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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?

    <p>S1</p> Signup and view all the answers

    Which of the following is a stroke risk scale?

    <p>CHADS2</p> Signup and view all the answers

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

    <p>First Molars</p> Signup and view all the answers

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

    <p>Grocery Shopping</p> 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?

    <p>Pregnancy-induced hypertension (pre-eclampsia)</p> 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?

    <p>Roseola infantum</p> Signup and view all the answers

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

    <p>Subconjunctival hemorrhage</p> 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?

    <p>Atrophic vaginitis</p> Signup and view all the answers

    What is the most common type of skin malignancy?

    <p>Basal skin cancer</p> Signup and view all the answers

    Koplik's spots are associated with which condition?

    <p>Measles</p> Signup and view all the answers

    At what level of prevention is lung cancer classified?

    <p>Primordial prevention</p> Signup and view all the answers

    What does the visual fields by confrontation test evaluate?

    <p>Peripheral vision</p> Signup and view all the answers

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

    <p>Administration of a glucocorticoid or ACTH.</p> Signup and view all the answers

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

    <p>Elevate her legs periodically.</p> 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?

    <p>Intraductal papilloma.</p> Signup and view all the answers

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

    <p>Direct nursing care role.</p> Signup and view all the answers

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

    <p>A type of hemophilia.</p> Signup and view all the answers

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

    <p>Most children achieve complete remission by adulthood.</p> Signup and view all the answers

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

    <p>Staphylococcus and Pasteurella multocida.</p> Signup and view all the answers

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

    <p>Caffeine may trigger breast pain.</p> Signup and view all the answers

    When do congenital heart disorders typically present with symptoms?

    <p>Birth, infancy, or in childhood.</p> Signup and view all the answers

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

    <p>Appendicitis.</p> Signup and view all the answers

    In what condition should Atenolol be avoided?

    <p>In patients with asthma.</p> Signup and view all the answers

    Which interventions are NOT appropriate for pediatric patients?

    <p>Pre-medicate for all interventions</p> Signup and view all the answers

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

    <p>Intussusception or volvulus.</p> Signup and view all the answers

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

    <p>Always follow rules during playground games.</p> Signup and view all the answers

    What symptom is an early indicator of heart failure?

    <p>Weight gain.</p> Signup and view all the answers

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

    <p>Blood pressure normally decreases during pregnancy.</p> Signup and view all the answers

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

    <p>6 weeks.</p> Signup and view all the answers

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

    <p>Testicular self-examination.</p> Signup and view all the answers

    What is the treatment of choice for chronic bacterial prostatitis?

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

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

    <p>Diabetes.</p> Signup and view all the answers

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

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

    What is the accurate normal level for PSA?

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

    What finding most strongly correlates with a myocardial infarction?

    <p>Elevated Troponin I levels.</p> Signup and view all the answers

    What is a secondary cause of hyperlipidemia?

    <p>Hypothyroidism.</p> Signup and view all the answers

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

    <p>Sterile in-and-out catheter urine specimen</p> 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.

    <p>voided urethral urine, voided mid-stream bladder urine, voided post-prostate massage urine</p> 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?

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

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

    <p>Start Clarithromycin (Biaxin) 500 mg 2 times a day for 10 to 14 days.</p> 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?

    <p>Obtain a gynecological consultation.</p> Signup and view all the answers

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

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

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

    <p>Pallor and cyanosis of the mucosa and nailbeds.</p> Signup and view all the answers

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

    <p>Serial quantitative beta-human chorionic gonadotropin levels.</p> Signup and view all the answers

    What is the most accepted recommendation regarding skin cancer prevention?

    <p>Avoidance of excessive sun exposure.</p> Signup and view all the answers

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

    <p>Isoniazid (INH).</p> Signup and view all the answers

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

    <p>The exclusion of other pathologies.</p> Signup and view all the answers

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

    <p>They may mask symptoms of hypoglycemia.</p> 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?

    <p>135 lbs.</p> 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?

    <p>Oral ferrous sulfate.</p> Signup and view all the answers

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

    <p>One missed dose of warfarin.</p> Signup and view all the answers

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

    <p>Meclizine (Antivert).</p> Signup and view all the answers

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

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

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

    <p>Alcohol abuse.</p> Signup and view all the answers

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

    <p>Daily inhaled steroids and long-acting bronchodilators.</p> 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:

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

    What is the recommended treatment for cat scratch disease?

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

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

    <p>E coli.</p> Signup and view all the answers

    What bacteria is responsible for causing cat scratch disease?

    <p>Bartonella henselae.</p> Signup and view all the answers

    What are the 4 different components of tetralogy of fallot?

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

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

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

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

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

    Where is the aorta best auscultated?

    <p>At the second ICS to the right of the sternum.</p> Signup and view all the answers

    Where is the pulmonary artery best auscultated?

    <p>At the second ICS to the left of the sternum.</p> Signup and view all the answers

    What is a scotoma?

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

    Is presbyopia nearsightedness or farsightedness?

    <p>True</p> Signup and view all the answers

    Is myopia nearsightedness or farsightedness?

    <p>True</p> Signup and view all the answers

    Do cataracts cause myopia or presbyopia?

    <p>True</p> Signup and view all the answers

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

    <p>Insufficient.</p> Signup and view all the answers

    When should adolescent girls be screened for scoliosis?

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

    When should adolescent boys be screened for scoliosis?

    <p>Between age 12-13.</p> Signup and view all the answers

    What is Auspitz sign?

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

    A positive Auspitz sign is indicative of what?

    <p>Psoriasis.</p> Signup and view all the answers

    When are pregnant women screened for gestational diabetes?

    <p>Week 24-28.</p> Signup and view all the answers

    What is round ligament pain?

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

    What are the components of the fetal biophysical profile?

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

    How is the fetal biophysical profile performed?

    <p>Via ultrasound and fetal heart rate monitoring.</p> Signup and view all the answers

    When is the fetal biophysical profile often performed?

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

    What is a normal kick count in pregnancy?

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

    How much weight should an underweight woman gain in pregnancy?

    <p>28-40 pounds.</p> Signup and view all the answers

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

    <p>25-35 pounds.</p> Signup and view all the answers

    How much weight should an overweight woman gain in pregnancy?

    <p>15-25 pounds.</p> Signup and view all the answers

    How much weight should an obese woman gain in pregnancy?

    <p>11-20 pounds.</p> 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?

    <p>1 pound.</p> Signup and view all the answers

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

    <p>0.5 pounds.</p> Signup and view all the answers

    What is the biggest risk associated with scabies?

    <p>Secondary infection due to itching.</p> Signup and view all the answers

    What do scabies look like on the skin?

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

    Sickle cell anemia is what type of anemia?

    <p>Normocytic.</p> Signup and view all the answers

    How is sickle cell anemia diagnosed?

    <p>Hemoglobin electrophoresis.</p> Signup and view all the answers

    Which age group is rheumatic fever most common in?

    <p>Children ages 5-15.</p> Signup and view all the answers

    What are the major symptoms of rheumatic fever?

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

    What are the minor symptoms of rheumatic fever?

    <p>Fever, elevated ESR, prolonged PR interval.</p> Signup and view all the answers

    How do we treat rheumatic fever?

    <p>Refer to the hospital.</p> 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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