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Nurse Practitioner Certification Examination and Practice Preparation 4th Edition, Fitzgerald, 2015 | Nurse Practitioner (NP) School Study Aid

Breastfeeding

Complete Nutrition

Antibody Protection

Bonding

Convenient

SIDS Risk Reduced

Possible Enhanced Cognitive Development

Long-Term Health Benefits

2 mins

Age 1 Year - Developmental Milestones

Pulls Up to Stand

First Steps

Drinks From an Open Cup with Assistance

Two-Finger Pincer Grasp

Understands “No”

Waves "Bye-Bye"

"Mama & Dada"

Plays Pat-A-Cake

Puts Block in Cup

Searches for Hidden Toys

2 mins

Age 2 Months - Developmental Milestones

Holds Head Up, But Unsteady

Moves Both Arms and Both Legs

Opens Hands Briefly

Tracks Objects to the Midline

Produces Sounds Aside from Crying

Reacts to Loud Noise

Social Smile

Recognizes Parents

Soothed When Spoken to or Picked Up

2 mins

Age 18 Months - Developmental Milestones

Walks Independently

Climbs On/Off Furniture Without Help

Drinks from Open Cup Independently

Scribbles

Eats with Fingers

Tries to Use a Spoon

Stacks Three Blocks

Attempts Three-word Phrases

Follows One-step Commands

Checks While Moving Away

Points to Objects

Engages With Toys Simply

Copies Parent Doing Chores

Extends Hands for Washing

2 mins

Age 4 Months - Developmental Milestones

Keeps Head Steady Without Support

Pushes Up on Elbows While on Tummy

Holds a Toy in Hands

Moves Hands Towards Mouth

Cooing

Turns to Voice

Chuckles

Enjoys Looking Around

Looks at Hands With Interest

Opens Mouth When Hungry

2 mins

Age 6 Months - Developmental Milestones

Sits Propped Up On Hands

Rolls

Raking Grasp

Makes Squealing Noises

Blows "Raspberries"

Turn-Taking in Sounds

Laughs

Enjoys Looking at Self in a Mirror

Recognizes Familiar People

Closes Lips to Signal Fullness

Puts Objects in Mouth

Reaches for Desired Toys

2 mins

Age 9 Months - Developmental Milestones

Sits Up Independently

Transfers Objects Between Hands

Uses Fingers to Pull Food Toward Self

Produces Various Sounds Like "mamamama" and "bababababa"

Raises Arms to be Lifted Up

Separation Anxiety

Shows Facial Expressions

Looks When Calling Name

Smiles or Laughs at Peek-a-boo

Looks for Dropped Objects Out of Sight

Bangs Two Items Together

2 mins

Age 2 Years - Developmental Milestones

Kicks a Ball

Runs

Walks Up Stairs With Help

Stacks Six Blocks

Feeds Self With a Spoon

Two-Word Phrases

Points to Book Items as Prompted

Demonstrates Varied Gestures

Identifies Body Parts When Prompted

Shows Empathy

Holds and Manipulates Objects Simultaneously

Engages With Multiple Toys

2 mins

Age 3 Years - Developmental Milestones

Starts Dressing Independently

Rides Tricycle

Stack Nine Block Tower

Threads Items Together

Copies Circle

Uses Fork

Engages in Two-way Conversation

75% Speech Understood by Stranger

Says First Name

Avoids Hot Objects When Warned

Joins Other Kids in Play

2 mins

Age 4 Years - Developmental Milestones

Unbuttons Some Buttons

Catches a Large Ball

Serves Food or Pours Water With Help

Copies Line, Circle, Stick Figure

100% Speech Understandable

Identifies Colors

Cooperative Play

Imaginary Friends

Likes Being a “Helper”

Avoids Danger

2 mins

Fragile X

Trinucleotide Repeat

CGG Repeats

FMR1 Gene

X-linked Dominant

Developmental Delay

Autism

Large Ears

Large Jaw

Long Face

Macroorchidism

2 mins

Norepinephrine (Levophed)

Alpha Agonist

Beta-1 Agonist

Severe Hypotension

Decreases Renal Blood Flow

Arrhythmias

Hypertension

Tissue Necrosis

Last Resort Medication

2 mins

Rubella

RNA Virus

Matonaviridae

Enveloped

Icosahedral

SS Positive Linear

German Measles or Three-Day Measles

Fever

Postauricular Tenderness

Lymphadenopathy

Truncal Rash

Arthritis

Congenital TORCH Infection

2 mins

Mumps Virus

Paramyxovirus

Parotitis

Increased Serum Amylase

Orchitis

Oophoritis

Aseptic Meningitis

Pancreatitis

59 secs

Rubella TORCH

Nonspecific TORCH Symptoms

Patent Ductus Arteriosus

Pulmonary Artery Hypoplasia

Cataracts

Deafness

Blueberry Muffin Rash

Glaucoma

1 min

Rotavirus

Reovirus

Non-enveloped

Double-Stranded

RNA Virus

Linear

11 Segments

Triple Icosahedral Capsid

Most Common Cause of Diarrhea Worldwide

Villous Atrophy

Winter Months

Day Care Centers

Oral Rehydration

2 mins

Influenza

High Fever

Cough

Headache

Muscle Aches

Chills

Vaccination

Zanamivir (Relenza)

Oseltamivir (Tamiflu)

2 mins

Hepatitis B Virus Disease

Can turn chronic

< 10% of adults become chronic carriers

90% of newborns become chronic carriers

Cirrhosis

Hepatocellular carcinoma

Membranous Glomerulonephritis

Polyarteritis nodosa

Serum sickness like syndrome

2 mins

Hepatitis B Virus Characteristics

Hepadnavirus

Enveloped

Circular

Partially Double-stranded DNA

Has Reverse Transcriptase

IV Drug Use

Sex

Maternal Fetal Routes

3 Month Incubation Period

2 mins

Varicella Zoster Virus (VZV)

Herpesvirus 3

Enveloped

Double Stranded DNA

Chickenpox

Pneumonia

Encephalitis

Trigeminal and Dorsal Root Ganglia

Shingles

Tzanck Test

Multinucleated Giant Cells

Cowdry A Inclusion

Acyclovir

2 mins

Hepatitis A

Picornavirus

4 Week Incubation Period

Fecal-oral

Day Care Centers

Travel to Developing Countries

Usually Asymptomatic

Acute Disease

Jaundice

Fever

Vomiting

2 mins

Lead Antidotes

Dimercaprol

CaEDTA

Succimer

39 secs

Sturge Weber Syndrome

GNAQ Gene

Port Wine Stain

Arterial Venous Malformation

Leptomeningeal Angiomas

Intellectual Disability

Seizures

Pheochromocytoma

Glaucoma

Tram-Track Calcifications

3 mins

Atopic Dermatitis / Eczema

Pruritic Vesicles

Inflammatory Skin Rash

Cheeks in Children

Skin Flexural Areas

Associated with Asthma and Allergic Rhinitis

Tacrolimus

Moisturizers

Corticosteroids

Phototherapy

Avoid Triggers

Antihistamines

2 mins

Moraxella catarrhalis

Gram-Negative

Diplococci

Oxidase-positive

Catalase-positive

Otitis Media

Sinusitis

Chronic Obstructive Pulmonary Disease (COPD)

Bronchitis

Laryngitis

2 mins

Haemophilus influenzae Characteristics

Gram-Negative

Coccobacilli

PRP Capsule in Type B

Positive Quellung Reaction

IgA Protease

Chocolate Agar

Factor V is NAD

Factor X is Hematin

Staph Aureus Provides Factor V

2 mins

Haemophilus Influenzae Disease

Pneumonia

Cherry Red Epiglottitis

Meningitis

Otitis Media

COPD Exacerbation

Thumbprint Sign (on X-ray)

Rifampin Prophylaxis

Ceftriaxone

2 mins

Clindamycin

Bacteriostatic

Binds 50S Ribosomal Subunit

Blocks Translocation

Anaerobic Infections above the Diaphragm

Aspiration Pneumonia

Lung Abscess

Can Cause Pseudomembranous Colitis

1 min

Otitis Media Assessment

Red or Bulging Tympanic Membrane

Ear Pain

Pulling at Ear

Fever

Upper Respiratory Infection

More Common in Young Children

Eustachian Tube Narrower

Conductive Hearing Loss

Smoking Increases Risk

2 mins

Otitis Media Interventions

Antipyretics

Analgesics

Antibiotics

Irrigation

Position on Affected Side

Myringotomy

Tympanostomy Tube

2 mins

Ampicillin and Amoxicillin

Aminopenicillin

Broad Spectrum Penicillin

Gram-Positive and Some Gram-Negative Infections

Rash

Ampicillin Rash in EBV

Diarrhea

Pseudomembranous Colitis

Allergic Reaction

No Effect Against Staph Aureus

Often Combined with Beta-Lactamase Inhibitor

2 mins

Cephalosporins Overview

Beta Lactam Drug

Inhibits Cell Wall Synthesis

Bactericidal

Meningitis

MRSA

Hypersensitivity Reactions

Vitamin K Deficiency

Disulfiram Like Reaction with Alcohol

Increased Nephrotoxicity of Aminoglycosides

Extended Spectrum Beta Lactamase

2 mins

3rd Generation Cephalosporin

Cefotaxime

Ceftriaxone

Cefdinir

Ceftazidime

Pseudomonas

Serious Gram-Negative Bacteria Resistant to Other Beta-Lactams

1 min

5th Generation Cephalosporin

Beta-Lactam

Resistant Bacteria

Broad Spectrum Gram-Positive and Gram-Negative

Ceftobiprole

Has Pseudomonas Coverage

Ceftaroline

No Pseudomonas Coverage

1 min

Fluoroquinolones Antibiotics

-floxacin

Inhibits Topoisomerase II & IV

Bactericidal

Gram-negative Rods

Pneumonia

Gastrointestinal Infections

Urinary Tract Infection

Genital Infections

Levofloxacin

Ciprofloxacin

Has Pseudomonas Coverage

Avoid Polyvalent Cations

3 mins

1st Generation Cephalosporin

Cefazolin

Cephalexin

Proteus mirabilis

E. coli

Klebsiella

Gram-Positive Cocci

1 min

2nd Generation Cephalosporin

Cefoxitin

Cefaclor

Cefuroxime

Proteus mirabilis

E. coli

Klebsiella

Gram-Positive Cocci

Haemophilus influenzae

Enterobacter

Neisseria

Serratia marcescens

2 mins

4th Generation Cephalosporin

Cefepime

Increased Activity Against Gram-Positive Infections and Pseudomonas

29 secs

Infectious Mononucleosis

Herpes-like Viral Infection

Fatigue

Fever

Sore Throat

Head and Body Aches

Hepatomegaly and Splenomegaly

Swollen Lymph Nodes in Neck and Armpits

Rash

Suppressed Immune Response

Positive Monospot

2 mins

Rubeola Virus

RNA Virus

Paramyxovirus

Measles

Rash Spreads From Head to Toe

Koplik Spots First

Red Spots with Blue-White Center on Buccal Mucosa

Cough

Coryza

Conjunctivitis

Subacute Sclerosing Panencephalitis

Giant Cell Pneumonia in Immunosuppressed Patients

Warthin-Finkeldey Multinucleated Giant Cells

Vitamin A

3 mins

Roseola

Exanthem

Herpesvirus 6

Enveloped

Double Stranded DNA

Linear

High Fevers Can Lead to Seizures

Diffuse Macular Rash After Fever

1 min

Kawasaki Disease

Prevalent in Asian Children

Necrotizing Vasculitis

Fever

Strawberry-Red Tongue and Mucosa

Lymphadenopathy

Desquamative Skin Rash

Erythema and Edema of the Hands and Feet

Conjunctivitis

Coronary Aneurysm

Intravenous Immunoglobulin (IVIG)

Aspirin

2 mins

Asthma

Obstructive lung disease

Bronchial Hyperresponsiveness

History of Atopic Disease

Beta2 agonists

Corticosteroids

Curschmann's spirals

Hypertrophy of smooth muscle

Reversible

Charcot Leyden crystals

Methacholine challenge

Wheezing

Cough

Initially decreased PaCO2

Pulsus paradoxus

2 mins

Intermittent Asthma

Symptoms (Bronchoconstriction) and Rescue Inhaler Use ≤ 2 / Week

No Interference With ADLs

Nighttime Awakening < 2 / Month

> 80 % of Predicted FEV1

1 min

Persistent Mild Asthma

Symptoms (Brochoconstriction) and Rescue Inhaler Use > 2 Days / Week

Nighttime Awakening 3-4 / Month

Greater or equal to 80 % of Predicted FEV1

1 min

Persistent Moderate Asthma

Symptoms (Bronchoconstriction) and Rescue Inhaler Use Daily

Nighttime Awakening > 1 / Week

60-80% Predicted FEV1

FEV1/FVC Decreased 5%

2 mins

Persistent Severe Asthma

Symptoms (Bronchoconstriction) and Rescue Inhaler Use: Multiple/ Day

With Minimal Activity

Nighttime Awakening: Nightly

< 60% Predicted FEV1

> 5% Decrease FEV1/FVC

2 mins

Stages of Asthma Treatments

Short-acting Inhaled Beta-Agonist

Low-Dose Inhaled Corticosteroid

Montelukast (Leukotriene Receptor Antagonist)

Low to Medium-dose Inhaled Corticosteroid

Zileuton

High-Dose Inhaled Corticosteroid

Systemic Corticosteroids

Omalizumab (Allergies)

2 mins

Asthma Implementation and Education

Oxygen

Corticosteroids

Ipratropium (Anticholinergic)

Albuterol

Inhaler/nebulizer

Pulse Oximetry

Pursed Lip Breathing

Carry Inhaler

Rinse Mouth after Inhaler

Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)

2 mins

Cromolyn (Mast Cell Stabilizers)

Mast Cell Stabilizer

Asthma Prophylaxis

Bronchial Inflammation

Allergic Rhinitis

Cough

Bronchospasm

Fixed Schedule Administration

2 mins

Montelukast (Singulair)

Leukotriene Receptor Blocker

Allergic Rhinitis

Asthma Prophylaxis

Exercise Induced Bronchospasm

Fatigue

Headache

Mood Changes

Suicidal Thoughts

Increased Risk of Churg Strauss

2 mins

Theophylline

Asthma

Inhibits Phosphodiesterase

Increases cAMP

Cardiotoxicity

Neurotoxicity

Blocks Adenosine Action

53 secs

Gastroenteritis

Viruses

Bacteria

Food Intolerances

Flu-Like Symptoms

GI Distress

Bloody Stool

Oral Rehydration

Self-Limiting

Prevention

2 mins

Albuterol (Proventil)

Short-Acting Beta-2 Agonist

Bronchospasm

Asthma

Angina

Tachycardia

Tremor

1 min

Kallman Syndrome

Mutation in KAL-1 or FGFR-1 Gene

Failure of GnRH Secreting Neurons

Delayed Puberty

Anosmia

Hypogonadism

Infertility

2 mins

Ventricular Septal Defect (VSD)

Opening at Intraventricular Septum

Most Common Congenital Heart lesion

High-pitched Holosystolic Murmer (over left sternal border)

Dyspnea and Respiratory Distress

Loud Pulmonic S2

Echocardiogram

Small VSDs Close Spontaneously

Large VSDs Require Surgery

Endocarditis

Eisenmenger's Syndrome

CHF

2 mins

Atrial Septal Defect (ASD)

Hole in Septum between the Atria

Often Asymptomatic

Wide and Fixed Split S2

Cyanosis and Dyspnea

Easily Fatigued

Chest X-ray shows Increased Pulmonary Vascular Markings

Echocardiogram

Surgery if CHF as Child

Antibiotic Prophylaxis

Most Close Spontaneously

2 mins

Aortic Stenosis

Age-related Calcifications

Bicuspid Aortic Valve

Crescendo-decrescendo Murmur

Systolic Murmur

Ejection Murmur

Ejection Click

Radiates to Carotids and Apex

Pulsus Parvus et Tardus

Syncope

Helmet Cells

2 mins

Patent Ductus Arteriosus

Continuous

Machine like murmur

Often Due to Congenital Rubella

Prematurity

1 min

Sepsis Assessment

Systemic Infectious Process

Fever

Hypotension

Change in LOC

Increased WBC

Shift to the Left

Tachycardia

Tachypnea

Hyperglycemia

Edema

2 mins

Ibuprofen (Advil, Motrin)

NSAID

COX Inhibitor

General Pain

Fever

Inflammatory Conditions

GI Ulcers

Nephrotoxicity

Rash

Avoid with Alcohol

Risk of Thrombotic Event

2 mins

Common Causes of Meningitis: Children (6 Months - 6 Years)

Enteroviruses

Neisseria meningitidis

Haemophilus influenzae Type B

Streptococcus pneumoniae

2 mins

Common Causes of Meningitis: Adolescent and Adult (6 - 60 Years Old)

Enteroviruses

Herpes Simplex Virus (HSV)

Neisseria meningitidis (#1 Cause in Teens)

Streptococcus pneumoniae

1 min

Common Causes of Meningitis: Elderly (60+ Years Old)

Streptococcus pneumoniae

Gram-Negative Rods

Listeria Monocytogenes

56 secs

Aspirin

Fever

Pain and Headache

Cardiovascular Disease (CAD)

Irreversible inhibition of COX-1 and COX-2

Suppress Thromboxanes and Prostaglandins

NSAID

Reye's Syndrome

Tinnitus

Peptic Ulceration

Mixed Acidosis/Alkalosis

Nephropathy

2 mins

Common Causes of Meningitis: Newborn (0-6 Months)

Group B Streptococci

E. coli

Listeria monocytogenes

1 min

Aspirin Poisoning (Salicylism) Assessment

Nausea and Vomiting

Tinnitus

Confusion

Hyperventilation

Respiratory Alkalosis

Metabolic Acidosis

Coma

Hyperthermia

1 min

Meningitis Assessment

Nausea and Vomiting

Fever

Nuchal Rigidity

Severe Headache

Purpura

Seizures

Photophobia

Opisthotonus Position

High-Pitched Cry

Bulging Fontanel

2 mins

Meningitis Interventions

IV Antibiotics

Dexamethasone

Analgesics

Antipyretics

Closely Monitor for Increased ICP

Bed Rest

Preventative Vaccinations

Droplet-Airborne Precautions

2 mins

Streptococcus Pneumoniae Characteristics

Gram-Positive

Diplococci

Lancet-Shaped

Catalase-Negative

Optochin-Sensitive

Bile Soluble

Alpha-Hemolytic

Polysaccharide Capsule

Positive Quellung Reaction

IgA Protease

1 min

Common Causes of Pneumonia: Neonates (< 4 Weeks Old)

Group B Streptococci

E. coli

44 secs

Streptococcus Pneumoniae Disease

Sickle Cell Anemia

Sepsis in Patients with Splenectomy

Rusty Sputum

MOPS

Meningitis

Otitis Media

Pneumonia

Sinusitis

2 mins

Common Causes of Pneumonia: Children (4 Weeks - 18 Years)

Runts May Cough Chunky Sputum

RSV (Viruses)

Mycoplasma

Chlamydia pneumoniae

Chlamydia trachomatis

Streptococcus pneumoniae

1 min

Common Causes of Pneumonia: Adults (18 - 40 Years Old)

Mycoplasma

Streptococcus pneumoniae

Chlamydia pneumoniae

41 secs

Common Causes of Pneumonia: Elderly (65+ Years Old)

Influenza Virus

Haemophilus influenzae

Anaerobes

Streptococcus pneumoniae

Gram-Negative Rods

59 secs

Common Causes of Pneumonia: Middle-Aged Adults (40 - 65 Years Old)

Streptococcus pneumoniae

Mycoplasma

Haemophilus influenzae

Anaerobes

Viruses

1 min

Bordetella pertussis

Gram-Negative

Coccobacillus

Bordet-Gengou Agar

ADP Ribosylating AB Toxin

Inhibits Gi to cause Increase in cAMP

Lymphocytosis

Increase in Insulin

Catarrhal Phase is Infectious Period

Paroxysmal Phase is Symptomatic Period

Whooping Cough

Macrolides

4 mins

Trimethoprim

Bacteriostatic

Inhibits Bacterial Dihydrofolate Reductase

Causes Sequential Block of Folate Synthesis

Used in Combination with Sulfamethoxazole

Combination Used For Recurrent Urinary Tract Infections

Shigella

Salmonella

Pneumocystis Jiroveci Pneumonia

Decrease in Red and White Blood Cells

Alleviated with Leucovorin Rescue

2 mins

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