ANCC Exam question with complete solution 2023 updated to pass

ANCC Exam question with complete solution 2023 updated to passTypes of prevention - correct answer primary- car restraints, bicycle helmets, immunizations secondary- prevent for those with RF-pap, mammo tertiary-mgmt of established disease- meds, lifestyle Primary - correct answer Preventing the health problem, most cost effective form of healthcare **IMMUNIZATIONS, ensuring adequate illumination at home (preventing falls) Secondary - correct answer Detecting disease in early asymptomatic stages, screenings -Early cause finding of asymptomatic disease via the use of a screening test Ex. highly abnormal mammo not final word Tertiary - correct answer Minimizing negative disease induced outcomes, potentially viewed as a failure of primary prevention Ex- rehab, PT, OT Who should not receive influenza vaccine - correct answer 4 mon old born at 32 weeks gestation receive flu- 6 mon and older can give during pregnancy/lactation give children 2x- 4 months apart MMR - correct answer preggers can't receive (no varicella, or zoster, smallpox, flu mist, rotavirus), but lactation OK! its live but weakened give again to those born after 1957 Give to 6-11 month who are travelling outside US May treat and have an innocent flat pink rash 2 doses ( at 12-15 mon and 4-6 years) Tetanus - correct answer can get from soil, a depth of the wound is important Preggers- get a tdap in her thirst trimester to pass onto the unborn child (pertusis is a bad outcome!), family members need to be up to date- can cause lockjaw T-dap- 1 at 11-64 and then booster every 10 dTap-five doses Pertussis- uncontrollable cough, vomitting, fatigue, dx: nasopharyngeal culture and PCR testing tx: Azithromycin No pap smear - correct answer prior to 21 or in elderly Benadryl - correct answer older, cross BBB, can cause sedation, urinary retention (bad for BPH) herpes zoster - correct answer stronger chickenpox vaccine-zoster vaccine post-herpetic neuralgia- persists after 1 month Herpes keratitis is damage to the corneal epithelium caused by the herpes virus, commonly shingles. The patient usually has acute onset of eye pain, photophobia, and blurred vision in the affected eye. primary open angle glaucoma - correct answer peripheral vision loss, elevated intraocular pressure, deep-cupping of optic disc, tx with beta-adrenergic antag (Timolol), alpha agonists, prostaglandin analogues Glaucoma screening test- Tonometry Normative aging - correct answer Need for increased illumination Macular degeneration - correct answer central vision loss, common cause of new onset blindness in elderly More females Screening tests- Amsler grid test Meniere's disease (idio) vs. Meniere's syndrome (secondary) - correct answer dizziness, tinnitius, nystagmus, vertigo RF: ototoxic drugs, tx: benzos for rest and corticosteroids for anti-inflam oral cancer - correct answer ulcerated lesion with indurated margins, most common SCC, RF: HPV 16, screening at dental visits beta lacatams with allergic reactions - correct answer penecillins, cephalosporins, carbapenems rashes with Epstein Barr Otitis externa - correct answer Caused by fungus- Candidia or Aspergillus/P. aeruginosa hallmark is pain on palpating tragus Tx--> fluoroquinolone AOM - correct answer S.penumoniae (gram pos)-40-50%, tx with amox/cephalo, macrolides, resistance protein binding sites H.influenza (gram neg)- can produce beta-lactamase M.catarrhalis (gram neg)- also produces beta-lactamase, can get better without antibiotic Need abnormal ear drum (bulging TM) + pain (otalgia)/rubbing/tugging ear tx- Acetaminophen and otic drops help with ST Watchful waiting- 6 months or older, with non-severe illness, unilateral, fever <102.2, otalgia <48 <6 months-begin antibiotic!! if allergy-Cefdinir], RF: pacifier use for 10 months, feedings in the supine, smoke exposure, day care, <2- 10 days 2-6 yrs- 7 days >6 yrs- 5 days 1st line- Amox 90 BID, Amox clav BID With PCN allergy- **Cefdinir (Cephlosporins) Group A strep (GABHS) - correct answer Streptococcus pyogenes, risk for rheumatic fever and Glomerulo., peritonsillar abscess, tx- amox then try macrolide if doesnt't improve GOLD STANDARD IS THROAT CULTURE indoor allergen - correct answer dust mites (perennial), pets, cockroaches, mold spores Acute Bacterial rhinosinusitis - correct answer S.penumoniae**, RF-viral infection, allergies, tobacco use, 1st line is Augmentin, penicillin allergy-Cefdinir 2nd line- if not better...Clindamycin and Cefixime Mono - correct answer 30-50 days ago was infected before sxs, give prednisone not amox (rash), at least 50% present with spleen enlargement, wait 1 month to go back to sports Anterior and posterior cervical lymph