Ancc Fnp Boards Random 1

Front 1

Allopurinol and colchicine each is used when?

Back 1

allopurinol - maintenance to keep uric acid low
colchicine - acute gout attack

Front 2

Dysdiadochokinesia refers to:

Back 2

Neuro triad of symptoms with gait, memory, and speech - common in MS.

Front 3

How do antioxidants help MS?

Back 3

- MS is believed to be destruction of myelin sheaths via oxidation by oxygen-free radicals. Antioxidants (i.e. cranberries) may benefit.

Front 4

Someone with post-polio symptoms, wearing leg brace, why do you have them keep their affected from the exposure to cold or chilling?

Back 4

- Cold temperatures can cause loss of muscle strength in the affected group muscle (“cold limb”)

Front 5

How do you tell a migraine from a tension HA?

Back 5

- Sleep pattern disturbances (too little or too little). Alcohol, lighting, noxious stimuli, stress can all trigger both HAs.

Front 6

ALP is found mostly where?

Back 6

Liver (mainly), then bones

Front 7

ALP high, GGT high

Back 7

liver problem

Front 8

ALP high, GGT normal

Back 8

bone disease (Paget's disease)

Front 9

AST high, GGT high

Back 9

liver problem (alcohol abuse)

Front 10

What chemical in the CNS change during a migraine?

Back 10

- Serotonin levels decrease

Front 11

What are the differences of symptoms that show in a TIA of ANTERIOR cerebral circulation vs. POSTERIOR?

Back 11

- Anterior: behavior and cognition disorders
- Posterior: b/l vision disturbance with diplopia, dysarthria, motor/sensory b/l

Front 12

In a pt who has sustained a closed head injury, lethargic, follow commands slowly, what abnormal VS will alert you?

Back 12

- Increase in BP, decrease HR  increasing cerebral edema and ICP

Front 13

Child with purpuric rash with centrifugal distribution (with well-demarcated borders) and fever.

Back 13

- Meningococcemia; due to impairment of protein C anticoagulation pathway

Front 14

Tx for myasthenia gravis:

Back 14

- Pyridostigmine (Mestinon) (Ach-ase inhibitor)

Front 15

Horner’s syndrome:

Back 15

- Horney PAMELa = Ptosis, Anhidrosis, Miosis, Enophthalmos, Loss of ciliospinal reflex)
- Due to lesion or compression of one side of the cervical or thoracic sympathetic chain which generates symptoms on the ipsilateral (same side as lesion) side of the body.
- Congenital, tumor, iatrogenic (meds)

Front 16

Where is AST and ALT found?

Back 16

AST = S for skeletal, myocardium, brain, kidneys (major organs)

ALT = L for liver

Front 17

What is the circulatory 1/2 life of AST and ALT? What is important about this?

Back 17

AST = 12-24 hrs
ALT = 37-57 (longer)

ALT can detect hepatic damage even after damage has ceased.
However, remember AST > ALT indicates alcohol, statin, and tylenol use. And ALT > AST indicates infectious hepatitis.

Front 18

urine has conjugated or unconjugated bilirubin?

Back 18

conjugated

Front 19

what medication for gout oversecretors? undersecretors?

Back 19

- oversecretors: allopurinol
- undersecretors (90%): probenecid

Front 20

Homonymous hemianopia:

Back 20

- Loss of vision in both eyes in either the R or L half of the visual field; due to CVA

Front 21

Where is the best place to evaluate skin turgor in adult?

Back 21

- Just below the clavicle or abdomen

Front 22

What skin disorder is sometimes associated with arthritis but may not be directed associated?

Back 22

- Psoriasis (psoriatic arthritis)

Front 23

Difference between nummular eczema and dyshidrotic eczema?

Back 23

- Nummular: coin-liked plaques, discoid, chronic pruritic, papules and vesicles on erythematous base
- Dyshidrotic: no evidence of sweating, bullous form called pompholyx, d/t emotional stress

Front 24

Maculopapular skin lesion on back, warty, scaly, greasy, light tan.

Back 24

- Seborrheic keratosis (raised, tan-brown)

Front 25

What is medical mgmt of a brown recluse spider bite?

Back 25

- Ice pack for inflammation, elevate area; also associated with black eschar of sloughing tissue

Front 26

Severe reaction to black widow spider bite:

Back 26

- Abd rigidity, nausea, HA, bronchospasm, HTN, seizures, AMS

Front 27

What is a major side effect of sulfa drugs?

Back 27

- Erythema multiforme – high fever, weakness, blisters, bulla, ulcerations of mucous membranes

Front 28

When can kid with Fifth’s Disease (Erythema infectiosum) go back to school?

Back 28

- Communicable before rash erupts, so may go back to school when rash appears

Front 29

Where does roseola and rubella start?

Back 29

- Roseola starts on trunk after fever; spreads to extremities; supportive care
- Rubella starts on face and goes down trunk, while facial rashes disappear; clears in 3-5 days

Front 30

How do BBs exacerbate psoriasis?

Back 30

- Decreases cAMP-dependent protein kinase (inhibitor of cell proliferation)

Front 31

Do not give what med in true postherpetic neuralgia?

Back 31

- Antiviral (acyclovir or valcyclovir); bc won’t work anymore (must give during early symptoms of tingling pain)

Front 32

Tx of rosacea:

Back 32

- Low-dose tetracycline or topical metronidazole

Front 33

Lidocaine with Epi 1-2% as local anesthesia maximum dose allowed is:

Back 33

- 7mg/kg

Front 34

Motor function of L4

Back 34

foot dorsiflexion
knee jerk reflex

Front 35

Motor function of L5

Back 35

great toe dorsiflexion

Front 36

Motor function of S1

Back 36

foot eversion

Front 37

1. What drugs can cause hyperglycemia?

2. What drugs can precipitate gout attack?

3. What drugs can cause acute pancreatitis?

Back 37

- corticosteroids, niacin, thiazide diuretics

- niacin, thiazide diuretics, ASA, cyclosporine

- corticosteroids, thiazides (causes increase of Ca2+), alcohol

Front 38

Lab that tests for autoimmune thyroid disease.

Back 38

TPOAb (thyroid peroxidase antibody)

Front 39

Sulfonylurea mechanism of action.

Back 39

insulin secretagogues (they stimulate pancrease to release more insulin); long-acting.

Front 40

Meglitinides mech of action.

Back 40

same like sulfonylureas, but SHORT-acting (works in 20 minutes).

Front 41

Metformin mech of action.

Back 41

Inhibits hepatic gluconeogenesis; ↑ peripheral sensitivity
to insulin.

Front 42

Why is weight loss seen in Metformin?

Back 42

- decreases intestinal absorption of glucose.

Front 43

Thiazolidinediones mech of action.

Back 43

↑ insulin sensitivity

Front 44

Caution what when giving sulfonylureas?

Back 44

- make sure pt has functioning beta cells.

- make sure pt does not have sulfa allergy.

Front 45

Caution what when giving Metformin?

Back 45

- impaired renal function

Front 46

Caution what when giving Thiazolidinediones?

Back 46

- must monitor for hepatic toxicity (ALTs)

Front 47

Januvia must be used in combo with?

Back 47

- Metformin or a TZD.

Front 48

Acute weight loss --> think 6 reasons:

Back 48

cancer
leukemia/lymphoma
TB
AIDS
depression
DM type 1

Front 49

Dawn phenomenon

Back 49

insulin wears DOWN by DAWN

solution: move PM dose of insulin closer to bedtime.

Front 50

Somogyi effect

Back 50

Pt is hypoglycemic in middle of night and REBOUNDS to hyperglycemia in morning.

solution: eliminate or reduce PM insulin.

Front 51

How do corticosteroids cause hyperglycemia?

Back 51

Steroids prevent the uptake of glucose in cells.

Front 52

How do steroids cause HTN?

Back 52

steroids cause vasoconstriction.

Front 53

pt taking ethambutol for TB. Monitor what?

Back 53

- visual acuity, green-red preception (optic neuritis)

Front 54

prophylactic migraine treatment

Back 54

BB (propranolol?)
CCB (Verapamil)
TCAs (amitriptyline)

Front 55

Most common pathogen in Acute Bronchitis?

Back 55

RSV

Front 56

A BOGGY and tender prostate gland is consistent with __? Treatment for man >35yo? <35yo?

Back 56

acute bacterial prostatitis.

Tx with bactrim or cipro x 14 days if >35yo

Tx with ceftriaxone 250mg IM + doxy if <35yo

Front 57

What are 3 causes of secondary hypertriglycemia?

Back 57

- excessive alcohol use
- uncontrolled DM
- untreated or undertreated hyperthryoidism

Front 58

dilatory

Back 58

delaying; tending to delay, slow to act : he had been dilatory in appointing a solicitor.

Front 59

What can you Rx to PREVENT duodenal ulcers?

Back 59

antibiotics

Front 60

does serum albumin increase or decrease in elderly?

Back 60

- decrease

Front 61

The general principle of how drug absorption is altered in the eldery is:

Back 61

rate of absorption

Front 62

How does age affect ACE-I?

Back 62

less effective in elderly because they have reduced renal elimination.

Front 63

T or F: majority of ectopics resolve unpredictably without intervention.

Back 63

True

Front 64

What do you use to treat chlamydia in a pregnant woman?

Back 64

Erythromycin is recommended.

Front 65

The best advice to give someone who is taking a medication with a narrow therapeutic index is to tell them to take the medication HOW?

Back 65

- take it at the same time every day.

Front 66

When you prescribe a drug >90% protein-bound, it means that ___.

Back 66

Only protein-bound portion of the drug is therapeutically active.

Front 67

T/F: The charge of the State Board of Nursing is to ensure public safety.

Back 67

True

Front 68

T/F: Once I am certified, I can practice as a nurse practitioner.

Back 68

False, you practice even without certification.

Front 69

T/F: State level authorization dictates the ability of the NP to obtain a Federal DEA number.

Back 69

True.

Front 70

What is the ethical principle of beneficence?

Back 70

- to help people in need.

Front 71

someone taking TZD, monitor what?

Back 71

ALT

Front 72

crescendo-decrescendo murmur

Back 72

aortic stenosis

Front 73

clue cells on smear

Back 73

bacterial vaginosis

Front 74

First-line treatment of:
1) syphillis
2) gonorrhea
3) chlamydia

Back 74

1) penicillin G
2) Suprax or ceftriaxone
3) azithromycin or doxy

Front 75

boggy prostate gland

Back 75

acute prostatitis

Front 76

prevent recurrence of duodenal ulcers, Rx:

Back 76

abx

Front 77

when is a child allowed to sit in a forward-facing car seat?

Back 77

- 1 year AND at least 20 lbs