FNP 1 Exam 3 New Full Exam Latest 2023-2024

FNP 1 Exam 3 | New Full Exam Latest 2023-2024

With 100% Verified Answers

• Leading cause of death Men

Answer:

1st CV disease 2nd CA 3rd is MVA, no seatbelt 4th ETOH

2. GU

Answer: Testicular Torsion: Acute ischemic, testis and spermatic cord twist result ing in obstruction of blood flow to testes. Send to ER.age 7-14 most common group

*S/S*:

Sudden unilateral pain, NV, abd pain, edema and erythema.

*Dx*: Doppler shows no blood flow.

*Tx*:

Gotta fix W/I 6 hrs.Relief of pain, resolution of the "bell-clapper" deformity (tunica vaginalis joins high on the spermatic cord, leaving the testis free to rotate).

3. GU

Answer: Epididymitis: Most common intra-scrotal infxn, age 35 or younger.Gonorhea and Chlamydia can be a big issue for the youngsters.> age 35 consider UTI or Prostatitis. Offending organisms can be E coli, pseudomonas, staph, or chemical/trauma.

*Dx*: Urine C&S, UA, US of scrotum 1 / 4

*STD Tx*:

• Cetriaxone [Rocephin] for G/C and Z-pak *or*
• Doxy and tx partner.
• Sx

*Non STD Tx*:

• Cipro BID x 10 days
• Ofoxacin or Bactrim DS (MRSA and Osteomyelitis)

4. GU

Answer: Hydrocele: Fluid sack - periotoneal fluid in tunica vaginalis; *communicat-

ing*: incomplete closure/retains fluid and dispenses. Refer to surgeon

*non-communicating*: closure of processus vaginalis traps fluid; painless, transil- luminates pink or red.

*Dx*:

A detailed description of the events that precipitated the complaint Details of any trauma incurred Inguinoscrotal US Testicular nuclear scan Abdominal x-ray studies

*Tx*: No tx is required unless complications are present or the clinician suspects a significant underlying cause, such as a tumor.If painful, large, unsightly, or uncomfortable; the Jaboulay-Winkelmann surgical procedure or the Lord procedure (sac is re- duced (plicated) by suture).Sclerotherapy Endoscopic procedures

Pt monitoring at 3 month intervals until the decision is made for or against sx.Postoperatively, pt monitoring should be in 2-3 wks intervals, followed by 2-3 month intervals until resolution.

5. GU

Answer: Spermatocele: Cystic dilation of epididymis, feels like marble; usually painless cystic mass, circumscribed mass in scrotum. 2 / 4

*Dx*: Scrotal US, refer to urologist

6. GU

Answer: Varicocele: Bag of worms. Refer out!

*S/S*:

Oligospermia, infertility, pain and decreased testicular growth.

*Dx*: US, IV pyelography to r/o renal tumor. Grade I: palpable on valsava maneuver

Grade II: palpable when pt standing.

Grade III: assessed with light palpation and visual inspection.

*Tx*: Scrotal support and NSAIDs

7. GU

Answer:

Acute Prostatitis: < age 50, suspect G/C or bacteria:

• coli: 58 to 88%. Proteus species: 3 to 6%.

Other Enterobacteriaceae (Klebsiella, Enterobacter, and Serratia species): 3 to 11%.

Pseudomonas aeruginosa: 3 to 7%.

*S/S*:

Fever, chills, malaise, myalgia, dysuria, irritative urinary s/s (frequency, urgency and UI), pelvic or perineal pain and cloudy urine. Pain at the tip of the penis.

*Dx*:

DRE CBC UA PSA

*Tx*:

*Outpt*: Bactrim BID x 28 days, Cipro 500 mg x 28 days; Doxy 100 mg BID once

then x 28 days. Consider Alpha-blocker therapy

*Inpt*: Give IV, Levofloxacin, Carbapenem or Cipro w/or W/O an aminoglycoside.

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8. GU

Answer: Chronic Prostatitis causes: Bacterial - Gram negative, or STD mycoplasm or chlamydia.

*S/S*: early am penile discharge, urinary discomfort and NO NODULES.

*Dx*: Culture, CT/US, PSA elevated and in smokers, Cytoscopy

*Tx*: FQ's x 4-12 wks

9. GU

Answer: Prostate Cancer: Black men at highest risk, American Indian at lowest.

*Dx*:

Organ nodular on DRE US, CT and MRI Alkaline phosphatase PSA (secreted only by prostate cells, not specific for CA, serum marker for prostate disorder, 2-3 day half life).Biopsy

10. Bell's Palsy:

Answer: A peripheral, usually unilateral, lower motor neuron facial con- dition.Median onset age is 40.

• Determine if the weakness is caused by a problem in the CNS or PNS.
• Flaccid paralysis of muscles on the affected side, including the forehead: impaired

closure of the ipsilateral eye, inability to smile, grin, or purse lips.

• *Bell phenomenon*: Upward diversion of the eye w/attempted closure of the lid.

*Causes*:

Damage secondary to inflammation and subsequent swelling and compression in the ganglia of CN VII (facial) and associated vasa nervorum.

• reactivation of latent (HSV-I and VZV) or
• d/t ischemia from arteriosclerosis associated w/DM.

*Risk factors*:

Pregnancy DM

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