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Questions And Answers
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
Questions And Answers
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
Questions And Answers
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.
Questions And Answers
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 For hematuria caused by an STI, when should follow up scheduled?
correct answer ✅one week Describe assessment findings for acute bronchitis - - - correct answer ✅Cough: dry and nonproductive, then productive; may be purulent URI symptoms Fatigue Fever due to bacterial infection; more common in smokers and patients with COPD Fever due to viral cause (unusual after first few days) Burning sensation in chest Crackles, wheezes Chest wall pain Perform detailed review of preexisting health conditions & exposure history
Questions And Answers
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
Questions And Answers
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
- heroin
- crack cocaine
- methamphetamine
- cocaine
- tobacco What action do you take if a patient is homicidal? - - - correct answer ✅- Call 911
- file application for detention
Questions And Answers
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
Questions And Answers
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
- apply a topical antibiotic
- apply dressing as necessary to keep the wound from drying out and interfering with healing.
- apply a topical analgesia if painful List the most common causes of an abscess - - - correct answer ✅- MRSA
- rarely caused by parasites in the US, but common in other areas of the world
- IV drug users often present with one at the injection site
Questions And Answers
- 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
Questions And Answers
- 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
Questions And Answers
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
Questions And Answers
- 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 Describe bursitis - - - correct answer ✅Inflammation of the small sacs of synovial fluid located near the joint.
Questions And Answers
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
Questions And Answers
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
