LEIK FNP EXAM PREP/ LEIK FNP PACTICE EXAM
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EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
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Why is Rhogam given? .....ANSWER..... Rho(D) immune globulin
(RhoGAM) is used to prevent the immunological condition known
as rhesus disease or hemolytic disease of the newborn. RhoGAM
is a solution of IgG anti-D (anti-RhD) antibodies that suppresses
the mother's immune system from attacking Rh-positive blood cells
that have entered the maternal bloodstream from fetal
circulation. In an Rh-negative mother, RhoGAM can prevent
temporary sensitization of the maternal immune system to RhD
antigens, which can cause Rh disease in the current or subsequent
pregnancies.
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Pt with GERD abrupt stop of PPI, with Barrett's esophagus
.....ANSWER..... This patient is having severe rebound symptoms
caused by abrupt cessation of the proton-pump inhibitor (PPI). In
addition, he has Barrett's esophagus, which increases the risk of
esophageal cancer. Neither an antacid nor an H2 blocker is
likely to be effective in controlling his symptoms. This question is a
good example of the ethical concept of beneficence
Depo-Provera side effect after 5 years .....ANSWER..... Depo-
Provera (contraceptive injection) is a progesterone hormone that
causes cessation of periods. One common side effect seen in
women who have been taking Depo-Provera for more than 5
years is amenorrhea. As women continue using Depo-Provera,
fewer experience irregular bleeding and more experience
amenorrhea. By month 12, amenorrhea was reported by 55% of
women, and by month 24, amenorrhea was reported by 68% of
women.
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NSAIDs affect which systems: .....ANSWER..... Chronic use of
nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with
increased risk of ulcers, perforation, and bleeding of the
gastrointestinal tract, heart attacks, cardiovascular damage,
strokes, acute interstitial nephritis and kidney injury, and liver
damage. It does not affect the lungs or the pulmonary system.
Watery diarrhea after hospitalization and Clindamycin therapy
.....ANSWER..... Important risk factors for CDAD and C. difficile
colitis are antibiotic therapy and hospitalization. Almost any
antibiotic can cause the condition, but the most common are
clindamycin, cephalosporins, and fluoroquinolones. Diarrhea can
occur during as well as after therapy (5-10 days; up to 10
weeks). Pseudomembranous colitis is a complication of C. difficile
colitis.
Drug interaction with Levothyroxine .....ANSWER..... Levothyroxine
does not interact with penicillins. But it does have numerous drugs
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it interacts with such as anticoagulants, tricyclic antidepressants,
antacids and calcium, iron, multivitamins, proton-pump inhibitors,
estrogens, statins, metformin, and others. Certain foods interfere
with absorption (calcium-fortified foods, dietary fiber, walnuts,
soy). Patients should avoid taking them together, and should
space these foods and drugs several hours apart. Levothyroxine
(Synthroid) is a synthetic form of T4.
First line therapy for pain in acute exacerbation of gout
.....ANSWER..... Nonsteroidal anti-inflammatory drugs (NSAIDs),
such as indomethacin (Indocin), have been used for the treatment
of acute gout. Colchicine may be added to the NSAIDs if relief is
not obtained. Maintenance therapy consists of allopurinol and/or
probenecid. Allopurinol is used to prevent gout attacks, not to
treat them once they occur. It may take several months or longer
before the full benefit of allopurinol is felt. Allopurinol may
increase the number of gout attacks during the first few months