Exam 4: NSG554/ NSG 554 (Latest 2023/ 2024) - Nurse Practitioners in Primary Care I Exam Review| Complete Guide with Verified Answers| 100% Correct

Exam 4: NSG554/ NSG 554 (Latest 2023/ 2024) - Nurse Practitioners in Primary Care I Exam Review| Complete Guide with Verified Answers| 100% Correct Q: Hyperthyroid examination findings Answer: -Diffusely enlarged thyroid -Frequent asymmetric and often with bruit -Subacute: moderately enlarged/tender, dysphagia, jaw/ear pain -toxic multi nodular goiter: palpable nodules -Silent thyroiditis: small nontender goiter Q: PALM-COEIN Answer: -Polyp, adenomyosis, leiomyoma, malignancy and hyperplasia -Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, Not yet classified Q: Abnormal premenstrual bleeding: Laboratory studies Answer: -CBC, pregnancy test, thyroid tests. -Vaginal and urine samples for PCR or culture to r/o chlamydia Q: Vaginitis Answer: -inflammation and infection of the vagina -caused by a variety of pathogens, allergic reactions to contraceptives or other products, vaginal atrophy, friction during coitus -normal pH is 4.5 or less Q: Vaginitis: Clinical findings Answer: -vaginal irritation, pain, unusual or malodorous discharge -Hx including LMP, recent sexual activity, use of contraceptives, tampons, douches, recent changes in meds or use of abx, presence of burning, pain, pruritus, profuse discharge Q: Vaginitis: PE Answer: -inspection of vulva -speculum exam of vagina, cervix -vaginal/cervical/urine sample for detection of chlamydia -discharge inspected under microscope in a drop of 0.9% saline solution to look for trichomonads or clue cells and in a drop of 10% potassium hydroxide to look for candida -pH should be tested: if 4.5 infections d/t trichomonads or bacterial vaginosis -bimanual exam to look for evidence of pelvic infection ** cervical motion tenderness Q: Vulvovaginal candidiasis Answer: -R/F include pregnancy, DM, use of broad spectrum abx or corticosteroids -Heat, moisture, occlusive clothing increase risk Q: Vulvovaginal candidiasis: S&S Answer: -pruritus -vulvovaginal erythema -white, curd like discharge not malodorous -Microscopic exam with 10% potassium hydroxide= hyphae and spores -culture swab with Nickerson medium or for PCR testing if candida is suspected but not demonstrated