NURS 5434/ NURS 5434 Final Exam V2– Family III (FNP 3) 2026/ 2027 | Latest Questions & Accurate Solutions | Grade A - UTA

NURS 5434/ NURS 5434 Final Exam V2– Family III (FNP 3) 2026/ 2027 | Latest Questions & Accurate Solutions | Grade A - UTA Q: Colorectal Cancer (CRC) Screening: Answer Recommendation: Begin screening at age 45. Methods: Colonoscopy every 10 years, flexible sigmoidoscopy every 5 years, or annual FIT (Fecal Immunochemical Test). Q: Cervical Cancer Screening: Answer Recommendation: Ages 21-29: Pap smear every 3 years. Ages 30-65: Pap plus HPV co-testing every 5 years or Pap alone every 3 years. Q: Breast Cancer Screening Answer Recommendation: Begin annual mammograms at age 40 (or 50, depending on guidelines) for women, continuing as long as the woman is in good health. Q: Prostate Cancer Screening (PSA): Answer Recommendation: Discuss potential benefits and harms of screening with men starting at age 50, or at 45 for those at higher risk (e.g., family history). Q: Cardiovascular Disease (CVD) Screening: Answer Recommendation: Regular blood pressure checks starting at age 20, lipid profile screening every 4-6 years starting at age 20, and diabetes screening as needed. Q: D Recommendations: Answer D Recommendations: Typically include recommendations against certain screenings or treatments where the harms outweigh the benefits. For example:Do not screen for cervical cancer in women under 21, regardless of sexual history.Do not screen for prostate cancer with PSA in men under 55 or over 69 unless there are specific risk factors. Q: 2017 ACC/AHA HTN Guidelines Answer Normal BP: 120/80 mmHg; Elevated: 120-129/80; Stage 1: 130-139/80-89; Stage 2: ≥140/90. Q: Lifestyle recommendations for HTN Answer o Exercise: At least 150 minutes of moderate aerobic activity per week. o Sodium Intake: Limit to 2,300 mg/day; ideally 1,500 mg/day for those with HTN. o Alcohol Intake: Limit to ≤1 drink/day for women and ≤2 drinks/day for men. Q: Drug Categories for HTN Answer Thiazide Diuretics: Side effects include electrolyte imbalances. ACE Inhibitors: May cause cough and angioedema. ARBs: Generally well-tolerated but may lead to hyperkalemia. Calcium Channel Blockers: Possible peripheral edema. Q: Target BP Goals Answer Start meds if BP ≥130/80; aim for 130/80. Target Organ Damage (TOD): Assess through history and physical exam, looking for signs of heart, kidney, and eye damage. Q: step up drug therapy Answer If BP remains high, consider adding a second agent, such as a thiazide or CCB, or increasing the dose. Q: Resistant HTN definition Answer Defined as BP ≥130/80 despite three or more medications. Evaluate for secondary causes and consider referral. Q: ABPM (Ambulatory blood pressure monitoring) Answer Useful for diagnosing HTN and assessing variability. Powerful Med Combo for HTN Common combinations include an ACE inhibitor with a thiazide or CCB. Q: Hypertensive urgency vs emergency Answer o Urgency: BP 180/120 without acute end-organ damage; treat with oral medications. o Emergency: BP 180/120 with evidence of TOD; treat with IV medications. Q: Four Major Statin Treatment Categories Answer Individuals with clinical ASCVD. Individuals with an LDL-C ≥190 mg/dL. Adults aged 40-75 with diabetes and LDL-C 70-189 mg/dL. Adults aged 40-75 without diabetes but with an estimated 10-year ASCVD risk of 20% or higher. Q: Cholesterol guidelines Answer 2013 AHA/ACC: Focus on statin therapy based on risk categories, emphasizing a more individualized approach. 2018: Emphasizes the importance of considering risk factors and shared decision-making. Q: Enhanced Risk Factors for Statin Consideration Answer Family history of premature ASCVD. Persistently elevated LDL-C despite lifestyle changes. Conditions like chronic kidney disease, metabolic syndrome, or inflammatory disorders. Q: Global Risk Levels Answer Assess using ASCVD risk calculators; higher risk warrants earlier intervention. Statin Intensities High-Intensity: Atorvastatin 40-80 mg, Rosuvastatin 20-40 mg. Moderate-Intensity: Atorvastatin 10-20 mg, Rosuvastatin 5-10 mg. Q: Statin Side Effects: Answer Common: Myalgias, liver enzyme elevation. Rare: Rhabdomyolysis; monitor liver enzymes periodically. Evaluating and Treating Myalgias Assess the timing and severity; consider switching to a different statin or lower dose, or try non statin alternatives. Universal Screening Criteria for Pediatric Lipid Levels Screen children ages 9-11 and 17-21; earlier screening for those with risk factors. Acceptable Drug Therapy for Pediatric Dyslipidemia: Lifestyle modifications first; consider statins in children aged ≥10 with severe dyslipidemia or high-risk situations. Metabolic syndrome definition cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. Components of METS characterized by the presence of at least three of the following five components: 1. Abdominal Obesity: o Waist circumference: 40 inches in men; 35 inches in women. 2. Hyperglycemia: o Fasting glucose: ≥100 mg/dL or diagnosed diabetes. 3. Hypertension: o Blood pressure: ≥130/85 mmHg or diagnosed hypertension. 4. Dyslipidemia: o Triglycerides: ≥150 mg/dL or on treatment for elevated triglycerides. o HDL-C: 40 mg/dL in men; 50 mg/dL in women. 5. Insulin Resistance: o Typically assessed through glucose levels and associated risk factors. Diagnostic criteria for METS presence of at least 3 out of the 5 abdominal obesity, hyperglycemia, hypertension, dyslipidemia, insulin resistance risk factors for METS Genetic Factors: Family history of metabolic syndrome, type 2 diabetes, or cardiovascular disease. Lifestyle Factors: Poor diet, physical inactivity, and sedentary behavior. Age: Risk increases with age. Ethnicity: Higher prevalence in certain populations (e.g., Hispanic, African American). implications of METS Individuals with metabolic syndrome are at a significantly increased risk of: Cardiovascular disease (CVD). Type 2 diabetes. Non-alcoholic fatty liver disease. Sleep apnea. Lifestyle modifications for METS 1. Lifestyle Modifications: o Diet: Emphasize a heart-healthy diet (Mediterranean or DASH diet). o Exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity weekly. o Weight Management: Achieve and maintain a healthy weight. Pharmacologic treatment of METS o Hypertension: Use of antihypertensive medications if lifestyle changes are insufficient. o Dyslipidemia: Statins or other lipid-lowering agents as needed. o Hyperglycemia: Metformin or other agents for glucose control if indicated. 1. Regular Monitoring: o Routine follow-ups to monitor blood pressure, lipid levels, and glucose levels. 2017 AAP guidelines for pedi HTN Hypertension is defined as consistent BP readings ≥95th percentile for age, sex, and height. pediatric HTN assessment 1. Measurement: BP should be measured annually starting at age 3, using appropriate-sized cuffs. 2. Classification: o Stage 1 HTN: BP 95th to 99th percentile + 5 mmHg. o Stage 2 HTN: BP ≥99th percentile + 5 mmHg. Differences between pedi HTN and adolescent HTN Childhood: More often related to secondary causes (e.g., kidney disease). Adolescents: Often linked to obesity, lifestyle factors, and may resemble adult hypertension patterns. Causes of pedi HTN and adolescent HTN Childhood:Secondary causes: Renal disease, endocrine disorders (e.g., Cushing’s), coarctation of the aorta. Adolescents:Primary (essential) hypertension, obesity, poor diet, sedentary lifestyle. Treatment of pedi HTN 1. Lifestyle Modifications: o Diet (DASH), exercise, weight management. 2. Medication (if lifestyle changes are insufficient): o First-line options include: § ACE Inhibitors (e.g., lisinopril). § ARBs (e.g., losartan). § Calcium Channel Blockers (e.g., amlodipine). § Thiazide Diuretics (e.g., hydrochlorothiazide). when to refer pedi HTN Refer to a pediatric cardiologist or nephrologist if:Secondary hypertension is suspected.Resistant hypertension or severe hypertension (Stage 2).Symptoms of target organ damage (e.g., headaches, vision changes). Anxiety- diagnostic & 1st line treatment Diagnostic Criteria: Excessive anxiety and worry occurring more days than not for at least 6 months about various events or activities (Generalized Anxiety Disorder - GAD). Associated with three (or more) of the following symptoms: Restlessness or feeling keyed up or on edge. Being easily fatigued. Difficulty concentrating or mind going blank. Irritability. Muscle tension. Sleep disturbance. First-Line Treatment: SSRIs (e.g., escitalopram) or SNRIs (e.g., venlafaxine), along with **cognitive behavioral therapy (CBT). Expected Duration of Treatment: 6-12 months for acute treatment, potentially longer for chronic cases. Panic disorder- diagnostic & 1st line treatment Diagnostic Criteria: Recurrent unexpected panic attacks with persistent concern about future attacks or behavior changes (e.g., avoidance). First-Line Treatment: SSRIs or SNRIs; CBT is also effective. Expected Duration of Treatment: 6-12 months, with consideration for longer-term treatment in chronic cases. Major Depressive Disorder- diagnostic & 1st line treatment Diagnostic Criteria: Five or more symptoms present during the same 2-week period, including depressed mood or loss of interest/pleasure. First-Line Treatment: Cognitive behavior therapy or interpersonal therapy. SSRIs (e.g., fluoxetine, sertraline) or SNRIs. Expected Duration of Treatment: At least 6-12 months after remission; longer if recurrent episodes occur. Depression screening approaches PHQ-9 is a self-administered questionnaire consisting of 9 items that assess the presence and severity of depressive symptoms over the past two weeks.0-4: Minimal or none, 5-9: Mild, 10 14: Moderate, 15-19: Moderately severe, 20-27: Severe (BECK) BDI-II is a 21-item self-report inventory that measures the severity of depression in adolescents and adults.0-13: Minimal depression, 14-19: Mild depression, 20-28: Moderate depression 29-63: Severe depression Possible Hazards of SSRI Potential increased risk of suicidal thoughts or behavior, particularly in children, adolescents and young adults when using SSRI as mono therapy for new depression Suicide Risk Evaluation assess risk factors (previous attempts, family history, psychosocial stressors) protective factors (support systems), and current ideation. Use direct questioning about suicidal thoughts and plans. common drug choices for depression with specific patient issues Fatigue: consider activating antidepressants like bupropion Sexual dysfunction: options include bupropion or mirtazapine, which are less likely to cause sexual side effects Chronic pain: SNRI (duloxetine) are effective for both depression and chronic pain management restless leg syndrome (RLS) definition A neurological disorder characterized by an irresistible urge to move the legs, often accompanied by an uncomfortable sensations. restless leg syndrome (RLS) symptoms Tingling, burning, or itching sensations in the legs. symptoms typically worsen in the evening or at night and are relieved by movement restless leg syndrome (RLS) Diagnosis based on clinical history, no specific lab test. Use the international restless legs syndrome study group criteria (IRLSSG) restless leg syndrome (RLS) Treatment Lifestyle changes, iron supplements, and medications like dopamine agonists. first line- dopaminergic agents (pramipexole, ropinirole) other options: gabapentin or pregabalin for patients with significant pain or insomnia Migraine prevention/ prophylaxis Indications for Prophylaxis: Frequent migraines (≥4-6 per month), severe migraines, or those not responsive to acute treatments. First-Line Medications:Beta-Blockers: Propranolol.Antidepressants: Amitriptyline.Anticonvulsants: Topiramate, valproate. Non-Pharmacological Approaches: Lifestyle modifications, dietary changes, stress management, and regular sleep patterns. supplements- magnesium and riboflavin Parkinson's Disease: Motor symptoms like tremors, rigidity, bradykinesia. Treat with dopaminergic agents (e.g., levodopa). Multiple Sclerosis: Autoimmune condition affecting the central nervous system. Treatment may include disease modifying therapies (e.g., interferons). Alzheimer's Disease: Characterized by cognitive decline. Treat with acetylcholinesterase inhibitors (e.g., donepezil). OTC analgesics Acetaminophen: Safe for mild to moderate pain; liver toxicity risk at high doses. NSAIDs (e.g., ibuprofen, naproxen): Effective for pain and inflammation; GI and renal risks, especially with long-term use. Patient Considerations: Advise on proper dosing, potential side effects, and contraindications (e.g., history of GI ulcers for NSAIDs). Patient education- RLS encourage good sleep hygiene and regular physical activity. discuss the importance of avoiding stimulants in the evening patient education- migraines educate on triggers (certain foods, stress) and encourage a headache diary. Discuss medication adherence and proper use of acute treatments patient education- general neuro health stress importance of regular medical follow-ups, adherence to treatment plans and lifestyle modifications (diet, exercise) to improve the overall neurological health