32-year-old patient who underwent an open splenectomy for a ruptured spleen, is preparing for discharge. An adult-
gerontology acute care nurse practitioner reviews the potential complications with the patient. The nurse practitioner
emphasizes which instruction to the patient?
Continue antibiotics for 14 days
Follow up with primary care provider for vaccinations
No international travel for five years
No weight lifting restrictions - Correct Answer Follow up with primary care provider for vaccinations
A 15-year-old patient with type 1 diabetes mellitus reports elevated blood glucose levels in the morning. An adult-
gerontology acute care nurse practitioner determines that the patient's hyperglycemia is due to the dawn
phenomenon and:
A) increases the insulin dosage at bed time.
B) reduces the insulin dosage at bed time.
C) tests the blood glucose level at 3:00 AM every morning.
D) tests the blood glucose level in the evening. - Correct Answer A) increases the insulin dosage at bed time.
A 19-year-old male patient arrives at the emergency department exhibiting symptoms of lower abdominal pain that
radiates to the groin, and that the patient rates as an 8 on a scale of 1 to 10. That patient states that the pain came on
suddenly, while he was playing football with friends. The patient's physical examination reveals positive bowel sounds
in all quadrants; a soft, non-tender abdomen; no rebounding and no guarding; and no palpable mass in the abdomen
or groin. Examination of the patient's genitalia reveals a unilateral cremasteric reflex. What is the adult-gerontology
acute care nurse practitioner's leading differential diagnosis, based on the patient's presentation?
Appendicitis
Epididymitis
Inguinal hernia
Testicular torsion - Correct Answer Testicular torsion
A 55-year-old man who has no history of diabetes mellitus, heart disease, hypertension, or thrombotic events is
diagnosed with paroxysmal atrial fibrillation. Based on national stroke prevention guidelines, the recommended
antithrombotic management for this patient is:
aspirin (Bayer).
aspirin with dipyridamole (Aggrenox).
clopidogrel (Plavix).
warfarin (Coumadin). - Correct Answer aspirin (Bayer)
A 65-year-old female patient has a confirmed diagnosis of terminal liver disease. The patient's advance directive
designates comfort measures, only. An adult-gerontology acute care nurse practitioner's action is to:
A) discuss the patient's decision with the patient's family members.
B) persuade the patient to participate in a hepatitis clinical trial.
C) reconfirm the patient's end-of-life decision.
D) refer the patient for a psychological evaluation. - Correct Answer C) reconfirm the patient's end-of-life decision.
A 68-year-old patient had surgery three days ago, for repair of an abdominal aortic aneurysm. The patient remains
intubated, is neurologically intact, and has active bowel sounds. The patient's liver function is within normal limits and
the patient has no signs or symptoms of heart failure. The patient's laboratory values are: blood urea nitrogen of 12
mg/dL, creatinine of 0.8 mg/dL, PaCO2 of 37 mm Hg. The preferred form of nutritional support for this patient is:
A) enteral feeding to the duodenum via a nasogastric small-bore tube.
B) enteral feeding to the stomach via a gastrostomy tube.
C) peripheral parenteral nutrition via an 18-gauge IV catheter.