NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100, Exams of Nursing

Download NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100 and more Exams Nursing in PDF only on Docsity! NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2022/2023 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+ NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 MIDTERM EXAM QUESTIONS AND ANSWERS. Question 1 1 out of 1 points The AGACNP is caring for a patient who is quite ill and has developed, among other things, a large right sided pleural effusion. Thoracentesis is sent for pleural fluid analysis. While evaluating the fluid analysis, the AGACNP knows that a fluid identified as a(n) is the least worrisome type. Respons e Feedbac k: “A” is the correct answer. A transudate is essentially just water and can occur as a consequence of increased hydrostatic pressure in the pulmonary vessels. It typically implies that the some condition has produced an imbalance in colloid-hydrostatic pressures, such as CHF or hypoalbuminemia. While it can represent a serious problem, it may also represent a transient NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Question 3 1 out of 1 points Mr. Banks has been admitted for surgical resection of a metastatic tumor, during surgery it is discovered that he has widespread, diffuse metastasis throughout the abdomen. Surgery is no longer an option, and his oncologist says that chemotherapy is unlikely to produce any meaningful benefit. Mr. Banks is concerned that his sons will not support a transfer to comfort care. The AGACNP advises that he: Respons e Feedbac k: “B” is the correct answer. If there is any concern about disagreement among family members, or any concern at all that a patient’s wishes will not be carried out, the best action is to ensure that there is a clearly defined legally executed document. “A” is not correct. Living wills are not legally enforceable documents and when dissention arises among family members they may not be carried out. “C” is not correct - while the patient should arrange for his care as long as he is capable of doing so, if questions arise at such a time that he is not NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE c a p a b l e of answering his next of kin will need to do so. “D” is not correct -- identifying the proxy is not enough without assigning legal rights and responsibilities. While “A,” “C,” and “D” should all be done and will support his care, the only way to ensure that one’s wishes are carried out is to ensure that a legally enforceable direction is in place. Question 4 Mr. Wilkerson is a 77-year-old male who is being evaluated and treated for his cardiogenic pain. His vital signs are as follows: Temperature of 99.1° F, pulse of 100 bpm, respirations of 22 bpm, and blood pressure of 168/100 mm Hg. A 12-lead ECG 1 out of 1 points reveals deep ST segment depression in leads V3-V6. The AGACNP recognizes which of the following as a contraindication to rTPA therapy? Respons e Feedbac k: “D” is the correct answer. rTPA is not indicated in patients with ST segment depression; this is not a ST elevation MI. “A” is not correct as age > 80 is a relative contraindication. “B” is not correct as a temperature of 99.1° F is an expected response to NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE m y ocardial necrosis, and “C” is not correct—the blood pressure is not prohibitive until > 180/110 mm hg. Question 5 A 71-year-old patient is recovering from a particularly severe exacerbation of chronic obstructive pulmonary disease. He has been in the hospital for almost two weeks and 1 out of 1 points was on mechanical ventilation for 7 days. While discussing his discharge plan he tells NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE of 1 out of 1 points increasing shortness of breath. The diagnostic evaluation ultimately supports a diagnosis of community acquired pneumonia. The AGACNP appreciates right middle lobe consolidation on chest radiography. Pending sputum cultures, empiric antibiotic therapy must be initiated to cover which organism? Response “D” is the correct answer. This patient presents from the outpatient NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Feedback: population where the most common cause of pneumonia is Streptococcus pneumoniae, and is the primary treatment target for any patient being treated empirically. “A” is not correct—while the patient’s sexual orientation is offered in the provided history, there is no indication that he has HIV/AIDS or any other condition characterized by immunosuppression that would increase his risk for this organism. “B” is not correct, as this organism is not typically seen in the outpatient population without specific risk, e.g. immunosuppression or chronic ventilator therapy. “C” is not the correct answer as this organism is not likely absent specific risk such as instrumentation or known colonization. Question 8 Which of the following is the greatest risk factor for vascular dementia? 0 out of 1 points Respons e Feedback: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE “ B ” i s t h e c orrect answer. Vascular dementia is a consequence of vascular disease, and is more likely to occur in patients with risk factors for target organ damage, such as hypertension, dyslipidemia, and diabetes. “A” is not a distinct risk factor for vascular dementia; it is a risk for Alzheimer’s dementia. “C” likewise increases risk for Parkinson’s dementia, but does not present a risk for vascular dementia. “D” is not a risk factor for vascular dementia. Although there may be some familial risk for certain vascular diseases that may lead to vascular dementia, there is no clear familial tendency for this type of dementia. Question 9 J.R. is a 55-year-old male who presents for a commercial driver’s license physical 1 out of 1 points examination with a blood pressure of 170/102 mm Hg. He has no medical history and is without complaint. Which of the following findings constitutes hypertensive urgency? NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE i ndicated by any other significant patient history. Question 11 0 out of 1 points The interpretation of a chest radiography should follow a systematic approach to ensure that all vital structures are evaluated and important clinical findings are not missed. The last thing to be assessed when looking at chest radiography should be the : Respons e Feedbac k: “A” is the correct answer. The lungs are the last thing to be examined; when not properly taught, new may clinicians go right to the heart and lungs and may miss important information. Like the nursing process (assess, diagnose, plan, intervene, evaluate) and the system for ECG interpretation (rate, rhythm, intervals, axis, morphology) the system for interpretation of the chest radiograph should proceed from assessing patient identification, patient rotation, level of inspiration, film exposure to an assessment of the film proceeding in this NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE o r d e r: Mediastinum and hila, thoracic cage, extrathoracic bones and soft tissues, and finally lungs. Using a systematic approach helps eliminate the risk of missing vital findings. Question 12 1 out of 1 points The Short Confusion Assessment Method (Short-CAM) is a widely used four item tool that assesses delirium in the hospitalized patient. It includes observation of all of the following except: Respons e Feedbac k: “D” is the correct answer. The tool was developed to improve identification and recognition of delirium, not to diagnose causation. The four items observed with the Short-CAM method are (1) acuity of onset, (2) inattention, (3) disorganized thinking, and (4) level of consciousness. Once delirium is recognized, then clinical diagnosis of underlying cause is indicated. Question 13 Ms. Yang NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE has been hospitalized for 5 days for the management of a gastrointestinal 1 out of 1 points NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE 0 out of 1 points Respons e Feedbac k: “C” is the correct answer. A factor VIII deficiency is hemophilia, in which patients have a decreased ability to clot and are at risk for pathologic bleeding. Conversely, “A” and “D” are not correct as protein C and protein S, activated by the products of clotting, ultimately inhibit the clotting cascade. Deficiencies in protein C and S result in an inability to inhibit clotting and are at risk for NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE pathologic clotting. Factor V is a clotting factor that is inhibited by the activated protein C and protein S complex. “B” is not correct— when patients have a mutation of factor V, it is insensitive to the inhibiting properties of protein C and S and clotting cannot be stopped appropriately—resulting in increased risk of clotting. Question 16 1 out of 1 points A patient is diagnosed with acute descending aortic aneurysm and hypertension should be immediately started on which medication pending surgical evaluation? Respons e Feedbac k: “A” is the correct answer. Beta adrenergic antagonists decrease the force of contraction therefore decreasing shear force exerted on the dissection. “B” is not correct, intravenous vasodilators are not used initially although are a NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE s e c o n d option to reduce systolic blood pressure but . “C” and “D” are not correct as other medical management strategies have not demonstrated improved outcomes. Ultimately these patients will require surgical intervention. Question 17 Jason is a 27-year-old with a long history of intermittently controlled asthma. He is currently prescribed Advair daily with albuterol as needed for symptoms. Today he 0 out of 1 points presents to the emergency department with cough and wheezing and difficulty catching his breath. His FEV1 is 51% at the time of presentation. He is given alternating albuterol and ipratropium nebulizer treatments along with oral prednisone. After one hour his FEV1 has increased 65%. The appropriate disposition for Jason at this point is: Respons e Feedbac k: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE initiate his own respirations and 24 hours later has not expired yet. The decision is made to leave him in the hospital on a general medical floor rather than transfer to another facility for hospice. Which of the following is the best indicator that the patient’s death is imminent? Respons e Feedbac k: “A” is the correct answer. Patient may survive in hospice care for days or even weeks after all support, including food and fluids, are withdrawn. “B,” “C,” and “D” can occur for weeks in patients who manage to sustain cardiopulmonary function. However, when there is no urine being produced, the combination of volume contraction and electrolyte and metabolic imbalance will cause death very quickly. The cessation of urine output is the strongest marker of the answer choices provided to predict imminent cardiac arrest. Question 20 0 out of 1 points A patient is newly admitted to your service for open reduction and internal fixation of the left hip. She seems very down, and as you talk with her you realize that her mood is not just related to her hip NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE fracture. Which of the following symptoms would not be consistent with major depressive disorder? Respons e Feedbac k: “D” is the correct answer. Major depressive disorder is not diagnosed when the symptoms may be attributed to bereavement over a loss of < 2 months duration. Conversely, “A,” “B,” and “C” are all consistent with a diagnosis of major depressive disorder. Question 21 0 out of 1 points You are evaluating a patient who has been admitted to the emergency room after being arrested for starting a fight in a local sports' bar. The patient is now being cooperative, but reports that he has been in treatment for PTSD for months. He has been prescribed fluoxetine but has not noticed any improvement in symptoms, and now has been arrested for violence. The AGACNP knows that the next step in medication management is likely to include: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “A” is the correct answer. While SSRIs, beta adrenergic antagonists, and even centrally acting antiadrenergic agonists (clonidine) are all used as first line agents depending upon symptom presentation, patients who have more severe symptoms and do not respond to initial treatments often require management with atypical antipsychotics. This patient has been treated with an SSRI, reports no improvement, and has been arrested for his behavior; these circumstances are a clear indication for escalation to the nest level of therapy. Question 22 1 out of 1 points Mrs. Salter is an 81-year-old lady who presents for evaluation of near- syncopal episodes. Her 12-lead ECG, complete blood count, and comprehensive metabolic panel are all essentially normal. A urinalysis shows some trace protein but is otherwise normal. A 24- hour rhythm monitor demonstrates rare premature ventricular contractions. Mrs. NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE occurs, more invasive measures are indicated. Question 23 Kevin is a 14-year-old male who presents for evaluation of a fever of 102.5° F and significant right ear pain. He appears quite ill and says he feels nauseous. Otoscopic evaluation reveals pain to palpation, a very erythematous and bulging tympanic 0 out of 1 points membrane with bullous myringitis. The AGACNP knows that antibiotic therapy must be selected to cover: Respons e Feedbac k: “D” is the correct answer. Streptococcus pneumoniae is the most common bacteria that infects the head and neck in immunocompetent persons, and is the primary treatment target when treating otitis media, bacterial sinusitis, and bacterial pharyngitis. “A” is not correct— while likely on broken skin and soft tissue, it is not common in the ear, nose, or throat unless specific risk factors exist. “B” is not correct—this is much more likely in an immunocompromised patient or a patient NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE o n mechanical ventilation. “C” is not correct—it is the second most common organism, but strep is the primary treatment target. Question 25 Who among the following patients is at greatest risk for a pulmonary embolus? 1 out of 1 points Respons e Feedbac k: “C” is the correct answer. The primary risk factor for pulmonary embolus is deep vein thrombosis, for which primary risks are polycythemia and stasis. “A” is not correct—the concentration of estrogen in most hormonal contraception is so low that it barely increases risk above that of the general circulation. Of the millions of women on hormonal contraception, only a handful develop DVT/PE. “B” is not correct—this patient is likely to have problems bleeding rather than clotting. “D” is not correct—while smoking is a risk factor for many things DVT is not among them. Question 26 NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE 1 out of 1 points Mrs. Birdsong is an 85-year-old female who has been admitted for surgical repair of a hip fracture. She is in remarkably good spirits and is quite talkative. She readily answers all of the questions on her intake assessment, and readily acknowledges information provided during her room orientation. Later while talking with the patient's son the AGACNP learns that the patient has had significant cognitive impairment for a few years. She has virtually no short term memory, but compensates by confabulating. Her NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE t o visualize corneal abrasions. Question 28 0 out of 1 points R.J. is a 55-year-old female who presents with acute onset left sided facial pain and an inability to move the left side of her face. She cannot smile, raise her eyebrow or even close her left eye, The immediate approach to this patient should include: Response “A” is the correct answer. This is the classic presentation of Bell’s NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Feedback: palsy, and rapid administration of corticosteroids can decrease the intensity and duration of symptoms, as well as reduce the likelihood of residual pain. “B” is not indicated; it does not contribute to the diagnosis. “C” may be used as there is a theory that herpes virus causes Bell’s palsy, but this is equivocal and not uniformly practiced. “D” may become necessary at some point to prevent corneal abrasion but the immediate approach should be corticosteroids. Question 29 A 78-year-old male present for a physical examination. He has no discomfort or 1 out of 1 points complaints other than a general decrease in vision, but it helps when he puts things under a bright light to read. He admits that while driving at night the streetlights appear to be a bit distorted and his night vision is pretty poor. Given the likely diagnosis, the AGACNP expects which of the following physical findings? NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “C” is the correct answer. This scenario is consistent with cataracts, a common abnormality seen in older adults. The presence of the cataract diminishes the red reflex and ultimately will obliterate it. “A” is not correct, injected conjunctiva are more consistent with inflammation. “B” is not correct—a sluggish pupil response may occur in response to a variety of conditions, including drug toxicities and poisonings, neurological, or ocular disease, but not with cataracts. “D” is not correct; white spots in the macula is most often suggestive of macular degeneration. Question 30 0 out of 1 points Jason is a 46-year-old male who is being managed for sepsis. He has HIV/AIDS and has had a prolonged hospitalization characterized by a variety of complications. He was extubated 3 days ago but continues gastric decompression with a nasogastric tube(NGT), total parenteral nutrition and antibiotic therapy via a central venous catheter, and urinary drainage via a Foley catheter. He continues to demonstrate consistent low grade fevers but all points of insertion of his tubes are NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “B” is the correct answer. The patient’s history is consistent with a metal injury and so an MRI should be avoided. “A” may or not be indicated as the history progresses, but there is no contraindication to it should the examiner determine the need to rule out an abrasion. “C” and “D” are both mechanisms to visualize behind the cornea which may be necessary if a penetration injury (which may occur with a high- velocity injury) is suspected. Question 32 0 out of 1 points D.E. is a 41-year-old female who had lumbar surgery two days ago to repair a ruptured nucleus pulposus. She has been doing well postoperatively but today is complaining of resting fatigue and some shortness of breath at rest. In ruling out a pulmonary embolus the AGACNP first orders a: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “B” is the correct answer. The D-dimer is a highly sensitive serology and is the least invasive mechanism by which a pulmonary embolus may be ruled out; a negative D-dimer virtually eliminates pulmonary embolus from the differential diagnosis. “A” is not correct—while it can be used to make the diagnosis it is more invasive and less specific than other options. “D” is not correct—there is no indication that the patient is on warfarin, and in any event it would not be used to rule in or out pulmonary embolus “C” is not accurate when after surgery, as it will be positive after surgery. Question 33 Mr. Nixon is being treated with unfractionated heparin infusion for acute pulmonary embolus. In order to avoid a potentially fatal complication of heparin infusion, the AGACNP monitors: 1 out of 1 points Respons e Feedback: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE “ D ” i s t h e c orrect answer. An uncommon but potentially serious consequence of heparin infusion is heparin-induced thrombocytopenia. Some patients make autoantibodies in response to exogenous heparin that activate their own platelets. When this occurs, heparin must be immediately discontinued and thrombin inhibitors started. “A” is not correct—this is not affected by heparin, but is monitored in those on Coumadin. “B” is not correct—this is also unaffected by heparin, but monitored on Coumadin. “C” is not correct—this is monitored to assess therapeutic efficacy, but not for complications. Question 34 1 out of 1 points While assessing a patient with a known psychiatric history, the AGACNP knows that the primary difference between a psychotic and NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE changes; the only thing new is that he got new eye drops for his glaucoma. The AGACNP correctly assumes that his new eye drops are: Respons e Feedbac k: “B” is the correct answer. The accelerated GI motility and bradycardia are cholinergic adverse effects. Ophthalmic medications are readily absorbed into systemic circulation. All of these medications are used to treat glaucoma and may cause class-related adverse effects, but cholinergic drops are the only ones shown that will slow heart rate and accelerate GI motility. Question 36 1 out of 1 points Janice is a 19-year-old female who presents to the emergency department via ambulance. She is pale, diaphoretic, agitated, and convinced she is having a stroke. Her vital signs include a temperature NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE of 98.9° F, pulse of 114 beats per minute, respirations of 32 breaths per minute, and a blood pressure of 110/74 mm Hg. Diagnostic evaluation is negative and Janice is diagnosed with an acute panic attack. The initial treatment of choice is: Respons e Feedbac k: “A” is the correct answer. A panic anxiety attack requires immediate intervention with a short acting benzodiazepine for immediate symptom control. A calm environment would be helpful, but is not adequate alone to manage acute episodes characterized by physical symptoms. Oxygen is not indicated in the absence of organic NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Question 37 problems. The numb hands and feet, known as “stocking-glove paresthesia,” are characteristic of respiratory alkalosis consistent with tachypnea and will resolve once the patient slows her breathing and retains CO2. While cognitive behavioral therapy is an important part of chronic anxiety management, is has no role in acute management of acute panic attack. Lorraine is a 41-year-old female who presents for an asthma follow- up visit. She says she feels very well, has almost no daytime symptoms, and is using her inhaled corticosteroid medication daily as prescribed. Her PEFR is 85% of her personal best. The best approach to this patient is to: 0 out of 1 points Respons e Feedbac k: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE AGACNP determines that he has experienced persistent, excessive anxiety and worry almost every day for more than one year. What other aspect of Mr. Owen's psychosocial history would be required to made a diagnosis of generalized anxiety disorder? Respons e Feedbac k: “D” is the correct answer. Generalized anxiety disorder (GAD) is an axis I disorder according to DSM-V. Diagnostic criteria require that the patient report both excessive anxiety and worry, and difficulty controlling that worry, for more days than not in the last six months. These two cardinal requirements are accompanied by three of at least six other findings, which may or may not include choices “A” through “C”; so while sleep disturbances, difficulty concentrating and muscle tension may or may not occur, excessive anxiety and worry and difficulty controlling that worry are required for the diagnosis. Question 40 1 out of 1 points NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Kevin T. is a 49-year-old male who is being discharged after hospitalization for an acute inferior wall myocardial infarction. This is his first hospitalization and his first chronic medical diagnosis. Aside from his elevated cardiac isoenzymes and troponins, his laboratory profile was essentially within normal limits. The only apparent cardiac risk factor is an LDL cholesterol of 200 mg/dL. Initiating an HMG- CoA reductase inhibitor is an example of which level of prevention for Kevin? NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Response Feedback: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE “ B ” i s t h e correct answer. Patients in these circumstances are vulnerable to a decrease in natural tear production and are at risk for iatrogenic corneal abrasion. and lubricants are integral to prevention. “A” is not correct as the retina is within the eye fundus and not affected by topical lubrication. “C” is not correct because ophthalmic pH is not a primary impact of drying—pH abnormalities are more likely with chemical irritations. “D” is not correct because lid mobility is a muscular action and not effected by drying or lubricants. Question 43 When reading a 12-lead electrocardiogram, the AGACNP knows that all 12 leads are required to provide: 1 out of 1 points Response “C” is the correct answer. Each lead provides a different perspective NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Feedback: from which to view the amplitude and direction of electrical activity as it moves through the heart in terms of length, width, and depth; the inferior, lateral, and anterior walls respectively. “A” is not correct because QRS axis is determined from the inferior and lateral leads only. “B” is not correct, both atrial and ventricular abnormalities can be determined from a lesser number of select leads. Similarly “D” is not correct as it does not take 12 leads to assess contraction and relaxation. Question 44 A 49-year-old male presents for evaluation of chest tightness. It has happened before, but he just ignored it and it went away. Today he just could not ignore it anymore. He 0 out of 1 points has always enjoyed good health and says he has never been told that he has any chronic medical conditions like high blood pressure or diabetes. A 12-lead ECG demonstrates changes consistent with inferior wall ischemia. Both his symptoms and inferior wall changes NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE improve with the administration of sublingual nitroglycerin. Consistent with ACS protocol, this patient’s assessment is consistent with: Respons e Feedbac k: “A” is the correct answer. ACS protocol categorizes acute myocardial pain as either unstable angina/non- ST elevation MI (low or high risk), and ST elevation MI. A non-ST elevation (subendocardial) MI is treated in the same manner as unstable angina and the only question is whether the patient is at high risk or low risk —this is determined by an objective assessment including tools like TIMI and GRACE scores. An ST elevation MI is an infarct that spans the entire thickness of the myocardium and warrants fibrinolytics if the patient is a candidate. This patient presents with inferior wall ischemia which is unstable angina. Therefore the only question is whether he is high or low risk. His absence of medical history, dysrhythmia, instability or any other abnormalities implies low risk. He will be treated conservatively and referred for outpatient long term management of coronary artery NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE n o t c o r rect—a positive Romberg test is more consistent with cerebellar dysfunction. “B” is not correct—it may be related to any number of etiologies or no identifiable ones, but there is no specific link to orbital fracture. “D” is not correct—in the setting of head injury bleeding from the ear’s is more consistent with increased intracranial pressure. Question 47 0 out of 1 points Mrs. Forbes is a 69-year-old lady being discharged from the hospital after complications following a cosmetic surgical procedure. She is basically in good health. She has a history of hypothyroidism for which she takes levothyroxine daily, and mild osteoarthritis which is controlled with only prn nonsteroidal use. Her blood pressure is 148/90 mm Hg. The AGACNP knows that in accordance with the most current guidelines published in JNC 8 the appropriate action is to: Respons e Feedbac k: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE “ C ” i s t h e c o r r e c t a n s w er. Absent chronic kidney disease or diabetes, any adult > 60 years old has goal blood pressure of 150/90 mm Hg. This patient is at goal and should just proceed with normal health promotion. “A” is not correct—there is no indication for drug therapy. “B” is not correct—we are not given the patient’s weight, and given her age lack of comorbid kidney disease or diabetes, weight reduction is not indicated in response to her blood pressure. “D” is no correct—while these are the three first line drugs for hypertension and would be indicated if drug therapy were needed, this patient does not require any medication at this time NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Question 48 When assessing driver safety in the older adult, the AGACNP considers that: 0 out of 1 points Respons e Feedbac k: “B” is the correct answer. Mental status is only one part of driver safety; older adults may have a normal mental status but be at risk due to poor vision, decreased hearing, decreased neck mobility, or decreased ability to quickly assimilate and respond to complex stimuli. “A” is not true, MMSE as an isolated correlate with road accidents is not reported. “C” is not true, dementia is not a condition that requires reporting, although the clinician does have a responsibility to counsel drivers when there is a safety concern. “D” is not true—driving to slowly can lead to accidents; if an older adult is not comfortable with the speed limit he or she should not be driving on the road. Question 49 0 out of 1 NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE of rehab because she was on her treadmill when she had her infarction and now she is afraid of making it happen again. She doesn’t understand how the rehab can force her to exercise her heart but not make her have another cardiac event. The AGACNP explains that the patient will be monitored and that her goal heart rate will be: Respons e Feedbac k: “B” is the correct answer. There are three phases of cardiac rehab— phase I begins in the hospital immediately upon acute treatment and involves getting out of bed and ambulating. Phase II is the medically supervised programs that most insurances pay for in which the patient’s heart is reconditioned. Phase III is essentially the rest of the patient’s life—30 minutes of moderately strenuous activity at least 5 days a week. In phase II rehab, the goal heart rate is calculated to be 10 beats per minute below the rate of ischemic change. This allows the heart to be exercised without endangering the patient. “A” is not correct—the goal does not increase over the period of phase II, although it may change over phase III. “C” is not correct, the heart must be exercised significantly above resting or NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE t h ere will be no improvement. “D” is not correct—the patient is not medicated to change target heart rate. Question 51 0 out of 1 points During physical examination of a 51-year-old African-American female you appreciate a decrease in her peripheral vision. The rest of her eye examination is within normal limits and she is symptom free. This presentation is consistent with: Respons e Feedbac k: “D” is the correct answer. Painless loss of peripheral vision is consistent with open angle glaucoma and this patient is from a high risk group (African-American population). “A” is incorrect because macular degeneration is a disease of central vision change/loss. “B” is incorrect—increased intraocular pressure is consistent with glaucoma but not intracranial pressure. “C” is incorrect— dacrocystitis is an acute inflammation of the lacrimal apparatus and presents as an acute abscess at the medial aspect of the eye and nasal border. NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Question 52 Mr. Moffett is a 66-year-old male with a long history of lower extremity edema. All other causes of lower extremity edema have been ruled out and his overall symptom 1 out of 1 points presentation and history are strongly supportive of chronic venous insufficiency. Today he presents with increased itching of both lower legs. Physical exam reveals 2-3+ pitting edema and trophic hyperpigmentation. The AGACNP know that treatment should NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “B” is the correct answer. Ophthalmic corticosteroids are contraindicated in the management of corneal abrasion as they will inhibit the healing trajectory of epithelium. “A” is not true—if there is any risk of a "dirty" abrasion ophthalmic antibiotics are appropriate. “C” is not correct—ophthalmic NSAIDs, such as ophthalmic ketorolac, are appropriate for abrasion-related pain management. “D” is not correct as topical anesthetics are routinely NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE used by health care providers to allow for thorough examination of the affected eye. Question 55 M.T. is a 41-year-old male patient in the intensive care unit. He was admitted to the hospital in septic shock and has been aggressively managed with broad spectrum antibiotics. He has become progressively hypoxemic and the last arterial blood gas revealed a paO2 of 58 mm Hg. Chest radiography reveals a "white out" pattern 1 out of 1 points bilaterally. The patient is intubated and ventilated. The AGACNP knows that appropriate management must include: Respons e Feedbac k: Question 56 NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE “B” is the correc t answe r. This prese ntatio n is classic acute respiratory distress syndrome and the patient requires PEEP in order to maximize alveolar-capillary contact and facilitate gas exchange. “A” is not the correct answer—the FIO2 will be increased to whatever is required, along with PEEP, to keep the patient out of respiratory failure. However, an FIO2 of 100% may cause pulmonary fibrosis and should be avoided unless absolutely necessary “C” is not correct—this is too much volume; volumes for ARDS are moderate at 6-8 mL/kg. “D” is not correct—the ventilator setting and rate is not mandated and determined based upon patient response. 0 out of 1 points Teenagers and adults with acute otitis media can often be treated with "watchful waiting" given the high incidence of spontaneous resolution and low risk of poor outcomes. Which of the following is an absolute indication to begin antibiotic therapy at the time of diagnosis? Respons e Feedbac k: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “A” is the correct answer. Patients with ARDS develop and increase in the permeability of the alveolar capillary membrane, which allows protein and other intravascular solutes to leak out of the pulmonary vessels into the alveoli resulting in decreased ability to ventilate the alveoli and ultimately right to left shunting. “B” is not correct—a decrease in this barrier would actually inhibit leakage from capillary to alveoli. “C” and “D” are not correct—pulmonary hydrostatic pressure is not an issue in ARDS, it is a factor in pulmonary edema when increased vascular congestion results in an increase in hydrostatic pressure and ultimately water leaking into the alveoli. Question 59 0 out of 1 points Acute respiratory distress syndrome is characterized by which abnormality of ventilation and perfusion? Respons e Feedback: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE “ B ” i s t h e c o r r e c t a n s w er. A shunt occurs when blood flows from the right side of the heart to the left side of the heart without any contact with aerated alveoli as occurs in ARDS. “A” is not correct—dead space occurs when the alveoli are inflated but no venous blood comes into contact with it —this is the case in pulmonary emboli in which emboli block the vessel and the inflated alveoli are wasted “C” is not correct—this is not a ventilation or perfusion problem; increased retrosternal airspace occurs with the long term retention NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE seen in COPD. “D” is not correct—ARDS results in fibroproliferation which will decrease compliance. Question 60 0 out of 1 points George Schulz is a 69-year-old male who presents for evaluation of acute foot pain. It is so painful that he cannot walk on it without assistance. At first he denies any significant medical history, but then reveals that he has been diagnosed with dyslipidemia and hypertension but stopped taking his medications because he couldn’t afford it. Pulses are not palpable but are audible by Doppler. The extremity is pale and shiny with decreased hair growth, suspecting peripheral arterial disease, the AGACNP expects which additional finding? Respons e Feedbac k: “D” is the correct answer. When patients have severe arterial disease, the microcirculation tries to compensate with widespread dilation and the foot will turn bright red when placed in a dependent position. NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE During the physical examination of a 31-year-old female, the AGACNP appreciates a bifurcate uvula. The most appropriate action would be to: Respons e Feedbac k: “C” is the correct answer. A bifurcate uvula (a uvula that is split in two or forked) is a normal variant in a small percentage of the population. It has no clinical significance. “A” is not correct as there is no indication for ENT evaluation. “B” is not correct because a bifurcate uvula is not among the anatomical risk factors for sleep apnea, and “D” is not correct— stimulation will not cause spasm. Stimulation is a concern when epiglottitis is suspected. Question 63 During routine immigration screening a 29-year-old male patient from Mexico has a 0 out of 1 points positive purified protein derivative (PPD) test at 17 mm induration. He reports no known history of tuberculosis (TB) infection or exposure, or vaccination with the BCG vaccine. Chest x-ray is negative for any NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE evidence of TB exposure. The AGACNP knows that the appropriate next step is to: Respons e Feedbac k: “B” is the correct answer. Patients who have a + PPD but negative chest radiography are considered exposed but not infected, and the Centers for Disease Control (CDC) and Prevention recommend a prophylactic regimen; while isoniazid (INH) and vitamin B6 are the classic combination other regimens do exist. “A” is not correct—the negative chest radiography makes this a non-reportable event. “C” is not correct—sputum cultures are collected when the chest radiograph is positive. “D” is not correct—the patient may ultimately elect not to take prophylactic therapy and be discharged from care, but before that decision is made prophylactic therapy should be offered and considered. Question 64 1 out of 1 points Clinical diagnostic criteria for acute respiratory distress syndrome (ARDS) include all of the following except: NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “D” is the correct answer. Hypoxemia may be due to any number or respiratory abnormalities and in itself is not among criteria for ARDS; however hypoxemia that is refractory to high oxygen flow concentrations is an anticipated clinical finding. “A,” “B,” and “C” are all among the clinical diagnostic criteria for ARDS—it is virtually always acute in onset, occurring over a matter of hours; chest radiography demonstrates classic characteristic bilateral NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE a n t i b i otics started. “C” is not true —an ophthalmologist should be consulted immediately. “D” is not true—antiemetics should be administered to prevent vomiting which increases pressure on the globe. Likewise patients should be discouraged from coughing or sneezing. Question 67 NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE 1 out of 1 points While evaluating a patient with diastolic failure due to a long history of uncontrolled hemochromatosis, the AGACNP appreciates an extra heart sound just before the S1 heart sound. This sound is most likely a(n): Respons e Feedbac k: Question 68 “B” is the correct answer. Diastolic failure is relaxation failure, and this is sometimes characterized by a ventricular vibration in response to forceful ventricular filling that occurs at the end of diastole when the atria contracts—this is known as S4. “A” is not correct—and S3 sound occurs when a weak walled ventricle vibrates in response to passive filling that occurs early in diastole. “C” is not correct—a split S2 occurs sometimes as a normal variant, or as a response to septal defects, and occurs at the very beginning of diastole when the aortic and pulmonic valve close. “D” is not correct. Mitral stenosis does not produce an extra heart sound—it produces a diastolic murmur. NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE 1 out of 1 points Secondary hypertension occurs in approximately 10% of all patients with hypertension, and requires management of the underlying problem in order to eliminate the cause. Which of the following is not a secondary cause of hypertension? Respons e Feedbac k: “C” is the correct answer. A defect in natriuresis, the kidney’s ability to excrete sodium, is proposed as a theory of primary or essential hypertension. Salt excretion abnormalities, as well as sympathetic nervous system abnormalities, are among the leading theories of primary hypertension. Conversely, renal artery stenosis is considered the most common cause of secondary hypertension. Similarly, “B” and “D” are endocrine disorders that produce vascular constriction and secondary hypertension. In the cases of “A,”, “B,” and “D” correcting the underlying problem, if able, will control the blood pressure. Question 69 1 out of 1 NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “B” is the correct answer. The D-dimer is a highly sensitive blood test that suggests activation of the clotting cascade. It requires only venipuncture and is less invasive and less expensive than other tests for deep vein thrombosis. A negative D-dimer essentially rules out a DVT and the diagnostic evaluation can proceed to rule out other differentials. “A” is not correct—it is not ordered first, but rather follows a positive D-dimer to confirm the presence of a DVT. c" is not correct—a venogram of the affected extremity may be ordered when clinical suspicion is very high and the Doppler inconclusive, but it is not an initial test. “D”A comprehensive metabolic panel may be ordered, but it does not contribute to the diagnosis and is indicated to rule DVT in or out. Question 71 The primary neurotransmitter implicated in post-traumatic stress disorder (PTSD) is: 0 out of 1 points NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE Respons e Feedbac k: “C” is the correct answer. There are several theories that implicate the role of catecholamine’s such as dopamine and serotonin, as well as secondary stress hormones such as cortisol, but these most of these are not uniformly accepted in terms of the neurobiology of PTSD. Conversely, norepinephrine is universally accepted as a key neurotransmitter in both initial neurological response to an extreme stressor and the subsequent PTSD attacks. Increased exposure to norepinephrine at the time of initial stressor is linked to the development of PTSD, and norepinephrine is an integral component NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE of the symptoms of subsequent attacks. Question 72 Mr. Avila is an 82-year-old male being counseled about the risks and benefits of his 1 out of 1 points upcoming abdominal surgery. While considering risk factors for atelectasis, pneumonia and other pulmonary complications, the AGACNP advises that the greatest risk comes from: Respons e Feedbac k: “A” is the correct answer. Among all the choice listed here, cigarette smoking confers the highest risk for poor outcomes. “B” is incorrect —while major abdominal procedures do have a link to pulmonary complications, it is not as big a risk as smoking. “C” is not correct— age alone is a risk factor for systemic complications, but it does not confer any specific independent risk for pulmonary complications — the middle aged smoker may be at higher risk that the elderly non- smoker. “D” is not correct—an FVC NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE The AGACNP is seeing a patient who was transferred from the correctional facility for evaluation. He has a profound purulent discharge from his right eye. The conjunctive is erythematous and there is mild photosensitivity. The inmate denies any real eye pain, just says that it is extremely uncomfortable. Treatment for this patient is likely to include: Respons e Feedbac k: “B” is the correct answer. This presentation is most likely descriptive of gonococcal conjunctivitis, which needs to be treated either with IM Rocephin and referred to ophthalmology. “A” is incorrect as eye irrigation is not indicated and would likely be uncomfortable while doing no good. “C” is not correct as a topical (or systemic) macrolide would be ineffective against gonorrhea. “D” is not indicated as ophthalmic steroids are only indicated for acute inflammatory ocular conditions. Question 75 Ms. Ewing is a 78-year-old female who lives in a long term care facility becaus e her NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE 0 out of 1 points dementia has progressed to the point at which her family cannot provide the necessary safety measures at home. In addition to her absent short term memory she has developed some affective changes and most recently is demonstrating sexual disinhibition. While considering management options, the AGACNP knows that all of the following are medications are options for the management of disinhibition except: Respons e Feedbac k: “D” is the correct answer. Testosterone will increase sex drive and is used therapeutically to do so, thus it is not indicated to suppress sexual disinhibition. “A” is used to capitalize on the well- documented adverse effect of decreased libido. “B” is used as is has antiandrogenergic properties that may counter testosterone. “D” is thought to be successful primarily to its general sedative properties. Question 76 1 out of 1 points NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE A patient recently had a nasal packing inserted for management of refractory epistaxis. One week later he presents with fatigue, a headache “inside of his nose” and a feeling generally unwell. The AGACNP considers: Respons e Feedbac k: “C” is the correct answer. These symptoms are consistent with bacterial sinusitis, which most often occurs as the consequence of some antecedent irritation or inflammation of the sinuses. Nasal packing, nasal instrumentation, viral infection, and allergic inflammation are common causes. “A” is not correct as hematomas are not likely because the pressure packing left in place typically NURS 6550 Midterm Exam Questions and Answers (Graded A+) 2023/2024 BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE