NR 511 FINAL EXAM QUESTIONS WITH ACCURATE
ANSWERS
Acute lymphoblastic leukemia (ALL) treatment in children correct answer -
induction: 4-drug regimen:
Daunorubicin (Cerubidine)
Vincristine (Oncovin)
Prednisone (Deltasone)
Asparaginase (DVP L-asp)
-Consolidation:
Daunorubicin (Cerubidine)
Cytarabine (Ara-C)
Maintenance: 4-drug regimen
-CNS prophylaxis: intrathecal methotrexate and cranial irradiation. Allogeneic
BMT in high-risk patients in first remission
Allen's Test- hands correct answer -Purpose: Assesses patency of radial and ulnar
arteries and the arterial arch.
-Procedure: Compress the radial artery at the wrist. Have patient rapidly open
and close his or her hand several times. Then have the patient open the hand.
(Hand should be pale or white.) Release pressure from the artery. The hand
should flush, indicating patency
Animal bites correct answer -considered contaminated
-usually dogs: Staphylococcus aureus, Pasteurella multocida, Corynebacterium
species, and α-hemolytic Streptococcus
-Cats: P. multocida
,- high risk wounds: distal extremities, scalp of infant, over a joint, penetrating the
cheek, puncture & nondebridable, fight bite
- after superficial decontamination of the wound-gram stain & culture
-NSAIDs, APAP, or toradol (severe), Tetanus shot, 3-5 day augmentin prophylaxis
or cefuroxime
Anterior drawer test—to test stability of anterior talofibular ligament; place the
ankle in approximately 20 degrees of plantar flexion correct answer Stabilize the
tibia, grasp the hindfoot, and pull forward. Asymmetrical or excessive motion will
occur with chronic ankle laxity and severe ankle sprains.
Apprehension sign—to test patellar instability correct answer Have the patient
seated with the quadriceps relaxed. Place the knee in extension. Displace the
patella laterally and then flex the knee to 30 degrees. With instability, this
maneuver displaces the patella to an abnormal position on the lateral femoral
condyle. The patient often perceives pain and demonstrates apprehension.
Assessment and management of prostate CA correct answer S: usually
asymptomatic early. May have bone pain, wt loss, anemia, SOB,
lymphadenopathy, inability to perceive pain, touch or temperature in perineal or
scrotal area, lack of sensation of bladder distention, urinary retention
- O: Palpable, hard prostate, may have nodules, induration of prostate, hematuria
and hematospermia (late signs)
- Test: PSA (start at 50yo), DRE
- Tx: When >70yo, conservative tx (radiation or brachytherapy with implants.
<70yo, surgery for jewett A, B and some C stages, radical prostatectomy, radiation
BPH management correct answer - rule out prostate CA (PSA)
- avoid caffeine & ETOH & highly seasoned foods
, - A1A medications: Tamsulosin, Doxazosin, Silodosin
- 5-alpha-reductase inhibitors: Finasteride, dutasteride
- surgery if urinary retention or sx unmanageable (TURP)
Bulge sign—to assess for effusion correct answer Apply lateral pressure to the
area adjacent to the patella. Medial bulge will appear if fluid is in the knee joint.
Cauda Equina Syndrome correct answer *medical emergency*
S: BLE weakness, anesthesia, or paresthesia of the perineum and buttocks (saddle
anesthesia). may or may not be B/B incontinence or bladder retention (may not
be reversed). S/S may be acute or insidious. stumbling, weak quads or hip
extensors, unable to walk on heels and toes, foot drop.
dx:MRI
management: surgical lumbar decompression
cervical Spondylosis correct answer - Chronic, degenerative, causes stiffness and
pain, very common >50yo
- S: neck stiffness, mild aching esp with activity, trouble turning neck from side to
side, limited ROM, Paresthesias follow dermatomes
O:weak shoulder abduction, bicep weakness (c6 involvement), tricep weakness
(C7 involvement), myelopathy s/s: leg weakness, gait disturbances, balance
problems, impaired fine motor loss of bowel and bladder control
dx: MRI
tx: if radiculopathy: cervical traction. physical therapy, NSAIDs, oral steroid,
steroid epidural injections, surgery (last)
edu: 75-90% of pts improve with conservative tx
ANSWERS
Acute lymphoblastic leukemia (ALL) treatment in children correct answer -
induction: 4-drug regimen:
Daunorubicin (Cerubidine)
Vincristine (Oncovin)
Prednisone (Deltasone)
Asparaginase (DVP L-asp)
-Consolidation:
Daunorubicin (Cerubidine)
Cytarabine (Ara-C)
Maintenance: 4-drug regimen
-CNS prophylaxis: intrathecal methotrexate and cranial irradiation. Allogeneic
BMT in high-risk patients in first remission
Allen's Test- hands correct answer -Purpose: Assesses patency of radial and ulnar
arteries and the arterial arch.
-Procedure: Compress the radial artery at the wrist. Have patient rapidly open
and close his or her hand several times. Then have the patient open the hand.
(Hand should be pale or white.) Release pressure from the artery. The hand
should flush, indicating patency
Animal bites correct answer -considered contaminated
-usually dogs: Staphylococcus aureus, Pasteurella multocida, Corynebacterium
species, and α-hemolytic Streptococcus
-Cats: P. multocida
,- high risk wounds: distal extremities, scalp of infant, over a joint, penetrating the
cheek, puncture & nondebridable, fight bite
- after superficial decontamination of the wound-gram stain & culture
-NSAIDs, APAP, or toradol (severe), Tetanus shot, 3-5 day augmentin prophylaxis
or cefuroxime
Anterior drawer test—to test stability of anterior talofibular ligament; place the
ankle in approximately 20 degrees of plantar flexion correct answer Stabilize the
tibia, grasp the hindfoot, and pull forward. Asymmetrical or excessive motion will
occur with chronic ankle laxity and severe ankle sprains.
Apprehension sign—to test patellar instability correct answer Have the patient
seated with the quadriceps relaxed. Place the knee in extension. Displace the
patella laterally and then flex the knee to 30 degrees. With instability, this
maneuver displaces the patella to an abnormal position on the lateral femoral
condyle. The patient often perceives pain and demonstrates apprehension.
Assessment and management of prostate CA correct answer S: usually
asymptomatic early. May have bone pain, wt loss, anemia, SOB,
lymphadenopathy, inability to perceive pain, touch or temperature in perineal or
scrotal area, lack of sensation of bladder distention, urinary retention
- O: Palpable, hard prostate, may have nodules, induration of prostate, hematuria
and hematospermia (late signs)
- Test: PSA (start at 50yo), DRE
- Tx: When >70yo, conservative tx (radiation or brachytherapy with implants.
<70yo, surgery for jewett A, B and some C stages, radical prostatectomy, radiation
BPH management correct answer - rule out prostate CA (PSA)
- avoid caffeine & ETOH & highly seasoned foods
, - A1A medications: Tamsulosin, Doxazosin, Silodosin
- 5-alpha-reductase inhibitors: Finasteride, dutasteride
- surgery if urinary retention or sx unmanageable (TURP)
Bulge sign—to assess for effusion correct answer Apply lateral pressure to the
area adjacent to the patella. Medial bulge will appear if fluid is in the knee joint.
Cauda Equina Syndrome correct answer *medical emergency*
S: BLE weakness, anesthesia, or paresthesia of the perineum and buttocks (saddle
anesthesia). may or may not be B/B incontinence or bladder retention (may not
be reversed). S/S may be acute or insidious. stumbling, weak quads or hip
extensors, unable to walk on heels and toes, foot drop.
dx:MRI
management: surgical lumbar decompression
cervical Spondylosis correct answer - Chronic, degenerative, causes stiffness and
pain, very common >50yo
- S: neck stiffness, mild aching esp with activity, trouble turning neck from side to
side, limited ROM, Paresthesias follow dermatomes
O:weak shoulder abduction, bicep weakness (c6 involvement), tricep weakness
(C7 involvement), myelopathy s/s: leg weakness, gait disturbances, balance
problems, impaired fine motor loss of bowel and bladder control
dx: MRI
tx: if radiculopathy: cervical traction. physical therapy, NSAIDs, oral steroid,
steroid epidural injections, surgery (last)
edu: 75-90% of pts improve with conservative tx
