NR 511 Midterm Exam Study Guide 2024- Chamberlain College of Nursing

NR 511 Midterm Study Guide

General Study Tips and Recommendations

 Topics and content on guides are intended to focus student attention when reading/studying and
some topics may be repeated in multiple chapters.
 Multiple test items are derived from the same topic areas to encourage deeper comprehension.
 Students must have a broad understanding of content and not simply memorize passages in
textbooks or articles.
 Information contained in the chapters as well as boxes and table within the chapters may
include test items.
 Exam questions represent various levels of cognitive learning. You are expected to analyze,
synthesis, and evaluate patient scenarios in order to answer the questions.
 Students are expected to use clinical decision making to prioritize treatment actions based on the
information provided in the exam question.
 Read all of the answers BEFORE reading the stem of the question. This will help you focus on the
key content and noimt get distracted by extraneous information. Once you have selected your
answer, read the question one more time to ensure that the best answer has been chosen.
 Utilize your time well by not rushing. You will have plenty of time to read each question for
understanding before you select your final answer.

Chapter 4 The Art and Diagnosis of Treatment

 Specificity and sensitivity of a diagnostic study (see course lesson)
o Specificity:
 High: a high percentage of healthy individuals will show
a normal result
 Low: getting a positive result when it is not present, a
high number of false positives, meaning a healthy
person has a disease when they actually do not.
 If a diagnostic study has high specificity, then a high
percentage of healthy individuals will show a normal result
o Sensitivity: is the proportion of true positives out of all
patients with a designated condition
 Highly sensitive tests will lead to positive findings for
patients with a disease

 What is the patient history in terms of documentation?
o HPI is for acute/episodic care and is for clinical reasoning regarding the differential
diagnoses
o Past medical history includes:
 Chronic conditions
 Childhood illnesses
 Significant adult illnesses
 Surgical history

,  Hospital admissions
 History of trauma
 OB/GYN history
 Psychiatric diagnoses
 Exposure to infectious/toxic agents (including recent travel)
 Medications (Rx & OTC), supplements, herbs
 Immunization history
 Family and social history

 Where in the chart is OLD CARTS used?
o In the HPI
o Onset
o Location
o Duration
o Characteristics
o Aggravating factors
o Relieving factors
o Treatments
o Symptoms severity – association with pain

Chapter 5 Evidence-based Practice

 Sources that NPs use to help with clinical decision-making (i.e. evidence-based research,
clinical practice guidelines)
o National Guideline Clearinghouse
o Cochrane Collaboration
o Essential Evidence plus
o UptoDate
o Dynamed
o Smartphone of tablet options
 Skyscape constellation
 Pepid primary care
o Evidence based research
o Clinical practice guidelines
o Published evidence based algorithms

Chapter 10 Infectious and Inflammatory Neurological Disorders (p. 131-134)
 Assessment and diagnosis of herpes zoster (shingles)
o Caused by varicella-zoster characterized by painful rash with blisters.
o Herpes zoster is characterized by a unilateral vesicular rash along a dermatome, most
commonly a thoracic or lumbar dermatome. The rash begins as erythema, then changes
to papular lesions that rapidly form vesicles. The vesicles rupture, releasing infectious
fluid, and then form scabs.

Chapter 11 Common Skin Complaints

,  Assessment and diagnosis of common skin complaints
o Medical Hx: recent illness
o Medications: Rx & OTC
o Social Hx: occupational exposure, travel, hobbies, pets, drug use
o Sexual Hx: STIs

 Health teaching for patients with pruritus
o avoid scratching
o use cool compresses and apply pressure to itchy areas
o keep fingernails trimmed
o avoidance of strong soaps
o taking shorter, tepid showers (10 to 20 minutes) instead of hot baths
o the use of effective emollients (Mild bland soaps such as Dove, Basis, Purpose, Cetaphil,
o and Neutrogena are recommended.)
o gently towel dry the skin after showering because rubbing the skin stimulates pruritus.
o To seal moisture in the skin, applying a bland emollient such as Eucerin, Lubriderm, or
Alpha-Keri immediately after dabbing the skin with a towel to partially pat dry is helpful.
Waiting too long (more than 5 minutes) after finishing a bath or shower allows moisture
o to evaporate.
o Severe cases of dry skin may be treated using the "soak and smear" technique

 Treatment of urticaria
o Hives: Look at the location of the rash; the first step is to determine the need
for epinephrine; Look for respiratory symptoms, difficulty breathing,
hoarseness; look at location of rash; is it on the neck, around the face, etc.; if
it is, epinephrine must be administered.
o Cholinergic urticaria: Cholinergic urticaria are hives or wheals that are pruritic
and occur on the trunk and arms following exercise, anxiety, elevated body
temperature, hot baths and showers.
o Treated with antihistamines

Chapter 12 Parasitic Skin Infections

 Assessment and diagnosis of common parasitic skin infections
 Pharmacological management of common parasitic skin infections
 Health promotion and teaching for patients with common parasitic skin infections
 Characteristics of scabies
o An intensely itchy rash caused by a mite known as Sarcoptes scabie
o Can last several days or weeks
o Transmitted to direct contact
o Clinical diagnosis of scabies is almost never made until hypersensitivity has occurred
 Differential diagnoses for scabies
o Atopic dermatitis
o Contact dermatitis
o Folliculitis