NSG 554/ NSG554 Exam 1 V2 – Nurse Practitioners in Primary Care I Guide| Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A

NSG 554/ NSG554 Exam 1 V2 – Nurse Practitioners in Primary Care I Guide| Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A Angioedema Localized areas of painless swelling beneath the skin, often around the eyes and lips, but it can also involve other body areas as well. Often triggered by an allergic reaction Signs and Symptoms of acute bronchospasm spasmatic cough, wheezing, SOB What diabetic meds increase weight gain Insulin, Thiazolidinediones (Roseiglitizone & Pioglitazone) What med classes are associated with weight gain? Diabetic meds, antidepressants, neuoleptics, seizure meds, antihistamines, hormonal preps, and cardiac meds (BB & AARA) Three options for emergency contraception Plan B(levonorgestrel), Uliprstal acetate (Ella), IUD Causes of syncope Neurally mediated (most common), orthostatic hypotensive, Cardiac (most severe) Tests to order for cases of presyncope/syncope episodes Ct Scan/MRI, EKG, Labs: CBC, Lytes, glucose, Mg, BUN/Crt, UA, ABGs, Coag Panel, Drug screen? Symptoms of chemical exposure HTN, hemodynamic instability, resp depression, arrhythmias, conduction defects, coronary ischemia Labs to order for chemical exposure CBC w/diff, CMP, Anion gap, liver fcn, Pt/PTT, ABG inahalation, Methemoglobin for CO Serum ammonia, lead, arsenic, mercury etc. Carboxyhemoglobin or blood urine tox. Initial stabilization steps for chemical exposure ABC, orogastric lavage and/or whole bowel irrigation if ingested, removed saturated clothing and irrigate for skin exposure The most frequent cause of orthostatic hypotension in elderly Peripheral autonomic dysfunction due to reduced baroreflex sensitivity associated with aging Orthostatic hypotension associated medications and diseases diuretics, antihypertensive, alpha blockers, nitrates, CCB, opiates, and antidepressants degenerative neurological diseases and peripheral neuropathic syndromes Heat stroke is... An emergent condition when core temp 104 CNS abnormalities occur Heat exhaustion is the result of excessive sweating, sodium and water loss that can quickly progress to severe and life threatening heat stroke Complications of heat stroke include rhabdomyolysis, renal, hepatic, or cardiac failure Influenza s/s Fever, cough, sore throat, runny nose, body aches, headache, chills, fatigue Gold standard for influenza diagnosis Conventional viral culture or RT-PCT assays Treatment for Influenza incudes Antivirals (Oseltamivir / Tamiflu, Zanamivir/Relenza, Peramivir/Rapivab)started within 48 hrs Adamantane drugs(Amantadine & Rimantadine) only effective against Influenza A Antihistamines to relieve drainage (Brompheniramine (Dimetapp) Chlorpheniramine Cough suppressants (Dextromethorphan -Tussen DM or Delsym 12) Epstein-Barr Virus s/s include sore throat, fever, cervical lymphadenopathy, fatigue, atypical lymphocytosis, splenomegaly How to diagnosis EBV CBC w/ diff, heterophil antibody, throat culture IF heterophil** antibody check VCA IgG, IgM, EBC nuclear antigen, CMV, HIV, LFT Abdominal US - check for splenomegaly Differentials to consider with EBV Strep, viral pharyngitis, CMV, hep A, toxoplasmosis, HIV infection Precautions to consider with EBV may cause airway obstruction, thrombocytopenia, hemolytic anemia, liver enzyme abnormalities NO contact sports EBV often leads to - infectious mononucleosis - the likelihood is higher in adolescents then in childhood EBV-IM symptoms sore throat, fever, pharyngitis, lymphadenopathy, tonsillar enlargement, pharyngeal inflammation, transient palatal petechiae, sometimes includes rash, abdominal pain, jaundice Immediate referral to emergency department for head trauma that includes alteration in consciousness, paralysis, paresthesia, rhinorrhea, raccoon sign, Battle sign (bruising over mastoid process), otorrhea, or hemotympanum (blood in ears) This scale is used to measure severity of damage from head trauma and scores these three categories: Glasgow Coma Scale (highest score is 15) Eye Opening Best Motor Response Best Verbal Response Diagnostic studies for head trauma includes: VS., Cervical spine x-ray CT if LOC, 65, deteriorating neuro sx, GCS score 15, if on anticoagulation therapy or antiplatelets, intoxicated, behavioral change, MRI may be needed after CT, Labs: CBC, glucose, Lytes, Mag, BUN, CRT, ABGs, Urinalysis, Coag studies, possible tox screen, type and cross match Cardiac issues that requires immediate ED referral symptomatic bradycardia, Morbitz II or 3rd degree block Sx of myocardial ishemia or infarction Bradycardia / Tachycardia indications for referral syncope with suspected ventricular arrhythmia, Unstable bradycardia New onset afib, flutter, sick sinus syndrome, v tach, SVT Three mechanisms of injury from electricity 1. Direct effect of current on tissue 2. Burns from the conversion of electrical energy to heat 3. mechanical injury from muscle contraction or fall etc... Three classes of syncope causes Neurally mediated (most common) orthostatic hypotension Cardiac (most serious) Cardioversion is used in these unstable patients with tachycardia stable a fib, atrial flutter, Monomorphic v tach, This immunoglobin is responsible for allegen developlement IgE skin prick test vs scratch test vs intradernak test for allergens SPT done on back, arms with results in 15-20min Scratch test - single stylus scratch for each allergen - safer but not as sensitive as ID testing ID testing starts with 0.02 injection and increases looking for response Antidote for acetaminophen overdose N-acetylcysteine preferably within 8 hours Antidote for benzo overdose Flumazenil (Romazicon) Antidote for opioid OD Naloxone What is NP responsibility in case of sexual assault? If occurred within previous 5 days (best within 72 hours) refer to ED for best collection of evidence. Prepare the pt for the examination. Advise pt not to shower etc. If it has been longer than 5 days, STI testing, treat injuries and wounds as needed. HIV testing after a sexual assault If positive at time of incidence means infection was already exisiting. TEsting for HIV at 6 wks, 3 mnths, 6 mnths The most common cause of syncope is... vasovagal syncope *review causes of syncope pp 223 Two major categories of cardiac cause of syncope mechanically or ventricular overflow obstructive process OR arrhythmia (more common). Most common cause of syncope in patients older than 70 orthostatic hypotension Diagnostics in women of child bearing age for syncope EKG, Pulse ox, blood pressures, CBC, serum glucose, Urine hCG Causes of emerging infectious diseases Increased travel and trade, deforestation, changing ecosystem and climate, rapid adaptation of microorganisms. Causes of re-emerging infectious diseases Like dengue fever, Chikungunya, and Zika likely due to increased international travel and expanding world commerce. Special considerations for treating TB in cases with: Latent TB, HPV, STI, Hep B/C, CV disease Three modes of transmission of infection diarrhea food borne, water borne, fecal-oral (person to person) Four pathogenic mechanisms of infectious diarrhea 1. Adherence 2. Invasion 3. Enterotoxin 4. Cytotoxin What are the three categories of infectious diarrhea inflammatory, non-inflammatory, and penetrating gastrointestinal illness The most common cause of non-inflammatory diarrhea in older children and adults Norovirus The most common cause of severe diarrhea in young children Rotavirus Which parasites should be considered for diarrhea lasting more than 1 wk? Giardia and Cryptosporidium S/S of This is an inflammatory reaction. testing should involve stool culture & Shiga toxin testing - looking for ova and parasites illness is located in the colon blood and mucus (dysentery), large volume diarrhea, low abd pain, tenesmus often the culprit of travelers diarrhea • can occur during or up to 10 after travel - lasting 3-7 days •usually self limiting Treatment for diarrhea due to oral hydration o loperamide (Imodium) - 4mg at onset, and 2mg after each loose stool - up to 16mg o a 3-day course of ciprofloxacin - 500mg bid or azithromycin single dose - 1000mg obismuth subsalicylate (Pepto Bismol) has anti inflammatory effects, 2 tabs Q 30-60min can be taken, up to 8 doses S/S of C. Diff inflammatory reaction leukocytosis is suggestive of c-diff testing - stool sample for ELISA of c-diff toxin - no more than 1 sample per 24hours illness is located in the colon blood and mucus (dysentery), large volume diarrhea, low abd pain, tenesmus who should get the flu vaccine? all pts 6 months old or greater unless pt has life threatening allergy to the vaccine or one of its ingredients (eggs) Who can get the live influenza? ages 2-49 but not during pregnancy , nasal spray What is the CDC now recommending for influenza vaccination in children age 6months to 8 years? first time vaccination should include second dose at least 4 weeks later The CDC recommends HPV recommendation for.. 11-12 years ideal but as early as 9 females up to age 26 and males to age 15 2 doses unless not 5 months apart; will require 3rd dose Important vaccines for adults with respiratory issues Tdap, COVID, FLU, RSV (over 60), Zoster, Pneumonococcal pneumonis CDC recommends MMR at what age? 12- 15mnths, 2nd dose at least 28 days later but recommended age 4-6 Hep B vaccination is a 3 dose series, first and second dose 30 days apart, 3 dose 6mths later. Herpes zoster vaccine recommended for 50 Characterized by slightly itchy, flesh-colored, shiny, pearly white, or waxy dome shaped papules with central dimple. Molluscum contagiosum Immunity your body develops through antibodies Active Immunity gained through injections of dead or attenuated strains of the disease causing agents Passive What is herd immunity? the resistance of a group to infection due to immunity of a high proportion of the group Typical pneumonia accounts for 60-70% of cases and most commonly caused by streptococcus pneumonia (Gram + Bacterial pneumonia) Atypical pneumonia is not detactable on gram stain and is often caused by mycoplasma pneumonia, chlamydophila pneumonai, legionella speicies, and resp viruses Treatment for EBV rest and sx therapy OTC meds for pain/fever, increase fluid intake