Nurse Practitioner Certification Exam Question with ( verified solution ), Exams of Nursing

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Nurse Practitioner Certification Exam Question with ( verified solution ) primary lesion - Correct Answers ✅lesion that develops on previously unaltered skin lesion - Correct Answers ✅a region in an organ or tissue that has suffered damage thru injury or disease secondary lesion - Correct Answers ✅lesion that either changes impression over time or occurs when a primary lesion is scratched it may be infected macule - Correct Answers ✅circumscribed flat area; different color and texture from surrounding tissue, <1cm ex.) ephelides (freckles), petechia, flat nevi (moles) patch - Correct Answers ✅a large macule; >1cm ex.) mongolian spot, Cafe, au lair spot papule - Correct Answers ✅Small solid elevated lesion; <1cm ex.) bug bite, elevated nevus (mole) or verruca (wart) plaque - Correct Answers ✅elevation of skin; >1cm; example psoriasis lesion Nurse Practitioner Certification Exam Question with ( verified solution ) pustule - Correct Answers ✅a visible accumulation of purulent fluid under skin; <1cm; examples acne and impetigo vesicle - Correct Answers ✅a circumscribed elevation of skin contains "SEROUS FLUID: <1cm; examples, herpes simples, varicella, shingles nodule - Correct Answers ✅solid mass of skin, is elevated or palpated >1cm; often extends deeper into dermis: examples xanthoma and fibroma bulla - Correct Answers ✅blister, circumscribed elevation containing fluid >1cm , extends only into epidermis, examples burns, superficial blister, contact dermatitis wheal - Correct Answers ✅elevated white or pink compressible papule or plaque, a red, axon-mediated flare often surround it, commonly associated with allergic reaction, examples PPD test and mosquito bites cyst - Correct Answers ✅any closed cavity or sac; contains fluid or semisolid material, normal or abnormal epithelium. example sebaceous cyst Nurse Practitioner Certification Exam Question with ( verified solution ) folliculitis - Correct Answers ✅inflammation of hair follicle; common cause staphylococci furuncle - Correct Answers ✅"boil" localized infection in hair follicle, caused by staph carbuncle - Correct Answers ✅>furuncle; may be necrotizing, staph cellulitis - Correct Answers ✅most common causes: out patients strep ; inpatient: gram negative (ecoli, klebsiels, psuedomonsa, enterbacter, staph aureus and strep MRSA - Correct Answers ✅trimethoprm-sulfamethoxazole (bactrim); doxy, clindamycin group a strep - Correct Answers ✅bactrim + beta lactam (PCN, amoxicillin , keflex) or doxy/inocycline +beta lactam or clindamycin erysipelas - Correct Answers ✅usually caused by strep, rapid progression of an erythematous, warm indurated area (looks like sunburn,) Nurse Practitioner Certification Exam Question with ( verified solution ) hidradenitis supparativa - Correct Answers ✅staph infection common in groin or axilla ; abscess formation common impetigo - Correct Answers ✅usually caused by staph, primary lesion is thin walled vesicle that breaks easily and honey colored crust at edge; satelite lesions appear and spread to remote areas of skin paronychia - Correct Answers ✅staph around nail fold candida balanitis - Correct Answers ✅inflammation of superficial tissues of penile head caused by candida albicans : managed by steroids, miconazole, clotrimazole or fluconazole candida intertrigo - Correct Answers ✅irruption of the fold of skin in warm, moist body areas; use drying agents like talc, cornstarch, topical antifungals, oral antifungals tinea capitus - Correct Answers ✅dermatophyte infection of scalp caused by trichophyton; managed with selenium shampoo, oral terbinafine, fluconanzole tinea corporis - Correct Answers ✅dermatophyte infection caused by trichomphyton or microsporum; managed with topical antifungals, severe axes systemic therapy ketoconazole Nurse Practitioner Certification Exam Question with ( verified solution ) tinea curis - Correct Answers ✅jock itch. dermatophyte infection in groin (used topical agents or oral antifungals) tinea pedis - Correct Answers ✅athletes foot treat with miconazole or clotrimazole (pedis) or aluminum sub acetate soaks tinea unguium - Correct Answers ✅onychomycosis ( persistent fungal infection affecting the toe nails and fingernails caused by dermatophytes. treated with oral antifungals tinea vesicolor - Correct Answers ✅fungal infection of skin caused by yeast, treated with topical selenium sulfide, topical antifungals herpes zoster - Correct Answers ✅pain along dermatomal distribution, usually on trunk, may be life threatening in immunocomprised individuals. grouped vesicles eruption of erythema and exudate along the dermatomal pathway, regional lymphadenoapathy may be present. zostavax - Correct Answers ✅approved 50> for prevention of shingles Nurse Practitioner Certification Exam Question with ( verified solution ) precisely defined plaques with silvery scales, fine pitting of the nails, (auspitz sign: droplets of blood when scales removed) treatment is topicals for scalp (tar, salicylic acid shampoo and topical steroids (betamethasone) UVB light exposure. pityriasis rosea - Correct Answers ✅mild acute inflammatory disorder more common in females (50%> males) during spring and fall; pruritic rash found on trunk and proximal extremities; initial lesion is 2- 10cm "herald Patch" generalized rash presents within 1-2 weeks' ;lesions follow a christmas tree pattern (follows cleavage lines on the trunk) eruption can last 4-8 weeks. ***serologic test for syphyllis should be done if lesions are NOT itching, lesions are present on palmar or plantar surfaces (this was on our exam)**and lesions are few and perfect treatment of pityriasis rosea - Correct Answers ✅oral antihistamines, topical antipruritic, cool compresses, topical steroids, uvb light, oral erythroymycin xanthelasma - Correct Answers ✅yellow plaques as a result of fat build up under the skin, usually near the inner canthus; hyperlipidemia is the underlying cause; treated with surgical excision, argon and carbon dioxide laser ablation, chemical cauterization, eletro-desication and cryotherapy. Signs and symptoms include: usually located in medial side of upper eyelids, does not affect function of eyelids, but ptosis can occur, more common in woman, peak onset 40-50, uncontrolled Nurse Practitioner Certification Exam Question with ( verified solution ) diabetes is common cause of secondary hyperlipidemia. Can do lipid panel, biopsy to rule in or rule out lyme disease - Correct Answers ✅ rocky mountain spotted fever - Correct Answers ✅ small pox definition - Correct Answers ✅infectious disease unique to humans, caused by virus variants, localizes in blood vessels of the skin mouth and throat signs and symptoms of small pox - Correct Answers ✅Sudden onset flu like symptoms, rash appears as flat , red spots/lesions that turn into blisters within 2 days filled with clear fluid and later with pus***pain is excruciating** what is the hallmark distribution of small pox, which is the primary way of diagnosing - Correct Answers ✅1st lesions appear in oral mucosa/face or forearms 2nd. centrifugal distribution (trunk and spreads out) with greatest concentration on face, distal extremities 3rd on any one part of body, all lesions are in the same stage of development 4th scabs lead to pitted scars. Nurse Practitioner Certification Exam Question with ( verified solution ) how to treat small pox - Correct Answers ✅1. small pox vaccine before infection 2. no cure once infected 3. supportive therapy and antibiotics to treat secondary bacterial infections 4. isolation of infected person to prevent spreading to others Antrax definition - Correct Answers ✅acute disease caused b the bacterium "bacillus anthraces" (referred to as spores) but are not fungal spores. 2. anthrax spores can be produced in vitro and used as biological weapon 3. disease is mostly lethal; affects humans and animals 4. spores are transported by clothing, shoes, body of dead animals that die of anthrax what are the signs and symptoms of anthrax? Cutaneous form - Correct Answers ✅1. cutaneous (95% cases) a. occurs on exposed areas on arms and hands, followed by face and neck b. pruritic papule leading to ulcer surround vesicles. c. develops into black necrotic central eschar with edema d. after 1-2 weeks, eschar dries, loosens and separates, leaving a permanent scar e. regional lymphadenopathy signs of symptoms of anthrax inhalation form - Correct Answers ✅5% of cases. follows deposition of spore-bearing particles into alveolar spaces, clinical presentation shows a biphasic pattern. (A) prodromal phase: non-specific flu-like symptoms, dyspnea, malaise, myalgia (B) Fulminant phase: fever, diaphoresis and septic shock Nurse Practitioner Certification Exam Question with ( verified solution ) typical first year failure rates of oral contraceptives1.____and what is typical first year failure in those less than 22 years of age 2.___ - Correct Answers ✅1. 3.0% 2. 4.7% What are the four mechanism of action on estrogenic effects - Correct Answers ✅1. OVULATION inhibited by suppression of FSH/LH 2. IMPLANTATION inhibited by alteration of endometrium 3. OVUM TRANSPORT is accelerated 4. LUTEOLYSIS may occur as estrogen causes progesterone levels to fall (L.O.O.I.) What are five mechanism of action on pro gestational effects - Correct Answers ✅1.Thick CERVICAL mucus interferes with sperm transport 2. CAPACITATION (sperm's ability to fertilize egg) is inhibited. 3. OVUM TRANSPORT may be slowed. 4. IMPLANTATION is hampered by suppression of endometrium 5. OVULATION inhibited by hypothalamic- pituitary-ovarium disturbances CCOIO what are some of advantages of using oral contraceptives? - Correct Answers ✅Less menstrual flow, decreased cramps, may provide protection against ovarian and endometrial cancer, ectopic pregnancy, PID, endometriosis, uterine fibroids, and functional ovarian cysts what are some disadvantages of using oral contraceptives? - Correct Answers ✅does not protect against HIV, mood changes, rare Nurse Practitioner Certification Exam Question with ( verified solution ) circulatory complications, rare liver tumors, must be taken daily, may cause nausea, headaches, breakthrough bleeding what are undesirable hormonal effects of estrogen deficiency - Correct Answers ✅no withdrawal bleeding, decreased duration of menstrual bleeding, continuous spotting, breakthrough bleeding, atrophic vaginitis. What are undesirable hormonal effects of EXCESSIVE pro gestational effects - Correct Answers ✅breast tenderness, transient hypertension, depression, fatigue, decreased libido, decreased duration of menstrual cycle, increased appetite what are undesirable hormonal effects of progesterone DEFICIENCY - Correct Answers ✅Breakthrough bleeding, delayed menses, What are some EXCESSIVE ESTROGENIC EFFECTS? - Correct Answers ✅Dysmenorrhea (painful periods), nausea, chloasma (mask like appearance) CVA, DVT, PE, telangiectasias (spider vein appearance in the face), Hepatic adenoma, adenocarcinoma, cervical changes, breast tenderness secondary to size1 EXCEssive androgenic effects of oral contraceptives - Correct Answers ✅hirsutism, acne, oily skin, edema, increased libido, Nurse Practitioner Certification Exam Question with ( verified solution ) What are some EXCESS estrogen/deficient progesterone combination effects? - Correct Answers ✅dysmenorrhea, menorrhagia (heavy bleeding), nausea, vomiting, headache, irritability, bloating, syncope what are some absolute contradictions in prescribing oral contraceptives - Correct Answers ✅history of thromboembolic disorders, CVA, CAD, known or suspected breast ca, or estrogen dependent neoplasia, pregnancy, benign or malignant liver tumor, impaired liver function, previous cholelithiasis during pregnancy, undiagnosed abnormal uterine bleeding, what are some prescriptive guideline for oral contraceptives - Correct Answers ✅1 begin low lose combo or multi phasic pill (35mcg or less), progestin only pills may be used in women with history of migraines, who are breast feeding or who have contraindication with combo pill what pregnancy category for Oral contraceptives/ - Correct Answers ✅X, stop immediately NuvaRing - Correct Answers ✅flexible, ring , 2 inches in diameter to prevent pregnancy; failure rate <1-2% Nurse Practitioner Certification Exam Question with ( verified solution ) what are advantages of DePO - Correct Answers ✅highly effective, prolonged amenorrhea, reduces pain associated with endometriosis, no estrogen side effects, reduction risk of PID, endometrial and ovarian cancers what are disadvantages of Depo? - Correct Answers ✅amenorrhea, delayed return of fertility of (up to one year) and must have injection every three months what are some undesirable effects of depo - Correct Answers ✅lipid changes, decreases HDL , reduction in bone density with long term use, anaphylactic reactions may occur what are some prescriptive guidelines for Depo - Correct Answers ✅pregnancy test if longer than 2 weeks since three month period ended, there is a two week grace period when injection is given every three months, do no massage injection site, use back up methods for first two weeks unless administer by doc 5 Implanon (implant contraception) - Correct Answers ✅it is a single thin flexible rod which contains etonogestrel with low diffusion of progestin from rod, failure rate 0.01% what are some advantages of implanon - Correct Answers ✅continuous protection for three years, no estrogen side effects, few Nurse Practitioner Certification Exam Question with ( verified solution ) serious system complications occur, absent menses or decreased anemia, decreased cramps, decreased risk for endometrial cancer what are some disadvantages of implanon - Correct Answers ✅requires informed consent, irregular periods, implant may be slightly visible initially, initials expenses higher IUD - Correct Answers ✅an artificial device with metal wrapping or chemically-impregnated surface to prevent pregnancy what are the two types of IUD - Correct Answers ✅1. copper releasing (ParaGuard) a t shaped plastic devise wrapped with fine copper and can remain in uterus for 10 years. 2 progesterin-releasing (mirena) t shaped also known as levonorgestrel releasing intrauterine system (LNG-IUS) can remain in uterus for 5 years, typical 1st failure rate is 1-3% how does IUD work - Correct Answers ✅immobilizes sperm, speeds ovum transport, inhibits fertilziation, causes lysis of blastocyst and prevents implantation what are some advantages of IUD - Correct Answers ✅progesterin releasing may decrease menstrual loss or dysmenorrhea, can prevent asherman's syndrome (Intrauterin adhesions, scarring or synechiae is an acquired uterine condition. Nurse Practitioner Certification Exam Question with ( verified solution ) what are some disadvantages of IUD - Correct Answers ✅pain and cramping may occur (40% removal rate due to pain), increase in bleeding may result in anemia, spontaneous abortion in up to 50% cased if IUD left in uterus, etctopic pregnancies occur in 5% of cases what are some undesirable effects of IUD - Correct Answers ✅expulsion of IUD (up to 10% in first year), lost IUD string, pregnancy, PID (rate is highest in first 6 weeks after insertion) what are some absolute contraindications for using IUD - Correct Answers ✅active, recent or recurrent pelvic infection, pregnancy, risk of PID, undiagnosed irregular uterine bleeding what are some prescriptive guidelines for IUD - Correct Answers ✅requires informed consent, may be inserted at anytime of cycle, but expulsion is greater during menses, may insert 4-8 weeks postpartum, make sure patients know to check strings, monitor for bleeding, fever, chills diaphragm /cervical cap - Correct Answers ✅flexible dome shape cup constructed of latex rubber that prevents pregnancy by blocking the transport of sperm through cervical os; typical first year failure rate ***18% not .18 Nurse Practitioner Certification Exam Question with ( verified solution ) intercourse, provides protection for up to 12 hours, should not be left in vagina for more than 30 hours condoms - Correct Answers ✅sheath-like covering usually made of latex, inserted over penis or into vagina, may have spermacide, failure fate male 12% and female 21% advantages of condom - Correct Answers ✅OTC, safe to use, immediate protection against pregnancy and most STDs disadvantages of condom - Correct Answers ✅produce less sexual sensation, they break or slip, foreplay is interrupted, if they are 'NATURAL skin" condoms, they DO NOT protect against STD's, also, do not use if allergic to spermicide or rubber how to use condoms - Correct Answers ✅avoid oil based lubricants, lubrications with increase sensation, to reduce breakage, leave half inch of empty space at end of condom, effectiveness increase if spermicide used emergency contraception - Correct Answers ✅mechanism used to either prevent fertilization or implantation of a fertilized egg in uterus Nurse Practitioner Certification Exam Question with ( verified solution ) what are the two forms of emergency contraception - Correct Answers ✅1. oral, (Levonorgestrel- plan B), the morning after pill; can be bought over the counter if you are >17, girls <17 need prescription, should be taken within 72 of sex **not abortion pill (mifepristone) 2. intrauterine device: copper-releasing IUD, must be inserted 5-6 days of intercourse what is effectiveness of plan B, what is effectiveness of IUD in emergency contraception - Correct Answers ✅plan b 85%; and IUD is 99% undesirable side effects of emergency contraception - Correct Answers ✅fluid retention, changes in period, dizziness, headaches, fatigue nasea what is failure rate of female sterization - Correct Answers ✅1:400 what is failure rate of male sterization - Correct Answers ✅1:600 natural family planning - Correct Answers ✅planned abstinence during the phase of menstrual cycle when fertility is optimal, effectiveness is 20% calendar method - Correct Answers ✅record serial cycles; identifying lingers and shorts cycles; determine fertile phase by subtracting 18 days from shortest cycle(ear lies day of fertility) and 11 Nurse Practitioner Certification Exam Question with ( verified solution ) days from longest (latest day of fertility)and abstain during that time frame basal body temperature method - Correct Answers ✅record daily BBT prior to rising in AM over a 3 to 4 month period, temp drops 12-24 hours prior to ovulation; rises following ovulation due to production of progesterone; avoid intercourse from 2-3 prior to expected drop to approx three days following rise Billings test - Correct Answers ✅cervical mucus testing: record changes in mucus (spinnbarkeit) over a 3-4 month period, notice when it changes from scant and thick to tun with increasing spinnbarkeit (elastic quality or stringy). Abstain from time of mucus change until approx 4 days after change, mucus will then become thick again symptothermal method - Correct Answers ✅uses both BBT and cervical mucus techniques for contraception lactational method of contraception - Correct Answers ✅relies on breastfeeding for family planning, which often delays the onset of ovulation and menstruation for about 6 months intrauterine pregnancy - Correct Answers ✅40 week process in which an embryo grows and develops into infant in uterus, first Nurse Practitioner Certification Exam Question with ( verified solution ) scheduling for prenatal visits - Correct Answers ✅0-28 weeks: every four weeks 28-36 weeks: every two weeks 36 weeks to delivery: every week Naegele's rule - Correct Answers ✅establishment of estimated date of confinement (EDC) based on last normal menstrual period (LNMP)= 1 year-3 months+7 days labs done on return OB visits - Correct Answers ✅routine, plus urine for protein, glucose, ketones at each visit (looking for preeclampsia) 95% of ectopic pregnancies occur in - Correct Answers ✅fallopian tubes symptoms of ectopic pregnancies - Correct Answers ✅abnormal uterine bleeding, abdominal or pelvic pain, lower back or shoulder p win, hemodynamic changes in vital signs (shock-rupture) physical exam of ectopic pregnancy - Correct Answers ✅tender adenexa ( appendages of uterus= ovaries, fallopian tubes, and Nurse Practitioner Certification Exam Question with ( verified solution ) ligaments that hold uterus in place); positive cervical motion tenseness, uterine enlargement with hegar's sign (softening and consistency of cervix), positive peritoneal signs if rupture abortion - Correct Answers ✅pregnancy termination at any time prior to viability (20 weeks) either through spontaneous or expulsion or medical/surgical removal approximately what percentage of pregnancies are abortions - Correct Answers ✅15% what causes abortion in first trimester - Correct Answers ✅chromosomal abnormalities what causes abortion in second trimester - Correct Answers ✅cervical incompetence, infection or uterine abnomalities management of spontaneous abortion - Correct Answers ✅refer, bed rest, abstinence, labs management of induced or elective abortion - Correct Answers ✅vacuum D and C up to 12 sees, D &E 13-14 weeks to 20-22 weeks, hysterectomy/hysterotomy Nurse Practitioner Certification Exam Question with ( verified solution ) medical management : for up to 49 days of pregnancy - Correct Answers ✅first trimester: abortion pill mifepristone (mifeprex) also known as RU 486 and in second trimester: prostaglandin (misoprostol) PIH Pregnancy induced hypertension - Correct Answers ✅BP>140/90 or rise in systolic >30 or diastolic over 15mmHg above baseline on at least two occasions with readings six hours apart (occurs about 12% cases) what are predisposing factors to PIH - Correct Answers ✅pre- existing hypertension, diabetes, renal or cardiovascular disease, lupus or autoimmune disorders, multiple gestation, primigravida (1st pregnancy) family history of PIH or preeclampsia, maternal age (young or more mature) what test besides labs would you do for PIH - Correct Answers ✅NST 32-34 weeks or pen, ultrasound prn to check for lag of fetal growth management of PIH - Correct Answers ✅rest, fetal surveillance, what is preecclampsia - Correct Answers ✅PIH+proteinuria+generalized edema after 20 weeks