NURS 6550N MIDTERM Exam Review Guide | Walden University

NURS 6550 Midterm Exam Review (Week 1-6) Medicolegal Considerations and the Role of the Advanced Practice Nurse • Coding and billing in nursing practice o ICD-10, CPT, and E&M codes • Role of the acute care nurse p ...

NURS 6550 Midterm Exam Review (Week 1-6) Medicolegal Considerations and the Role of the Advanced Practice Nurse • Coding and billing in nursing practice o ICD-10, CPT, and E&M codes • Role of the acute care nurse practitioner o populations, limitations, common practice settings • Certification exam content areas • Informed consent • HIPPA and patient confidentiality • Radiology – appropriate orders and interpreting reports • Evaluation, differential diagnosis, diagnostic studies, and treatment options for common symptoms o Cough o Dyspnea o Hemoptysis o Chest pain o Palpitations o Lower extremity edema o Fever and hyperthermia o Involuntary weight loss o Fatigue o Acute headache o Dysuria • Assessment of the older adult • Evaluation, differential diagnosis, and treatment of geriatric disorders o Dementia  Types, differentiating different types, treatment o Delirium (how to differentiate between dementia and delirium)  Common causes, assessment, treatment o Urinary incontinence o Skin pressure injuries • Care of patients at the end of life o Symptom treatment / pain control o Decision making o DNR orders • Pain Management o Differentiate types of pain (acute, chronic, cancer) o Classes of medications to treat pain (opioids, NSAIDS, adjuvant) o Side effects and adverse effects of the medications • Medications that treat neuropathic pain o complications Psychosocial Health Conditions • Evaluation, differential diagnosis, and treatment of psychiatric disorders (review medication indications of treatment and medication complications) o Trauma and stress related trauma disorders o Anxiety disorders / panic attack  treatment o Somatic symptom disorders o Chronic pain o Personality disorders o Bipolar disorder  Long term treatment, monitoring, complications o Schizophrenia o Depression and mania (Initial treatment and common side effects to monitor for) o Substance use disorders Conditions of the Eye, Ear, Nose, and Throat • Evaluation, differential diagnosis, and treatment of eye, ENT disorders o Conjunctivitis  Differentiate between viral, bacterial, gonococcal o Infectious keratitis o Glaucoma  Acute vs chronic  Diagnosis – use tonometry  treatment o Cataract o Retinal detachment o Macular degeneration o Optic disc swelling o Ocular trauma o Corneal abrasion o Orbital cellulitis o Orbital trauma o Hearing loss  Conductive vs sensorineural o Otitis media o Cholesteatoma o Vertigo  Evaluation and treatment o Sinusitis o Nasal trauma / bleeding  Use of nasal packing o Pharyngitis / peritonsillar abscess o Epiglottitis o Salivary gland disorders o Bell’s palsy • Procedures – review the indications, procedure, and patient instructions o Eyebrow laceration repair o Woods light evaluation of the eye o Eyelid eversion o Tooth avulsion and fracture Cardiovascular Conditions • Evaluation, differential diagnosis, treatment options, and complications o Congenital heart disease  Pulmonary valve stenosis  Coarctation of the aorta  Atrial septal defect  Ventricular septal defect  Tetralogy of fallot  Patent ductus arteriosus o Valvular heart disease (differentiate each of these from the others, diagnosis, treatment, murmurs location)  Mitral stenosis  Mitral regurgitation  Mitral valve prolapse  Aortic stenosis  Aortic regurgitation  Tricuspid stenosis  Tricuspid regurgitation  Pulmonary valve regurgitation o Coronary artery disease o Angina o Coronary vasospasm (what drug class NOT to use for this dx) o Acute Coronary syndromes (NSTEMI) o Acute Myocardial infarction (STEMI)  Initial treatment  When is fibrinolytic therapy indicated  Contraindications to fibrinolytic therapy o Arrythmias  Different classes of medications  Medication indications for specific rhythms  Be able to recognize arrythmias on 12 lead EKG – review book and simulator (http://www.skillstat.com/tools/ecg-simulator#/-home)  Bradycardia / tachycardia  Superventricular tachycardia  Atrial fibrillation • Treatments including indication for anticoagulation • Be familiar with the clinical practice guideline on anticoagulation management  Ventricular tachycardia / fibrillation  Syncope o Heart failure  Differentiate systolic / diastolic failure  Review heart murmurs and their association with pathology  NY Heart rating scale  First line treatment  How treatment differs based on ejection fraction o Myocarditis o Cardiomyopathies  Differentiate between types  How assessment and treatment differs between types o Pericarditis  12 lead EKG changes seen in pericarditis  Diagnostic criteria  treatment o Endocarditis  Duke criteria  Common causes  Common symptoms o Pericardial effusion / tamponade o Pulmonary Hypertension o Hypertension  Be very familiar with practice guideline JNC 9  Target BP by age  Treatment based on co-morbidities  Hypertensive urgency / emergency – diagnostic criteria o Atherosclerotic peripheral vascular disease (symptoms)  Aortic and iliac occlusions  Femoral and popliteal occlusions  Tibial and pedal occusions o Occlusive cerebrovascular disease  Diagnosis and treatment o Abdominal aortic aneurysms o Thoracic aortic aneurysms  Monitoring and treatment guidelines o Peripheral artery aneurysms o Aortic dissection o Shock  How to differentiate between the types of shock  Be familiar with the shock guidelines via Surviving Sepsis  Hemodynamic readings related to each shock type  treatment o Thrombophlebitis o Venous insufficiency  Diagnosis and treatment o Lipid disorders  Be familiar with the 2018 practice guideline on management of blood cholesterol  Be able to use the risk calculator • Procedures o Be able and familiar with EKG interpretation o Use the simulator to practice o Know the criteria for each arrhythmia, AV block, STEMI with associated location o Defibrillation - indications and procedure Respiratory System • Evaluation, differential diagnosis, treatment options, and complications o Asthma  Be familiar with the Global Initiative for Asthma, diagnostic criteria, step wise approach to treatment  Be familiar with the FEV monitoring and intervention o COPD  GOLD classification and treatment recommendations  Indication for supplemental oxygen  Smoking cessation / stages of change o Bronchiectasis o Cystic fibrosis o Bronchitis o Pneumonia  Differentiate CAP, HAP, and VAP along with treatment changes  VAP prevention / risk factors  CURB-65 criteria o Pulmonary tuberculosis  Monitoring, when to treat, how to treat, when to report o Pulmonary neoplasms o Interstitial lung disease o Sarcoidosis o Pulmonary Embolism  Treatment – be familiar with the CHEST guidelines for anticoagulation management (2016)  Diagnosis – effectiveness of D-dimer / what effects result  Congenital risk factors o Pulmonary hypertension o Smoke inhalation o Aspiration syndromes o Pleuritis o Pleural effusion  Lab findings related to the pleural fluid o Pneumothorax o Obstructive sleep apnea o Acute Respiratory Failure  Different types of respiratory support  Ventilator management / blood gases o ARDS  Phases  Clinical symptoms o Hypothermia o Drowning o Burns o Altitude sickness o Sepsis  Be familiar with the Surviving Sepsis guidelines  Diagnosis  Monitoring  Treatment  Differentiate SIRS/Sepsis/MODS • Procedures o Peak flow meter o Pulmonary function tests  Be familiar with how to differentiate different disease  Determine baseline and disease progreassion o Stress tests o Chest xray interpretation  Review and be able to do some basic interpretation Gastrointestinal System • Evaluation, differential diagnosis, treatment options, and complications o Dyspepsia o Nausea / vomiting o Constipation /diarrhea o GI Bleeding o Ascites o Bacterial Peritonitis o GERD o Esophagitis o Esophageal lesions  treatment o Esophageal varices o Achalasia o Gastritis o PUD o Zollinger-Ellison Syndrome o Celiac disease o Acute paralytic ileus o Appendicitis o Irritable bowel syndrome o Colitis o Inflammatory bowel disease o Crohns disease o Ulcerative colitis o Diverticulitis o Jaundice o Hepatitis  Differentiate between all types  Know the serologic testing o Acute liver failure o Alcoholic liver disease o Non alcoholic fatty liver disease o Cirrhosis o Non cirrhotic portal hypertension o Cholelithiasis o Cholecystitis o Choledocholithiasis o Pancreatitis o Protein energy malnutrition o Obesity o Anorexia o Bulimia o Vitamin deficiencies o Enteral nutrition  When to use o Parenteral nutrition  When to use  complications • Procedures o Abdominal xray interpretation o Nasogastric tube insertion