Therapeutic INR values below ____ increase stroke risk sixfold. - ANSWER-
2
Diabetic Retinopathy Findings - ANSWER-Microaneurysms
Neovascularization
Cotton Wool Spots
Hard exudates
All of the following would require the nurse practitioner to delay testing
a patient's prostate-specific antigen (PSA), except:
a. Urinary retention
b. Urinary tract infection
c. After a digital rectal exam
d. Vigorous exercise 3 days prior - ANSWER-Vigorous exercise 3 days
prior
PSA testing is falsely elevated in a patient with urinary retention and
urinary tract infection and after a digital rectal exam. Vigorous exercise
does not have to be stopped 3 days prior to testing; however, vigorous
exercise should be discouraged before testing because it will falsely
,elevate the PSA levels. Ejaculation within 48 hours will also falsely raise
the PSA level.
Tic Douloureaux - ANSWER-There are two types of tic douloureux
(trigeminal neuralgia).
Type 1--presents with extreme, shock-like facial pain, which lasts from a
few seconds to 2 minutes per event and can last up to 2 hours total. Type
1 does not awaken the patient at night.
Type 2-- is a constant, aching, burning facial pain with less intensity but
may occur with Type 1. Type 2 is more common in women and peaks in
their 60s. Type 2 can also be related to secondary neurologic disease
such as multiple sclerosis or HSV-1.
The nurse practitioner sees a 58-year-old female patient who reports
abscesses and pustules in the axilla and groin and under the breasts,
which burst and drain purulent green discharge. She has a history of
smoking and a body mass index (BMI) of 37.1.
Which diagnosis is most likely?
a. Impetigo
b. Carbuncles
c. Shingles
d. Hidradenitis suppurativa - ANSWER-hidradenitis suppurativa
,Hidradenitis suppurativa is most common in women (3:1). Smoking and
obesity are significant risk factors. Lesions are treated with topical
antibiotics (or oral antibiotics, warm compresses, and pain
medications). Institute diet changes to reduce high glycemic and dairy
food intake. Refer to a dermatologist for additional treatment options.
Insulin Lispro (Humalog) - ANSWER-Lispro is a rapid-acting insulin that
is used on a sliding scale to work from meal to meal
Atopic dermatitis (eczema) - ANSWER-chronic, pruritic rash of the hands,
flexural folds, and neck that can be exacerbated by stress and
environmental factors.
Toxic Epidermal Necrolysis (TEN) - ANSWER-TEN is the result of a severe
skin reaction to medications such as allopurinol, nonsteroidal anti-
inflammatory drugs (NSAIDs), and anticonvulsants.
Melanoma - ANSWER-Melanoma are nevi with uneven texture, irregular
borders, variegated colors, size larger than 6 mm, and changing size (the
mnemonic ABCDE stands for asymmetry, border irregularity, color
variations in the same region, diameter >6 mm, and enlargement or
change in size over time), and they can be pruritic. Risk factors include
family history of melanoma (10% of cases), extensive/intense sunlight
exposure, blistering sunburn in childhood, tanning beds, and atypical
nevus
Seborrheic keratoses - ANSWER-Seborrheic keratoses are soft, fleshy,
painless growths that are located mostly on the back. Skin lesions look
like they are "pasted" on the skin and can range in color from light tan to
black.
, Acanthosis nigricans - ANSWER-Acanthosis nigricans are diffuse, soft
thickenings of the skin usually located at the neck and axilla. They are
also associated with diabetes, metabolic syndrome, obesity, and
gastrointestinal cancer.
Acrochordon - ANSWER-Acrochordons (skin tags) are painless,
pedunculated outgrowths of skin that are common in the neck and
axillary areas. If the growths are traumatized, they become necrotic and
fall off. They are most common in diabetics and patients who are obese.
Which of the following is associated with male aging?
a. Increased levels of estrogen
b. Decreased sperm production
c. Increased production of semen
d. Decreased concentration of sperm - ANSWER-Decreased sperm
production
A nurse practitioner sees a patient for an evaluation of sexually
transmitted diseases. Assessment reveals Fitz-Hugh-Curtis. The nurse
practitioner will prescribe: - ANSWER-Ceftriaxone 500 mg IM × one dose
plus doxycycline 100 mg BID × 14 days plus metronidazole 500 mg BID ×
14 days.
Fitz-Hugh-Curtis syndrome should be treated as a complicated
gonorrheal/chlamydial infection: Ceftriaxone 500 mg IM × one dose plus
doxycycline 100 mg BID × 14 days plus metronidazole 500 mg BID × 14
days for anaerobic coverage.