ATI EXAM vc
Exam Solution vc
ANCC FNP BOARD REVIEW PART 1 2026 A+ GRADE ASS vc vc vc vc vc vc vc vc vc
URED COMPLETE SOLUTIONS AND VERIFIED ANSWERS vc vc vc vc vc vc
(475A2)
QUESTION 1 vc
You are managing the warfarin dose for an older adult with a prosthetic heart valve. Whi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ch situation listed requires that warfarin be discontinued now?
vc vc vc vc vc vc vc vc
ANSWER
INR of 8, no significant bleeding. INR is a good measure of the clotting status in an outpatient who takes
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
an oral anticoagulant like warfarin. When warfarin is overdosed and INR climbs, or when warfarin is ov
c vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
erdosed because of food or medication that produces deleterious side effects, warfarin doses may be om
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
itted or discontinued until the INR is in a more acceptable range. Generally, one or two doses may be o
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
mitted before rechecking INR and resuming warfarin or decreasing the dose.
vc vc vc vc vc vc vc vc vc vc
QUESTION 2 vc
The frequency for cervical screening depends on the patient and her age. What is the lon
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
gest recommended time interval between cervical screens for patients who are 21-
vc vc vc vc vc vc vc vc vc vc vc
65 years of age?
vc vc vc
ANSWER
5 years Women ages 21-
vc vc vc vc
65 who have a cervix should be screened for cervical cancer. Screening intervals every 3 years should ta
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ke place for women of who are aged 21-29 years. Women aged 30-
vc vc vc vc vc vc vc vc vc vc vc vc
65 should take place every 3 years if only cytology is performed (this is not preferred); or every 5 years
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if cytology plus HPV screening takes place.
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QUESTION 3 vc
A 40-year-
vc
old patient with newly diagnosed Type 2 diabetes asks what his target blood pressure sh
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ould be. The most correct response in mm Hg is
vc vc vc vc vc vc vc vc vc
ANSWER
,less than 140/90. The 2017 American Diabetes Association's target blood pressure for "most patients wi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
th diabetes and hypertension" is less than 140/90 mmHg. Less than 140/90 means that the systolic blo
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
od pressure should be in the 130s at the highest and the diastolic blood pressure should be in the 80s a
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
t the highest. Lower blood pressure targets such as 130/80 mmHg may be appropriate for patients at hi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
gh risk for cardiovascular disease if they can be easily achieved (Level C).
vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 4 vc
Warfarin treatment is greatly influenced by a patient's food and medication intake. Whic
vc vc vc vc vc vc vc vc vc vc vc vc
h group listed can potentially decrease INR (International Normalized Ratio) in an outpa
vc vc vc vc vc vc vc vc vc vc vc vc
tient who takes warfarin? vc vc vc
ANSWER
Sucralfate and cholestyramine The drugs listed in choice D will decrease international normalized ratio
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
(INR) in patients who take warfarin concurrently. Sucralfate and calcium carbonate decrease absorption
vc vc vc vc vc vc vc vc vc vc vc vc v
of warfarin. The drugs listed in the other choices will increase INR. Major interactions can occur with ce
c vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
lecoxib, ketoprofen, and naproxen. These three NSAIDs are commonly taken by older adults, so this sho
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
uld be part of education with a patient who takes warfarin.
vc vc vc vc vc vc vc vc vc vc
QUESTION 5 vc
Which class of medication is frequently used to improve long-
vc vc vc vc vc vc vc vc vc
term outcomes in patients with systolic dysfunction?
vc vc vc vc vc vc
ANSWER
ACE inhibitors ACE inhibitors are commonly used in patients with systolic dysfunction because they red
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
uce morbidity and mortality, i.
vc vc vc vc
e. these medications alter prognosis. They also improve symptoms of fatigue, shortness of breath, and e
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
xercise intolerance. Loop and thiazide diuretics improve symptoms, but do not alter long-
vc vc vc vc vc vc vc vc vc vc vc vc
term prognosis with heart failure. Beta blockers should be used in conjunction with ACE inhibitors and
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
diuretics, but not as solo agents. Beta blockers can potentially worsen heart failure, so their use in patie
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
nts with heart failure should be monitored carefully. Despite this fact, beta blockers decrease morbidity
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
and mortality associated with heart failure.
vc vc vc vc vc
QUESTION 6 vc
Which of the following results in a clinically INSIGNIFICANT increase in the prostatespeci
vc vc vc vc vc vc vc vc vc vc vc vc
fic antigen (PSA)?
vc vc
ANSWER
Digital rectal exam Digital rectal exam (DRE) leads to a clinically insignificant increase of 0.26-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
0.4 ng/mL for about 48-
vc vc vc vc
72 hours afterwards. Prostate biopsy increases the PSA about 8 ng/mL for up to 4 weeks following biop
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
sy. Prostate infection and ejaculation both can significantly increase the PSA levels in varying amounts.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
,QUESTION 7 vc
The two tests that can indicate current infection with hepatitis B are:
vc vc vc vc vc vc vc vc vc vc vc
ANSWER
presence of hepatitis B surface antigen and IgM The earliest serologic marker that indicates acute hepati
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
tis B infection is the presence of hepatitis B surface antigen. It becomes positive about 1-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
10 weeks after infection, but usually before symptom onset. A positive IgM indicates current infection. T
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
he presence of hepatitis B core antibody identifies hepatitis B infection (present or past) with certainty.
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It does not indicate timing of infection.
vc vc vc vc vc vc
QUESTION 8 vc
Which study listed below is considered an experimental study?
vc vc vc vc vc vc vc vc
ANSWER
Meta-
analysis Observational studies are studies in which subjects are observed. No intervention takes place w
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ith them. Examples of these are found in the first three choices. A meta-
vc vc vc vc vc vc vc vc vc vc vc vc vc
analysis takes published information from other studies and combines the information to arrive at a con
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
clusion. Although a meta analysis can use observational studies, these should be reported separately.
vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 9 vc
Which mitral disorder results from redundancy of the mitral valve's leaflets?
vc vc vc vc vc vc vc vc vc vc
ANSWER
Mitral valve prolapse Mitral valve prolapse (MVP) is the most common adult murmur. It is best heard w
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ith the diaphragm of the stethoscope over the cardiac apex. It is a result of redundancy of the mitral val
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ve leaflets and subsequent degeneration of the mitral tissue. The posterior leaflet is more commonly aff
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ected than the anterior leaflet. The valve's annulus becomes enlarged in conjunction with elongation of t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
he chordae tendineae.
vc vc
QUESTION 10 vc
A patient who takes HCTZ 25 mg daily has complaints of muscle cramps. He probably has
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
:
ANSWER
hypokalemia. HCTZ is a thiazide diuretic that is potassium- vc vc vc vc vc vc vc vc
wasting. Patients can become hypokalemic and experience side effects of this. A common one is muscle
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
cramps.
QUESTION 11 vc
, A mammogram in a healthy 50-year-old female patient is an example of:
vc vc vc vc vc vc vc vc vc vc vc
ANSWER
secondary prevention. This is an example of secondary prevention. Secondary prevention is represented
vc vc vc vc vc vc vc vc vc vc vc vc
by screenings intended to identify early course of a disease. In this example, a mammogram is intended
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
to identify early breast cancer.
c vc vc vc vc
QUESTION 12 vc
The age at which a child can first walk backwards is:
vc vc vc vc vc vc vc vc vc vc
ANSWER
18 months. Common developmental tasks for an 18-month-
vc vc vc vc vc vc vc
old include: walking backwards, throwing a ball, saying 15-
vc vc vc vc vc vc vc vc
20 words, pointing to multiple body parts, pointing and naming objects in a book, and stacking 3-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
4 blocks.
vc
QUESTION 13 vc
Which of the following is true about metatarsus adductus?
vc vc vc vc vc vc vc vc
ANSWER
Mild flexible metatarsus usually spontaneously corrects. Metatarsus adductus (MA) is the most common
vc vc vc vc vc vc vc vc vc vc vc vc v
congenital foot deformity. It is not related to clubfoot. In MA, the forefoot deviates medially, and the hin
c vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
dfoot remains in a neutral position. This is a common cause of in-
vc vc vc vc vc vc vc vc vc vc vc vc
toeing gait and usually spontaneously corrects. This can be diagnosed on clinical presentation. An X-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ray is not necessary. Casting is usually reserved for severe MA characterized by a rigid forefoot.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 14 vc
Which class of medications is NOT used for migraine prophylaxis?
vc vc vc vc vc vc vc vc vc
ANSWER
Triptans The class of medications known as triptans, which includes sumatriptan, is used as abortive ag
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ents, not for prophylaxis. The other classes mentioned can be used for prophylaxis. Other prophylactic a
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
gents commonly used include lithium, SSRIs, anticonvulsants, and feverfew.
vc vc vc vc vc vc vc vc
QUESTION 15 vc
The primary therapeutic intervention for patients who present with hives is:
vc vc vc vc vc vc vc vc vc vc
ANSWER
antihistamines. The primary cause of pruritus associated with hives is histamine release. Histamine is re
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
leased from mast cells with other substances of anaphylaxis. Antihistamines are the primary therapeutic
vc vc vc vc vc vc vc vc vc vc vc vc vc
intervention. Topical steroid use is not helpful. Calcium channel blockers (nifedipine) are used as a "last
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
Exam Solution vc
ANCC FNP BOARD REVIEW PART 1 2026 A+ GRADE ASS vc vc vc vc vc vc vc vc vc
URED COMPLETE SOLUTIONS AND VERIFIED ANSWERS vc vc vc vc vc vc
(475A2)
QUESTION 1 vc
You are managing the warfarin dose for an older adult with a prosthetic heart valve. Whi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ch situation listed requires that warfarin be discontinued now?
vc vc vc vc vc vc vc vc
ANSWER
INR of 8, no significant bleeding. INR is a good measure of the clotting status in an outpatient who takes
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
an oral anticoagulant like warfarin. When warfarin is overdosed and INR climbs, or when warfarin is ov
c vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
erdosed because of food or medication that produces deleterious side effects, warfarin doses may be om
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
itted or discontinued until the INR is in a more acceptable range. Generally, one or two doses may be o
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
mitted before rechecking INR and resuming warfarin or decreasing the dose.
vc vc vc vc vc vc vc vc vc vc
QUESTION 2 vc
The frequency for cervical screening depends on the patient and her age. What is the lon
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
gest recommended time interval between cervical screens for patients who are 21-
vc vc vc vc vc vc vc vc vc vc vc
65 years of age?
vc vc vc
ANSWER
5 years Women ages 21-
vc vc vc vc
65 who have a cervix should be screened for cervical cancer. Screening intervals every 3 years should ta
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ke place for women of who are aged 21-29 years. Women aged 30-
vc vc vc vc vc vc vc vc vc vc vc vc
65 should take place every 3 years if only cytology is performed (this is not preferred); or every 5 years
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
if cytology plus HPV screening takes place.
c vc vc vc vc vc vc
QUESTION 3 vc
A 40-year-
vc
old patient with newly diagnosed Type 2 diabetes asks what his target blood pressure sh
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ould be. The most correct response in mm Hg is
vc vc vc vc vc vc vc vc vc
ANSWER
,less than 140/90. The 2017 American Diabetes Association's target blood pressure for "most patients wi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
th diabetes and hypertension" is less than 140/90 mmHg. Less than 140/90 means that the systolic blo
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
od pressure should be in the 130s at the highest and the diastolic blood pressure should be in the 80s a
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
t the highest. Lower blood pressure targets such as 130/80 mmHg may be appropriate for patients at hi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
gh risk for cardiovascular disease if they can be easily achieved (Level C).
vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 4 vc
Warfarin treatment is greatly influenced by a patient's food and medication intake. Whic
vc vc vc vc vc vc vc vc vc vc vc vc
h group listed can potentially decrease INR (International Normalized Ratio) in an outpa
vc vc vc vc vc vc vc vc vc vc vc vc
tient who takes warfarin? vc vc vc
ANSWER
Sucralfate and cholestyramine The drugs listed in choice D will decrease international normalized ratio
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
(INR) in patients who take warfarin concurrently. Sucralfate and calcium carbonate decrease absorption
vc vc vc vc vc vc vc vc vc vc vc vc v
of warfarin. The drugs listed in the other choices will increase INR. Major interactions can occur with ce
c vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
lecoxib, ketoprofen, and naproxen. These three NSAIDs are commonly taken by older adults, so this sho
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
uld be part of education with a patient who takes warfarin.
vc vc vc vc vc vc vc vc vc vc
QUESTION 5 vc
Which class of medication is frequently used to improve long-
vc vc vc vc vc vc vc vc vc
term outcomes in patients with systolic dysfunction?
vc vc vc vc vc vc
ANSWER
ACE inhibitors ACE inhibitors are commonly used in patients with systolic dysfunction because they red
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
uce morbidity and mortality, i.
vc vc vc vc
e. these medications alter prognosis. They also improve symptoms of fatigue, shortness of breath, and e
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
xercise intolerance. Loop and thiazide diuretics improve symptoms, but do not alter long-
vc vc vc vc vc vc vc vc vc vc vc vc
term prognosis with heart failure. Beta blockers should be used in conjunction with ACE inhibitors and
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
diuretics, but not as solo agents. Beta blockers can potentially worsen heart failure, so their use in patie
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
nts with heart failure should be monitored carefully. Despite this fact, beta blockers decrease morbidity
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
and mortality associated with heart failure.
vc vc vc vc vc
QUESTION 6 vc
Which of the following results in a clinically INSIGNIFICANT increase in the prostatespeci
vc vc vc vc vc vc vc vc vc vc vc vc
fic antigen (PSA)?
vc vc
ANSWER
Digital rectal exam Digital rectal exam (DRE) leads to a clinically insignificant increase of 0.26-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
0.4 ng/mL for about 48-
vc vc vc vc
72 hours afterwards. Prostate biopsy increases the PSA about 8 ng/mL for up to 4 weeks following biop
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
sy. Prostate infection and ejaculation both can significantly increase the PSA levels in varying amounts.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
,QUESTION 7 vc
The two tests that can indicate current infection with hepatitis B are:
vc vc vc vc vc vc vc vc vc vc vc
ANSWER
presence of hepatitis B surface antigen and IgM The earliest serologic marker that indicates acute hepati
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
tis B infection is the presence of hepatitis B surface antigen. It becomes positive about 1-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
10 weeks after infection, but usually before symptom onset. A positive IgM indicates current infection. T
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
he presence of hepatitis B core antibody identifies hepatitis B infection (present or past) with certainty.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
It does not indicate timing of infection.
vc vc vc vc vc vc
QUESTION 8 vc
Which study listed below is considered an experimental study?
vc vc vc vc vc vc vc vc
ANSWER
Meta-
analysis Observational studies are studies in which subjects are observed. No intervention takes place w
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ith them. Examples of these are found in the first three choices. A meta-
vc vc vc vc vc vc vc vc vc vc vc vc vc
analysis takes published information from other studies and combines the information to arrive at a con
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
clusion. Although a meta analysis can use observational studies, these should be reported separately.
vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 9 vc
Which mitral disorder results from redundancy of the mitral valve's leaflets?
vc vc vc vc vc vc vc vc vc vc
ANSWER
Mitral valve prolapse Mitral valve prolapse (MVP) is the most common adult murmur. It is best heard w
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ith the diaphragm of the stethoscope over the cardiac apex. It is a result of redundancy of the mitral val
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ve leaflets and subsequent degeneration of the mitral tissue. The posterior leaflet is more commonly aff
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ected than the anterior leaflet. The valve's annulus becomes enlarged in conjunction with elongation of t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
he chordae tendineae.
vc vc
QUESTION 10 vc
A patient who takes HCTZ 25 mg daily has complaints of muscle cramps. He probably has
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
:
ANSWER
hypokalemia. HCTZ is a thiazide diuretic that is potassium- vc vc vc vc vc vc vc vc
wasting. Patients can become hypokalemic and experience side effects of this. A common one is muscle
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
cramps.
QUESTION 11 vc
, A mammogram in a healthy 50-year-old female patient is an example of:
vc vc vc vc vc vc vc vc vc vc vc
ANSWER
secondary prevention. This is an example of secondary prevention. Secondary prevention is represented
vc vc vc vc vc vc vc vc vc vc vc vc
by screenings intended to identify early course of a disease. In this example, a mammogram is intended
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
to identify early breast cancer.
c vc vc vc vc
QUESTION 12 vc
The age at which a child can first walk backwards is:
vc vc vc vc vc vc vc vc vc vc
ANSWER
18 months. Common developmental tasks for an 18-month-
vc vc vc vc vc vc vc
old include: walking backwards, throwing a ball, saying 15-
vc vc vc vc vc vc vc vc
20 words, pointing to multiple body parts, pointing and naming objects in a book, and stacking 3-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
4 blocks.
vc
QUESTION 13 vc
Which of the following is true about metatarsus adductus?
vc vc vc vc vc vc vc vc
ANSWER
Mild flexible metatarsus usually spontaneously corrects. Metatarsus adductus (MA) is the most common
vc vc vc vc vc vc vc vc vc vc vc vc v
congenital foot deformity. It is not related to clubfoot. In MA, the forefoot deviates medially, and the hin
c vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
dfoot remains in a neutral position. This is a common cause of in-
vc vc vc vc vc vc vc vc vc vc vc vc
toeing gait and usually spontaneously corrects. This can be diagnosed on clinical presentation. An X-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ray is not necessary. Casting is usually reserved for severe MA characterized by a rigid forefoot.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 14 vc
Which class of medications is NOT used for migraine prophylaxis?
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ANSWER
Triptans The class of medications known as triptans, which includes sumatriptan, is used as abortive ag
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ents, not for prophylaxis. The other classes mentioned can be used for prophylaxis. Other prophylactic a
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gents commonly used include lithium, SSRIs, anticonvulsants, and feverfew.
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QUESTION 15 vc
The primary therapeutic intervention for patients who present with hives is:
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ANSWER
antihistamines. The primary cause of pruritus associated with hives is histamine release. Histamine is re
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leased from mast cells with other substances of anaphylaxis. Antihistamines are the primary therapeutic
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intervention. Topical steroid use is not helpful. Calcium channel blockers (nifedipine) are used as a "last
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