Final Exam: NR 577 (NR577) |Latest 2023/ 2024| Primary Care Management of Adolescents and Adults Final Exam Review| Guide with Verified Answers

Final Exam: NR 577 (NR577) |Latest 2023/

2024| Primary Care Management of

Adolescents and Adults Final Exam Review|

Guide with Verified Answers

Q: Signs and symptoms of concussion

Answer:

headache drowsiness

dizziness sensitivity to light memory difficulties difficulty concentrating feeling slowed down

Q: When is a CT scan warranted for concussions

Answer:

CT scan to evaluate for hemorrhage is recommended for patients who are over 60, patients who

are on anticoagulants, or patients with:

vomiting

persistent short-term memory loss drug/alcohol intoxication

post-injury seizure persistent headache

Q: What should you observe patients for who have a concussion

Answer:

loss of consciousness

increasing headache repeated vomiting slurred speech confusion

unusual behaviors seizures

limb weakness or numbness

The presence of any worsening symptoms requires emergency care.

Q: Immediately after injury (for concussions)

Answer:

Conduct serial assessments since signs and symptoms may not appear for minutes to hours after

the injury or may evolve over time.

Apply guidelines for assessment and management that support the use of a multi- disciplinary

approach including qualified sports medicine specialists.

Use the Balance Error Scoring System (BESS) assessment tool at the sideline to objectively

assess balance after a concussion.

Q: How do you grade a TBI

Answer:

Glasgow coma scale (GCS)

Q: Mild injury on GCS

Answer:

Mild injury: GCS 13-15

Q: Moderate injury on GCS

Answer:

Moderate injury: GCS 9-12

Q: Severe injury on GCS

Answer:

Severe injury: 3-9

Q: Chronic Traumatic Encephalopathy (CTE)

Answer:

a degenerative brain disease caused by repeated head trauma. CTE is seen in athletes, such as

boxers and football players, and veterans

Q: s/s of Chronic traumatic encephalopathy

Answer:

depression confusion

irritability impulsivity aggression memory problems attention problems

poor decision-making

Q: Impetigo

Answer:

begins as a small, erythematous macule (commonly the face) that evolves into a vesicle beneath

the stratum corneum. The thin-roofed collection of fluid ruptures easily, leaving denuded, oozing

areas. A honey-colored crust forms as the fluid dries and collects. Intense erythema at the base of

the pustule. New lesions appear in the same location, and they coalesce. When the honey-colored

crusts are removed, the skin appears raw and glistening. Individual lesions usually do not exceed

2 cm in size. Impetigo is seen most frequently in children, but it also occurs in adults, especially

those with poor hygiene.

Q: Tx of imeptigo

Answer:

The crusts of impetigo should be debrided to expose the skin surface where bacteria are present.

The use of a washcloth for this purpose is rec- ommended. Furuncles and carbuncles are treated

with hot compresses to enhance drainage. Fluctuant lesions with abscess formation usually

require incision and drainage. Sometimes, packing of the wound is necessary. With exudative

lesions, drying compresses are required to remove detritus and desiccate the lesion. Saline

solution, tap water, or Burow solution (aluminum acetate) may be applied for 10 to

20 minutes three to four times a day.

Q: Scabies

Answer:

Transmission is through close personal contact, either sexual or non- sexual. Patients usually

present with intense pruritus, which is often more severe during the night. Eighty-five percent of

infested persons have burrows on the fingers, interdigital areas, and wrists; these appear as linear

marks a few millimeters in length.

Q: Dx of scabies

Answer:

A skin scraping is performed by placing a drop of mineral oil on a suspicious lesion, shaving off

the roof of the burrow with a scalpel, scraping the base to remove the contents, and placing the

material on a microscope slide with cover slip.

Q: tx of scabies

Answer:

Permethrin 5% cream, which is synthetically derived from the chrysanthemum flower, is the

FDA-approved and first-line treatment for scabies for patients aged 2 months and older.

Q: Head lice

Answer:

The diagnosis is made by direct examination of the involved areas. Few adult lice are found at

the bases of the hairs, but many nits are typically seen. Both are usually visible to the naked eye,

but a hand lens and bright light may help. Nits appear as gray or white specks attached to the hair

shafts.

Q: Lice tx

Answer:

Permethrin 1% cream rinse shampoo is the first-line treatment for pedicu- losis and can be

obtained over the counter. Only permethrin has activity against eggs because it retains residual

activity for 2 weeks and remains on the hair for 14 days after treatment, thereby killing hatched

eggs. Some physicians still recommend that a second permethrin treatment be given 1 week after

the first, for maximum cure rate.