2
ANCC Adult Gerontology Acute Care Exam questions with
|| || || || || || || ||
verified answers ||
Cardiac Index - ✔✔2-4 || || ||
SVR/Afterload - ✔✔800-1200 || ||
MAP - ✔✔mean CVx80/CO
|| || ||
PA pressure - ✔✔15-30
|| || ||
Wedge PCWP pressure - ✔✔6-12
|| || || ||
Hypovolemic Shock Parameters - ✔✔Preload CVP decreased, SVR afterload increased, CI
|| || || || || || || || || || ||
decreased, Oxygen delivery Decreased, Venous Oxygen saturation increased
|| || || || || || ||
Types of hypovolemic shock - ✔✔Hemorrhage, burns, pancreatitis
|| || || || || || ||
Cardiogenic shock parameters - ✔✔CVP preload increased, SVR afterload increased, CI
|| || || || || || || || || || ||
decreased, oxygen delivery decreased, SV02 decreased
|| || || || ||
Types of cardiogenic shock - ✔✔Post mi, malignant dysrhythmia, acute myocarditis
|| || || || || || || || || ||
Obstructive shock parameters - ✔✔Preload either, SVR increased, CI decreased, oxygen
|| || || || || || || || || || ||
delivery decreased, SV02 decreased
|| || ||
,2
Types of obstructive shock - ✔✔Tension pneumo, cardiac tamponade, PE
|| || || || || || || || ||
Distributive shock parameters - ✔✔Preload CVP decreased, afterload SVR decreased, CI
|| || || || || || || || || || ||
increased, SV02 decreased, oxygen delivery increased
|| || || || ||
Types of distributive shock - ✔✔Septic shock, anaphylaxis, neurogenic shock
|| || || || || || || || ||
CVP Preload - ✔✔2-8
|| || ||
Cardiac Output - ✔✔4-8 || || ||
MAP - ✔✔70-90 || ||
Fractional Excretion of NA <1% - ✔✔Prerenal state of kidney dysfunction (i.e. dehydration)
|| || || || || || || || || || || ||
Fractional Excretion of NA >2% - ✔✔ATN (acute tubular necrosis)
|| || || || || || || || ||
CPP equation - ✔✔MAP-ICP
|| || ||
SIADH Hyposmolar hyponatremia "inappropriate water retention" - ✔✔serum sodium low,
|| || || || || || || || || ||
serum osmo low <280, urine osmo high >100, no dehydration, tx restrict fluids
|| || || || || || || || || || || ||
if neuro symptoms give 3%NS
|| || || ||
DI Hyperosmolar hypernatremia dry - ✔✔Serum sodium high, serum osmo high >290,
|| || || || || || || || || || || ||
urine osmo low <100, urine spec grave 1.005 (urine is like water), urine sodium >20,
|| || || || || || || || || || || || || || ||
dehydration, if serum Na >150 give D5W to replace ½ volume deficit in 12-24 hours, avoid
|| || || || || || || || || || || || || || || ||
rapid lowering of Na, DDAVP for acute situations
|| || || || || || ||
,2
Serum Osmo - ✔✔280 || || ||
Urine Osmo - ✔✔300-800 || || ||
Sodium - ✔✔~140 || ||
Total cholesterol - ✔✔<200
|| || ||
Triglycerides - ✔✔<150 || ||
HDL - ✔✔>40 || ||
LDL - ✔✔<100 || ||
Management of pulm edema - ✔✔02, sitting up, morphine 2-4mg, Lasix 40, another Lasix || || || || || || || || || || || || || ||
40 if needed
|| ||
Left heart failure - ✔✔LUNGS, dyspnea at rest, rales, wheezing, generally healthy except
|| || || || || || || || || || || || ||
acute event, S3, murmur of mitral regurg
|| || || || || ||
Right heart failure - ✔✔JVD, hepatomegaly, peripheral edema
|| || || || || || ||
MR ASS - ✔✔Mitral regurg, aortic stenosis, systolic murmurs
|| || || || || || || ||
MS ARD - ✔✔Mitral Stenosis, aortic regurg, diastolic
|| || || || || || ||
, 2
Mitral murmur locations - ✔✔5th ICS, apex
|| || || || || ||
Aortic murmur locations - ✔✔2nd or 3rd ICS, base
|| || || || || || || ||
S1 - ✔✔AV valves closed, SL open
|| || || || || ||
S2 - ✔✔SL closed, AV open
|| || || || ||
Cardiac blood flow - ✔✔SVC,RA, tricuspid, RV, pulmonic valve, pulmonary artery, lungs,
|| || || || || || || || || || || ||
pulmonary veins, LA, mitral, LV, Aortic valve, aorta, body
|| || || || || || || ||
Cushing's - ✔✔Moon face, buffalo hump, hypertension, HYPERglycemia, HYPERnatremia,
|| || || || || || || || ||
HYPOkalemia, tx depends on cause (stop meds, tumor) || || || || || || ||
Addison's ADRENOcorticoid deficiency - ✔✔Remember: SEX, SALT, and SUGAR
|| || || || || || || || ||
Deficient cortisol, androgens, and aldosterone, hyperpigmentation in buccal mucosa,
|| || || || || || || || ||
tanning, HYPOtension, scant hair, HYPOglycemia, HYPOnatremia, HYPERkalemia,
|| || || || || || ||
cosyntropin is the rule out for addison's, manage: referral, glucorticoid, hydrocortisone,
|| || || || || || || || || || ||
fludrocortisone inpatient: hydrocortisone and fluids || || || ||
HYPERthyroidism/Grave's - ✔✔TSH LOW, T3 High, Grave's Disease, bulgy eyes, weight || || || || || || || || || || ||
loss, fine thin hair, smooth skin, a fib
|| || || || || || || ||
Specialist referral, propranolol, methimazole, PTU, lugol's
|| || || || ||
Thyroid crisis - ✔✔PTU or Methimazole with adjunct within 1 hour Lugol's propranolol,
|| || || || || || || || || || || || ||
hydrocortisone
No ASA ||
ANCC Adult Gerontology Acute Care Exam questions with
|| || || || || || || ||
verified answers ||
Cardiac Index - ✔✔2-4 || || ||
SVR/Afterload - ✔✔800-1200 || ||
MAP - ✔✔mean CVx80/CO
|| || ||
PA pressure - ✔✔15-30
|| || ||
Wedge PCWP pressure - ✔✔6-12
|| || || ||
Hypovolemic Shock Parameters - ✔✔Preload CVP decreased, SVR afterload increased, CI
|| || || || || || || || || || ||
decreased, Oxygen delivery Decreased, Venous Oxygen saturation increased
|| || || || || || ||
Types of hypovolemic shock - ✔✔Hemorrhage, burns, pancreatitis
|| || || || || || ||
Cardiogenic shock parameters - ✔✔CVP preload increased, SVR afterload increased, CI
|| || || || || || || || || || ||
decreased, oxygen delivery decreased, SV02 decreased
|| || || || ||
Types of cardiogenic shock - ✔✔Post mi, malignant dysrhythmia, acute myocarditis
|| || || || || || || || || ||
Obstructive shock parameters - ✔✔Preload either, SVR increased, CI decreased, oxygen
|| || || || || || || || || || ||
delivery decreased, SV02 decreased
|| || ||
,2
Types of obstructive shock - ✔✔Tension pneumo, cardiac tamponade, PE
|| || || || || || || || ||
Distributive shock parameters - ✔✔Preload CVP decreased, afterload SVR decreased, CI
|| || || || || || || || || || ||
increased, SV02 decreased, oxygen delivery increased
|| || || || ||
Types of distributive shock - ✔✔Septic shock, anaphylaxis, neurogenic shock
|| || || || || || || || ||
CVP Preload - ✔✔2-8
|| || ||
Cardiac Output - ✔✔4-8 || || ||
MAP - ✔✔70-90 || ||
Fractional Excretion of NA <1% - ✔✔Prerenal state of kidney dysfunction (i.e. dehydration)
|| || || || || || || || || || || ||
Fractional Excretion of NA >2% - ✔✔ATN (acute tubular necrosis)
|| || || || || || || || ||
CPP equation - ✔✔MAP-ICP
|| || ||
SIADH Hyposmolar hyponatremia "inappropriate water retention" - ✔✔serum sodium low,
|| || || || || || || || || ||
serum osmo low <280, urine osmo high >100, no dehydration, tx restrict fluids
|| || || || || || || || || || || ||
if neuro symptoms give 3%NS
|| || || ||
DI Hyperosmolar hypernatremia dry - ✔✔Serum sodium high, serum osmo high >290,
|| || || || || || || || || || || ||
urine osmo low <100, urine spec grave 1.005 (urine is like water), urine sodium >20,
|| || || || || || || || || || || || || || ||
dehydration, if serum Na >150 give D5W to replace ½ volume deficit in 12-24 hours, avoid
|| || || || || || || || || || || || || || || ||
rapid lowering of Na, DDAVP for acute situations
|| || || || || || ||
,2
Serum Osmo - ✔✔280 || || ||
Urine Osmo - ✔✔300-800 || || ||
Sodium - ✔✔~140 || ||
Total cholesterol - ✔✔<200
|| || ||
Triglycerides - ✔✔<150 || ||
HDL - ✔✔>40 || ||
LDL - ✔✔<100 || ||
Management of pulm edema - ✔✔02, sitting up, morphine 2-4mg, Lasix 40, another Lasix || || || || || || || || || || || || || ||
40 if needed
|| ||
Left heart failure - ✔✔LUNGS, dyspnea at rest, rales, wheezing, generally healthy except
|| || || || || || || || || || || || ||
acute event, S3, murmur of mitral regurg
|| || || || || ||
Right heart failure - ✔✔JVD, hepatomegaly, peripheral edema
|| || || || || || ||
MR ASS - ✔✔Mitral regurg, aortic stenosis, systolic murmurs
|| || || || || || || ||
MS ARD - ✔✔Mitral Stenosis, aortic regurg, diastolic
|| || || || || || ||
, 2
Mitral murmur locations - ✔✔5th ICS, apex
|| || || || || ||
Aortic murmur locations - ✔✔2nd or 3rd ICS, base
|| || || || || || || ||
S1 - ✔✔AV valves closed, SL open
|| || || || || ||
S2 - ✔✔SL closed, AV open
|| || || || ||
Cardiac blood flow - ✔✔SVC,RA, tricuspid, RV, pulmonic valve, pulmonary artery, lungs,
|| || || || || || || || || || || ||
pulmonary veins, LA, mitral, LV, Aortic valve, aorta, body
|| || || || || || || ||
Cushing's - ✔✔Moon face, buffalo hump, hypertension, HYPERglycemia, HYPERnatremia,
|| || || || || || || || ||
HYPOkalemia, tx depends on cause (stop meds, tumor) || || || || || || ||
Addison's ADRENOcorticoid deficiency - ✔✔Remember: SEX, SALT, and SUGAR
|| || || || || || || || ||
Deficient cortisol, androgens, and aldosterone, hyperpigmentation in buccal mucosa,
|| || || || || || || || ||
tanning, HYPOtension, scant hair, HYPOglycemia, HYPOnatremia, HYPERkalemia,
|| || || || || || ||
cosyntropin is the rule out for addison's, manage: referral, glucorticoid, hydrocortisone,
|| || || || || || || || || || ||
fludrocortisone inpatient: hydrocortisone and fluids || || || ||
HYPERthyroidism/Grave's - ✔✔TSH LOW, T3 High, Grave's Disease, bulgy eyes, weight || || || || || || || || || || ||
loss, fine thin hair, smooth skin, a fib
|| || || || || || || ||
Specialist referral, propranolol, methimazole, PTU, lugol's
|| || || || ||
Thyroid crisis - ✔✔PTU or Methimazole with adjunct within 1 hour Lugol's propranolol,
|| || || || || || || || || || || || ||
hydrocortisone
No ASA ||
