ANCC AGACNP - Frances Guide Review

ANCC AGACNP - Frances Guide Review 15 year old patient with DMI reports increased BG in AM. The ACNP determines hyperglycemia is d/t dawn phenomenon? What should you do to his tx regimen? - Increase the insulin dosage at bedtime 23 yo female presents with DKA. Abg pH 7.3, glucose 520, BP 90/65, HR 120, and she is confused. Which of the following are not included in the initial management of DKA? a. isotonic fluids b. insulin infusion c. sodium bicarbonate d. supportive care - c. sodium bicarbonate Only indicated for DKA if pH 7.1 24 yo male presents with DKA. He is now confused and irritable. AbgL 7.29/33/22. Received isotonic fluids x 1 hour, BP 110/70, HR 90. Blood glucose is 550. What is the best IV fluid indicated? - 1/2 NS because BG500 25yo female presents with green vaginal discharg,e what is the diagnosis? - Gonorrhea 28 yo female presents with fever, malaise, rash across the back and splinter hemorrhages, Hgb 10, positive ANA, UA, proteinuria, and elevated ESR. What is the suspected diagnosis? - SLE 31 yo male with a blowing murmur occurring during S1 and galloping addition heart sound. Mumur is heard best at the base of the heart. What is MM? - Mitral regurgitation 32 yo presents with c/o fever, night sweats, and unexplained weight loss. Upon exam you note a swollen cervical lymph node. A subsequent CXR reveals mediastinal adenopathy. What is the diagnosis? - Hodgkin's lymphoma 32yo M presented with a gunshot wound (GSW) to the FA. Injuries are negligible and pt is stable. Pt reports the shot was an accident during hunting. What should the NP do? - Report to the police. All GSW must be reported 35yo Asian american is in good health. He is worried about life prolonging measures. What is the most likely cause of death for a man like him? - Unintentional injury (if he's African american, it's homicide 35 and heart disease at 35) 35yo F presents with c/o bilateral wrist pain. You suspect spouse abuse. You notice a handgun in her purse. What would be your next action? - Call security to ensure safety 36yo with history of Crohn's disease arrives in the ER with c/o abd pain, frequent vomiting and water bowel movements. You notice high-pitched, tinkling bowel sounds and a transabdominal US reveals a partial SBO. Which is not necessary? a. NPO and IVF b. NGT for LIS c. immediate surgical consult d. monitor for spontaneous resolution - c. immediate surgical consult 37 yo s/p ET intubation 2 days ago has fever, chills, and purulent sputum. CXR shows lung infiltrates. Which of the following regimen for the patient's condition? - Cefepime and ciprofloxacin 38 yo female immobilized for 4 months. Examining her before releasing you not dyspnea and tachycardia. You suspect PE, but VQ scan does not confirm. What is the next diagnostic test? - Pulmonary angiography 42 yo male with epigastric pain that is better after he eats? - Duodenal ulcer 45yo M s/p abd surgery has now developed ARF: BUN 100/cr 4.5, what are indications for dialysis? - Increased K, metabolic acidosis, and encephalopathy 45yo s/p double mastectomy 2 months ago. Now is c/o pain at the incision site - Neuropathic pain 47 yo male comes in complaining of intense right eye pain which has worsened since he woke up. Eye exam: copious tearing/redness. What do you do to confirm the suspected diagnosis? - Sodium fluorescein stain for corneal abrasion 48yo with fever, abdominal pain and bloody diarrhea with h/o chronic sinusitis, arthritis, and recent DVT. Which represents the most likely diagnosis and test to order? - Ulcerative colitis, sigmoidoscopy 49 yo male presents with c/o abdominal swelling that progressed over 2 days. Patient also reports mucous-filled diarrhea and abdominal pain. Exam is significant for profound abd distention. You suspect SBO. What type of bowel sounds are associated?