ANCC Quizlet questions Flashcards
This is a severe sore throat, difficulty swallowing, trismus (lock jaw), & muffled “hot potato” voice. This abscess displaces the uvula.
Peritonsillar abscess
Yellow, triangular thickening of the conjuntiva that extends across the cornea on the nasal side.
Pterygium
A yellowish, raised growth on the conjunctiva next to the cornea?
Pinguecula
This is chronic inflammation of the meibomian gland.
Chalazion
This is an abcess of a hair follicle & sebaceous gland on the eyelid.
Hordeolum (Stye)
“HEARS” is a neumonic for 5 of 7 high risk factors for hearing loss in a premature baby.
1) Hyperbilirubinemia
2) Ear infection freqency
3) Low Apgar score
4)Exposure to Rubella
5) Seizure
Other 2 are Cytomegalovirus & toxoplasmosis
Identify A,C, D, & E
A) Hemorrhoids
C) Aneurysm
D) Cotton Wool Spots
E) Hard Exudates
What is normal intraocular pressure?
8 to 21 mm Hg
This condition is common in infants younger than 20 weeks. It responds spontaneously, refer if present after 20 weeks.
Intermittent Esotropia
This presents with high fever x 5 days, enlarged lymph nodes, conjunctivitis, dry, cracked lips, & strawberry tongue. Occurs typically in children under 5 years of age. How is it treated
Kawasaki Disease
Tx: High dose aspirin & IVIG
This is an acute infection of the pharynx, stuffy nose, rhinitis with clear mucus, & watery eyes. What 2 antibiotics are 1st line? What are 2 antibiotcs are used if allergic to PCN?
Pharyngitis
Tx: Penicillin V or Amoxicillin
PCN allergy: Clarithromycin (Biaxin) or
Azithromycin
This causes inflammatory changes of the nasal mucosa d/t an allergy response most common sign is a transverse nasal crease (allergic salute)
Allergic rhinitis
This causes inflammation of the tonsils, sore throat, difficulty swallowing, & tender lymph nodes.
Tonsillitis
Name 4 tx options for otitis externa
1) Aluminum acetate
2) Ciprofloxacin
3) Ofloxacin
4) Polymyxin B
This is a small, fluid filled blister form on the ear
Bullous myringitis
Viral keratoconjunctivitis is also known as? What causes it?
Pink eye, adenovirus
What are the 1st & 2nd line antibiotics for otitis media? What antibiotic is given for pcn allergy?
1) Amoxicillin
2) Augmentin
PCN allergy- Azithromycin
This is a chronic condition caused by inflammation of the eyelids. It occurs when tiny oil glands at the base of the eyelashes become clogged. Meibomian glands, sensation of foreign body, greasy (danduff like) flakes, red, buring, itchy eyes. How is it treated (3)?
Blepharitis
Tx: Baby John’s shampoo
warm water compress
Erythromycin/bacitracin eye drops
Sudden blockage of aqueous humor resulting in rapid increase in IOP (> or = 40) causing eye pain.
Primary closed angle glaucoma
3 side effects of thiazide diuretics
Think HCT= Hyperglycemia, crystals (avoid in pt. with gout), triglycerides
High dose steroid (e.g., amcinonide) can be used on which part of the body?
Hands (avoid face, chest, groin, genitals)
What is the best way to prevent Hep D that is transmitted through air droplets?
Vaccination with Hep B
Best test for H. pylori
Urea breath test
Triple therapy for H. pylori includes what 3 meds?
Clarithromycin, amoxicillin, & PPI (omeprazole)
If allergic to amoxicillin in triple therapy, what med do you substitute it for?
Flagyl
What medication should be avoided in pt.’s with URI with HTN?
Pseudoephedrine (Sudafed)
What does + HBsAG mean?
+ for hep B infection
What does anti-HBc indicate?
Previous or ongoing infection
What does anti-HBs mean?
Immunity due to previous infection/ from vaccination
This piece of legislation incentivized the use of electronic medical records & helps enforce HIPPA?
HITECH Act
This act allows the NP to get paid by medicare
The Budget Reconciliation Act
This act requires the NP to have an NPI # to get reimbursed for services
The Balanced Budget Act
What antibiotic is used for strep throat in pt.’s with penicillin allergy or sensitivity to cephalexin (Keflex)?
Macrolide (azithromycin, clarithromycin, or erythromycin)
BUN may be elevated in what 3 conditions?
Heart failure, GI bleed, Cirrhosis
3 things that would be seen in fundoscopic exam in pt. with CV problems?
AV nicking, Papilledema, & Flame shaped hemorrhages
What is a good medication to prescribe for hot flashes? Name 1 herb that is commonly used for this condition?
SSRI- Paroxetine (Paxil). Herb-Black cohosh
In pt.’s who are pregnant, how should synthroid be managed?
Increase dose by 30%
Medications used to treat gout (4).
Cholichacine for acute attack
Allopurinol for chronic attacks
Steroids for gout flares
Indomethacin for gout flares
What 3 things can long-term use of PPI’s lead to?
Vit B12 deficiency (neuro symp: burning sensation in hands and feet), C-diff infections, & ostoporosis
Alternative med for erythema migrans/ Lyme dz if pt. is allergic to tetracycline (doxycycline) unless he/she is pregnant?
Amoxicillin (note: doxy is used in all pregnant pt.s)
Which 2 types of murmurs are always referred for further evaluation?
Mitral stenosis & aortic regurgitation (diastolic murmurs)
This condition is described as “ loss of central vision” or “ straight lines appear curvy”
Macular degeneration
This condition is described as “vision is uniformly cloudy”
Cateracts
This condition is described as “ curtain has been pulled down over my vision” or sudden onset of “floaters”, & “Cobweb like lines” moving in and out of central vision.
Retinal detachement
This condition is described as “ My arms are too short all of a sudden”
Presbyopia (farsightedness)
What is normal TSH?
0.5 to 5.0
Conductive hearing loss will reveal?
Rinne =
Weber =
Rinne will show BC>AC
Weber will lateralize to bad ear
What test (and result) would confirm COPD?
FEV1/FVC ratio < 0.7 (or 70%)
Term for inability to recognized people/ objects that were once familiar to them?
Agnosia
Term for difficulty with movement?
Apraxia
Term for lack of interest/ motivation
Apathy
Term for difficulty with speech
Aphasia
Most likely diagnosis for a pt. with complaint of intense stabbing pain while eating or cold temp? How is it tx’d? (2)
Tic douloureux/ trigeminal neuralgia
Treatment: carbamazepine (Tegretol), TCA’s
This medication is often used for stomach ulcers as it helps coat the stomach?
Sucralfate (Carafate)
What 2 GI meds should not be used if there is a concern for electrolyte imbalances?
Lactulose & magnesium hydroxide (MOM)
Condition that causes shivering, seizures, agitation, sweaty palms, tachycardia, & tremors? Typically seen when 2 meds are combined. Provide 1 example of a combination of 2 meds.
Serotonin syndrome
Sertraline (zoloft) an SSRI + St. Johns wart
Manage the following INR results:
1) INR 5
2) INR 8-10 if no bleed & if active bleed
3) INR > 10 (no active bleed & active bleed)
1) Hold one dose of Coumadin
2) Hold 2 doses of Coumadin if active bleed IV
Vit k
3) PO Vit k if no active bleed, IV if active bleed
Cranial nerves associated with the eye? (4)
CN II, III, IV, & VI
What to tell a pt. if she misses 1 pill yesterday?
OK to take the missed pill ASAP + the one due today
What if she misses 2 days of her birth control pill?
Take only the most recent missed pill on the same day the current pill is due. Discard the 1st missed pill and use extra contraception,
What if 3 days of birth control pills are missed?
Discontinue current pack and start a new pack of pills right away + backup contraception x 7 days
This drug inhibits prostaglandins & irreversibly inhibits COX-1. It is used to tx CAD, RA, & MI?
Aspirin
Pt. will complain of itching in anal area, restlessness, & teeth grinding at night. It is confirmed using scotch tape test. What is it & how is it treated?
Pinworms, Mebendazole (Emverm)
Name 3 antibiotics used in pneumonia & 2 alternative antibiotics used in pt.’s with asthma, co-morbidities, or recent antibiotic use.
Macrolide (not 1st line), amoxicillin (PCN), or
doxycycline (think MAD lungs)
Respiratory pt.’s alternative: Levofloxacin or
Macrolide/amoxicillin combination
Tx for mild, moderate, & severe acne
Mild: Benzoyl peroxide
Mod: Retinoid (retinol A, tretinoin) & antibiotic
(tetracycline, doxycycline, erythromycin)
Severe: Isotretinoin (Accutane)
H2 Blockers end in?
PPIs end in?
H2 = “zole”
PI = “dine”
What is the most likely bacteria that cause bullous impetigo? (2)
Staphylococcus aureus & streptococcus pyogenes
How is non-bullous impetigo tx’d?
How is bullous impetigo tx’d?
Non-bullous= Topical antibiotic (mupirocin),
permethrin, or fusidic acid 2%
cream
Bullous= PO antibiotic cephalexin (Keflex),
dicloxacin, or azithromycin if PCN
allergy
C/o abd. pain, green/yellow halo, increasing HA, confusion, ventricular tach, N&V, diarrhea, & loss of appetite shows signs of what medication toxcicity?
Digoxin
Tx for pt with osteopenia (DEXTA score between -1 and -2.5?
Calcium, Vit D, & wt. bearing exercise
The following are examples of:
1) Albuterol =
2) Salmeterol (Serevent) or formoterol =
3) tiotropium bromide (spiriva) =
4) Pulmicort, flovent, Qvar =
1) SABA
2) LABA
3) LAMA
4) Inhaled corticoid steroid
This type of murmur is heard in the 5th ICS, left of the MCL with a mid systolic click?
MVP
This type of murmur is best heard 2nd ICS, Right of the sternal boarder during systole & radiates to the neck?
Aortic stenosis
This murmur radiates to the axilla?
Mitral Regurgitation
Inability to look directly into a light, N&V, flashes of light, photosensitivity, photophobia, visual changes are all symptoms of what form of headache?
Migraine
Abrupt onset of high fever, chills, HA, myalgia, photophobia, painless rash with small red petechae that starts on hands, wrist, forearms, & ankles that spread centrally after visiting North Carolina diagnosis? what is the tx?
Rocky Mountain Spotted Fever, Doxycycline
In this type of injury swelling is seen immediately & pt. is unable to finish whatever activity they were doing? How do you test for it?
Torn ACL, Lachman test
This type of injury has delayed swelling up to 24 hours & what is the test for it?
Meniscus injury, McMurray test
Normal INR for A fib =
for Mechanical valve=
1 to 2
2.5 to 3.5
This class of diabetic medication inhibits hepatic glucose production in the liver & decreases intestinal absorption of glucose.
Biguanides (Metformin)
Medicaid is funded by?
Federal & State
Medicare is funded by?
Federal
Annual exams for newly diagnosed diabetes pt.’s include what 3 referrals?
Podiatrist, dietitian, & ophthalmologist
What class of medication is used for postpartum depression?
SSRI (ex: citalopram, paxil, prozac, & sertraline)
Feeding, bathing, toileting, ambulating/ moving & dressing oneself are considered what form of ADL?
Functional
Driving, preparing meals, & handing medications are what form of ADL?
Complex
Visual & gait changes with memory trouble are symptoms of which toxicity? At what level will this occur?
Lithium, > 1.5
Treatment for otitis externa? (3)
Ciprofloxacin gtt, ofloxacin, or Polymyxin B
This class of antidepressants require EKG prior to initiating due to side effects of heart block, arrhythmia, & even death.
TCA Ex: amitriptyline (Elavil), Clomipramine (Anafranil), Sertraline (Zoloft)
3 medications that can cause urinary retention
Amitriptyline, benadryl, & hydroxyzine
Estradiol contains _____________? So, it should be avoided in pt.’s with ______________?
Estrogen, migraine with aura
This type of injury is commonly caused by overuse (esp. in tennis, racquet ball, or manual labor jobs) & presents with pain at the elbow?
Lateral epicondylitis (tennis elbow)
What is the ASCVD cutoff for prescribing BP meds?
10%
What needs to be done prior to starting tadalafil (Cialis)?
EKG
8 risk factors for breast cancer development.
1) Increasing age (> 50)
2) Genetic predisposition (BRCA 1 or 2)
3) Menarche before age 12
4) Menopause after age 55
5) Personal history of breast/ovarian ca
6) Low parity
7) Hormone use
8) 1st degree/ multiple relatives
The squat & rise exam with diminished knee jerk links to the ______nerve associated with which condition?
L4, Sciatica
The heel walk exam assesses what nerve?
L5
The toe walk assesses what nerve?
S1
Inward rotation of the pt. hip & flexing the knee while the pt. is supine describes which maneuver? What condition?
Obturator’s sign, appendicitis
This maneuver requires the pt to raise their leg against resistance/ having them lay on side while passively extending the hip.
Psoas sign, appendicitis
This maneuver causes pain/tenderness when palpated the opposite side is palpated.
Rovsing’s sign, appendicitis
This maneuver causes midinspiratory arrest when deep palpation of the RUQ under the coastal boarder occurs
Murphy’s sign, Choleocystits
This maneuver is referred to as “rebound” tenderness. Think “blume, blume, blume”
Blumberg sign, appendicitis/ peritonitis
What would you expect to see if pt. has triglyceride > 500 (2 signs? What should be prescribed if triglycerides are > 500?
Grey Turner & Cullen’s sign
Prescribe fenofibrate
What 3 conditions may cause + Grey turner’s sign or + Cullen’s sign?
Pancreatitis, abdominal bleed, & ruptured ectopic pregnancy
What 3 conditions are commonly seen in PCOS?
Insulin resistance, hyperlipidemia, & endometrial cancer.
Diagnosis “boggy prostate”
Prostatitis
Diagnosis “ enlarged, non-tender, rubbery prostate”
BPH
Diagnosis “ firm, fixed, painless, & asymmetric nodule felt on prostate”
Prostate cancer
Diagnosis & treatment for pt. c/o fever, CVA tenderness with history of frequent UTI’s
Acute pyelonephritis, refer to ED
Treatment for mild pyelonephritis?
Quinolone such as cipro or levofloxacin
Diagnosis for sudden, severe, unilateral scrotal pain with absent cremasteric reflex on ipsilateral side?
Testicular torsion
Diagnosis for dull pain, intermittent swelling of the testicles? How is it treated?
Varicocele, observation
This condition presents with fever, dysuria, painful ejaculation, & urethral discharge with positive cremasteric reflex? How is it treated if it is noninfectious? (4)
Epididymitis. Noninfectious occurs from prolonged sitting. Tx: avoid strenuous activity, lots of fluids, analgesics, & scrotal elevation.
Term for maintaining trust & keeping one’s promise with pt.
Fidelity
Term for doing good (ex: starting metformin in a pt. with DM2)
Beneficence
Term for doing no harm (ex: stopping metformin in pt with GFR < 30)
Nonmaleficence
Term for telling the truth (ex: telling the pt. their diagnosis despite probable outcome)
Veracity
Diagnosis for unilateral joint pain & stiffness in am lasting < 1 hr
Ostoearthritis (OA)
Diagnosis for elevated labs, bilateral erythema & edema with swan neck deformity?
Rheumatoid arthritis
4 long term complications for bulemia
Renal failure
Infertility
Heart failure
Seizure
Name 3 microvascular complications of diabetes
All the “opathies” Retinopathy, nephropathy, & neuropathy
Which class of diabetic medication is notorious for causing hypoglycemia?
Sulfonylureas such as glipizide (Glucotrol)
Low levels of _______ can lead to twitching of the upper lip & cheek, new paresthesias in fingertips & toes, muscle spasms, & confusion/ memory loss?
Calcium
Pt.’s taking MAOIs (such as phenelzine or Nardil) should avoid foods high in _______? Foods include fermented drinks, beer, wine, aged cheeze, fava beans, yeast products, grapefruit/grapfruit juice?
Tyramine
Name 2 classes of drugs to avoid with heart failure?
NSAIDs such as Voltaren & calcium channel blockers
This condition will present with erythematous papules & burrows in between fingers? How is it treated?
Scabies, Perethrin (Nix)
Postmenopausal vaginal bleeding is most concerning for ______________ cancer?
Endometrial
DM2, renal artery stenosis, & HTN will likely cause?
Chronic kidney dz
A patient takes positive health actions to avoid negative health consequences is an example of?
Health Belief Model
Long term steroid use can lead to what 3 conditions?
Wt. gain, osteoporosis, Hyperglycemia
Diagnosis of concern in pt with c/o constant HA every morning in the same spot that worsens with activity?
Brain tumor
BP 130-139 systolic & 80-89 diastolic is what stage HTN?
Stage 1
Black box warning for fluoroquinolones such as levaquin.
Achilles tendon rupture
ACE inhibitors should be discontinued for what 3 reasons?
GFR < 30%, dry cough, or angioedema
This condition starts in one eye, associated with watery drainage, & preauricular/ submandibular lymphadenopathy. What is another name for this condition?
Viral/ adenoviral conjunctivitis, Pink eye
This condition presents with stringy white discharge, itchy, painless tearing, clear rhinorrhea, & cobblestone papillae under the eye? How is it treated?
Allergic conjuntivitis, tx: antihistamines such as fexofenadine (allegra) cetirizine (zyrtec), or Loratadine (Claritin)
This condition presents with stinging pain, bil. mucopurulent discharge, & “glued eyes.” How is it treated?
Bacterial conjunctivitis, Topical azithromycin, cipro ointment, or moxifloxacin ointment
What is the black box warning for SSRI’s?
Suicidal Ideation
Step 2 treatment for asthma control?
Low dose ICS-LABA daily
Diagnosis for c/o new HA on one side of head causing tenderness upon palpation, mandibular fatigue, & vision changes? How is it diagnosed?
Temporal arteritis (aka Giant cell arteritis), diagnosed with temporal artery biopsy
Diagnosis for well-demarcated boarder that is erythematous on lower extremity? How is it treated? (3)
Erysipelas, PCN (1st line) amoxicillin & clindamycin or ceftriazone (Keflex)
Diagnosis for recent productive cough, fever, wt. loss, & profuse sweating at night. Test that confirms diagnosis?
TB, sputum culture
This diabetic medication requires staying hydrated & increases the risk for UTI/ yeast infections?
SGLT2 such as dapagliflozin (Farxiga)
This form of billing requires the NP to care for a pt. while the physician is in the building for a condition that already been established by the MD?
Incident-to-billing
What class of antibiotics should be avoided if pt. is on coumadin?
Sulfa drugs such as Bactrim
This eye conditions presents with white arch around both irises?
Arcus senilis
1st line BP medication for African Americans
Thiazide diuretics & CCB
Abrupt cessation of ____________ can lead to adrenal suppression, withdrawal symptoms, & joint pain?
Inhaled corticosteroids such as budesonide (Rhinocort) or fluticasone (flonase)
This is heard at the pulmonic valve 2nd ICS left sternal boarder during inspiration?
S2 split
Nasal congestion, conjunctivitis, diarrhea, fever, koplik spots are seen in what condition?
Measles
Parotid gland swelling is most commonly associated with what condition?
Mumps
Skin condition that shows yellow/tan spots of increased pigmentation that is scattered?
Solar lentigo spots
Best test for one type of microcytic, hypochromic anemia?
Hemoglobin electrophoresis
What does ambylopia mean?
Lazy eye
What class of antidepressant should be avoided in pt.’s with hypertension?
SNRI such as venlafaxine (Effexor)
This is a broad spectrum antibiotic that can be used for trichomoniasis, diverticulitis, & liver abcess? What is contraindicated in this medication?
Flagyl, alcohol consumption
What does the “HAG” mnemonic represent in pulmonary function tests?
Height, age, gender
Instruct pt. taking metformin to avoid? Why?
Alcohol, causes lactic acidosis
What medications can cause glactorrhea?
Atypical antipsychotics such as olanzapine (Zyprexa)
What is a pt at increased risk for when taking HMG-CoA inhibitors (statins)
Rhabdomyolysis (muscle pain)
Tetracyclines such as doxycycline causes what side effect?
Photophobia (sensitivity to light) sunburn
What birth control should be avoided in pt who is a smoker > 35 yrs of age, has migraine with aura, or is breastfeeding/pregnant?
Combined oral contraceptives
This is the term used when pt.’s gradually develop a central blind spot with macular degeneration?
Scotoma
Term for nearsightedness
Myopia
Term used when the eyes don’t look in the same direction at the same time (cross-eyed)
Strabismus
B12 deficiency anemia may have issues with paresthesias, but may also have what other 3 conditons?
Koilonychia, Ataxia, & Glossitis
Isolated systolic HTN is best treated with what class BP med?
CCB (Calcium channel blocker) such as amlodipine (Norvasc)
