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NR 511Exam 2024/2025 Final Exam 2024/2025 Questions With Completed & Verified Solutions.
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NR 511Exam 2024/2025 Final Exam 2024/2025 Questions With Completed & Verified Solutions.
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NR 511 Final2 Coding Classification systems that are currently used in the US healthcare system -
ANS - CPT-recognized universally and provide logical means to be able to track
healthcare data, trends, and outcomes.
ICD-10-shorthand for the patient's diagnosis, which are used to provide the payer
information on the necessity of the visit or procedures performed.
31. Describe how to perform a
Tinnel test - ANS - Purpose: Assess for compression neuropathy
Procedure: Percuss the median nerve at the wrist. If the patient complains of tingling in
the digits (POSITIVE TINEL SIGN), compression at the site of percussion is likely.
5ths disease - ANS - o 3 Stages:
1. Classic "slapped cheek" rash bright red bilateral cheeks which spare the forehead,
nasal bridge, and perioral area
2. Pink lacy (or reticulated) erythematous macules on all extremities and trunk spare the
palms and sole surfaces.
• The rash may be itchy at this stage.
3. 2-3 weeks of the body rash.
This rash may come and can last for up to 3 weeks.
8. Discuss common characteristics (objective findings) of patients with lumbar spinal
stenosis - ANS - - Muscle weakness
- Impaired proprioception
- Diminished reflexes
- Sensory changes (numbness/tingling)
- Bowel or bladder symptoms
o Sphincter tone decreased
o Don't confuse w/ prostate problems in older men
Accurately document why every procedure code must have a corresponding diagnosis
code - ANS - every procedure code needs a diagnosis to explain the necessity whether
the code represents an actual procedure performed or a nonprocedural encounter like an
office visit
Acute appendicitis - ANS - Inflammation of the vermiform appendix; due to obstruction or
infection
Most common surgical emergency of the abdomen
Hollow tube - most common cause is obstruction of appendix
,Fecaltih - hard lump of fecal matter
Undigested seeds
Pinworm infections
Lymphoid follicle growth/lymphoid hyperplasia Symptoms
4. Symptoms
Nausea/vomiting
RLQ pain
Guarding
Acute appendicitis diagnostics - ANS - Diagnosis is made clinically and based on history
and physical
Elevated WBC
Mild Fever, 99-100
RLQ pain/McBurneys point
CT abd may help rule out other diagnostic possibilities
ABD ultrasound helps to visualize the inflamed appendix
Acute appendicitis treatment - ANS - • Appendectomy
• Antibiotic
• Drain abscesses
• Can be removed prophylactically
Acute cholecystitis - ANS - Inflammation of gallbladder (GB)
Usually due to gallstone in cystic duct
1. Cystic duct - leaves gall bladder & connects to common bile duct
Symptoms
Patient will have mid-epigastric pain
Because GB is still squeezing, increasing pressure w/ nowhere for bile to go
Can lead to nausea/vomting
Stone can get more stuck w/ more squeezing
Bile starts to irritate mucosa
Mucosa starts to produce mucous and inflamm enzymes
Leads to inflammation, distention, pressure build up
Bacterial growth (E. coli, enterococci, bacteroides fragilis, colstriduim)
As GB "balloons", pain shifts to RUQ, R scapula/shoulder
Bacteria invades in & through GB wall, into peritoneum, causing peritonitis
Rebound tenderness
Murphy's Sign = Put pressure on right side under ribs. This will hold GB in place. Have
patient take a deep breath. The diaphragm will push on the GB & a painful response =
Cholecystitis
Immune response
Neutrophilic leukocytosis
Fever
,Acute cholecystitis diagnostics - ANS - US confirmed
Detects stones
Sonographic murphy sign
Tenderness when sonogram is over gallbladder
GB wall thickening
Sludge
Distention of GB or common bile duct
Cholescintigraphy (HIDA scan)
Radiolabeled marker used to visualize the biliary system
Acute cholecys - ducts are blocked, GB can't be seen
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscope down to pancreas
Dye injected & viewed via fluoro
Magnetic Resonance Cholangiopancreatography (MRCP)
1. Visualizes bili system with MRI
Acute cholecystitis treatment - ANS - o Supportive measures
IV
Pain management
ATB
o Surgical Removal
1. Cholecystectomy
1. Laparoscopic
Acute pancreatitis - ANS - Sudden inflammation and hemorrhaging of the pancreas due
to destruction by its own digestive enzymes
1. Autodigestion
Most of the time mild, but can be severe
Pancreas
Long skinny gland, length of dollar bill
Located in upper abdomen
Behind the stomach
Endocrine
Alpha/beta cells produce insulin & glucagon that are secreted into the blood stream
Exocrine
Leading causes:
ETOH abuse
Gallstones
Other Causes of acute pancreatitis
1. I Get Smashed
I - idoipathic
G- gallstones
E- ETOH abuse
T - trauma
, S - steroids
M - mumps virus
A - autoimmune diseases
S - scorpion stings
H - hypertriglyceridemia & hypercalcemia
E - ERCP
D - drugs
Symptoms
Nausea
Vomiting
Hypocalcemia
Cullen's sign - bruising around umbilicus
Grey-Turner's Sign - Bruising along flank
Necrosis induced hemorrhaging spreads
Acute pancreatitis diagnostics - ANS - Pain in epigastrium which radiates to back
Labs
Increase in amylase; gold standard in diagnoses (up to 3x the normal level)
Increase in lipase
CT scan
US to look for gallstones
Acute pancreatitis treatment - ANS - o pain management
o hydration
o electrolytes
o rest bowels
NPO
IV nourishment
o Treat complications
O2
ATB
Allergic conjunctivitis - ANS - environmental: uniquely identifying "bumps" on the
conjunctiva: follicles
Assessing for prior antibiotic use is a critical part of the history in patients with
presenting with _______________ due to_________________ - ANS - Diarrhea/CDiff
atopic dermatitis - ANS - a disorder that is the result of a gene variation that affects the
skin's ability to retain moisture and protection from irritants
-Example: Eczema
Bacterial conjunctivitis - ANS - Pink eye: purulent discharge
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