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ANCC Boards - DRT Review (Final Two Week Grind) – Q’s And A’s
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ANCC Boards - DRT Review (Final Two Week Grind) – Q’s And A’s
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ANCC Boards - DRT Review (Final Two Week Grind) – Q’s And A’sAnemia found primarily in non-caucasians: MCV < 80, MCHC < 32, normal ferritin Right Ans - Thalassemia A typical of the Mediteranean/Asians
Thalassemia B most common
Presents with copious purulent sputum, mild to mod dyspnea, larger body habitus, normal A-P diameter, normal percussion, CXR hyperinflation (diaphragm low and flat) w Right Ans - Chronic bronchitis - excessive bronchial mucus and productive cough for 3 months - help them quit smoking!!
Present with weakness, HA, mild exertional fatigue, pallor, tachycardia - low hgb & crit, MCV < 80, MCHC < 32, TIBC > 450 Right Ans - Iron Deficiency Anemia - most common cause of anemia
Best option for Cancer patient having severe breakthrough type pain (sudden worsening of pain in setting of chronic pain) Right Ans - Typically oral opioids (Fentanyl) are a good option however fent can be administered via transdermal or transmucosal routes
Atypical findings in elderly UTIs
Incontinence Lethargy Weakness Frequency Decreased Appetite Dehydration Urgency Dysuria Confusion Right Ans - Incontinence, Lethargy, Decreased Appetite, Dehydration, Confusion are all Atypical findings in the elderly UTI
A shift to the right in the oxyhgb dissociation curve results in an increase or decrease in oxygen affinity resulting in increased or decreased oxygen off loading. A shift to the right is typically caused by acidic or alkalotic pH and/or hyper or hypothermia Right Ans - Which New York Heart Association Class of heart failure first demonstrates symptoms at rest? Right Ans - Class I: no limitations of physical activity
Class II: slight limitation of physical activity but comfortable at rest
Class III: marked limitations of physical activity but comfortable at rest
Class IV: Severely impacted physical activity WITH symptoms while at rest The degree to which an instrument measures the same way over time with the
same subjects - the consistency of a measurement
Board exams show this with consistency over time Right Ans - RELIABILITY
The degree to which a variable measures what it is intended to measure Right Ans - VALIDITY
Patient presents with hypotension and the following lab values:
Leukocytosis with a left shift
Thrombocytopenia
Hypoglycemia
Increased LDH Right Ans - Consider Septic Shock
Severe allergic reaction with signs and symptoms indicating respiratory involvement - med to consider Right Ans - Anaphylaxis - Epi first, consider diphenhydramine and fluids
Low CO/CI (4-8) High SVR (800-1200)
Low CVP (2-8) Low SvO2 (60-80)
Low PCWP (6-12) Right Ans - Hypovolemic Shock
What reading in a purified protein derivative is considered positive in HIV infected persons and what is the suggested management? Right Ans - > 5mm in HIV - (>10mm in health care workers/high prevalence areas/high risk groups & > 15mm for all others)
RIPE - Rifampin 600, Isoniazid 300, Pyrazinamide 1.5-2g, Ethambutol 15mg/kg
Adult Nutritional Considerations:
Normal Albumin?
Normal HGB?
Avg Adult fluid requirement?
1 lbs body weight = how many kcal? Right Ans - Albumin 3.5-5.0
Hgb 12-16 female 14-18 male
25-35 ml/kg/24 hours fluid requirement
1 lbs = 3500 kcal Asthma patient not getting good relief from Alupent (metaproterenol) - what should be considered? Right Ans - Alupent is a SABA - would be reasonable to add an anticholinergic (Ipratropium bromide)
The most important factor for determining the size of a study sample within qualitative research Right Ans - Data Saturation: this occurs when no new info is found in the data
Effect size represents the frequency of an observed phenomenon
Symmetrical - impacts proximal interphalangeal joints (PIPs), metacarpophalangeal joints (MCPs), wrists, pain and heat, swelling. Worse in morning and better as day progresses. Likely see joint space narrowing, osteopenia, progressive cortical thinning Right Ans - Rheumatoid Arthritis - Women 3:1 Men
DMARDs include:
Corticosteroids
Methotrexate (watch LFTs closely)
Antimalarials (hydrochloroquine)
Gold Salts
Asymmetrical affecting men and women equally - impacts proximal interphalangeal joints (PIPs) Bouchard's nodes, distal interphalangeal joints (DIPs) Haberden's nodes, wrists, knees, hips (weight bearing), swelling and edema but no redness or heat, gets worse as day progresses. osteophytes, narrowed joint space, juxta-articular sclerosis Right Ans - Osteoarthritis
Tx includes:
ASA, Acetaminophen, NSAIDS, Cox-2 inhib (celecoxib - careful with heart)
What type of feeding can cause these complications:
Cath sepsis, Air emboli, Pneumothorax, Hemothorax, Cath thrombus, Hyperglycemia, HHNK Right Ans - Parenteral feeding
What type of feeding can cause these complications:
Aspiration, diarrhea, emesis, Hypernatremia, Dehydration, Refeeding syndrome (hyposphosphatemia, hypokalemia, hypocalcemia, hypomagnesemia, thiamine deficiency) Right Ans - Enteral feeding
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