature H- Formulate the hypothesis D- Select study Design P- Identify Population M- methods of data collection D- Design the Study C- Conduct the Study A- Analyze the data I- interpret the results C- communicate the findings What is arcus senilis? - correct answer blue/grey corneal ring elderly due to hyperlipidemia permanent does not affect Vision Vent settings ARDS - correct answer low tidal volume to prevent ALI IF shunting increase peep Medicare part A covers? Medicare b covers? Medicare C covers? Part D covers? - correct answer inpatient/hospice, SNF, HH outpatient, medical equipment, labs, test
A+B=C managed care HMO/PPO Prescription coverage- monthly premium what is therapeutic communication? - correct answer listen more than talk never ask why focus on feelings (mad, sad, glad) no euphemism When do you transfer pts? - correct answer serious ill/injured pts if services not available *Major maxillofacial injuries -leforte fractures skull 1-floating pallete 2-maxilla 3-face assess, stabilize, ship if needed What lab to check to see if enteral feeding may be needed? - correct answer Pre-albumin what is Refeeding syndrome? - correct answer complication enteral feeding -Hypokalemia -Hypophosphatemia **** -Hypomagenemia -Hypocalcemia -Thiamine Def What labs do you check for TPN - correct answer Albumin
Pt says don't tell my daughter about my diagnosis what ethical principle is this honoring? - correct answer Fidelity- Faithful pt icu 2 DAYS POST extubation fails swallow study? - correct answer Transfer to step down DNR with advanced directives, family asking for everything to be done? - correct answer we don't go against advanced directives pt comes in with CHF and dementia first thing NP should do? - correct answer assess cognition Side effect synthroid? - correct answer Alopecia What pt most likely to have angioedema with ACE? - correct answer AA LABS for ASA overdose? - correct answer Hyperkalemia elevated liver enzymes metabolic acidosis what should you watch for with CA pts with bone mets? - correct answer Hypercalcemia treatment for antifreeze ingestion? - correct answer Fomepizole (antizole) GCS Level/severity - correct answer 13-15-mild 9-12-moderate 3-8-severe wheezing/stridor secondary to anaphylaxis? - correct answer sub q epinephrine causes pre-renal failure
what must be true? - correct answer Impaired renal perfusion -shock -dehydration -cardiac failure -burns -diarrhea -sepsis/vasodilation ** reversible when perfusion restored Causes intra-renal failure? - correct answer #1 nephrotoxic agents (ahminoglycosides-mycin drugs) allergic disorders mismatched blood transfusion ATN Thalassemia what type of anemia? problem with what? TIBC/Ferritin are? Thalassemia minor is what? - correct answer microcytic, hypochromic alpha/beta Hgb chains normal heterozygous IDA Ferritin? TIBC? RDW? Type of anemia? - correct answer low high
high microcytic, hypochromic pernicious anemia
contraindication IABP? - correct answer Aortic Insuff moderate-severe AR Dissecting Aneurysm asthma ladder - correct answer step 1: SABA -Albuterol step 2: ICS (Budesonide, fluticasone, trimcinolone) step 3 LABA -Salmeterol, fomoterol combo Salmeterol+ fluticasone=advair fomoterol+budesonide= symbicort step 4: medium dose ICS +LABA STEP 5 high dose ICS+LABA STEP 6 ADD Oral corticosteroid UC tx? - correct answer mesalamine hydrocortisone supp and or enema Diverticulitis tx? - correct answer NPO IVF ATB cipro/flagyl or levo/flagyl surgical consult on admit SIADH - NOT PEEING NA SERUM OSMO URINE OSMO URINE SODIUM - correct answer Hyponatremia low < high >
high > DI -PEEING NA BUN/CRT SERUM OSMO URINE OSMO URINE SPECIFIC GRAVITY - correct answer HYPERNATREMIA ELEVATED HIGH > LOW < LOW <1. 005 what side effect to watch for metoclopramide? - correct answer EPS What is a contraindication for using succs? - correct answer hyperkalemia NP Collaboration - correct answer enhance quality of care, improve patient outcome, true partnership in which all parties have desire and power, share common goals, accept separate areas of responsibilities and activities what is the treatment for pericarditis? what test to identify what is a complication to watch for? - correct answer NSAIDS ECHO Cardiac tamponade What are the s/s of epiglottitis? - correct answer dysphagia drooling
exp stridor who should be tested for HIV give order highest priority lowest - correct answer IVDA MSM anal Unprotectec vaginal sex what is the treatment for pleural effusion? - correct answer thoracentesis AAA screening guidelines? - correct answer 65-75 who have/currently smoke selective screening for those that have never smoked Colorectal screening? - correct answer 45-75 yrs stool based test every 3 years flexible sigmoid every 5yrs colonoscopy every 10 yrs PSA/DRE - correct answer Start at 40 yrs for men FAMILY HX or AA Annually for everyone else > Mammogram - correct answer start 45-54, every 2 yrs, d/c when not 10+ yrs live paps cytology HPV co-test - correct answer PAPs age 21
what electrolyte abnormality do you see with metabolic alkalosis? - correct answer hypokalemia research level highest to lowest - correct answer meta analysis system review RCT RCT -quantitative Quasi-experimental qualitative cohort case controlled studies expert opinion Quality Assurance (QA) - correct answer Process that evaluates patient care by establishing standards of care to ensure quality. Management process of monitoring, evaluating, continuous review, and improving the quality in providing health care. CQI (continuous quality improvement) - correct answer Sytematic process that identifies and analyzes problems , then testing, implementing, learns from, and revising solutions what can be used for breakthrough cancer pain - correct answer Fentanyl Patch what can be used for cancer mets bone pain? - correct answer Biphosphonates what medication is used prep to control BP pheochromocytoma? what should it be changed to post op? - correct answer Phentolamine (regitine) phenooxybenzamine PO What do you give for serotonin syndrome? - correct answer Dantrolene Sodium Acetaminophen OD S/S TX? - correct answer Hepatotoxicity
RUQ pain N+V Delirium/AMS ACTIVATED charcoal N-Acetylcysteine (Mucomyst) when do should you get PNA vaccine? - correct answer age 19-64 if smoke/asthma
65 get both PCV 23 and PCV 13 What is homonymous hemianopsia? - correct answer loss of half of the field of view on the same side in both eyes who do you give stress ulcer prophylaxis to? - correct answer mechanical vent >48hrs long term corticosteroiids coagulopathy TBI BURNS SEPSIS Vasopressors GI bleeding/PUD Political advocacy - correct answer start local then district, regional, state who pain ladder - correct answer step 1: NSAID/APAP +- ADJUVANT STEP 2: ABOVE + MILD opioid (oxycodone/tramadol) step 3: above + stronger opioid what is a standard of practice to start after 72 hrs? - correct answer DVT prophalyxis
why is enteral feeding superior? - correct answer less metabolic issues maintains fx GI tract less electrolyte imbalance issues less Clabsi Cancer pt low WBC, high neutrophil, high fever, phlegm, cough what do you do first? - correct answer ATB or antipyretic>?? Runner with crush injury down >5hrs concerned for? - correct answer rhabdo average American reads at what level? - correct answer 8th grade what do institutional bylaws do? - correct answer provides further restrictions standards of practice? - correct answer developed by the ANA Provides guidelines for nursing practice rules/definitions what it means to provide competent care what is quality improvement? - correct answer using data to monitor outcomes of care process. and use improvement methods to design and test changes to continuously improve quality and safety of the health care system. Florence Nightingale theory? - correct answer emphasis on a restorative environment based on fresh air, light, nutrition, cleanliness, and warmth what is the purpose of managed care? - correct answer focus on prevention, care management to produce better patient outcomes, and help control health care cost What is QSEN? - correct answer aimed at providing future nurses with the knowledge, skills, attitude necessary to ensure continuous improvement in quality and safety of the health care system.
what are the 6 competencies of QSEN? - correct answer Patient-Centered Care Teamwork and Collaboration Evidence-Based Practice Quality Improvement Safety Informatics What is root cause analysis? - correct answer identifies prevention strategies to ensure safety. "Build a culture of Safety" what are some Standardized Assessment tools CPOT CAM-ICU - correct answer Critical care pain observation tool Assesses delirium, done every day/every shift ICU. Asses AMC, LOC, Inattention, disorganized thinking EM coding? - correct answer Expanded problem focused - 2 body system detailed problem focused- 3 body systems Comprehensive- H+P IOWA model? - correct answer Developed IOWA university hospitals/clinics 1990's serve as a guide for nurses to use research finding to improve patient care. It was pathway or method to EBP. guide to help nurses identify steps to help identify issues, research solutions, and implement change. cost effective med RA? Cost effective meds Gerd? - correct answer methotrexate use H2 blocker before PPI
Imaging for diverticulosis? for cholecystitis? for pancreatitis? for acute appendicitis? - correct answer plain abdominal films can see free air to diagnose pneumoperitoneum US gold standard CT better than US US OR CT New Orleans criteria is for what? - correct answer need for head CT after TBI
18 yrs age, GCS 15, with hx blunt head trauma last 24 hours with LOC, Amnesia/disorientation. in order to get a head CT you must have one of the following -HA -N+V -Age > -Drug/ETOH intoxication -persistent antegrade amnesia -visible trauma of clavicle -seizures Cancer pt new diagnosis discharging who should you consult? - correct answer Casemanagement
Adverse effect tamoxifen? - correct answer dvt what is counseling? - correct answer instructing pts how to responsibly manage meds, conditions, and courses of tx what is coaching? - correct answer instructing patients how to manage their own conditions
-instructing DM, to control BS via diet and exercise pt who has high cholesterol teaching diet/exercise to decrease cholesterol what level of prevention is this? - correct answer Secondary- goal reduce impact injury/disease Patient with known COPD gets flu vaccine what level prevention? - correct answer Secondary - reducing impact injury/disease already present primary prevention is? Ex? - correct answer preventing injury or disease -life style/behavioral change wearing seat belt immunization/vaccine safety initiatives secondary prevent is? ex? - correct answer reduce impact of current injury or disease -Screening (PAP, PSA, CHOL) -tx existing problems tertiary prevention? ex?: - correct answer rehab/recovery of injury or disease cardiac rehab after MI physical therapy after MVC What is part of reflexology? - correct answer Foot massage Blurred vision, ptosis, extreme weakness, dysphagia what is it? - correct answer Myasthenia gravis
Lower ext weakness/rigidity ascending paralysis? - correct answer GBS recent viral infx, ascending paralysis, weakness? - correct answer GBS Rigid tremor bradykinesia decreased blinking resting tremor? - correct answer Parkinsons Disease Pt has Hip fracture, carotid bruit, weakness, and confusion what do you order>? - correct answer carotid US, look for carotid stenosis, syncope or TIA may have caused fall When do you begin volume resuscitation for burns? - correct answer time the patient is burned external rotation of the hip? - correct answer hip fx Hyper active reflexes LE, NP assesses for clones how? - correct answer sharply Dorsiflex foot leave in that position support knee hx heart failure, sob, LE swelling why is this? - correct answer Increase capillary hydrostatic pressure young pt with emphysema and does not smoke?? - correct answer Alpha-1 antitrypsin def pt with strep infx ankle order? - correct answer Bactrim what ethnicity is likely to take care of family when they get older? - correct answer Hispanics and Asians what is Becks Triad? - correct answer muffles heart sounds JVD
Hypotension -signs cardiac tamponade Teach a crohns patient? - correct answer stop smoking and avoid gluten pt comes in with change mental status what do you order first? - correct answer Head CT Aortic dissection what should you order first echo or CTA? - correct answer CTA Bacterial conjunctivitis no insurance what do you do? - correct answer do nothing, self limiting gone 10- 14 days CURB 65 What is it? - correct answer for PNA Admission Guidelines C-Confusion U-BUN > R- RR> B- BP SBP<90/DBP< age > SCORING 1= LOW RISK, outpatient tx 2=mod risk, brief inpatient VS abs admit
=3=high risk, inpatient, 4-5 consider ICU CHADS2VASC - correct answer C-CHF H-Hypertension A- Age > D-DM
S-Stroke -2pts 2 V-Vascular DX A-age 65- S-Sex female
=2 males=anticoag DOAC over warfarin =3 females=anticoag DOAC over warfarin 44 yr old obese woman recovering from Fem POP, Sudden dyspnea, CP on inspiration, cough, fever. gALLOP rhythm. EKG non-specific ST changes and t WAVES. Most likely dx? - correct answer Pulmonary Embolism Test Cranial nerve X (Vagus nerve) - correct answer Test gag reflex test glossopharyngeal IX - correct answer Taste sugar/salt back mouth differentiate? Spinal Nerve XI TEST? - correct answer Ask pt to shrug shoulders test Hypoglossal XII? - correct answer Protrude tongue move side/side 25 yrs multiple fx, MVA, Hypoxia, dyspnea, precordial CP, tachycardia, thick milky sputum, Physical exam crackles/wheezing, HA, FEVER? DO what first? - correct answer High flow 02 PT MI increased preload, increased after load, decreased contractility, decreased CO, Increased SVR, BP 80/40, PULSE 124, thready irregular, tachypnea, CP, Basilar rails, pallor what is likely dx? - correct answer Cardiogenic Shock 36 yr old injured fall, CT contusion left side brain. pt responds lethargically to verbal commands, confused, restless vitals 156/76, HR 68, Resp 28
previous vitals BP 128/70, HR 76, RR 16 why did the vitals change? - correct answer Increased ICP What component of evidenced based practice most important for nurse to participate? - correct answer Formulate research hypothesis educate pt to reduce flair ups diverticulitis? - correct answer stop smoking What research design has greatest strength in determining if an intervention is effective? - correct answer Clinical Trial 55 yra old man no hx DM, Hypertension, or thrombotic event has paroxysmal fib based on national stroke guideline prevention what is recommended anti-thrombotic management? - correct answer ASA Profound hypotension, icu, fluids, and levo. Blood cultures 48 hrs ago from tunneled catheter show prelim gram negative bacilli, recent echo 40%what atb? - correct answer zosyn for central line infection AGACNP cardio gives presentation lipid lowering drug. drug company pay presenter ask them limit remarks to their drug what is this? - correct answer Conflict of interest 65yr, terminal liver dx, advance directive comfort care only. Agacnp action? - correct answer Reconfirm patients end of life decision 68 yrs old repair AAA 3 days ago, intubated, neurologically intact, active bowel sounds. liver fx normal, no s.s hf, labs BUN 12, CRT 0.8, PAC02 37, Preferred form nutrition? - correct answer enteral feeding duodenum via NG small bore - Aspiration risk why do hospitals require NP's to submit credentialing application? - correct answer Verify education, licensure, and experience Which endocrine system response to sepsis is hypotension, essential to guide therapy? - correct answer Adrenal
Older adult recent lapses memory and decreased alertness labs mild macrocytic anemia, what test to confirm diagnosis? - correct answer Serum Floate level 70 yrs HF, No functional limitations, can walk 5 city blocks before tiring, euvolemic what med is first line?
Elderly pt wants to die doesn't want to live anymore what do you do? - correct answer Refer to psych, elderly have high suicide rates Best exercise for osteoarthritis? - correct answer Isometric exercise Meds ASA over dose? - correct answer Bicarbonate activated charcoal Which subgroup would have trouble telling they had type 2 DM because of BMI? - correct answer Asians Cancer with poor oral intake bone scan bad? - correct answer Hypercalcemia bone disease Pt with epistaxis worse? - correct answer Cirrhosis Best way diagnose pulm hypertension? - correct answer Diagnose 2d Echo. Confirm-cardiac cath Pericarditis ekg signs - correct answer Diffuse St changes PRsegment depression How do you prevent MI? - correct answer Diet and stop smoking and what outcome data of rapid implememtation - correct answer QI works towards a defined aim, gathering and reviewing frequent measures and implementing change Strategy using rapid cycle movements when evaluating side effects of medication you evaluate? - correct answer relative risk reduction What is a sentinel event? - correct answer an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof needs immediate investigation and response.
avoid diverticulitis flare ups? - correct answer stop smoking what has to be monitored with methotrexate? - correct answer LFT Earliest sign PNA elderly? - correct answer Tachypnea after fx signs of compartment syndrome what do you do next? - correct answer Measure the intra- compartmental pressure what are the side effects of Detrol LA? - correct answer Anticholinergic. dry eyes, HA,** DYSPEPSIA. Dysuria When getting trach NP should discuss? - correct answer Risk and benefits of Trach wound with hydrocolloid dressing how do you know need to do somethings else? - correct answer eschar on the wound Big N stands for? n= P= - correct answer Population for research sample size Less than alpha coefficient Test for syphillus? - correct answer VDRL gENETIC gene for Alzheimers? - correct answer APOE ATB uncomplicated UTI - correct answer Bactrim
What is Grey Turner's sign? what is Cullens sign? - correct answer ecchymosis at the flank due to retroperitoneal bleed bleeding around the umbilicus test to confirm AAA - correct answer CT Cushing patient body habits? - correct answer obese Diverticulitis after 3 days ATBS? - correct answer Call surgeon to drain access Nephrolithiasis with fever what do you do? - correct answer Cipro/flagyl considering sample size what does a meta analysis represent - correct answer meta-analysis are quantitative Meta synethesis - qualitative Iowa model question? - correct answer Pilot Study MS. ARD & MR. ASS Apex - Base- Mnemonic for Murmurs - correct answer Mitral stenosis/Aortic Regurg= diastolic Mital Regurg/Aortic Stenosis=.Systolic Aortic- Base Mitral- Apex