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

Nurs 5338 Urgent Emergencies UTA Questions and Answers Guaranteed Pass.

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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
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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.

When a high dose of a drug is used for recreation - Correct answer there is a greater duration in use and use began at an earlier age. This creates worsened physical dependence and severe withdrawal State the types of withdrawals - Correct answer - Acute withdrawal syndrome

  • 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
  • Allergy is one of four forms of hypersensitivity
  • excessive activation of mast cells and basophils facilitated by IgE causing and inflammatory response ranging from uncomfortable to dangerous What is the treatment for allergic reactions? - Correct answer - avoid the allergen
  • steroids
  • antihistamines/decongestants
  • epinephrine for anaphylaxis
  • immunotherapy 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

Describe conjunctivitis - Correct answer Conjunctivitis, or pinkeye, is inflammation of the conjunctiva, generally caused by a pathogenic infection or by physical, allergic, or chemical irritation of the conjunctival surface. The most obvious sign of conjunctivitis, redness, results from the dilation of blood vessels deep to the conjunctival epithelium

  • usually a viral infection Describe herpes of the eye - Correct answer - consists of linear branching corneal ulcer
  • during eye exam stained with fluorescein dye
  • patients with epitheal keratitis complain of foreign-body sensation, light sensitivity, redness and blurred vision
  • focal or diffuse reduction in corneal sensation develops following recurrent epithelial keratitis The FNP has diagnosed the patient with herpes of the eye, what's the next step? - Correct answer - Opthalmic emergency
  • Do not treat
  • 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%
  • inflamed tonsils
  • infections of the nose and pharynx
  • throat cancer
  • occasionally as a sensory aura that precedes a migraine Describe otitis media - Correct answer Middle ear infection - bacterial or viral Complications include: perforated ear drum, chronic mastoiditis, scarring and hearing loss Describe the treatment for otitis media - Correct answer - first line: amoxicillin
  • if there's resistance or use of amoxicillin in the last 30 days then amoxicillin-clavulanate or another penicillin derivative plus beta lactamase inhibitor is recommended Prescribing antibiotics longer than this will likely result is side effects - Correct answer Prescribing antibiotics more than 7 days will have less side effects When prescribing azithromycin for otitis media, the FNP should know - Correct answer - For a short course
  • long-acting
  • more likely to be successful than short-acting alternatives
  • 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

Describe mastitis - Correct answer - inflamed breast tissue

  • commonly etiology is S. aureus
  • occasionally S. epidermis and streptococci How is mastitis classified? - Correct answer - milk stasis
  • non-infectious or infectious inflammation and abscess
  • differentiated based on leukocyte count and bacteria culture What are the symptoms of mastitis? - Correct answer - fever
  • pain
  • erythema Describe mastoiditis - Correct answer complication of acute otitis media with protrusion of the auricle, confirmed by CT scan with opacification of mastoid cells; can cause meningitis if left untreated Describe symptoms of meningitis - Correct answer - headache and neck stiffness
  • fever
  • confusion
  • altered consciousness
  • vomiting
  • photophobia
  • phonophobia
  • specific type of meningitis will present with a rash How does meningitis present in children? - Correct answer - irritability and drowsiness Describe mononucleosis - Correct answer - Triad: LAD, fever, pharyngitis
  • positive monospot, atypical lymphocytosis
  • may see HSM, palatial petechiae and white or purple exudate