NSGl 554/l NSG554l Examl 1l –l (NEWl
2026/l 2027l Update)l Nursel Practitionersl
inl Primaryl Carel Il Guide|l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
Lymel diseasel causel andl transmission
Answer:
Transmittedl primarilyl byl ixodidl ticksl (deerl ticksl orl black-leggedl ticks)
-bacterial borrelial spirochetes
QUESTION
Lymel diseasel earlyl symptoms
Answer:
-erythemal multiformel (bullseye)l rash
l -round.l flatl orl raised.l expandsl overl daysl orl weeks,l mayl bel clearl inl center.
-fever
-fatigue
-headache
-myalgias
-arthralgias
-regionall lymphadenopathy
-followingl tickl bitel 3-30l days
QUESTION
Lymel diseasel earlyl disseminatedl symptoms
,Answer:
-carditisl (chestl pain,l palpitations,l lightl headaches,l fainting,l SOB)l PEl showsl bradycardia,l
irregularl pulse,l frictionl rub
-faciall palsiesl orl otherl craniall neuropathies
-jointl pain
QUESTION
Lymel diseasel latel symptoms
Answer:
-monthsl afterl exposure
-severel headachesl andl neckl stiffness,l confusion,l faciall palsyl
-recurrentl synovitis,l tendonitis,l bursitis
-peripherall nervel -l radiculoneuropathy,l n/t,l shootingl pain,l weaknessl inl armsl orl legs
-MSl likel symptoms,l stroke-likel symptoms
QUESTION
Lymel diseasel latel disseminatedl symptoms
Answer:
-monoarthritis
-iritis
-conjunctivitis
-migratoryl musculoskeletall pain
QUESTION
Lymel diseasel diagnosticl testing
Answer:
tickl bitel highl riskl onlyl ifl confirmedl ixodesl sppl tick,l endemicl area,l >36l hrl attached
-ifl typicall EMl lesion,l livel orl traveledl inl endemicl areal -l canl dxl withoutl labl testing
-Standardl two-tierl testing
1-enzymel immunoassayl (mayl bel negativel inl firstl 6l weeks)
2-westernl blot
,QUESTION
Lymel diseasel treatmentl forl earlyl dz
Answer:
-doxycyclinel 100mgl POl BIDl 10-14l daysl (notl forl childrenl <8l orl pregnantl women)
OR
-amoxicillinl 500mgl POl TIDl 14l daysl (pedsl dosel 50mg/kg/day)
OR
-cefuroximel axetill 500mgl POl BIDl 14l days
Alternative:
-azithromycinl 500mgl dailyl 7-10l days
ORl
-clarithromycinl 500mgl BIDl 14-21l days
QUESTION
Lymel dzl txl speciall considerations
Answer:
-faciall palsyl addl coricosteroids
-otherl complicationsl usel longerl coursel ofl abx
QUESTION
Lymel diseasel preventionl education
Answer:
-Inl endemicl areas,l usel repellentsl thatl containl 20-30%l DEET.l
-Bathel ASAPl afterl comingl indoorsl withinl 2l hours.l -Performl regularl tickl checks.
QUESTION
Lymel diseasel post-exposurel prophylaxis
Answer:
prophylacticl forl high-rickl tickl bitesl withinl 72l hours,l notl forl low-risk
, -doxycyclinel 200mgl POl forl adults
-doxycyclinel 4.4mg/kgl upl tol 200mgl forl children
QUESTION
Lymel diseasel longl terml effectsl andl follow-upl care
Answer:
-dol notl retestl bcl antibodiesl remainl elevated
-symptomsl mayl takel weeksl tol resolve
-neurologicl symptomsl arisel inl aboutl 15%l ofl untreatedl lymel dzl pts
-postl treatmentl lymel diseasel syndromel mayl occurl inl 10-20%l -l pain,l fatigue,l jointl pain,l
difficultyl thinkingl >6l monthsl -l nol tx
-lymel carditisl >40%l syncopall presentation
QUESTION
Rockyl Mountainl Spottedl Feverl generall H&Pl findings
Answer:
Considerl inl acutel febrilel illnessl andl rash,l particularlyl withl tickl exposure,l outdoorl
activitiesl orl travelsl tol endemicl area,l duringl latel springl orl summerl months
-tickl bitel goesl unnoticedl inl 30-50%l ofl cases,l lackl ofl hxl shouldl notl excludel dx
-presentsl likel virall illnessl inl firstl 1l tol 4l daysl withl suddenl onsetl ofl feverl >102,l severel
frontall HA,l malaise,l myalgia,l anorexia,l n/v,l abdominall pain,l photophobia
-rashl presentsl 2-4l daysl afterl fever,l asl smalll blanching,l pinkl maculesl onl wristl andl
anklesl beforel spreadingl tol thel trunkl wherel rashl mayl becomel maculopapularl inl
appearance
-involvementl ofl palmsl andl solesl usul byl 5thl tol 6thl day,l alongl withl generalizedl
petechiall rash,l al signl ofl advancedl dz
-rashl generallyl sparesl thel facel andl isl notl pruritic
-otherl symptoms:l confunctivall injection,l mentall statusl impairments,l restlessness,l
arthralgia,l peripherall orl periorbitall edema,l calfl pain,l hearingl loss
QUESTION
Malarial symptoms
2026/l 2027l Update)l Nursel Practitionersl
inl Primaryl Carel Il Guide|l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
Lymel diseasel causel andl transmission
Answer:
Transmittedl primarilyl byl ixodidl ticksl (deerl ticksl orl black-leggedl ticks)
-bacterial borrelial spirochetes
QUESTION
Lymel diseasel earlyl symptoms
Answer:
-erythemal multiformel (bullseye)l rash
l -round.l flatl orl raised.l expandsl overl daysl orl weeks,l mayl bel clearl inl center.
-fever
-fatigue
-headache
-myalgias
-arthralgias
-regionall lymphadenopathy
-followingl tickl bitel 3-30l days
QUESTION
Lymel diseasel earlyl disseminatedl symptoms
,Answer:
-carditisl (chestl pain,l palpitations,l lightl headaches,l fainting,l SOB)l PEl showsl bradycardia,l
irregularl pulse,l frictionl rub
-faciall palsiesl orl otherl craniall neuropathies
-jointl pain
QUESTION
Lymel diseasel latel symptoms
Answer:
-monthsl afterl exposure
-severel headachesl andl neckl stiffness,l confusion,l faciall palsyl
-recurrentl synovitis,l tendonitis,l bursitis
-peripherall nervel -l radiculoneuropathy,l n/t,l shootingl pain,l weaknessl inl armsl orl legs
-MSl likel symptoms,l stroke-likel symptoms
QUESTION
Lymel diseasel latel disseminatedl symptoms
Answer:
-monoarthritis
-iritis
-conjunctivitis
-migratoryl musculoskeletall pain
QUESTION
Lymel diseasel diagnosticl testing
Answer:
tickl bitel highl riskl onlyl ifl confirmedl ixodesl sppl tick,l endemicl area,l >36l hrl attached
-ifl typicall EMl lesion,l livel orl traveledl inl endemicl areal -l canl dxl withoutl labl testing
-Standardl two-tierl testing
1-enzymel immunoassayl (mayl bel negativel inl firstl 6l weeks)
2-westernl blot
,QUESTION
Lymel diseasel treatmentl forl earlyl dz
Answer:
-doxycyclinel 100mgl POl BIDl 10-14l daysl (notl forl childrenl <8l orl pregnantl women)
OR
-amoxicillinl 500mgl POl TIDl 14l daysl (pedsl dosel 50mg/kg/day)
OR
-cefuroximel axetill 500mgl POl BIDl 14l days
Alternative:
-azithromycinl 500mgl dailyl 7-10l days
ORl
-clarithromycinl 500mgl BIDl 14-21l days
QUESTION
Lymel dzl txl speciall considerations
Answer:
-faciall palsyl addl coricosteroids
-otherl complicationsl usel longerl coursel ofl abx
QUESTION
Lymel diseasel preventionl education
Answer:
-Inl endemicl areas,l usel repellentsl thatl containl 20-30%l DEET.l
-Bathel ASAPl afterl comingl indoorsl withinl 2l hours.l -Performl regularl tickl checks.
QUESTION
Lymel diseasel post-exposurel prophylaxis
Answer:
prophylacticl forl high-rickl tickl bitesl withinl 72l hours,l notl forl low-risk
, -doxycyclinel 200mgl POl forl adults
-doxycyclinel 4.4mg/kgl upl tol 200mgl forl children
QUESTION
Lymel diseasel longl terml effectsl andl follow-upl care
Answer:
-dol notl retestl bcl antibodiesl remainl elevated
-symptomsl mayl takel weeksl tol resolve
-neurologicl symptomsl arisel inl aboutl 15%l ofl untreatedl lymel dzl pts
-postl treatmentl lymel diseasel syndromel mayl occurl inl 10-20%l -l pain,l fatigue,l jointl pain,l
difficultyl thinkingl >6l monthsl -l nol tx
-lymel carditisl >40%l syncopall presentation
QUESTION
Rockyl Mountainl Spottedl Feverl generall H&Pl findings
Answer:
Considerl inl acutel febrilel illnessl andl rash,l particularlyl withl tickl exposure,l outdoorl
activitiesl orl travelsl tol endemicl area,l duringl latel springl orl summerl months
-tickl bitel goesl unnoticedl inl 30-50%l ofl cases,l lackl ofl hxl shouldl notl excludel dx
-presentsl likel virall illnessl inl firstl 1l tol 4l daysl withl suddenl onsetl ofl feverl >102,l severel
frontall HA,l malaise,l myalgia,l anorexia,l n/v,l abdominall pain,l photophobia
-rashl presentsl 2-4l daysl afterl fever,l asl smalll blanching,l pinkl maculesl onl wristl andl
anklesl beforel spreadingl tol thel trunkl wherel rashl mayl becomel maculopapularl inl
appearance
-involvementl ofl palmsl andl solesl usul byl 5thl tol 6thl day,l alongl withl generalizedl
petechiall rash,l al signl ofl advancedl dz
-rashl generallyl sparesl thel facel andl isl notl pruritic
-otherl symptoms:l confunctivall injection,l mentall statusl impairments,l restlessness,l
arthralgia,l peripherall orl periorbitall edema,l calfl pain,l hearingl loss
QUESTION
Malarial symptoms
