Nurse Practitioner Certification Exam: Skin Lesions and Infections, Exams of Nursing

Download Nurse Practitioner Certification Exam: Skin Lesions and Infections and more Exams Nursing in PDF only on Docsity! Nurse Practitioner Certification Exam Test with 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 19.configuration: annular - Correct answer circular, begins in center and spreads to periphery 20.configuration: confluent - Correct answer lesions run together 21.configuration: grouped - Correct answer lesion cluster 22.configuration: gyrate - Correct answer twisted, coiled, spiral and snake like 23.configuration: linear - Correct answer scratch, streak, line stripe 24.configuration: polycyclic - Correct answer annular lesions merge 25.configuration: solitary or discrete - Correct answer individual and distinct lesions that remain separate 26.configuration: target (iris) - Correct answer resembles iris of eye; lesion with concentric rings of color 27.configuration: zosteriform - Correct answer linear arrangement along nerve route 28.comedones - Correct answer open are called black heads (openings capped with a blackened skin debris); and closed are called white head (obstructed) 29.acne - Correct answer can be comedones, pustules, papules (pimples and zits), cysts, nodules and scaring 30.nonpharmacological management of acne - Correct answer wash several times daily with soap and water; avoid topical oil based; use oil free cleansers and moisterizers 31.pharmacological management of acne - Correct answer comedolytic agents: benzoyl peroxice, salicylic acid, topical antibiotics (clindamycin, erythromycin, tetracycline and metronidazole for rosacea). May consider oral antibiotics and oral contraceptives 60.what does ABCDE - Correct answer asymmetry, border irregularity, color variation, diameter >6cm, elevation, enlargement. treatment is biopsy and surgical excision 61.eczema - Correct answer chronic skin condition characterized by intense pruritus, acute flare ups: red shiny, thickened patches, inflamed/scabbed and erythema, scaling, dry leathery lichenification treated with topical steroids, rubbed ins ell: clobetasol cream 62.allergic contact dermatitis - Correct answer acute or chronic condition characterized by inflammation at the site of contact with chemical allergens (redness, pruritus, scabbing, sharp defined borders) treat with topical steroids , do not scrub with soap and water, prednisone taper if severe 63.psoriasis - Correct answer benign hyperproliferative inflammation of the skin that can be acute or chronic. (HIV: may present as a first sign of HIV infection (explosive event); itching red, 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. 64.pityriasis rosea - Correct answer 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 65. treatment of pityriasis rosea - Correct answer oral antihistamines, topical antipruritic, cool compresses, topical steroids, uvb light, oral erythroymycin 66.xanthelasma - Correct answer 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 diabetes is common cause of secondary hyperlipidemia. Can do lipid panel, biopsy to rule in or rule out 67. lyme disease - Correct answer 68. rocky mountain spotted fever - Correct answer 69.small pox definition - Correct answer infectious disease unique to humans, caused by virus variants, localizes in blood vessels of the skin mouth and throat 70.signs and symptoms of small pox - Correct answer 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** 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. LUTEOLYSIS may occur as estrogen causes progesterone levels to fall (L.O.O.I.) 90.What are five mechanism of action on pro gestational effects - Correct answer 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 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 119. what are some disadvantages of implanon - Correct answer requires informed consent, irregular periods, implant may be slightly visible initially, initials expenses higher 120. IUD - Correct answer an artificial device with metal wrapping or chemically-impregnated surface to prevent pregnancy 121. what are the two types of IUD - Correct answer 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% 122. how does IUD work - Correct answer immobilizes sperm, speeds ovum transport, inhibits fertilziation, causes lysis of blastocyst and prevents implantation 123. what are some advantages of IUD - Correct answer progesterin releasing may decrease menstrual loss or dysmenorrhea, can prevent asherman's syndrome (Intrauterin adhesions, scarring or synechiae is an acquired uterine condition. 124. what are some disadvantages of IUD - Correct answer 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 125. what are some undesirable effects of IUD - Correct answer expulsion of IUD (up to 10% in first year), lost IUD string, pregnancy, PID (rate is highest in first 6 weeks after insertion) 126. what are some absolute contraindications for using IUD - Correct answer active, recent or recurrent pelvic infection, pregnancy, risk of PID, undiagnosed irregular uterine bleeding 127. what are some prescriptive guidelines for IUD - Correct answer 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 128. diaphragm /cervical cap - Correct answer 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 .18 129. when used with spermicidal gel or cream destroys the cell membrane of sperm - Correct answer diaphragm/cervical cap 130. what are advantages of diaphragm/cervical cup - Correct answer may provide protection against some STD's when used with spermicidal gel (nonoxynol-9), safe and easy to use, inserted before inters coarse, provides immediate protection 131. what are some undesirable effects of diaphragm/cervical cap - Correct answer skin irritation may occur secondary to latex or spermicide, increased risk of UTIs and vulvovaginitis; allergic reaction, or inability to insert product 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 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; reflexes WNL progress to 3-4+ with worsening condition; lagging fundal height 191. management of preeclampsia - Correct answer strict bed rest with worsening condition in left lateral recumbent position, fetal surveillance, referral, kick counts at home, weekly steroid injections (B-methasone) for fetal lung maturity if <34 weeks and hospitalization with MgSo4 therapy if severe condition, then delivery if >34 weeks or 2 doses of B-methasone