Sarah Michelle crash course Latest Update 215 Questions and Correct Answers Graded A+
- Correct Answer: "Mammograms for patients who are at a regular risk for breast
cancer should begin at age 45 and be repeated at least every year, according to the American Cancer Society.
After age 54, it is safe to move to every other year, although every year should still be encouraged.
This does not apply to patients with a family history of breast cancer as they may need screening earlier.
BRCA 1 and 2 testing is recommended by The American Society of Clinical Oncology for those with familial history of breast cancer and/or a personal history of epithelial ovarian cancer."
. Which of the following wet mount descriptions would make the nurse practitioner suspect bacterial vaginosis? - Correct Answer: Squamous epithelial cells with blurred margins that are coated with bacteria (clue cells)
- HBsAg, +IgM Anti-HBc, - IgG Anti-HBc, and - HBsAb. Which of the following is the
correct interpretation of these results? - Correct Answer: Acute infection
HBsAg is the surface antigen used to determine if a hepatitis B infection is present. The Anti-HBc is the core antibody. The core antibody will always remain positive after an infection has occurred and can be further broken down into the IgG and IgM to determine if the infection is current or resolved. HBsAb is used to detect the surface antibody. This patient's surface antigen is positive, meaning there is a hepatitis B infection present. Since the IgM is positive, it meCorrect Answer: there is an acute Hepatitis B infection.
- types of Impetigo treatment - Correct Answer: Bullous: PO antibiotics
Nonbollous: mupirocin ointment
- year old daughter in today for a sick visit. He reports that for the last 3 days she has
had a fever of 101.3 to 102.4, a runny nose, and red rash across her face. Today upon awakening, he noted a rash on her chest and the soles of her feet. - Correct Answer: Fifths disease (also known as erythema infectiosum), caused by parvovirus B19, is more common in children than adults. It typically begins with a fever and progresses into the development of a rash. The rash classically appears as a slapped cheek rash on the face and a lacy net like rash on the body. This dad should be informed that since the rash has appeared, she is no longer contagious and he can continue treating the 1 / 3
fever with acetaminophen (Tylenol) and ibuprofen (Motrin) at home and ensure she is receiving adequate hydration and rest.
3A's - Correct Answer: Asthma, allergies, atopic dermatitis
25 year old male and notes a single, skin-colored, cauliflower-like lesion on his penis.He denies associated pain. Upon further examination, the lesion is soft and 5 mm in diameter. Which of the following is the most likely diagnosis? - Correct Answer: Condylomata acuminata
Condylomata acuminata (anogenital warts) may present as single lesions or in groups.They range from skin-colored, to erythematous, to brown and may be flat, dome- shaped, cauliflower-like, or plaque-like. They are typically asymptomatic, consistent with this patient's experience. Molluscum contagiosum commonly present as umbilicated papules while syphilis commonly presents as a nontender, indurated lesion. Bowenoid papulosis, a premalignant condition, presents as several red papules in the gential area.
40 pack-year smoking history complains of painful cramping in the leg muscles that occurs after walking for 20 minutes. - Correct Answer: intermittent claudication.
a "red flag" for colorectal cancer when reported by the patient - Correct Answer: A new onset of ribbon-like stool
A 12-year-old child diagnosed with mild persistent asthma has a peak expiratory flow (PEF) of less than 80% of predicted. The most appropriate action would be to: - Correct
Answer: add a long-acting beta agonist to the inhaled corticosteroid.
A 37 year old female patient presents with unusual complaints of continued fatigue, increasing bone pain, and nausea. She has had several visits in the last several months but no resolution of symptoms. Which of the following is the most likely differential for this patient given her presenting symptoms and history? - Correct Answer: Some of the classic symptoms of hyperparathyroidism include abdominal pain, nausea, vomiting, fatigue, confusion, muscle weakness, and bone pain. A patient with depression may have the symptom of fatigue, but would not necessarily present with the other symptoms. Patients with iron deficiency anemia do not present with nausea or bone pain but instead present with pallor, palpitations, pica, nail pitting, etc. Patients with undiagnosed diabetes normally present with the classic symptoms of polydipsia, polyuria, and polyphagia.
A 60 year old female presents with dull, aching back pain in her lower back and occasional weakness in her left foot. She states that the pain is relieved when she sits down and rests. What does the nurse practitioner suspect? - Correct Answer: Spinal stenosis
Low back pain that is relieved by sitting is a sign of spinal stenosis. Weakness or "foot drop," burning in the buttocks and thigh, and abnormal reflexes can all be signs of spinal 2 / 3
stenosis as well. Spinal stenosis is most common in patients older than 50 years old and is many times due to osteoarthritis. The pain is often described as dull or aching.
A 63 year old patient diagnosed with COPD has a CAT (COPD Assessment Test) score of 6 and has not had any severe exacerbations in the last year, placing them in treatment Group A. Which medications might this patient be on? - Correct Answer: Levoalbuterol (Xopenex), Fomoterol (Perforomist)
Patients in COPD group A should be prescribed a bronchodilator - either a short acting or a long acting bronchodilator depending on the patient's response. Therefore, this patient could be prescribed levoalbuterol (a SABA) or fomoterol (a LABA) from the list above.
A geriatric patient presents with a bump on the vulva, associated with pruritis and malodorous drainage. Examination reveals a raised, ulcerated lesion. - Correct Answer: vulvar cancer.
A geriatric patient with anemia, back pain, osteoporosis, and elevated erythrocyte sedimentation rate should be evaluated for: - Correct Answer: multiple myeloma
A male patient presents with bilateral pain and swelling of his scrotum. Which of the following findings would make the nurse practitioner suspect a potential diagnosis of
orchitis? - Correct Answer: Swelling near his left cheek and neck
Orchitis is often preceded by a mumps infection and the development of parotitis. With administration of the MMR vaccine, cases of orchitis are much more rare.
a non-healing ulcer on his right foot. Upon evaluation of the wound, you note red streaking away from the area into the ankle and lower leg. There is a foul smelling purulent drainage coming from the ulcer as well and when questioned, the patient states "it has been getting worse over the last few days". What is the most appropriate treatment for this patient? - Correct Answer: The most appropriate treatment for this patient is clindamycin (Cleocin) as cellulitis is the most likely diagnosis.
This patient's wound and diabetes put him at risk for an infection.
Cellulitis commonly presents as redness, warmth, and edema and frequently affects the lower extremities.
Due to the presence of purulent drainage, this patient specifically has purulent cellulitis making cephalexin (Keflex) an inappropriate choice.
A patient presents with intense pruritus. In which of the following scenarios would the nurse practitioner treat the entire household? - Correct Answer: "Pruritic lesions around the waistline, in folds of skin, or webs of fingers/toes that are itchy at night are suspicious of scabies. Scabies is an infestation of the Sarcoptes scabiei mite. They
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