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 QUESTION 79 A

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 QUESTION 79 A.Ceftriaxone and azithromycin B. Metronidazole and ciprofloxacin

When a patient has lower abdominal discomfort, cervical wall motion tenderness, and adnexal tenderness, the AGACNP knows that this will likely be treated with:

C. Trimethoprim/sulfamethoxazole

D. IV fluid and pain control

 

QUESTION 80

1.      J.L. is an 81-year-old female who is admitted from home after her daughter found her confused and unkempt. She is not a good historian, and her daughter cannot provide any information—when she saw her mother a week ago, she was fine. J.L.'s vital signs are as follows: Temperature 101.4° F, pulse 99 b.p.m., respirations 22 b.p.m., and blood pressure 90/58 mm Hg. Her urinalysis is shows +++ leukocytes, + RBC, and + nitrites. Her metabolic panel reveals a BUN of 39 mg/dL and creatinine of 1.5 mg/dL. The AGACNP knows that J.L has findings consistent with:

A. Pre-renal failure

B. Intra-renal failure

C. Post-renal failure

D. Chronic renal failure

  

QUESTION 81

Patients with giant cell arteritis are at increased risk of:

A. Cerebrovascular accident

B. Rheumatoid arthritis

C. Polymyalgia rheumatica

D. Osteoarthritis

  

QUESTION 82

1.      The AGACNP is called to the bedside for a patient who is in cardiopulmonary arrest. The monitor demonstrates ventricular fibrillation which will not convert despite several attempts to defibrillate at maximal voltage. While being briefed by the staff nurse on the patient medical history, he learns that the patient has a history of Cushing's syndrome. The AGACNP recognizes that the patient is probably failing to convert due to:

A. Advanced atherosclerotic disease

B. Hypokalemia

C. Hypocalcemia

D. Catecholamine excess

 

QUESTION 83

  When performing an evaluation of a patient following seizure activity, the AGACNP knows that the most important component of that evaluation is:

A. A CT scan of the head

B. Eyewitness description

C. An EEG

D. Administering a benzodiazepine

  

QUESTION 84

  Which of the following etiologic organisms is most likely to appear as lobar consolidation on chest radiography?

A. Legionella pneumophilia

B. Streptococcus pneumoniae

C. Pneumocystis carinii

D. Mycoplasma pneumoniae

 

QUESTION 85

A patient with chronic kidney disease presents with an eGFR of 30 mL/min/1.73m². The AGACNP knows that the most compelling implication of this value is:

A. Control of risk factors for renal deterioration

B. Careful attention to renal dosing of medications

C. Referring the patient for shunt placement

D. Preventing occurrence of renal ischemia

 

QUESTION 86

Differential diagnosis of hematuria include all of the following except:

A. Bladder cancer

B. Nephrolithiasis in the renal parenchyma

C. Urinary tract infection

D. Prerenal azotemia

 

QUESTION 87

 A 29-year-old male patient presents with acute scrotal pain and dysuria. He has a temperature of 101.8° F and a pulse of 115 b.p.m. but otherwise vital signs are within normal limits. He gets some relief of the scrotal discomfort when his scrotum is elevated on a rolled towel. This is known as:

A. Varicocele

B. Prehn's sign

C. Cremasteric sign

D. Testicular torsion

 

QUESTION 88

The AGACNP knows that patients with psoriasis are at greater risk for:

A Arthritis

B. Eczema

C. Cellulitis

D. Melanoma

 

QUESTION 89

Mr. McCarran is a 68-year-old male with a long history of poorly controlled T2DM. He has had progressive burning pain in both feet for the last year or so, but in the last few months it has become increasingly worse. He has tried taking ibuprofen and naproxyn over-the-counter with no improvement. Now, he is presenting for more effective pain management. The AGACNP knows that the medication of choice will be from which drug class?

A. NSAIDs

B.Opiates

C. Antiepileptics

D. Anesthetics

 

QUESTION 90

1.      Mr. Starwood is a 61-year-old male who was admitted last night for the management of acute pancreatitis. He was admitted n.p.o and started on intravenous fluid and opiate pain management. This morning he reports feeling significantly better. His C-reactive protein this a.m. is 5 mg/dL, amylase and lipase are both just over 2 x upper limits of normal, and his Ransom score is 2. The AGACNP knows that the next step in his care is to:

A. Begin clear liquids as tolerated

B. Order an abdominal CT

C. Order an ERCP

D. Continue the current management for 24 hours

 

QUESTION 91

When beginning pharmacotherapy for depression, the AGACNP discusses with the patient that a primary safety consideration includes the:

A. Increased risk of suicide when patients begin antidepressant therapy

B. Potential for sexual adverse effects

C. Better likelihood of success when medications and therapy are used together

D. High incidence of serotonin syndrome

 

QUESTION 92

When ruling out meningitis in a patient, the AGACP appreciates that the spinal fluid is cloudy and the glucose content is 20 cells/microliter. This is most consistent with:

A. Aseptic meningitis

B. Septic meningitis

C. Chemical meningitis

D. Chronic meningitis

 

QUESTION 93

A 44-year-old male patient presents in a hypertensive crisis. The blood pressure is 240/136 mm Hg, pulse is 128 b.p.m. and the patient is complaining of a severe, pounding headache. His skin is diaphoretic and he is visibly tremulous. The first diagnostic study to evaluate the suspected diagnosis should be a:

A. 24 hour urine for catecholamine metabolites

B. Serum epinephrine and metanephrines

C. T scan of the abdomen

D. MRI of the abdomen

 

QUESTION 94

1.      An unidentified patient is brought to the emergency department by ambulance after being hit by a motor vehicle. She has multiple injuries and an estimated blood loss of 2 liters. The hematocrit is 19%. The AGACNP expects that the mean cell volume (MCV) would most likely be:

A. 70 fL

B. 80 fL

C. 90 fL

D. 110 fL

 

QUESTION 95

Mrs. Oliver is a 71-year-old petite Caucasian female. During a routine dexa screening she was found to have a T-score of -3.0. The AGACNP knows that the first intervention should include:

A. Calcium

B. Vitamin D

C. Bisphosphonates

D. Estrogen

 

QUESTION 96

When evaluating a family with suspected carbon monoxide exposure, the AGACNP knows that assessment should include all of the following except:

A. Vital signs

B. Pulse oximetry

C. Cardiac rhythm strip

D. Carboxyhemoglobin level

 

QUESTION 97

Mr. Riley is a 61-year-old male who just had bilateral knee replacements. There was more fluid loss than intended during the procedure. The AGACNP knows that metabolic alkalosis is the most common postoperative acid-base imbalance and is best treated with:

A. Normal saline infusion

B. An insulin drip

C. Low volume hydrochloric acid

D. Albumin

 

QUESTION 98

Patients in advanced stages of chronic kidney disease are at greatest risk for which of the following conditions?

A. Polycythemia

B. Hypokalemia

C.Metabolic alkalosis

D. Anemia

  

QUESTION 99

 The diagnostic study of choice in mesenteric ischemia is:

A. Ultrasound

B. CT angiography

C. MR angiography

D. Diagnostic peritoneal lavage

 

QUESTION 100

Mr. Maxwell is a 58-year-old male who presents with left foot pain. Physical examination reveals a foot that is normal in appearance with DP and PT pulses that are barely audible by Doppler. The AGACNP has the patient cross the leg with the left foot resting on the right knee; after 30 seconds that left foot is briskly lowered to the floor. Instantly the left foot turns bright red. This is known as:

A. Venous insufficiency

B. Brawny hyperpigmentation

C. Homan's sign

D. Dependent rubor