NURS 623 Exam 1 CORRECT SOLUTION
GRADE A+ ACCURATE
Is transmission of Lyme disease likely if the thick attachment is
less than 48 hours?
No
What is the incubation period of Lyme disease?
3 to 31 days but typically around 7 to 14 days
How many stages does Lyme disease have?
4
What is the first stage of Lyme disease called?
Early localized Lyme disease
What is the second stage of Lyme disease called?
Early disseminated Lyme disease
What is the third stage of Lyme disease called?
Late disseminated Lyme disease
What is the fourth stage of Lyme disease called?
Late stage or chronic Lyme arthritis
Which pathogen causes Lyme disease?
Borrelia burgdorferi
What may the patient present with that makes you suspect Lyme disease?
Fever, rash, facial paralysis, arthritis, chills, headache, fatigue,
muscle and joint aches, and swollen lymph nodes
Which test is most commonly used to diagnose Lyme disease?
ELISA
Which test is performed to confirm ELISA results with Lyme disease?
Immunoblot test
How long may stage 1 Lyme disease (early localized Lyme disease) last
for?
1 to 4 weeks
Which symptoms may present with stage 1 (early localized) Lyme
disease?
Erythema migrans with bulls eye appearance, flu like symptoms such as
fever, chills, joint and muscle pain, stiff neck and headache,
general feeling of illness, and swollen lymph glands
A circular rash that may expand over time which may also have a bulls
eye appearance.
Erythema migrans
What is treatment for stage 1 (early localized) Lyme disease?
,Doxycycline, Cefuroxime, or amoxicillin
How soon may stage 2 (early disseminated) Lyme disease present after
initial infection?
Weeks to months
With this stage of Lyme disease, symptoms can range from mild to
severe, or not at all. Flu like symptoms may be similar to or worse
than stage 1 and includes fever, chills, joint and muscle pain, stiff
neck and headache, swollen lymph nodes or glands, fatigue, sore
throat, visual disturbances such as blurry vision, paralysis or
weakness in the face, pain or numbness in the bite area, and heart
palpitations.
Stage 2 (early disseminated) Lyme disease
What is treatment of stage 2 (early disseminated) Lyme disease if IV
treatment is needed?
Azithromycin, doxycycline, amoxicillin, cefuroxime, or ceftriaxone.
(Most commonly is doxycycline except for children 8 years old and
younger or nursing/pregnant women).
What are oral antibiotic choices for treatment of stage 2 (early
disseminated) Lyme disease?
Azithromycin, doxycycline (except in children <8 years old, nursing
or pregnant women), amoxicillin, and cefuroxime. (Most common is
doxycycline except for <8 y.o., pregnant, or nursing).
When does stage 3 (late disseminated) Lyme disease typically present?
When the infection has not been treated during stages 1 and 2. It
starts months or even years after the original tick bite.
What are symptoms of stage 3 (late disseminated) Lyme disease?
Severe headaches, arthritis of the large joints (knees, hips, etc.),
heart arrhythmia, brain disturbances (memory loss, mood disturbances,
sleep interruptions), difficulty concentrating and mental fogginess,
temporary amnesia, difficulty following conversations or speaking,
numbness or tingling in the limbs (arms, legs, feet, or hands),
extreme fatigue, and temporary paralysis of facial muscles
With this stage of Lyme disease, presentation is a recurrent form of
joint inflammation which may include episodes of severe arthritis
symptoms. The most common joint affected is the knee joint but it may
also occur in other large or small joints as well.
Stage 4- late stage or chronic Lyme arthritis
Which symptoms will present with stage 4 late stage or chronic Lyme
arthritis?
Swelling, redness, and fluid buildup with episodes lasting greater
than 6 months
How long may symptoms of stage 4 late stage or chronic Lyme arthritis
last?
Months to years
, What history is important for assisting with the diagnosis of Lyme
disease?
Exposure to tick bites, recent camping trips, frequent yard work,
pets that go outside and have contact with the patient, duration and
characteristics of lesion(s).
What is the dosage and duration and first line treatment for an adult
with early Lyme disease?
Doxycycline 100 mg PO BID for 14-21 days
What is the second line treatment for adults with early Lyme disease?
Amoxil 500 mg TID for 14-21 days
What is the causative agent of infectious mono?
Epstein Barr virus
What is the incubation period for infectious mono?
30 to 50 days
How is mono contacted?
Person via saliva (rarely via blood)
What is the common presentation of infectious mono?
Fever, pharyngitis, adenopathy, fatigue, HA, glottis edema, pain
behind eyes, petechiae rash on palate
What lab test would most likely be elevated with infectious mono?
A. hgb
B. MCHC
C. liver function test
D. UA
C
What is the duration of infectious mono?
3 to 4 weeks
How long can fatigue last with mono?
6 to 12 months
Which patient education is important to discuss with mono?
A. none, it is all in their head
B. douching every day
C. splenic rest (no contact sports for 3 weeks)
D. all of the above
C
Which tests should be ordered with infectious mono?
CBC, monospot, RPR titers, IgG, IgM, rapid strep test
True of false: Mono can cause abnormal LFT, splenic enlargement,
lymphcytosis, and fatigue.
True
What would IgG show with mono?
past infection
What would IgM show with mono?
GRADE A+ ACCURATE
Is transmission of Lyme disease likely if the thick attachment is
less than 48 hours?
No
What is the incubation period of Lyme disease?
3 to 31 days but typically around 7 to 14 days
How many stages does Lyme disease have?
4
What is the first stage of Lyme disease called?
Early localized Lyme disease
What is the second stage of Lyme disease called?
Early disseminated Lyme disease
What is the third stage of Lyme disease called?
Late disseminated Lyme disease
What is the fourth stage of Lyme disease called?
Late stage or chronic Lyme arthritis
Which pathogen causes Lyme disease?
Borrelia burgdorferi
What may the patient present with that makes you suspect Lyme disease?
Fever, rash, facial paralysis, arthritis, chills, headache, fatigue,
muscle and joint aches, and swollen lymph nodes
Which test is most commonly used to diagnose Lyme disease?
ELISA
Which test is performed to confirm ELISA results with Lyme disease?
Immunoblot test
How long may stage 1 Lyme disease (early localized Lyme disease) last
for?
1 to 4 weeks
Which symptoms may present with stage 1 (early localized) Lyme
disease?
Erythema migrans with bulls eye appearance, flu like symptoms such as
fever, chills, joint and muscle pain, stiff neck and headache,
general feeling of illness, and swollen lymph glands
A circular rash that may expand over time which may also have a bulls
eye appearance.
Erythema migrans
What is treatment for stage 1 (early localized) Lyme disease?
,Doxycycline, Cefuroxime, or amoxicillin
How soon may stage 2 (early disseminated) Lyme disease present after
initial infection?
Weeks to months
With this stage of Lyme disease, symptoms can range from mild to
severe, or not at all. Flu like symptoms may be similar to or worse
than stage 1 and includes fever, chills, joint and muscle pain, stiff
neck and headache, swollen lymph nodes or glands, fatigue, sore
throat, visual disturbances such as blurry vision, paralysis or
weakness in the face, pain or numbness in the bite area, and heart
palpitations.
Stage 2 (early disseminated) Lyme disease
What is treatment of stage 2 (early disseminated) Lyme disease if IV
treatment is needed?
Azithromycin, doxycycline, amoxicillin, cefuroxime, or ceftriaxone.
(Most commonly is doxycycline except for children 8 years old and
younger or nursing/pregnant women).
What are oral antibiotic choices for treatment of stage 2 (early
disseminated) Lyme disease?
Azithromycin, doxycycline (except in children <8 years old, nursing
or pregnant women), amoxicillin, and cefuroxime. (Most common is
doxycycline except for <8 y.o., pregnant, or nursing).
When does stage 3 (late disseminated) Lyme disease typically present?
When the infection has not been treated during stages 1 and 2. It
starts months or even years after the original tick bite.
What are symptoms of stage 3 (late disseminated) Lyme disease?
Severe headaches, arthritis of the large joints (knees, hips, etc.),
heart arrhythmia, brain disturbances (memory loss, mood disturbances,
sleep interruptions), difficulty concentrating and mental fogginess,
temporary amnesia, difficulty following conversations or speaking,
numbness or tingling in the limbs (arms, legs, feet, or hands),
extreme fatigue, and temporary paralysis of facial muscles
With this stage of Lyme disease, presentation is a recurrent form of
joint inflammation which may include episodes of severe arthritis
symptoms. The most common joint affected is the knee joint but it may
also occur in other large or small joints as well.
Stage 4- late stage or chronic Lyme arthritis
Which symptoms will present with stage 4 late stage or chronic Lyme
arthritis?
Swelling, redness, and fluid buildup with episodes lasting greater
than 6 months
How long may symptoms of stage 4 late stage or chronic Lyme arthritis
last?
Months to years
, What history is important for assisting with the diagnosis of Lyme
disease?
Exposure to tick bites, recent camping trips, frequent yard work,
pets that go outside and have contact with the patient, duration and
characteristics of lesion(s).
What is the dosage and duration and first line treatment for an adult
with early Lyme disease?
Doxycycline 100 mg PO BID for 14-21 days
What is the second line treatment for adults with early Lyme disease?
Amoxil 500 mg TID for 14-21 days
What is the causative agent of infectious mono?
Epstein Barr virus
What is the incubation period for infectious mono?
30 to 50 days
How is mono contacted?
Person via saliva (rarely via blood)
What is the common presentation of infectious mono?
Fever, pharyngitis, adenopathy, fatigue, HA, glottis edema, pain
behind eyes, petechiae rash on palate
What lab test would most likely be elevated with infectious mono?
A. hgb
B. MCHC
C. liver function test
D. UA
C
What is the duration of infectious mono?
3 to 4 weeks
How long can fatigue last with mono?
6 to 12 months
Which patient education is important to discuss with mono?
A. none, it is all in their head
B. douching every day
C. splenic rest (no contact sports for 3 weeks)
D. all of the above
C
Which tests should be ordered with infectious mono?
CBC, monospot, RPR titers, IgG, IgM, rapid strep test
True of false: Mono can cause abnormal LFT, splenic enlargement,
lymphcytosis, and fatigue.
True
What would IgG show with mono?
past infection
What would IgM show with mono?
