Podcast
Questions and Answers
What is the primary factor associated with hot flashes during perimenopause?
What is the primary factor associated with hot flashes during perimenopause?
- Low estrogen levels
- Fluctuating estrogen levels (correct)
- Fluctuating progesterone levels
- Low progesterone levels
Which physical examination finding in a 65-year-old woman necessitates further evaluation?
Which physical examination finding in a 65-year-old woman necessitates further evaluation?
- Atrophic vaginitis
- A new retraction of the nipple (correct)
- Decrease in axillary hair
- Atrophy of glandular breast tissue
Which is NOT a typical symptom of primary syphilis?
Which is NOT a typical symptom of primary syphilis?
- A painless ulcer
- Spontaneously healing lesion
- Flu-like symptoms
- Chance (correct)
A patient with trichomoniasis is prescribed metronidazole. What should the nurse practitioner advise the patient?
A patient with trichomoniasis is prescribed metronidazole. What should the nurse practitioner advise the patient?
At what age is it recommended to begin screening for cervical cancer in women?
At what age is it recommended to begin screening for cervical cancer in women?
Which assessment findings are consistent with Chlamydia?
Which assessment findings are consistent with Chlamydia?
What is the first-line treatment option for a primary herpes infection?
What is the first-line treatment option for a primary herpes infection?
A patient presents with foul-smelling, frothy, copious vaginal discharge. What is the most likely treatment?
A patient presents with foul-smelling, frothy, copious vaginal discharge. What is the most likely treatment?
What is the treatment of choice for bacterial vaginosis (BV)?
What is the treatment of choice for bacterial vaginosis (BV)?
Jane presents with a thick, white, curd-like vaginal discharge and vulvar itching. Which treatment is most likely indicated?
Jane presents with a thick, white, curd-like vaginal discharge and vulvar itching. Which treatment is most likely indicated?
A female patient is diagnosed with chlamydia. What is recommended treatment of her male partner to prevent reinfection?
A female patient is diagnosed with chlamydia. What is recommended treatment of her male partner to prevent reinfection?
A 31-year-old woman has normal PAP and HPV results. How often should she have cervical cancer screening?
A 31-year-old woman has normal PAP and HPV results. How often should she have cervical cancer screening?
A 53-year-old woman on HRT develops atrophic symptoms. What is the best treatment?
A 53-year-old woman on HRT develops atrophic symptoms. What is the best treatment?
First-line treatment for a UTI is:
First-line treatment for a UTI is:
Which clinical finding indicates pyelonephritis?
Which clinical finding indicates pyelonephritis?
Which pharmacological management for pyelonephritis?
Which pharmacological management for pyelonephritis?
Mrs. Lowell presents with dysuria and fatigue. She is type II diabetic. What appropriate pharmacotherapy?
Mrs. Lowell presents with dysuria and fatigue. She is type II diabetic. What appropriate pharmacotherapy?
Mrs. Jones is asymptomatic. She is found to have pyuria. How should she be managed?
Mrs. Jones is asymptomatic. She is found to have pyuria. How should she be managed?
When a patient's GFR is 65, which intervention is least important?
When a patient's GFR is 65, which intervention is least important?
What is the highest NP priority differential diagnosis to consider when a patient shows signs of hematuria?
What is the highest NP priority differential diagnosis to consider when a patient shows signs of hematuria?
Flashcards
Menopause Hot Flashes
Menopause Hot Flashes
Hot flashes during menopause are thought to be related to fluctuating estrogen levels.
Nipple Retraction
Nipple Retraction
A new retraction of the nipple warrants further evaluation.
Primary Syphilis - Not
Primary Syphilis - Not
A flu-like symptom is NOT representative of primary syphilis. Primary syphilis includes painless ulcer, a chance and spontaneously healing lesion
Metronidazole & Alcohol
Metronidazole & Alcohol
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Cervical Cancer Screening
Cervical Cancer Screening
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Chlamydia Assessment
Chlamydia Assessment
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Primary Herpes Treatment
Primary Herpes Treatment
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Trichomonas Treatment
Trichomonas Treatment
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Bacterial Vaginosis Treatment
Bacterial Vaginosis Treatment
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Vaginal Yeast Infection
Vaginal Yeast Infection
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Chlamydia Treatment - Partners
Chlamydia Treatment - Partners
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Normal Pap Smear + HPV test Next Steps
Normal Pap Smear + HPV test Next Steps
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Atrophic Vaginitis
Atrophic Vaginitis
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UTI treatment
UTI treatment
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Pyelonephritis
Pyelonephritis
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Pyelonephritis
Pyelonephritis
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UTI treatment
UTI treatment
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GFR of 65 Interventions
GFR of 65 Interventions
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Testicular Torsion Finding
Testicular Torsion Finding
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Diagnostic test for kidney stones
Diagnostic test for kidney stones
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Study Notes
- Hot flashes during peri-menopause are thought to be related to fluctuating estrogen levels.
- A new retraction of the nipple warrants further evaluation in a 65-year-old woman.
- Chance is not representative of the presentation of primary syphilis.
- For a patient treated with metronidazole (Flagyl) for trichomoniasis, advise, "Do not drink alcohol while you are taking this mediator."
- The recommended age to initiate cervical cancer screening in women is at age 21 years.
- Mucopurulent cervicitis and edematous, congested friable cervix are assessment findings consistent with Chlamydia.
- The first-line treatment option for primary herpes infection includes acyclovir.
- Metronidazole 2 G PO x 1 dose is the most likely treatment for a patient with foul-smelling frothy, copious, pale yellow to gray-green vaginal discharge, vulvar irritation, and cervical petechiae, indicating Trichomonas.
- Metronidazole 500 mg PO BID x 7 days is the treatment of choice for a 36-year-old woman with vaginal burning, greyish-white adherent vaginal discharge with a fishy odor, a discharge pH level of 5.1, and a positive whiff test, indicating bacterial vaginosis.
- Fluconazole (Diflucan) 150 mg by mouth single dose is the most likely treatment for a 38-year-old female who presents with non-odorous thick, white, curd-like vaginal discharge and vulvar itching, recently treated for a sinus infection.
- A female patient diagnosed with chlamydia, who has complaints of vaginal discharge and dysuria, and her asymptomatic male partner, should both be treated with doxycycline x 7 days or azithromycin 1g IM.
- A 31-year-old female patient, who has never had an abnormal PAP smear and has had regular screening since age 22, has a normal PAP smear with HPV testing today, should have her next cervical cancer screening every 5 years with cervical cytology plus HPV co-testing, according to the ACS and ACOG guideline.
- For a 53-year-old woman who is taking HRT with conjugated estrogen, 0.45 mg/day with medroxyprogesterone acetate (MPA), 1.5 mg, and has bothersome atrophic vaginitis symptoms, the addition of a topical estrogen can be helpful.
- For a 23-year-old female presents with urinary burning, frequency, and urgency, urine dipsticks is positive for leukocytes and nitrites, with no medical history and no other pertinent clinical findings, the recommended treatment of choice is Nitrofurantoin 100 mg BID x 5 days.
- Costovertebral angle tenderness would be consistent in a 29-Year-old female patient with no medical history presented to the NP office with fever chills and +WBC casts has been diagnosed with pyelonephritis.
- Levaquin 750 mg PO daily x 5 days is the recommended pharmacological management for a 29-year-old female patient who presented to the NP office with fever chills and +WBC casts has been diagnosed with pyelonephritis.
- For a 45-year-old active woman with diabetes presenting with urinary frequency, dysuria, and fatigue, and a urine dipstick showing leukocytes and nitrites but no fever or chills. Bactrim DS 800/160 mg BID x7 days is the appropriate treatment.
- For a physically independent 65 y/o, beginning to have some joint pain but is otherwise healthy and takes only her hormones, and is found on a routine well visit to have WBCs in her urine, with no signs or symptoms of UTI infection. Monitor her for symptoms of UTI.
- With a HTN patient with GFR of 65, the nurse practitioner should consider all of the following interventions EXCEPT refer to nephrologist for hemodialysis.
- For a 42-year-old male patient presents to the NP office with a sudden unset of lower back pain, hematuria, and diaphoresis. He has no scrotal pain, fever or penile discharge. He is currently on thiazides diuretic for high blood pressure. The NP' highest differential diagnosis consideration should be renal lithiasis.
- For a 22-year-old male patient who is otherwise healthy presents to the NP office with a sudden onset of scrotal pain. He complains of nausea and is found to have an asymmetric, high-riding testes on the right side. The NP suspect Testicular Torsion.
- A classic physical finding in a patient with testicular torsion include absences of cremasteric reflex on affected side.
- Ben is 28-year-old sexually active male who the APN suspects as having epididymitis. Physical exam findings are most consistent with the diagnosis scrotal edema, low back pain, pain relieved with scrotal elevation level.
- A client has stress incontinence. When obtaining the health history, the nurse should ask if the client has loss of urine when coughing.
- Cheryl, 72-year-old female, is complaining of difficulty holding her urine when she has the urge to void This results in leaking. She is asking for medications to help her problem as a NP. you would consider which medication for this patient Oxybutynin 2.5 mg TID.
- A 40-year-old healthy Caucasian male with no risk factors and no significant medical or family history, who requests a baseline screening for prostate cancer, should be informed that guidelines do not recommend screening at this time.
- The American Cancer Society recommends discussion for PSA screening starting at age 45 years for initial prostate cancer screening in African-American males.
- Mr. Cruz was started on Proscar 5 mg daily 4 weeks ago, if a repeat PSA was done today, the NPs initial expectation is it may take 6 months to assess efficacy.
- Mr. Adams is a 52-year-old male truck driver who informs the NP that his sexual performance has not been adequate lately. Recently he was speaking to one of his. "buddies" who had been prescribed medication for the same problem and was wondering if he could be prescribed the same medication. the NP knows that the risk factors for ED include all of following EXCEPT: family history.
- TSH may be used to exclude a common secondary cause of hyperlipidemia.
- A 65-year-old male patient with NO history of ACVD or DM Lipid profile Total cholesterol = 210, LDL = 130, HDL= 35, Triglycerides= 129. Based on the guidelines, the next step To manage this patient is Calculate the patients 10-year CV risk.
- A 52-Year-old male patient with known diabetes has the following lipid profile total cholesterol 198. LDL 115, HDL 35triglicerides 124 ASCVD. Risk score 6.7/%: Manage this patient by Start Atorvastatin 40 mg PO daily.
- A patient on Simvastatin for newly diagnosed hyperlipidemia complains of generalized muscle aches for about 2 weeks. Evaluate with Order a CPK.
- A 45-year-old diabetic patient with elevated BP, consider treating his HTN with Enalapril 10 mg dally.
- A 40-year-old African American patient with no medical history has had BP readings between 136/90 and 144/80 despite lifestyle modifications for 3 months, the plan of care for this patient is start amlodipine 5 mg daily.
- When starting patient on ACE inhibitor, monitor BMP for elevated potassium level.
- A 54-year-Old patient was recently diagnosed with HTN She was started on Lisinopril 20 mg OD 3 months ago: Her current BP Is 156/94. Using the guidelines, the appropriated next step? Add HCTZ 25 mg PO daily.
- The choice of anti-hypertensive agent for the indicated patient's condition Beta-blocker for a patient with a history of MI.
- Which anti-hypertensive medication would you avoid using in a patient with severe asthma? Beta blockers.
- ACE inhibitors class of anti-hypertensive medication Is used to improve long-term outcomes of patient with systolic dysfunction.
- You are trying to determine the thromboembolic risk in a patient with Afib Using the CHADSVASC score, you would consider the following as risk factors EXCEPT: age of 55.
- A patient with new onset Afib has a CHADSVASC score of 4 with no bleeding risks. The best approach for this patient is to start Rivaroxaban 20 mg daily.
- A serious complication of deep venous thrombosis is pulmonary embolus.
- A patient presents to the office with left lower leg swelling and discomfort Based on his history and PE findings, he has a Well's score of 4. The most appropriated next step? order a venous ultrasound.
- A patient, with no significant co-morbidities, is diagnosed with proximal DV A decision has been made to start him on pharmacologic management the appropriated initial medication start the patient on is: Rivaroxaban 15 mg bid.
- An indicator of severe peripheral artery disease would be is claudication unrelieved with rest.
- The management of peripheral arterial disease include all of the following EXCEPT: vasodilator therapy.
- In a patient with an ABI of 0.9, you would recommend all of the above.
- In a patient suspected of having PAD, the following statement is true ABI can be used lo diagnoses PAD.
- Factors included in the Wells criteria used to evaluate the patient's risk for DVT include patient immobilization.
- In order to reduce lipid levels, statins are most beneficial when taken in conjunction with diet and exercise.
- The gold standard diagnostic test for kidney stones is Helical computed tomography (CT) non-contrast of the abdomen and pelvis - considered the best initial and gold standard test for detection of stones because of its high sensitivity (95%) and specificity (98%)
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