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NSG 6420 FINAL Exam-with 100% verified solutions- 2024-2025.docx, Exams of Nursing

NSG 6420 FINAL Exam-with 100% verified solutions- 2024-2025.docx

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2023/2024

Available from 06/20/2024

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NSG 6420 FINAL Exam-with 100% verified solutions-

2024-

Most accurate test in diagnosing pancreatitis? LIPASE When to d/c an ACE I based on creatinine

Predisposing factors of hyperthyroidism Fam hx of hyperthy or other autoimmune, RA, vitiligo, pernicious anemia, trisomy 21, pregnancy/mothers with grave's, puberty, myasthenia gravis, addison, amiodarone, Iodine contrast dye, stress, sex steroids, DM I, SLE, smoking, neck radiation hypothyroidism prevalence More prevalent in women than men at a ratio of 5- 10: More common in older: >60 yrs increases to 6-10% of women and 2-3% of men with 13.7% with subclinical presentation DM diagnosis A1C: >/6.5% FPG >/ 2 hour PP glucose >/200 during OGTT Random: >/200 with sx DM 2 symptoms fatigue, recurrent infections, recurrent vaginal yeast infections, prolonged wound healing, visual changes, may have classic sx of type 1 (polys) When is Niacin used? In combo with other meds to tx triglycerides Common sign associated with parkinsons? pill rolling tremor

First line tx for OA? Acetaminophen MOA of metformin? Pulls glucose into muscle cells to be utilized -enhances insulin sensitivity at tissues -Reduces glucose production by liver When is MRI indicated in low back pain? neuro defects Test for tenosynovitis? Finkelstein Tests for Carpal tunnel? Phalen's and Tinnel's Rotator cuff injury test Inability to maintain abduction Initial treatment for diagnosis of bursitis? Rest/avoidance of activity and NSAIDs OA risk factors? Older age, sex (women), obesity, joint injuries, genetics, bone deformities OGTT diagnoses what? gestational diabetes Lab indicative of hypothyroidism? TSH primary screening test: Increased TSH, dec free T4: primary Central: Dec TSH, serum T4 dec, notice impaired TSH response to TRH

Tx levels above 10 or if symptomatic Normal TSH levels? 0.40-4. Hypothyroidism labs? Increased TSH Decreased T3 T S/sx of grave's Diffuse enlargement of both thyroid lobes, with uniform uptake of isotope and elevated radioactive iodine uptake -weight loss/inc appetite Fatigue/weakness, tremors, heat intolerance, nervousness/anxiety, heart palps, consipation/diarrhea, swelling, inc sweating, diplopia, fine hair, moist smooth skin, hyperactivity, nightmares RAI in hyperthyroid tx single dose to 2 doses of 75-200 mCi/g capsule orally to render hypothyroid **Tx of choice for Grave's dx -Euthyroid in 2-6 months **NOT IN children or pregnancy Lantus- type of insulin and peak Long-acting -Peak: no pronounced peak -onset 1-2 hours duration 24+ hours CKD risk factors DM, HTN, Heart dx, smoking, obesity, high cholesterol, AA/NA/Asian-am, fam hx,

65yrs Gold standard for diagnosis of CKD?

MVP heart sound crisp mid systolic click Rovsing sign RLQ pain with palpation of the LLQ- suggests peritoneal irritation in the RLQ precipitated by palpation at a remote location Obturator sign RLQ pain with internal and external rotation of flexed right hip- suggests inflamed appendix is located deep in the right hemipelvis Psoas sign RLQ pain with extension of right hip or with flexion of right hip against resistance- inflamed appendix located along course of right psoas muscle -(lifting extended right leg against resistance) Murphy sign Increased tenderness with inspiration in RUQ- gallbladder Tenderness at McBurney's point appendicitis Negative HbsAg Positive HbsAb Negative HbcAB indicative of immunization Synthroid dosage Kg x 1. Hypothyroid prevalence in countries prevalence in US is low compared to rest of world 0.3% d/t iodine consumption S/sx hypothyroidism

depression, forgetfulness, los of hair, weight gain, dry skin, infertility, brady, goiter, brittle nails, cold skin, constipation, fullness in throat (hashimoto), jaundice, and distention, muscle aches Hypothyroidism physical findings decreased mentation, swelling hands and feet (non pitting), periorbital puffiness, coarsening of voice, brady, inc DBP, reduced SBP, delayed relaxation of DTR (achilles) Most common etiology of cervicitis? Infection: STDs -Chlamydia. trachomatis (number 1)and N.Gonorrhoeae Choice of antibiotics for cervicitis? Azithromycin and doxy DOC for tx of trich metronidazole or tinidazole Tx of choice for epididymitis ceftriaxone plus doxycycline Skin lesion fluoresces under a wood's lamp- what microscopic finding is consistent with this? Spores Conditions associated with atopic dermatitis? food allergy, asthma, allergic rhinitis "atopic march" Positive WB and ELISA with a tick bite and erythema migrans- how to treat Lyme disease

  • 14-21 days tx -Doxy, amoxicillin Elderly and appendicitis?

present late with atypical symptoms -Half of pts are afebrile half demonstrate no rebound or involuntary guarding 1/4 have no RLQ tenderness Med of choice for scabies? permethrin 5% lotion H.pylori treatment Triple: clarith + amox + PPI clarith + flagyl + PPI levo + amox + PPI QUAD: Pepto + flagyl + tetracycline + PPI Hyperlipidemia treatment and LFTs-- which med doesn't monitor Bile Acid sequestran Anterior drawer test? tests integrity of ACL Red flags associated with a migraine? first or worst HA of life, change in frequency/severity, new progressive HA persisting for days, precipitation of HA with valsalva, presence of neuro sx, onset after 55, persistent one sided, stiff neck/fever Indications for migraine prophy? *Suffers from frequent high-impact migraine attacks (>/3 attacks per month) *Significant disability despite receiving acute tx *concomitant co-morbids or illness that precludes effective acute therapy *At risk of using acute meds and therefore developing chronic daily HA *One of rare migraine subtypes such as hemiplegic or basilar migraine, migraine with prolonged aura or migrainous infarction Asthma definition Primarily inflammation with superimposed bronchospasm

What does the get up and go test evaluate for? balance/falls fall risk Most common s/sx of cholecystitis Upper abd pain right shoulder/scapula pain colicky or constant pain N/V/fever High frequency hearing loss d/t non-pathological/normal aging Prebycusis Interference of sound through external auditory canal or transmission of vibration from tympanic membrane through ossicular chain to the oval window Conductive hearing loss Hearing loss- involves inner ear, cochlea, or auditory nerve sensorineural Sensorineural hearing loss causes loud noises, ototoxic meds (antibiotics-vanco, gent, diuretics, salicylates) neuro disorders (MS, syphilis, meniere's) chalky white mark on TM scarring 3 types of ADHD

  1. inattentive
  2. Hyperactie-impulsive
  3. combo What is cervical cancer usually associated with? HPV

Short acting insulin? regular Osteoporosis diagnosis? BMD of -2.5 or below Trigeminal neuralgia s/sx stabbing unilateral facial pain triggered by chewing or similar activities or by touching affected areas on the face (affects right side 5x more than left) Bell's Palsy s/sx acute onset of unilateral upper and lower facial paralysis (over 48 hour period) posterior auricular pain decreased tearing taste disturbances Meniere's dx s/sx vertigo (minutes to hours) loss of hearing/tinnitus loss of balance headaches N/V/sweating What BPH meds work immediately? Alpha blockers What do 5 alpha reductase meds do to PSA? lower it Rust colored sputum? S. Pneumo PNA Tx of choice for HSV 1 on lips?

oral acyclovir treating elderly with tricyclic cognitive changes and urinary retention Lab test confirms menopause? FSH increase, estrogen decreases Most common cause of bleeding in post menopause? atrophy of vaginal mucosa or endometrium Drugs to avoid with G6PD? NSAIDs, aspirin Thalassemia type of anemia Microcytic hypochromic Time interval for cervical screening in women less than 60? 21-65: every 3 years or age 30-65 every 5 years what does topical 5-Fu treat? Fluorouracil cream- treats actinic or solar keratoses Difference between cellulite and erysipelas? Erysipelas involves upper dermis and superficial lymphatics -has more distinctive anatomic features than cellulitis; lesions are raised above the level of surrounding skin with a clear line of demarcation bt involved and uninvolved tissue- "butterfly" involvement of face Cellulitis involves deeper dermis and subq fat Ischemic arterial ulcer characteristics? Cool to touch, pale shiny taut thin, no hair, often located distally on dorsum of foot or toes Base grayish, unhealthy appearing granulation tissue

pain at night when supine RA xray findings soft tissue swelling (fusiform and periarticular) Joint effusion osteoporosis joint space narrowing marginal erosions Acute bacterial prostatitis PE? Tender, nodular, hot, boggy or normal feeling prostate gland Suprapubic abd tenderness enlarged tender bladder d/t urinary retention Most common cause of sinusitis in elderly? strep pneumo When to check PSA after prostatitis? 8 weeks after treatment OA thinning of what cartilage? articulate (surface) cartilage seborrheic keratosis sharply defined, light brown, flat macules Most common oral precancerous lesion? leukoplakia Causes associated with exacerbation of psoriasis stress, anxiety, illness -strep pharyngitis and some drugs (beta blockers, antimalarial, steroids, aspirin) Alzheimer's diagnostic criteria

-Development of multiple cognitive deficits manifested y memory impairment and cognitive disturbances -Cognitive deficits cause sig. impairment in social or occupational functioning and represent a sig. decline -gradual onset -R/o other causes -no delirium Crohn's mucosal appearance inflammation, patchy cobblestone Epidiymitis presentation gradual onset of scrotal pain and swelling, one side, fever/chills Cryptorchidism undescended testis Varicocele asymptomatic; sometimes scrotal pain or heaviness "bag of worms" Testicular torsion sudden onset of severe unilateral scrotal pain followed by swelling 1/3 have GI upset How long to stay on antidepressants? 1 year Tinea capitis appearance scaly, patchy, crusty, hair breakage Urticarial full body rash 7 days into PCN with strep throat? MONO

Gold standard for CKD diagnosis? GFR through 24 hour urine