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12 Tips for Succeeding in Clinical Rotations: Practical Advice from Preceptors

Clinical rotations provide NP students with the real-life practice experience they need to transition from student to clinician. This month a group of Fitzgerald faculty contributed their tips and advice about how to get the most out of your rotations and get a start on a successful NP career. Read More

Certification Q&As: Feature Test Question Analysis

Studying content and concepts is critical to preparing for the NP certification exam. Dr. Fitzgerald provides important insights on the proper analysis of the exam questions to increase your likelihood of success. Read More

Communicating with Patients, Parents, and Caregivers About Vaccination

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

Vaccine hesitancy—the refusal, delay, or acceptance of vaccines but with concern about them—poses a potential public health problem because vaccine refusal or delay by even a small percentage of patients can lead to disease outbreaks. Dr. Fitzgerald offers advice about improving clinician-patient communication, which is key to overcoming parents’/patients’ resistance to vaccination. Read More

Certification Q&A: Top Diagnoses in Primary Care Offices

Using data from national surveys of primary care office visits, Dr. Fitzgerald presents the top 20 diagnoses to learn evaluation, diagnosis, and treatment of, so that you can be prepared for the family or the adult-gerontology-primary care NP certification exams. Read More

Certification Q&As: Costs Related to Practice

Once you complete your NP program and prepare to enter NP practice, there are several additional steps you must take, such as obtaining national certification, state licensure, malpractice insurance, and a Drug Enforcement Agency registration number. Dr. Fitzgerald explains the various fees and expenses you will incur for these necessities. Read More

Maintaining NP Certification: Family, Adult-Gerontology Primary Care, & Emergency

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

Recertification requirements are dynamic, and you must fulfill the requirements of the year of recertification for your certifying organization. Dr. Fitzgerald helps you set a plan for meeting their requirements with an overview of the current recertification requirements for family, adult-gerontology primary care, and emergency NPs. Read More

NP Clinical Preceptors: Challenges and Opportunities

The rapid expansion of NP programs over the past 20 years has led to a shortage of clinical preceptors. who provide a vital link between NP curriculum and clinical application, and are thus essential to NP education and the ongoing success of the NP profession. Dr. Fitzgerald discusses common challenges associated with preceptorship and reviews strategies for successful precepting. Read More

Providing Competent Care for Transgender Patients

No matter whom they serve, all clinicians should be well-versed in caring for vulnerable populations. As more patients begin identifying as non-binary or gender nonconforming, it’s vital for clinicians to educate themselves on the appropriate care of the LGBTQA+ community. Read More

Monkeypox: What We Know Now and What We Are Learning

Vanessa Pomarico-Denino, EdD, FNP-BC, FAANP

First identified in 1970, monkeypox became a global public health concern in 2022 and was declared a public health emergency on August 4. Learn more about transmission, symptoms, and treatment options. Read More

Appropriate Antibiotic Prescribing for Acute Respiratory Infections

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

Inappropriate use of antibiotics leads to the spread of antibiotic resistance and puts patients at risk for adverse events. Up to half of antibiotic prescriptions for acute respiratory tract infections (ARTIs) are unnecessary because they are prescribed for viral infections.. Dr. Fitzgerald discusses the clinical management of ARTIs based on current CDC guidelines that were developed to promote appropriate antibiotic prescribing for these infections. Read More

COVID-19 Vaccine Hesitancy Among Parents: NPs’ Role in Disseminating Facts, Debunking Myths

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

Pediatric uptake of COVID-19 vaccination remains low. One survey found that 30% of parents of both teens and younger children said they “definitely” will not get their child vaccinated for COVID-19. Dr. Fitzgerald examines the reasons behind parents’ reluctance to vaccinate children against COVID-19 and explains how to work with parents and caregivers to increase pediatric COVID-19 vaccination rates. Read More

Gender Diverse Individuals and Clinical Preventive Services: Addressing Access to Treatment and Healthcare Experiences of LGBTQIA+ People

There are more than 11 million individuals in the United States who identify as lesbian, gay, bisexual, transgender, queer, intersex, or asexual—a group NIH identifies as a “health disparity population.” Recent guidance from the US Preventive Services Task Force and the Kaiser Family Foundation will help healthcare providers better understand the healthcare needs of this population and address barriers to their care. Read More

Cognitive Errors in Clinical Diagnosis: Representativeness

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

Find out if you can avoid the diagnostic error featured in this case. In the latest article in the cognitive errors series, Dr. Fitzgerald addresses the cognitive elements involved in misdiagnoses that arise when clinicians use a cognitive heuristic (short-cut) known as representativeness, which relies on pattern recognition. Pattern recognition does make clinical decision-making more manageable, but when not accompanied by an analytic approach that overrides intuitive thinking, it can misdirect clinical reasoning and lead to diagnostic error. Read More

Evaluating and Treating Vitamin D Deficiency

Vitamin D plays an important role in many areas of health, from bone and muscle health to blood pressure control. A common problem, vitamin D deficiency is associated with many chronic diseases and may increase risk for poor COVID outcomes. Dr. Fitzgerald discusses risk factors for vitamin D deficiency, testing, diagnosis, treatment, and prevention of recurrence. Read More

Cognitive Errors in Clinical Diagnosis: Anchoring and Confirmation Bias

Can you decide what the next step should be in this case-based article? Dr. Fitzgerald addresses the case of a misdiagnosis that arises when anchoring and confirmation biases alter the clinician’s thoughts and impact their judgment. Such cognitive errors are flaws in clinical reasoning and lead to unconsciously making decisions based on intuitive judgments rather than analytical thinking. Read More

Cognitive Errors in Clinical Diagnosis: Attribution Errors

Follow this case and see if you arrive at the correct next step. Dr. Fitzgerald addresses the case of a misdiagnosis that arises when attribution errors affect the clinician’s judgment. Such cognitive errors are flaws in clinical reasoning and lead to incorrectly assigning meaning to other persons’ actions, while underestimating the influence of situational factors. Read More

Cognitive Errors in Clinical Diagnosis: Availability Bias and Premature Closure

Test your diagnostic skills and reasoning. Dr. Fitzgerald presents a case of a misdiagnoses arising when clinicians overestimate the likelihood of a diagnosis based on the ease with which it comes to mind (availability bias), and premature closure, when a clinician stops considering or exploring important alternative diagnoses. Read More

Testing for H. pylori: Which Patients, Which Test, How to Treat?

Helicobacter pylori infection can lead to chronic inflammation of the gastric mucosa and acid-related damage to the duodenal mucosa. Dr. Fitzgerald discusses current guideline recommendations on diagnosis, testing, and treatment for H. pylori infection. Read More

The Use of Aspirin in the Primary Prevention of Cardiovascular Disease

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

The US Preventive Services Task Force updated its recommendations on the use of aspirin to reduce the risk of cardiovascular events in adults ages 40 years or older without signs or symptoms of cardiovascular disease (CVD) or known CVD, and who are not at risk of bleeding. Find out what the update’s important changes are on the use of aspirin for those at increased risk of cardiovascular disease. Read More

AAN Updated Guideline for Treatment of Painful Diabetic Neuropathy: Top Takeaways

The American Academy of Neurology (AAN) issued an update of its practice guideline on oral and topical treatments for painful diabetic neuropathy (PDN). Here are the top takeaways to help provide clinicians with guidance to better tailor a treatment plan to each person living with PDN, focusing on the four classes of oral medications that have demonstrated evidence of pain reduction. Read More

Diagnosis & Evaluation of Chest Pain in Adults: Top Ten Take-Away Points

Here are ten of the most important take-away points from the updated clinical practice guideline from The American Heart Association and American College of Cardiology. It provides guidance to better evaluate patients presenting with chest pain, identify patients who may be having a cardiac emergency, and then select the right test or treatment for the right patient. Read More

CDC Updates Recommendations for 2021-22 Influenza Season

The CDC’s Advisory Committee on Immunization Practices (ACIP) issued its updated recommendations for the use of seasonal influenza vaccines for the 2021-22 influenza season, which will coincide with the continued circulation of SARS-CoV-2, the virus that causes COVID-19. Read highlights of the ACIP’s recommendations for clinicians during this year’s flu season. Read More

Sudden Cardiac Arrest in Young

The American Academy of Pediatrics (AAP) has updated its 2012 policy statement for primary care providers (PCPs) on prevention of sudden cardiac arrest (SCA) and sudden cardiac death (SCD) in young people. The update includes a comprehensive review of conditions that should prompt more attention and cardiology evaluation. Read More

2021 Sexually Transmitted Infections Treatment Guidelines

The guidelines for the treatment of people who have, or are at risk for, sexually transmitted infections (STIs) have been updated by the Centers for Disease Control and Prevention (CDC). The previous guideline was published in 2015. The CDC recently reported that the number of STIs in the United States reached an all-time high for the sixth consecutive year. Read More

AHA/ASA 2021 Guideline for the Prevention of Secondary Stroke

The American Heart Association/American Stroke Association (AHA/ASA) issued its most recent guideline for the prevention of stroke in patients with previous stroke and transient ischemic attack (TIA). The last guideline was published in 2014. The overall message of the 2021 update is that the risk of second stroke can be reduced with prevention efforts based on the cause of the first stroke. Read More

New USPSTF Recommendations for Colon Cancer Screening

The US Preventive Services Task Force (USPSTF) issued an update to its colorectal cancer (CRC) screening guideline that includes a recommendation lowering the age at which to start screening US adults at average risk from the current recommendation of age 50 to age 45. The new recommendation matches that of the American Cancer Society. Read More

GINA Releases Updated Asthma Guidelines for 2022

Learn more about the Global Initiative for Asthma’s latest guidelines in the 2022 Global Strategy for Asthma Management and Prevention, including refined methodology and updated definitions. Read More

NP Settles Civil Suit for “Unlawfully Advertising As ‘Doctor’”

An NP from California has settled a civil case with the District Attorney, agreeing to an injunction and nearly $20,000 in civil penalties for allegedly implying that she was a medical doctor. Read More

California Approves Rule Change to Allow NPs to Treat Without Physician Supervision

The California Board of Registered Nursing has approved rules which will allow qualified nurse practitioners to treat patients independently of a physician’s supervision, provided they “practice within the limits of their knowledge, experience, and national certification.” Read More

Healthcare Providers Dismiss Challenge to Ruling in No Surprises Act

The AHA weighs in on the recent adjustment to the rule governing the independent dispute resolution process in the No Surprises Act, which expands restrictions on charging healthcare plan holders out-of-network rates for certain services. Read More

ICAN Act Proposes Increased Access to NP Services

Introduced to Congress in 2022, the Improving Care and Access to Nurses (ICAN) Act proposes to increase access to services provided by advanced practice registered nurses under the Medicare and Medicaid programs. Read More

Modified MVA Vaccine Used in Monkeypox Post-Exposure Prophylaxis

The modified vaccinia virus Ankara (MVA) is being used for post-exposure prophylaxis among individuals with known or likely exposure to the virus. Read More

Updated COVID-19 Vaccine Recommendations for Children and Test Results for Omicron Subvariant Boosters

The CDC has expanded the use of updated (bivalent) COVID-19 vaccines to children ages 5 through 11 years. Additionally, Pfizer and BioNTech have adapted their COVID-19 vaccine booster for the BA.4 and the BA.5 subvariants of Omicron. Read More

Nonstimulant Approved for Adult ADHD

The FDA approved the use of viloxazine (Qelbree) extended-release capsules for adults 18 years of age and older with attention deficit/hyperactivity disorder. Read More

FDA Approves Topical Cream for Inflammatory Rosacea

The FDA approved benzoyl peroxide 5% cream (Epsolay) for adults with inflammatory lesions of rosacea. Read More

Drug Approved for Recurrent Vulvovaginal Candidiasis

Oteseconazole (Vivjoa) was approved by the FDA to reduce the incidence of recurrent vulvovaginal candidiasis (RVVC) in females with a history of RVVC who are not of reproductive potential. Read More

FDA Approves Two Products for H pylori Infection

The FDA approved vonoprazan, amoxicillin, and clarithromycin (Voquezna Triple Pack) and vonoprazan, amoxicillin (Voquezna Dual Pak) for the treatment of Helicobacter pylori infection in adults. Read More

Topical Medication for Plaque Psoriasis in Adults Approved by FDA

The FDA approved tapinarof cream 1% (VTAMA), a steroid-free topical cream applied once daily for the treatment of mild, moderate, or severe plaque psoriasis in adults. Read More

New York and Kansas Grant Full Practice Authority to NPs

Nurse practitioners licensed in New York and Kansas are now fully able to practice independently, joining 24 other states, the District of Columbia, and two US territories in adopting Full Practice Authority legislation. Read More

FDA Approves First Sublingual Medication for Agitation in Serious Mental Illness

The FDA approved dexmedetomidine (Igalmi) sublingual film for the acute treatment of agitation associated with schizophrenia or bipolar I or II disorder in adults. Read More

Semaglutide 2 mg Approved for Additional Glycemic Control in T2D

The FDA approved a 2-mg dose of semaglutide (Ozempic) for additional glycemic control in people with type 2 diabetes. Read More

CDC: STDs Continued to Increase During First Year of COVID-19 Pandemic

The CDC announced that sexually transmitted diseases (STDs) continued to increase during 2020, the first year of the COVID-19 pandemic. Read More

CDC Warns of Severe Hepatitis and Adenovirus Infections in Children

The CDC issued a Health Alert Network Health Advisory to notify clinicians and public health authorities of a cluster of children with hepatitis and adenovirus infection. Read More

WHO Panel Concludes That a Single Dose of HPV Vaccine is Protective

The World Health Organization’s immunization panel announced that there is enough evidence to conclude that a single dose of Human Papilloma Virus (HPV) vaccine will protect girls ages 9 to 20 years from cervical cancer. Read More

PreHevbrio Hepatitis B Vaccine Now Available for Adult Hepatitis B Vaccination

Hepatitis B vaccine (recombinant) (PreHevbrio ) is now available for the prevention of infection caused by all known subtypes of hepatitis B virus (HBV) in adults 18 years of age and older. Read More

FDA Warns of Risks Associated with Noninvasive Prenatal Screening Tests

The FDA is warning the public of the risk of false results, inappropriate use, and inappropriate interpretation of results with noninvasive prenatal screening tests. Read More

Vaccination Coverage in School Children Fell During the Pandemic

During the 2021-22 school year, vaccination coverage among kindergartners nationwide was lower than during the 2019-20 school year. Read More

New Migraine Treatment Approved in Adults

Celecoxib oral solution (Elyxyb) was approved for the acute treatment of migraine with or without aura in adults. Read More

FDA Approves Treatment for Wider Range of Patients With Heart Failure

The FDA approved empagliflozin (Jardiance) to reduce the risk of cardiovascular death and hospitalization for heart failure in adults. Read More

Carbidopa/Levodopa Fractional Tablet Now Available for Parkinson’s Disease

A carbidopa/levodopa tablet formulation (Dhivy) designed to ease dose adjustment is now available for the treatment of Parkinson’s disease. Read More

FDA Approves New Indication for IL-23 Inhibitor for Adults With Active Psoriatic Arthritis

Risankizumab-rzaa (Skyrizi) is now approved for the treatment of adults with active psoriatic arthritis. Read More

National NP Practitioner Residency & Fellowship Training Consortium Receives Federal Recognition as Accrediting Agency

The National Nurse Practitioner Residency & Fellowship Training Consortium received federal recognition as an accrediting agency by the US Department of Education, which granted the Consortium initial recognition for a period of five years. Read More

New Medication Spray Approved for Seasonal Allergic Rhinitis

The FDA approved olopatadine hydrochloride/mometasone furoate (Ryaltris) nasal spray, a combination histamine-1 (H1) receptor inhibitor/corticosteroid, for the treatment of symptoms associated with seasonal allergic rhinitis in adults and pediatric patients 12 years of age and older. Read More

Rivaroxaban (Xarelto) Approved for Pediatric Indication to Help Prevent, Treat Clots

The FDA approved two new pediatric indications for rivaroxaban (Xarelto), a factor Xa anticoagulant, including treatment of venous thromboembolism (VTE) and reduction in the risk of recurrent VTE. Read More

CDC Issues Simplified New Recommendations for Pneumococcal Vax in Adults

The Centers for Disease Control and Prevention issued updated pneumococcal vaccine recommendations for adults that call for the use of two recently approved vaccines in a more simplified approach. Read More

First Generic of Cyclosporine Ophthalmic Emulsion Eye Drops (Restasis) Approved for Dry Eye

The first generic version of cyclosporine ophthalmic emulsion 0.05% single-use vials (Restasis) is now approved to increase tear production in patients with presumed keratoconjunctivitis sicca. Read More

Nurse Practitioner Ranked as Top Healthcare Job in 2022

Read about why U.S. News & World Report has ranked the nurse practitioner role in the top spot on its 2022 Best Health Care Jobs list, second on its 2022 100 Best Jobs list, and second on its Best STEM Jobs list. Read More

FDA Approves New Drug for Insomnia in Adults

The FDA approved daridorexant (Quviviq) 25 mg and 50 mg for the treatment of adult patients with insomnia characterized by difficulties with sleep onset and/or sleep maintenance. Read More

New Biologic Drug Approved for Moderate-to-Severe Atopic Dermatitis

The FDA approved tralokinumab-ldrm (Adbry), a biologic for the treatment of moderate-to-severe atopic dermatitis in adults 18 years of age or older whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. Read More

Add-On Therapy Approved to Lower LDL Cholesterol in High-Risk Patients

The FDA approved inclisiran (Leqvio) injection as an adjunct to diet and maximally tolerated statin therapy for the treatment of heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease in adults who require additional lowering of low-density lipoprotein cholesterol. Read More

FDA Approves Three-Antigen Hepatitis B Vaccine

The FDA approved a new hepatitis B vaccine (PreHevbrio) for the prevention of infection caused by all known subtypes of hepatitis B virus in adults 18 years of age and older. Read More

Vaginal Gel Approved for Bacterial Vaginosis

The FDA approved clindamycin phosphate vaginal gel, 2% (Xaciato), for the treatment of bacterial vaginosis in females 12 years of age and older. Read More

Shingrix for Immunocompromised Adults Ages 19+

The CDC’s Advisory Committee on Immunization Practices (ACIP) voted unanimously to recommend two doses of Zoster Vaccine Recombinant (Shingrix) for the prevention of shingles and its complications in adults 19 years of age and older who are or will be immunodeficient or immunosuppressed due to disease or therapy. Read More

Pneumococcal Vax Guideline Update

ACIP voted in favor of updates to the pneumococcal vaccination recommendations for certain adults 65 years of age and older and for adults 19 to 64 years of age with certain underlying health conditions or other disease risk factors. Read More

Hepatitis B Virus/Ebola/Smallpox, Monkeypox Immunizations

ACIP updated its recommendations for hepatitis B virus, ebola, smallpox, and monkeypox immunizations. Read More

Younger Patients Now Indicated for Asthma Drug

The FDA expanded the indications for dupilumab (Dupixent) to include add-on maintenance treatment of patients 6 to 11 years of age with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticoid-dependent asthma. Read More

First Liquid Topiramate Formulation Approved for Seizure Indication

The FDA authorized the first ready-to-use liquid formulation of topiramate (Eprontia oral solution) for partial-onset, primary generalized tonic-clonic seizures. Read More

USPSTF Draft Changes Aspirin Recommendation for Primary Prevention of CVD Events

A draft recommendation posted by the US Preventive Services Task Force proposes changes in the current recommendation on the use of aspirin for the primary prevention of cardiovascular disease. Read More

In a First, FDA Allows Marketing of Three New ENDS E-Cigarette Products

The FDA authorized the marketing of three new tobacco products, the first set of electronic nicotine delivery system (ENDS) products ever to be authorized by the FDA through the Premarket Tobacco Product Application pathway. Read More

Undergrad Nursing Programs Included in College Ranking for First Time

U.S. News & World Report’s undergrad college rankings now include undergraduate nursing programs conferring the BSN degree. Read More

Mirena IUD Now Approved for Pregnancy Prevention Up to 7 Years

The Mirena levonorgestrel-releasing intrauterine device was approved by the FDA for up to 7 years of pregnancy prevention. Read More

FDA Approves Treatment of Severe Hypoglycemia That Does Not Need Reconstitution

The FDA approved Gvoke Kit for the treatment of hypoglycemia in pediatric and adult patients with diabetes 2 years of age and older. Read More