SARAH MICHELLE LIVE REVIEW STUDY
GUIDE
A child that has a history of mononucleosis is at increased risk for development for what cancer
later in life? And why? - ANS-Hodgkin's Lymphoma and Burkitt's Lymphoma, this is due to the
exposure of the Epstein-Barr virus
\A new graduate nurse practitioner has a patient presented with a hearing complaint. The
patient states that they have had decreased hearing on the right side for the last month that is
continuing to get worse. The NP completes both the Rinne and Weber tests. If the patient has
Ménière's disease, what would be the expected finding on the Weber test?
1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear - ANS-4. The tuning fork lateralizes to the left ear
\A presence of thyroid peroxidase antibodies indicate that? - ANS-Hypothyroidism is caused by
an autoimmune process of some sort
\A score of 0-10 on the MMSE indicates what? - ANS-Severe cognitive impairment
\A score of 10-20 on the MMSE indicates what? - ANS-Moderate decline in cognitive impairment
\Antacids are most effective when taken how many minutes before a meal? - ANS-30 minutes
\Antacids with calcium or aluminum may cause what? - ANS-Constipation- this is a
consideration especially in the elderly population
\Antacids with magnesium may cause what? - ANS-Diarrhea
\Anytime a female of childbearing age is having GU complaints, what should we order? -
ANS-Hcg urine pregnancy test
\Are down syndrome patients able to play sports? - ANS-As long as they are cleared prior with a
C-Spine XR and it does not show any instability
\Are we able to have collaborative agreements with people other then physicians? - ANS-Yes,
dentists and DO's, NOT chiropractors
\At what HgbA1c are we going to initiate insulin? - ANS-> 9%
\Beside thalassemia, what is another condition that can cause you to absorb too much iron?
What is the treatment? - ANS-Hemochromatosis- treatment is regular phlebotomy
\Can bulk laxatives be taken long term? - ANS-Yes, they can be used to treat and prevent
constipation
\Colcrys should be prescribed with caution to those with what condition? - ANS-Renal
impairment
\Colcrys should be prescribed with caution to those with what condition? - ANS-Renal
impairment
\Define autonomy - ANS-The patient has the ability to make their own decisions.
\Define beneficence - ANS-To do good- an action that is done for the benefit of others.
\Define fidelity - ANS-Loyalty
,\Define justice - ANS-Fair and equal treatment for all
\Define non-maleficence - ANS-To do no harm
\Define paternalism - ANS-You are trying to decide what is best for them, because you disagree
with what they chose.
\Define veracity - ANS-Telling the truth
\Describe use of Depo-Provera - ANS-Injection every 12-13 weeks
\Describe use of Depo-Provera - ANS-Injection every 12-13 weeks
\Describe use of Ortho-Vera patch - ANS-Apply once a week for 3 weeks and then take off for
one week for period
\Describe use of Ortho-Vera patch - ANS-Apply once a week for 3 weeks and then take off for
one week for period
\Describe use of the Nuvaring - ANS-Keep in place for 3 weeks, then remove for one week
If it falls out, be sure to reinsert ASAP
Provides low and steady amounts of hormones- less ups and downs
\Describe use of the Nuvaring - ANS-Keep in place for 3 weeks, then remove for one week
If it falls out, be sure to reinsert ASAP
Provides low and steady amounts of hormones- less ups and downs
\Determining which nerve is the root of the patient's sciatica: L4 - ANS-If L4 is the root cause of
the sciatica: Squat and rise exam and their knee jerk will be diminished
\Determining which nerve is the root of the patient's sciatica: L5 - ANS-If L5 is the root cause of
the sciatica: Have patient do heel walking and there will be numbness at the great toe
\Determining which nerve is the root of the patient's sciatica: S1 - ANS-If S1 is the root cause of
the sciatica: Have patient walk on their toes and there will be a diminished or absent ankle jerk
\Do type 2 diabetes patients need to take a daily aspirin? - ANS-Not necessarily, if they are at
increased risk of heart disease then they can take a daily aspirin
\Do we treat patients that have a UA + for leukocytes/nitrites but no symptoms? - ANS-The only
patient that you would treat this is if they are pregnant- this would a risk for the baby, all other
patient, if asymptomatic there is no need to treat
\Do you stop alloipurinol during an acute attack? - ANS-No, patient should continue taking
allopurinol during an acute attack
\Does Medicaid coverage vary from state to state? - ANS-Yes, because the states have some
control of it.
\Does Metformin cause hypoglycemia? - ANS-NO, Metformin works in the body by inhibiting
glucose production in the liver. Due to that there are no issues with hypoglycemia
\Does SGLT-2 inhibitors cause hypoglycemia? - ANS-SGLT-2 inhibitors have a LOW risk for
hypoglycemia
\DPP-4 inhibitors are contraindicated in patients with a history of what condition? -
ANS-Pancreatitis
\DRE- what is the expected assessment of prostate gland of a patient with BPH? - ANS-Non
tender, enlarged, symmetrical, rubbery prostate
\Gastroenteritis- how do we diagnosis it? - ANS-Look at overall clinical picture:
Basic lab work: CBC, CMP, UA
Stool studies: Stool culture, occult blood, C Dif, and stool for ova and parasites
,\Hep A: If BOTH IgM anti-HAV and IgG anti-HAV are negative, what does this mean? -
ANS-They are susceptible and need immunization!
\Hepatitis D only occurs in what population? - ANS-Those who are also infected with Hepatitis B
\How are scaphoid fractures most caused? - ANS-If patient reports they fell with their hands
braced to catch them
\How can osteoporosis be prevented? - ANS-Weight bearing exercise
Calcium 1200 mg
Vitamin D 800-1000 units
\How can you diagnose RA? - ANS-Lab work: ESR, RF
Refer to rheumatology for official diagnosis
\How can you diagnose RA? - ANS-Lab work: ESR, RF
Refer to rheumatology for official diagnosis
\How do alpha-glucose dose inhibitors work? - ANS-Inhibit glucosidase in the small intestines
\How do anti-diarrheal work? - ANS-Works by slowing down how quickly fluid is able to move
through the GI tract.
\How do biphosphonates work? - ANS-Inhibits the reabsorption of bone by the osteoclasts,
which in turn increases bone density because it allows the osteoblasts to build up the bone to
work more effectively.
\How do biphosphonates work? - ANS-Inhibits the reabsorption of bone by the osteoclasts,
which in turn increases bone density because it allows the osteoblasts to build up the bone to
work more effectively.
\How do bulk laxatives work? - ANS-They work by absorbing fluid in the intestines, which
creates a jelly-like passable stool. "Bulk up" that bowel movement, so it can pass.
\How do NSAIDs work? - ANS-Block the COX enzyme, which inhibits the production of
prostaglandins
\How do NSAIDs work? - ANS-Block the COX enzyme, which inhibits the production of
prostaglandins
\How do we diagnose and treat hydrocele? - ANS-Transillumination, light will shine throughout
the scotrum which reveals that fluid is present and not a solid mass
Treat: Typically will resolve on its own, conservative management required for most patients
\How do we diagnose scaphoid fracture? - ANS-This fracture doesn't usually show up on X-Ray
right away, if we suspect this to happen, we are going to go ahead and treat them. It's going to
show up on X-Ray about 2 weeks after the initial injury.
\How do we screen for gestational diabetes? - ANS-One Step: 2 hour oral glucose tolerance
test, and if the result is > 200 the patient has gestational diabetes
Two Step: One hour glucose challenge, and if the pregnant fails the one hour, a 3 hour test will
be initiated
\How do we screen for gestational diabetes? - ANS-One Step: 2 hour oral glucose tolerance
test, and if the result is > 200 the patient has gestational diabetes
Two Step: One hour glucose challenge, and if the pregnant fails the one hour, a 3 hour test will
be initiated
\How do we treat a scaphoid fracture? - ANS-Thumb spica cast
\How do we treat diverticulitis? - ANS-Clear Liquid Diet, Antibiotics (Augmentin or Cipro or
Metronidazole)
, \How do we treat syphilis? - ANS-IM PCN specifically Bicillin
PCN VK
\How do you diagnose fibromyalgia? - ANS-There is no diagnostic test currently
Diagnosis is based on symptoms- must be present for at least 3 months and there can not be
an alternative explanation for the symptoms
\How do you diagnose fibromyalgia? - ANS-There is no diagnostic test currently
Diagnosis is based on symptoms- must be present for at least 3 months and there can not be
an alternative explanation for the symptoms
\How do you perform Finkelstein test? - ANS-The examiner is going to grab the thumb and
perform ulnar deviation, positive test if pain occurs
\How do you perform Lachman test? - ANS-Patient should be supine
Put one hand on lower thigh and one on lower leg
Bend the knee to a 20 degree angle
Pull the lower leg forward while keeping the thigh stable
Assess for whether the knee has too much ROM
\How does an abdominal aortic aneurysm usually present? - ANS-Pulsating mass in the
abdomen
\How does breast cancer present? - ANS-Fixed, non movable lump in breast/axilla, painless,
dimpling, red or flaky nipples, discharge
\How does Compazine work? - ANS-Blocking the dopamine receptors inside your brain. These
dopamine receptors are what lead to the patient feeling nauseous.
\How does docusate sodium work? - ANS-Helps prevent and treat constipation by allowing fecal
masses to be penetrated by fluid in the intestines. This process allows for those stools to
ultimately become softer and therefore easier to pass by the patient. Prevents the patient from
straining.
\How does gabapentin work? - ANS-Works in the brain by altering electrical activity and working
on neurotransmitters
\How does Lactulose work? - ANS-In the colon, Lactulose is broken down into parts that help
shift water from the body and into the colon, which then makes your patient have a bowel
movement.
\How does Metformin impact weight? - ANS-Metformin is weight NEUTRAL, some patient even
will have weight loss with this drug
\How does NSAIDs effect gastric acid? - ANS-NSAIDs increase the production of gastric acid.
\How does NSAIDs effect gastric acid? - ANS-NSAIDs increase the production of gastric acid.
\How does NSAIDs effect platelets? - ANS-NSAIDs decrease activity of your body's platelets,
patients will be more prone to bleeding
\How does NSAIDs effect platelets? - ANS-NSAIDs decrease activity of your body's platelets,
patients will be more prone to bleeding
\How does NSAIDs impact sodium and fluid? - ANS-NSAIDs cause sodium and fluid retention
which is why they are C/I in HF patients
\How does NSAIDs impact sodium and fluid? - ANS-NSAIDs cause sodium and fluid retention
which is why they are C/I in HF patients
\How does Phenergan work? - ANS-Blocks histamine in patient's brain, which allows the brain
to relax.
GUIDE
A child that has a history of mononucleosis is at increased risk for development for what cancer
later in life? And why? - ANS-Hodgkin's Lymphoma and Burkitt's Lymphoma, this is due to the
exposure of the Epstein-Barr virus
\A new graduate nurse practitioner has a patient presented with a hearing complaint. The
patient states that they have had decreased hearing on the right side for the last month that is
continuing to get worse. The NP completes both the Rinne and Weber tests. If the patient has
Ménière's disease, what would be the expected finding on the Weber test?
1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear - ANS-4. The tuning fork lateralizes to the left ear
\A presence of thyroid peroxidase antibodies indicate that? - ANS-Hypothyroidism is caused by
an autoimmune process of some sort
\A score of 0-10 on the MMSE indicates what? - ANS-Severe cognitive impairment
\A score of 10-20 on the MMSE indicates what? - ANS-Moderate decline in cognitive impairment
\Antacids are most effective when taken how many minutes before a meal? - ANS-30 minutes
\Antacids with calcium or aluminum may cause what? - ANS-Constipation- this is a
consideration especially in the elderly population
\Antacids with magnesium may cause what? - ANS-Diarrhea
\Anytime a female of childbearing age is having GU complaints, what should we order? -
ANS-Hcg urine pregnancy test
\Are down syndrome patients able to play sports? - ANS-As long as they are cleared prior with a
C-Spine XR and it does not show any instability
\Are we able to have collaborative agreements with people other then physicians? - ANS-Yes,
dentists and DO's, NOT chiropractors
\At what HgbA1c are we going to initiate insulin? - ANS-> 9%
\Beside thalassemia, what is another condition that can cause you to absorb too much iron?
What is the treatment? - ANS-Hemochromatosis- treatment is regular phlebotomy
\Can bulk laxatives be taken long term? - ANS-Yes, they can be used to treat and prevent
constipation
\Colcrys should be prescribed with caution to those with what condition? - ANS-Renal
impairment
\Colcrys should be prescribed with caution to those with what condition? - ANS-Renal
impairment
\Define autonomy - ANS-The patient has the ability to make their own decisions.
\Define beneficence - ANS-To do good- an action that is done for the benefit of others.
\Define fidelity - ANS-Loyalty
,\Define justice - ANS-Fair and equal treatment for all
\Define non-maleficence - ANS-To do no harm
\Define paternalism - ANS-You are trying to decide what is best for them, because you disagree
with what they chose.
\Define veracity - ANS-Telling the truth
\Describe use of Depo-Provera - ANS-Injection every 12-13 weeks
\Describe use of Depo-Provera - ANS-Injection every 12-13 weeks
\Describe use of Ortho-Vera patch - ANS-Apply once a week for 3 weeks and then take off for
one week for period
\Describe use of Ortho-Vera patch - ANS-Apply once a week for 3 weeks and then take off for
one week for period
\Describe use of the Nuvaring - ANS-Keep in place for 3 weeks, then remove for one week
If it falls out, be sure to reinsert ASAP
Provides low and steady amounts of hormones- less ups and downs
\Describe use of the Nuvaring - ANS-Keep in place for 3 weeks, then remove for one week
If it falls out, be sure to reinsert ASAP
Provides low and steady amounts of hormones- less ups and downs
\Determining which nerve is the root of the patient's sciatica: L4 - ANS-If L4 is the root cause of
the sciatica: Squat and rise exam and their knee jerk will be diminished
\Determining which nerve is the root of the patient's sciatica: L5 - ANS-If L5 is the root cause of
the sciatica: Have patient do heel walking and there will be numbness at the great toe
\Determining which nerve is the root of the patient's sciatica: S1 - ANS-If S1 is the root cause of
the sciatica: Have patient walk on their toes and there will be a diminished or absent ankle jerk
\Do type 2 diabetes patients need to take a daily aspirin? - ANS-Not necessarily, if they are at
increased risk of heart disease then they can take a daily aspirin
\Do we treat patients that have a UA + for leukocytes/nitrites but no symptoms? - ANS-The only
patient that you would treat this is if they are pregnant- this would a risk for the baby, all other
patient, if asymptomatic there is no need to treat
\Do you stop alloipurinol during an acute attack? - ANS-No, patient should continue taking
allopurinol during an acute attack
\Does Medicaid coverage vary from state to state? - ANS-Yes, because the states have some
control of it.
\Does Metformin cause hypoglycemia? - ANS-NO, Metformin works in the body by inhibiting
glucose production in the liver. Due to that there are no issues with hypoglycemia
\Does SGLT-2 inhibitors cause hypoglycemia? - ANS-SGLT-2 inhibitors have a LOW risk for
hypoglycemia
\DPP-4 inhibitors are contraindicated in patients with a history of what condition? -
ANS-Pancreatitis
\DRE- what is the expected assessment of prostate gland of a patient with BPH? - ANS-Non
tender, enlarged, symmetrical, rubbery prostate
\Gastroenteritis- how do we diagnosis it? - ANS-Look at overall clinical picture:
Basic lab work: CBC, CMP, UA
Stool studies: Stool culture, occult blood, C Dif, and stool for ova and parasites
,\Hep A: If BOTH IgM anti-HAV and IgG anti-HAV are negative, what does this mean? -
ANS-They are susceptible and need immunization!
\Hepatitis D only occurs in what population? - ANS-Those who are also infected with Hepatitis B
\How are scaphoid fractures most caused? - ANS-If patient reports they fell with their hands
braced to catch them
\How can osteoporosis be prevented? - ANS-Weight bearing exercise
Calcium 1200 mg
Vitamin D 800-1000 units
\How can you diagnose RA? - ANS-Lab work: ESR, RF
Refer to rheumatology for official diagnosis
\How can you diagnose RA? - ANS-Lab work: ESR, RF
Refer to rheumatology for official diagnosis
\How do alpha-glucose dose inhibitors work? - ANS-Inhibit glucosidase in the small intestines
\How do anti-diarrheal work? - ANS-Works by slowing down how quickly fluid is able to move
through the GI tract.
\How do biphosphonates work? - ANS-Inhibits the reabsorption of bone by the osteoclasts,
which in turn increases bone density because it allows the osteoblasts to build up the bone to
work more effectively.
\How do biphosphonates work? - ANS-Inhibits the reabsorption of bone by the osteoclasts,
which in turn increases bone density because it allows the osteoblasts to build up the bone to
work more effectively.
\How do bulk laxatives work? - ANS-They work by absorbing fluid in the intestines, which
creates a jelly-like passable stool. "Bulk up" that bowel movement, so it can pass.
\How do NSAIDs work? - ANS-Block the COX enzyme, which inhibits the production of
prostaglandins
\How do NSAIDs work? - ANS-Block the COX enzyme, which inhibits the production of
prostaglandins
\How do we diagnose and treat hydrocele? - ANS-Transillumination, light will shine throughout
the scotrum which reveals that fluid is present and not a solid mass
Treat: Typically will resolve on its own, conservative management required for most patients
\How do we diagnose scaphoid fracture? - ANS-This fracture doesn't usually show up on X-Ray
right away, if we suspect this to happen, we are going to go ahead and treat them. It's going to
show up on X-Ray about 2 weeks after the initial injury.
\How do we screen for gestational diabetes? - ANS-One Step: 2 hour oral glucose tolerance
test, and if the result is > 200 the patient has gestational diabetes
Two Step: One hour glucose challenge, and if the pregnant fails the one hour, a 3 hour test will
be initiated
\How do we screen for gestational diabetes? - ANS-One Step: 2 hour oral glucose tolerance
test, and if the result is > 200 the patient has gestational diabetes
Two Step: One hour glucose challenge, and if the pregnant fails the one hour, a 3 hour test will
be initiated
\How do we treat a scaphoid fracture? - ANS-Thumb spica cast
\How do we treat diverticulitis? - ANS-Clear Liquid Diet, Antibiotics (Augmentin or Cipro or
Metronidazole)
, \How do we treat syphilis? - ANS-IM PCN specifically Bicillin
PCN VK
\How do you diagnose fibromyalgia? - ANS-There is no diagnostic test currently
Diagnosis is based on symptoms- must be present for at least 3 months and there can not be
an alternative explanation for the symptoms
\How do you diagnose fibromyalgia? - ANS-There is no diagnostic test currently
Diagnosis is based on symptoms- must be present for at least 3 months and there can not be
an alternative explanation for the symptoms
\How do you perform Finkelstein test? - ANS-The examiner is going to grab the thumb and
perform ulnar deviation, positive test if pain occurs
\How do you perform Lachman test? - ANS-Patient should be supine
Put one hand on lower thigh and one on lower leg
Bend the knee to a 20 degree angle
Pull the lower leg forward while keeping the thigh stable
Assess for whether the knee has too much ROM
\How does an abdominal aortic aneurysm usually present? - ANS-Pulsating mass in the
abdomen
\How does breast cancer present? - ANS-Fixed, non movable lump in breast/axilla, painless,
dimpling, red or flaky nipples, discharge
\How does Compazine work? - ANS-Blocking the dopamine receptors inside your brain. These
dopamine receptors are what lead to the patient feeling nauseous.
\How does docusate sodium work? - ANS-Helps prevent and treat constipation by allowing fecal
masses to be penetrated by fluid in the intestines. This process allows for those stools to
ultimately become softer and therefore easier to pass by the patient. Prevents the patient from
straining.
\How does gabapentin work? - ANS-Works in the brain by altering electrical activity and working
on neurotransmitters
\How does Lactulose work? - ANS-In the colon, Lactulose is broken down into parts that help
shift water from the body and into the colon, which then makes your patient have a bowel
movement.
\How does Metformin impact weight? - ANS-Metformin is weight NEUTRAL, some patient even
will have weight loss with this drug
\How does NSAIDs effect gastric acid? - ANS-NSAIDs increase the production of gastric acid.
\How does NSAIDs effect gastric acid? - ANS-NSAIDs increase the production of gastric acid.
\How does NSAIDs effect platelets? - ANS-NSAIDs decrease activity of your body's platelets,
patients will be more prone to bleeding
\How does NSAIDs effect platelets? - ANS-NSAIDs decrease activity of your body's platelets,
patients will be more prone to bleeding
\How does NSAIDs impact sodium and fluid? - ANS-NSAIDs cause sodium and fluid retention
which is why they are C/I in HF patients
\How does NSAIDs impact sodium and fluid? - ANS-NSAIDs cause sodium and fluid retention
which is why they are C/I in HF patients
\How does Phenergan work? - ANS-Blocks histamine in patient's brain, which allows the brain
to relax.
