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ANCC FNP Board Questions & Answers.
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ANCC FNP Board Questions & Answers.
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ANCC FNP BoardQuestions & Answers
A middle-age female patient presents to the clinic with a recurrence of mild hidradenitis
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suppurativa after topical therapies failed. Which first-line treatment is recommended? -
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(CORRECT ANSWER)-Tetracycline
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Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line treatment for
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hidradenitis suppurativa.
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__________________________________________________
Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in apocrine
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gland-bearing skin. It is a chronic, disabling disorder that progresses, often causing
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keloids, contractures, and immobility. It is characterized by comedone-like follicular
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,occlusion, chronic and relapsing inflammation, mucopurulent discharge, and progressive
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scarring.
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Arthropathy associated with hidradenitis may be present. Typical presentation includes
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nodules and sinus tracts (inflamed or noninflamed), abscesses, and scarring found in the
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axilla, genitofemoral area, perineum, gluteal area, and inframammary area in women.
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Recommended treatments include antibiotics, steroids, retinoids, dapsone, and anti-tumor
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necrosis factor agents. A dermatology consultation should also be considered.
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First-line treatment is a 12-week course of an oral tetracycline (Sumycin) such as
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doxycycline. For patients who do not respond to doxycycline, the next recommended step
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is a combination of twice-daily clindamycin (Cleocin) and rifampicin (Rifadin) for 10-12
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weeks. If treatment fails, acitretin (Soriatane, for males and nonfertile females) or dapsone
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(Aczone) may be considered by a dermatologist. In patients with moderate to severe
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hidradenitis suppurativa, adalimumab (Humira) may possibly be considered.
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When providing culturally competent health care services to an American Indian elder, the
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nurse practitioner understands which is traditionally true? - (CORRECT ANSWER)-The
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"Medicine Wheel" is used by many for the purpose of health and healing
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The "Medicine Wheel" is traditionally used and contains four directions; north, south, east,
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and west. Traditionally each tribe has different meanings for each direction and they may
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represent the season of the year or stage of life. It is aimed at providing a holistic view of
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life.
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,An understanding of different cultural preferences leads to cultural competence in
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healthcare. Some patients may value traditional culture and preferences as it relates to
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healthcare. These individual preferences should be included in the interview and
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treatment plan for patients.
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Traditionally, the American Indian culture values a holistic approach to health care
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integrating the person, lifestyle, environment, family, and religion. Patients adhering to
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these traditional cultural practices often feel that illness is due to a lack of harmony with
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the physical body, mind, spirit, and emotions. Patients may seek care from western
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medicine for specific ailments while also consulting with traditional healers for spiritual
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guidance.
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Healthcare providers should seek to understand relevant cultural factors and assess each
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individual's healthcare literacy in order to provide culturally competent care.
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The nurse practitioner sees an older adult patient in the clinic with the primary report of
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hearing loss and a sensation of fullness in the right ear. The nurse practitioner suspects
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conductive hearing loss. Which could contribute to this? - (CORRECT ANSWER)-Cerumen,
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commonly called earwax, is a combination of secretions and sloughed epithelial cells that
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protects the ears from infection, water, and insects. It is normally expelled from the ear
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canal through natural jaw movement. When this self-cleaning process fails, cerumen can
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become impacted. Cerumen impaction occludes the ear canal and can press against the
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tympanic membrane, resulting in conductive hearing loss.
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, _________________________________________
Conductive hearing is the transition of sound from the external and middle ear to the inner
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ear. Conductive hearing loss is caused by problems in the external and middle ear that
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interfere with the transmission of sound and its conversion to mechanical vibration.
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Causes of conductive hearing loss include obstruction of the external auditory canal by
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cerumen, foreign bodies, debris from otitis externa, and large exocytosis and osteomas.
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Sensorineural hearing loss involves difficulty converting mechanical vibrations to
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electrical potential in the cochlea or in auditory nerve transmission to the brain. It is
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mostly caused by permanent damage in the organ of Corti. It can be caused by age-related
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hearing loss, noise trauma, medications, autoimmune diseases, mechanical trauma,
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Meniere disease, infection, and neoplasm (acoustic neuroma).
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Approximately one-third of older adults between the ages of 61 and 70 years have hearing
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loss. More than 90% of adults older than 85 years of age have hearing loss. The most
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common type of hearing loss is age-related and sensorineural. All adults older than 60
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years of age should be screened for hearing loss at periodic health examinations.
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An otherwise healthy adult patient presents to the clinic with a diagnosis of community-
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acquired pneumonia and no recent antibiotic therapy. Which is the best option for
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treatment? - (CORRECT ANSWER)-Amoxicillin
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High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line therapy for
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adults without comorbidities.
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