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Exam (elaborations)

ANCC review UPDATED Actual Questions and CORRECT Answer

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ANCC review UPDATED Actual Questions and CORRECT Answers Metformin - CORRECT ANSWER- rare risk of lactic acidosis, often occures w/ impaired renal fx, hypovolemia, low perfusion, advanced age. hold during surgery or imaging w/ radiocontrast the day of and 48 hrs post. lisinopril - CORRECT A...

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  • October 3, 2024
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  • 2024/2025
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ANCC review UPDATED Actual Questions
and CORRECT Answers
Metformin - CORRECT ANSWER- ✔✔rare risk of lactic acidosis, often occures w/ impaired
renal fx, hypovolemia, low perfusion, advanced age. hold during surgery or imaging w/
radiocontrast the day of and 48 hrs post.


lisinopril - CORRECT ANSWER- ✔✔cat d drug in pregnancy



teenager w/ menorrhagia who cant insert tampons - CORRECT ANSWER- ✔✔mirena IUD
best choice


(copper increases bleeding, implant increases bleeding)


tension headaches - CORRECT ANSWER- ✔✔bilateral. moderate pressing pain, recurring.
no photophobia or nausea.


prevent recurrence - TCAs (SE weight gain, drowsiness, dry mouth)


LNG-IUD - CORRECT ANSWER- ✔✔casues endometrial atrophy, 50% of users have
amenorrhea by end of 2 years. fertility returns soon after removal. progestin conrtibutes to
thickening og cervical mucus. minimizes upper reproductive rtact infections. atrophy
prevents impantation of ovum.


COCs - CORRECT ANSWER- ✔✔reduce menstrual volume by 60%



copper IUD - CORRECT ANSWER- ✔✔increases menstrual bleeding and may contribute to
increase in upper reproductive rtact infections.


BPH. which tests to assess degree of voiding dysfunction - CORRECT ANSWER-
✔✔residual volume and urine flow rates- non invasive so immediate testing.

,rectal US - prostate size and weight


cystography and retrograde and voiding urethrography - eval of bladder or urethral
diverticula


cytourethroscopy - confirm presence and effects of bladder neck obstruction d/t BPH


urethral stricture - CORRECT ANSWER- ✔✔c/o urinary dribbling after voiding, urge
incontinence, hx of STI


can result from infection, injuries (falling off bike), post surgical procedures. more common
in men <45.


pelvic floor weakness - stress incontinence


detrusor overactivity and UTI - urge incontinence


prilosec - CORRECT ANSWER- ✔✔can decrease mg



Meningitis - CORRECT ANSWER- ✔✔brudzinski sign
kernig sign


appendicitis - CORRECT ANSWER- ✔✔McBurney's Point - point bt umbilicus and
anteriosuperior iliac spine (find maximal amount of tenderness)


Obturator sign - pain w/ passive flexion and internal rotation of the right hip, indicative of
peritoneal irritation


Psoas sign - pain on passive extension of the right hip, illicit by having pt lay straight and
raise right leg against resistance

,Rovsing's sign - pain elicited by palpating LLQ


CT best dx tool


MCL - CORRECT ANSWER- ✔✔Valgus stress test (gum, push knee in)



LCL - CORRECT ANSWER- ✔✔varus stress test



ACL - CORRECT ANSWER- ✔✔lachman and anterior drawer


audible pop at injury


Meniscus - CORRECT ANSWER- ✔✔mcmurray, thessaly, apley


rotational pain


hip flexed, knee externally rotated as knee is moved from full flexion to extension. snap
heard or felt suggests tear.


Thessaly test


(meniscus) - CORRECT ANSWER- ✔✔•pt standing and facing dr while holding
hands/shoulders to stablize them
•stand on one leg, initially have knee relaxed (*this is about 5° of flexion*)
•then tell them to rotate about their knee (internal/external) about 3x and "let me know if this
causes or changes your sx"


•If negative at 5°, have them flex slightly more to just 20° and repeat.
•do bilaterally


(+) pain, joint line clicking and/or sense of locking/catching

, ind: lateral P = lateral meniscus issue or medial P = medial meniscus issue


mild acne - CORRECT ANSWER- ✔✔open comedones (blackheads), closed comedones
(noninflammatory acne) w/ or w/o small papules


tx - topicals only
rx meds - retin A, benzoyl peroxide w/ erytheomycin, clindamycin (start lowest does, qod)


moderate acne - CORRECT ANSWER- ✔✔papules, pustules, inflamatory lesions w/
comodomes


tx
continue w/ topical for mild acne
add oral abt - tetracyclin, minocycline, doxycycline, erythromycin, clindamycin


tetracycline - can start at age 13 w/o risk to tooth discoloration, cat d in pregnancy, need
backup contraceptive


OCs - yaz, desogen


diet - limit dairy


severe acne - CORRECT ANSWER- ✔✔plus painful nodules, cysts, abscesses and pustules
over face shoulders, chest


tx
accutane - cat x PLEDGE program
2 forms of reliable contraception

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