family nurse practitioner study guide latest update 2022
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FAMILY NURSE PRACTITIONER STUDY GUIDE LATEST
UPDATE
Sensitivity - defined as the ability of a test to detect a person who has the disease.
Specificity - defined as the ability of a test to detect a person who is healthy or to detect the person
without the disease.
Trauma to Kiesselbachs plexus - will result in an anterior nosebleed
The diagnostic or gold standard test for sickle cell anemia, G6PD anemia, and alpha or beta thalassemia -
hemoglobin electrophoresis
questions asking for "action" - the initial action might be to interview and gather subjective data or the
history
erythromycin "allergy" vs adverse reaction - adverse reactio-symptoms of nausea or GI upset
allergy -hives, angioedema
acute mononucleosis - the patient will most likely be a teen presenting with the classic triad of sore
throat, prolonged fatigue, and enlarged cervical nodes.
Alpha thalassemia - more common among Southeast Asians such as filipinos
Lupus - present with malar rash(butterfly rash)Pts need to avoid or to minimize sunlight
exposure(photosensitivity)
treatment for polymyalgic rheumatica(PMR) - first line treatment for PMR includes long-term steroids.
Long term steroids are commonly used to control symptoms(pain, stiffness on shoulders, and hip girdle).
PMR pts have higher risk for temporal arteritis.
Gold standard exam for temporal arteritis - biopsy of the temporal artery. refer pt to opthalmologist for
mgt
Finkelstein's test - Positive in De Quervains tenosynovitis
Anterior Drawer maneuver and Lachman maneuver - Positive if anterior cruciate ligament (ACL) of knee
damaged. The knee may also be unstable
McMurray's sign - Positive in meniscus injuries of the knee
Damaged Joints - order X-ray first, but MRI is the Gold Standard
Diabetic retinopathy - neovascularization, hard exudates, cotton wool spots, and micoaneurysms
,Hypertensive retinopathy - AV nicking, silver and or copper wire arterioles
Checking deep tendon reflexes - absent(0),
hypoactive (1)
normal(2)
hyperactive(3)
clonus(4)
define clonus - Clonus is typically seen in patients with stroke, multiple sclerosis, spinal cord damage and
hepatic encephalopathy. Clonus has also appeared after ingesting potent serotonergic drugs, where
ingestion strongly predicts imminent serotonin toxicity (serotonin syndrome). Clonus is a series of
involuntary, rhythmic, muscular contractions and relaxations. Clonus is a sign of certain neurological
conditions, particularly associated with upper motor neuron lesions involving descending motor
pathways, and in many cases is, accompanied by spasticity (another form of hyperexcitability).Unlike
small, spontaneous twitches known as fasciculations (usually caused by lower motor neuron pathology),
clonus causes large motions that are usually initiated by a reflex.
A rare but serious adverse effect of ACE inhibitors is - angioedema
A common side effect of ACE inhibitors is a - dry cough(10%)
First line drug to treat hypertension in diabetics and patients with mild renal disease because of their
renal protective properties - ACE inhibitors or ARBS
Drugs allowed for pregnant or lactating women - Category B
Pregnancy in pain - order Tylenol instead of Ibuprofen
Avoid nitrofurantoin and sulfa drugs during 3rd trimester - increase the risk of hyperbilirubinemia
best way method of spreading viruses or bacteria is - making them airborne or nebulized
treatment of cutaneous anthrax - Ciprofloxacin 500mg orally BID for 60 days or 8 weeks. If pt allergic to
ciprofloxacin , use doxycycline 100mg BID
Good communication rules - Ask open ended questions, do not reassure patients, avoid angering the
patient, and respect the patients culture.
Eriksons Stages of Psychosocial Development - Stage 1: Infancy -- Age 0 to 1
Crisis: Trust vs. Mistrust
Stage 2: Toddler -- Age 1 to 2
Crisis: Autonomy (Independence) vs. Doubt (or Shame)
Stage 3: Early Childhood -- Age 2 to 6
Crisis: Initiative vs. Guilt
Stage 4: Elementary and Middle School Years -- Age 6 to 12
Crisis: Competence (aka. "Industry") vs. Inferiority
Stage 5: Adolescence -- Age 12 to 18
Crisis: Identity vs. Role Confusion
Stage 6: Young Adulthood -- Age 19 to 40
Crisis: Intimacy vs. Isolation
Stage 7: Middle Adulthood -- Age 40 to 65
Crisis: Generativity vs. Stagnation Stage 8: Late Adulthood -- Age 65 to death
Crisis: Integrity vs. Despair Important
primary vs secondary - "Will performing this action prevent the disease or the social condition from
happening? If it does, then it is considered as primary prevention(if it doesn, then it is secondary)
breast self exam and genital self exam - considered secondary prevention
, tertiary prevention - involves not only rehabilitation, but also includes actiivities that will help to prevent
complications from disease treatment, such as patient education about medication side effects or the
proper use of equipment such as cane. Support groups for a disease /condition are all considered as part
of a tertiary prevention activity.
secondary prevention - (Detect disease.condition as Early as Possible)
any lab test to screen disease, US preventive Services Task Force-screening rec-mammograms, PSA, PPD,
screening for high risk behaviour-suicide, depression, personal action to detect cancer
Tertiary prevention - (Limiting Further harm and disability)
All types of rehabilitation-cardiac, pt/ot, speech therapy , addition/drug rehab, support groups, exercise
for an obese person
clue cells - mature squamous epithelial cells with numerous bacteria noted on the cell borders(bacterial
vaginosis)
Bacterial Vaginosis - has a alkaline pH(vagina normally has an acidic pH of 4.0) BV is the only vaginal
condition with the only alkaline pH for the exam. BV is not considered an STD(it is imbalance of vaginal
bacteria-sex partner does not need to be treated. The microscopy slide will have very few WBC and
large number clue cells.
Candida vaginal discharge - white in color with a thick and curd like consistency. it frequently causes
redness and itching in the vulvovagina due to inflammation
microscopy in candidiasis - will show a large number of WBC, pseudohyphae, and spores(saghetti and
meatballs
candida yeast - normal flora of gastrointestinal tract and in some womens vaginas
trichomonas infection - vaginal discharge is copious, bubbly, and green in color. It causes a lot of
inflammation resulting in itching and redness of the vulvvagina. It is considered a sexually transmitted
infection. The sex partner needs treatment.
Gold standard of diagnosis for BV, candida vaginitis, and trichomoniasis for the exam - microscopy is the
gold standard.
treatment for strep throat - penicillin VK PO for 10 days. If pt is PCN allergy, macrolides can be used
instead.
mortality - most common cause of death
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