NSG 555/ NSG555 Exam 3 V2 – Nurse Practitioners in Primary Care II Review| Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A

NSG 555/ NSG555 Exam 3 V2 – Nurse Practitioners in Primary Care II Review| Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A What is the difference between MRI and MRA? MRI = Magnetic Resonance Imaging. CANNOT give you any information on blood vessels, just structures and ventricles. MRA = Magnetic Resonance Angiography - Can look at the blood vessels .. should be ordered if there's a concern for an occlusion What is a mammography? -x-ray imaging of the breast tissue for early signs of cancer. It is the only way to detect microcalcifications What is BI-RADS? Breast Imaging Reporting and Data System -Includes breast density on every single report and summary of findings Bi-Rad System Grading 0-6 Stage 6; known malignancy/they already know they have breast cancer, they've already had a biopsy and are positive for breast cancer. The indication of the test would be to see if the patient is responding to treatment/progression to disease. Stage 5; highly suggestive of malignancy; get a follow-up biopsy Stage 4; suspicious; consider biopsy Stage 3; probably benign, short term f/u Stage 2; benign Stage 1; negative Stage 0; incomplete Other pertinent information in the Bi-RADS report -Patient information -imaging findings -universal discussion of findings/assessment so everyone can communicate to eachother (providers, radiologists, oncologists), -density of breast tissue -clinical correlations -summary of findings Importance of cervical screenings (like a papsmear) A papsmear is the brushing of the cervix that removes sell, sent off to detect cancer. -It is essential to make sure there is an adequate amount of sample to send off! (That's why we do a pap smear before the pelvic exam). Papsmear abnormalities Pap smear abnormalities refer to various types of cell changes in the cervix that may indicate the presence of HPV or precancerous conditions. examples of papsmear results are... -squamous cell abnormalities, -glandular abnormalities, -hpv, -ASC-US (atypical squamous cells of undetermined significance.. this is inconclusive and may require a coloscopy) -ASC-H (atypical squamous cells - cannot exclude high-grade / suggestive of cancer) -LSIL, (low grade squamous intraepithelial lesion) -HSL (high grade squamous intraepithelial lesion) What's your next step after an abnormal papsmear? Colposcopy What is a colposcopy? -An exam that looks at the cervix, vagina, and vulva through a magnifying device (colposcope). -Typically done if you have an abnormal pap smear (screening) or concern for HPV. It can be done at bedside. What is the Bethesda system? -The National Cancer Institute developed a standard system called the Bethesda System to classify and report cervical cytology (PAP). -it improves accuracy and consistency to guide follow up and treatment. Bethesda system findings The Bethesda system findings categorize different types of cells found in cervical samples, ranging from no abnormal cells to pre-cancerous and cancerous cells, helping to identify potential risks and guide further medical decisions. examples are... -NILM (negative for intraepithelial lesion or malignancy.. no abnormal cells are present) -ASC-US -ASC-H -LSIL -HSIL -AGC - atypical glandular cells (pre-cancerous cells) - cells that line the inside of the cervix - precancerous -AIS - adenocarcinoma in situ - abnormal glandular cells that are cancerous but not spread beyond site of origin -Invasive carcinoma - cancerous cells with invasion of surrounding tissue What is a DEXA scan? X-ray to measure bone density (risk of osteoporosis, fractures) If you are concerned about iron deficiency you need to... send off an iron panel. If you're worried about low iron levels, think of sending an iron panel as exploring a diagnosis - like investigating a crime scene to find clues about whether it's macrocytic anemia or microcytic anemia. What is included in an iron panel? -TIBC (total iron binding capacity) measures transferrin (protein that transports iron). -Transferrin saturation calculates the percentage of transferrin that is carrying iron -Iron Saturation Ferritin is NOT included in panel - this needs to be sent separately. If someone presents with vague fatigue symptoms, what labs should you consider? -evaluate for anemia -thyroid studies What is included in a CBC with differential CBC; WBC, hgb, hct, MCB, MCH, platelets. -your differential has to equal 100. If something is elevated, something else has to drop down/compensate. What can cause a left shift in our differential? Neutrophils, often referred to as "bandemia" A left shift in our differential, which refers to an increase in immature neutrophils called "bandemia," can be caused by infections or other inflammatory conditions. Interpreting antibiotic tables S: Sensitive (think of suitable), which means that the antibiotic will kill the pathogen R: resistant—will NOT kill the pathogen I: indeterminant, not the best choice What is a biophysical profile? A biophysical profile is like a comprehensive check-up for a baby before it is born, using ultrasound to assess its movement, muscle tone, breathing, and the amount of amniotic fluid. -Performed pre-delivery/antepartum What is a fetal stress test? When you're actively in labor and monitoring deceleration and contractions, making sure the baby and mom is handling the labor process well. Importance aspects of newborn metabolic screening test -heel stick -hearing screen and pulse ox (24-48 hours). Each state is different... The top 5 things found on screening are -PKU -glucose-6 phosphate dehydrogenase deficiency -congenital hypothyroidism -congenital adrenal hyperplasia -galactosemia -maple syrup urine disease, -cystic fibrosis -biotinidase deficiency. -ALL states test for PKU What is a human chorionic gonadotropin (hCG)? What are considerations of HCG? Human chorionic gonadotropin (hCG) is a hormone produced during pregnancy that helps maintain the pregnancy, and its levels can be measured to determine the health of the pregnancy or detect certain medical conditions. -Normal2 -Negative 5 -Indeterminate 5-25 -Positive 25 Any issues or complications with the pregnancy, you'll want to do a quantitative level as well. -A Positive hCG can also happen in the setting of hCG secreting tumor, gestational trophoblastic disease (GTD), nontrophoblastic neoplasm or pituitary source of hCG (cancer) What is the difference between a quantitative and qualitative HCG test? -QuaLitative HCG test is like a pregnancy test that tells you if you're pregnant or not. -QuaNtitative HCG test is like a pregnancy test that measures the level of HCG hormone in your body, allowing you to track the progress of your pregnancy and ensure there are no complications. Different ways to test for STI's (such as Chlamydia/Ghonnorhea, Trichomonas) -pelvic exam -urethral swab -urine -pharyngeal chlamydia or pharyngeal gonorrhea swab (if oral sex is indicated) -rectal swab (if anal sex is indicated) EEG -a test that measures electrical activity in the brain using electrodes attached to the scalp. -Test for subclinical seizures/indicated with epilepsy Findings of a lumbar puncture A lumbar puncture is like collecting a sample of cerebrospinal fluid (CSF) from your lower back to check for serious conditions such as.. -meningitis -Guillain-Barre syndrome -multiple sclerosis (MS) -cancer of the nervous system Symptoms that would warrant for an LP -headache -altered mental status -fever -+meningeal signs (high sensitivity and specificity for infection) -seizures -light sensitivity/double vision LP lab findings -Appearance - clear -Opening pressure - 10-20cmCSF -WBC - 0-5 cells 2PMN -Glucose - 60% of serum glucose -Protein - 45mg/dl -Culture and gram stain Carotid artery duplex US study of the carotid arteries, provides a range of occlusion not a specific number. -1-15% -16-49% -50-79% -80-99% -Complete occlusion -Asymptomatic patients with 70% stenosis would warrant some follow up. -Those with 50% and are symptomatic that warrants for a need surgical referral/evaluation CT with myelogram a special CT scan that looks at muscle function, innervation of the nerve, and disc vertebrae (like if someone comes in with back pain) -it is an option for people who can't get MRi's (like an implanted device) What does the american college of radiology recommend for a 24 year old with atraumatic back pain? No diagnostic - nothing Patient presents with AMS, what are some important tests to evaluate? -Always look for metabolic and infectious causes -BMP, CBC, urine culture and sensitivity, ammonia levels, thyroid levels, -b12 and folic acid -infections processes; syphillis or an RPR. What is a toxicology report? Toxicology is like investigating a crime scene to find evidence of drugs or medications in someone's body, just like checking for fingerprints or DNA to see if someone is telling the truth or not. Examples of things it can measure; -salicylate levels -Tylenol levels -anti-epileptic levels.. if someone comes in with seizures but claims they've been taking their meds, do a toxicology report to see if they're lying/noncompliant What is the most routine presenting symptom of herpes zoster/shingles? Pain and rash over dermatomal distribution / linear distrubition / zosterform unilateral (shouldn't cross over midline) What is a MIC (minimum inhibitory concentration)? The MIC is like the smallest amount of medicine/antibiotic needed to stop the growth and kill the bacteria.. (just like how a tiny drop of poison can take down a whole colony of ants). Differences in lumbar/cervical spine MRI vs. MRI of the brain MRI lumbar spine/cervical spine will provide detailed pictures of the bones, discs, nerves, and surrounding soft tissues in these specific areas. These details are specific to the lumbar and cervical spine regions and would not be included in an MRI focused on the brain. The brain MRI focuses on the brain's structures, including the cerebrum, cerebellum, and brainstem, and is used to evaluate conditions such as tumors, vascular abnormalities, or other neurological disorders in the brain.