AGPCNP Board Review Questions and answers, 100% proven pass rate.

AGPCNP Board Review Questions and answers, 100% proven pass rate. Lesions often begin as small, firm, dome-shaped growths on genitals or other parts of the body (armpits, neck, face, hands); have a surface that feels smooth, waxy, or pearly; are flesh-colored or pink; have a dimple in the center (may be filled with a thick, white substance that is cheesy or waxy); and are painless but itch. Scratching or picking can spread the virus. - Molluscum contagiosum Thayer-Martin Selective Agar is an enriched medium for the selective isolation of - Neisseria species. N. gonorrhoeae Trauma to Kiesselbach's plexus will result in an - anterior nosebleed The diagnostic or gold-standard test for sickle cell anemia - glucose- 6-phosphate dehydrogenase (G6PD) anemia the test is positive in De Quervain's tenosynovitis - Finkelstein's test—positive in De Quervain's tenosynovitis Anterior drawer maneuver and Lachman maneuvers are positive when: - anterior cruciate ligament (ACL) of the knee is damaged positive in meniscus injuries of the knee - McMurray's sign neovascularization, cotton wool spots, and microaneurysms are suggestive off - diabetic retinopathy atrioventricular [AV] nicking, silver and/or copper wire arterioles on fundal exam are suggestive of - hypertensive retinopathy A S4 heart sound is auscultated in an elderly patients, suggesting: - S4 heart sounds absent other symptoms in the elderly are often a benign finding For pain relief during pregnancy use: - For pain relief, pick acetaminophen (Tylenol) instead of NSAIDs such as ibuprofen (Advil) or naproxen (Aleve, Anaprox) which hand should the ophthalmoscope be held in to examine a patient's eye - should be held in the same hand as the eye being examined the cut to disc ratio of a normal fundal exam should not exceed - 1:2, e.g. the cup should not be more than half the size of the disc diameter if the provider is having trouble visualizing the macula on fundoscopic exam, the patient should be asked to look: - directly into the light of the ophthalmoscope clinical term used to described patient who have trouble seeing items that are far away (nearsightedness) - myopia clinical term for farsightedness - hyperopia difficulty in maintaining a clear focus at a new distance due to lessening of flexibility of the crystalline lens and weakening of ciliary muscles - common after 40 years - presbyopia raised, wedge-shaped growth of noncancerous tissue over the conjunctiva exacerbated by sun, wind and dust - pterygium acute inflammatory process affecting the eyelid usually caused by staphylococcus aureus - hordeolum (stye) hordeolum (stye) is most commonly caused by what organism - staphylococcus aureus hordeolum is commonly managed with: - 1. warm compresses 2. topical bacitracin or erythromycin ointment 3. refer to an ophthalmologist if not resolved in ~ 2 days beady nodule on the eye lid that is usually painless apart from the tenderness caused by swelling - chalazion seborrheic dermatitis of the LID EDGE, often presents with red, scaly, greasy flakes - blepharitis tends to be the most irritating clinical symptoms of blepharitis - itching TX for blepharitis - 1. hot compress 2. topical abx: bacitracin or erythromycin 3. Vigorously scrub lashes and lid margins with eyes closed and follow with thorough rinsing organism most commonly responsible for blepharitis - staphylococcus most common inflammatory eye disorder with itching, burning, increases tearing, blurred vision (possible), sensation of foreign body in the eye which may be caused by allergies, chemical irritation, bacterial, viral or gonococcal/chlamydial infection - conjunctivitis (pink-eye) results from an increased intraocular pressure - glaucoma acute increase in IOP, opthalmic emergency - closed-angle glaucoma a patient who presents with extreme eye pain, blurred vision, pupils that are dilated or fixed and HALOS AROUND LIGHTS should be: - referred to opthlamology for emergent suspicion of closed-angel glaucoma screening for glaucoma should begin at age - 40 results from clouding and opacification of the normally clear lens of the eye - cataracts highest cause of treatable blindness is: - cataracts most common surgical procedure in patients 65+ - cataract surgery a patient presents with painless, clouded or dim vision with halos around lights, no red reflex and DIPLOPIA IN A SINGLE EYE would be suspected of - cataract floaters in the eye is the most concerning symptom for: - retinal detachment the most important diagnostic indicator in the evaluation of headache is: - chronology patient describes a "vise-like", generalized headache that is more intense about his neck and back of head. The most probable diagnosis is: - tension headache duration of tension headaches are usually: - no more than a few hours management of tension headache include: - OTC analgesics and relaxation the pathophysiology of most migraines is: - a result of dilation and excessive pulsation of the external carotid artery migraine's typically last: - at least 2 but no more than 72 hours migraines without aura are classified as: - common migraine migraines with aura are classified as: - classic migraine migraine headaches, which affect females males can commonly be triggered by this inciting event in women: - hormonal changes seen with onset of the menstrual cycle patient reports a unilateral throbbing headache that occurs episodically. she states reports "seeing stars" and some weakness. she has no history of migraines. the appropriate first step is: - all patients with new migraines must be worked up to R/O organic causes of disease. the provider should order: CBC CMP VDRL ESR CT scan the priority management of chronic migraine includes: - 1. avoidance of triggers 2. relaxation / stress avoidance 3. prophylactic daily therapy if attacks occur more than 2-3 times per month if amitriptyline (Elavil) is being used for migraine prophylaxis, the provider knows to monitor for: - prolongation of the QT interval which is a BLACK BOX warning on all tricyclics abortive therapy for migraines include: - sumatriptan 6mg sub-q, repeated every other to max of 3 doses OR sumatriptan 25 mg PO an onset a patient presents with unilateral periorbital pain with no prior history of migraine. the most likely diagnosis is: - cluster headache abortive therapy for cluster headache - usually includes sumatriptan and 100% O2 for which two headache types is sumitriptan indicated: - cluster and migraine patient presents with hx of diagnosed parkinson's and onset of tremors that had previously been controlled. which medication should the NP add: - an anticholinergic to help alleviate the tremor, e.g. trihexyphenidyl (Artane) on physical exam a patient who has a positive glabellar reflex when repetitively tapped over the bridge of the nose is illiciting what sign? name the sign and the commonly associated clinical condition - myerson's sign (blinks in response to tap on the nose) which is suggestive of parkinsons the classic triad of parkinson's is represented by what clinical symptoms: - tremor rigidity bradykinesia contraction of the facial muscles when the facial nerve (VII) is tapped briskly in front of the ear is termed: what does the condition result from - chvostek's sign usually resulting from low calcium the group with the highest prevalence of cluster headaches are: - middle-aged men name the two most common types of dementia in order of prevalence: - Alzheimer's disease Vascular Dementia first line agents for migraine prophylaxis include: - propranolol (Inderal) amitriptyline (Elavil) sodium valproate topiramate the gag reflex is a function of which cranial nerve - X - the vagus nerve. the gag reflex evaluates nasopharyngeal sensation acute onset of headaches behind one eye with eye pain, autonomic s/sx with hazy cornea or partial dilation of the affected pupil: - acute/narrow angle-close glaucoma requiring referral to ED a patient who demonstrates resistance to a flex hip (or back pain) that is attempted to be straightened while keeping the hip flexed shows: - positive kernig's sign indicative of inflammation on lumbar nerve roots which may indicate menigeal irritation patient reflexes the hips and knee to relieve pressure when the provider flexes the patients head toward the chest - positive brudzinski's sign indicative of menigeal irritation two physical exam tests for meningeal irritation are: - kernig's sign and brudzinski's sign a patient has been diagnosed with chronic migraine and is being started on sumitriptan for abortive therapy. Counseling should include: - R/O hx of cardiovascular disease, HPTN, CVA, TIA - warn patients that flushing, tingling, chest/neck/sinus/jaw discomfort can occur SUPERVISE 1st dose if patient has any risk factor for cardiovascular disease, diabetics, obesity, males40 etc. as there is increased risk of MI Name the V cranial nerves and its major divisions: - the trigeminal nerve has three branches: - ophthalmic - maxillary - mandibular shock like facial pain, lasting from seconds to minutes per episode that follows a branch of CN V is most likely: - trigeminal neuralgia (Tic Douloureux) patient responds that it feels like pins and needles sensation when the provider tap on the anterior wrist briskly. What test has been performed and what does the finding indicate - tinel's sign indicative of carpel tunnel T=Tinel=Tingling patient reports tingling sensation when asked to place her wrists together in full flexion. What test has been performed and what does the finding indicate: - Phalen's Sign indicative of carpel tunnel