BOARD Flashcards
The hemagglutination inhibition (HAI) test
detect immunity to rubella and to diagnose rubella infection.
1: 10 or greater indicate immunity to rubella
1: 64 or greater may indicate current rubella infection
HVP vaccination
first dose : Now
second dose: 2 months
third dose : 6 months
Pubertal events
breast development
pubic hair & axillary hair
increase height
menses
Bronchitis lungs sound
Rhonchi - low pitched snoring quality adventitious lungs sound that may be heard when air passes over thick secretions in the large airways
normal lungs field sound
vesicular with inspiratory lungs lasting longer than expiratory sounds
percussion to find the liver
percussing downward in midclavical line to find the upper border of the liver will change from resonance when over the lung fields to dull when over the liver
resonace to dullness
predominate estrogen after menopause
estrone _“rhyme with hormones”
chronological events during ovulation
LH surge
ovulation
rise in BBT
thickened cervical mucus
Levonorgesterel EC
may have reduced effectiveness in obese women
systemic lupus erythematous should not use combination oral contraceptives
if she has positive antiphospholipid antibodies. they have higher risk for both arterial and venous thrombosis and should not use combination hormonal contraceptives.
recommendation for vitamin D dose after 50 years old
800 to 1000 IU daily
estrogen of pregnancy
estriol
how long does genital herpes shows up in blood test
1 to 2 months to determine whether she has herpes antibodies
bariatric surgery for reproductive age woman
no contraceptive methods are specifically contraindicated if she has a restrictive procedures (laparoscopic adjustable gastric band)
diaphragm vs cervical cap
diaphragm no more than 24 hours
cervical cap may be left in place up to 48 hours
menopausal woman experiences
decreased vasocongestion and decreased vaginal expansion
main mechanism of misopristol
stimulating uterine contractions
NP with medicare provider status
In fee for service medicare
NPs are reimbursed at 85%
CNM at at 100% of physician fee for the same service
correlational research
relationships but not examine the causes and effect
managed care organization (MCo)
capitated system of payment
opportunity for service bundling
some finanical risk assumed by the provider
Medicaid requirements
pregnant women
children under 6
childern younger than 19
adult under 65 w/o dependent children, and adults with short term disability
if they meet specificed income eligibility requirement
claims made policies
the incident must happen and be reported while the polity is in force to be covered
certification :
is the formal process by which a private agency or organization certifies (usually by examination) that an individual has met standards as specified by that profession. Almost all states require national certification for nurse practioners and CNM
occurrence-based policy
provides coverage for any incident that occured during the same time of the policy was in effect.
claims made policies
cover the individual for any suit filed while the policy is in effect
tail coverage extends claims
into the future to cover claims filed after the basic claims coverage period
integrated delivery system/managed care organizations
strive to provide high-quality, cost-effective care through coordination of services; there is a shift in emphasis from fee-for service strategy to one in which a network of providers assumes some responsibility for provision and cost of care
medicare part A vs part B
monthly premium requirement for part B
part B is supplementary medical insurance available to individuals for a monthly premium if they are eligible for part A. Part B covers provider services, outpatient care, diagnostics, and durable medical equipment.
where does ARNP obtained their National provider identifier (NPI)
Centers for medicare and medicaid services (CMS)
Battery
actual, intentional, and unlawful touching or striking of another person against the will of another
ex: place an IUD in an intellectually disabled patient who is not able to give informed consent
incident to billing
billing for medicare services provided by ARNP under the supervision of a physician and does not include initial visits or subsequent visits with a new problems. Billing as a medicare provider rather than incident to promotes the visibility and status of ARNPs
definition of primary care
context in which care is provided
major role of review board
evaluate the ethical considerations r/t proposed or ongoing research study in order to protect human service.
ensure the rights of human subjects are being protected.
chronic fatigue syndromes diagnose
severe fatigue for longer than 6 months
at least 4 symptoms: sore throat, short term memory loss/impairment, tender cervical or axillary lymph nodes, headaches of new type, pattern, or severity; unrefreshing sleep, postextertional malaise lasting more than 24 hours, multijoint pain w/o swelling or inflammation; and muscle pain.
common side effect of nicotinic acid
flushing and pruritus
takes 325mg of aspirin or 200mg ibuprofen 30-60 minutes prior to taking nicotinic acid
nicotinic acid - treat dyslipidemia
action of saline laxative (MOM)
draw water into the intestinal lumen, causing fecal mass to soften and swell; swelling stretches the intestinal lumen and simulates peristalsis.
agorophobia
anxiety disorder that includes avoidance of places or situations in which the ability to leave suddenly may be difficulty in the event of having panic attack. The recurrence of these panic attacks and fear r/o their possible occurence are considered panic disorder
cycle of violence
tension building
acute battering
honeymoon
labs to diagnose mononucleosis
elevated liver enzymes
elevated basophils and eosinophils
presence of heterophil antibodies
s/sx appendicitis
acute onset of pain starts in epigastrum or periumbilical area migrates to RLQ
low grade fever, anorexia, nausea, vomiting are common
abdominal rigidity
diagnosis of SLE
4/11 criteria
presence of specific dermatologic symptoms: arthritis, serositis, renal, neurologic, and hematologic condition. positive ANA test , and other immunlogogic positive tests.
macrocytic anemia
B12 deficiency
folate deficiency
liver disease
hypothyroidsm
when stool culture indicated
if symptoms (diarrhea persists) more than 24 hours or client has fever, or bloody stools
Hashitomoto thyroiditis
hypothyroidsm
tx: levothyroxine : which has a half life of 6 days and slow rate of achieving steady state. Adjust dose every 6 weeks until TSH normalizes
anorexia nervosa
emanciation dry skin fine body hair wasting muscle peripheral edema bradycardia arrhythmias hypotension delayed sexual maturation, and stress fractures.
lumbosacral strain
stretching or tearing of muscles, tendons, ligaments, and fascia d/t trauma or repetitive mechanical stress.
antiretrovial therapy
monitoring
response to drug therapy is monitored by HIV RNA levels.
referral for neurological evaluations
focal neurological findings
specific secondary diagnosis is suspected
chronic headaches develop new features
new headaches in individuals older than 50 years.
psoriasis features
erythematous base with scaly silvery white papules and plaques that are adherent.
tiny pinpoint bleeding points are revealed if the scale is removed. Common sites: elbows, knees, scalp, genitals, and cleft of the buttocks. Lesions are asymptomatic, although some degree of itching may occure.
first line treatment of community acquired pneumonia whether viral or bacterial
macrolide : azithromycine
when should antibiotic initiated for acute sinusitis
when s/sx persists 10 days or more after onset of URI or if symptoms improve then then within 10 days they worsen again
diagnose acute cholecystitis
ultrasound
sumatriptan
abortive therapy
beneficial effect of relieve nausea
should NOT used if ergotamine preparations have been used in the past 24 hours.
does not carry a risk for addiction
migraine
begins in adolescent decline after 4o years old.
typically : unilateral throbbing, last up to 72 hours accompanied by nausea/ photophobia
side effects of SSRI
anxiety, insomnia/hypersomnia, HA, n/v, anorexia, and sexual dysfunction
indication for rapid streptococcal antigen test
fever, lack of cough, tonsillar exudates, tender anterior cervical adenopathy
most common cause of community acquired bacterial pneumonia
S. pneumonia
temporal arteritis or giant cell arteritis
sharp throbbing or aching pain localized to the temporal area.
other symptoms: scalp tenderness, jaw pain with chewing anorexia, wt loss & fatigue. The individual may have a known hx of polymyalgia rheumatica. Physical examination findings may include : fever tenderness over a nodular temporarl artery, decreased pulsation of artery, diminished or absent pulses in upper extremities. unilateral blindness may occur if untreated. the age of onsest usualy olver than 50 y.o.
labs: ESR - greater than 50mm/hour
metabolic syndrome
3/5 risks - abdominal obesity/waist circumference greater than 35 triglyceride 150mg or greater HDL less than 50mg BP 130/85 or greater fasting glucose 110 or greater
osteoarthritis vs SLE
osteoarthritis - joint pain in asymmetric fashion
SLE- inflammatory & symmetrically distributed
leading killer of women in US
Coronary heart disease
active TB symptoms
night sweat fever malaise weakness anorexia weight loss
pulmonary symptoms: productive cough, hemoptysis, chest pain, dyspnea
contact dermatitis
pruritus or burning at the site of contact of an irritant.
lesions: oozing vesicles
fungal infection
affects scalp, trunk, limbs, face, groin, or feet
erythematous, scaling plaques
cellulitis
diffuse sharply defined erythema
red streaks run from the cellulitis toward regional lymph nodes.
scabies
minute vesicles and linear runs or burrows often found in digital webs, palms, wrists, gluteal folds, buttocks, and toes.
allergic rhinitis symptoms
horizontal crease along the lower bridge of nose from the patient pushing nose upward and backward because of itching and nasal discharge.
most gallstones composed of
cholesterol
disease modifying antirheumatic drugs (DMARD)
preferred therapy for long term management of rheumatoid arthritis.
methotrexate a nonbiologic DMARD is cat X
bacterial pharyngitis s/sx
sudden onset of severe sore throat pain with swallowing fever w/ chills.
headaches, n/v
does not typically have cough, rhinitis, conjunctivitis, or myalgia
typical findings: fever, marked erythema of throat and tonsils, patchy discrete white or yellow exudate, petechiae at junction of hard and soft palates, and tender anterior cervical lymphadenopathy.
