NURS 642 Exam 4 questions with correct answers
pulmonary tuberculosis phases Correct Answer-Intensive phase (<
8wks)• Continuation Phase (4mo after)•
Latent Phase (6-9mo)
pulmonary tuberculosis 4 medications of treatment during the intensive
phase Correct Answer-•Pyrazinamide, Rifampin,
Isoniazid,
Ethambutol
Medications during the continuation phase of TB Correct Answer-INH
AND RIFAMPIN
LATENT PHASE TB MEDICATIONS Correct Answer-•INH x 9mo:
daily or twice weekly
•INH x 6mo: daily or twice weekly
•INH + RIF x 3mo once weekly
•RIF x 4 months daily
Active Infection must be R/O BY Correct Answer-Negative Sputum cx
q8h x 3•
IF acid-fast bacillus(AFB)/Mycobacterium TB (Mtb) Correct Answer-
Limit high risk visitors
,TB Symptoms: Correct Answer-Cough > 3wks (hemoptysis), Night
sweats, Fever, Pleuritic CP
Elderly: Most likely non-specific
TB DAIGNOSIS Correct Answer-•Rapid Diagnosis: MTB/RIF Assay
(Checks Mtb and rifampin resistance)
•CXR (Mainstay)
Findings (Rarely Normal): Active lesions vs. scarring of past infection
•PPD (Assesses does NOT diagnose): Often negative <8-10 wks
PPD SKIN TEST Correct Answer-Often negative <8-10 wks
•Cut-Offs: 48 - 72 hr after administration (Induration)
•15 mm: those without risk factors
•10 mm: "healthy" with risk factors (such as healthcare workers, foreign-
born persons)
•5 mm: household contact, CXR suspicious, and immunocompromised
pleural effusion Correct Answer-abnormal accumulation of fluid in the
pleural space
Breast and lung cancer: 50% may develop pleural effusions (poor
prognosis)
,TRANSUDATIVE PLEURAL EFFUSION Correct Answer-Systemic
causes: CHF, nephrotic sx, cirrhosis:
No pulm dz (HF ~90%)
Aspiration fluid: Similar glucose to serum and low WBC (<1000)
HF = Diuretics
Exudative pleural effusion Correct Answer-Pulm dz, infection
(Malignancy ~50%)
Aspiration fluid: High Protein & LDH on (exudes proteins)
PLEURAL EFFUSION DIAGNOSIS Correct Answer-Once *blunting
of the costovertebral angles* (which requires at least 250cc) is seen the
diagnosis is made.
CXR (Upright PA & Lateral - 175mL to visualize)
High Suspicion and <175mL = Lateral Decubitus (75mL)
HUMAN INFLUENZA Correct Answer-PRIMARILY B AND C -
START ANTIVIRALS ASAP
STATIN INITIATION Correct Answer-•Do not: initiate if K > 5.5,
combine with ARB, pregnant
•ACC/AHA Guidelines:
, 1. Patients with any form of clinical ASCVD
2. Patients with primary LDL >/= 190 (ASCVD)
3. Patients with DM, 40-7yo w/ LDL 70 to 189
4. Patients w/o DM, 40-75yo w/ estimated 10-year ASCVD risk ≥ 7.5%
HTN, PRIMARY Correct Answer-(95%): No one identifiable cause
(Genetic or lifestyle)
OSA, High Na diet, ETOH, Smoking, NSAIDs
HTN, SECONDARY Correct Answer-Something is Causing (Cushings)
•High Suspicion Age < 50
HTN TREATMENT Correct Answer-< 55Y/O
GOAL SPB <140/90
1st line: Lifestyle modification
Look for secondary cause in young patients
Non-blacks: Thiazide, CCB, ACEI, ARB
Black: Thiazide, CCB
pulmonary tuberculosis phases Correct Answer-Intensive phase (<
8wks)• Continuation Phase (4mo after)•
Latent Phase (6-9mo)
pulmonary tuberculosis 4 medications of treatment during the intensive
phase Correct Answer-•Pyrazinamide, Rifampin,
Isoniazid,
Ethambutol
Medications during the continuation phase of TB Correct Answer-INH
AND RIFAMPIN
LATENT PHASE TB MEDICATIONS Correct Answer-•INH x 9mo:
daily or twice weekly
•INH x 6mo: daily or twice weekly
•INH + RIF x 3mo once weekly
•RIF x 4 months daily
Active Infection must be R/O BY Correct Answer-Negative Sputum cx
q8h x 3•
IF acid-fast bacillus(AFB)/Mycobacterium TB (Mtb) Correct Answer-
Limit high risk visitors
,TB Symptoms: Correct Answer-Cough > 3wks (hemoptysis), Night
sweats, Fever, Pleuritic CP
Elderly: Most likely non-specific
TB DAIGNOSIS Correct Answer-•Rapid Diagnosis: MTB/RIF Assay
(Checks Mtb and rifampin resistance)
•CXR (Mainstay)
Findings (Rarely Normal): Active lesions vs. scarring of past infection
•PPD (Assesses does NOT diagnose): Often negative <8-10 wks
PPD SKIN TEST Correct Answer-Often negative <8-10 wks
•Cut-Offs: 48 - 72 hr after administration (Induration)
•15 mm: those without risk factors
•10 mm: "healthy" with risk factors (such as healthcare workers, foreign-
born persons)
•5 mm: household contact, CXR suspicious, and immunocompromised
pleural effusion Correct Answer-abnormal accumulation of fluid in the
pleural space
Breast and lung cancer: 50% may develop pleural effusions (poor
prognosis)
,TRANSUDATIVE PLEURAL EFFUSION Correct Answer-Systemic
causes: CHF, nephrotic sx, cirrhosis:
No pulm dz (HF ~90%)
Aspiration fluid: Similar glucose to serum and low WBC (<1000)
HF = Diuretics
Exudative pleural effusion Correct Answer-Pulm dz, infection
(Malignancy ~50%)
Aspiration fluid: High Protein & LDH on (exudes proteins)
PLEURAL EFFUSION DIAGNOSIS Correct Answer-Once *blunting
of the costovertebral angles* (which requires at least 250cc) is seen the
diagnosis is made.
CXR (Upright PA & Lateral - 175mL to visualize)
High Suspicion and <175mL = Lateral Decubitus (75mL)
HUMAN INFLUENZA Correct Answer-PRIMARILY B AND C -
START ANTIVIRALS ASAP
STATIN INITIATION Correct Answer-•Do not: initiate if K > 5.5,
combine with ARB, pregnant
•ACC/AHA Guidelines:
, 1. Patients with any form of clinical ASCVD
2. Patients with primary LDL >/= 190 (ASCVD)
3. Patients with DM, 40-7yo w/ LDL 70 to 189
4. Patients w/o DM, 40-75yo w/ estimated 10-year ASCVD risk ≥ 7.5%
HTN, PRIMARY Correct Answer-(95%): No one identifiable cause
(Genetic or lifestyle)
OSA, High Na diet, ETOH, Smoking, NSAIDs
HTN, SECONDARY Correct Answer-Something is Causing (Cushings)
•High Suspicion Age < 50
HTN TREATMENT Correct Answer-< 55Y/O
GOAL SPB <140/90
1st line: Lifestyle modification
Look for secondary cause in young patients
Non-blacks: Thiazide, CCB, ACEI, ARB
Black: Thiazide, CCB
