MARYVILLE NURS 623 EXAM 2 2024 ACTUAL EXAM
COMPLETE 137 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Lupis SLE dx criteria - ANSWER..At least 4 of the following 11 criteria (in the
absence of drugs or other disorders known to induce these effects)
-Arthritis: non-erosive, usually involving at least 2 joints
-Photosensitivity: often triggers skin rashes; exposure to the sun's UV-B rays may
also trigger SLE exacerbation
-Oral or nasal ulcers: typically painless
-Malar rash: bilateral butterfly formation across the cheeks and nasal bridge
-Discoid rash: red, raised patches
-Serositis: inflammation of the pleura or pericardia
-Renal disease: more than 0.5 g/day proteinuria, 3+ or more proteinuria, or
cellular casts
-Hematologic disorders: hemolytic anemia, leukopenia (>4000 WBC/mL),
lymphopenia (>1500 lymphocytes/mL), or low platelets
-Neurologic disease (e.g., seizures, psychoses) not otherwise explained by
iatrogenic or metabolic causes
-Positive ANA (anti-nuclear antibodies)
-Immunologic abnormalities: positive antiphospholipid antibodies, anti-double-
stranded native DNA (dsDNA), anti-Sm (Smith) antibody, or false-positive
serologic test for syphilis (VDRL, RPR)
,Classic symptoms of SLE - ANSWER..Malaise
Fever
Anorexia
Unplanned weight loss
Blurred vision and conjunctival swelling
Sleeplessness and depression may be focal complaints
Swollen and painful joints
Shortness of breath and painful inspiration
Vague abdominal pains and/or abdominal cramping
SLE skin findings - ANSWER..Characteristic malar "butterfly" rash
Alopecia and scalp exanthems
Splinter hemorrhages, periungual erythema, and lesions on the fingertips or toes
Lymphadenopathy in systemic disease
Scarring and highly inflammatory lesions - discoid lupus
Raynaud's phenomenon (in 40% of patients)
Management of SLE - ANSWER..Primary goal is symptom control
Nonpharmacologic interventions
Emotional support and referral to SLE support groups
If conservative management fails, patient may require corticosteroids,
antimalarials or cyclophosphamide (refer to rheumatologist)
Review triggering factors for acute exacerbations;
-Exposure to UVB and UVA
-Stress
-Pregnancy and post partum hormone fluctuations
-Exposure to cigarettes of silica dust (increased risk of inflammatory lung
problems)
Infectious Mononucleosis - ANSWER..EBV
Kissing disease
Usually between 10-35 y.o .age
Review subjective/objective findings: fever, sore throat, fatigue, cervical
adnopathy, headaches, nausea, anorexia splenic enlargement.
Dx:
heterophile antibody test (Monospot)
,CBC w/diff (lymphocytosis)
Tx: Symptoms
Review patient education
Lyme disease - ANSWER..Multisystem inflammatory disease
cause by Borrelia burgdorferi (tick bite)
Usually eastern US (but can be found elsewhere)
Three phases
1.Initially presentation:
Flu-like symptoms
Rash (erythema migrans) Bullseye rash
2.Late presentation:
Generalize pain
stiffness fatigue
malaise
3. Untreated: multiple joint arthritis
Lyme Disease Dx and Management - ANSWER..Based on History and Clinical
findings
Usually Doxycyline 100 mg bid initial management
(10-14 days)
Review alternatives drug management
Review Patient Education
HIV: Clinical Presentation - ANSWER..Flu-like symptoms: 6 days to 6 weeks
Darkish, purple-colored spots on the skin: indicative of Kaposi's sarcoma
Nonproductive cough, shortness of breath, and fever: present for several days to
weeks
Other constitutional symptoms: weight loss, night sweats, chronic fever, and/or
chronic diarrhea
Evaluating risk of HIV infections
HISTORY (? Frequent STDs)
, Parasitic Skin Infections - ANSWER..scabies and lice
Scabies - ANSWER..Highly contagious infestation that occurs mainly in
children, young adults, health care workers, and institutionalized persons of all
ages.
Subjective: Complaints of intense itching that is usually more severe at night.
Objective:Earliest physical sign is small 1 to 2 mm red papules located in areas
of body most attractive to mites. Itching, excoriation, , crusting, and scaling may
be present making it hard to see scabies.
Diagnostics:Ink burrow test
Scabies treatment - ANSWER..Permethrin 5% cream (Remember you have 5
fingers)- leave on for 8-14 hours then shower- daily for 7 days.
Oral antihistamines for itching, topical steroids for itching.
The entire household must be treated. Everything should be washed with hot
water/detergent, treat any infection that is present.
Starve mites by sealing them in a bag for about 10 days.
Lice treatment - ANSWER..Permethrin 1% leave on for 10 mins then rinse. May
repeat in 7 days if needed.
Fungal skin infections - ANSWER..· Candidiasis- bright, beefy red rash treat with
topical antifungal,
· Dermatophytoses - the tineas (ringworm)
· Onychomycosis treat with Terbinafine for 6-12 weeks (only 73-79% effective,
educate patient.
· Fungal infections survive on keratin, so considered superficial.
COMPLETE 137 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Lupis SLE dx criteria - ANSWER..At least 4 of the following 11 criteria (in the
absence of drugs or other disorders known to induce these effects)
-Arthritis: non-erosive, usually involving at least 2 joints
-Photosensitivity: often triggers skin rashes; exposure to the sun's UV-B rays may
also trigger SLE exacerbation
-Oral or nasal ulcers: typically painless
-Malar rash: bilateral butterfly formation across the cheeks and nasal bridge
-Discoid rash: red, raised patches
-Serositis: inflammation of the pleura or pericardia
-Renal disease: more than 0.5 g/day proteinuria, 3+ or more proteinuria, or
cellular casts
-Hematologic disorders: hemolytic anemia, leukopenia (>4000 WBC/mL),
lymphopenia (>1500 lymphocytes/mL), or low platelets
-Neurologic disease (e.g., seizures, psychoses) not otherwise explained by
iatrogenic or metabolic causes
-Positive ANA (anti-nuclear antibodies)
-Immunologic abnormalities: positive antiphospholipid antibodies, anti-double-
stranded native DNA (dsDNA), anti-Sm (Smith) antibody, or false-positive
serologic test for syphilis (VDRL, RPR)
,Classic symptoms of SLE - ANSWER..Malaise
Fever
Anorexia
Unplanned weight loss
Blurred vision and conjunctival swelling
Sleeplessness and depression may be focal complaints
Swollen and painful joints
Shortness of breath and painful inspiration
Vague abdominal pains and/or abdominal cramping
SLE skin findings - ANSWER..Characteristic malar "butterfly" rash
Alopecia and scalp exanthems
Splinter hemorrhages, periungual erythema, and lesions on the fingertips or toes
Lymphadenopathy in systemic disease
Scarring and highly inflammatory lesions - discoid lupus
Raynaud's phenomenon (in 40% of patients)
Management of SLE - ANSWER..Primary goal is symptom control
Nonpharmacologic interventions
Emotional support and referral to SLE support groups
If conservative management fails, patient may require corticosteroids,
antimalarials or cyclophosphamide (refer to rheumatologist)
Review triggering factors for acute exacerbations;
-Exposure to UVB and UVA
-Stress
-Pregnancy and post partum hormone fluctuations
-Exposure to cigarettes of silica dust (increased risk of inflammatory lung
problems)
Infectious Mononucleosis - ANSWER..EBV
Kissing disease
Usually between 10-35 y.o .age
Review subjective/objective findings: fever, sore throat, fatigue, cervical
adnopathy, headaches, nausea, anorexia splenic enlargement.
Dx:
heterophile antibody test (Monospot)
,CBC w/diff (lymphocytosis)
Tx: Symptoms
Review patient education
Lyme disease - ANSWER..Multisystem inflammatory disease
cause by Borrelia burgdorferi (tick bite)
Usually eastern US (but can be found elsewhere)
Three phases
1.Initially presentation:
Flu-like symptoms
Rash (erythema migrans) Bullseye rash
2.Late presentation:
Generalize pain
stiffness fatigue
malaise
3. Untreated: multiple joint arthritis
Lyme Disease Dx and Management - ANSWER..Based on History and Clinical
findings
Usually Doxycyline 100 mg bid initial management
(10-14 days)
Review alternatives drug management
Review Patient Education
HIV: Clinical Presentation - ANSWER..Flu-like symptoms: 6 days to 6 weeks
Darkish, purple-colored spots on the skin: indicative of Kaposi's sarcoma
Nonproductive cough, shortness of breath, and fever: present for several days to
weeks
Other constitutional symptoms: weight loss, night sweats, chronic fever, and/or
chronic diarrhea
Evaluating risk of HIV infections
HISTORY (? Frequent STDs)
, Parasitic Skin Infections - ANSWER..scabies and lice
Scabies - ANSWER..Highly contagious infestation that occurs mainly in
children, young adults, health care workers, and institutionalized persons of all
ages.
Subjective: Complaints of intense itching that is usually more severe at night.
Objective:Earliest physical sign is small 1 to 2 mm red papules located in areas
of body most attractive to mites. Itching, excoriation, , crusting, and scaling may
be present making it hard to see scabies.
Diagnostics:Ink burrow test
Scabies treatment - ANSWER..Permethrin 5% cream (Remember you have 5
fingers)- leave on for 8-14 hours then shower- daily for 7 days.
Oral antihistamines for itching, topical steroids for itching.
The entire household must be treated. Everything should be washed with hot
water/detergent, treat any infection that is present.
Starve mites by sealing them in a bag for about 10 days.
Lice treatment - ANSWER..Permethrin 1% leave on for 10 mins then rinse. May
repeat in 7 days if needed.
Fungal skin infections - ANSWER..· Candidiasis- bright, beefy red rash treat with
topical antifungal,
· Dermatophytoses - the tineas (ringworm)
· Onychomycosis treat with Terbinafine for 6-12 weeks (only 73-79% effective,
educate patient.
· Fungal infections survive on keratin, so considered superficial.
