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NR511 FINAL EXAM ACTUAL EXAM COMPLETE
QUESTIONS AND DETAILED ANSWERS|ALREADY
GRADED
__________ is the most common cause of megaloblastic anemia. Correct Answers Vitamin B12 deficiency
- IBD is characterized by Correct Answers bloody and purulent diarrhea 1st dx of Erectile dysfunction Correct Answers Perform a medication history to determine if one of those could be causing the ED A man with a first degree relative with prostate cancer is twice as likely to develop the disease. Correct Answers Acute bacterial prostatitis is always associated with a ______ and has a characteristically abrupt onset. Correct Answers UTI Fever, chills, low back pain, tenesmus, and urinary complaints typical of UTI are common. All puncture wounds should be assessed for Correct Answers skin integrity, vascular and neurological function and range of motion Although urine culture is considered the gold standard for UTI with the greatest sensitivity for laboratory confirmation of UTI, urinalysis with
microscopy is also helpful and provides rapid results in the primary care setting. Correct Answers Anemia of chronic disease: ACD presents with Correct Answers a low serum iron level, along with a low TIBC. The serum transferrin level is either normal or increased in patients with ACD. Finally, the clinician should expect the transferrin saturation to be low, as it is in iron-deficiency anemia. Anterior Drawer Test Correct Answers ACL tear Antibiotic prophylaxis for wounds Correct Answers Patients with DM or who have a hx of vascular compromise should be started on antibiotics prophylactically. Parental administration of ampicillin/sulbactam, cephalexin, or ceftriaxone is the initial treatment choice. This should be followed by oral therapy with amoxicillin/clavulanate, cephalexin or cefdroxil. If the patient has allergies to penicillin or cephalosporins, the clinician should consider prescribing doxycycline, with or without clindamycin, or ciprofloxacin. Appendicitis Correct Answers Constant periumbilical RLQ pain; vomiting following the pain; a small volume of diarrhea; may not always vomit
If the patient received a primary immunization series but not a booster within the past 5 years a tetanus booster should be administered. Patients should receive antibiotic prophylaxis for 3 to 5 days if the wound is a fresh bite wound If a dog or cat is healthy and available for 10 days of observation and shows no signs of rabies, no treatment of the exposed person is necessary. BPH sugery teaching Correct Answers Within 4 to 6 weeks after surgery, it is safe to resume a full sex life, including intercourse. Before this time, the spasmodic contractions that occur in the prostatic urethra at the time of ejaculation could trigger delayed bleeding. After 6 weeks, the risk of delayed bleeding is very slight. However, if the area has not completely healed, there may be slight discomfort because of the spasms. C-diff can exist in..... Correct Answers air, water, soil, processed food and human feces c-diff causes Correct Answers profuse, watery, mucoid diarrhea C-diff is an infection of the _______ intenstine Correct Answers large
care for abscess Correct Answers Carpal Tunnel Syndrome is Characterized by Correct Answers wrist achiness that radiates to the base of the thumb on the palm of the hand; may be awakened at night with pain and numbness in the area Carpal Tunnel Syndrome is inflammation of Correct Answers the median nerve cause of herniated discs Correct Answers posterior longitudinal ligament is weaker cause of microcytic hypochromic anemia Correct Answers inability to make enough hemoglobin causes of diarrhea Correct Answers Contaminated food Viral infection Dietary change Side effect of a medication Fluid and electrolyte imbalances causes of gastroenteritis Correct Answers Viruses are the majorette of causes and are especially active during the winter
Children receiving radiation therapy for acute lymphoblastic leukemia are at an increased risk of developing _______ Correct Answers brain tumor as a secondary malignancy. This has been seen more often in children who were treated with radiation at age 5 or younger. In general, about 3% to 12% of children treated for cancer will develop a new cancer within 20 years of being treated for the primary cancer. Chronic bacterial prostatitis Correct Answers a recurrent bacterial infection of the prostate and urinary tract, affects men aged 50 to 80. Cleansing a lacerated wound Correct Answers Saline irrigation or even soapy water is preferred to a dilute povidone-iodine (Betadine) solution, because povidone-iodine can be irritating and cytotoxic to lacerated tissue. The clinician should avoid hydrogen peroxide (H2O2), because it can be irritating to the wound. Consider red flags from the patient history that alerts you to a potential spinal fracture Correct Answers fall history, prolonged steroid use, osteopenia, osteoporosis Decreased MCV and MCHC are indicative of a _______ Correct Answers microcytic hypochromic anemia. To make a more final diagnosis, the NP needs to order a serum iron level, a TIBC level, and a serum ferritin level.
Degrees of ankle sprains Correct Answers First: ligaments are stretched but not torn Second: most common; partial tearing of the ligament Third: most severe; ligament is torn completely Differential diagnoses for acute and chronic low back pain Correct Answers ovarian cyst, ankylosing spondylitis and infection. differential diagnoses for diarrhea Correct Answers differential diagnoses for gastroenteritis Correct Answers differential dx for diverticulitis and how to rule them out Correct Answers CT scan with contrast may sometimes be done to r/o if the gynecologic etiology (ovarian cyst or tumor) as well as bowel pathology such as abdominal abscess. dx for acute lymphoblastic leukemia Correct Answers CBC with differential: leukopenia with lymphoblasts DX for GERD Correct Answers biopsy can be done and sent for H pylori at that time.
Evaluation of a herniated disk Correct Answers Straight leg test: with patient in supine position, elevate affected leg; if this elicits back and sciatic nerve pain, this is a positive test for herniated disc eversion ankle sprain Correct Answers medial ankle sprain resulting in stretching or tearing of deltoid ligament Flexor tendon injuries usually require primary wound closure by an orthopedic specialist. There is a high morbidity associated with flexor tendon injuries. Correct Answers going for surgery folic acid and B-12 anemia Correct Answers deficiency causes macrocytic normochromic anemias in which the cell size is large and irregular. Folic acid deficiency anemia Correct Answers inability to produce sufficient red blood cells due to the lack of folic acid, a B vitamin essential for erythropoiesis foods high in iron Correct Answers Meats, eggs, legumes, whole grains, green leafy vegetables , and dried fruits for phimosis, In anyone older than infancy, refer to ,.... Correct Answers urologist Functional incontinence: occurs due to Correct Answers Delirium, fecal impaction, lack of manual dexterity, or decreased mobility and taking
the following medications: diuretics, hypnotics, alcohol, narcotics, decongestants Gastroenteritis is characterized by Correct Answers irritation and inflammation of the stomach Glucose- 6 - phosphate dehydrogenase (G6PD) deficiency Correct Answers is an X-linked recessive disorder commonly seen in African American males. It is an enzyme defect that causes episodic hemolytic anemia because of the decreased ability of red blood cells to deal with oxidative stress. High risk for diverticulitis includes Correct Answers obesity how to identify a muscle strain Correct Answers Look for location; e.g. acute low back strain; low back pain that is NOT associated with sciatica; Is aggravated by sitting, standing, and certain movements; alleviated with rest; pain locally on palpation and muscle spasms are felt. how to identify Symptoms of Nerve Root Involvement Correct Answers Paresthesia over the anterior thigh just above the knee indicates L involvement. Hypospadias Correct Answers Condition where the opening of the penis is on the underside of the organ.
iron supplementation Correct Answers avoid antacid, tetracyclines and dairy, absorbed better on empty stomach but not tolerable (grapefruit juice aids in absorption) Iron supplements should be taken on an ______ stomach Correct Answers empty Is the most common type of cancer in young children Correct Answers Acute Lymphoblastic Leukemia knee pain management is conservative Correct Answers NSAIDs and quadriceps-strengthening exercises. Labs for appendicitis Correct Answers mild elevation of WBC white blood cells (WBCs) or red blood cells (RBCs) in the urine are indications of appendicitis. The WBC count becomes high only with gangrene or perforation of the appendix. The urine may have WBCs or RBCs if the bladder is irritated and ketonuria if there is prolonged vomiting. Mean Corpuscular Volume (MCV) Correct Answers indicates the avg size of individual red blood cells (RBCs). The normal (normocytic) range is 76 to 96 fL
median age onset of chronic lymphocytic leukemia Correct Answers 70 yrs Megaloblastic Anemia (Pernicious Anemia) Correct Answers Megaloblastic Anemia (Pernicious Anemia) microcytic hypochromic anemia Correct Answers iron deficiency anemia Most common area of herniated disc Correct Answers L4-L5 (weakness in the great toe) most common cause of appendicitis Correct Answers Fecalith stone made of feces typically found in the colon most common cause of chronic bacterial prostatitis Correct Answers Escherichia coli. muscle strains can be due to Correct Answers not warming up prior to exercise; Teachable moment when the patient presents with a strain is just to suggest stretching and warm-up exercises prior to the full exercise routine Myofacial Pain Correct Answers Painful contractions of muscles after exertion, such as heat cramps; may be related to hyponatremia or other electrolyte imbalances. Usually the gastrocnemius and hamstring muscles are involved.
one-third of patients with OAB have urge incontinence, not all. OAB is most common in women pain mgmnt for bites/wounds Correct Answers NSAIDs and acetaminophen (Tylenol). If nonnarcotic oral agents are ineffective and the patient is in severe pain, ketorolac (Toradol) 30 to 60 mg may be effective. Patellofemoral dysfunction Correct Answers encompasses a continuum of disorders due to overuse. patient teaching for herniated disk Correct Answers Cessation of smoking, weight reduction, good posture and body mechanics, and adherence to an exercise regimen are all ways to improve health and prevent recurrence of a herniated disc patients with diverticulitis present with Correct Answers bleeding not associated with pain or discomfort. peripheral neuropathy Correct Answers Is characterized by is "stocking- glove" or distal sensorimotor paresthesia, with diminished or variable deep tendon reflexes. Phalen's test Correct Answers carpal tunnel syndrome Phimosis Correct Answers unusually long foreskin or a foreskin that cannot be retracted over the glans penis during physical examination
phimosis occurs most in Correct Answers uncircumcised males and is normal in infancy. priapism Correct Answers A prolonged erection of the penis, usually without sexual arousal Prostate cancer is associated with ________ Correct Answers human cytomegalovirus Pt teaching for GERD Correct Answers Patients should be instructed to avoid coffee, alcohol, chocolate, peppermint, and spicy foods; eat smaller meals; stop smoking; remain upright for 2 hours after meals; elevate the head of the bed on 6-8 in blocks; and refrain from eating for 3 hours before retiring. pt. teaching for bites/ wounds Correct Answers watch for red streaks, increased warmth at the wound site, increasing pain, foul odor, or increased drainage from the bite wound—all of which should trigger the patient to seek urgent assessment in the clinic or ED. pts with diverticulitis present with Correct Answers localized pain and tenderness in the LLQ of the abdomen with associated anorexia, n/v Red flags for back pain Correct Answers back pain following a motor vehicle accident would be a red flag that warrants extensive investigation.
risk factors for prostate cancer Correct Answers Men with diets high in fat, particularly animal fat and smoking are also risk factors. Rotavirus is common in children younger than age ______ Correct Answers 3 Rovsign's sign Correct Answers acute appendicitis S/S BPH (Benign Prostatic Hyperplasia) Correct Answers Frequency, decreased force of urinary stream, trouble starting to void, dribbling after urination, feeling like bladder not empty, decreased or interrupted urinary stream The prostate is usually diffusely smooth and enlarged. S/S gastroenteritis Correct Answers Watery diarrhea Nausea and vomiting Abdominal pain and cramping Low grade fever, headache dehydration s/s lumbar spinal stenosis Correct Answers Symptoms progress from proximal to distal direction and walking or prolonged standing causes pain and weakness in the legs and buttocks.
S/S of appenditicitis Correct Answers pain (dull, sharp, mild or severe); fever, chills, loss of appetite, malaise, diarrhea, nausea or vomiting S/S of chronic bacterial prostatitis Correct Answers bladder obstruction symptoms such as weak urine stream, hesitancy or dribbling, hematuria, hematospermia, and/or painful ejaculation. S/s of GERD Correct Answers Symptoms occur at night with regurgitation; heartburn is classic for GERD (mild to severe). Dysphagia is frequently a prominent symptom of GERD. It is usually associated with other symptoms, including regurgitation, water brash (reflex salivation), sour taste in the mouth in the morning, odynophagia, belching, coughing, hoarseness, or wheezing, usually at night. S/S of H-pylori Correct Answers •Most do not suffer any symptoms •Infected persons 2-6 fold ⇧ risk gastric cancer •Spread from person-person via fecal-oral or oral-oral route s/s of herniated disk Correct Answers Patient is unable to walk on toes or heels S/s of inflamed diverticula Correct Answers fever, chills, and tachycardia
