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NR 511 Midterm Exam 2023/2024 With 100% Correct And Verified Answers, Exams of Advanced Education

NR 511 Midterm Exam 2023/2024 With 100% Correct And Verified Answers Sensitivity - Correct answer-Few false negatives Specificity - Correct answer-Few false positives Predictive Value - Correct answer-Likelihood person has disease 3 key components that determine risk-based E&M codes - Correct answer-History Physical Medical Decision Making Complexity of a visit is based on three criteria (aka MDM) - Correct answer-Risk Data Diagnosis 13. Identify the 3 components required in determining an outpatient, office visit E&M code - Correct answer-Place of service Type of service (consult, office visit, hospital admit) Pt status (new vs established) SNAPPS - Correct answer--S: Summarize -N: Narrow

Typology: Exams

2024/2025

Available from 11/07/2024

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Download NR 511 Midterm Exam 2023/2024 With 100% Correct And Verified Answers and more Exams Advanced Education in PDF only on Docsity!

NR 511 Midterm Exam 2023/2024 With

100% Correct And Verified Answers

Sensitivity - Correct answer-Few false negatives Specificity - Correct answer-Few false positives Predictive Value - Correct answer-Likelihood person has disease 3 key components that determine risk-based E&M codes - Correct answer-History Physical Medical Decision Making Complexity of a visit is based on three criteria (aka MDM) - Correct answer-Risk Data Diagnosis

  1. Identify the 3 components required in determining an outpatient, office visit E&M code - Correct answer-Place of service Type of service (consult, office visit, hospital admit) Pt status (new vs established) SNAPPS - Correct answer--S: Summarize -N: Narrow -A: Analyze -P: Probe -P: Plan -S: Self-directed learning most common type of pathogen responsible for acute gastroenteritis - Correct answer- Viral: Norovirus (Leading cause for adults) -Rotovirus (Leading cause for peds up to 2 years old) IBS - Correct answer-disorder of bowel function not from anatomic abnormality -constipation, diarrhea, bloating, urgency w/ diarrhea -NOT assoc w/ serious medical consequences, IBD or CA +S/S: result from disordered sensation or abnormal function of the small and large bowel IBD - Correct answer-chronic immunologic disease that manifests in intestinal inflammation
  • UC/CD

UC - Correct answer-the mucosal surface of the colon is inflamed and ultimately results in friability, erosions, and bleeding.

  • Most common in recto-sigmoid colon. Can involve entire colon
  • Pain in RLQ Chrons - Correct answer-the inflammation extends deeper into the intestinal wall and can involve all or any layer of the bowel wall and any portion of the GI tract from the mouth to the anus.
  • Skipped lesions
  • Pain in LLQ Diverticulitis - Correct answer-Symptoms: LLQ pain/ tenderness, fever, N/V/D Need imaging especially if perforation or peritonitis is suspected; free air = perforation; patient may have ileus, small or large bowel obstruction Can use plain x-ray CT or barium enema are preferred CT with contrast is more sensitive and accurate Barrett's Esophagus - Correct answer-After repeated exposure to gastric contents, inflammation of the esophageal mucosa becomes chronic. · Blood flow increases, erosion occurs ·Premalignant tissue ·Increased risk for development of esophageal adenocarcinoma · Fibrosis and scarring during healing of erosions; leads to strictures Acute Appendicitis - Correct answer-N/V RLQ pain Guarding Rebound Tenderness Dx: Elevated WBC, CT Tx: Remove appendix, ATB Acute Pancreatitis - Correct answer-N/V Cullen's Sign (bruising around umbilicus) Grey-Turner's Sign (bruising in flank) Dx: Amylase/Lipase, CT, US Tx: Bowel rest, fluids, ATB Acute Cholecystitis - Correct answer-Mid epigastric pain N/V Fever Rebound tenderness Murphy's sign Dx: US, HIDA scan, ERCP, MRCP Tx: Removal, IV fluids, ATB

Sensorineural Hearing Loss - Correct answer-Results from deterioration of cochlea -Loss of hair cells form the organ of Corti -Gradual and progressive -Not correctable but preventable Conductive - Correct answer-Obstruction between middle and outer ear -Most types are reversible Meniere's Disease - Correct answer-Sensory disorder of labyrinth (semi-circular canal system) and cochlea -S/S: -Vertigo -Hearing loss -Tinnitus Peritonsilar Abscess - Correct answer--Increasing unilateral ear and throat pain ipsilateral to the affected tonsil -Dysphagia -Drooling -Trismus -Erythema -Edema of the soft palate with fluctuance on palpation most common cause of viral pharyngitis - Correct answer--Adenovirus: MOST common -RSV -Influenza A&B -Epstein-Barr -coxsackie -enteroviruses -herpes simplex most common cause of acute nausea & vomiting - Correct answer-Gastroenteritis Colon CA Screening - Correct answer--Anyone over age 50 should have a routine c- scope -African American's should start screenings at age 40 -Individuals with a single first-degree relative with CRC or advanced adenomas diagnosed at age ≥60 years can be screened like average-risk persons. Red Flag Symptoms for GI - Correct answer-unintentional weight loss rectal bleeding diffuse lower abdomen pain new onset diarrhea/constipation early satiety loss of appetite

disorders related to conductive hearing loss - Correct answer--Chronic Otitis Media (OM) -middle ear effusion -mass -vascular anomaly -cholesteatoma - abnormal noncancerous skin growth in ear canal most common bacterial cause of pharyngitis - Correct answer--Group A Beta Hemolytic Streptococcus (GABHS) -Absence of cough -Tonsillar exudates -History of fever -Tender anterior cervical adenopathy clinical findings associated with mononucleosis - Correct answer--Fever -Malaise -Severe sore throat -Exudative tonsillitis (50% of cases) -Palatal petchiae -Rash ---Anterior/posterior cervical lymphadenopathy -Splenic enlargement -POC Monospot test: (+) common characteristics in a rash caused be Group A Strep - Correct answer- Sandpaper rash Fine, red, sparing hands & soles diagnosis of streptococcal pharyngitis can be made clinically based on the Centor criteria - Correct answer--Absence of cough -Tonsillar exudates -History of fever -Tender anterior cervical adenopathy intervention for a patient with gastroenteritis - Correct answer--Supportive care: fluid and nutrients -Low residue diet (BRAT) - no evidence that this helps, but may be more tolerable for pt -Viral cause = NO antibiotics -Education surrounding not prescribing antibiotics/not spreading germs/eating safe foods -Imodium/Zofran/Phenergan appropriate treatment for prophylaxis or treatment of traveler's diarrhea - Correct answer--ciprofloxacin (Cipro) 500 mg -norfloxacin (Noroxin) 400 mg -ofloxacin (Floxin) 300 mg -Bactrim

one effective treatment for IBS-C - Correct answer-o Psyllium (fiber) o docusate (softner) o bisacodyl/senna (stimulant/irritant) o loperamide (antidiarrheal) one effective treatment for IBS-D - Correct answer-odicyclomine (bentyl), hycosamine sulfate (Levsin) phenobarb/hycosamine (donnatal) anticholenergics - decrease motility of smooth muscle tone/decrease cramping, relaxes muscles in stomach/intestines oLinzess (linaclotide), Trulance (plecanatide), and Amitiza (lubiprostone): drugs work by acting locally on the apical membrane of the GI tract to increase intestinal fluid secretion and improve fecal transit -Antidepressants for depression/anxiety component one prescription medication for the treatment of chronic constipation - Correct answer- Linzess Trulance Amitiza Movtanik Miralax (OTC) Intrathorax flow disorders - Correct answer-originate from obstruction of distal/smaller airways -asthma -bronchiolitis -vascular ring -solid foreign body aspiration -lymph node enlargement pressure Extrathorax flow disorders - Correct answer-originate from obstruction of the larger airways -rhinitis with nasal obstruction, nasal polyp -cranio-facial malformation -obstructive sleep apnea -tonsil-adenoid hypertrophy -laryngo-tracheo-malacia -larynx papilloma -Diphtheria -croup, epiglottitis -thymus hypertrophy Measles (Rubeola) - Correct answer-skin is a reddish purple generalized macular and papular rash. oLesions start out on the head, particularly on the face or behind the ears, and spread down the body within 1-2 days

Rubella (German Measles) - Correct answer-skin rash will appear with "rose-pink" macules and papules ofirst present on the head and travel down the body. ofade in 1-2 days in the same order the lesions appeared Varicella (Chicken Pox) - Correct answer-arthralgia, then 1-2 days later the urticarial (or itching) erythematous macules & papules appear, quickly turn into vesicles & pustules. oThe rash starts on the face and chest then spreads quickly over the entire body. Roseola - Correct answer-The skin rash presents with light pink, erythematous macules and papules on the face, neck, and extremities. 5th's Disease - Correct answer-3 Stages:

  1. Classic "slapped cheek" rash bright red bilateral cheeks which spare the forehead, nasal bridge, and perioral area
  2. Pink lacy (or reticulated) erythematous macules on all extremities and trunk spare the palms and sole surfaces. •The rash may be itchy at this stage. 2-3 weeks of the body rash. This rash may come and can last for up to 3 weeks. Pityriasis rosea (PR) - Correct answer-solitary 2-4 patch or plaque on the trunk that starts 2-3 weeks prior to the general rash oHerald's patch oChristmas tree Hand, Foot, and Mouth - Correct answer-vesicles on the hands and feet with mouth sores. o Mouth sores are in almost 90% of the cases and are usually the first sign. o There can be more than 10 mouth apthae (sores) anywhere in the oral cavity and frequently are asymptomatic. o The hand vesicles appear with erythematous halos and appear mostly on the soles and palms. o Vesicles might appear on the legs, buttocks, and face. o Molluscum contagiosum: Tiny pustules which are 2-5 mm, and some even have a slight depression in the center of the flesh-colored dome. Tinea Pedis - Correct answer-Athlete's foot Tx: Antifungal cream (ketaconizole x 4 weeks) Tinea Cruris - Correct answer-Jock itch Tx: Topical antifungal Tinea Corporis - Correct answer-Ring Worm Tx: Topical antifungal cream

Tinea Ungulum - Correct answer-Onychomycosis Tx: topical agent: Ciclopirox nail laquer 8% applied daily for months at the base of the nail Contact Dermatitis - Correct answer-allergic reaction to a substance that produces an immune reaction in your skin resulting in a very pruritic and erythemic rash -Example: Poison Ivy Atopic Dermatitis - Correct answer-a disorder that is the result of a gene variation that affects the skin's ability to retain moisture and protection from irritants -Example: Eczema Blepharitis - Correct answer-an inflammation around the eyelid margins that is caused by staphylococcal infection at the lash bases and dysfunctional Meibomian glands Chalazion - Correct answer-a chronic internal granulomatous reaction of the Meibomian gland that produces a mass in the lid Hordeolum - Correct answer-Stye: an abscess of the lid margin caused from a staph infection Conjunctivitis Types - Correct answer--Bacterial: Pink eye: purulent discharge -Viral: Adenovirus: watery or mucousy drainage: NOT purulent -Allergic: environmental: uniquely identifying "bumps" on the conjunctiva: follicles -Toxic: Overuse of eye drops: clear/watery discharge/red conjunctiva -HSV: Corneal infection with the hallmark "dendrite" appearance which chemical injury is associated with the most damage and highest risk to vision loss

  • Correct answer-Alkali injuries (moderate or severe) cause permanent scarring and vision loss