Untitled Quiz

Questions and Answers

What is Cranial Nerve VIII responsible for?

Acoustic (Hearing and balance) (correct)

Taste

Smell

Vision

What is the function of Cranial Nerve IX?

Taste and swallowing (correct)

Vision

Balance

Hearing

What function does Cranial Nerve XI serve?

Hearing

Taste

Movement of shoulder and neck (correct)

Balance

The deep tendon reflex for the ankle is primarily associated with which nerve root?

S1 Signup and view all the answers

Which of the following is a stroke risk scale?

CHADS2 Signup and view all the answers

Which permanent teeth are the first to erupt in children around the age of 6?

First Molars Signup and view all the answers

Which activity is NOT classified as an activity of daily living (ADL)?

Grocery Shopping Signup and view all the answers

What is the most likely diagnosis for a pregnant woman at 30 weeks with proteinuria, weight gain, and negative nitrites?

Pregnancy-induced hypertension (pre-eclampsia) Signup and view all the answers

What is the most likely diagnosis for a child with a high fever that resolved followed by a maculopapular rash?

Roseola infantum Signup and view all the answers

Which condition is characterized by bright red blood in the eye without pain or visual changes?

Subconjunctival hemorrhage Signup and view all the answers

What is the likely diagnosis for a woman with dyspareunia and atrophic squamous cells found on a microscopy slide?

Atrophic vaginitis Signup and view all the answers

What is the most common type of skin malignancy?

Basal skin cancer Signup and view all the answers

Koplik's spots are associated with which condition?

Measles Signup and view all the answers

At what level of prevention is lung cancer classified?

Primordial prevention Signup and view all the answers

What does the visual fields by confrontation test evaluate?

Peripheral vision Signup and view all the answers

What is the most common cause of Cushing's syndrome?

Administration of a glucocorticoid or ACTH. Signup and view all the answers

What intervention provides the greatest relief for a patient complaining of aching legs due to varicose veins?

Elevate her legs periodically. Signup and view all the answers

What is the most likely diagnosis for a 25-year-old female with scant nipple discharge and no palpable mass?

Intraductal papilloma. Signup and view all the answers

According to the ANA, what is the role of the nurse practitioner who provides primary health care?

Direct nursing care role. Signup and view all the answers

What is the most likely diagnosis for an 8-month-old male with hemarthrosis in both knees?

A type of hemophilia. Signup and view all the answers

What is the long-term prognosis for most children with juvenile rheumatoid arthritis?

Most children achieve complete remission by adulthood. Signup and view all the answers

What is the most common organism found in dog bite wounds?

Staphylococcus and Pasteurella multocida. Signup and view all the answers

What should education for women with fibrocystic breast disease include regarding caffeine?

Caffeine may trigger breast pain. Signup and view all the answers

When do congenital heart disorders typically present with symptoms?

Birth, infancy, or in childhood. Signup and view all the answers

What is the most likely diagnosis for a 21-year-old male with abdominal guarding and rebound tenderness?

Appendicitis. Signup and view all the answers

In what condition should Atenolol be avoided?

In patients with asthma. Signup and view all the answers

Which interventions are NOT appropriate for pediatric patients?

Pre-medicate for all interventions Signup and view all the answers

What is the most urgent complication infants with celiac disease are at risk for?

Intussusception or volvulus. Signup and view all the answers

Which of the following activities is NOT characteristic of preschool children?

Always follow rules during playground games. Signup and view all the answers

What symptom is an early indicator of heart failure?

Weight gain. Signup and view all the answers

What is the most appropriate action for a pregnant patient who feels light-headed when standing?

Blood pressure normally decreases during pregnancy. Signup and view all the answers

When should the nurse practitioner check the TSH of a patient on thyroid hormone replacement therapy?

6 weeks. Signup and view all the answers

What is essential to teach a male with a history of cryptorchidism?

Testicular self-examination. Signup and view all the answers

What is the treatment of choice for chronic bacterial prostatitis?

A fluoroquinolone twice daily for 3 weeks to 4 months. Signup and view all the answers

Which underlying condition is likely for a female with frequent candidal vaginal infections?

Diabetes. Signup and view all the answers

Which of the following is NOT a characteristic of the S3 heart sound?

The sound is high-pitched and occurs just prior to the S1 heart sound Signup and view all the answers

What is the accurate normal level for PSA?

4ng/ml or less Signup and view all the answers

What finding most strongly correlates with a myocardial infarction?

Elevated Troponin I levels. Signup and view all the answers

What is a secondary cause of hyperlipidemia?

Hypothyroidism. Signup and view all the answers

What specimen should NOT be collected for suspected acute bacterial prostatitis?

Sterile in-and-out catheter urine specimen Signup and view all the answers

The sequence for obtaining specimens when prostate infection is suspected is: voided urethral urine, voided mid-stream bladder urine, and voided post-prostate massage urine.

voided urethral urine, voided mid-stream bladder urine, voided post-prostate massage urine Signup and view all the answers

What should the nurse practitioner advise a 24-year-old female who has missed her last 2 contraceptive pills to minimize her risk of pregnancy?

Double today's dose and tomorrow's dose and use a barrier method for the rest of the month. Signup and view all the answers

What action should the nurse practitioner take for a 50-year-old non-smoker diagnosed with pneumonia?

Start Clarithromycin (Biaxin) 500 mg 2 times a day for 10 to 14 days. Signup and view all the answers

What is the most appropriate intervention for a 38-year-old patient with heavy vaginal bleeding due to multiple uterine leiomyomas?

Obtain a gynecological consultation. Signup and view all the answers

What are expected spirometry readings in a patient with chronic emphysema?

Increased total lung capacity (TLC), increased residual volume, decreased volume capacity, and decreased FEV-1. Signup and view all the answers

Physical exam findings consistent with emphysema include all of the following EXCEPT:

Pallor and cyanosis of the mucosa and nailbeds. Signup and view all the answers

Which laboratory test is useful in the diagnosis of spontaneous abortion?

Serial quantitative beta-human chorionic gonadotropin levels. Signup and view all the answers

What is the most accepted recommendation regarding skin cancer prevention?

Avoidance of excessive sun exposure. Signup and view all the answers

What prophylaxis medication is recommended for a patient under 35 years of age with a positive PPD?

Isoniazid (INH). Signup and view all the answers

The diagnosis of Meniere's disease is based on what?

The exclusion of other pathologies. Signup and view all the answers

Why should beta-adrenergic blockers be avoided in patients with diabetes?

They may mask symptoms of hypoglycemia. Signup and view all the answers

What is the ideal body weight for a female who is 5 feet 7 inches tall using the height-weight formula?

135 lbs. Signup and view all the answers

What is the appropriate initial treatment for a 19-year-old female college student with iron deficiency anemia secondary to heavy menstrual bleeding?

Oral ferrous sulfate. Signup and view all the answers

A male patient taking Coumadin (warfarin) should report all of the following EXCEPT?

One missed dose of warfarin. Signup and view all the answers

Which medication class does NOT have dizziness or vertigo as potential adverse side effects?

Meclizine (Antivert). Signup and view all the answers

A PPD is considered positive at 5 millimeters or more for which populations?

Confirmed or suspected HIV infection, injecting drug users, close contacts of a TB case, persons with a chest X-ray suggestive of TB. Signup and view all the answers

Education targeted towards adolescents should first focus on which issue related to mortality statistics?

Alcohol abuse. Signup and view all the answers

What is the effective management for a patient with moderate persistent asthma?

Daily inhaled steroids and long-acting bronchodilators. Signup and view all the answers

For a child with a second-degree burn, appropriate instructions to the mother include all of the following EXCEPT:

Applying butter, cooking oil, or lanolin for pain relief. Signup and view all the answers

What is the recommended treatment for cat scratch disease?

Usually self-limiting; severe cases may benefit from azithromycin. Signup and view all the answers

What is the most common cause of traveler's diarrhea?

E coli. Signup and view all the answers

What bacteria is responsible for causing cat scratch disease?

Bartonella henselae. Signup and view all the answers

What are the 4 different components of tetralogy of fallot?

Overriding aorta, pulmonary stenosis, right ventricular hypertrophy, and a ventricular septal defect. Signup and view all the answers

What does the murmur auscultated in tetralogy of fallot sound like?

Systolic murmur best heard at the left upper sternal border. Signup and view all the answers

What does the murmur auscultated in a ventricular septal defect sound like?

Systolic murmur best heard at the left lower sternal border. Signup and view all the answers

Where is the aorta best auscultated?

At the second ICS to the right of the sternum. Signup and view all the answers

Where is the pulmonary artery best auscultated?

At the second ICS to the left of the sternum. Signup and view all the answers

What is a scotoma?

A blind spot or aura that obstructs part of your vision. Signup and view all the answers

Is presbyopia nearsightedness or farsightedness?

True Signup and view all the answers

Is myopia nearsightedness or farsightedness?

True Signup and view all the answers

Do cataracts cause myopia or presbyopia?

True Signup and view all the answers

What is the USPSTF's recommendation on scoliosis screening for adolescents?

Insufficient. Signup and view all the answers

When should adolescent girls be screened for scoliosis?

As early as 10 years old and then again at age 12. Signup and view all the answers

When should adolescent boys be screened for scoliosis?

Between age 12-13. Signup and view all the answers

What is Auspitz sign?

The appearance of small bleeding points after successive layers of scale have been removed from the surface of psoriatic papules or plaques. Signup and view all the answers

A positive Auspitz sign is indicative of what?

Psoriasis. Signup and view all the answers

When are pregnant women screened for gestational diabetes?

Week 24-28. Signup and view all the answers

What is round ligament pain?

A deep, sharp, stabbing or stretching sensation that begins or worsens with movement. Signup and view all the answers

What are the components of the fetal biophysical profile?

Nonstress test (heart rate monitoring), amniotic fluid analysis, fetal movements, fetal tone, and fetal breathing. Signup and view all the answers

How is the fetal biophysical profile performed?

Via ultrasound and fetal heart rate monitoring. Signup and view all the answers

When is the fetal biophysical profile often performed?

In the third trimester, often after week 28-32. Signup and view all the answers

What is a normal kick count in pregnancy?

At least 10 kicks in a consecutive two hour period. Signup and view all the answers

How much weight should an underweight woman gain in pregnancy?

28-40 pounds. Signup and view all the answers

How much weight should a normal weight woman gain in pregnancy?

25-35 pounds. Signup and view all the answers

How much weight should an overweight woman gain in pregnancy?

15-25 pounds. Signup and view all the answers

How much weight should an obese woman gain in pregnancy?

11-20 pounds. Signup and view all the answers

Underweight and normal weight women should be gaining how much weight per week in their second and third trimesters?

1 pound. Signup and view all the answers

Overweight and obese women should be gaining how much weight per week in their second and third trimesters?

0.5 pounds. Signup and view all the answers

What is the biggest risk associated with scabies?

Secondary infection due to itching. Signup and view all the answers

What do scabies look like on the skin?

Red papular bumps that have s-shaped burrows on them. Signup and view all the answers

Sickle cell anemia is what type of anemia?

Normocytic. Signup and view all the answers

How is sickle cell anemia diagnosed?

Hemoglobin electrophoresis. Signup and view all the answers

Which age group is rheumatic fever most common in?

Children ages 5-15. Signup and view all the answers

What are the major symptoms of rheumatic fever?

Carditis, arthritis, chorea, erythema marginatum (rash), subcutaneous nodules. Signup and view all the answers

What are the minor symptoms of rheumatic fever?

Fever, elevated ESR, prolonged PR interval. Signup and view all the answers

How do we treat rheumatic fever?

Refer to the hospital. Signup and view all the answers

Study Notes

Cranial Nerves

Cranial Nerve VIII: Responsible for acoustic functions (hearing and balance).
Cranial Nerve IX: Glossopharyngeal nerve involved in swallowing, palate elevation, and the gag reflex.
Cranial Nerve XI: Spinal accessory nerve primarily affects upper trapezius muscle function.

Reflexes and Scales

Deep tendon reflexes assessment:
- Ankle reflex is primarily mediated by S1.
- Knee reflex involves lumbar segments L2-L4.
- Supinator (or brachioradialis) reflex correlates with C5,6.
- Bicep and triceps reflexes are associated with C6,7.
CHADS2 stroke risk scale includes:
- Congestive heart failure (C)
- Hypertension (H)
- Age greater than 75 years (A)
- Diabetes (D)
- Previous stroke or TIA (S)

Pediatric and Women’s Health

First permanent teeth eruption starts around age 6, typically the first molars.
Activities of Daily Living (ADLs) exclude grocery shopping; include feeding oneself, managing bladder/bowel, and personal hygiene.
Analysis of urinalysis results in a pregnant woman suggests potential pregnancy-induced hypertension (pre-eclampsia) due to the classic triad of symptoms encompassing hypertension, edema, and proteinuria.

Infections and Conditions

Maculopapular rash following fever in infants is commonly linked to roseola infantum (exanthema subitum).
Subconjunctival hemorrhage is indicated by a bright red spot in the eye without pain or other vision changes.
Microscopy revealing atrophic squamous epithelial cells and a vaginal pH of 4.0 suggests atrophic vaginitis.

Skin and Cardiovascular Health

Most common skin malignancy is basal cell cancer, significantly more prevalent than squamous cell cancer.
Koplik's spots are classic for measles, accompanied by fever, conjunctivitis, and coryza.
Early symptoms of heart failure include weight gain, which is the most sensitive indicator.

Prevention and Diagnosis

Lung cancer screening is under considered primordial prevention due to a lack of general population guidelines.
Peripheral vision is evaluated via the visual fields by confrontation test.
The most frequent cause of Cushing's syndrome is the administration of glucocorticoids.

Management and Treatments

Elevating legs helps alleviate symptoms in patients with varicose veins.
Patients with hypothyroidism should have their TSH levels checked six weeks after initiating thyroid hormone replacement therapy.
Treatment for chronic bacterial prostatitis involves using a fluoroquinolone over several weeks.

Infants and Children

Infants with celiac disease are at risk for intussusception or volvulus, requiring urgent surgical intervention.
Preschool children may not consistently follow rules during games.
In pediatric settings, pre-medication is not universally applied to all painful interventions, such as before routine immunizations.

Gynecological and Urological Considerations

Testicular self-examination is crucial for males with a history of cryptorchidism due to increased cancer risk.
In cases of missed oral contraceptive pills, doubling doses and using barrier methods are crucial for pregnancy prevention.
Obtaining a gynecological consultation is warranted for a female patient with significant uterine enlargement and notable anemia not responsive to hormonal treatment.

Laboratory Assessments and Guidelines

Elevated Troponin I levels correlate strongly with myocardial infarction.
Normal PSA levels should be 4 ng/mL or less; levels above indicate the need for further investigation.
A sterile in-and-out catheter urine specimen does not help in diagnosing prostatitis, as it only reflects bladder infection rather than differentiating between infection sites.

Miscellaneous

Frequent candidal infections in women may relate to underlying diabetes.
Edema and symptoms of chronic venous insufficiency can often be improved through leg elevation and support stockings.
Various medications, particularly certain antihypertensives and antidepressants, can contribute to erectile dysfunction.### Chronic Emphysema
Expected spirometry readings show increased total lung capacity (TLC), while residual volume is increased and volume capacity is decreased.
FEV-1 is decreased in emphysema, unlike in chronic bronchitis where TLC is normal or only slightly increased.

Physical Exam Findings in Emphysema

Emphysema (Type A COPD) is characterized by the absence of pallor and cyanosis, which are typical of chronic bronchitis (Type B COPD).
An increased anteroposterior (AP) diameter leads to a "barrel chest".
The thoracic muscles appear thin and wasted, with hypertrophied accessory muscles of respiration.
Breath sounds are diminished, and cough is weak and ineffective.

Diagnosis of Spontaneous Abortion

Serial quantitative beta-human chorionic gonadotropin levels are crucial for diagnosing spontaneous abortion and typically show progressive decline.

Skin Cancer Prevention

The primary recommendation is to avoid excessive sun exposure, particularly for high-risk groups, including fair-skinned individuals over 65 and those with atypical moles or 50+ moles.

Prophylaxis for Tuberculosis in Young Adults

Isoniazid (INH) is recommended for individuals under 35 with a positive PPD to prevent the progression from latent to active TB.

Diagnosis of Meniere's Disease

Diagnosis is primarily based on excluding other conditions, as Meniere’s disease is often idiopathic.
Symptoms include low-frequency hearing loss and central vertigo.

Beta-Adrenergic Blockers in Diabetes

These medications may mask hypoglycemia symptoms, particularly peripheral signs such as jitteriness and tachycardia, but not diaphoresis.

Ideal Body Weight Calculation

For a 5'7" female, the ideal body weight is estimated at 135 lbs using the height-weight formula.

Initial Treatment for Iron Deficiency Anemia

Oral ferrous sulfate is the first line of treatment for iron deficiency anemia, especially when secondary to heavy menstrual bleeding.

Warfarin Management in Atrial Fibrillation

Patients on warfarin should report significant changes but one missed dose is less critical due to the long-lasting effects of the medication.

Dizziness and Vertigo Causes

Certain medications, including antibiotics and high-dose salicylates, can cause dizziness; meclizine does not induce these side effects.

PPD Test Interpretation

A positive PPD is designated at 5 mm or more in high-risk populations such as those with HIV or close contacts of TB cases.

Alcohol Abuse in Adolescents

Alcohol is the most prevalent psychoactive substance among adolescents, with driving under its influence being the leading cause of death in the 15-24 age group.

Moderate Persistent Asthma Management

Best managed with daily inhaled steroids and long-acting bronchodilators, potentially supplemented by oral leukotriene blockers.

Burn Care for Second-Degree Burns

Cool water should be applied to burns; oils should be avoided as they can trap heat.

Cat Scratch Disease Treatment

Typically self-limiting; severe cases might require azithromycin.

Common Cause of Traveler's Diarrhea

Escherichia coli (E. coli) is the most frequent bacterial cause.

Cat Scratch Disease Causative Agent

Caused by Bartonella henselae.

Components of Tetralogy of Fallot

Includes overriding aorta, pulmonary stenosis, right ventricular hypertrophy, and a ventricular septal defect.

Murmurs in Cardiac Conditions

Tetralogy of Fallot presents a systolic murmur best heard at the left upper sternal border; a ventricular septal defect presents similarly at the left lower sternal border.

Aorta and Pulmonary Artery Auscultation

Aorta is best auscultated at the second intercostal space (ICS) to the right of the sternum; pulmonary artery at the second ICS to the left.

Visual Disturbances

A scotoma represents a blind spot obstructing part of vision, while presbyopia is associated with difficulty seeing close objects.

Scoliosis Screening

Insufficient evidence exists for routine screening; girls should be screened as early as 10, boys between ages 12-13.

Auspitz Sign

The appearance of small bleeding points after removing scales from psoriatic lesions, indicating psoriasis.

Gestational Diabetes Screening

Recommended between weeks 24 and 28 of pregnancy.

Round Ligament Pain in Pregnancy

Characterized by sharp, stabbing sensations, normal and benign during pregnancy.

Fetal Biophysical Profile Components

Includes monitoring fetal heart rate, analyzing amniotic fluid, and assessing fetal movements, tone, and breathing.

Normal Kick Count

At least 10 kicks within a two-hour period is considered normal during pregnancy.

Weight Gain Guidelines in Pregnancy

Underweight women should gain 28-40 lbs, normal-weight women 25-35 lbs, overweight women 15-25 lbs, and obese women 11-20 lbs.

Weight Gain Rate

Underweight and normal-weight women should gain 1 lb/week in the second and third trimesters, while overweight and obese women should gain 0.5 lbs/week.

Scabies Presentation and Risks

Caused by red papular bumps with S-shaped burrows; the biggest risk is secondary infection from itching.

Sickle Cell Anemia Classification and Diagnosis

Considered normocytic anemia and diagnosed via hemoglobin electrophoresis.

Rheumatic Fever Demographics and Symptoms

Most common in children aged 5-15; major symptoms include carditis, arthritis, chorea, and rash; minor symptoms involve fever and prolonged PR interval.

Rheumatic Fever Treatment

Hospital referral is recommended for management.

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