NRNP 6550 Midterm | UPDATED Questions with 100% Verified
Answers
Walden University • NRNP 6550
Q1: Vaccinations and immunosuppression. 2 keypoints
A: - give inactive agents instead of live agents - might not work as effectively
Q2: live virus vaccine types
A: Virus: - measles - mumps - polio (oral) - rubella - varicella - yellow fever - herpes zoster Bacteria: - typhoid
Q3: inactive vaccine virus
A: Virus: - Hep A and B - HPV - influenza - polio (subq) - rabies Bacteria: - anthrax - cholera - diphteria - Lyme -
meningococcus - pertussis - plague - pneumococcus - tetanus
Q4: Immunization recommendation influenza
A: all ages, all types (pregnant, diabetes, immunocompromised, etc)
Q5: Immunization recommendation pregnancy and weakened immune system
A: - 1 dose Tdap - no varicella, zoster, MMR
Q6: HIV and vaccinations
A: Give inactive agents when CD4 count is greater than 200 cells/ mm3
Q7: health screening 18 - 45 years
A: - BMI - BP (q2years) - at age 20: fasting lipid profile: total cholesterol, LDL, HDL, triglycerides (cardiac testing if LDL
greater than 200 or HDL lower than 40) - annual breast exam, females - Pap-smear annually
Q8: health screening 45 and up
A: - blood glucose q3years - 50 and up: colorectal screening (digital exam annually, sigmoidscopy q5years, colonoscopy
q10yrs) - PSA with digital exam annually for males - mammography q1 -2 yrs - women 65 and up: screen for
osteoporosis
,Q9: top 5 leading causes of death
A: 1. heart disease 2. cancer 3. respiratory disease 4. stroke 5. accidents
Q10: Conjunctivitis; definition
A: -Pink eyey - Inflammation of conjuctiva (outer layer of eye)
Q11: Conjunctivitis: causes
A: Chemical, bacterial, viral, allergic, herpetic. Adenovirus is the most common cause, but bacteria (Haemophilus
influenzae and Streptococcus pneumoniae) are also common causes in children.
Q12: Conjunctivitis: findings
A: - redness - itching - discharge - edema eyelid - may find gonorrhea or chlamydia in eye discharge
Q13: Conjunctivitis: management
A: - cooling - rule out corneal abrasion - bacteria: antibiotic solution (gentamicin, neomycin) - chlamydia: oral tetracycline
or erythromycin - gonorrhea: single dose ceftriaxone - herpes: refer to opthalmologist
Q14: Corneal abrasion: definition, cause, findings, treatment
A: - disruption of cornea (clear covering of eye) - foreign body/ trauma - pain, redness, photophobia, decreased visual
acuity - ab ointment: gentamicin, sulfacetamide, eye-patch, ophthalmologist
Q15: diabetic retinopathy: definition, cause, findings, treatment
A: - ocular retinal disease due to DM - DM, exac by smoking and HTN (macular edema) - flashing lights in vision,
blurred vision, black spots, loss of vision, sustained glucose greater than 130 - Laser therapy for macular edema,
smoking cessation, glucose control, BP control
Q16: retinal detachment: definition, cause, findings, treatment
A: - separation of retina and choroid - trauma, intraocular mass, iris inflammation, cataract surgery, DM, sickle cell -
painless vision changes, blurred vision, light flashes, "curtain" over visual field, bullous elevation without tears -
ophthalmologist for cryotherapy, laser therapy, vitrectomy. If from trauma: eye patch
Q17: Central & Branch Retinal Artery Occlusion: definition, cause, findings, treatment
A: - abrupt blockage of retinal artery causing sudden vision loss> will become permanent without intervention -
thrombosis/ embolism, arteritis (migraine, older age, afib, DM, HTN, coagulopathies) - sudden, painless vision loss,
sluggish pupil, cherry-red spot at fovea - EMERGENCY. Put pressure on eyelid, heparin, immediate consult
opthalmolohgist. check coagulopathies, check labs for artherosclerotic disease, blood cultures (endocarditis?),
, Q18: Glaucoma: definition, cause, findings, treatment
A: - progressive visual loss, first peripherally then centrally: chronic open angle or actute closed angle. Optic
neuropathy. - open: too much intraocular fluid production without removal. Secondary from trauma, tumor, or
cataracts. Causes: age, steroids, trauma, family history - Photophobia, visual blurring, unilateral headache. Increased
intraocular pressure.Acute closed: eye pain and visual disturbance with N/V. - Acute: Emergency. immediate
medication and surgery. Chronic: consult opthalmologist and monitor. Bimatropost, and beta-blockers. Laser-therapy
Q19: Bell's Palsy: definition, cause, findings, treatment
A: - sudden self-limited unilateral facial paralysis - Idiopathic. Cranial nerve VII (7), sometimes viral cause (herpes),
HTN, DM, Lyme's - Unilateral paralysis of face (can't close eye, upper and lower face involved), herpetic lesions,
taste disturbances - artificial tears, steroids (to treat CN 7 inflammation), antivirals
Q20: otitis externa: definition, cause, findings, treatment
A: - inflammation of the outer ear (swimmers ear) - water, fungi, bacterial, trauma, viral - pain with fullnes of ear, itching,
edema, otorrhea - suction of debris, ab and steroid solution in ear, oral ab's (based on bld culture)
Q21: otitis media: definition, cause, findings, treatment
A: - inflammation of middle ear - congestion in eustachian tube, respiratory bacteria, neoplasm - pain, hearing loss,
vertigo, nausea, pulsatile otorrhea, red and bulging tympanic membrane, hole in tympanic membrane with rupture -
ab's (amoxi - 10 days), analgesic for pain, ENT for recurrent
Q22: vertigo: definition, cause, findings, treatment
A: - dizziness - vestibular neuronitis, meniere disease, damage to CN 8 (meningitis, trauma), damage to brain stem
nuclei, syphilis, drugs, dm, TIA/ CVA - dizziness, tinitis, N/V, "full" ear, Romberg sign (sways/ falls with eyes closed) -
TSH (to rule out hypothyroidism), CT/ MRI, glucose, treat symptoms/ bedrest, vestibular suppressants (meclizine,
diazepam, scopalamine), antiemetics. low salt and diuretic with meniere
Q23: epistaxis: definition, cause, findings, treatment
A: - nosebleed - forceful expiration, winter, trauma, sinusitis, HTN, coagulopathies - bleeding from nose - head erect and
elevated, cotton ball with Afrin, topical lidocaine, nasal packing
Q24: sinusitis: definition, cause, findings, treatment
A: - inflammation of the sinuses - upper respiratory infections, neoplasms - pain, headache, congestion - ab's (amoxi,
doxycycl), analgesics
Q25: pharyngitis: definition, cause, findings, treatment
A: - inflammation of pharynx, often with tonsillitis - viral (influenza A & B, Adeno) (most common), bacterial
(streptococcus), fungal - pain, fever. Viral: ulcers in oral cavity, edema of lymphoid tissue. Bacterial: white/ yellow
exudate, swollen tonsils, bright red mucosa, high fever. Fungal: white spots - rapid strep test, throat culture, mono
spot, chlamydia testing, pain relief. Strep: AB's (Bicillin, Cephalxein, azithromycin. Candida/ fungal: Nystatin,
fluconazole
Answers
Walden University • NRNP 6550
Q1: Vaccinations and immunosuppression. 2 keypoints
A: - give inactive agents instead of live agents - might not work as effectively
Q2: live virus vaccine types
A: Virus: - measles - mumps - polio (oral) - rubella - varicella - yellow fever - herpes zoster Bacteria: - typhoid
Q3: inactive vaccine virus
A: Virus: - Hep A and B - HPV - influenza - polio (subq) - rabies Bacteria: - anthrax - cholera - diphteria - Lyme -
meningococcus - pertussis - plague - pneumococcus - tetanus
Q4: Immunization recommendation influenza
A: all ages, all types (pregnant, diabetes, immunocompromised, etc)
Q5: Immunization recommendation pregnancy and weakened immune system
A: - 1 dose Tdap - no varicella, zoster, MMR
Q6: HIV and vaccinations
A: Give inactive agents when CD4 count is greater than 200 cells/ mm3
Q7: health screening 18 - 45 years
A: - BMI - BP (q2years) - at age 20: fasting lipid profile: total cholesterol, LDL, HDL, triglycerides (cardiac testing if LDL
greater than 200 or HDL lower than 40) - annual breast exam, females - Pap-smear annually
Q8: health screening 45 and up
A: - blood glucose q3years - 50 and up: colorectal screening (digital exam annually, sigmoidscopy q5years, colonoscopy
q10yrs) - PSA with digital exam annually for males - mammography q1 -2 yrs - women 65 and up: screen for
osteoporosis
,Q9: top 5 leading causes of death
A: 1. heart disease 2. cancer 3. respiratory disease 4. stroke 5. accidents
Q10: Conjunctivitis; definition
A: -Pink eyey - Inflammation of conjuctiva (outer layer of eye)
Q11: Conjunctivitis: causes
A: Chemical, bacterial, viral, allergic, herpetic. Adenovirus is the most common cause, but bacteria (Haemophilus
influenzae and Streptococcus pneumoniae) are also common causes in children.
Q12: Conjunctivitis: findings
A: - redness - itching - discharge - edema eyelid - may find gonorrhea or chlamydia in eye discharge
Q13: Conjunctivitis: management
A: - cooling - rule out corneal abrasion - bacteria: antibiotic solution (gentamicin, neomycin) - chlamydia: oral tetracycline
or erythromycin - gonorrhea: single dose ceftriaxone - herpes: refer to opthalmologist
Q14: Corneal abrasion: definition, cause, findings, treatment
A: - disruption of cornea (clear covering of eye) - foreign body/ trauma - pain, redness, photophobia, decreased visual
acuity - ab ointment: gentamicin, sulfacetamide, eye-patch, ophthalmologist
Q15: diabetic retinopathy: definition, cause, findings, treatment
A: - ocular retinal disease due to DM - DM, exac by smoking and HTN (macular edema) - flashing lights in vision,
blurred vision, black spots, loss of vision, sustained glucose greater than 130 - Laser therapy for macular edema,
smoking cessation, glucose control, BP control
Q16: retinal detachment: definition, cause, findings, treatment
A: - separation of retina and choroid - trauma, intraocular mass, iris inflammation, cataract surgery, DM, sickle cell -
painless vision changes, blurred vision, light flashes, "curtain" over visual field, bullous elevation without tears -
ophthalmologist for cryotherapy, laser therapy, vitrectomy. If from trauma: eye patch
Q17: Central & Branch Retinal Artery Occlusion: definition, cause, findings, treatment
A: - abrupt blockage of retinal artery causing sudden vision loss> will become permanent without intervention -
thrombosis/ embolism, arteritis (migraine, older age, afib, DM, HTN, coagulopathies) - sudden, painless vision loss,
sluggish pupil, cherry-red spot at fovea - EMERGENCY. Put pressure on eyelid, heparin, immediate consult
opthalmolohgist. check coagulopathies, check labs for artherosclerotic disease, blood cultures (endocarditis?),
, Q18: Glaucoma: definition, cause, findings, treatment
A: - progressive visual loss, first peripherally then centrally: chronic open angle or actute closed angle. Optic
neuropathy. - open: too much intraocular fluid production without removal. Secondary from trauma, tumor, or
cataracts. Causes: age, steroids, trauma, family history - Photophobia, visual blurring, unilateral headache. Increased
intraocular pressure.Acute closed: eye pain and visual disturbance with N/V. - Acute: Emergency. immediate
medication and surgery. Chronic: consult opthalmologist and monitor. Bimatropost, and beta-blockers. Laser-therapy
Q19: Bell's Palsy: definition, cause, findings, treatment
A: - sudden self-limited unilateral facial paralysis - Idiopathic. Cranial nerve VII (7), sometimes viral cause (herpes),
HTN, DM, Lyme's - Unilateral paralysis of face (can't close eye, upper and lower face involved), herpetic lesions,
taste disturbances - artificial tears, steroids (to treat CN 7 inflammation), antivirals
Q20: otitis externa: definition, cause, findings, treatment
A: - inflammation of the outer ear (swimmers ear) - water, fungi, bacterial, trauma, viral - pain with fullnes of ear, itching,
edema, otorrhea - suction of debris, ab and steroid solution in ear, oral ab's (based on bld culture)
Q21: otitis media: definition, cause, findings, treatment
A: - inflammation of middle ear - congestion in eustachian tube, respiratory bacteria, neoplasm - pain, hearing loss,
vertigo, nausea, pulsatile otorrhea, red and bulging tympanic membrane, hole in tympanic membrane with rupture -
ab's (amoxi - 10 days), analgesic for pain, ENT for recurrent
Q22: vertigo: definition, cause, findings, treatment
A: - dizziness - vestibular neuronitis, meniere disease, damage to CN 8 (meningitis, trauma), damage to brain stem
nuclei, syphilis, drugs, dm, TIA/ CVA - dizziness, tinitis, N/V, "full" ear, Romberg sign (sways/ falls with eyes closed) -
TSH (to rule out hypothyroidism), CT/ MRI, glucose, treat symptoms/ bedrest, vestibular suppressants (meclizine,
diazepam, scopalamine), antiemetics. low salt and diuretic with meniere
Q23: epistaxis: definition, cause, findings, treatment
A: - nosebleed - forceful expiration, winter, trauma, sinusitis, HTN, coagulopathies - bleeding from nose - head erect and
elevated, cotton ball with Afrin, topical lidocaine, nasal packing
Q24: sinusitis: definition, cause, findings, treatment
A: - inflammation of the sinuses - upper respiratory infections, neoplasms - pain, headache, congestion - ab's (amoxi,
doxycycl), analgesics
Q25: pharyngitis: definition, cause, findings, treatment
A: - inflammation of pharynx, often with tonsillitis - viral (influenza A & B, Adeno) (most common), bacterial
(streptococcus), fungal - pain, fever. Viral: ulcers in oral cavity, edema of lymphoid tissue. Bacterial: white/ yellow
exudate, swollen tonsils, bright red mucosa, high fever. Fungal: white spots - rapid strep test, throat culture, mono
spot, chlamydia testing, pain relief. Strep: AB's (Bicillin, Cephalxein, azithromycin. Candida/ fungal: Nystatin,
fluconazole
