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ANCC FNP BOARD EXAM | QUESTIONS AND ANSWERS | VERIFIED ANSWERS GRADED A+ | LATEST EXAM UPDATE

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ANCC FNP BOARD EXAM | QUESTIONS AND ANSWERS | VERIFIED ANSWERS GRADED A+ | LATEST EXAM UPDATE

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ANCC FNP BOARD EXAM | QUESTIONS AND ANSWERS | VERIFIED
ANSWERS GRADED A+ | LATEST EXAM UPDATE




A middle-age female patient presents to the clinic with a recurrence of mild
hidradenitis suppurativa after topical therapies failed. Which first-line treatment
is recommended? - CORRECT ANSWERS - Tetracycline
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line
treatment for hidradenitis suppurativa.


__________________________________________________


Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in
apocrine gland-bearing skin. It is a chronic, disabling disorder that progresses,
often causing keloids, contractures, and immobility. It is characterized by
comedone-like follicular occlusion, chronic and relapsing inflammation,
mucopurulent discharge, and progressive scarring.
Arthropathy associated with hidradenitis may be present. Typical presentation
includes nodules and sinus tracts (inflamed or noninflamed), abscesses, and
scarring found in the axilla, genitofemoral area, perineum, gluteal area, and
inframammary area in women.
Recommended treatments include antibiotics, steroids, retinoids, dapsone, and
anti-tumor necrosis factor agents. A dermatology consultation should also be
considered.
First-line treatment is a 12-week course of an oral tetracycline (Sumycin) such
as doxycycline. For patients who do not respond to doxycycline, the next
recommended step is a combination of twice-daily clindamycin (Cleocin) and
rifampicin (Rifadin) for 10-12 weeks. If treatment fails, acitretin (Soriatane, for
males and nonfertile females) or dapsone (Aczone) may be considered by a
dermatologist. In patients with moderate to severe hidradenitis suppurativa,
adalimumab (Humira) may possibly be considered.

,When providing culturally competent health care services to an American
Indian elder, the nurse practitioner understands which is traditionally true? -
CORRECT ANSWERS - The "Medicine Wheel" is used by many for the
purpose of health and healing
The "Medicine Wheel" is traditionally used and contains four directions; north,
south, east, and west. Traditionally each tribe has different meanings for each
direction and they may represent the season of the year or stage of life. It is
aimed at providing a holistic view of life.


________________________________________


An understanding of different cultural preferences leads to cultural competence
in healthcare. Some patients may value traditional culture and preferences as it
relates to healthcare. These individual preferences should be included in the
interview and treatment plan for patients.
Traditionally, the American Indian culture values a holistic approach to health
care integrating the person, lifestyle, environment, family, and religion. Patients
adhering to these traditional cultural practices often feel that illness is due to a
lack of harmony with the physical body, mind, spirit, and emotions. Patients
may seek care from western medicine for specific ailments while also
consulting with traditional healers for spiritual guidance.
Healthcare providers should seek to understand relevant cultural factors and
assess each individual's healthcare literacy in order to provide culturally
competent care.


The nurse practitioner sees an older adult patient in the clinic with the primary
report of hearing loss and a sensation of fullness in the right ear. The nurse
practitioner suspects conductive hearing loss. Which could contribute to this? -
CORRECT ANSWERS - Cerumen, commonly called earwax, is a
combination of secretions and sloughed epithelial cells that protects the ears
from infection, water, and insects. It is normally expelled from the ear canal
through natural jaw movement. When this self-cleaning process fails, cerumen
can become impacted. Cerumen impaction occludes the ear canal and can press
against the tympanic membrane, resulting in conductive hearing loss.

, _________________________________________


Conductive hearing is the transition of sound from the external and middle ear
to the inner ear. Conductive hearing loss is caused by problems in the external
and middle ear that interfere with the transmission of sound and its conversion
to mechanical vibration. Causes of conductive hearing loss include obstruction
of the external auditory canal by cerumen, foreign bodies, debris from otitis
externa, and large exocytosis and osteomas.
Sensorineural hearing loss involves difficulty converting mechanical vibrations
to electrical potential in the cochlea or in auditory nerve transmission to the
brain. It is mostly caused by permanent damage in the organ of Corti. It can be
caused by age-related hearing loss, noise trauma, medications, autoimmune
diseases, mechanical trauma, Meniere disease, infection, and neoplasm
(acoustic neuroma).
Approximately one-third of older adults between the ages of 61 and 70 years
have hearing loss. More than 90% of adults older than 85 years of age have
hearing loss. The most common type of hearing loss is age-related and
sensorineural. All adults older than 60 years of age should be screened for
hearing loss at periodic health examinations.


An otherwise healthy adult patient presents to the clinic with a diagnosis of
community-acquired pneumonia and no recent antibiotic therapy. Which is the
best option for treatment? - CORRECT ANSWERS - Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line
therapy for adults without comorbidities.


_____________________________________________


Community-acquired pneumonia (CAP) is pneumonia not acquired in a hospital
or long-term care facility. Patients with suspected CAP should receive a chest
X-ray for diagnosis. The Pneumonia Severity Index should be used to assist in
decisions regarding the need for hospitalization in patients with CAP.

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