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A pregnant woman comes in with a soft 2/6 ejection systolic murmur. When should you be concerned? -
Correct Answers-This is normal along with an S3. Do not be concerned unless symptoms of HF
develop. Diastolic murmurs and S4 are abnormal however.
actinic keratosis - Correct Answers-a precancerous skin growth that occurs on sun-damaged skin.
Rough, flesh colored, pink. Treatment is liquid nitrogen.
basal cell carcinoma - Correct Answers-Most common and least severe type of skin cancer; often
characterized by light or pearly nodules. Slow growing (1-2 cm after years). Punch biopsy and surgical
excision.
Black cohosh use and warning - Correct Answers-Menopausal discomfort
INCREASED RISK OF BLEEDING
Large amounts may cause seizures, visual changes and bradycardia
can LABA be used as monotherapy in persistent asthma - Correct Answers-No!
Cancer with highest mortality in both men and women? - Correct Answers-Lung
Cluster headaches - Correct Answers-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
Cranial nerve I - Correct Answers-Olfactory (smell)
Cranial nerve II - Correct Answers-Optic - vision
Cranial nerve III - Correct Answers-Oculomotor - eye movement and pupillary cOnstriction
Cranial nerve IV - Correct Answers-Trochlear - down and inward eye movement
Cranial nerve IX - Correct Answers-Glossopharyngeal - taste & senses, swallowing, gag reflex
Cranial nerve V - Correct Answers-Trigeminal - chewing
face & mouth touch & pain
,Cranial nerve VI - Correct Answers-Abducens - lateral eye movement
Cranial Nerve VII - Correct Answers-Facial - controls most facial expressions & secretion of tears &
saliva & taste
Cranial nerve VIII - Correct Answers-Vestibulocochlear or acoustic
Heating and balance
Cranial nerve X - Correct Answers-Vagus - senses aortic blood pressure & slows heart rate &
stimulates digestive organs & taste
Cranial nerve XI - Correct Answers-Spinal Accessory - controls trapezius & sternocleidomastoid
Cranial nerve XII - Correct Answers-Hypoglossal - moves the tongue
Describe fluid resuscitation in burns - Correct Answers-- Fluid resuscitation begins at the time of the
burn injury.
- Use the parkland formula: 4 mL/kg * TBSA in the first 24 hours
- half of all fluids should be given in the first 8 hours
Describe the WHO's ladder for pain management - Correct Answers-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
Does osteoarthritis have morning stiffness? - Correct Answers-Yes but less than 30 minutes
How did the inpatient NP develop? - Correct Answers-As a result of managed care, hospital
restructuring and decreases in medical residency programs
How do defamation, libel and slander differ? - Correct Answers-Defamation - the act of making a
damaging, false statement about a person to someone else as if the statement is fact
Slander - spoken
Libel - written or printed
How do you calculate anion gap? - Correct Answers-Na - (Cl + HCO3)
How do you calculate MAP? - Correct Answers-(SBP + 2DBP)/3 or [(1/3 of SBP) + (2/3 of DBP)]
How do you confirm lung cancer? - Correct Answers-Biopsy
How do you confirm rhabdo? - Correct Answers-Urinalysis
How do you diagnose and treat pheochromocytoma? - Correct Answers-Check plasma free
metanephrines
CT of adrenals to confirm tumor
,Surgical removal of tumor
May use phentolamine preoperatively
How do you diagnose COPD? - Correct Answers-Diagnosis REQUIRES spirometry confirmation of
airflow limitation.
FEV1/FVC ratio < 0.70 post bronchodilator
How do you diagnosis a left bundle branch block on an ECG? - Correct Answers-Widened QRS.
THEN LOOK AT V1: it QRS deflecting downward, then this is left.
If QRS is upward, then this is right
How do you diagnosis diverticulitis? - Correct Answers-CT scan
How do you differentiate the leukemia's? - Correct Answers-CLL - often found incidentally with
smudge cells on a blood smear
AML - bone marrow failure: bleeding, fatigue infection
ALL: pancytopenia, blasts in smear
CML: Philadelphia chromosome
How do you distinguish between DKA and HHNK in terms of presentation? - Correct Answers-Both:
polyuria, weakness, changes in LOC, dehydration, hypotension, tachycardia
DKA: N/V, diffuse abd pain, fruity breath, ketones in urine, glucose > 300
HHNK: coma (usually has longer onset), no ketones, glucose > 600
How do you distinguish cardiac tamponade vs. constructive pericarditis - Correct Answers-Cardiac
tamponade: pulsus paradoxus (a decrease of BP or an increase in systemic venous return with inspiration),
hypotension, JVD, muffled heart sounds
Constrictive pericarditis: JVD, pericardial knock, Kussmaul's sign: the lack of an inspiratory decline or
increase in CVP)
How do you evaluate cytology only in a tumor - Correct Answers-Fine needle biopsy
How do you grade murmurs? - Correct Answers-1: barely audible
2: faint
3: moderate, easily heard
4: loud with a THRILL
5: very loud heard with stethoscope off the wall
6: loudest
How do you manage migraines? - Correct Answers-- 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
How do you remember respiratory vs. metabolic in acid/base imbalances? - Correct Answers-ROME:
respiratory opposite, metabolic equal
How do you remember valvular disease? - Correct Answers-MS ARD
MR ASS
How do you tell gastric ulcer from duodenal? - Correct Answers-Gastric is not relieved by food
Most common with chronic NSAID use
Epigastric pain 1-3 hours after eating
How do you test for multiple myeloma? - Correct Answers-Serum and urine assessment for
monoclonal protein
How does capsaicin work? - Correct Answers-Depolarization of depleted sensory neurons
How does the PCWP usually relate to the PA pressure? - Correct Answers-The PCWP is usually lower
than the diastolic number of the PA pressure
How is H. pylori diagnosed? - Correct Answers-Biopsy, serological testing for H. pylori antibody, or
urea breath test
How is licensure and certification different? - Correct Answers-Certification is granted by
nongovernmental agencies once mastery of specialized knowledge is demonstrated. Licensure is by the
state when a person is qualified.
How long should someone be on anticoagulation prior and post cardio version for afib? - Correct
Answers-3 weeks prior. 4 weeks post.
How often should you get a physical exam? - Correct Answers-Once from 11-14, 15-17, 18-21
Every 5-6 years from ages 20-59
Every 2 years from age 60+
How should patients take iron supplements? - Correct Answers-With orange juice (not with
calcium!!!)
If a patient has the "worst headache of my life" that comes on suddenly, what is the differential and plan -
Correct Answers-Subarachnoid hemorrhage
CT
Lumbar puncture if CT is negative
Update Questions with Verified Answers
Graded Perfect Score Download to Get
Perfect Score
A pregnant woman comes in with a soft 2/6 ejection systolic murmur. When should you be concerned? -
Correct Answers-This is normal along with an S3. Do not be concerned unless symptoms of HF
develop. Diastolic murmurs and S4 are abnormal however.
actinic keratosis - Correct Answers-a precancerous skin growth that occurs on sun-damaged skin.
Rough, flesh colored, pink. Treatment is liquid nitrogen.
basal cell carcinoma - Correct Answers-Most common and least severe type of skin cancer; often
characterized by light or pearly nodules. Slow growing (1-2 cm after years). Punch biopsy and surgical
excision.
Black cohosh use and warning - Correct Answers-Menopausal discomfort
INCREASED RISK OF BLEEDING
Large amounts may cause seizures, visual changes and bradycardia
can LABA be used as monotherapy in persistent asthma - Correct Answers-No!
Cancer with highest mortality in both men and women? - Correct Answers-Lung
Cluster headaches - Correct Answers-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
Cranial nerve I - Correct Answers-Olfactory (smell)
Cranial nerve II - Correct Answers-Optic - vision
Cranial nerve III - Correct Answers-Oculomotor - eye movement and pupillary cOnstriction
Cranial nerve IV - Correct Answers-Trochlear - down and inward eye movement
Cranial nerve IX - Correct Answers-Glossopharyngeal - taste & senses, swallowing, gag reflex
Cranial nerve V - Correct Answers-Trigeminal - chewing
face & mouth touch & pain
,Cranial nerve VI - Correct Answers-Abducens - lateral eye movement
Cranial Nerve VII - Correct Answers-Facial - controls most facial expressions & secretion of tears &
saliva & taste
Cranial nerve VIII - Correct Answers-Vestibulocochlear or acoustic
Heating and balance
Cranial nerve X - Correct Answers-Vagus - senses aortic blood pressure & slows heart rate &
stimulates digestive organs & taste
Cranial nerve XI - Correct Answers-Spinal Accessory - controls trapezius & sternocleidomastoid
Cranial nerve XII - Correct Answers-Hypoglossal - moves the tongue
Describe fluid resuscitation in burns - Correct Answers-- Fluid resuscitation begins at the time of the
burn injury.
- Use the parkland formula: 4 mL/kg * TBSA in the first 24 hours
- half of all fluids should be given in the first 8 hours
Describe the WHO's ladder for pain management - Correct Answers-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
Does osteoarthritis have morning stiffness? - Correct Answers-Yes but less than 30 minutes
How did the inpatient NP develop? - Correct Answers-As a result of managed care, hospital
restructuring and decreases in medical residency programs
How do defamation, libel and slander differ? - Correct Answers-Defamation - the act of making a
damaging, false statement about a person to someone else as if the statement is fact
Slander - spoken
Libel - written or printed
How do you calculate anion gap? - Correct Answers-Na - (Cl + HCO3)
How do you calculate MAP? - Correct Answers-(SBP + 2DBP)/3 or [(1/3 of SBP) + (2/3 of DBP)]
How do you confirm lung cancer? - Correct Answers-Biopsy
How do you confirm rhabdo? - Correct Answers-Urinalysis
How do you diagnose and treat pheochromocytoma? - Correct Answers-Check plasma free
metanephrines
CT of adrenals to confirm tumor
,Surgical removal of tumor
May use phentolamine preoperatively
How do you diagnose COPD? - Correct Answers-Diagnosis REQUIRES spirometry confirmation of
airflow limitation.
FEV1/FVC ratio < 0.70 post bronchodilator
How do you diagnosis a left bundle branch block on an ECG? - Correct Answers-Widened QRS.
THEN LOOK AT V1: it QRS deflecting downward, then this is left.
If QRS is upward, then this is right
How do you diagnosis diverticulitis? - Correct Answers-CT scan
How do you differentiate the leukemia's? - Correct Answers-CLL - often found incidentally with
smudge cells on a blood smear
AML - bone marrow failure: bleeding, fatigue infection
ALL: pancytopenia, blasts in smear
CML: Philadelphia chromosome
How do you distinguish between DKA and HHNK in terms of presentation? - Correct Answers-Both:
polyuria, weakness, changes in LOC, dehydration, hypotension, tachycardia
DKA: N/V, diffuse abd pain, fruity breath, ketones in urine, glucose > 300
HHNK: coma (usually has longer onset), no ketones, glucose > 600
How do you distinguish cardiac tamponade vs. constructive pericarditis - Correct Answers-Cardiac
tamponade: pulsus paradoxus (a decrease of BP or an increase in systemic venous return with inspiration),
hypotension, JVD, muffled heart sounds
Constrictive pericarditis: JVD, pericardial knock, Kussmaul's sign: the lack of an inspiratory decline or
increase in CVP)
How do you evaluate cytology only in a tumor - Correct Answers-Fine needle biopsy
How do you grade murmurs? - Correct Answers-1: barely audible
2: faint
3: moderate, easily heard
4: loud with a THRILL
5: very loud heard with stethoscope off the wall
6: loudest
How do you manage migraines? - Correct Answers-- 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
How do you remember respiratory vs. metabolic in acid/base imbalances? - Correct Answers-ROME:
respiratory opposite, metabolic equal
How do you remember valvular disease? - Correct Answers-MS ARD
MR ASS
How do you tell gastric ulcer from duodenal? - Correct Answers-Gastric is not relieved by food
Most common with chronic NSAID use
Epigastric pain 1-3 hours after eating
How do you test for multiple myeloma? - Correct Answers-Serum and urine assessment for
monoclonal protein
How does capsaicin work? - Correct Answers-Depolarization of depleted sensory neurons
How does the PCWP usually relate to the PA pressure? - Correct Answers-The PCWP is usually lower
than the diastolic number of the PA pressure
How is H. pylori diagnosed? - Correct Answers-Biopsy, serological testing for H. pylori antibody, or
urea breath test
How is licensure and certification different? - Correct Answers-Certification is granted by
nongovernmental agencies once mastery of specialized knowledge is demonstrated. Licensure is by the
state when a person is qualified.
How long should someone be on anticoagulation prior and post cardio version for afib? - Correct
Answers-3 weeks prior. 4 weeks post.
How often should you get a physical exam? - Correct Answers-Once from 11-14, 15-17, 18-21
Every 5-6 years from ages 20-59
Every 2 years from age 60+
How should patients take iron supplements? - Correct Answers-With orange juice (not with
calcium!!!)
If a patient has the "worst headache of my life" that comes on suddenly, what is the differential and plan -
Correct Answers-Subarachnoid hemorrhage
CT
Lumbar puncture if CT is negative
