Medical Terminology: Answers to Assessment Questions, Exams of Nursing

Download Medical Terminology: Answers to Assessment Questions and more Exams Nursing in PDF only on Docsity! 1 NP Board Exam Review: Class Book with Questions and Answers 2024 A patient has hyperactive reflexes of the lower extremities. The adult-gerontology acute care nurse practitioner assesses for ankle clonus by: - Correct Answer-sharply dorsiflexing and maintaining the foot in this position, while supporting the knee. A 15-year-old patient with type 1 diabetes mellitus reports elevated blood glucose levels in the morning. The adult-gerontology acute care nurse practitioner determines that the patient's hyperglycemia is due to the dawn phenomenon and - Correct Answer- increases the insulin dosage at bedtime A patient with a history of atrial fibrillation, who has maintained normal sinus rhythm with sotalol (Betapace), is hospitalized for acute pyelonephritis. The appropriate antibiotic regimen for this patient is intravenous - Correct Answer-ceftriaxone A patient who has been in the intensive care unit for 17 days develops hypernatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is intubated, and is receiving mechanical ventilation. The serum osmolality is 320 mOsm/L kg H2O. Clinical signs include tachycardia and hypotension. The adult-gerontology acute care nurse practitioner's initial treatment is to - Correct Answer-The right answer was replenish volume by infusing a 0.9% sodium chloride solution Cytology is evaluated with - Correct Answer-fine needle biopsy What is the single best predictor of one's health status? - Correct Answer-health literacy Patient Health Questionnaire (PHQ-9) - Correct Answer-common depression screening tool, self rank 9 signs and symptoms over last 2 weeks on scale of 0-3 CAGE-AID - Correct Answer-C-have you ever felt that you ought to cut down on your drinking or drug use? A-have people annoyed you by criticizing your drinking or drug use? G-have you ever felt bad or guilty about your dirnking or drug use? E-Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover? (e.g. eye opener) Ramsay Sedation scale - Correct Answer-Awake: 1: anxious, agitated, restless 2: cooperative, oriented, tranquil 3: responsive to commands only Sleeping: 4:response to light glabellar tap ro loud auditory stimulus 5: sluggish response to light glabellar tap or loud auditory stimulus 6: no response to light glabellar tap or loud auditory stimulus Brief pain inventory - Correct Answer-Assess impact of pain on daily life 2 What is a good assessment tool for chronic pain such as with cancer patients? - Correct Answer-Brief pain inventory Go review MMSE - Correct Answer- What physical activity is good for Parkinson's patients? - Correct Answer-Tai chi What is salsa dancing good for? - Correct Answer-Coordination What is benchmarking? - Correct Answer-Comparison and measurement of a healthcare organization's services against other national healthcare organizations HIPAA title I - Correct Answer-protects health insurance coverage for workers and their families when they change or lose their jobs i.e. cobra HIPAA title II - Correct Answer-administrative simplification provisions, standards for electronic healthcare transactions and national identifiers for providers, health insurance, and employers Who enforces HIPAA? - Correct Answer-Office of civil rights Levels of facial fracture - Correct Answer-1. floating pallet 2. mandible 3. Face What is a tertiary facility - Correct Answer-Provides specialized care i.e. level 1 trauma 2 goals of healthy people 2020 - Correct Answer-increase quality and years of healthy life and eliminate health disparities among Americans Infections that require reporting to health department (5) - Correct Answer-gonorrhea, chlamydia, syphilis, HIV, TB Who sets standards of coding (E&M) ? - Correct Answer-medicare What are examples of 3rd party payers? - Correct Answer-Medicare, Medicaid, commercial insurers, HMOs, schools providing insurance Medicare A - Correct Answer-covers hospitalizations, SNFs, home health, hospice if associated with hospitalizations Medicare B - Correct Answer-Covers provider services, outpatient, labs and diagnostics, supplemental requiring premium, medicare pays 80% of bill 5 What electrolyte imbalance can vitamin D intoxication cause? - Correct Answer- hypercalcemia What do you do if a patient's calcium level is >12? - Correct Answer-NS infusion with loop diuretics what does respiratory acidosis result from? - Correct Answer-decreased alveolar ventilation Anion gap equation - Correct Answer-NA - (Chloride + bicarb) Normal anion gap - Correct Answer-12+/- 5 Clinical symptoms in respiratory alkalosis are related to what physiological process? - Correct Answer-decreased cerebral blood flow What is the hallmark sign of metabolic acidosis? - Correct Answer-Low HCO3 Examples of causes for metabolic acidosis with increased anion gap - Correct Answer- DKA, alkoholic KA, lactic acidosis, drug or chemical anion Examples of causes for metabolic acidosis with normal anion gap - Correct Answer- diarrhea, illeostomy, renal tubular acidosis, recovery from DKA When is giving HCO3 indicated in metabolic acidosis? - Correct Answer-When significant hyperkalemia is present Common causes of metabolic acidosis - Correct Answer-NG suctioning, vomitting Rule of 9's - Correct Answer-arm = 9 leg = 9 thorax = 18 head=9 peri=1 Equation for burn fluid resuscitation - Correct Answer-4 ml x kg x TBSA Examples of crystalloid fluids - Correct Answer-NS D5 LR Example of common colloid - Correct Answer-albumin In burn patients, when do you prophylactically intubate? - Correct Answer-Facial burns singed nares or eyebrows dark soot/mucous from nares and/or mouth 6 What acid/base imbalance is expected during resuscitation from burns? - Correct Answer-metabolic acidosis What electrolyte abnormality should be monitored for 24-48 hrs after burn injury - Correct Answer-hyperkalemia What electrolyte abnormality should be monitored for at 72 hrs post burn injury? - Correct Answer-hypokalemia In a human bite, what do you cover for and what is a common abx to use? - Correct Answer-staph and anaerobes, augmentin, 3-7 days Most common cause of cellulitis - Correct Answer-strep A Abx for CA-MRSA - Correct Answer-bactrim, doxy, clinda Abx for A strep - Correct Answer-bactrim + beta lactam Doxy + beta lactam clinda Examples of beta lactams - Correct Answer-amoxicillin, keflex, cephelosporin Alternative to narcan? - Correct Answer-Stadol What overdose is tinnitus a symptom of? - Correct Answer-ASA What is the drug of choice in organophosphate toxicity? - Correct Answer-atropine Treatment of serotonin syndrome - Correct Answer-dantrolene sodium, clonazepam, cooling blankets Does cocaine cause mydriasis or miosis? - Correct Answer-mydriasis - dilated Does heroin cause mydriasis or miosis? - Correct Answer-miosis - pinpoint Standard transplant therapy - Correct Answer-CNI + antimetabolite + steroid Calcineurin inhibitor examples - Correct Answer-tacrolimus, cyclosporine antimetabolite examples - Correct Answer-azathioprine, cellcept MTOR inhibitor - Correct Answer-sirolimus Actinic keratosis (picture) and treatment - Correct Answer-liquid nitrogen 7 Squamous cell carcinoma (picture) and treatment - Correct Answer-biopsy and surgical excision (Mohs) Seborrheic keratosis (picture) and treatment - Correct Answer-benign, liquid nitrogen Basal cell carcinoma (picture) treatment - Correct Answer-most common, shave/punch bx and surgical excision Malignant melanoma (picture) and treatment - Correct Answer-biopsy and surgical excision ABCDE of malignant melanoma - Correct Answer-Asymetry Border irregularity color variation diameter >6 cm elevation, enlargement How does SIADAH work? - Correct Answer-ADH is released independent of osmolality or volume dependent stimulation causing inappropriate water retention. It is hyponatremic euvolemia. How does diabetes insipidus work? - Correct Answer-ADH deficiency causes pituitary or hypothalamus damage In SIADH, what would you expect serum osmo, urine osmo, urine sodium to be? - Correct Answer-serum osmo: low <280 urine osmo: up >100 urine sodium: >20 What is a pheochromocytoma? - Correct Answer-excess catecholamine (epi and norepi) release characterized by paroxysmal or sustained HTN. Almost always related to tumor in adrenal medulla S/s of phenochromocytoma - Correct Answer-HTN labile diaphoresis hyperglycemia severe HA palpitations sweating tremor tachycardia weight loss postural hypotension How do you confirm a pheochromocytoma - Correct Answer-assay of urine catecholamines and 10 Gluco and mineral ocorticoids - Correct Answer-hydrocortisone fludrocortisone JNC8 recommendations for medications in HTN non african americans - Correct Answer-thiazide CCB ACEI ARB JNC8 recommendations for medications in HTN african americans - Correct Answer- thiazide (unless DM, then get ACEI or ARB) CCB JNC8 recommendations for meds in HTN in adults with CKD - Correct Answer-ACEI ARB What is the difference between SVT and ST on an EKG - Correct Answer-no p wave in SVT First degree block strip - Correct Answer- Second degree block strip - Correct Answer- What kind of allergy do you screen for before giving a thiazide? - Correct Answer-Sulfa What do ACEI and ARBs do besides cause lower BP? - Correct Answer-vasodilation and block sodium and water retention What is malignant hypertension - Correct Answer-fundoscopic chnages including flame shaped retinal hemorrhages, soft exudates and papilledema Treatment of prinzmetals - Correct Answer-CCB, vasospastic so give CCB becaue related to calcium influx Goals for LDL, HDL and TG in DM and/or CAD patients? - Correct Answer-LDL <70 HDL >40 TG <150 Common pharmacotherapy for angina - Correct Answer-nitrates, BB, CCBs Normal lipid profile - Correct Answer- Adults with a LDL of what should get statin therapy - Correct Answer->=190 Where is a lateral MI shown on the ECG? - Correct Answer-I,aVL 11 Where is an inferior MI shown on the ECG? - Correct Answer-II, III, aVF Where is an anterior MI shown on an ECG? - Correct Answer-V leads or V3 and V4 Where is a septal infart seen on ECG? - Correct Answer-V1, V2 Which troponin is cardioselective? - Correct Answer-Troponin I When do you see leukocytosis in a MI? - Correct Answer-second day Drug therapy in acute MI - Correct Answer-ASA, NTG, morphine, lasix, BB, ACEI Normal INR Normal APTT Normal PT Normal PTT - Correct Answer-0.8-1.2 28-38 11-16 60-90 What is the door to TPA goal? - Correct Answer-30 minutes Are legs shiny and hairless in PVD or CVI? - Correct Answer-PVD ST changes in pericarditis - Correct Answer-ST elevation temporary T wave inversion PR segment depression highly indicative of pericarditis What is the drug of choice for pericarditis? - Correct Answer-NSAIDS, maybe steroids if NSAIDS fail How do you identify a GI bleed of an unknown cause? - Correct Answer-GI angio Common causes of PUD - Correct Answer-h pylori meds duodenal ulcers in young and gastric in old smoking Pain in PUD - Correct Answer-relieved with eating in duodenal worse with eating gastric PUD 1st-3rd line treatment - Correct Answer-HS HS BID PPI 12 Common h pylori regimens - Correct Answer-flagyl BID and/or amoxicillin, prilosec BID, clarithro BID x7 days then anti ulcer for 3-7 weeks Hepatitis A incubation period - Correct Answer-2-6 weeks Murphy's sign - Correct Answer-for cholecystitis deep pain on inspiration while fingers are placed under the right rib cage Grey turner's sign cullen's sign - Correct Answer-flank discoloration umbilical discoloration Where is pain generally in diverticulitis? - Correct Answer-LLQ How does cholecystitis present? - Correct Answer-sudden steady, severe pain in epigastrum or right hypochondrium, vomitting provides relief, precipitated from a fatty meal What imaging test is the gold standard for cholecystitis? - Correct Answer-ultrasound What abnormal lab values could cause acute pancreatitis? - Correct Answer- hypercalcemia, hyperlipidemia Gold standard imaging for acute pancreatitis? - Correct Answer-CT scan Serum amylase and lipase in acute pancreatitis? - Correct Answer-amylase 50-180 lipase 14-280 Ranson's criteria - Correct Answer-prognosis of acute pancreatitis - 5-6 40% mortality >7 appx 100% mortality George washington got lazy after he broke CABE >55 yo WBC >16K glucose >200 LDH > 350 AST >250 Hct drop >10 BUN >5 increase calcium <8 arterial 02 <60 base deficit >4 est fluid sequestration >6K 15 What are the 5 most common disorders caused by strep P.? - Correct Answer- meningitis sinusitis otitis media bronchitis CAP Why, in meningitis, does the CSF have an increase in pressure, protein, and WBCs but a decrease in glucose? - Correct Answer-The protein eats up the glucose What abx do you give for meningitis? - Correct Answer-Pen G, vanco, third gen cephalosporin or quinolone until C&S back What is cushing's triad and what does it mean? - Correct Answer-Widening pulse pressure, decrease RR, decrease HR; decompensation in head trauma 16 NP Board Exam Review: Class Book with Questions and Answers 2024