Test questions Flashcards
What is the correct action to correct pulmonary shunting?
Pulmonary shunting=atelectasis, answer is to increase the PEEP
Things to remember regarding tx:
Tx medical problems before psych issues
Save the patient first, then make calls
Don’t prescribe before you work up the pt
Perform within scope for the type of practice/ provider choice
Call the right person when you need to!
Always lead, don’t follow
Personal observation is always stronger than a number!!!!
What is the initial test in aortic stenosis with bruit?
Echo
What vitamin do you give for alcoholics?
Vitamin B1=thiamine,
for folic acid deficiency anemia in alcoholics
What labs will always be given together when asking a question about pancreatitis?
Amylase/ipase
What is strongest predictor of functional impairment?
Cognitive impairment
What blood protein may increase toxicity (Dilantin) d/t protein binding being decreased?
Low albumin
What is the first thing to try for hyponatremia?
Start by restricting free water
What drug class for arthritis/pain causes hyperkalemia?
NSAIDS
What is the tx for a Human bite?
PO ATB with Augmentin/ amox-clavulante
How long does it take for Pressure ulcer healing begins in a clean ulcer?
2 days
If a patient with AFib is >65 OR has risk factors, what is the preferred anticoagulant?
Coumadin
If a pt is having a Renal angiogram- what drug class should be held?
do not give an ACE inhibitor
How is pulmonary HTN diagnosed?
Pulm HTN is diagnosed by echo, confirmed by cardiac cath!
Breast CA is what % of all female deaths?
What is the cure rate?
Breast CA is 5% of all female deaths, cure rate 95%
What percentage of strokes are hemorrhagic?
Head bleeds are 15-20%
What parameter should be monitored on the ABG in a head injury pt?
For head injuries: watch the CO2 @ on the ABG!!!
In a rigid acute abd, what is the primary dx?
Always, peritonitis!!!!!!
What is the common metabolic disturbance in a new PE?
New onset PE, hyperventilation
= respiratory alkalosis!!
If pt has low serum sodium and high serum osomo and hyperglycemia, what condition is most likely?
Hyperglycemia++++low serum sodium and high serum osomo
HHNK)
What is the drug of choice for DT’s in a patient able to take PO?
Librium PO **** not Ativan
What two phsycial exam findings are common in PID?
Adnexal tenderness and cervical wall motion tenderness
What GI drug prevents nosocomial PNA?
Carafate prevents nosciomial PNA
What enviornment is desired for a post aneurysm clipping?
Quiet room
What is the drug of choice for a pt in AF with preserved LVEF?
BB
What blood test is used to follow effectiveness of synthroid?
TSH
What is the best way to approach ATB therapy with unkown cultures?
Broad to narrow coverage! Narrow to hit target!
What is the most common but least treated disorder?
Depression
What is an initial undesired side effect of synthroid?
Alopecia
What drug is used to prevent tumor lysis syndrome in Non-Hodgkins?
Allopurinol
What drug is used to r/o adrenal insufficiency in Addisons dz?
Cosyntropin
What is an uncommon cause of pancreatitis?
Cholelithiasis causes pancreatitis
What are the drug therapies for tx of kidney stones?
dilaudid or morphine ,tordol and reglan
What does lyme disease tick bite look like?
erythema migrans- erythema with circle
What is term for basic inflammation of pulmonary tissue?
Pneumonitits
Is sarcopenia a normal change in aging?
Yes, decreased muscle strength and mass
Which is bigger in the eyes, veins or arteries?
Veins bigger than arteries in the eyes
What are the five causes of true night sweats?
True night sweats:
TB
Menopause
AIDS
Lymphoma
Endocarditis
Strep pneumoniae top problems?
Strep pneumoniae top problems
OM
Bronchitis
CAP
Sinusitis
4 conditions that cause major geriatric changes in behavior?
- UTI
- Drugs
- PNA
- TIA
What is the term for pupillary constriction?
Miosis
What drug can be can be used and prevent narcotic intoxication?
Stadol (butorphenal)
What drug can be used to tx staph and anaerobes?
Amoxicillin clavulante
What electrolyte abnormality might be seen 3 days post burn?
Hypokalemia
If urine output drops in a burn patient, what action needs to be taken?
check fluid resuscitation
What conditions is sumitriptan used to tx?
Migraines and cluster HA’s
Why would a pt who does not have neuropathy (or is not depressed) be on gabapentin???
SSRI migraine prophylaxis!!!!
If the pt has neuromalignant syndrome, what is the needed action?
Neuromaglignant syndrome caused by thorazine or SSRI, need to flush out the toxin
What electrolyte abnormalitiy is an absolute contraindication for the use of Succs?
Hyperkalemia
What is the celcius for a fever of 101.6?
38.6
What factor increases robustness of the study?
Sample size
What is the highest level of evidence by study type?
1) Review of literature “meta-analysis”
2nd- quantitative study
- Randomized Control Trial
- Quasi-experimental
3rd qualitative
4th-editorial, personal experience
What are the four roles of the NP?
What level of physical exam would be appropriate for a patient without an H&P?
**** comprehensive
What strategy best ensures that a pt follows-up?
Scheduling appts FOR the patient
Define Hyjob:
Define Berkha:
Hyjob- hair is covered, face is open,
berkha- only see the eyes –
get a woman, not a man, who hopefully speaks the language and explain why is needed and have woman do the exam
Additional practice notes:
Note high acuity is specialty practice!!!!
If you have an Advanced Directive in place, you work FOR the PATIENT, respect their wishes
Communication: Listen more than talk!!!!, short answer is best, Tell me ….., no why!, focus on feelings, no euphemisms Use the short, piercing truth
Name a good strategy for exhibiting independent prace?
Bill for independent practice
What are you treating on the lipid panel?
LDL
What does a t-test determine?
Compares the difference between 2 means
