Walden University NRNP 6550 Midterm (pdf) | 2026/2027 | Adv
Practice Care | Adult-Gerontology Acute Care
**1. The AGACNP is caring for a patient who is quite ill and has developed 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.**
A) Transudate
B) Exudate
C) Chyliform effusion
D) Hemorrhagic effusion
**Correct Answer: A**
**Rationale:** A transudate is essentially just water and can occur as a
consequence of increased hydrostatic pressure in the pulmonary vessels. It
typically implies that 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 imbalance. An
exudate has more protein and implies a condition characterized by protein
leaking from vessels, such as a malignancy or serious systemic stressor. A
chyliform effusion is characterized by fat and indicates a pathology causing
massive triglyceride degradation. A hemorrhagic effusion is blood and
typically means traumatic injury.
---
**2. Differentiating vertigo from near-syncope and ataxia is one of the goals
of history-taking when a patient presents as "dizzy." The AGACNP knows that
vertigo is the problem when the patient reports the primary symptom as:**
A) A sense of spinning
,B) A feeling of imbalance or unsteadiness
C) Nausea
D) Lightheadedness
**Correct Answer: A**
**Rationale:** When the patient identifies the primary symptom as a sense
of spinning, this supports vertigo, which is usually an inner ear problem.
Ataxia is neurologic and presents with imbalance or unsteadiness. Near-
syncope may be cardiac, neurological, or neurocardiogenic. Nausea is not
specific and can occur with any of these complaints.
---
**3. A 55-year-old female presents with acute onset left-sided facial pain and
an inability to move the left side of her face. She cannot close her left eye
completely. What is the most likely diagnosis?**
A) Trigeminal neuralgia
B) Bell's palsy
C) Stroke
D) TMJ disorder
**Correct Answer: B**
**Rationale:** Bell's palsy is an acute peripheral facial nerve palsy of
unknown cause. It presents with sudden onset of unilateral facial weakness
or paralysis, inability to close the eye, and often facial pain. Unlike stroke,
Bell's palsy typically involves the entire side of the face (both upper and
,lower face), and there are no other neurologic deficits. Trigeminal neuralgia
presents with severe, episodic facial pain without motor weakness.
---
**4. What is the primary risk factor for pulmonary embolus?**
A) Atrial fibrillation
B) Deep vein thrombosis (DVT)
C) Hyperlipidemia
D) Smoking
**Correct Answer: B**
**Rationale:** The primary risk factor for pulmonary embolus is deep vein
thrombosis (DVT). DVT risks include polycythemia and stasis. Other risk
factors include prolonged immobility, surgery, trauma, cancer, and inherited
hypercoagulable states.
---
**5. What testing assesses for macular degeneration?**
A) Snellen chart
B) Amsler Grid
C) Tonometry
D) Slit lamp examination
, **Correct Answer: B**
**Rationale:** The Amsler Grid is used to assess central vision changes seen
in macular degeneration. Patients with macular degeneration may report
seeing wavy lines or missing areas on the grid. Snellen chart assesses visual
acuity, tonometry measures intraocular pressure (glaucoma), and slit lamp
examination evaluates anterior segment structures.
---
**6. What is the Woods Lamp used for?**
A) Illuminate fungi, bacteria, pigmentation, and corneal abrasions
B) Measure intraocular pressure
C) Assess visual fields
D) Evaluate the retina
**Correct Answer: A**
**Rationale:** The Woods Lamp is used to illuminate fungi, bacteria,
pigmentation, and other skin problems. It can also be used to detect corneal
abrasions. It is a useful diagnostic tool in dermatology and ophthalmology.
---
**7. Differentiate between the types of dementia. Which type of dementia is
characterized by a long trajectory that progresses to confabulations?**
A) Lewy Body dementia
Practice Care | Adult-Gerontology Acute Care
**1. The AGACNP is caring for a patient who is quite ill and has developed 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.**
A) Transudate
B) Exudate
C) Chyliform effusion
D) Hemorrhagic effusion
**Correct Answer: A**
**Rationale:** A transudate is essentially just water and can occur as a
consequence of increased hydrostatic pressure in the pulmonary vessels. It
typically implies that 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 imbalance. An
exudate has more protein and implies a condition characterized by protein
leaking from vessels, such as a malignancy or serious systemic stressor. A
chyliform effusion is characterized by fat and indicates a pathology causing
massive triglyceride degradation. A hemorrhagic effusion is blood and
typically means traumatic injury.
---
**2. Differentiating vertigo from near-syncope and ataxia is one of the goals
of history-taking when a patient presents as "dizzy." The AGACNP knows that
vertigo is the problem when the patient reports the primary symptom as:**
A) A sense of spinning
,B) A feeling of imbalance or unsteadiness
C) Nausea
D) Lightheadedness
**Correct Answer: A**
**Rationale:** When the patient identifies the primary symptom as a sense
of spinning, this supports vertigo, which is usually an inner ear problem.
Ataxia is neurologic and presents with imbalance or unsteadiness. Near-
syncope may be cardiac, neurological, or neurocardiogenic. Nausea is not
specific and can occur with any of these complaints.
---
**3. A 55-year-old female presents with acute onset left-sided facial pain and
an inability to move the left side of her face. She cannot close her left eye
completely. What is the most likely diagnosis?**
A) Trigeminal neuralgia
B) Bell's palsy
C) Stroke
D) TMJ disorder
**Correct Answer: B**
**Rationale:** Bell's palsy is an acute peripheral facial nerve palsy of
unknown cause. It presents with sudden onset of unilateral facial weakness
or paralysis, inability to close the eye, and often facial pain. Unlike stroke,
Bell's palsy typically involves the entire side of the face (both upper and
,lower face), and there are no other neurologic deficits. Trigeminal neuralgia
presents with severe, episodic facial pain without motor weakness.
---
**4. What is the primary risk factor for pulmonary embolus?**
A) Atrial fibrillation
B) Deep vein thrombosis (DVT)
C) Hyperlipidemia
D) Smoking
**Correct Answer: B**
**Rationale:** The primary risk factor for pulmonary embolus is deep vein
thrombosis (DVT). DVT risks include polycythemia and stasis. Other risk
factors include prolonged immobility, surgery, trauma, cancer, and inherited
hypercoagulable states.
---
**5. What testing assesses for macular degeneration?**
A) Snellen chart
B) Amsler Grid
C) Tonometry
D) Slit lamp examination
, **Correct Answer: B**
**Rationale:** The Amsler Grid is used to assess central vision changes seen
in macular degeneration. Patients with macular degeneration may report
seeing wavy lines or missing areas on the grid. Snellen chart assesses visual
acuity, tonometry measures intraocular pressure (glaucoma), and slit lamp
examination evaluates anterior segment structures.
---
**6. What is the Woods Lamp used for?**
A) Illuminate fungi, bacteria, pigmentation, and corneal abrasions
B) Measure intraocular pressure
C) Assess visual fields
D) Evaluate the retina
**Correct Answer: A**
**Rationale:** The Woods Lamp is used to illuminate fungi, bacteria,
pigmentation, and other skin problems. It can also be used to detect corneal
abrasions. It is a useful diagnostic tool in dermatology and ophthalmology.
---
**7. Differentiate between the types of dementia. Which type of dementia is
characterized by a long trajectory that progresses to confabulations?**
A) Lewy Body dementia
