Risk Assessment Ancc Agacnp Exam Prep

Front 1

At what age should an adolescent have a full physical exam?

Back 1

Start between ages 11 and 14; then there are 3 recommended visits:
ages:
11 - 14
15- 17
18 - 21

Front 2

What should be included in the physical exam of an adolescent?

Back 2

height/weight (checking for eating disorders)
Skin exam
Oral Cavity (gingivitis, cavities, etc.)
Hearing
Abuse/neglect (depression)
BP (normal: 120/80 or less)

Front 3

What age should the female patient recieve vaccination for HPV with Gardisil?

Back 3

between age 11 - 26

Front 4

What age should the female patient recieve vaccination for HPV with Cervarix?

Back 4

Between age 10 - 25

Front 5

How are the HPV vaccinations scheduled? (i.e. how many and when)

Back 5

Three over six months:
2nd - two months after first
3rd - two and six months after first

(Series of 3 shots - zero, one, and six months schedule)

Front 6

WHen should screening for syphyllis in males and females begin?

Back 6

Upon becoming sexually active

Front 7

When should Self-Breast/Testicular Exam begin?

Back 7

During adolescence and monthly

Front 8

What is the leading cancer killer for adolescents?

Back 8

Testicular cancer

Front 9

When should screening for HIV begin?

Back 9

Depends on level of sexual activity, assess knowledge of prevention)

Front 10

When should vaccination wit the Tetanus- diphtheria vaccine occur?

Back 10

in adolescence, then every 10 years

Front 11

What does TDAP cover?

Back 11

accellular pertussis

Front 12

When should the meningococcal vaccine be given?

Back 12

between ages 11 - 18

Front 13

What groups are recommended to receive the meningococcal vaccine?

Back 13

Those going to live in a dorm, traveling to Africa, entering the military

This is NOT a routine vaccination for adults

Front 14

Who should get the influenza vaccine?

Back 14

everybody 6months of age and older
Given annually

Front 15

When is the PPD screening begun

Back 15

Once during adolescence, every 2 years if at risk

Really depends on where they live and what conditions they live in (i.e., Manhatten vs. rural Kansas)

Front 16

What is the age group for the Young adult?

Back 16

Between age 20 and 39

Front 17

How often should those in the young adult category have a complete physical exam?

Back 17

every 5 - 6 years if everything is normal

Front 18

What should be included for females during a physical exam in the young adult group?

Back 18

Pap smear
Should include screens for GC and Chlamydia) for all under age 25 and annually till age 29, then may go to every 2-3 years if several negative results obtained

Front 19

When should pap smears begin for young adult females?

Back 19

Begins at age 21

Front 20

When should mammograms begin?

Back 20

Unless there is a strong famly history, age 40 - 49 at every 1 - 2 years schedule, then annually ages 50 -74

Front 21

What is the recommended age to stop mammograms

Back 21

Continue through age 74 if in good health

Front 22

72 y/o female comes into office for regular female exam; she has been seen in your clinic for 10+ years, but you've never seen her, noted in chart is she has been consistent with regular pap smears and mammograms all with normal results; what will you order for her today?
a. mammogram
b. pap smear
c. mammogram and pap smear
d. neither of these is needed

Back 22

a. mammogram

Front 23

When should males perform self-breast and testicular exams?

Back 23

Monthly

Front 24

How often should BP be checked during the adolescence period?

Back 24

every 2 years and every office visit

Front 25

When should total cholesterol checks begin?

Back 25

age 20, then every 5 years if WNL

Front 26

How would you manage an abnormal lipid panel?

Back 26

By "hammering" the LDL until it gets to goal; once LDL is in goal, the total will be relatively ok

Front 27

PPD in the young adult?

Back 27

annually for high-risk populations

Front 28

Complete physical exams for middle-aged adults?

Back 28

every 5-6 years

Front 29

What should be included in the PE of a female in the middle-aged adults?

Back 29

Pap Smear (every 2 -3 years with 3 negative cytology tests)

Front 30

How often should the middle-aged female have a clinical breast exam?

Back 30

annually

Front 31

Middle aged female should have a mammogram how often?

Back 31

every 1-2 years for ages 40-49; then annually for ages 50-74

Front 32

When should males begin having prostate screenings?

Back 32

age 40 if positive family history, otherwise age 50

Front 33

When should PSA's begin

Back 33

age 50 unless African American or strong family history

Front 34

What group has the highest rate of Prostate cancer?

Back 34

African American

Front 35

When should an initial ECG be obtained?

Back 35

age 40 for baseline

Front 36

Colorectal Cancer screening should begin with a colonscopy at what age?

Back 36

age 50, then every 10 years

Front 37

What is the second leading cause of cancer deaths?

Back 37

Colo-rectal Cancer

Front 38

When should glaucoma screening begin?

Back 38

age 40

Front 39

What is the test for glaucoma called and what is the normal result of this test?

Back 39

Tonometry and normal intra-ocular pressure is 10-20mmHg

Front 40

What is the number one cause of death in adults in the US?

Back 40

Cardiovascular disease

Front 41

What is the leading cancer killer for both men and women?

Back 41

Lung

Front 42

Cancer with highest incidence in women other than skin?

Back 42

breast

Front 43

At what age should the vaccine for Herpes Zoster (Zostavax) be given and how often?

Back 43

50 and only once

Front 44

What age is considered the beginning of the elderly or older adult category?

Back 44

60

Front 45

How often should the older adult have a complete Physical exam? What should be included that hasn't been included with other age groups?

Back 45

every 2 years and now should include lab assessments

Front 46

What age should receive the pneumococcal vaccine?

Back 46

65, and only once if not in a high-risk category

Front 47

WHat kind of pneumoniae does the vaccine cover?

Back 47

Strep pneumoniae

Front 48

Sensitivity

Back 48

(+) True positives show positives, the degree to which those who have a disease screen/test positive

Front 49

Specificity

Back 49

(-) True negative: the degree to which those who do not have a disease screen/test negative

Front 50

Incidence

Back 50

The frequency with which a disease or disorder appears in a particular population or area at a given time; the rate in which new cases occur during a specific time period

Front 51

Prevalence

Back 51

The proportion of a population that is affected by a disease or disorder at a particular time; Ex. the prevalence of lupus in women living in Illinois during 2010 was <1%.

Front 52

Major causes of death for adolescent group:

Back 52

 Motor vehicle crashes
 Suicide
 Other accidents
 Homicide
 Malignancy
 Cardiovascular or Congenital disease

Front 53

Major causes of death for Young Adults

Back 53

 MVC
 Homicide
 Suicide
 Injuries
 heart disease
 AIDS: if this is one of the major killers in this age group; what does it say about when they are contracting HIV? In their TEENS

Front 54

The leading killer of African Americans in the US <40 y/o

Back 54

AIDS

Front 55

Leading killer of African American Men <35 y/o

Back 55

Homicide

Front 56

Major causes of death for the Middle Aged

Back 56

 Heart disease
 Accidents
 Lung Cancer
 CVA
 Breast and colorectal cancer
 COPD

Front 57

Major causes of death for the elderly

Back 57

 Heart disease
 CVA
COPD
 Pneumonia and/or influenza:
 The elderly with these Diagnoses will most likely require hospitalization
 IVF's, antibiotics since these are killers in this age group
 Lung and colorectal cancer

Front 58

Primary Prevention

Back 58

Includes measures to promote health prior to any recognizable problems:
 Examples: Healthy diet, exercise, avoiding tobacco, wearing seat belts, immunizations/vaccinations, safety initiatives, etc.

Front 59

Secondary Prevention

Back 59

Focus on early identification and treatment of existing problems
 Examples: Pap smear screening, prostate cancer screening, cholesterol screening, etc.

Front 60

Tertiary Prevention

Back 60

Includes rehabilitation and restoration of health
 Examples: Cardiac rehab following MI, PT following MVC, etc.

Front 61

What is My Plate?

Back 61

 Make half your plate fruits and vegetables
 Switch to skim or 1% milk
 Make at least half your grains whole
 Vary your protein food choices

Front 62

What is the USDA recommendation for carbohydrates in the diet?

Back 62

55-60%

Front 63

What is the recommended amount of fat in the diet?

Back 63

= <30% total calories with <10% being saturated fats

Front 64

What is the recommended amount of protein in the diet?

Back 64

0.8-1.0g/kg/day (remainder of diet); these are the needs of someone not septic or trauma, etc.

Front 65

What are some of the positive effects of exercise?

Back 65

 Decreasing low density LDL's
 Increased the basal metabolic rate
 Reducing stress
 Improving cardiovascular fitness
 Decreasing signs of aging

Front 66

What should patients over 35 have before instituting an exercise program?

Back 66

 Complete history
 Physical Exam
 Exercise Stress Test

Front 67

What is Active immunity

Back 67

Conferred by antibody formation stimulated with a specific antigen such as typhoid fever immunization and toxoids

Front 68

What is Passive immunity?

Back 68

Conferred by the introduction of antibody proteins such as gamma globulin injections or maternal immunity transferred to the fetus (Can be mom to baby, but also gamma globulin, which is given or Hep B exposure

Front 69

WHo should get the vaccine for Hepatitis A?

Back 69

military personnel, travelers to endemic areas, and men who have sex with men

Front 70

Admitting 82 y/o female for cellulitis, which of the following immunizations would it be most important to ensure that she has had

a. Zosivax
b. Meningococcal
c. Pneumococcal
d. Seasonal Influenza

Back 70

c. Pneumococcal