NSGl 555/l NSG555l Examl 2–l (NEWl 2026/l
2027l Update)l Nursel Practitionersl inl
Primaryl Carel IIl Guidel |l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
BNP
Answer:
Al cardiacl neurohormonel secretedl byl ventricularl myocytesl inl responsel tol increasedl walll
stretchl andl pressure
QUESTION
Clinicall indicationsl forl orderl BNP
Answer:
-unexplainedl dyspnea
-seriall measurementl inl chronicl HFl aidl prognosis
-hospitalizedl HFl -l admissionl &l prel d/cl levelsl guidel planning
-canl bel usedl asl earlyl detectionl forl high-riskl pts
QUESTION
Lowl levelsl ofl BNP
Answer:
stronglyl arguesl AGAINSTl HF
QUESTION
,Elevatedl levelsl ofl BNP
Answer:
supportsl HFl diagnosisl butl isl notl specific
-alsol elevatedl inl ACS,l A-fib,l renall failure,l PE,l sepsis
QUESTION
Highl levelsl ofl BNPl inl HF
Answer:
-associatedl w/l worsel prognosis,l severel dz,l highl riskl ofl mortalityl andl hospitalization
QUESTION
BNPl confounders,l increasesl levels
Answer:
Age,l renall dysfunction,l noncardiacl illnessl (acute/chronic).
QUESTION
BNPl confounders,l decreasesl level
Answer:
obesity
QUESTION
BNPl andl NT-proBNP
Answer:
arel notl interchangeablel -l interpretl accordingl tol specificl assayl cutoffsl andl clinicall context
QUESTION
Infectivel endocarditisl essentialsl ofl diagnosis
,Answer:
-fever
-underlyingl valvularl dzl orl prostheticl endovascularl material
-positivel bloodl cultures
-evidencel ofl vegetationl onl echocardiography
-evidencel ofl systemicl emboli
QUESTION
Leadingl causel ofl nativel valvel infectivel endocarditis
Answer:
S.l aureus
QUESTION
Leadingl causel ofl infectivel endocarditisl inl injectionl drugl users
Answer:
S.l aureus
QUESTION
Leadingl causel ofl infectivel endocarditisl inl prostheticl valves
Answer:
-thosel occurringl withinl 2l monthsl afterl implantationl -l staphylococcil andl fungi
-laterl -l streptococci
QUESTION
Infectivel endocarditisl s/s
Answer:
-feverl (mayl bel lowl grade)
-nonspecificl symptomsl arel common
-changingl murmurl
, -sxl ofl embolization,l metastaticl infx,l orl immunologic
--cough,l dyspnea,l arthralgiasl orl arthritis,l diarrhea,l abd/back/flankl pain
-25%l ofl ptsl havel petechial (palate,l fonjunctiva,l beneathl fingernails),l splinterl hemorrhagesl
(nails),l Oslerl nodesl (onl fingers,l toes,l feet),l Janewayl lesionsl (painlessl erythematousl
lesionsl ofl palmsl orl soles),l Rothl spotsl (exudativel lesionsl inl retina)
-strokesl andl majorl systemicl embolicl eventsl -l 25%
-hematurial andl proteinuria
QUESTION
Infectivel endocarditisl cultures
Answer:
THREEl setsl ofl bloodl culturesl arel recommendedl beforel startingl antibiotics
-mustl havel 10mLl ofl bloodl perl bottle
QUESTION
Infectivel endocarditisl diagnosticl criteria
Answer:
MAJOR:
-2l positivel bloodl culturesl forl organisml thatl typicallyl causesl IE,l 3l orl morel positivel
culturesl forl organisml thatl occasionallyl orl rarelyl causesl IE,l orl bloodl testsl consistentl
withl acutel infxl w/l coxiella,l bartonella,l tropheryma
-evidencel ofl endocardiall involvementl documentedl byl echol (vegetation,l abscess,l
dehiscencel ofl valve,l regurg)
-directlyl observedl evidencel ofl endocarditisl duringl cardiacl surg
MINOR:
-presencel ofl predisposingl condition
-feverl ofl 38cl orl higher
-vascularl phenomenal (cutaneousl hemorrhages,l aneurysm,l systemicl emboli,l pulml
infarction,l immunologicl phenomenal suchl asl glomerulonephritis,l Oslerl nodes,l Rothl spots,l
orl rheumatoidl factor,l +bloodl cultl notl meetingl majorl criterial orl otherl labl evidencel ofl
activel infx,l abnormall PET/CTl w/inl 3l monthsl ofl valve,l worseningl regurg)
QUESTION
2027l Update)l Nursel Practitionersl inl
Primaryl Carel IIl Guidel |l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
BNP
Answer:
Al cardiacl neurohormonel secretedl byl ventricularl myocytesl inl responsel tol increasedl walll
stretchl andl pressure
QUESTION
Clinicall indicationsl forl orderl BNP
Answer:
-unexplainedl dyspnea
-seriall measurementl inl chronicl HFl aidl prognosis
-hospitalizedl HFl -l admissionl &l prel d/cl levelsl guidel planning
-canl bel usedl asl earlyl detectionl forl high-riskl pts
QUESTION
Lowl levelsl ofl BNP
Answer:
stronglyl arguesl AGAINSTl HF
QUESTION
,Elevatedl levelsl ofl BNP
Answer:
supportsl HFl diagnosisl butl isl notl specific
-alsol elevatedl inl ACS,l A-fib,l renall failure,l PE,l sepsis
QUESTION
Highl levelsl ofl BNPl inl HF
Answer:
-associatedl w/l worsel prognosis,l severel dz,l highl riskl ofl mortalityl andl hospitalization
QUESTION
BNPl confounders,l increasesl levels
Answer:
Age,l renall dysfunction,l noncardiacl illnessl (acute/chronic).
QUESTION
BNPl confounders,l decreasesl level
Answer:
obesity
QUESTION
BNPl andl NT-proBNP
Answer:
arel notl interchangeablel -l interpretl accordingl tol specificl assayl cutoffsl andl clinicall context
QUESTION
Infectivel endocarditisl essentialsl ofl diagnosis
,Answer:
-fever
-underlyingl valvularl dzl orl prostheticl endovascularl material
-positivel bloodl cultures
-evidencel ofl vegetationl onl echocardiography
-evidencel ofl systemicl emboli
QUESTION
Leadingl causel ofl nativel valvel infectivel endocarditis
Answer:
S.l aureus
QUESTION
Leadingl causel ofl infectivel endocarditisl inl injectionl drugl users
Answer:
S.l aureus
QUESTION
Leadingl causel ofl infectivel endocarditisl inl prostheticl valves
Answer:
-thosel occurringl withinl 2l monthsl afterl implantationl -l staphylococcil andl fungi
-laterl -l streptococci
QUESTION
Infectivel endocarditisl s/s
Answer:
-feverl (mayl bel lowl grade)
-nonspecificl symptomsl arel common
-changingl murmurl
, -sxl ofl embolization,l metastaticl infx,l orl immunologic
--cough,l dyspnea,l arthralgiasl orl arthritis,l diarrhea,l abd/back/flankl pain
-25%l ofl ptsl havel petechial (palate,l fonjunctiva,l beneathl fingernails),l splinterl hemorrhagesl
(nails),l Oslerl nodesl (onl fingers,l toes,l feet),l Janewayl lesionsl (painlessl erythematousl
lesionsl ofl palmsl orl soles),l Rothl spotsl (exudativel lesionsl inl retina)
-strokesl andl majorl systemicl embolicl eventsl -l 25%
-hematurial andl proteinuria
QUESTION
Infectivel endocarditisl cultures
Answer:
THREEl setsl ofl bloodl culturesl arel recommendedl beforel startingl antibiotics
-mustl havel 10mLl ofl bloodl perl bottle
QUESTION
Infectivel endocarditisl diagnosticl criteria
Answer:
MAJOR:
-2l positivel bloodl culturesl forl organisml thatl typicallyl causesl IE,l 3l orl morel positivel
culturesl forl organisml thatl occasionallyl orl rarelyl causesl IE,l orl bloodl testsl consistentl
withl acutel infxl w/l coxiella,l bartonella,l tropheryma
-evidencel ofl endocardiall involvementl documentedl byl echol (vegetation,l abscess,l
dehiscencel ofl valve,l regurg)
-directlyl observedl evidencel ofl endocarditisl duringl cardiacl surg
MINOR:
-presencel ofl predisposingl condition
-feverl ofl 38cl orl higher
-vascularl phenomenal (cutaneousl hemorrhages,l aneurysm,l systemicl emboli,l pulml
infarction,l immunologicl phenomenal suchl asl glomerulonephritis,l Oslerl nodes,l Rothl spots,l
orl rheumatoidl factor,l +bloodl cultl notl meetingl majorl criterial orl otherl labl evidencel ofl
activel infx,l abnormall PET/CTl w/inl 3l monthsl ofl valve,l worseningl regurg)
QUESTION
