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SARAH MICHELLE LIVE REVIEW STUDY GUIDE| Complete Questions and Correct Answers 100% Correct| A+ Rated Solution Guide| Latest 2024/2025. 716 Q&A.

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SARAH MICHELLE LIVE REVIEW STUDY GUIDE|
Complete Questions and Correct Answers 100% Correct|
A+ Rated Solution Guide| Latest 2024/2025. 716 Q&A.

A new graduate nurse practitioner has a patient presents with a hearing complaint. The patient states
that they have had decreased hearing on the right side for the last month that is continuing to get
worse. The NP completes both the Rinne and Weber tests. If the patient has Ménière's disease, what
would be the expected finding on the Weber test?

1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear

4. The tuning fork lateralizes to the left ear

What are common signs and symptoms of Meniere's Disease?

Vertigo, tinnitus, ear pressure, nystagmus

What is our biggest worry for a Meniere's Disease patient?

There is a possibility for a potential, permanent hearing loss.

What is rhinitis meidcamentosa?

Drug-induced rebound nasal congestion, this can happen after use of nasal decongestants like Afrin.
These nasal decongestants should ideally not be used for greater than 3-5 days because of this risk.

What is herpes keratitis?

This is an infection of the cornea due to herpes simplex virus

How is herpes keratitis diagnosed?

By examining the eye under a black lamp and visualized the cornea, in herpes keratitis, fern like lines will
be seen on the cornea

A child that has a history of mononucleosis is at increased risk for development for what cancer later
in life? And why?

Hodgkin's Lymphoma and Burkitt's Lymphoma, this is due to the exposure of the Epstein-Barr virus

What types of patients will be at a higher risk of pneumonia?

Patient with chronic lung diseases: asthma, COPD, cystic fibrosis.

Why are cough suppressants not helpful in pneumonia patients?

,Because we WANT them to get that gunk out, we do not want them to hold it in their lungs, an
expectorant would be a better option for these patients.

When should a follow up chest X-Ray be completed after treatment of pneumonia?

Around 8 week mark

What is COPD?

Chronic Obstructive Pulmonary Disease. This is a chronic condition that is made up of chronic bronchitis
and emphysema. It is a progressive inflammatory lung disease that makes it hard for the patients to
breathe, because the chronic bronchitis leads to mucous build up and the emphysema portion destroys
areas of the lungs.

What signs and symptoms are common in COPD patients?

Chronic cough
Sputum production
Dyspnea- difficulty breathing

What signs and symptoms are specific to B12 deficiency anemia?

Neurological symptoms, paresthesia (numbness and tingling in hands and feet), unsteady gait, memory
issues
Beefy red tongue

What diet can result in B12 deficiency?

Vegan- oral supplements can be used for treatment

What surgery can result in B12 deficiency?

Gastric surgery- patient will lose intrinsic factor that is required to absorb B12- these patients will require
life long IM B12 injections

What patient population is lupus commonly seen?

Women of childbearing age- ages 15-45, African Americans are going to be at higher risk

What is the diagnostic criteria for Lupus?

Must have 4/11 diagnostic criteria:

Malar rash
Discoid rash
Photosensitivity
Oral/nasal ulcers
Non-erosive arthritis
Cardio-pulmonary complaints
Renal complaints
Neurological concerns

,Immunological disorders
+ ANA test
Hematologic disorders

What is Sjogren's Syndrome and what is the treatment?

Dry eyes and dry mouth- treatment revolves around symptom management- artificial tears, hard
candies, etc.
Common in lupus patients

What is a major concern for lupus patients? How do we monitor this?

Impact on the kidneys- Lupus nephritis
Be on the look out for glomerularnephritis as well as proteinuria
These patients will require routine UA for assessment of their kidneys and protect them

What is the function of the thyroid?

Viral hormone gland
Metabolism regulation- impacts every SINGLE cell within the body
Proper growth and development across the entire lifespan

What produces TSH?

Pituitary gland

What is the function of TSH?

Tells your thyroid when to produce and release those critical thyroid hormones- T3 and T4.

What disorders include hypothyroidism?

Iodine deficiency, Hashimoto's, or thyroiditis

A presence of thyroid peroxidase antibodies indicates that?

Hypothyroidism is caused by an autoimmune process of some sort

What are some signs and symptoms of hypothyroidism?

Weight gain, constipation, dry skin, cold intolerance, fatigue, course hair, facial puffiness, thick tongue,
and maybe some cardiac side effects

What patient education must be included regarding Synthroid administration?

Must be taken on an empty stomach before other medications

What are signs and symptoms of a myxedema coma?

Low body temperature, edema, confusion, lethargy, tongue thickening, difficulty breathing

What medications can precipitate myxedema coma?

Lithium or amiodarone

, Your patient who is on 75 mcg Synthroid PO daily comes in for a 6 week follow up to check their TSH
level. When you get the results, their TSH is 0.1. What should you do next as the NP?

Assess how the patient is taking their Synthroid

What signs and symptoms are common in hyperthyroidism?

Anxiety, palpitations, cardiac abnormalities, tachycardia, diaphoresis, weight loss, and increased
appetite, menstrual irregularities, amenorrhea, tremors, lid lag, exophthalmos

What needs to be considered with PTU medication administration?

Need frequent lab work: CBC, and Thyroid panel
Required to take PTU multiple times a day

What is the most common treatment for Grave's Disease?

Radioactive iodine therapy

Hyperthyroidism left untreated may lead to what conditions?

Heart disease- patient's heart is in a constant high-output state, your heart can't keep up with that all of
the time, may lead to heart failure
Osteoporosis
Infertility

What is worst case scenario in hyperthyroid patients?

Thyroid storm- Temperature, HR, and BP- dangerously HIGH levels
Puts body into compromised state, especially impacting your heart. Heart starts to go into Letha
dysrhythmias and even heart failure.

What are the 8 most common drug classes for diabetes medications?

Biguanides (Metformin)
DPP-4 inhibitors
GLP-1 Agonists
SGLT-2 inhibitors
Insulin

Sulfonylureas
TZDs
Alpha-glycosides inhibitors

Why are type 1 diabetics insulin dependent?

They have an autoimmune destruction of their beta cells

What are some examples of rapid acting insulin?

Humalog, Novalog, Apidra

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