Questions Flashcards
A 16-year-old Nigerian boy somatic symptoms after moving 3 months ago.
What is this considered?
What treatment would you recommend?
a. This is cultural bound syndrome.
b. Treatment is brief supportive therapy
A patient came in for appointment and verbalize to the NP that they feel terrible and believes the group home where they live is trying to poison their food. So they are thinking about the setting the house on fire while everyone’s sleep at night. How would the NP respond?
Call the group home staff and notify law enforcement about his homicidal thoughts
A 3 year is brought in because her parent think she is “over-sexed” she is preoccupied with the woman’s breast and has been masturbating. What do you tell the parents?
This is normal
12 year old that cries, isolates, has no friends, and is not doing well in school. According to Erickson, which stage has he not resolved?
Identity vs role confusion
What CN deal with mastication (Chewing, biting down)?
CN-V trigeminal
What CN is responsible for puffing out cheeks?
CN VII facial
What CN is asking to stick your tongue out and say ahh?
CN XII hypoglossal use for checking TD
Fungus to toenail. What is the first priority?
Scrape area and send to the lab prior to initiating treatment
This means they have a B12 deficiency, check for b12. Vitamin b12 and folate deficiencies must be ruled out
Microcystic anemia
Man working at the gym and his urine is cherry color
Order myoglobinuria
Adolescent with substance abuse and working out has muscle aches. Urine is red colored hematuria
Concerned for rhabdomyolysis – need to check CK-MB
Dark brown urine (patient with Depakote) = liver damage/problem with liver function.
Check LFTs
Erythromycin increases level of carbamazepine (Tegretol) = Agranulocytosis. What should you do?
Decrease Tegretol medication to avoid toxicity
The patient is on oral antipsychotic meds then develop infection and are prescribed with 14 days antibiotics. What should the np do?
Decrease the antipsychotic medication
A patient has been stabilized on Zyprexa or Seroquel and is also a long time smoker. He is now involved in a smoking cessation program. How will you need to adjust his medication after he stop smoking
Decrease his dosage of Zyprexa
A patient takes Flonase daily for asthma. He was dx with bipolar and needs to be started on a mood stabilizer, what mood stabilizer DECREASES the effectiveness of Flonase
TEGRETOL (carbamazepine)
Patient is taking lithium developed severe back pain and reports this complaint to the pcp. Motrin 400 mg tid was prescribed. You know that the patient developed lithium toxicity if the patient displays what?
COARSE hand tremors, slurred speech, confusion, severe GI problem, metallic taste
Patient present with lithium 1.4, what does that mean?
Monitor for lithium toxicity signs and symptoms
A patient having a performance anxiety and taking albuterol. What medication would be prescribed for maintenance therapy
SSRI
Patient on interferon, Wellbutrin, and taking Lexapro and has complaints that symptoms are the same. What should you do?
Increase lexapro
Patient on Accutane and taking Wellbutrin and has complaints of no change in symptoms. What should you do?
Increase Wellbutrin
When a patient is on 21. Disulfiram (Antabuse), what should you educate him on?
a. Safety first.
b. Alcohol use stay away from alcohol due to severe side effects.
c. 12 hours from the time of the last drink.
d. Wait 2 weeks, mouth wash, shaving cream or any content that contains alcohol.
Patient has weight loss drug due to binge eating d/o for 2 days, BMI 27, and asked for medication.
Continue their Vyvanse.
(Not enough info)
Patient is anxious before going on stage. What would you give?
Propranolol (beta blocker end lol)
Found in children who frequently change foster homes or caregiver) unable to feel loved with caregiver, not seeking comfort or showing no response when comfort is given.
a. What dx would you give?
b. What theory is this?
a. Reactive attachment disorder
b. Bowlby theory of attachment
14 year old patient who moved 2 months ago has been sad, crying, skipping school (truancy), what dx?
Adjustment Disorder
Child in foster care with poor eye contact, isolates, and eats without default.
a. What is it?
b. What screening tools to use?
The patient has autism. Screening tool to use:
(MCHAT) modified checklist for autism in toddlers
iii. (ADOS-G)
iv. (ASQ) ages and stages questionnaires
Mom died or patient loses their job. What do you suggest?
Provide brief supportive therapy
How would an NP measure the readiness of a hospital staff to implement change?
Would ask them to fill out a survey
Patient goes to group therapy and does not want to go back
Offer individual or interpersonal therapy
Couples, referred by pediatric urologist, report that their stepchild is disturbing them by intentionally having enuresis. What will you tell them?
Family contract the family will have agreement
If you give ADHD medication Adderall and at 2pm they start exhibiting the symptoms. What does this mean?
Medication has cleared and may required a 2nd dose or longer acting stimulant.
Trazodone adverse effects
Priapism and QT Prolongation
Patient is taking an antipsychotic but medication is not effective.
Check to see if patient taking antacid or PPI because it can decrease absorption of antipsychotics. You can avoid this by taking them at least two hours before or one hour after taking your medication
Neuropathic pain and do not want to take medications
Refer for acupuncture
What do you perform with a patient that has disseminated encephalomyelitis?
A neurological exam
You do a neurological exam with a patient that has disseminated encephalomyelitis. What are some findings and what do you assess for?
a. Assess for asymmetry of extremities
b. Patient usually have blurring or double vision, weakness, numbness, loss of balance – unsteady and falling
How long does palmar and grasp reflex last?
They last 5-6 months
There is a question on the boards that talk about a neglected 2 year old who still has grasp reflex. What is the answer?
This is abnormal so order an x-ray
7 year old child complains of pain when its time for gym class. His parents think its performance anxiety. He has a positive Trendelenburg sign, what does the NP tell parents?
He has an issue with his hips. We need to consult with a specialist or refer him to specialists.
Kids received too many calories due to staff letting him eat more food, what do you do?
Meet with dietician, discuss with manager
a. Assess means of two groups are statistically different from each other
b. Analysis of variance (ANOVA) – Test the differences among three or more groups
c. Person R correlations – tests the relationship between two variables
T-Test
Patient couldn’t sleep and has anxiety, presented with this during the working phase (not enough info. Just memorize)
Identify goals
Patient is on Risperdal and started on Reglan, what is the priority teaching for the NP?
Metoclopramide (Reglan) can cause TD
Patient with 20 year IV drug use starts showing signs of cognitive decline, what test should be ordered
Order HIV test
Patient presents with for evaluation of suspected dementia, cognitively intact with s/s of depression and answers “ I don’t know” to all screening questions
Pseudo dementia or depression
Antacids altered absorption of antipsychotic medications-what do you educate?
Do not take with 2 hours of medication.
75-year-old patient wandering, disoriented, with hallucination. What does he have and what do you do?
He has delirium
but to rule out UTI, so GET LABS
On the boards, they will have a question referring to Depakote and Lamictal. (Just read)
a. Lamictal will double causing Stephen Johnson syndrome
b. So reduce Lamictal to 50%
14 year old boy with anxiety because his 11 year old sister has smaller breast than him
Normal response and will resolve spontaneously
A mom comes in with a child with ODD. What do you suggest to the parents?
Reinforce firm parenting skill with parents
Patient diagnosed with herpes zoster 3 weeks prior to assessment but lost job
Adjustment disorder with depressed mood
13 year old patient with s/s anxiety for 6 months prior, now with s/s of agoraphobia after a shooting in his neighborhood
GAD
What kind of question do you ask a child that is reluctant to participate in answering your questions?
Use Open-ended questions
Patient from Zimbabwe stating he needed tx for think to much, what assessment would NP use?
Culturally competent care
Native American patient dx with schizo, does not want medical treatment, wants to use spiritual counseling, after confidentiality clearance what does the NP do?
Involve parents and spiritual healer in treatment planning
Patient states, its not right they wont let me get treatment because they think I cant afford it which principle was violated?
Justice
Performing med rec and see ACE inhibitor prescribed, what condition is being treated?
Cardiac Failure
Family in crisis, what do you suggest to family to help cope?
Choose to review past and present coping mechanism that were successful.
Pseudo Parkinson, what pathway has been affected
Nigrostriatal pathway
Hesitant to prescribe to amphetamines to patient dx with schizo?
Potentiate dopamine release