AANP FNP TEST REVIEW: Questions & Answers: Updated A+ Guide Solution

ADA screening for DM in Children (Ans- -symptomatic children (polyuria, polydipsia, polyphagia, blurred vision) regardless of risk factors -asymptomatic children after puberty or 10 years of age or older if overweight or obese (>85th percentile). Plus 1 of the following: *T2DM in 1st or 2nd degree relative *high risk racial/ethnic group *signs of insulin resistance (HTN, dyslipidemia, acanthosis nigricans, PCOS, SGA) *maternal hx of DM or GDM during the child's gestation Statistics (Ans- - leading causes of death: Heart disease, cancer, lung disease - leading cause of cancer death: lung - leading cause of death in adolescents: accidents - most common cancer: skin. - in males: prostate. in females: breast suicide: males more successful, women more attempts. highest rate is older white males. Osgood-Schlatter: (Ans- knee pain in young adults, overuse. Repetitive stress pain, tenderness, swelling at the tendon's insertion site. The tibial tuberosity. Rule out avulsion fracture if there is an acute onset and order a lateral xray. RICE. Usually stops when the growth stops. If patient has right sided weakness, etc. the CVA occurred where (Ans- left side initial evaluation of symptoms of acute prostatitis (Ans- Urinalysis and urine culture A 65-year-old woman presents for a follow-up examination after a new patient visit. She has not seen a healthcare provider for several years. She is a smoker and her hypertension is now adequately controlled with medication. Her mother died at age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200. In addition to starting Therapeutic Lifestyle Changes, the nurse practitioner should start the patient on: 1. bile acid sequestrant. 2. a statin drug. 3. a cholesterol absorption inhibitor. 4. low-dose aspirin. (Ans- A statin drug Ortolani's Click (Ans- a click is heard or felt as dislocation is reduced (developmental dysplasia of hip) (good until one year) Which of the following laboratory tests should a nurse practitioner order when the suspected diagnosis is temporal arteritis? (Ans- Erythrocyte sedimentation rate (ESR) What are narrow therapeutic index drugs? (Ans- 1. Warfarin sodium (Coumadin): monitor INR 2. Digoxin (lanoxin): monitor digoxin level, EKG, electrolytes(potassium, magnesium, calcium) 3. Theophylline: monitor blood levels 4. Carbamazepime (Tegretol) and Phenytoin (Dilantin): Monitor blood levels 5. Levothyroxine: Monitor TSH 6. Lithium: Monitor blood levels, TSH (risk of hypothyroidism) Otitis Externa tx (Ans- Fluoroquinolone & Polymyxin B cortisporin drops An elderly male patient complains of a new-onset, left-sided temporal headache accompanied by scalp tenderness and indurated temporal artery. The NP suspects temporal arteritis. What screening test would you order to assist with diagnosis? (Ans- sedimentation rate (expect to be very elevated) Basal Cell Carcinoma (Ans- Pearly domed nodule with overlaying telangiectatic vessels. Could be plaque, papule, possible central ulceration and crusting. Dx: Biopsy Tx: Normal, healthy woman of reproductive age (Ans- white, clear, flocculent(physiologic leukorrhea), no complaints, pH 3.8-4.2 (toward acidic), no odor, microscopic shows lactobacilli (gram+bacteria) Multiple infections from bacteria and fungus? (Ans- Screen for HIV Screening Tests (Ans- - sensitivity: detect those WITH the disease. higher the sensitivity is higher the false positives - Specificty: detect those who DONT have the disease. to assess pts ability to think abstractly a nurse pract could ask the patient (Ans- the meaning of a common proverb The most commonly prescribed medication for mild systemic lupus erythematosus (SLE) is: 1. azathioprine (AZA). 2. belimumab (Benlysta). 3. ibuprofen (Advil). 4. cyclophosphamide (Cytoxan). (Ans- ibuprofen (advil) A 17-year-old female is suspected of having polycystic ovary syndrome. In addition to testosterone, the most appropriate diagnostic tests to order would be: (Ans- follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and thyroid-stimulating hormone (TSH). Barlow's Maneuver (Ans- Feeling of a slip as the femoral head slips away from the acetabulum (toward the butt) (good until 6 mo) Candida vulvovaginitis (Ans- etiology: candida albican (80-90%) white, curdy, "cottage-cheese" like, sometimes increased, itching/burning discharge, pH <4.5, odor is usually absent, microscopic shows mycelia, budding yeast, pseudohyphae w/KOH prep. Treatment: oral diflucan or vaginal miconazole or terconazole PSEUDOHYPHAE, CLOTRIMAZOLE CREAM Proton Inhibitors (Ans- Increased risk of fractures(postmenopausal women), Pneumonia, Clostridium difficile infection, hypomagnesemia, B12 and iron malabsorption, atrophic gastritis, and kidney disease Bacterial Conjunctivitis tx (Ans- Eye drops or ointment: Polytrim, trimethoprim, polymyxin, macrolide A patient with an elevated WBC (>11k) accompanied by neutrophilia (>70%) and the presence of bands is what kind of shift and prognosis? (Ans- -Shift to the left -Serious bacterial infection Actinic Keratosis (Ans- Rough flat, dry crusty, erythematous papules or plaques. Scaly patch of red brown skin caused by years of SUN exposure. Precursor to squamous cell carcinoma. Dx. Biopsy. Tx: topical 5 fluroracil 5-FU, cryotherapy.