NR 511 Midterm Exam Study Guide 2024- Chamberlain College of Nursing/NR 511 Midterm Exam Study Guide 2024- Chamberlain College of Nursing/NR 511 Midterm Exam Study Guide 2024- Chamberlain College of Nursing/NR 511 Midterm Exam Study Guide 2024- Chamberlain College of Nursing
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Chapter 4 The Art and Diagnosis of Treatment
Specificity and sensitivity of a diagnostic study (see course lesson)
o Specificity:
High: a high percentage of healthy individuals will show
a normal result
Low: getting a positive result when it is not present, a
high number of false positives, meaning a healthy
person has a disease when they actually do not.
If a diagnostic study has high specificity, then a high
percentage of healthy individuals will show a normal result
o Sensitivity: is the proportion of true positives out of all
patients with a designated condition
Highly sensitive tests will lead to positive findings for
patients with a disease
What is the patient history in terms of documentation?
o HPI is for acute/episodic care and is for clinical reasoning regarding the differential
diagnoses
o Past medical history includes:
Chronic conditions
Childhood illnesses
Significant adult illnesses
Surgical history
, Hospital admissions
History of trauma
OB/GYN history
Psychiatric diagnoses
Exposure to infectious/toxic agents (including recent travel)
Medications (Rx & OTC), supplements, herbs
Immunization history
Family and social history
Where in the chart is OLD CARTS used?
o In the HPI
o Onset
o Location
o Duration
o Characteristics
o Aggravating factors
o Relieving factors
o Treatments
o Symptoms severity – association with pain
Chapter 5 Evidence-based Practice
Sources that NPs use to help with clinical decision-making (i.e. evidence-based research,
clinical practice guidelines)
o National Guideline Clearinghouse
o Cochrane Collaboration
o Essential Evidence plus
o UptoDate
o Dynamed
o Smartphone of tablet options
Skyscape constellation
Pepid primary care
o Evidence based research
o Clinical practice guidelines
o Published evidence based algorithms
Chapter 10 Infectious and Inflammatory Neurological Disorders (p. 131-134)
Assessment and diagnosis of herpes zoster (shingles)
o Caused by varicella-zoster characterized by painful rash with blisters.
o Herpes zoster is characterized by a unilateral vesicular rash along a dermatome, most
commonly a thoracic or lumbar dermatome. The rash begins as erythema, then changes
to papular lesions that rapidly form vesicles. The vesicles rupture, releasing infectious
fluid, and then form scabs.
Chapter 11 Common Skin Complaints
, Assessment and diagnosis of common skin complaints
o Medical Hx: recent illness
o Medications: Rx & OTC
o Social Hx: occupational exposure, travel, hobbies, pets, drug use
o Sexual Hx: STIs
Health teaching for patients with pruritus
o avoid scratching
o use cool compresses and apply pressure to itchy areas
o keep fingernails trimmed
o avoidance of strong soaps
o taking shorter, tepid showers (10 to 20 minutes) instead of hot baths
o the use of effective emollients (Mild bland soaps such as Dove, Basis, Purpose, Cetaphil,
o and Neutrogena are recommended.)
o gently towel dry the skin after showering because rubbing the skin stimulates pruritus.
o To seal moisture in the skin, applying a bland emollient such as Eucerin, Lubriderm, or
Alpha-Keri immediately after dabbing the skin with a towel to partially pat dry is helpful.
Waiting too long (more than 5 minutes) after finishing a bath or shower allows moisture
o to evaporate.
o Severe cases of dry skin may be treated using the "soak and smear" technique
Treatment of urticaria
o Hives: Look at the location of the rash; the first step is to determine the need
for epinephrine; Look for respiratory symptoms, difficulty breathing,
hoarseness; look at location of rash; is it on the neck, around the face, etc.; if
it is, epinephrine must be administered.
o Cholinergic urticaria: Cholinergic urticaria are hives or wheals that are pruritic
and occur on the trunk and arms following exercise, anxiety, elevated body
temperature, hot baths and showers.
o Treated with antihistamines
Chapter 12 Parasitic Skin Infections
Assessment and diagnosis of common parasitic skin infections
Pharmacological management of common parasitic skin infections
Health promotion and teaching for patients with common parasitic skin infections
Characteristics of scabies
o An intensely itchy rash caused by a mite known as Sarcoptes scabie
o Can last several days or weeks
o Transmitted to direct contact
o Clinical diagnosis of scabies is almost never made until hypersensitivity has occurred
Differential diagnoses for scabies
o Atopic dermatitis
o Contact dermatitis
o Folliculitis
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