ANCC exam study 2023|2024

Symptoms of irregular periods and galactorrhea (milky nipple discharge) would warrant a draw for what lab? ️️Prolactin What is transillumination used for? ️️To visualize fluid beneath the skin surface such as a hydrocele (swelling of the scrotum) This method is usually recommended in the clinical setting d/t a CT scan or ultrasound not be readily available What diagnosis are topical retinoids recommended for? ️️Acne vulgaris Topical retinoids (such as tretinoin) are the first line therapy for acne vulgaris. Recommended to be used in conjunction with Benzoyl peroxide (anti-bacterial). Azelaic acid is recommended for those if the first line therapy have not been effective What is tinea corporis and how is it treated and contracted? ️️Ringworm; antifungals; contact Which lab is low/high in hypothyroidism? ️️Low T3, Low T4 High TSH On the exam, which murmur will radiate? ️️Systolic murmurs will radiate (to the axilla w/ mitral regurgitation and to the neck w/ aortic stenosis) What treatment option is available within the first 48 hours of onset with AF ️️cardioversion What medications can reverse an anticoagulant/antiplatelet? ️️Vitamin K and/or fresh frozen plasma What are some examples of direct acting anticoagulants (DOAC) that are first line agents for non-valvular AF? What are some other anticoags that can be used as an alternative aside from DOAC's and warfarin? ️️Pradaxa, Xarelto, eliquis, savais Other anticoags that may be used are plavix and asa, alone or in combination may be better tolerated but won't be as effective as DOAC's or warfarin Pt. education on DOAC's ️️Take medication on schedule and do not skip doses. Effects only last 12 hours. Does not require INR monitoring does not have any major dietary restrictions and has fewer drug interactions. Pt. education on Warfarin ️️Consume one serving of vitamin K rich foods (greens) Normal levels of INR with AF patients and those w/ synthetic/prosthetic valves When should you hold a dose of warfarin? ️️AF INR: 2.0-3.0 Synthetic/Prosthetic INR: 2.5-3.5 Hold if INR 4.01-4.99 (<4.5) and DO NOT give Vitamin K Exam shows "Irregularly irregular rhythm with no P waves" What's the rhythm? ️️AF Exam shows "ST segment elevation in leads V2 to V4" or "tombstoning" What's the rhythm? ️️Anterior wall MI or anterior STEMI Most common type of MI Exam shows "Jagged irregular QRS" What's the rhythm? ️️V-tach Exam shows "Normal P waves but PP interval increases and decreases during inspiration and exhalation" What's the rhythm? ️️Sinus Arrhythmia What is pulsus paradoxus? ️️Defined as a fall in systolic BP of more than 10 mmHG during the inspiratory phase How long does warfarin take for a full anticoagulation effect? ️️3 days