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QUESTION 72 Hgb 10

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QUESTION 72 Hgb 10.3 g/dL  Hct 31%  MCV 88 fL  RDW 15% L.W. is a 41-year-old woman with a history of systemic lupus erythematosus which has been managed primarily with symptom control. Today she presents for evaluation of fatigue which has been slowly progressive over the last few months. She has a history of gastric bypass surgery 10 years ago and has maintained a 100 lb weight loss, but she maintains that she has been very adherent to her vitamin and mineral replacement regimen. Other than chronically heavy menses, for which she takes hormonal contraception, she is without complaint. A complete blood count is as follows: 

The AGACNP suspects that the patient's fatigue is most likely due to:

A. Iron deficiency anemia

B. Anemia of chronic disease

C. Pernicious anemia

D. Folic acid deficiency

 

QUESTION 73

1.      A patient presents for follow up after being started on an ACE inhibitor for hypertension. Her blood pressure has improved, but her pulse is 56 b.p.m down from 76 b.p.m. at her last visit. The AGACNP knows that the patient should assessed for:

 

A. Hypercalcemia

B. Hypernatremia

C. Hyperkalemia

D. Hyperchloremia

 

QUESTION 74

1.      A young-adult male patient was dropped off outside of the emergency department and some staff members brought him inside. The patient is restless, irritable, and either unwilling or unable to participate in her own care. No history is available. His vital signs are essentially stable, finger stick blood sugar is 111 mg/dL, there are no signs of trauma, and no physical findings consistent with common drug or alcohol use. A toxicology screen is pending. The AGACNP orders acute psychiatric stabilization with a combination of haloperidol and lorazepam and considers which of the following mediations to decrease the risk of adverse effects?

 

A. Risperidone

B. Olanzapine

C. Benztropine

D. Zolpidem

 

QUESTION 75

1.      Amy is a 21-year-old female who presents with acute nephrolithiasis. CT scan reveals a 2 mm stone in the left ureter. The AGACNP knows that the appropriate course of action is:

 

A. Pain control and IV fluid

B. Consultation for stent placement

C. Lithotripsy stone destruction

D. Transurethral stone destruction

 

QUESTION 76

1.      B.T. is a 49-year-old male being admitted for lung volume reduction surgery. His preoperative pulmonary function tests are as follows:

FVC 66% predicted

FEV1 60% predicted

PEFR 69% predicted

TLC 104% predicted

RV 90% predicted

The AGACNP knows that the pulmonary function studies are consistent with:

A. Mild restrictive disease

B. Moderate restrictive disease

C. Mild obstructive disease

D. Moderate obstructive disease

  

QUESTION 77

1.      A 30-year-old male patient presents for evaluation of a lump on his neck. He denies pain, itch, erythema, edema, or any other symptoms. He is concerned because it won't go away. He says, "I noticed it a few months ago, then it seemed to disappear, and now it is back." The AGACNP proceeds with a history and physical exam and concludes which of the following as the leading differential diagnosis?

A. Subclinical infection

B. Non-Hodgkin's lymphoma

C. Catscratch disease

D. Syphilis

 

QUESTION 78

1.      Ms. Teller presents with a chief complaint of weight loss. She reports an unplanned 10 lb weight loss over the last 5-6 months. She has no significant medical history, but review of systems reveals bilateral shoulder discomfort and some impaired range of motion—she has trouble pulling clothing over her head. Over the last few months she has generalized upper body stiffness, but seems to get better after an hour or so of activity. When considering a diagnosis of polymyalgia rheumatica, laboratory assessment may be expected to reveal:

A. An erythrocyte sedimentation rate (ESR) of 75 mm/hr

B. A microcytic, hypochromic anemia

C. Elevated liver function enzymes

D. Positive antinuclear antibodies