FNP Adult Health Final Study Guide
What is the recommended antibiotic therapy for previously healthy patients with no risk
factors for drug-resistant S. pneumonia infection that have community acquired
pneumonia (CAP)? Correct answer- Macrolide (Azithromycin, clarithomycin, or
erythromycin) OR Doxycycline
What is the recommended antibiotic therapy for patients with chronic comorbidites, such
as chronic disease of heart, liver, lungs, or kidneys; diabetes, alcoholism, malignancies,
immunospression, antimicrobial use within the last 3 months that have community
acquired pneumonia? Correct answer- Respiratory fluoroquinolone (moxifloxacin,
gemifloxacin or levofloxacin {750 mg}) OR beta lactam plus macrolide (preferably high-
dose amoxicillin (1 to 3 times daily) or amoxicillin-clavulanate (2 tabs twice daily).
Alternatives include ceftriaxone, cefpodoxime, and cefuroxime (500 mg, twice daily);
with doxycycline as an alternative to the macrolide)
What is the recommended antibiotic therapy for suspected pseudomonas aeruginosa
infection? Correct answer- Antipneumococcal antipseudomonoal beta lactam
(pipercillin-tazobactam, cefepime, meropenem, or imipenem-cilastatin) plus either
ciprofloxacin or levofloxacin (750 mg dose) OR
Antipneumococal antipseudomonoal beta-lactam plus an amino glycoside and
azithromycin OR
Antipneumonoccal antipseudomonal beta-lactam plus an amino glycoside and an
antipneumococcal fluoroquinolone.
Aztreonam plus an amino glycoside and an antipneumococcal fluoroquinolone for
patients allergic to penicillin
What is the recommended antibiotic therapy for suspected community acquired MRSA
infection with community acquired pneumonia? Correct answer- Addition of vancomycin
or linezolid
When should you obtain a chest X ray on COPD patient? Correct answer- During a
COPD exacerbation when attempting to rule out a concomitant pneumonia.
What Pathogen is most commonly seen in COPD caused by bacteria? Correct answer-
Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
What is the preferred meds for Persistent asthma treatment? Correct answer- Low dose
ICS; Low dose ICS plus LABA, or Medium dose ICS; Medium dose ICS plus LABA.
What are examples of inhaled corticosteroids? Correct answer- Fluticasone (Flovent
HFA)
Budesonide (Pulmicort)
, Mometasone (Asmanex Twisthaler)
Beclomethasone (Qvar)
Ciclesonide (Alvesco)
Flunisolide (Aerospan HFA)
What are examples of long acting beta agonists? Correct answer- Advair, Dulera, and
Symbicort (a combination of a long-acting beta-agonist bronchodilator and an inhaled
steroid) Serevent (salmeterol) Foradil (formoterol) Perforomist (formoterol solution for
nebulizers)
What are x-ray findings of acute asthma attack? Correct answer- Hyperinflation, focal
atelectasis, and bronchial thickening are clinical findings on chest X-ray of exacerbated
asthma.
How is asthma managed without medication? Correct answer- Peak flow monitoring
Avoidance of asthma triggers
Extensive, ongoing asthma education for the patient and family regarding disease,
treatment, avoidance of triggers, asthma managed plan, and emergency actions. Use of
an asthma action plan can reduce the number of ED visits as well as hospitalizations.
What screening is appropriate for diabetic neuropathy? Correct answer- Urinalysis for
urine protein and a Blod test to check for GFR (kidney function).
The most appropriate screen for diabetic nephropathy is? Correct answer-
Microalbuminuria
a 26 y/o pt with long hx of chronic sinusitis presents today with temperature of 103.2F,
headache, and stiff neck. Which finding below should make the NP suspect meningitis?
Correct answer- A positive Kernig's and Brudzinski's sign
What two tests demonstrate nuchal ridgidity? Correct answer- Kernig's and Brudzinski's
sign
Kernig's sign refers to the what? Correct answer- inability to allow full extension of the
knee when the hip is flexed 90 degrees
Brudzinski's sign refers to the Correct answer- spontaneous flexion of the hips during
attempted passive flexion of the neck
A pt is examined and found to have a positive Kernig's and Brudzinski's signs. What is
the most likely dx? Correct answer- meningitis
What symptoms point to acute meningitis rather than encephalitis? Correct answer-
Photophobia and severe headache may point to
What is the recommended antibiotic therapy for previously healthy patients with no risk
factors for drug-resistant S. pneumonia infection that have community acquired
pneumonia (CAP)? Correct answer- Macrolide (Azithromycin, clarithomycin, or
erythromycin) OR Doxycycline
What is the recommended antibiotic therapy for patients with chronic comorbidites, such
as chronic disease of heart, liver, lungs, or kidneys; diabetes, alcoholism, malignancies,
immunospression, antimicrobial use within the last 3 months that have community
acquired pneumonia? Correct answer- Respiratory fluoroquinolone (moxifloxacin,
gemifloxacin or levofloxacin {750 mg}) OR beta lactam plus macrolide (preferably high-
dose amoxicillin (1 to 3 times daily) or amoxicillin-clavulanate (2 tabs twice daily).
Alternatives include ceftriaxone, cefpodoxime, and cefuroxime (500 mg, twice daily);
with doxycycline as an alternative to the macrolide)
What is the recommended antibiotic therapy for suspected pseudomonas aeruginosa
infection? Correct answer- Antipneumococcal antipseudomonoal beta lactam
(pipercillin-tazobactam, cefepime, meropenem, or imipenem-cilastatin) plus either
ciprofloxacin or levofloxacin (750 mg dose) OR
Antipneumococal antipseudomonoal beta-lactam plus an amino glycoside and
azithromycin OR
Antipneumonoccal antipseudomonal beta-lactam plus an amino glycoside and an
antipneumococcal fluoroquinolone.
Aztreonam plus an amino glycoside and an antipneumococcal fluoroquinolone for
patients allergic to penicillin
What is the recommended antibiotic therapy for suspected community acquired MRSA
infection with community acquired pneumonia? Correct answer- Addition of vancomycin
or linezolid
When should you obtain a chest X ray on COPD patient? Correct answer- During a
COPD exacerbation when attempting to rule out a concomitant pneumonia.
What Pathogen is most commonly seen in COPD caused by bacteria? Correct answer-
Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
What is the preferred meds for Persistent asthma treatment? Correct answer- Low dose
ICS; Low dose ICS plus LABA, or Medium dose ICS; Medium dose ICS plus LABA.
What are examples of inhaled corticosteroids? Correct answer- Fluticasone (Flovent
HFA)
Budesonide (Pulmicort)
, Mometasone (Asmanex Twisthaler)
Beclomethasone (Qvar)
Ciclesonide (Alvesco)
Flunisolide (Aerospan HFA)
What are examples of long acting beta agonists? Correct answer- Advair, Dulera, and
Symbicort (a combination of a long-acting beta-agonist bronchodilator and an inhaled
steroid) Serevent (salmeterol) Foradil (formoterol) Perforomist (formoterol solution for
nebulizers)
What are x-ray findings of acute asthma attack? Correct answer- Hyperinflation, focal
atelectasis, and bronchial thickening are clinical findings on chest X-ray of exacerbated
asthma.
How is asthma managed without medication? Correct answer- Peak flow monitoring
Avoidance of asthma triggers
Extensive, ongoing asthma education for the patient and family regarding disease,
treatment, avoidance of triggers, asthma managed plan, and emergency actions. Use of
an asthma action plan can reduce the number of ED visits as well as hospitalizations.
What screening is appropriate for diabetic neuropathy? Correct answer- Urinalysis for
urine protein and a Blod test to check for GFR (kidney function).
The most appropriate screen for diabetic nephropathy is? Correct answer-
Microalbuminuria
a 26 y/o pt with long hx of chronic sinusitis presents today with temperature of 103.2F,
headache, and stiff neck. Which finding below should make the NP suspect meningitis?
Correct answer- A positive Kernig's and Brudzinski's sign
What two tests demonstrate nuchal ridgidity? Correct answer- Kernig's and Brudzinski's
sign
Kernig's sign refers to the what? Correct answer- inability to allow full extension of the
knee when the hip is flexed 90 degrees
Brudzinski's sign refers to the Correct answer- spontaneous flexion of the hips during
attempted passive flexion of the neck
A pt is examined and found to have a positive Kernig's and Brudzinski's signs. What is
the most likely dx? Correct answer- meningitis
What symptoms point to acute meningitis rather than encephalitis? Correct answer-
Photophobia and severe headache may point to
