ANCC AGACNP Certification Questions and Answers 2023

ANCC AGACNP Certification Questions and Answers 2023 When should adults get the PNA vaccine? Age 19-64: smoker, asthma, COPD, DM, ETOH, is immunocompromised or living in facility Age 65+: PPSV23 AND PCV13 How often should you get a physical exam? Once from 11-14, 15-17, 18-21 Every 5-6 years from ages 20-59 Every 2 years from age 60+ When should you check lipid panel? Starting at age 20 and every 5 years unless 200 mg/dL When should mammography and prostate screening begin? Mammography: starting between 40-50 and continue as long as she has 10+ more years Prostate: At 40 if family hx of AA. At 50 for everyone else When should you have baseline ECG in place? Age 40 When should colorectal screening start? Age 50. Annual FOBT with flex sig q 5 years and colonoscopy q 10 years When should glaucoma testing start? Age 40 and yearly When should herpes zoster be given? Age 50-60 When can Pap smear be discontinued? Age 65-70 with three consecutive normal tests and no abnormal tests in last 10 years Top 4 killers in the US of everyone Heart disease, colorectal cancer, Lowe respiratory disease (COPD, asthma, flu, PNA), CVA stroke Cancer with highest mortality in both men and women? Lung What is the most common cancer in women in the US? Breast What is the most common cancer in men in the US? Prostate Who should get hep A vaccine? Military, travelers, men who have sex with men Who should have hep B vaccine? Healthcare workers and high risk patients What is ginger used for and what should you watch for? Nausea, dyspepsia, constipation, colic INCREASED RISK OF BLEEDING What is ginseng used for and what should you watch for? Increase overall well-being, Lower cholesterol, reduce fatigue, enhance libido INCREASED RISK OF BLEEDING, mania with MAOIs, May inhibit opioids What is St. John's wort used for and what should you watch for? Depression, anxiety, sleep disorders, BPH INCREASED RISK OF CLOTTING, many drug interactions, may increase efficacy of opioids What is echinacea used for and what should you watch for? Common cold Anaphylaxis, hepatotoxicity, nephrotoxicity, increased sedation during anesthesia What is gingko Biloba used for and what should you watch for? Memory and concentration, claudication and glaucoma INCREASED RISK OF BLEEDING, increased blood pressure Black cohosh use and warning Menopausal discomfort INCREASED RISK OF BLEEDING Large amounts may cause seizures, visual changes and bradycardia What is evening primrose used for and what should you watch for? Menopausal discomfort May elevate blood glucose May increase the risk of seizures What is kava kava used for and what should you watch for? Improve relaxation without messing with clarity High doses can lead to HTN, liver damage, visual impairment and dry skin Do not use with ETOH May worsen Parkinson's What is garlic used for and what should you watch for? Indigestion, respiratory complaints, increase energy INCREASED RISK OF BLEEDING What are the two titles of HIPAA? Title 1: projects health insurance coverage for workers and their families when they lose their job (Cobra) Title 2: requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans and employers Who is required to follow HIPAA? Health care providers, clearinghouses, and health plans What are the two goals of healthy people 2020? 1) Increase the quality and years of healthy life 2) Eliminate health disparities among Americans What diagnoses must NPs report to the Department of Health? Gonorrhea Chlamydia Syphilis HIV TB Animal bites to animal control What is covered in Medicare A? Hospital, SNF, home care services and hospice What is covered by Medicare B? Known as supplemental medical insurance, pays for physicians visits, outpatient services, lab and diagnostics, medical equipment and flu shots Medicare pays 80% and patient pays 20% What is Medicare C? Medicare Advantage - combines A B into one plan What is Medicare D? Limited prescription drug coverage Monthly premium required, only available if you have part A What do the State Practice Acts do? - authorize boards of nursing in each to establish authority for licensure - define scope of practice and prescriptive authority How is licensure and certification different? Certification is granted by nongovernmental agencies once mastery of specialized knowledge is demonstrated. Licensure is by the state when a person is qualified. What are the components of decisional capacity? The ability to understand, reason, differentiate good and bad, and communicate Who was the first NP in the US? Loretta Ford, who worked with Dr. Henry Silver at the University of Colorado and began the NP in pediatrics in 1964 due to physician shortages How did the inpatient NP develop? As a result of managed care, hospital restructuring and decreases in medical residency programs Roles of NP Clinicians, consultants, educators, and researchers What makes an experiment study? Randomization and control group What is deductive reasoning? Vs. inductive Deductive reasoning uses general premises to make specific predictions Inductive is the process of developing a generalization after specific information has been studied What are the USPSTF recommendation grades? A recommended with high evidence of benefit, B recommended with moderate net benefit, C recommended in select individuals with small benefits, D not recommended due to harm, I insufficient evidence What does a sensitive test mean? - identifies those who have the disease (true positives) - it will have minimal false negatives - it helps rule out disease What does a test with high specificity mean? - identifies the true negatives - has minimal false positives - rules in the positive disease What is Nightingale's theory of nursing Based on creating a restorative environment Fresh air, light, nutrition, cleanliness, warmth What is Fay Abdullah's theory of nursing? Care for the whole person including physical, spiritual and social What is Orem's theory of nursing? Focused on professional and technological operations. The nurse diagnoses and plans the care and then manages it. What is Roger's theory of nursing? Individual is seen as an energy field existing within the universe What is Leininger's theory of nursing? Culture care Describe the WHO's ladder for pain management Step 1: aspirin, apap, or NSAID +|- adjuvants Step 1: maintain step 2 and add low opioid (codeine, hydrocodone, oxy, tramadol) Step 3: add stronger opioids What is a fever? What numbers should you watch for? - elevated body temperature above normal (37 Celsius) - 101.5 F = 38.3 C Tension headaches Most common type in adults. Mechanism is uncertain but though to be related to muscle contraction. Produces generalized bilateral pain that is described as frontotemporal band like discomfort. Pain is described as mild to moderate, non-throbbing pain, tightness, or pressure with a gradual onset that may last hours. It is associated with hunger, depression or stress. Treatment is over the counter analgesics and relaxation. Migraine headache description Unilateral, lateralized throbbing headache that occurs episodically; May be dull or throbbing. Builds up gradually and may last for several hours or longer Types of migraines classical (with aura) and common (without aura) How do you manage migraines? - avoid triggers - relaxation and stress management - prophylactic daily meds can be considered if attacks occur more than 3-4 times a month - for acute attach, rest in quiet dark room and take sumatriptan Cluster headaches Mostly affecting middle aged men May be precipitated by ETOH Severe, unilateral, periorbital pain occurring daily for several weeks Usually last less than 2 hours What is critical thinking in nursing practice? Patient driven, purposeful, outcome-focused thought based on both knowledge and experience What drug is used as PEP for anthrax? Doxycycline What are the symptoms and treatment of organophosphate poisoning? Symptoms: AMS, diaphoresis, lacrimation, miosis, urination, defecation, bradycardia and diffuse wheezing Treatment: atropine to block muscarinic effects, pralidoxime chloride reactivates the enzyme cholinesterase (reversing muscle paralysis and CNS depression) What do you use in cyanide poisoning? sodium nitrite What clinical features increase the likelihood of MI? Radiation of pain to both arms, a third heart sound, and hypotension What is the most likely finding in lab on a person with diarrhea Metabolic acidosis as the stool due to the loss of alkaline salts A pregnant woman comes in with a soft 2/6 ejection systolic murmur. When should you be concerned? This is normal along with an S3. Do not be concerned unless symptoms of HF develop. Diastolic murmurs and S4 are abnormal however. What should you recommend for an incidental adrenal mass? Overnight dexamethasone suppression test What symptoms and monitoring indices are consistent with cardiac tamponade? - Diastolic equalization of right atrial, pulmonary artery diastolic and PAWP - distant heart sounds, pulsus paradoxus, distended jugular veins