ANCC Exam PRACTICE
Types of Prevention
Primary Prevention: Aims to prevent the health problem from occurring in the first place. This
is often the most cost-effective form of healthcare.
o Examples:
Car restraints
Bicycle helmets
Immunizations
Ensuring adequate illumination at home to prevent falls
Secondary Prevention: Focuses on detecting disease in its early, asymptomatic stages.
o Involves screenings to identify asymptomatic disease through testing.
o Example: A highly abnormal mammogram requires further investigation and is not a
definitive diagnosis.
Tertiary Prevention: Centers on managing established disease to minimize negative outcomes.
It can be seen as a consequence when primary prevention has not been fully effective.
o Examples:
Medications
Lifestyle management
Rehabilitation (rehab)
Physical Therapy (PT)
Occupational Therapy (OT)
Vaccinations: Key Considerations
Influenza Vaccine
Contraindications: Generally not recommended for infants younger than 6 months.
o Specifically, a 4-month-old born at 32 weeks gestation should not receive the flu vaccine.
Recommendations:
o 6 months and older: Can receive the influenza vaccine.
o Pregnancy/Lactation: Safe to administer during both.
o Children: Require two doses administered 4 weeks apart.
MMR Vaccine (Measles, Mumps, Rubella)
Contraindications:
, .
o Pregnancy: Absolutely contraindicated (along with varicella, zoster, smallpox, flu mist,
rotavirus vaccines).
o Lactation is safe.
Important Notes:
o It is a live but weakened vaccine.
o A second dose is recommended for individuals born after 1957.
o Infants aged 6-11 months traveling outside the US should receive a dose.
o A mild, innocent flat pink rash may occur post-vaccination.
o Dosage Schedule: Two doses are typically given:
First dose: 12-15 months
Second dose: 4-6 years
Tetanus Vaccine
Transmission: Can be contracted from soil. The depth of the wound is a significant factor.
Pregnancy: Pregnant individuals should receive a Tdap vaccine during their third trimester to
provide passive immunity to the unborn child against pertussis.
Pertussis Prevention: Family members should be up-to-date on their pertussis vaccination to
protect newborns (pertussis can lead to lockjaw).
Vaccine Types and Schedules:
o Tdap: One dose between 11-64 years, followed by a booster every 10 years.
o DTaP: A series of five doses typically given in childhood.
Pertussis (Whooping Cough):
o Symptoms: Uncontrollable cough, vomiting, fatigue.
o Diagnosis: Nasopharyngeal culture and PCR testing.
o Treatment: Azithromycin.
Screening Guidelines
Pap Smear
No Routine Screening: Recommended prior to age 21 or in elderly individuals who meet
specific low-risk criteria.
Medication Considerations
Benadryl (Diphenhydramine)
Older Adults: Use with caution due to anticholinergic effects.
o Can cross the blood-brain barrier (BBB), leading to sedation.
, o May cause urinary retention, which is particularly problematic for individuals with
Benign Prostatic Hyperplasia (BPH).
Viral Infections
Herpes Zoster (Shingles)
A reactivation of the varicella-zoster virus (chickenpox).
Zoster Vaccine: A stronger vaccine specifically for shingles.
Post-Herpetic Neuralgia: Persistent nerve pain that can last for more than one month after the
shingles rash resolves.
Herpes Keratitis: Damage to the corneal epithelium caused by the herpes virus (commonly
shingles).
o Symptoms: Acute onset of eye pain, photophobia, and blurred vision in the affected eye.
Ophthalmological Conditions
Primary Open Angle Glaucoma
Characterized by peripheral vision loss, elevated intraocular pressure, and deep-cupping of
the optic disc.
Treatment: Medications such as:
o Beta-adrenergic antagonists (Timolol)
o Alpha agonists
o Prostaglandin analogues
Screening Test: Tonometry measures intraocular pressure.
Normative Aging (Eyesight)
A common physiological change is the need for increased illumination for tasks.
Macular Degeneration
Leads to central vision loss.
A major cause of new-onset blindness in the elderly.
More prevalent in females.
Screening Test: Amsler grid test.
, .
Inner Ear Disorders
Meniere's Disease vs. Meniere's Syndrome
Symptoms: Dizziness, tinnitus, nystagmus, vertigo.
Risk Factors: Ototoxic drugs.
Treatment:
o Benzodiazepines: For rest and acute management.
o Corticosteroids: For anti-inflammatory effects.
Distinction:
o Meniere's disease: Idiopathic (unknown cause).
o Meniere's syndrome: Secondary to a known underlying condition.
Oral Health
Oral Cancer
Typically presents as an ulcerated lesion with indurated margins.
The most common type is Squamous Cell Carcinoma (SCC).
Risk Factors: HPV 16.
Screening: Often detected during dental visits.
Pharmacology: Allergic Reactions
Beta-Lactam Antibiotics
Include penicillins, cephalosporins, and carbapenems.
Rashes are a common allergic reaction, particularly associated with Epstein-Barr virus (EBV)
infection when taking certain beta-lactams.
Ear Infections
Otitis Externa (Swimmer's Ear)
Commonly caused by fungus (Candida or Aspergillus) or Pseudomonas aeruginosa.
Hallmark Sign: Pain on palpating the tragus (the small flap of cartilage in front of the ear
canal).
Treatment: Fluoroquinolone ear drops.
Types of Prevention
Primary Prevention: Aims to prevent the health problem from occurring in the first place. This
is often the most cost-effective form of healthcare.
o Examples:
Car restraints
Bicycle helmets
Immunizations
Ensuring adequate illumination at home to prevent falls
Secondary Prevention: Focuses on detecting disease in its early, asymptomatic stages.
o Involves screenings to identify asymptomatic disease through testing.
o Example: A highly abnormal mammogram requires further investigation and is not a
definitive diagnosis.
Tertiary Prevention: Centers on managing established disease to minimize negative outcomes.
It can be seen as a consequence when primary prevention has not been fully effective.
o Examples:
Medications
Lifestyle management
Rehabilitation (rehab)
Physical Therapy (PT)
Occupational Therapy (OT)
Vaccinations: Key Considerations
Influenza Vaccine
Contraindications: Generally not recommended for infants younger than 6 months.
o Specifically, a 4-month-old born at 32 weeks gestation should not receive the flu vaccine.
Recommendations:
o 6 months and older: Can receive the influenza vaccine.
o Pregnancy/Lactation: Safe to administer during both.
o Children: Require two doses administered 4 weeks apart.
MMR Vaccine (Measles, Mumps, Rubella)
Contraindications:
, .
o Pregnancy: Absolutely contraindicated (along with varicella, zoster, smallpox, flu mist,
rotavirus vaccines).
o Lactation is safe.
Important Notes:
o It is a live but weakened vaccine.
o A second dose is recommended for individuals born after 1957.
o Infants aged 6-11 months traveling outside the US should receive a dose.
o A mild, innocent flat pink rash may occur post-vaccination.
o Dosage Schedule: Two doses are typically given:
First dose: 12-15 months
Second dose: 4-6 years
Tetanus Vaccine
Transmission: Can be contracted from soil. The depth of the wound is a significant factor.
Pregnancy: Pregnant individuals should receive a Tdap vaccine during their third trimester to
provide passive immunity to the unborn child against pertussis.
Pertussis Prevention: Family members should be up-to-date on their pertussis vaccination to
protect newborns (pertussis can lead to lockjaw).
Vaccine Types and Schedules:
o Tdap: One dose between 11-64 years, followed by a booster every 10 years.
o DTaP: A series of five doses typically given in childhood.
Pertussis (Whooping Cough):
o Symptoms: Uncontrollable cough, vomiting, fatigue.
o Diagnosis: Nasopharyngeal culture and PCR testing.
o Treatment: Azithromycin.
Screening Guidelines
Pap Smear
No Routine Screening: Recommended prior to age 21 or in elderly individuals who meet
specific low-risk criteria.
Medication Considerations
Benadryl (Diphenhydramine)
Older Adults: Use with caution due to anticholinergic effects.
o Can cross the blood-brain barrier (BBB), leading to sedation.
, o May cause urinary retention, which is particularly problematic for individuals with
Benign Prostatic Hyperplasia (BPH).
Viral Infections
Herpes Zoster (Shingles)
A reactivation of the varicella-zoster virus (chickenpox).
Zoster Vaccine: A stronger vaccine specifically for shingles.
Post-Herpetic Neuralgia: Persistent nerve pain that can last for more than one month after the
shingles rash resolves.
Herpes Keratitis: Damage to the corneal epithelium caused by the herpes virus (commonly
shingles).
o Symptoms: Acute onset of eye pain, photophobia, and blurred vision in the affected eye.
Ophthalmological Conditions
Primary Open Angle Glaucoma
Characterized by peripheral vision loss, elevated intraocular pressure, and deep-cupping of
the optic disc.
Treatment: Medications such as:
o Beta-adrenergic antagonists (Timolol)
o Alpha agonists
o Prostaglandin analogues
Screening Test: Tonometry measures intraocular pressure.
Normative Aging (Eyesight)
A common physiological change is the need for increased illumination for tasks.
Macular Degeneration
Leads to central vision loss.
A major cause of new-onset blindness in the elderly.
More prevalent in females.
Screening Test: Amsler grid test.
, .
Inner Ear Disorders
Meniere's Disease vs. Meniere's Syndrome
Symptoms: Dizziness, tinnitus, nystagmus, vertigo.
Risk Factors: Ototoxic drugs.
Treatment:
o Benzodiazepines: For rest and acute management.
o Corticosteroids: For anti-inflammatory effects.
Distinction:
o Meniere's disease: Idiopathic (unknown cause).
o Meniere's syndrome: Secondary to a known underlying condition.
Oral Health
Oral Cancer
Typically presents as an ulcerated lesion with indurated margins.
The most common type is Squamous Cell Carcinoma (SCC).
Risk Factors: HPV 16.
Screening: Often detected during dental visits.
Pharmacology: Allergic Reactions
Beta-Lactam Antibiotics
Include penicillins, cephalosporins, and carbapenems.
Rashes are a common allergic reaction, particularly associated with Epstein-Barr virus (EBV)
infection when taking certain beta-lactams.
Ear Infections
Otitis Externa (Swimmer's Ear)
Commonly caused by fungus (Candida or Aspergillus) or Pseudomonas aeruginosa.
Hallmark Sign: Pain on palpating the tragus (the small flap of cartilage in front of the ear
canal).
Treatment: Fluoroquinolone ear drops.
