Nurse Practitioner Certification Exam Test For 2024 candidates with the best marking sche, Exams of Nursing

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Nurse Practitioner Certification Exam Test For 2024 candidates with the best marking scheme 1. primary lesion - Correct answer lesion that develops on previously unaltered skin 2. lesion - Correct answer a region in an organ or tissue that has suffered damage thru injury or disease 3. secondary lesion - Correct answer lesion that either changes impression over time or occurs when a primary lesion is scratched it may be infected 4. macule - Correct answer circumscribed flat area; different color and texture from surrounding tissue, <1cm 5. ex.) ephelides (freckles), petechia, flat nevi (moles) 6. patch - Correct answer a large macule; >1cm 7. ex.) mongolian spot, Cafe, au lair spot 8. papule - Correct answer Small solid elevated lesion; <1cm 9. ex.) bug bite, elevated nevus (mole) or verruca (wart) 10. plaque - Correct answer elevation of skin; >1cm; example psoriasis lesion 11. pustule - Correct answer a visible accumulation of purulent fluid under skin; <1cm; examples acne and impetigo 12. vesicle - Correct answer a circumscribed elevation of skin contains "SEROUS FLUID: <1cm; examples, herpes simples, varicella, shingles 13. nodule - Correct answer solid mass of skin, is elevated or palpated >1cm; often extends deeper into dermis: examples xanthoma and fibroma 14. bulla - Correct answer blister, circumscribed elevation containing fluid >1cm , extends only into epidermis, examples burns, superficial blister, contact dermatitis 15. wheal - Correct answer 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 16. cyst - Correct answer any closed cavity or sac; contains fluid or semisolid material, normal or abnormal epithelium. example sebaceous cyst 17. Abscess - Correct answer a localized collection of purulent fluid in a cavity formed by disintegration or necrosis of tissues >1cm 18. tumor - Correct answer "MASS: > few cm in diameter; firm or soft; benign or malignant 37. group a strep - Correct answer bactrim + beta lactam (PCN, amoxicillin , keflex) or doxy/inocycline +beta lactam or clindamycin 38. erysipelas - Correct answer usually caused by strep, rapid progression of an erythematous, warm indurated area (looks like sunburn,) 39. hidradenitis supparativa - Correct answer staph infection common in groin or axilla ; abscess formation common 40. impetigo - Correct answer 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 41. paronychia - Correct answer staph around nail fold 42. candida balanitis - Correct answer inflammation of superficial tissues of penile head caused by candida albicans : managed by steroids, miconazole, clotrimazole or fluconazole 43. candida intertrigo - Correct answer irruption of the fold of skin in warm, moist body areas; use drying agents like talc, cornstarch, topical antifungals, oral antifungals 44. tinea capitus - Correct answer dermatophyte infection of scalp caused by trichophyton; managed with selenium shampoo, oral terbinafine, fluconanzole 45. tinea corporis - Correct answer dermatophyte infection caused by trichomphyton or microsporum; managed with topical antifungals, severe axes systemic therapy ketoconazole 46. tinea curis - Correct answer jock itch. dermatophyte infection in groin (used topical agents or oral antifungals) 47. tinea pedis - Correct answer athletes foot treat with miconazole or clotrimazole (pedis) or aluminum sub acetate soaks 48. tinea unguium - Correct answer onychomycosis ( persistent fungal infection affecting the toe nails and fingernails caused by dermatophytes. treated with oral antifungals 49. tinea vesicolor - Correct answer fungal infection of skin caused by yeast, treated with topical selenium sulfide, topical antifungals 50. herpes zoster - Correct answer 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. 51. zostavax - Correct answer approved 50> for prevention of shingles 52. management of shingles pharmacological - Correct answer acyclovir, famciclovir, valacyclovir 53. actinic keratosis - Correct answer small patches occurring on sun-exposed parts of the body. Pre-malignant (1:1000) lesions progress to squamous cell carcinoma. systematic, small patches may be tender, fought, flesh colored, pink and hyperpigmented 54. squamous cell carcinoma - Correct answer arise out of actinic keratoses; firm , irregular papule or nodule, develop over few months 3-7% metastasize, prolonged sun-exposed areas in fair skin people, keratitic, scaly bleeding 55. treatment of squamous cell carcinoma - Correct answer biopsy and surgical excision (MOHS) 56. seborrheic keratoses - Correct answer benign, not painful lesion, beigh, brown, or black plaques, stuck on appearance, 3- 20cm 57. basal cell carcinoma - Correct answer MOST common skin cancer; slow growing; grows 1-2 cm in years; waxy, pearly appearance (may be shiny red), central depression or rolled edge; may have telangiectatic vessels 58. treatment of basal cell carcinoma - Correct answer shave/punch biopsy and surgical excision 59. malignant melanoma - Correct answer mortality rate highest of all skin cancers; mediate age of diagnoses 40, may spread to any organ ABCDE 71. what is the hallmark distribution of small pox, which is the primary way of diagnosing - Correct answer 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. 72. how to treat small pox - Correct answer 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 73. Antrax definition - Correct answer 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 74. what are the signs and symptoms of anthrax? 75. Cutaneous form - Correct answer 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 76. signs of symptoms of anthrax inhalation form - Correct answer 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 77. lab testing and treatment for anthrax - Correct answer gram stain of specimen. vaccine exist for those at risk such military. Antibiotics: penicillin, cipro, doxycycline and report to health deparment 78. Warts definition - Correct answer 1. benign epidural neoplasm caused by HPV 2. transmitted by direct contact 3. several types 79. Common wart : verruca vulgaris - Correct answer flesh- colored papule with rough surface treated with salicylic acid, liquid nitrogen, electrocautery 80. filiform warts (digitate) - Correct answer finger-like appearances with various projections. Treated with tretinoin cream, liquid nitrogen and electrocautery 81. flat warts - Correct answer pink or light yellow. Treated with tretinoin cream, liquid nitrogen and electrocautery 82. plantar warts - Correct answer roughened surface, slightly raised and may be painful. Treated with salicylic acid c, compound W freeze off (OTC-cyro) blunt dissection, laser therapy 83. genital warts - Correct answer pale pink with several projections and broad base (think cauliflower) treated with 20% podophyllin resin (pododerm) podofilox (condylox) cryosurgery, trichloroacetic acide 84. What is an allergic reaction and treatment - Correct answer hypersensitivity reaction to a particular allergen; symptoms can vary from mild to severe. Treated with withdrawal of any medication that is causing reaction, antipruritic agent and antihistamine 85. frost bite - Correct answer tissue damage resulting from exposure to cold. Assess for hypothermia, soak in water 100F, treat for pain 86. insect stings or bites - Correct answer may cause a toxic reaction that range from local to mild to life threatening; remove stinger, topical or intra-lesional corticosteroids, topic anesthetics 87. Oral contraceptives categories - Correct answer 1. combined pills alter dosage of estrogen and progestin throughout the cycle and progestin only pills (not as effective) in which mechanism of action affects the cervical mucus and endometrium, most likely changes tubal transport of oocyte and sperm 88. 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 answer 1. 3.0% 2. 4.7% 89. What are the four mechanism of action on estrogenic effects - Correct answer 1. OVULATION inhibited by suppression of FSH/LH 2. IMPLANTATION inhibited by alteration of endometrium 3. OVUM TRANSPORT is accelerated 4. history of migraines, who are breast feeding or who have contraindication with combo pill 101. what pregnancy category for Oral contraceptives/ - Correct answer X, stop immediately 102. NuvaRing - Correct answer flexible, ring , 2 inches in diameter to prevent pregnancy; failure rate <1-2% 103. what is mechanism of action of NuvaRing - Correct answer releases synthetic estrogen and progestin (etonogestrel) , 1 month protection, release of hormone activated by vaginal contact, prevents ovulation, thickens cervical mucus, inhibits sperm penetration 104. what are some of advantages of Nuva Ring - Correct answer discreet, can not be felt by partner, once a month insertion, shorter and lighter periods, improves acne, depression and cramps 105. what are some disadvantages of Nuva Ring - Correct answer similar to O.C.; also diaphragms, cervical caps or shields can not be used as back up methods while using rings, may worsen depression if previously diagnosed, no protection STDS, can't be used in pt >35 or uncontrolled HTN, or smoke >15 cigarettes daily 106. how long is a NovaRing left in place for - Correct answer 21 days, if ring slips out, must be re-inserted within three hours or must use back up 107. the patch - Correct answer a transdermal contraceptive patch that releases synthetic estrogen and progesterone ; failure rate <1-2%; prevents ovulation 108. What are advantages of the patch - Correct answer administered once a week, can be worn for three weeks, easily reversible, sexual activity not interrupted 109. what are disadvantages of the patch - Correct answer site reactions, similar to OC's, reduced effectiveness in woman >90Kg or 198 lbs, reduce effectiveness with concurrent use of antibiotics, antifungals, anticonvulsants, St John's wart, Seriously increased cardiovascular risks b/c it releases 60% more estrogen then O.C's, do not use woman>35 110. how should you use patch - Correct answer patch applied on first day of cycle or on first sunday after, patch removed seven days later and then add new patch, after the third week, you wait 7 days (patch free) before re-applying patch, if patch stays off for more than 24 horus, you must restart a 4 week cycle along with using back up 111. what is repo-provera (DMPA)? - Correct answer long-acting progestin by IM injection, failure rate <1%, 112. how does DMPA work (Depo) - Correct answer supresses follicle stimulating hormone (FSH) and luteining hormone (LH), thus blocking LH surge which inhibits ovulation, thickens mucus and thins endometrium lining 113. what are advantages of DePO - Correct answer highly effective, prolonged amenorrhea, reduces pain associated with endometriosis, no estrogen side effects, reduction risk of PID, endometrial and ovarian cancers 114. what are disadvantages of Depo? - Correct answer amenorrhea, delayed return of fertility of (up to one year) and must have injection every three months 115. what are some undesirable effects of depo - Correct answer lipid changes, decreases HDL , reduction in bone density with long term use, anaphylactic reactions may occur 116. what are some prescriptive guidelines for Depo - Correct answer 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 5 117. Implanon (implant contraception) - Correct answer it is a single thin flexible rod which contains etonogestrel with low diffusion of progestin from rod, failure rate 0.01% 118. what are some advantages of implanon - Correct answer continuous protection for three years, no estrogen side effects, few serious system complications occur, absent menses or decreased anemia, decreased cramps, decreased risk for endometrial cancer 132. what are some management and prescriptive guidelines for diaphragm/cervical cap use? - Correct answer check for holes and tears, should be re-fitted with weight gain or loss of 20 pounds or more, avoid oil-based lubricants because it destroys latex, must be left in vagina for at least 6 hours following intercourse, must instill spermicide in vagina (not removing diaphragm) for repeated intercourse. 133. spermacides - Correct answer preparations which contain chemicals, nonoxynol-9 or octoxynol, that destroys sperm. typical first year failure rates 21% 134. advantages of spermicides - Correct answer OTC product, immediate protection, also agains some STD,s, enhances effectiveness of barrier methods 135. disadvantages of spermacides - Correct answer vaginal or penile irritation, suppositories may completely dissolve, unpleasant taste , (what? lol), allergy, 136. sponge - Correct answer disposable, round barrier of soft polyurethane which fits over the cervix, similar to diaphragm, that contains spermacide; failure rate 10%, brand names are today or protectAID IN CANADA 137. Advantages of sponge - Correct answer no felt, inserted up to 6 hours before intercourse, may provide protection against gonorrhea and chlaymdia 138. what are disadvantages of sponge - Correct answer risk of toxic shock syndrome if you leave in too long, contraindicated if allergic to spermacides, 139. what are management /prescriptive guidelines for sponge - Correct answer inserted into vagina using cord loop attachment, can be inserted up to 6 hours before, should be left in place 6 hours after intercourse, provides protection for up to 12 hours, should not be left in vagina for more than 30 hours 140. condoms - Correct answer sheath-like covering usually made of latex, inserted over penis or into vagina, may have spermacide, failure fate male 12% and female 21% 141. advantages of condom - Correct answer OTC, safe to use, immediate protection against pregnancy and most STDs 142. disadvantages of condom - Correct answer 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 143. how to use condoms - Correct answer 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 144. emergency contraception - Correct answer mechanism used to either prevent fertilization or implantation of a fertilized egg in uterus 145. what are the two forms of emergency contraception - Correct answer 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 146. what is effectiveness of plan B, what is effectiveness of IUD in emergency contraception - Correct answer plan b 85%; and IUD is 99% 147. undesirable side effects of emergency contraception - Correct answer fluid retention, changes in period, dizziness, headaches, fatigue nasea 148. what is failure rate of female sterization - Correct answer 1:400 149. what is failure rate of male sterization - Correct answer 1:600 150. natural family planning - Correct answer planned abstinence during the phase of menstrual cycle when fertility is optimal, effectiveness is 20% 151. calendar method - Correct answer 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 days from longest (latest day of fertility)and abstain during that time frame 166. what other screening test are done in second trimester - Correct answer triple or quad screen (multiple marker test) and ultrasound for fetal survey at 18-20 weeks; and one hour GTT at 20 weeks if family history of diabetes or pt weighs more than 200 pounds 167. third trimester screening - Correct answer RhoGam for un- sensitized Rh-negative mothers at 28 weeks, Hgb/Hct at 28-36 weeks; non stress test (NST) biophysical profile (BPP) as needed for assessment of fetal well being 168. scheduling for prenatal visits - Correct answer 0-28 weeks: every four weeks 169. 28-36 weeks: every two weeks 170. 36 weeks to delivery: every week 171. Naegele's rule - Correct answer establishment of estimated date of confinement (EDC) based on last normal menstrual period (LNMP)= 1 year-3 months+7 days 172. labs done on return OB visits - Correct answer routine, plus urine for protein, glucose, ketones at each visit (looking for preeclampsia) 173. 95% of ectopic pregnancies occur in - Correct answer fallopian tubes 174. symptoms of ectopic pregnancies - Correct answer abnormal uterine bleeding, abdominal or pelvic pain, lower back or shoulder p win, hemodynamic changes in vital signs (shock- rupture) 175. physical exam of ectopic pregnancy - Correct answer tender adenexa ( appendages of uterus= ovaries, fallopian tubes, and 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 176. abortion - Correct answer pregnancy termination at any time prior to viability (20 weeks) either through spontaneous or expulsion or medical/surgical removal 177. approximately what percentage of pregnancies are abortions - Correct answer 15% 178. what causes abortion in first trimester - Correct answer chromosomal abnormalities 179. what causes abortion in second trimester - Correct answer cervical incompetence, infection or uterine abnomalities 180. management of spontaneous abortion - Correct answer refer, bed rest, abstinence, labs 181. management of induced or elective abortion - Correct answer vacuum D and C up to 12 sees, D &E 13-14 weeks to 20- 22 weeks, hysterectomy/hysterotomy 182. medical management : for up to 49 days of pregnancy - Correct answer first trimester: abortion pill mifepristone (mifeprex) also known as RU 486 and in second trimester: prostaglandin (misoprostol) 183. PIH Pregnancy induced hypertension - Correct answer 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) 184. what are predisposing factors to PIH - Correct answer 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) 185. what test besides labs would you do for PIH - Correct answer NST 32-34 weeks or pen, ultrasound prn to check for lag of fetal growth 186. management of PIH - Correct answer rest, fetal surveillance, 187. what is preecclampsia - Correct answer PIH+proteinuria+generalized edema after 20 weeks 188. what is eclampsia - Correct answer preeclampsia+seizure activity 189. What is HELLP syndrome? - Correct answer Hemolysis Elevated Liver and Low Platelet count 190. what are symptoms of preeclampsia - Correct answer sudden weight gain(>6 pounds in month or 2 pounds per week, progression frond digital or modal facial edema to generalized edema, frontal or occipital headaches, visual disturbances;