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NR 511 Final Exam Study Guide ü Topics and content on guides are intended to focus student attention when reading/studying and some topics may be repeated in multiple chapters. ü Multiple test items are derived from the same topic areas to encourage deeper comprehension. ü Students must have a broad understanding of content and not simply memorize passages in textbooks or articles. ü Information contained in the chapters as well as boxes and tables within the chapters may include test items. ü Exam questions represent various levels of cognitive learning. You are expected to analyze, synthesis, and evaluate patient scenarios in order to answer the questions. ü Students are expected to use clinical decision making to prioritize treatment actions based on the information provided in the exam question. ü Read all of the answers BEFORE reading the stem of the question. This will help you focus on the key content and not get distracted by extraneous information. Once you have selected your answer, read the question one more time to ensure that the best answer has been chosen. ü Utilize your time well by not rushing. You will have plenty of time to read each question for understanding before you select your final answer. Chapter 38 Common Abdominal Complaints Work-up of abdominal pain (including differential diagnoses) Assessment, diagnosis and management of diarrhea and constipation Strategies for managing chronic constipation Work-up of heart burn Assessment techniques for abdominal assessment Chapter 39 Infectious Gastrointestinal Disorders Assessment, diagnosis and management of appendicitis Signs and symptoms for diagnosing appendicitis Assessment, diagnosis and management of gastroenteritis Gastrointestinal assessment techniques Signs and symptoms of ischemic colitis Rotavirus infection Treatment for Giardia Chapter 40 Gastric and Intestinal Disorders Rome IV Criteria Assessment, diagnosis and treatment of inflammatory bowel disease Assessment, diagnosis and management of diverticulitis Assessment, diagnosis and management of gastroesophageal reflux disease (GERD) Assessment, diagnosis and management of peptic ulcer disease Diagnostic test to confirm peptic ulcer disease Assessment, diagnosis and management of irritable bowel syndrome Diagnosing Irritable bowel syndrome CT scan with contrast is highly sensitive and specific for diagnosing acute abdominal conditions, including diverticulitis, appendicitis, and other intra-abdominal pathologies. When is it appropriate to order a colonoscopy? Chapter 41 Gallbladder and Pancreatic Disorders • Signs and symptoms of acute cholecystitis Chapter 62 Hematological Disorders Risk factors, assessment, diagnosis and management of anemias Anemia of chronic disease and relationship to chronic kidney disease Expected lab values for the various anemias Iron supplementation instructions Differential diagnoses for the various anemias (e.g. differentiating between iron deficiency anemia and anemia of chronic disease) Hemolytic anemia and Glucose-6-phosphate dehydrogenase (G6PD) deficiency Sickle cell crisis-what it is, how to recognize it; parent teaching Signs and symptoms of splenic sequestration Chronic Lymphocytic Leukemia (CLL) prevalence Diagnosing acute lymphoblastic leukemia (ALL) and when to refer to oncologist Secondary cancer in children receiving radiation therapy for acute lymphocytic leukemia (ALL) Assessment, diagnosis, management and referral for leukemia Role of serum ferritin level in evaluating and managing microcytic hypochromic anemia Chapter 44 Urinary Tract Disorders Assessment, diagnosis and management of urinary incontinence Management of stress incontinence Assessment, diagnosis and management of overactive bladder Assessment, diagnosis and management of urinary tract infection Signs and symptoms of pyelonephritis Signs and symptoms of cystitis Signs and symptoms of urethritis Chapter 46 Common Reproductive System Complaints-Nocturia in Men & Testicular Pain Using elements of the physical examination as diagnostic tests Evaluating diagnostic tests Critically appraising clinical evidence Communicating clinical evidence to patients Age of men who should be screened for HIV based on age and risk factors Chapter 49 Prostate Disorders Prostate screening Assessment, diagnosis and management of prostate cancer Assessment, diagnosis and management of benign prostatic hyperplasia (BPH) When to refer the patient for prostate biopsy Signs and symptoms that diagnose BPH Patient teaching following prostate surgery Assessment, diagnosis and management of acute and chronic bacterial prostatitis Chapter 50 Penile and Testicular Disorders Assessment, diagnosis and management of priapism Management of hypospadias Signs and symptoms that diagnose epididymitis Phimosis Diagnosing testicular torsion Pharmacological agents that contribute to erectile dysfunction Assessment, management and patient teaching regarding undescended testes Diagnosing varicocele Chapter 53 Common Musculoskeletal Complaints Assessment and diagnosis of patients with acute and chronic low back pain Causes and evaluation of shoulder pain Differential diagnoses for shoulder pain and stiffness Evaluating shoulder pain for rotator cuff issue; positive drop arm test Signs and symptoms of carpal tunnel syndrome (Phalens’ and Tinel’s sign) Assessment of ankle sprains and strains Degrees of ankle sprains Signs and symptoms of ankle fracture Musculoskeletal assessment techniques to evaluate an ankle and knee injuries What does a positive McMurray’s sign diagnose? Positive Lachman and anterior drawer test- what does it diagnose? Evaluation of hand pain Work-up of a cervical neck sprain What test is necessary when finding a positive Spurling maneuver and decreased biceps reflex Evaluating peripheral neuropathy Role of gabapentin in treating both neuropathic pain and focal seizures Meaning of a Positive Thompson test and how to manage Chapter 54 Spinal Disorders Assessment, diagnosis and management of herniated disc Work-up of a spinal fracture Assessment, diagnosis and management of spinal stenosis Diagnosing spinal stenosis Assessment, diagnosis and management of cervical spondylosis Risk factors and assessment of vertebral fractures Chapter 55 Soft Tissue Disorders Assessment and diagnosis of carpal tunnel syndrome Work-up and management of myofascial pain Treating myofascial pain Assessment, diagnosis and management of tendonitis Chapter 75 Common Injuries Assessment and management of animal bites Pasteurella multocida and cat bites Signs and symptoms of a spider bite First-line treatment for high-risk bite wounds-which antibiotic- Evaluating a patient’s tetanus status Assessment, diagnosis and management of wounds and injuries (including abscesses and lacerations) Best treatment option for an abscess Other Notes: The patient taking desiccated thyroid (e.g., Armour Thyroid) should be switched to levothyroxine, the synthetic form of T4, as the preferred treatment for hypothyroidism. The hormone content in desiccated thyroid can vary between batches, leading to inconsistent therapeutic effects and potential overtreatment or undertreatment. Levothyroxine, a synthetic T4, provides a stable, standardized, and predictable dose, ensuring better control of thyroid hormone levels. Although some older patients who have been treated for many years with desiccated thyroid are wary of changing medications after decades of replacement therapy at stable doses, few clinicians in the United States will start new patients on these preparations. They should not be used for patients with underlying cardiac disease, given the varied concentrations of highly active T3, which poses a greater risk of overreplacement and iatrogenic thyrotoxicosis. For a patient experiencing unpredictable blood glucose readings and an increase in hypoglycemic episodes while using Novolin N (NPH insulin) twice daily, a good alternative would be a long-acting basal insulin such as insulin glargine (Lantus, Basaglar) The oral diabetic agent most likely causing hypoglycemia is a sulfonylurea, such as glipizide Haloperidol given for psychotic-like crisis can cause involuntary muscle contractions of his neck, jaw, and tongue muscles.
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