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Nursing AANP Family Nurse Practitioner (AANP-FNP) Sample Questions (Q100-Q105):NEW QUESTION # 100
As an FNP you would recognize that your patient with herpangina should be treated for as long as he or she is symptomatic. How long would you expect the course of this disease would be?
- A. 3 - 5 days
- B. 10 days
- C. 2 - 3 weeks
- D. within one month
Answer: A
Explanation:
Herpangina is typically a self-limiting disease, characterized primarily by small, painful ulcers and sores (lesions) in the mouth. These symptoms are often accompanied by fever, a sore throat, and sometimes a runny nose or cough, collectively known as coryza. As an acute viral illness, herpangina is most commonly caused by Coxsackievirus A, a type of enterovirus. The virus spreads primarily through contact with respiratory droplets or the fecal-oral route, making it more prevalent among young children, who are less likely to maintain good hygiene.
The typical duration for herpangina is relatively short. Symptoms generally appear suddenly and can be quite severe, but they resolve quickly, usually within 3 to 5 days. This rapid resolution of symptoms is due to the body's immune response effectively combating the virus. During this period, supportive care is essential to help manage symptoms and ensure hydration, especially since painful mouth sores can make eating and drinking uncomfortable.
Treatment for herpangina focuses primarily on symptom relief. This can include the use of over-the-counter pain relievers such as acetaminophen or ibuprofen to reduce fever and alleviate pain. Additionally, mouthwashes or sprays that numb pain can help relieve the discomfort caused by mouth ulcers. It is important for caregivers to monitor fluid intake to prevent dehydration. Since herpangina is caused by a virus, antibiotics are not effective and are not prescribed.
The expected course of herpangina being 3 to 5 days is typical for uncomplicated cases. However, it is crucial for healthcare providers, including FNPs (Family Nurse Practitioners), to educate patients and caregivers about the signs of potential complications, such as dehydration or more severe infections, which could extend the duration of the illness or require more intensive medical care. Regular follow-up during the period of illness can help ensure that the patient is recovering as expected and maintaining adequate hydration and nutrition.
NEW QUESTION # 101
Which of the following parts of Medicare pays 80% of durable medical equipment such as wheelchairs and walkers?
- A. Part D
- B. Part B
- C. Part A
- D. Medicare does not pay for durable medical equipment.
Answer: B
Explanation:
The correct answer to the question of which part of Medicare pays 80% of durable medical equipment, such as wheelchairs and walkers, is Part B.
Medicare Part B is primarily responsible for covering outpatient medical services. This includes not only doctor visits and outpatient hospital services but also extends to cover necessary medical equipment. Durable medical equipment (DME) is classified under these provisions.
Medicare Part B's coverage of DME is designed to assist patients who require medical aids to perform daily activities or to manage their medical conditions. This category of equipment includes items like wheelchairs, walkers, hospital beds, and other medically necessary equipment that can be used in the home. It's important that the equipment must be prescribed by a doctor and deemed medically necessary for it to qualify under Part B.
Under Medicare Part B, once the deductible is met, Medicare typically pays for 80% of the approved amount for the durable medical equipment. The beneficiary is responsible for the remaining 20%. This cost-sharing measure ensures that the equipment is both accessible and affordable for those who need it.
It is crucial for beneficiaries to understand that not all equipment may be covered or may only be partially covered depending on specific Medicare rules. Additionally, the supplier of the equipment must be enrolled in Medicare and must meet strict standards to ensure that they are providing quality equipment and services.
In contrast, Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care, but it does not typically cover durable medical equipment. Part D of Medicare covers prescription drugs and certain supplies that are not covered under Part B, but it does not cover durable medical equipment either.
Therefore, when it comes to durable medical equipment like wheelchairs and walkers, Medicare Part B is the appropriate part under which these items are covered, generally paying 80% of the costs associated with the equipment.
NEW QUESTION # 102
You are doing a physical assessment of a female patient whose probable diagnosis is Addison's disease. If this is indeed the final diagnosis you would expect to find all but which of the following during this examination?
- A. loss of hair in the axillary and pubic region
- B. orthostatic hypotension
- C. loss of weight
- D. bradycardia
Answer: D
Explanation:
Addison's disease, also known as primary adrenal insufficiency, is a condition where the adrenal glands do not produce sufficient steroid hormones, including cortisol and aldosterone. This insufficiency leads to a variety of symptoms and signs that can be identified during a physical examination. Here, we will discuss each of the listed findings and clarify which one is not typically associated with Addison's disease.
**Loss of Weight:** Weight loss is a common symptom in Addison's disease. Due to the lack of cortisol, which plays a critical role in metabolism and the management of carbohydrates, proteins, and fats, patients often experience decreased appetite and significant weight loss.
**Bradycardia:** Contrary to what might be expected, Addison's disease is more commonly associated with tachycardia rather than bradycardia. Bradycardia, or a slower than normal heart rate, is not a typical finding in Addison's disease. Cortisol deficiency generally leads to low blood pressure, and the body often compensates by increasing heart rate, resulting in tachycardia. Therefore, bradycardia would be the finding you would not expect in a patient with Addison's disease during a physical examination.
**Loss of Hair in the Axillary and Pubic Region:** Addison's disease can also impact androgen levels, leading to changes in hair distribution. The decrease in androgens can result in the thinning or loss of pubic and axillary hair, making this a relevant finding in the assessment of someone with suspected Addison's disease.
**Orthostatic Hypotension:** This is another common finding in Addison's disease. Due to aldosterone deficiency, there is less sodium retention which can lead to a decrease in blood volume, exacerbating the issue of low blood pressure. Patients with Addison's disease often experience a significant drop in blood pressure upon standing, known as orthostatic hypotension.
In conclusion, during the physical assessment of a patient suspected of having Addison's disease, the presence of bradycardia would be unusual and not expected. The symptoms consistent with Addison's disease include weight loss, loss of hair in the axillary and pubic regions, orthostatic hypotension, and typically tachycardia, not bradycardia. Other signs to look for include hyperpigmentation of the buccal mucosa and other pressure areas, as well as muscle wasting.
NEW QUESTION # 103
Your assessment of a patient reveals a speech disturbance in which the patient is unable to comprehend spoken words and phrases. This is known as which of the following?
- A. Broca's aphasia
- B. fluent aphasia
- C. nonfluent aphasia
- D. global aphasia
Answer: B
Explanation:
The correct answer to the assessment of a patient who reveals a speech disturbance characterized by an inability to comprehend spoken words and phrases is fluent aphasia, specifically linked to an issue in Wernicke's area of the brain. This condition is also known as Wernicke's aphasia.
Wernicke's aphasia arises from damage to the posterior section of the superior temporal gyrus in the brain, which is crucial for language comprehension. Patients with this type of aphasia typically produce speech that is fluent-grammatically correct with normal rate and intonation-but it often lacks meaning or is filled with nonsensical words and phrases. This is because while their ability to produce speech remains intact, their language comprehension abilities are impaired.
Additionally, individuals with Wernicke's aphasia may demonstrate difficulty in repeating phrases or naming objects, which is a reflection of their inability to process language correctly. Despite producing fluent speech, they often do not understand spoken language directed at them and are unaware of their own errors in speech.
It is important to differentiate this from other types of aphasia such as Broca's aphasia, where patients typically have broken speech but retain better comprehension, or global aphasia where both production and understanding of language are severely affected. In clinical assessments, recognizing these differences aids in pinpointing the specific areas of brain damage and tailoring appropriate therapy and interventions for the patient.
NEW QUESTION # 104
There are signs of jaundice in the newborn that you are examining. What will you use to determine the approximate level of jaundice in this newborn?
- A. Azabo's rule
- B. George's rule
- C. White's rule
- D. Kramer's rule
Answer: D
Explanation:
To determine the approximate level of jaundice in a newborn, Kramer's rule is commonly used. This method provides an estimation of bilirubin levels based on the extent of yellow discoloration observed in different parts of the infant's body.
Kramer's rule involves visually inspecting the newborn's skin and correlating the level of jaundice based on the anatomic progression of skin yellowing. The examination should be conducted in natural light, which provides the most accurate assessment of skin color. To perform the evaluation, a healthcare provider presses on the skin to blanch it and then observes the color as the skin returns to its normal state. This blanching technique helps differentiate the yellow color of the skin caused by jaundice from the underlying skin pigmentation.
The progression of jaundice according to Kramer's rule is typically graded as follows: - Grade 1: Yellowing of the skin appears only on the face, particularly the forehead and nose. - Grade 2: The yellow color extends down to the chest and abdomen. - Grade 3: Jaundice is visible on the arms and thighs. - Grade 4: The lower extremities (legs and feet) also show yellow discoloration.
Each grade corresponds to higher levels of bilirubin in the bloodstream, with the extent of body involvement suggesting more severe jaundice. For example, if jaundice is observed only on the face (Grade 1), it suggests a lower level of bilirubin compared to jaundice that has progressed to the legs and feet (Grade 4).
It is important to note that while Kramer's rule provides a quick and non-invasive way to estimate the severity of jaundice, it is not definitive. For accurate measurement of bilirubin levels, laboratory tests such as a serum bilirubin test are necessary. Moreover, in cases where the clinical assessment and the severity of jaundice are uncertain, or if the newborn shows signs of illness, further diagnostic evaluation and intervention may be required.
NEW QUESTION # 105
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