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Leik bank Flashcards

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1
Q

The NP is managing a stable middle-aged adult with emphysema. In addition to reinforcing smoking cessation and med schedules, which annual intervention will the NP recommend?

A

Quadrivalent inactivated influenza vaccine (QIV)

An older adult with chronic respiratory disease should receive this

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2
Q

Who can receive the Live Attenuated Influenza vaccine?

A

2 years - 49 years
administered via nasal spray

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3
Q

PPSV23 is recommended for people that are….

A

65+
aged 19 to 64 who smoke

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4
Q

PCV13 is recommended for

A

children <2 years

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5
Q

What is the Murphy’s sign?

A

deeply press RUQ during inspiration. Mid inspiratory arrest = cholecystitis

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6
Q

What is rovsing’s sign

A

Deep palpation of the LLQ of the abdomen.

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7
Q

What is the Markle test

A

patient raises their heels and drops them suddenly

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8
Q

What is the psoas test?

A

When patient experiences abdominal pain while flexing the hip and knee

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9
Q

what causes PSA testing to be falsely elevated?

A

urinary retention
UTI
DRE
Ejaculation within 48 hours

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10
Q

A young adult with myasthenia gravis is diagnosed with pertussis. Which antibiotic is contraindicated in a patient with this condition?
Why?
What would you give instead?

A

Erythromycin
Telithromycin

Potential for respiratory collapse.

Give Azithromycin
or Clarithromycin

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11
Q

The NP who is evaluating a patient with polycystic kidney disease wil pay close attention to which area of the kidney?

A
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12
Q

A 29-year-old female patient presents to the clinic with complaints of painful sexual intercourse and pain when urinating. The patient’s temperature is 100.1F. Upon physical examination, the nurse practitioner notes a healthy appearance of the internal and external genitalia. The patient has lower abdominal and cervical motion tenderness in response to palpation. What will the NP order to confirm the diagnosis and determine the appropriate treatment?

A

Cervical culture

Patient findings associated with endometritis. blood cultures only when signs of sepsis. US if post partum for retained products

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13
Q

The NP is reviewing the chart of an 8 month old infant scheduled to receive immunizations. Which vaccine woudl the NP question if noted in teh infant’s chart?
MMR?
Hep B?
Hib?
Rotavirus

A

MMR because it is not given until 12 months of age

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14
Q

What is the first line treatment for osteoporosis?

A

Bisphosphonates
EX: alendronate, risedronate, “-ronate”

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15
Q

What are the 1st and 2nd line treatment for acne?

A

1st: OTC topical antibiotic gels and medicated soap
2nd Tetracycline

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16
Q

What hemopoietic disorder will the NP assess for in a 3 y/o with lead poisoning?

A

iron deficiency anemia

irone defiency has been shown to increase in lead retention

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17
Q

What is pernicious anemia?

A

inability to absorb vitamin B12

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18
Q

What is the cause of normocytic anemia? who does it normally effect?

A

long-term chronic disease

Elderly

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19
Q

A male patient presents with urethritis, migratory arthritis in the large joints, and ulcers on the glans penis secondary to chlamydial infection. The NP will implement all of the following interventions except?
a. Tx w/ NSAID
b. antibiotics to tx infection
c. treat with alpha-linolenic acid

A

This is Reiter’s syndrome
immune mediated reaction 2ndary to chlamydia infection.

EXCEPT!!! alpha-linolenic acid (treats ankylosing spondylosis)

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20
Q

What are the ACS guidelines for screening for colon cancer?

A

Annual colonoscopy and/or fecal occult blood testing starting at 50 years old

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21
Q

hat is Bowen’s disease?

A

SCC of epidermis that has not invaded the dermis.
well defined, primary lesions <20 mm over trunk and extremities

Tx: Curettage and electrodessication

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22
Q

What is the mnemonic for high risk hearing loss ?

A

HEARS
Hyperbilirubinemia
ear infection frequency
low Apgar scores
Exposure to rubella
CMV
Seizures

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23
Q

For women that are not high risk, what should we start mammograms for breast cancer screening? How often should we repeat?

A

Start at age 50
Repeat every 2 years

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24
Q

What is the screening for congenital heart defects for a newborn?

A

O2 saturation measure greater than/equal to 95% and no more than a 3% difference between the hand and feet

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25
Q

What are common signs of pregnancy induced hypertension?

A

edema of face and upper extremities
Weight gain
Blurred vision
Elevated BP
proteinuria
Headaches

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26
Q

What would you prescribe for urinary incontinence for a women?

A

Oxybutynin (Ditropan)

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27
Q

What drug class is Chlorthalidone (Hygroton)?

A

thiazide

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28
Q

What diuretics are contraindicated in patients who are allergic to sulfa poducts?

A

thiazides
Loop diuretics

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29
Q

what does a 24 hr urine collection measure?

A

creatinine clearance to assess for proteinuria, albuminuria, and GFR

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30
Q

What are hematologic findings with beta thalassemia?

A

decreased hemoglobin a
hypochromic RBCs
MCV decreased
MCHC decreased

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31
Q

What would you prescribe to treat HTN and BPH

A

Terazosin (Hytrin)

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32
Q

What type of tear would produce a positive McMurray?

A

meniscus

33
Q

What can cause a false positive ovulation test?

A

PCOS
menopause
endometriosis
ovarian insufficiency

34
Q

What do you prescribe to treat an 18 months old with a symptomatic UTI?

A

Augmentin and Bactrim

35
Q

At 12 weeks gestation, the fundus of the uterus should be located approximately at ____

A

symphysis pubis

36
Q

a patient with Grave’s disease for 2 years is found to have afib….what do you prescribe?

A

Warfarin (Coumadin)
People with hyperthyroid are at higher risk of osteoporosis and afib.

37
Q

What would an EKG show for someone that took too much TCA (Elavil (Amitriptyline)

A

Sinus tachycardia

38
Q

What is the recommended care for a women with preeclampsia?

A

bedrest with bathroom privileges
weight & BP monitoring
Urine protein & serum protein, creatinine
Platelet counts

MEDS ARE NOT FIRST LINE

39
Q

What is HBsAg a marker of?

A

positive = acute or chronic Hep B infection

40
Q

What is anti-HBs a marker of?

A

marker of immunity

41
Q

what is anti-HBc a marker of?

A

antibody to hep B core antigen
acute, chronic, or resolved Hep B infection

42
Q

What are contraindications to Timolol (Betimol) opthalmic drops?

A

Bronchial asthma
Asthma
severe COPD
uncompensated HF
heart block
sinus bradycardia
shock

43
Q

A patient presents with epigastric pain and intermittent diarrhea that worsens with food. She has a history of multiple ulcers. The NP reviews the results of the serum fasting gastrin level and finds there is no inhibition of gastrin levels. Whats your diagnosis?

A

Zollinger-Ellison

Neuroendocrine tumor that causes gastrin hypersecretion and peptic ulcer formation

44
Q

What are the signs and symptoms of tennis elbow?

A

Lateral epicondylitis
-lateral tenderness at insertion site
-pain is worse with grasping or twisting movements

45
Q

What symptoms are associated with golfers elbow?

A

medial epicondylitis
-pulling pain

46
Q

What is the MOA of probenecid (Probalan)?

A

Increases uric acid excretion
exreted through kidneys

47
Q

An adult visits the UC with a fever of 104.2F, vomiting, and petechiae on hands and feet progressing to the trunk over the past 3 days.
Dx?
Tx?

A

Rocky Mountain spotted fever
Tx: doxy

48
Q

In the US the most common cause of cancer deaths in men is?

A

lung cancer

49
Q

A patient presents with c/o acute epigastric pain that is relieved by taking OTC antacids. The NP discovers the patient takes NSAID TID for joint pain. All of the following diagnostic tests should be ordered to verify the suspected diagnosis, except:
a. fecal occult
b CBC
c. HbA1c
d. urea breath test

A

A1c

50
Q

Define Inevitable abortion

A

vaginal bleeding with pain
cervical dilation AND/OR
cervical effacement

51
Q

Define threatened abortion

A

vaginal bleeding with absent or minimal pain
closed, long, and thick cervix

52
Q

Define incomplete abortion

A

moderate to diffuse vaginal bleeding, with the passage of tissue and painful uterine cramping/contractions

53
Q

What should patients taking HCTZ and nifedipine be monitored for?

A

Acquired neutropenia

54
Q

In an adolescent with scoliosis, what degree of spinal curvature requires a referral for surgical correction?
When is bracing necessary?

A

> 40 degrees

20 to 40 degrees

55
Q

What are symptoms of Vit B12 deficiency

A

-Paresthesia
-Hyperreflexia
-Balance disorders (Romberg)

56
Q

First-line therapy for an elderly patient diagnosed with isolated systolic htn?

A

HCTZ

57
Q

What age should healthy full-term infants be screened for anemia?

A

9 to 12 months

(at birth hemoglobin is elevated from maternal RBCs mixed with fetal RBCs)

58
Q

Signs of a syphilis infection

dx

A

wartlike lesions
rash on palms and soles of feet

dx RPR or VDRL &raquo_space; if reactive order confirmatory test

59
Q

What are the triad of symptoms for preeclampsia?

A

hypertension
edema (weight gain)
proteinuria

60
Q

What is the first line treatment for an unvaccinated infant diagnosed with pertussis?

A

Macrolides
-azithromycin
-erythromycin
-clarithromycin

61
Q

what should you test for before treating hep c?

A

hepB
it can reactivate during treatment and cause serious liver problems

62
Q

How do you calculate ABI

A

right/left ankle/ highest sbp of both arms

63
Q

What is the most common cause of dementia in the elderly

A

alzheimer’s

64
Q

What is CN5
how is it tested?

A

trigeminal nerve
chewing and clenching teeth

65
Q

elderly adult c/o centra vision blurred and cannot see when driving…dx?

A

macular degeneration

66
Q

What tanner stage do the areola, nipple, and breast tissue develop and become elevated as one mound?

A

Tanner III

67
Q

What tanner stage do the areola and nipple separate to form a distinct secondary mound?

A

Tanner IV

68
Q

The NP sees an adult patient who reports frequent headaches over the past few months. The patient has tried acetaminophen and ibuprofen without relief. The patient has a history of MI, bradycardia, and kidney stones. What meds are most appropriate? why are the others not?
a. topiramate (topamax)
b. sumatriptan (imitrex)
c. imipramine (elavil)
d. atenolol (tenormin)

A

Imipramine (Elevil) is most appropriate

Topiramate contraindicated d/t kidney stones

Atenolol contraindicated d/t bradycardia

sumatriptan contraindicated d/t MI

69
Q

What is a positive Kernig sign?

A

Resistance to leg straightening from back pain

this causes painful hamstrings from lumbar nerve root inflammation

70
Q

Is it ulcerative colitis or CD that has mucosal inflammation throughout the colon?

A

UC

71
Q

is it CD or UC that has skip lesions

A

CD

72
Q

What meds help with IBS with diarrhea?

A

Amtriptyaline (Elavil) anticholinergic effects
Dicyclomine (Bentyl) anticholinergic
Alosetron

73
Q

What is recommended to treat COPD
category A
B
C

A

A: SABA
B: LABA
C: LAMA

74
Q

Pioglitazone is contra indicated in what disease?

A

This is a diabetic medication that causes water retention
- CHF
-Bladder Cancer

75
Q

Who should not take Biguanides

A

Renal disease
alcoholism
hypoxia

76
Q

How do you treat a cluster headache?

A

100% oxygen at 12L via mask
Intranasal 4% lidocaine

77
Q

How do you treat trigeminal neuralgia?

A

Phenytoin (Dilantin)

78
Q

What is first line med for tinea unguium?

A

Oral terbinafine (Lamisil)
(fungal infection of big toe nail)

78
Q

What is first line med for tinea unguium?

A

Oral terbinafine (Lamisil)
(fungal infection of big toe nail)

Brain Dump (22 decks)

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