NURS 7330 Final Study Guide

NURS 7330 Final Study Guide 1. Who started the first NP program? Loretta Ford, PhD 2. Recommended vaccines for age 65 Shingrix, PCV13 PPSV23; flu; Td q10y with one Tdap 3. Practice guidelines are designed to: a. Be inflexible b. Be utilized in every circumstance c. Provide a reference point for decision making d. Be created by a professional organization to guide the practice of a profession 4. What is an example of a secondary level of prevention measure for an older adult patient? a. Dietary counseling b. Focus on preventing complications related to a disease process c. Assessment of vitamin D level d. Identification of smoking based on self-report from the patient 5. What are tertiary prevention activities for an older adult woman who has had a stroke? a. Annual mammogram b. Annual ophthalmic examination to evaluate for glaucoma c. Physical therapy d. Annual flu vaccine 6. A patient is continuing his recovery at home after an extensive surgery. The NP would instruct the patient to increase intake of which foods to promote healing? a. Tomatoes, rice, and whole grain cereal b. Red meat, oranges, and green beans c. Milk, poultry, and yellow vegetables d. Liver, corn, and eggs 7. Which of the following management plans demonstrates an understanding of primary prevention of falls among older adults? a. Evaluate the need for assistive devices for ambulation after the patient has been injured in a fall b. Provide resources to correct hazards that contribute to falling in the home environment c. Reinforce the need to use prescribed eyeglasses to prevent further injury resulting from falls d. Provide information about medications, side effects, and interactions 8. According to the CDC, which 2 immunizations are recommended as primary prevention for adults age 60 and above? There are 2. a. Flu b. Shingles c. Yearly tetanus prophylaxis d. Adult who has had previous allergic reaction to immunizations 9. Which of the following patient situations requires the use of inactivated (not live) vaccines? a. Immunocompromised b. History of nonspecific allergies c. Mild acute illness d. Concurrent antimicrobial therapy 10. In taking the history of a healthy 50-year-old man, the NP determines the patient is an avid gardener and spends much of his time enjoying outdoor activities. A health maintenance recommendation for this patient is to obtain a: a. Hep B vaccine b. Pneumococcal vaccine c. Tdap/Td vaccine d. Varicella vaccine 11. Which authority regulates the scope of practice of NPs? a. Federal law b. Academic institutions c. Individual state laws d. Individual practice settings 12. Which risk assessment for coronary artery disease is recommended for all female patients? a. Coronary artery calcium score b. ECG c. Exercise stress test d. Framingham risk score p. 449 Mental Health 1. Who is at highest risk for suicide? P. 1066 Unemployment, fall in economic status, medical illness, family history, previous suicide attempt, anniversary of a loss; males more likely, 65 and older; adolescents SAD (sex, age, depression) 2. What labs need to be assessed before placing a pt on lithium? Toxic due to low Na Therapeutic level 0.6-1.2 3. True/False: Benzodiazepines cause dependence 4. What is the preferred antidepressant for older adults? Celexa 5. What are the symptoms of schizophrenia? Paranoid, delusions, hallucinations 6. How do you differentiate confusion of dememtia with confusion of delirium? Time of day 7. What is the medication for OCD? SSRI (Paxil) 8. What electrolyte imbalance do you watch for in a pt on Lasix and Celexa? hyponatremia 9. Elderly pt comes in with worsening confusion. CBC shows mild anemia. What lab tests do you do next? Folic acid, B12, Ferritin 10. When do DTs typically start? What are the symptoms? 48hrs; disorientation, diaphoresis, hallucinations, tachycardia, HTN, agitation 11. Initial treatment for panic disorder? Benzo followed by SSRI or SNRI 12. Pt c/o nausea while taking fluoxetine. What do you advise? Take with food 13. Symptoms of depression p. 1049 14. Symptoms of bipolar I mania (insomnia, hyperactive, euphoria, impulsive, irritable, hypersexuality, gambling; lacks judgement Bipolar 2 hypomania 15. What is the screening for alcohol addiction? What do the letters stand for? CAGE – cut down, annoyed, guilty, eye-opener Billing/Geriatrics 1. E&M code for new pt means the pt has not been seen in how long? 3 years 2. What are the age-related changes in the elderly? p. 1272 3. When evaluating serum creatinine in the elderly adult, the clinician considers that a. The value is influenced by GFR (this is what she marked correct) b. Age-related physiological changes do not influence this lab value c. Male and female norms are equivalent d. An increase is an expected age-related change (the book also says this) 4. At which patient age should the NP recommend routine use of the pneumococcal vaccine? a. 65 and over b. 60 and over c. 55 and over d. 50 and over 5. The ACIP recommends that healthy older adults receive the Td or tetanus booster vaccine a. Every 5 years b. Every 10 years c. At age 65 d. At age 50 6. Which type of liability insurance covers only situations in which the incident occurred, and the claim was made while the policy was in effect? a. A “tail” policy b. An employment coverage policy c. Occurrence policy d. Claims made policy Male GU 1. Which results in a clinically insignificant increase in PSA? DRE 2. What test is used to confirm epididymitis? US 3. 25 yo training for a marathon. Reports acute onset of scrotal pain after a 10-mile run; nausea and found to have an asymmetric, high-riding testis on the right side. What is suspected? Testicular torsion 4. What class of medication can be used to treat BPH with immediate relief? Alpha 1 blocker