NCA 621 Comprehensive Exam UPDATED
ACTUAL QUESTIONS AND CORRECT
ANSWERS
Which source of evidence would best support a practice change? - CORRECT
ANSWER Peer reviewed systematic reviews
When evaluating illness symptoms in older patients, the disease often presents in a manner
different or "atypical" from younger adults because of...? - CORRECT
ANSWER Normal age-related decline
Which group of older adults had the highest rate of growth between 1980-2017? - CORRECT
ANSWER Age 100 and over
What age is considered geriatric? - CORRECT ANSWER 65 years or older
What organisms mostly cause cellulitis? - CORRECT ANSWER Gram-positive cocci -
Staph aureus or strep
What antibiotics would you expect to give for mild cellulitis? - CORRECT
ANSWER Oral ABX as an outpatient
-PCN VK or amoxicillin
-Cephalexin
-Azithromycin
What antibiotics would you give for moderate-severe cellulitis? - CORRECT
ANSWER IV ABX for about 5 days - gram positive coverage bc most likely d/t staph
or strept
-PCN G
-Cefazolin or Ceftriaxone (3rd gen Cephalosporins)
-Vancomycin or daptomycin
,-Zosyn
What is a significant clinical finding of necrotizing fasciitis? - CORRECT
ANSWER Lower extremity X-ray/CT that shows subcutaneous air
*Get a surgical consult!
0.72cm lesion in diameter that is brown, flat, and nonpalpable. - CORRECT
ANSWER Macule
Lesions that are vesicles that occur in clusters on erythematous bases are known as what? -
CORRECT ANSWER Herpetiform lesions
Higher lipophilic corticosteroids mean that the steroid is what? - CORRECT
ANSWER More potent
Are clinical practice guidelines considered primary or secondary sources? - CORRECT
ANSWER Secondary
-Set of recommendations for practice
-Most often developed by organizations w resources
What does PICOT stand for and what is it used for? - CORRECT ANSWER P:
Population
I: Intervention
C: Comparison
O: Outcome
T: Time
Used to form clinical question
The 2021 USPSTF guidelines recommend HTN screening for adults age 18-39 w/o elevated
BP and w/o CVD risk factors for every ... years? - CORRECT ANSWER 3-5 years
,What are major risk factors for breast cancer in women? - CORRECT ANSWER Age
genetic predisposition (BRCA gene)
Estrogen exposure
HIV infection should be screened in adults until what age? - CORRECT ANSWER 75
yo
What is an example of acquired immunity? - CORRECT ANSWER A vaccine
What is an example of passive immunity? - CORRECT ANSWER breast feeding
USPSTF recommends BP screening in adults starting at what age? - CORRECT
ANSWER 18
The US Department of Health and Human Services and the CDC recommend that adults
engage in ___ minutes of moderate-intensity or ____ minutes of vigorous-intensity each
week. - CORRECT ANSWER 150 minutes of moderate-intensity or 75 minutes of
vigorous intensity
What is the most important preventable cause of cancer? - CORRECT
ANSWER Smoking
Lifetime prevalence of drug abuse is approximately 8% and is generally greater among which
populations? - CORRECT ANSWER -Young and unmarried individuals
-Men
-Native Americans
-Low SES
Which vaccines should be avoided during pregnancy? - CORRECT ANSWER Live
attenuated
, -Varicella, MMR, Oral Polio Vaccine
What is a conjugate vaccine? - CORRECT ANSWER contains pieces of the pathogens
they protect against
-Pneumococcal
What is the most common mode of transmission for Hepatitis A? - CORRECT
ANSWER Oral fecal route
How many doses is Twinrix? - CORRECT ANSWER 3 doses
Vaccinates for Hep A and Hep B
-Check for yeast protein, polymycxin, neomycin, or latex allergy
What allergies must you avoid for Hep B vaccinations? - CORRECT ANSWER -
Engerix B, Heplisav B (not latex), Twinrix
-Yeast
-Polymixin
-Neomycin
-Latex
At what age can an immunocompetent patient receive the herpes zoster (Shingrix) vaccine
series? - CORRECT ANSWER 50 yo with no comorbidities
*Live vaccine*
Avoid vaccination in pregnant women
How often would an adult need a Tdap booster without a recent history of an open wound? -
CORRECT ANSWER every 10 years
What is the Hib vaccine for? - CORRECT ANSWER Protection against bacteria that
causes serious illness (epiglottitis, bacterial meningitis, septic arthritis) in small children &
those with chronic illness such as sickle cell
ACTUAL QUESTIONS AND CORRECT
ANSWERS
Which source of evidence would best support a practice change? - CORRECT
ANSWER Peer reviewed systematic reviews
When evaluating illness symptoms in older patients, the disease often presents in a manner
different or "atypical" from younger adults because of...? - CORRECT
ANSWER Normal age-related decline
Which group of older adults had the highest rate of growth between 1980-2017? - CORRECT
ANSWER Age 100 and over
What age is considered geriatric? - CORRECT ANSWER 65 years or older
What organisms mostly cause cellulitis? - CORRECT ANSWER Gram-positive cocci -
Staph aureus or strep
What antibiotics would you expect to give for mild cellulitis? - CORRECT
ANSWER Oral ABX as an outpatient
-PCN VK or amoxicillin
-Cephalexin
-Azithromycin
What antibiotics would you give for moderate-severe cellulitis? - CORRECT
ANSWER IV ABX for about 5 days - gram positive coverage bc most likely d/t staph
or strept
-PCN G
-Cefazolin or Ceftriaxone (3rd gen Cephalosporins)
-Vancomycin or daptomycin
,-Zosyn
What is a significant clinical finding of necrotizing fasciitis? - CORRECT
ANSWER Lower extremity X-ray/CT that shows subcutaneous air
*Get a surgical consult!
0.72cm lesion in diameter that is brown, flat, and nonpalpable. - CORRECT
ANSWER Macule
Lesions that are vesicles that occur in clusters on erythematous bases are known as what? -
CORRECT ANSWER Herpetiform lesions
Higher lipophilic corticosteroids mean that the steroid is what? - CORRECT
ANSWER More potent
Are clinical practice guidelines considered primary or secondary sources? - CORRECT
ANSWER Secondary
-Set of recommendations for practice
-Most often developed by organizations w resources
What does PICOT stand for and what is it used for? - CORRECT ANSWER P:
Population
I: Intervention
C: Comparison
O: Outcome
T: Time
Used to form clinical question
The 2021 USPSTF guidelines recommend HTN screening for adults age 18-39 w/o elevated
BP and w/o CVD risk factors for every ... years? - CORRECT ANSWER 3-5 years
,What are major risk factors for breast cancer in women? - CORRECT ANSWER Age
genetic predisposition (BRCA gene)
Estrogen exposure
HIV infection should be screened in adults until what age? - CORRECT ANSWER 75
yo
What is an example of acquired immunity? - CORRECT ANSWER A vaccine
What is an example of passive immunity? - CORRECT ANSWER breast feeding
USPSTF recommends BP screening in adults starting at what age? - CORRECT
ANSWER 18
The US Department of Health and Human Services and the CDC recommend that adults
engage in ___ minutes of moderate-intensity or ____ minutes of vigorous-intensity each
week. - CORRECT ANSWER 150 minutes of moderate-intensity or 75 minutes of
vigorous intensity
What is the most important preventable cause of cancer? - CORRECT
ANSWER Smoking
Lifetime prevalence of drug abuse is approximately 8% and is generally greater among which
populations? - CORRECT ANSWER -Young and unmarried individuals
-Men
-Native Americans
-Low SES
Which vaccines should be avoided during pregnancy? - CORRECT ANSWER Live
attenuated
, -Varicella, MMR, Oral Polio Vaccine
What is a conjugate vaccine? - CORRECT ANSWER contains pieces of the pathogens
they protect against
-Pneumococcal
What is the most common mode of transmission for Hepatitis A? - CORRECT
ANSWER Oral fecal route
How many doses is Twinrix? - CORRECT ANSWER 3 doses
Vaccinates for Hep A and Hep B
-Check for yeast protein, polymycxin, neomycin, or latex allergy
What allergies must you avoid for Hep B vaccinations? - CORRECT ANSWER -
Engerix B, Heplisav B (not latex), Twinrix
-Yeast
-Polymixin
-Neomycin
-Latex
At what age can an immunocompetent patient receive the herpes zoster (Shingrix) vaccine
series? - CORRECT ANSWER 50 yo with no comorbidities
*Live vaccine*
Avoid vaccination in pregnant women
How often would an adult need a Tdap booster without a recent history of an open wound? -
CORRECT ANSWER every 10 years
What is the Hib vaccine for? - CORRECT ANSWER Protection against bacteria that
causes serious illness (epiglottitis, bacterial meningitis, septic arthritis) in small children &
those with chronic illness such as sickle cell
