NRNP 6550 MIDTERM 2023 COMPLETE
QUESTIONS AND ANSWERS ALREADY PASSED
1. Vaccinations and immunosuppression. 2 keypoints: - give inactive agents
instead of live agents
- might not work as effectively
2. live virus vaccine types: Virus:
- measles
- mumps
- polio (oral)
- rubella
- varicella
- yellow fever
- herpes zoster
Bacteria:
- typhoid
3. inactive vaccine virus: Virus:
- Hep A and B
- HPV
- influenza
- polio (subq)
- rabies
Bacteria:
- anthrax
- cholera
- diphteria
- Lyme
- meningococcus
- pertussis
- plague
- pneumococcus
- tetanus
4. Immunization recommendation influenza: all ages, all types (pregnant, dia-
betes, immunocompromised, etc)
5. Immunization recommendation pregnancy and weakened immune system: -
1 dose Tdap
- no varicella, zoster, MMR
6. HIV and vaccinations: Give inactive agents when CD4 count is greater than 200
cells/ mm3
7. health screening 18 - 45 years: - BMI
- BP (q2years)
- at age 20: fasting lipid profile: total cholesterol, LDL, HDL, triglycerides (cardiac
,NRNP 6550 MIDTERM 2023 COMPLETE
QUESTIONS AND ANSWERS ALREADY PASSED
testing if LDL greater than 200 or HDL lower than 40)
- annual breast exam, females
- Pap-smear annually
8. health screening 45 and up: - blood glucose q3years
- 50 and up: colorectal screening (digital exam annually, sigmoidscopy q5years,
colonoscopy q10yrs)
- PSA with digital exam annually for males
- mammography q1 -2 yrs
- women 65 and up: screen for osteoporosis
9. top 5 leading causes of death: 1. heart disease
2. cancer
3. respiratory disease
4. stroke
5. accidents
10. Conjunctivitis; definition: -Pink eyey
- Inflammation of conjuctiva (outer layer of eye)
11. Conjunctivitis: causes: Chemical, bacterial, viral, allergic, herpetic. Aden-
ovirus is the most common cause, but bacteria (Haemophilus influenzae and Strep-
tococcus pneumoniae) are also common causes in children.
12. Conjunctivitis: findings: - redness
- itching
- discharge
- edema eyelid
- may find gonorrhea or chlamydia in eye discharge
13. Conjunctivitis: management: - cooling
- rule out corneal abrasion
- bacteria: antibiotic solution (gentamicin, neomycin)
- chlamydia: oral tetracycline or erythromycin
- gonorrhea: single dose ceftriaxone
- herpes: refer to opthalmologist
14. Corneal abrasion: definition, cause, findings, treatment: - disruption of
cornea (clear covering of eye)
- foreign body/ trauma
- pain, redness, photophobia, decreased visual acuity
- ab ointment: gentamicin, sulfacetamide, eye-patch, ophthalmologist
15. diabetic retinopathy: definition, cause, findings, treatment: - ocular retinal
disease due to DM
- DM, exac by smoking and HTN (macular edema)
- flashing lights in vision, blurred vision, black spots, loss of vision, sustained glucose
, NRNP 6550 MIDTERM 2023 COMPLETE
QUESTIONS AND ANSWERS ALREADY PASSED
greater than 130
- Laser therapy for macular edema, smoking cessation, glucose control, BP control
16. retinal detachment: definition, cause, findings, treatment: - separation of
retina and choroid
- trauma, intraocular mass, iris inflammation, cataract surgery, DM, sickle cell
- painless vision changes, blurred vision, light flashes, "curtain" over visual field,
bullous elevation without tears
- ophthalmologist for cryotherapy, laser therapy, vitrectomy. If from trauma: eye patch
17. Central & Branch Retinal Artery Occlusion: definition, cause, findings,
treatment: - abrupt blockage of retinal artery causing sudden vision loss> will
become permanent without intervention
- thrombosis/ embolism, arteritis (migraine, older age, afib, DM, HTN, coagu-
lopathies)
- sudden, painless vision loss, sluggish pupil, cherry-red spot at fovea
- EMERGENCY. Put pressure on eyelid, heparin, immediate consult opthalmolo-
hgist. check coagulopathies, check labs for artherosclerotic disease, blood cultures
(endocarditis?),
18. Glaucoma: definition, cause, findings, treatment: - progressive visual loss,
first peripherally then centrally: chronic open angle or actute closed angle. Optic
neuropathy.
- open: too much intraocular fluid production without removal. Secondary from
trauma, tumor, or cataracts. Causes: age, steroids, trauma, family history
- Photophobia, visual blurring, unilateral headache. Increased intraocular pres-
sure.Acute closed: eye pain and visual disturbance with N/V.
- Acute: Emergency. immediate medication and surgery. Chronic: consult opthalmol-
ogist and monitor. Bimatropost, and beta-blockers. Laser-therapy
19. Bell's Palsy: definition, cause, findings, treatment: - sudden self-limited uni-
lateral facial paralysis
- Idiopathic. Cranial nerve VII (7), sometimes viral cause (herpes), HTN, DM, Lyme's
- Unilateral paralysis of face (can't close eye, upper and lower face involved), herpetic
lesions, taste disturbances
- artificial tears, steroids (to treat CN 7 inflammation), antivirals
20. otitis externa: definition, cause, findings, treatment: - inflammation of the
outer ear (swimmers ear)
- water, fungi, bacterial, trauma, viral
- pain with fullnes of ear, itching, edema, otorrhea
- suction of debris, ab and steroid solution in ear, oral ab's (based on bld culture)
21. otitis media: definition, cause, findings, treatment: - inflammation of middle
ear
QUESTIONS AND ANSWERS ALREADY PASSED
1. Vaccinations and immunosuppression. 2 keypoints: - give inactive agents
instead of live agents
- might not work as effectively
2. live virus vaccine types: Virus:
- measles
- mumps
- polio (oral)
- rubella
- varicella
- yellow fever
- herpes zoster
Bacteria:
- typhoid
3. inactive vaccine virus: Virus:
- Hep A and B
- HPV
- influenza
- polio (subq)
- rabies
Bacteria:
- anthrax
- cholera
- diphteria
- Lyme
- meningococcus
- pertussis
- plague
- pneumococcus
- tetanus
4. Immunization recommendation influenza: all ages, all types (pregnant, dia-
betes, immunocompromised, etc)
5. Immunization recommendation pregnancy and weakened immune system: -
1 dose Tdap
- no varicella, zoster, MMR
6. HIV and vaccinations: Give inactive agents when CD4 count is greater than 200
cells/ mm3
7. health screening 18 - 45 years: - BMI
- BP (q2years)
- at age 20: fasting lipid profile: total cholesterol, LDL, HDL, triglycerides (cardiac
,NRNP 6550 MIDTERM 2023 COMPLETE
QUESTIONS AND ANSWERS ALREADY PASSED
testing if LDL greater than 200 or HDL lower than 40)
- annual breast exam, females
- Pap-smear annually
8. health screening 45 and up: - blood glucose q3years
- 50 and up: colorectal screening (digital exam annually, sigmoidscopy q5years,
colonoscopy q10yrs)
- PSA with digital exam annually for males
- mammography q1 -2 yrs
- women 65 and up: screen for osteoporosis
9. top 5 leading causes of death: 1. heart disease
2. cancer
3. respiratory disease
4. stroke
5. accidents
10. Conjunctivitis; definition: -Pink eyey
- Inflammation of conjuctiva (outer layer of eye)
11. Conjunctivitis: causes: Chemical, bacterial, viral, allergic, herpetic. Aden-
ovirus is the most common cause, but bacteria (Haemophilus influenzae and Strep-
tococcus pneumoniae) are also common causes in children.
12. Conjunctivitis: findings: - redness
- itching
- discharge
- edema eyelid
- may find gonorrhea or chlamydia in eye discharge
13. Conjunctivitis: management: - cooling
- rule out corneal abrasion
- bacteria: antibiotic solution (gentamicin, neomycin)
- chlamydia: oral tetracycline or erythromycin
- gonorrhea: single dose ceftriaxone
- herpes: refer to opthalmologist
14. Corneal abrasion: definition, cause, findings, treatment: - disruption of
cornea (clear covering of eye)
- foreign body/ trauma
- pain, redness, photophobia, decreased visual acuity
- ab ointment: gentamicin, sulfacetamide, eye-patch, ophthalmologist
15. diabetic retinopathy: definition, cause, findings, treatment: - ocular retinal
disease due to DM
- DM, exac by smoking and HTN (macular edema)
- flashing lights in vision, blurred vision, black spots, loss of vision, sustained glucose
, NRNP 6550 MIDTERM 2023 COMPLETE
QUESTIONS AND ANSWERS ALREADY PASSED
greater than 130
- Laser therapy for macular edema, smoking cessation, glucose control, BP control
16. retinal detachment: definition, cause, findings, treatment: - separation of
retina and choroid
- trauma, intraocular mass, iris inflammation, cataract surgery, DM, sickle cell
- painless vision changes, blurred vision, light flashes, "curtain" over visual field,
bullous elevation without tears
- ophthalmologist for cryotherapy, laser therapy, vitrectomy. If from trauma: eye patch
17. Central & Branch Retinal Artery Occlusion: definition, cause, findings,
treatment: - abrupt blockage of retinal artery causing sudden vision loss> will
become permanent without intervention
- thrombosis/ embolism, arteritis (migraine, older age, afib, DM, HTN, coagu-
lopathies)
- sudden, painless vision loss, sluggish pupil, cherry-red spot at fovea
- EMERGENCY. Put pressure on eyelid, heparin, immediate consult opthalmolo-
hgist. check coagulopathies, check labs for artherosclerotic disease, blood cultures
(endocarditis?),
18. Glaucoma: definition, cause, findings, treatment: - progressive visual loss,
first peripherally then centrally: chronic open angle or actute closed angle. Optic
neuropathy.
- open: too much intraocular fluid production without removal. Secondary from
trauma, tumor, or cataracts. Causes: age, steroids, trauma, family history
- Photophobia, visual blurring, unilateral headache. Increased intraocular pres-
sure.Acute closed: eye pain and visual disturbance with N/V.
- Acute: Emergency. immediate medication and surgery. Chronic: consult opthalmol-
ogist and monitor. Bimatropost, and beta-blockers. Laser-therapy
19. Bell's Palsy: definition, cause, findings, treatment: - sudden self-limited uni-
lateral facial paralysis
- Idiopathic. Cranial nerve VII (7), sometimes viral cause (herpes), HTN, DM, Lyme's
- Unilateral paralysis of face (can't close eye, upper and lower face involved), herpetic
lesions, taste disturbances
- artificial tears, steroids (to treat CN 7 inflammation), antivirals
20. otitis externa: definition, cause, findings, treatment: - inflammation of the
outer ear (swimmers ear)
- water, fungi, bacterial, trauma, viral
- pain with fullnes of ear, itching, edema, otorrhea
- suction of debris, ab and steroid solution in ear, oral ab's (based on bld culture)
21. otitis media: definition, cause, findings, treatment: - inflammation of middle
ear
