AANP Adult gerontology primary care
nurse practiotioner study guide with
Answers
Pheochromocytoma - correct answer ✅✅small vascular tumor of the
adrenal medulla, causing irregular secretion of epinephrine and
norepinephrine, leading to attacks of raised blood pressure, palpitations, and
headache. Tx with Alpha blockers
Rovsing's Sign - correct answer ✅✅Palpation in LLQ ilicits pain in RLQ
indicates appendicitis
NYHA classes of Heart Failure - correct answer ✅✅I No limitation of
physical activity. Ordinary physical activity does not cause undue fatigue,
palpitation, dyspnea (shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary physical
activity results in fatigue, palpitation, dyspnea (shortness of breath).
III Marked limitation of physical activity. Comfortable at rest. Less than
ordinary activity causes fatigue, palpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort. Symptoms of
heart failure at rest. If any physical activity is undertaken, discomfort
increases.
Step-wise Approach to Asthma Diagnosis & Treatment - correct answer
✅✅Step 1- Mild Intermitten FEV1/PEF > 80% predicted. Symptoms <2
days/week. Albuterol as needed.
Step 2- Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms > 2
days/week. Albuterol as needed. Low dose ICS ex Flovent. Alt cromolyn,
montelukast, nedocromil, theophylline.
Step 3- Mod presistent (FEV1 or PEF 60-80% predicted. Daily Symptoms.
SABA plus low dose ICS or med dose ICS or low dose with leukotriene
inhibitor (singulair, theophylline, zileuton).
Step 4- Severe presistent asthma (FEV1/PEF <60% predicted. Symptoms
most of day. High dose ICS plus long acting B2 agonist plus oral steroid daily
(prednisone).
,AANP Adult gerontology primary care
nurse practiotioner study guide with
Answers
Peak Expiratory Flow Rate (HAG):
Green Yellow Red Zone: - correct answer ✅✅PEF based on Height Age
Gender. Blow hard using spirometer highest value recorded.
80-100% expected volume Green Zone maintain or reduce meds
50-80% expected volume Yellow Zone increase maintenance therapy. Or
Having exacerbation.
Below 50% expected volume Red Zone call 911 give epinephrine inj.
PPD - correct answer ✅✅Neg- No firm bump forms at the test site, or a
bump forms that is smaller than 5 mm (0.2 in.).
A firm bump that is 5 mm (0.2 in.) in size suggests a TB infection in people
who are in a high-risk group. HIV, immunocompromise, exposed.
A firm bump that is 10 mm (0.4 in.) in size suggests a TB infection in people
who are in a moderate-risk group. healthcare workers, immigrants,
homeless.
A firm bump that is 15 mm (0.6 in.) in size suggests a TB infection in people
who are in a low-risk group no risk for tb.
Digoxin (Cardiac Glycosides) - correct answer ✅✅Therapuetic 0.5-2.0
, AANP Adult gerontology primary care
nurse practiotioner study guide with
Answers
Overdose toxcitity GI upset, arrhythmias, confusion visual changes
(yellow/green tinge vision- scotomas). Tx with digibind. order dig level,
electrolytes, creatinine ekg.
Thiazide Diuretics - correct answer ✅✅Pt with both htn and osteoporosis
have an extra benefit from thiazides. thiazide diuretics decrease calcium
excretion by the kidneys and stimulate osteoclasts formation. Patients with
serious sulfa allergies should avoid thiazide diuretics. Potassium sparing
diuretics can be used as alternative.
Chlorthalidone (hygroton), hydrochlororthiazide (esidrix, microzide),
indapamide (lozol), metolazone (zaroxolyn); indicated for decreased fluid
volume, inexpensive, effective, useful in severe hypertension, effective
orally, enhances other antihypertensives; adverse reactions: hypokalemia
symptoms, hyperuricemia, glucose tolerance, hypercholesterolemia, sexual
dysfunction; observe for postural hypotension, caution with renal failure gout
and client taking lithium; hypokalemia increases risk for digitalis toxicity,
administer postassium supplements.
Avoid with Gout, Best fist line for elderly w/ systolic htn.
Coumadin (Warfarin) - correct answer ✅✅an anticoagulant administered
to prevent blood clots from forming or growing larger
Prophylaxis and/or treatment of venous thrombosis, pulmonary embolus, a
fib, valve replacement, recurrent MI, stroke; also immobile pt
Afiib target INR 2-3
If INR 5-9 w/o bleeding hold 2-3 days low dose vit k
nurse practiotioner study guide with
Answers
Pheochromocytoma - correct answer ✅✅small vascular tumor of the
adrenal medulla, causing irregular secretion of epinephrine and
norepinephrine, leading to attacks of raised blood pressure, palpitations, and
headache. Tx with Alpha blockers
Rovsing's Sign - correct answer ✅✅Palpation in LLQ ilicits pain in RLQ
indicates appendicitis
NYHA classes of Heart Failure - correct answer ✅✅I No limitation of
physical activity. Ordinary physical activity does not cause undue fatigue,
palpitation, dyspnea (shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary physical
activity results in fatigue, palpitation, dyspnea (shortness of breath).
III Marked limitation of physical activity. Comfortable at rest. Less than
ordinary activity causes fatigue, palpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort. Symptoms of
heart failure at rest. If any physical activity is undertaken, discomfort
increases.
Step-wise Approach to Asthma Diagnosis & Treatment - correct answer
✅✅Step 1- Mild Intermitten FEV1/PEF > 80% predicted. Symptoms <2
days/week. Albuterol as needed.
Step 2- Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms > 2
days/week. Albuterol as needed. Low dose ICS ex Flovent. Alt cromolyn,
montelukast, nedocromil, theophylline.
Step 3- Mod presistent (FEV1 or PEF 60-80% predicted. Daily Symptoms.
SABA plus low dose ICS or med dose ICS or low dose with leukotriene
inhibitor (singulair, theophylline, zileuton).
Step 4- Severe presistent asthma (FEV1/PEF <60% predicted. Symptoms
most of day. High dose ICS plus long acting B2 agonist plus oral steroid daily
(prednisone).
,AANP Adult gerontology primary care
nurse practiotioner study guide with
Answers
Peak Expiratory Flow Rate (HAG):
Green Yellow Red Zone: - correct answer ✅✅PEF based on Height Age
Gender. Blow hard using spirometer highest value recorded.
80-100% expected volume Green Zone maintain or reduce meds
50-80% expected volume Yellow Zone increase maintenance therapy. Or
Having exacerbation.
Below 50% expected volume Red Zone call 911 give epinephrine inj.
PPD - correct answer ✅✅Neg- No firm bump forms at the test site, or a
bump forms that is smaller than 5 mm (0.2 in.).
A firm bump that is 5 mm (0.2 in.) in size suggests a TB infection in people
who are in a high-risk group. HIV, immunocompromise, exposed.
A firm bump that is 10 mm (0.4 in.) in size suggests a TB infection in people
who are in a moderate-risk group. healthcare workers, immigrants,
homeless.
A firm bump that is 15 mm (0.6 in.) in size suggests a TB infection in people
who are in a low-risk group no risk for tb.
Digoxin (Cardiac Glycosides) - correct answer ✅✅Therapuetic 0.5-2.0
, AANP Adult gerontology primary care
nurse practiotioner study guide with
Answers
Overdose toxcitity GI upset, arrhythmias, confusion visual changes
(yellow/green tinge vision- scotomas). Tx with digibind. order dig level,
electrolytes, creatinine ekg.
Thiazide Diuretics - correct answer ✅✅Pt with both htn and osteoporosis
have an extra benefit from thiazides. thiazide diuretics decrease calcium
excretion by the kidneys and stimulate osteoclasts formation. Patients with
serious sulfa allergies should avoid thiazide diuretics. Potassium sparing
diuretics can be used as alternative.
Chlorthalidone (hygroton), hydrochlororthiazide (esidrix, microzide),
indapamide (lozol), metolazone (zaroxolyn); indicated for decreased fluid
volume, inexpensive, effective, useful in severe hypertension, effective
orally, enhances other antihypertensives; adverse reactions: hypokalemia
symptoms, hyperuricemia, glucose tolerance, hypercholesterolemia, sexual
dysfunction; observe for postural hypotension, caution with renal failure gout
and client taking lithium; hypokalemia increases risk for digitalis toxicity,
administer postassium supplements.
Avoid with Gout, Best fist line for elderly w/ systolic htn.
Coumadin (Warfarin) - correct answer ✅✅an anticoagulant administered
to prevent blood clots from forming or growing larger
Prophylaxis and/or treatment of venous thrombosis, pulmonary embolus, a
fib, valve replacement, recurrent MI, stroke; also immobile pt
Afiib target INR 2-3
If INR 5-9 w/o bleeding hold 2-3 days low dose vit k
