AG-ACNP Boards Exam Questions
with Verified Solutions
58 yo. M presents to ED with complaints of dry cough. CXR revealed generalized,
inflamed film throughout. What is the most likely diagnosis? - ANS-Pneumonitis
What drug has been known to prevent nosocomial PNA? - ANS-Sulcarafate (Carafate) -
Mucosal Protective Agent
What is an initial finding associated with a pulmonary embolism? - ANS-Respiratory
Alkalosis - secondary to increased RR and blowing off CO2
What is diagnostic of pulmonary HTN? - ANS-2D echo
Your patient is intubated on the following settings: SIMV/FiO2 .6/PEEP 5. You notice
shunting. What should your next action be? - ANS-Increase PEEP from 5 to 10 to
recruit alveoli and increase surface area to improve oxygenation
32 yo. M with PMH significant for mitral valve replacement now complains of wheezing
during physical activity 2-3 times/week. What should you do next? - ANS-Send patient
for pulmonary function testing.
What is the pathology of asthma? - ANS-Increased
responsiveness/hyperresponsiveness of the trachea and bronchi to a stimuli.
Acute inflammation
Narrowing of airways
Hypertrophy of smooth muscle
Mucosal plugging of airways
What are the hallmark signs and symptoms of asthma? - ANS-Respiratory distress at
rest
Difficulty speaking in sentences
RR > 28
Pulsus paradoxus > 12 mmHg
What PFT value is suggestive of an obstructive disease? - ANS-Decreased FEV1
Which acid-base imbalance is associated with asthma? - ANS-Respiratory Alkalosis
with mild hypoxemia
, What is duration of therapy for a patient with HIV diagnosed with TB? - ANS-NINE
months
What is the monitoring protocol for patient newly diagnosed with pulmonary TB? - ANS-
Weekly sputum smears and cultures for SIX weeks then MONTHLY after negative
cultures
What labs should be evaluated at baseline when initiating TB therapy? - ANS-Liver
function tests
CBC
serum Creatinine
What is the risk with ethambutol? - ANS-Changes in visual acuity
Red-green color blind
For those with a positive PPD test, what drug is indicated and for how long? - ANS-INH
x 6 months
High risk - 5 mm induration
Moderate risk - 10 mm induration
Low risk - 15 mm induration
Define PNA. - ANS-Inflammation of the LOWER respiratory tract
What microorganism is most responsible for community acquired pneumonia (CAP)? -
ANS-Strep. pneumoniae - gram +
What is the gold standard in diagnosing PNA? - ANS-CXR - infiltrates
Blood cultures x 3
Identify the management of CAP in the healthy adult < 60 yo? - ANS-Macrolides
- azithromycin (Zithromax)
- clarithromycin (Biaxin)
- erythromycin
OR
Doxyclycline
Identify the management of CAP in the adult >60 yo with comorbidities? - ANS-
Fluroquinolone
- levofloxacin (Levaquin)
- ciprofloxacin (Cipro)
What is the inpatient ICU management of a patient dx with PNA? - ANS-Beta lactam -
ceftriaxone (Rocephin)
PLUS
with Verified Solutions
58 yo. M presents to ED with complaints of dry cough. CXR revealed generalized,
inflamed film throughout. What is the most likely diagnosis? - ANS-Pneumonitis
What drug has been known to prevent nosocomial PNA? - ANS-Sulcarafate (Carafate) -
Mucosal Protective Agent
What is an initial finding associated with a pulmonary embolism? - ANS-Respiratory
Alkalosis - secondary to increased RR and blowing off CO2
What is diagnostic of pulmonary HTN? - ANS-2D echo
Your patient is intubated on the following settings: SIMV/FiO2 .6/PEEP 5. You notice
shunting. What should your next action be? - ANS-Increase PEEP from 5 to 10 to
recruit alveoli and increase surface area to improve oxygenation
32 yo. M with PMH significant for mitral valve replacement now complains of wheezing
during physical activity 2-3 times/week. What should you do next? - ANS-Send patient
for pulmonary function testing.
What is the pathology of asthma? - ANS-Increased
responsiveness/hyperresponsiveness of the trachea and bronchi to a stimuli.
Acute inflammation
Narrowing of airways
Hypertrophy of smooth muscle
Mucosal plugging of airways
What are the hallmark signs and symptoms of asthma? - ANS-Respiratory distress at
rest
Difficulty speaking in sentences
RR > 28
Pulsus paradoxus > 12 mmHg
What PFT value is suggestive of an obstructive disease? - ANS-Decreased FEV1
Which acid-base imbalance is associated with asthma? - ANS-Respiratory Alkalosis
with mild hypoxemia
, What is duration of therapy for a patient with HIV diagnosed with TB? - ANS-NINE
months
What is the monitoring protocol for patient newly diagnosed with pulmonary TB? - ANS-
Weekly sputum smears and cultures for SIX weeks then MONTHLY after negative
cultures
What labs should be evaluated at baseline when initiating TB therapy? - ANS-Liver
function tests
CBC
serum Creatinine
What is the risk with ethambutol? - ANS-Changes in visual acuity
Red-green color blind
For those with a positive PPD test, what drug is indicated and for how long? - ANS-INH
x 6 months
High risk - 5 mm induration
Moderate risk - 10 mm induration
Low risk - 15 mm induration
Define PNA. - ANS-Inflammation of the LOWER respiratory tract
What microorganism is most responsible for community acquired pneumonia (CAP)? -
ANS-Strep. pneumoniae - gram +
What is the gold standard in diagnosing PNA? - ANS-CXR - infiltrates
Blood cultures x 3
Identify the management of CAP in the healthy adult < 60 yo? - ANS-Macrolides
- azithromycin (Zithromax)
- clarithromycin (Biaxin)
- erythromycin
OR
Doxyclycline
Identify the management of CAP in the adult >60 yo with comorbidities? - ANS-
Fluroquinolone
- levofloxacin (Levaquin)
- ciprofloxacin (Cipro)
What is the inpatient ICU management of a patient dx with PNA? - ANS-Beta lactam -
ceftriaxone (Rocephin)
PLUS
