PMHNP APEA 3P EXAM WITH COMPLETE QUESTIONS
AND CORRECT VERIFIED ANSWERS (DETAILED
ANSWERS) ALREADY GRADED A+ 100% GUARANTEED
TO PASS CONCEPTS!!!.
Actinic keratosis treatment gold standard - ANSWER-small- cryotherapy
large- number 5-FU (5-flouracil aka efudex). 5-FU medication Causes skin to
ooze, crust, scab and be red
**5-flouracil/ efudex-wear sunscreen!!**
squamous cell cancer - ANSWER-chronic red scaly rough textured lesion w/
irregular borders
crusting or bleeding may be present
Squamous cell carcinoma common locations - ANSWER-rims of ears, lips, nose,
face and top of hands
precursor lesion to squamous cell cancer - ANSWER-actinic keratosis
squamous cell carcinoma diagnosis by? - ANSWER-biopsy gold standard. if
biopsy is not an option, refer to dermatology .
,Risk factors for skin cancer(melanoma and both non-melanoma) - ANSWER-
Blistering sunburn as a child, history of sunburns, light skin, chronic exposure to
UV light (sunlight/tanning beds), moles, family hx for skin cancer
Melanoma symptoms (ABCDE) - ANSWER-asymmetry (shape/uneven texture)
border (irregular/notched/blurred)
color (variegated colors from black, blue, dark to light brown)
diameter (size >6mm size of pencil eraser or larger)
evolving (changes in color/size/shape)
may be itchy
Acral lengtiginous melanoma - ANSWER-Most common type of melanoma in
dark skinned individuals (blacks & asians)
--> look for longitudinal brown to black bands under the nailbed. a changing
spot or mole in the palms, or the soles of the feet
seborrheic keratosis - ANSWER-soft, round, wart-like growth that is light tan to
black and looks pasted on
asymptomatic &benign
Bacterial Meningitis Bacteria - ANSWER-Streptococcus pneumoniae- most
common strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
,Nuchal rigidity
rapid change in mental status w/ headache
Triad=neck up
erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions
(purpura) which are non-blanchable
Is bacterial meningitis a reportable disease - ANSWER-yes!
Treatment for Bacterial meningitis-patient - ANSWER-IV Abx ASAP, resp/droplet
iso for first 24-48 hrs, hydrate (low maintenance after initial fluid correction),
Maintain ventilation and reduce increased intra cranial pressure if present
(dexamethosone(to reduce inflammation, mannitol to diurese the brain), low
stim environment, tx complications that may arrive and support family
Treatment for bacterial meningitis-close encounter - ANSWER-Close contacts
should be treated w/ rifampin 600 mg q 12 hours x 2 days
**Rifampin changes urine color to reddish orange and can stain contacts
**AVOID RIFAMPIN IN PREGNANCY
Most common type of skin cancer in USA - ANSWER-Skin cancer
Most common type of skin cancer - ANSWER-basal cell carcinoma
basal cell carcinoma symptoms - ANSWER-Appearance varies; smooth, shiny
bump, pink to pearly white
Basal cell carcinoma common locations - ANSWER-cheeks, nose, face, neck,
arms, back
, basal cell carcinoma diagnosis gold standard - ANSWER-biopsy. if not an option,
refer to derm
Actinic keratosis - ANSWER-Precursor to squamous cell carcinoma
numerous dry, round and pink to red lesions w/ rough and scaly texture
--> does not heal, slow growing in sun exposed areas
Actinic keratosis diagnosis gold standard - ANSWER-Biopsy.
if not an option, refer to derm
Brudzinkski sign (meningeal irritation) - ANSWER-Tests for meningeal irritation
Patient supine, raise BACK of head and flex chin towards chest
+ result if pt automatically beds both hips
--Brudzinski and back of head start with B as well as bends--
Kernig's sign - ANSWER-Tests for meningeal irritation
patient supine. flex patients hips and knees in a right angle, then slowly
straighten/extend the legs up
+ result if when the patient complains of pain during extension of leg
MCV4 (meningococcal vaccine) Age 11-19 - ANSWER-Give one dose of
menactra or menveo
primary dose given age 12 or younger give a booster at age 16-18
MCV4 (meningococcal vaccine) Age 19-21 - ANSWER-Give one dose of
menactra or menveo if never had either
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