ANCC FNP BOARD QUESTIONS AND ANSWERS

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ANCC FNP BOARD QUESTIONS AND ANSWERS

Abymiddle-
agebyfemalebypatientbypresentsbytobythebyclinicbywithbyabyrecurrencebyofbymildbyhidradenitisbysuppurativabyafterbytopicalbyt
rapiesbyfailed.byWhichbyfirst-linebytreatmentbyisbyrecommended?by-byanswer--Tetracycline
Twelvebyweeksbyofbyoralbytetracyclineby(Sumycin)byisbythebyrecommendedbyfirst-
linebytreatmentbyforbyhidradenitisbysuppurativa.

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Hidradenitisbysuppurativabyisbyabydisorderbyofbythebyterminalbyfollicularbyepitheliumbyinbyapocrinebygland-
bearingbyskin.byItbyisbyabychronic,bydisablingbydisorderbythatbyprogresses,byoftenbycausingbykeloids,bycontractures,byandby
mobility.byItbyisbycharacterizedbybybycomedone-
likebyfollicularbyocclusion,bychronicbyandbyrelapsingbyinflammation,bymucopurulentbydischarge,byandbyprogressivebyscar
g.
Arthropathybyassociatedbywithbyhidradenitisbymaybybebypresent.byTypicalbypresentationbyincludesbynodulesbyandbysinus
actsby(inflamedbyorbynoninflamed),byabscesses,byandbyscarringbyfoundbyinbythebyaxilla,bygenitofemoralbyarea,byperineum
glutealbyarea,byandbyinframammarybyareabyinbywomen.
Recommendedbytreatmentsbyincludebyantibiotics,bysteroids,byretinoids,bydapsone,byandbyanti-
tumorbynecrosisbyfactorbyagents.byAbydermatologybyconsultationbyshouldbyalsobybebyconsidered.
First-linebytreatmentbyisbyaby12-wee
kbycoursebyofbyanbyoralbytetracyclineby(Sumycin)bysuchbyasbydoxycycline.byForbypatientsbywhobydobynotbyrespondbytobydox
ycline,bythebynextbyrecommendedbystepbyisbyabycombinationbyofbytwice-
dailybyclindamycinby(Cleocin)byandbyrifampicinby(Rifadin)byforby10-
12byweeks.byIfbytreatmentbyfails,byacitretinby(Soriatane,byforbymalesbyandbynonfertilebyfemales)byorbydapsoneby(Aczone)bym
ybybebyconsideredbybybyabydermatologist.byInbypatientsbywithbymoderatebytobyseverebyhidradenitisbysuppurativa,byadalimu
abby(Humira)bymaybypossiblybybebyconsidered.

WhenbyprovidingbyculturallybycompetentbyhealthbycarebyservicesbytobyanbyAmericanbyIndianbyelder,bythebynursebypractitio
rbyunderstandsbywhichbyisbytraditionallybytrue?by-byanswer--
Theby"MedicinebyWheel"byisbyusedbybybymanybyforbythebypurposebyofbyhealthbyandbyhealing
Theby"MedicinebyWheel"byisbytraditionallybyusedbyandbycontainsbyfourbydirections;bynorth,bysouth,byeast,byandbywest.byTra
ionallybyeachbytribebyhasbydifferentbymeaningsbyforbyeachbydirectionbyandbytheybymaybyrepresentbythebyseasonbyofbythebyy
rbyorbystagebyofbylife.byItbyisbyaimedbyatbyprovidingbyabyholisticbyviewbyofbylife.

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Anbyunderstandingbyofbydifferentbyculturalbypreferencesbyleadsbytobyculturalbycompetencebyinbyhealthcare.bySomebypatie
sbymaybyvaluebytraditionalbyculturebyandbypreferencesbyasbyitbyrelatesbytobyhealthcare.byThesebyindividualbypreferencesby
ouldbybebyincludedbyinbythebyinterviewbyandbytreatmentbyplanbyforbypatients.
Traditionally,bythebyAmericanbyIndianbyculturebyvaluesbyabyholisticbyapproachbytobyhealthbycarebyintegratingbythebyperson
festyle,byenvironment,byfamily,byandbyreligion.byPatientsbyadheringbytobythesebytraditionalbyculturalbypracticesbyoftenbyfee
hatbyillnessbyisbyduebytobyabylackbyofbyharmonybywithbythebyphysicalbybody,bymind,byspirit,byandbyemotions.byPatientsbymayb
eekbycarebyfrombywesternbymedicinebyforbyspecificbyailmentsbywhilebyalsobyconsultingbywithbytraditionalbyhealersbyforbyspi
ualbyguidance.
Healthcarebyprovidersbyshouldbyseekbytobyunderstandbyrelevantbyculturalbyfactorsbyandbyassessbyeachbyindividual'sbyhea
hcarebyliteracybyinbyorderbytobyprovidebyculturallybycompetentbycare.
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Thebynursebypractitionerbyseesbyanbyolderbyadultbypatientbyinbythebyclinicbywithbythebyprimarybyreportbyofbyhearingbylossbyan
abysensationbyofbyfullnessbyinbythebyrightbyear.byThebynursebypractitionerbysuspectsbyconductivebyhearingbyloss.byWhichbyc
uldbycontributebytobythis?by-byanswer--
Cerumen,bycommonlybycalledbyearwax,byisbyabycombinationbyofbysecretionsbyandbysloughedbyepithelialbycellsbythatbyprot
sbythebyearsbyfrombyinfection,bywater,byandbyinsects.byItbyisbynormallybyexpelledbyfrombythebyearbycanalbythroughbynaturalby
wbymovement.byWhenbythisbyself-
cleaningbyprocessbyfails,bycerumenbycanbybecomebyimpacted.byCerumenbyimpactionbyoccludesbythebyearbycanalbyandbyc
bypressbyagainstbythebytympanicbymembrane,byresultingbyinbyconductivebyhearingbyloss.



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Conductivebyhearingbyisbythebytransitionbyofbysoundbyfrombythebyexternalbyandbymiddlebyearbytobythebyinnerbyear.byConduc
ebyhearingbylossbyisbycausedbybybyproblemsbyinbythebyexternalbyandbymiddlebyearbythatbyinterferebywithbythebytransmission
fbysoundbyandbyitsbyconversionbytobymechanicalbyvibration.byCausesbyofbyconductivebyhearingbylossbyincludebyobstruction
ofbythebyexternalbyauditorybycanalbybybycerumen,byforeignbybodies,bydebrisbyfrombyotitisbyexterna,byandbylargebyexocytosi
andbyosteomas.
Sensorineuralbyhearingbylossbyinvolvesbydifficultybyconvertingbymechanicalbyvibrationsbytobyelectricalbypotentialbyinbytheb
ochleabyorbyinbyauditorybynervebytransmissionbytobythebybrain.byItbyisbymostlybycausedbybybypermanentbydamagebyinbythebyo
ganbyofbyCorti.byItbycanbybebycausedbybybyage-
relatedbyhearingbyloss,bynoisebytrauma,bymedications,byautoimmunebydiseases,bymechanicalbytrauma,byMenierebydisea
,byinfection,byandbyneoplasmby(acousticbyneuroma).
Approximatelybyone-
thirdbyofbyolderbyadultsbybetweenbythebyagesbyofby61byandby70byyearsbyhavebyhearingbyloss.byMorebythanby90%byofbyadultsb
derbythanby85byyearsbyofbyagebyhavebyhearingbyloss.byThebymostbycommonbytypebyofbyhearingbylossbyisbyage-
relatedbyandbysensorineural.byAllbyadultsbyolderbythanby60byyearsbyofbyagebyshouldbybebyscreenedbyforbyhearingbylossbyatby
riodicbyhealthbyexaminations.

Anbyotherwisebyhealthybyadultbypatientbypresentsbytobythebyclinicbywithbyabydiagnosisbyofbycommunity-
acquiredbypneumoniabyandbynobyrecentbyantibioticbytherapy.byWhichbyisbythebybestbyoptionbyforbytreatment?by-byanswer--
Amoxicillin
High-dosebyamoxicillinby(Amoxil)byorbydoxycyclinebyarebyrecommendedbyasbyfirst-
linebytherapybyforbyadultsbywithoutbycomorbidities.

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Community-acquiredbypneumoniaby(CAP)byisbypneumoniabynotbyacquiredbyinbyabyhospitalbyorbylong-
termbycarebyfacility.byPatientsbywithbysuspectedbyCAPbyshouldbyreceivebyabychestbyX-
raybyforbydiagnosis.byThebyPneumoniabySeveritybyIndexbyshouldbybebyusedbytobyassistbyinbydecisionsbyregardingbythebyne
byforbyhospitalizationbyinbypatientsbywithbyCAP.

AccordingbytobythebyAmericanbyThoracicbySocietyby(ATS)byandbythebyInfectiousbyDiseasesbySocietybyofbyAmericaby(IDSA
2019byguidelines,bythebyinitialbytreatmentbyofbyCAPbyforbymostbypatientsbyisbyamoxicillinbyorbydoxycycline.byMacrolidesbya
yanbyoptionbyforbytreatment,bybutbyarebynobylongerbyrecommendedbyroutinelybyasbyfirst-

linebytreatment,bygivenbyincreasedbymacrolidebyresistance.byThisbyisbyabychangebyfrombytheby2007byATS/
IDSAbyguidelines.byRespiratorybyfluoroquinolonesbyandbyamoxicillin/
clavulanatebyshouldbybebyusedbyinbypatientsbywhobyfailbyfirst-
linebymedications,byhavebysignificantbycomorbidities,byhavebyhadbyrecentbyantibioticbytherapy,byarebyallergicbytobyalternat
ebyagents,byorbyhavebyabydocumentedbyinfectionbywithbyhighlybydrug-resistantbypneumococci.



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