Nurs 5338 Urgent Emergencies UTA Questions and Answers Guaranteed Pass., Exams of Nursing

Nurs 5338 Urgent Emergencies UTA Questions and Answers Guaranteed Pass.Nurs 5338 Urgent Emergencies UTA Questions and Answers Guaranteed Pass.

Typology: Exams

2024/2025

Available from 11/18/2024

Prof-bales
Prof-bales šŸ‡¬šŸ‡§

3

(2)

3.1K documents

1 / 16

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
Nurs 5338 Urgent Emergencies UTA
Questions and Answers Guaranteed Pass.
Describe the pharmacological treatment for gonorrhea - Correct answer
Ceftriaxone 500 mg IM as a single dose, for persons weighing < 150 kg
For persons weighing > 150 kg, ceftriaxone 1gm IM as a single dose
Describe the pharmacological treatment for chlamydia - Correct answer
Doxycycline 100 mg PO BID for 7 days
During pregnancy, azithromycin 1 gm as a single dose to treat chlamydia
Alternative regimens:
Gentamicin 240 mg IM as a single dose + azithromycin 2 gm PO as a
single dose
Cefixime 800 mg orally as a single dose + doxycycline 100 mg PO BID for
7 days (if chlamydia CANNOT be excluded)
When assessing a patient, what is done first? - Correct answer - Observe
- Inspect
- Listen
- Palpate, respectively
Describe assessment findings for appendicitis - Correct answer
Abdominal pain, usually severe; localized to the right lower quadrant (RLQ)
Most common symptoms: anorexia, abdominal pain, nausea and vomiting
(typically present in this order)
Constipation and diarrhea occur after the pain
Describe acute abdominal pain - Correct answer - severe, persistent pain
- sudden onset
- nausea, vomiting
- abdominal distention
- fever, signs of shock
What is obturator sign? - Correct answer - The patient lies on the back
with hip and knee flexed at 90 degrees while the knee is stabilized and the
ankle rotated away from the body
How is sepsis handled in the primary care setting? - Correct answer refer
patient to the ED
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff

Partial preview of the text

Download Nurs 5338 Urgent Emergencies UTA Questions and Answers Guaranteed Pass. and more Exams Nursing in PDF only on Docsity!

Nurs 5338 Urgent Emergencies UTA

Questions and Answers Guaranteed Pass.

Describe the pharmacological treatment for gonorrhea - Correct answer Ceftriaxone 500 mg IM as a single dose, for persons weighing < 150 kg For persons weighing > 150 kg, ceftriaxone 1gm IM as a single dose Describe the pharmacological treatment for chlamydia - Correct answer Doxycycline 100 mg PO BID for 7 days During pregnancy, azithromycin 1 gm as a single dose to treat chlamydia Alternative regimens: Gentamicin 240 mg IM as a single dose + azithromycin 2 gm PO as a single dose Cefixime 800 mg orally as a single dose + doxycycline 100 mg PO BID for 7 days (if chlamydia CANNOT be excluded) When assessing a patient, what is done first? - Correct answer - Observe

  • Inspect
  • Listen
  • Palpate, respectively Describe assessment findings for appendicitis - Correct answer Abdominal pain, usually severe; localized to the right lower quadrant (RLQ) Most common symptoms: anorexia, abdominal pain, nausea and vomiting (typically present in this order) Constipation and diarrhea occur after the pain Describe acute abdominal pain - Correct answer - severe, persistent pain
  • sudden onset
  • nausea, vomiting
  • abdominal distention
  • fever, signs of shock What is obturator sign? - Correct answer - The patient lies on the back with hip and knee flexed at 90 degrees while the knee is stabilized and the ankle rotated away from the body How is sepsis handled in the primary care setting? - Correct answer refer patient to the ED

Describe treatment for an abscess - Correct answer I&D Describe assessment findings for cellulitis - Correct answer Erythema Warmth Edema Pain Fever Lymphadenopathy Fissuring, scaling or maceration in toe webs may be source of colonization (treat with antifungal agents such as econazole, naftifine) History of recurrent abscesses How is a puncture wound from an animal bite treated? - Correct answer - typically not sutured closed

  • treat with Augmentin Describe assessment findings for bacterial vaginosis - Correct answer Most women with BV are asymptomatic Fishy or musty vaginal odor, more prominent after sexual intercourse and menses Thin, homogenous discharge No redness or edema Normal bimanual exam Describe the diagnostic study for bacterial vaginosis - Correct answer Amsel's criteria specify that diagnosis of BV requires three or more of the following clinical signs and symptoms:
  • Homogenous, thin, gray-white discharge coating the vaginal wall
  • Vaginal pH >4.
  • Positive whiff test: amine (fishy) odor after application of 10% KOH on vaginal discharge sample
  • Presence of more than 20% epithelial cells (clue cells) on saline microscopy: microscopic evaluation of vaginal discharge on glass slide with normal saline shows few WBCs, and epithelial cells are obscured with coccobacilli. What is the most reliable predictor of bacterial vaginosis? - Correct answer Presence of clue cells identified by an experienced microscopist is the single most reliable predictor of BV
  • post-acute withdrawal syndrome (PAWS) Describe acute withdrawal syndrome - Correct answer - Starts when a drug is stopped
  • continues for days, weeks, or months Describe protracted withdrawal - Correct answer - post-acute withdrawal syndrome (PAWS)
  • low grade continuation of some symptoms of acute withdrawal
  • occurs in a pattern of remitting-relapsing
  • often results in relapse into addiction and prolonged disability that affects chances of employment
  • rarely, but can be indefinite Protracted withdrawal syndrome is commonly caused by - Correct answer
  • benzodiazepines
  • may be present with alcohol and opioid addiction A patient has a plan to commit suicide, what's the next step? - Correct answer - Call 911
  • file application for detention
  • do not take no for an answer What are the top 3 most harmful drugs? - Correct answer 1. alcohol
  1. heroin
  2. crack cocaine
  3. methamphetamine
  4. cocaine
  5. tobacco What action do you take if a patient is homicidal? - Correct answer - Call 911
  • file application for detention
  • do not take no for an answer If a patient is suicidal, agreeing to this will prevent detention - Correct answer - a contract to call 911 instead of suicide
  • the patient and provider both must sign it

How long does it take for motrin to develop a therapeutic level? - Correct answer 5 days or more Describe assessment findings for tenosynovitis - Correct answer - Median paresthesias affecting the thumb, index finger, middle finger, and radial side of the ring finger

  • Nocturnal paresthesias
  • Bilateral presentation common at first, but may be unilateral
  • Positive Phalen's test
  • Positive Tinel's test Describe Phalen's test - Correct answer Hold pt's wrists in acute flexion for 60 seconds, or you may ask pt's to press back of both hands together to form right angles. Describe Tinel's test - Correct answer Done to diagnose carpal tunnel Tap over the median nerve; Pain = positive When prescribing NSAIDS for long-term always assess - Correct answer kidney function Non-pharmacologic treatments for URI - Correct answer - commonly caused by viruses
  • remove triggers, such as smoking, allergens- What's important to remember when the assessment reveals AMS? - Correct answer It's a Medical Emergency It's important for the FNP to assess abdominal pain by - Correct answer - assessing the patient's history of the presenting complaint and the physical exam
  • this should derive the diagnosis in 90% of the cases It's important for the FNP to understand that abdominal pain can - Correct answer be caused by problems outside the abdomen, such as MI and pneumonias What is the treatment for an abrasion? - Correct answer - an injury caused by grinding or rubbing away layers of skin
  • remove any debris from the wound

What is the treatment for an anaphylatic reaction? - Correct answer - Epinephrine injected immediately

  • Dosage: 0.3mg (0.3ml, 1:1000) >30kg
  • 0.15mg (0.3ml, 1:2000) 15-30kg
  • CALL 911 List several antagonistic drugs used to block allergic mediators - Correct answer - antihistamines
  • glucocorticoids
  • epinephrine
  • theophylline
  • cromolyn sodium
  • antileukotrienes, such as montelukast, zafirlukast
  • anti-cholinergics
  • compounds that impair eosinophil chemotaxis Iron deficiency anemia from diet is rare commonly caused by - Correct answer - GI bleeding from ulcers, colon cancer
  • anemias of chronic disease: chemotherapy, renal disease How is anemia treated? - Correct answer - ferrous sulfate, ferrous fumerate, ferrous gluconate
  • recombinant erythropoietin
  • epoetin alfa
  • parenteral iron Describe acute asthma treatment - Correct answer - inhaled short-acting beta-2 agonist
  • oral corticosteroids
  • L-acting beta agonists or leukotriene agonists How is severe asthma treated? - Correct answer - intravenous corticosteroids
  • magnesium sulfate
  • hospitalization What is a peak flow meter used for? - Correct answer - to measure peak expiratory flow rate
  • important to monitor and diagnose asthma

The addition of this is superior in treating bacterial vaginosis - Correct answer - several studies have found probiotics (containing lactobacillus, including L. rhamnosus, L. reuteri. L acidophilus, and L. fermentum)

  • 88-90% cure rate at 1 month
  • either taken orally or vaginally Describe Bell's Palsy - Correct answer - rapid onset unilateral facial paralysis caused by an inflamed facial nerve compressed by a narrow bone canal beneath the ear
  • usually self-limiting Describe the treatment for Bell's palsy - Correct answer - corticosteroids within 3 days after onset
  • lacrilube for dry eye Describe how an animal bite is treated - Correct answer - wash the bite with soap and water
  • antibiotics for dog, cat, and human bites that break skin and for immunocompromised
  • First choice is Augmentin
  • alternatively, doxycycline and metronidazole How much blood can a healthy person lose? - Correct answer - the loss of 10-15 % of total blood volume without causing medical issues
  • blood donations typically take 8-10% of blood volume Describe treatment for superficial burns - Correct answer cooling water may provide pain relief and prevent damage Describe the treatment for partial thickness burns - Correct answer - cleaning may be required with soap and water
  • apply dressing
  • ok to leave blisters intact Describe the treatment for full thickness burns - Correct answer - extensive burns often require large amounts of IV fluids
  • the inflammatory response can cause significant capillary fluid leakage and edema
  • infection is often a complication
  • Consult opthalmology What follow up question should the FNP ask for an eye injury? - Correct answer - Always ask someone with conjunctivitis if they have recently injured their eye or if they wear contact lenses
  • Fluorescein dye is used with a woods lamp
  • If the injury is from a tree branch or any vegetation, do not patch the eye
  • Ophthalmic emergency
  • Refer out for foreign body which is embedded in the eye When conducting a biopsy what should the FNP complete first? - Correct answer - always measure nevus or what you are biopsying and record What objective tests are conducted when Bell's Palsy is diagnosed? - Correct answer - eyebrow raise
  • smile What is the treatment for an acute asthma attack? - Correct answer - Duoneb, albuterol 2.5mg/ml and atrovent .5mg
  • then up to three albuterol nebulizers
  • O2 may be needed
  • solumedrol injection
  • monitor for tachycardia Is an I&D in primary care a sterile procedure? - Correct answer often not a sterile procedure What clinical prediction rule is used when DVT is suspected? - Correct answer - Wells score
  • D-dimer test (high sensitivity) What type of imaging is used to diagnose DVT? - Correct answer ultrasound of suspected veins How is DVT treated? - Correct answer - commonly treated outpatient
  • lovenox injections BID for a few days plus coumadin and then coumadin alone
  • INR is required (should be between 2.0-3.0)
  • coumadin diet
  • Vitamin K is the antidote for increased INR

What is the treatment for orofacial pain in primary care? - Correct answer - amoxicillin or clindamycin

  • Peridex oral rinse and pain medication
  • naproxen Describe assessment findings for ketoacidosis - Correct answer - nausea
  • vomiting
  • abdominal pain
  • acetone breath
  • deep breathing (kussmaul breathing)
  • decreased consciousness What is the main cause of hyperosmolar non-ketotic state? - Correct answer dehydration What is the goal A1C for diabetics? - Correct answer - less than 7%
  • 6.5% Describe vertigo - Correct answer Sense of movement and rotation of oneself or the surrounding environment with a typical spinning sensation Describe disequilibrium. - Correct answer - shakiness or instability when walking related to musculoskeletal disorder or multi sensory deficits
  • feeling off balance Describe pre-syncope - Correct answer - lightheadedness, muscular weakness and feeling faint
  • different from syncope Non-specific dizziness - Correct answer - often psychiatric in origin
  • sometimes d/t hyperventilation
  • sometimes caused by stroke Describe the Epley maneuver - Correct answer 1. Involves sequential movement of head in 4 positions,
  1. Patient stays in each position for 30 seconds,
  2. 30% recurrence rate @ 1 year,
  3. 2nd treatment may be necessary
  • no improvement after 2-3 days of treatment, then change therapy Describe otitis externa - Correct answer Infection of the auditory canal. -History of trauma or moist environment. -Itching in the ear canal. -Intense pain with movement of pinna such as chewing. -Discharge may be watery at first, then purulent and thick mixed with pus and epithelial cells. Foul smelling. -Conductive hearing loss. -Canal is red, edematous. Tympanic membrane obscure. Describe the treatment for bone fractures - Correct answer - either surgical or conservative
  • conservative treatment with pain management, immobilization, non- surgical stabilization
  • either open vs closed treatment How should an open fracture be treated in primary care? - Correct answer It's a medical emergency What are the pain sensitive structures in the head? - Correct answer - Brain tissue isn't sensitive to pain
  • periosteum of the skull
  • muscles
  • nerves
  • arteries
  • veins
  • subcutaneous tissues
  • eyes
  • ears
  • sinuses
  • mucous membranes What is the first line treatment for a headache? - Correct answer Naproxen Describe the symptoms of TBI - Correct answer - exchangeable with concussion
  • clumsiness
  • fatigue
  • confusion
  • nausea
  • blurry vision
  • headaches describe hidradenitis suppurativa - Correct answer chronic skin disease w/ clusters of abscesses or subcutaneous boil-like skin lesion around the apocrine glands that most commonly affects the underarms, under the breasts, inner thighs, groin, and buttocks. Outbreaks are painful and may persist for years with interspersed periods of inflammation, often culminating in sudden drainage of pus. This process often forms open wounds that will not heal and frequently leads to SIGNIFICANT SCARRING How is hidradenitis suppurativa treated? - Correct answer - antibiotics
  • corticosteroids Tumor necrosis factor (TNF)-alpha inhibitors
  • infliximab (remicade), adalimumab (humira) have promise as third line treatment- What is expected with surgical intervention for hidradenitis suppurativa? - Correct answer Surgery doesn't cure the disease because it will likely return Describe secondary hypertension - Correct answer caused by underlying disease of the kidneys, arteries, heart or endocrine system Describe ingrown toenail - Correct answer - also called onychocryptosis
  • starts with microbial inflammation of the paronychium
  • results in nail buried inside the granuloma How is an ingrown toenail treated? - Correct answer - wedge resection
  • removal of toenail
  • if recurs then destruction of the side nail bed with anesthesia
  • topical antibiotics post procedure
  • warm epsom salt soaks BID may be beneficial How is an open laceration treated in primary care? - Correct answer - closed within 6 hours and up to 24 hours after cleaning the wound
  • concern for infection if closed after this time
  • positive monospot, atypical lymphocytosis
  • may see HSM, palatial petechiae and white or purple exudate