ANCC Review Questions and Answers(PMHNP IQ)(Latest 2021/2022 updated questions with complete solution)

ANCC QUESTION AND ANSWERS Types of prevention primary- car restraints, bicycle helmets, immunizations secondary- prevent for those with RF-pap, mammo tertiary-mgmt of established disease- meds, lifestyle Primary Preventing the health problem, most cost effective form of healthcare **IMMUNIZATIONS, ensuring adequate illumination at home (preventing falls) Secondary 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 Minimizing negative disease induced outcomes, potentially viewed as a failure of primary prevention Ex- rehab, PT, OT Who should not receive influenza vaccine 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 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 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 prior to 21 or in elderly Benadryl older, cross BBB, can cause sedation, urinary retention (bad for BPH) herpes zoster 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 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 Need for increased illumination Macular degeneration 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) dizziness, tinnitius, nystagmus, vertigo RF: ototoxic drugs, tx: benzos for rest and corticosteroids for anti-inflam oral cancer ulcerated lesion with indurated margins, most common SCC, RF: HPV 16, screening at dental visits beta lacatams with allergic reactions penecillins, cephalosporins, carbapenems rashes with Epstein Barr Otitis externa Caused by fungus- Candidia or Aspergillus/P. aeruginosa hallmark is pain on palpating tragus Tx-- fluoroquinolone AOM 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