AG-ACNP DRT #3
24 yo. M presented in DKA. I'm now lost and irritable. ABGs read pH 7.28/33/22. Received
isotonic fluids for past hour, and BP 110/70, HR 90. 550 mg/dL of glucose remains in the
blood. What is the best intravenous fluid indicated at this point:
a. 1/2 standard saline b. 1/2 normal saline and 5 percent dextrose c. ANS1/2 normal saline
at 0.9 percent 35 yo. F presents to ED with c/o b/l wrist pain. You think that your spouse is
abusing you. A gun is in the patient's purse, you notice. How would you proceed next? a.
contact social services about spousal abuse
b. Remove the patient from the handgun c. call security to ensure safety
d. to ensure your safety, contact the authorities and report a dangerous weapon to
ANSsecurity. 38 year old female patients has been immobilized for four months. You
observe that dyspnea and tachycardia have occurred when you examined her prior to her
release. You suspect pulmonary embolus, but a ventilation/perfusion lung scan does not
confirm the diagnosis. What is the best next step?
• Another lung scan • Test arterial blood gas
• Pulmonary angiography
• ANSpulmonary angiography using spiral CT 48 year old admitted w/ fever, abdominal pain
and bloody diarrhea. History includes chronic sinusitis, arthritis and recently resolved DVT.
These S/S are the first to occur, especially the bloody diarrhea. Which represents the most
likely diagnosis and appropriate test to order?
• Sigmoidoscopy for diverticulitis • Diverticulitis: stool culture
• Sigmoidoscopy for ulcerative colitis • Ulcerative Colitis: stool culture - ANSulcerative colitis
sigmoidoscopy
54 yo. M s/p AMI treated with NTG, levophed, and epinepherine. BP 160/75 and now
81/50. Which medication would you stop taking? ANSStop NTG 59 yo. M with s/s
suggestive of BPH. UA is negative and PSA 3.2. What should you order next?
a. transrectal ultrasound
b. ct of pelvis
c. KUB - ANStransrectal ultrasound
62 yo. M presents with c/o angina that started after his daily walk. The lipid panel shows
250 LDL, 25 HDL, 350 total cholesterol, and 250 triglycerides. You prescribe niacin. How
would you explain the MOA of niacin to the patient? - ANSniacin lowers LDL and increases
HDL
63 yo. Caucasian M presents for annual physical exam. BP 120/82 at the start. Patient has
no significant PMH. 125/80 second BP What treatment plan would you recommend for this
patient? a. CCB
b. changes in one's lifestyle c. exercise stress test
d. ACE Inhibitor - ANSlifestyle changes
73 year old female presents w/ dizziness, palpitations and an anorexic appearance.
Additionally, the patient states that she frequently experiences feelings of weakness,
exhaustion, and loss of motor control. MCV is 110, HGB is 10, and HCT is 30%, according to
lab testing. Most likely treatment? • Iron deficiency anemia
, • Dangerous anemia • Chronic disease anemia • Folic acid deficiency - ANSpernicious
anemia
A mother comes to your office w/ her 18 year old son, who was stung by a bee and has
subsequently develop respiratory distress and stridor. Which one of the following should you
treat right away? • phenylephrine • Fluids with crystals • Inhaled beta agonists
• ANSepinepherine vasopressors A patient gas his appendix removed and is now
experiencing post-op fever. Which of the following management options should be initiated
for this patient?
• Antibiotic regimen
• Supportive fluid therapy
• Have pt. go on a post-op diet
• Discontinue all meds as this is an allergic reaction to treatment - ANSsupportive fluid
therapy
Adult child of your patient reports that her father has expressed desire to commit suicide
and has a history of depression and ETOH abuse. The best response to the adult child by
the ACNP would be:
a. 5% of depressed patients take their own lives b. ETOH abuse individuals rarely commit
suicide
c. hospitalize the father and start psychotherapy - ANShospitalize the patient and start
psychotherapy
At what age do males start colonoscopy every 10 years? - ANS50
At what age is a PSA screening indicated in a non-African American male with no family
history? - ANS50
Structure, outcomes, and CPI use these three measures to monitor nursing improvement: a.
standards
b. conformity c. processes
d. indicatiors - ANSprocesses
ANSflank pain distinguishing between upper and lower UTIs Elderly pt. takes an herbal root
to help fight cold symptoms, however, he has a history of renal insufficiency. Which of the
following could occur as a result of the patient's ailments and homeopathic treatment? •
Ginseng counteracting warfarin
• Echinacea causing nephrotoxicity
• Ginger impairs renal function • Echinacea causing anaphylaxis - ANSechinacea causing
nephrotoxicity
Elderly woman who has a history of lung dysfunction comes to your office. She presents w/
a number of respiratory symptoms, but one of her main complaints is a severe HA. Which of
the following conditions is most likely to present with these symptoms? • Asthma
• Acute bronchitis
• Pneumonia
• ANSacute bronchitis and emphysema Evan, 37, is in the ED s/p endotracheal intubation
two days prior. He now exhibits fever, chills and purulent sputum. A CXR reveals lung
infiltrates. For the patient's most likely condition, which of the following regimens is most
appropriate? • Cefepime and Ciprofloxacin
• Cephalexin and PCN • Vancomycin, ampicillin-sulbactam and azithromycin
• Tetracycline - ANScefepime and ciprofloxacin
F patient has normal PAP smear and reports that she has not had an abnormal PAP smear
for the past 10 years. At what age is it appropriate to discontinue pap smears in this case?
a. 60-65
24 yo. M presented in DKA. I'm now lost and irritable. ABGs read pH 7.28/33/22. Received
isotonic fluids for past hour, and BP 110/70, HR 90. 550 mg/dL of glucose remains in the
blood. What is the best intravenous fluid indicated at this point:
a. 1/2 standard saline b. 1/2 normal saline and 5 percent dextrose c. ANS1/2 normal saline
at 0.9 percent 35 yo. F presents to ED with c/o b/l wrist pain. You think that your spouse is
abusing you. A gun is in the patient's purse, you notice. How would you proceed next? a.
contact social services about spousal abuse
b. Remove the patient from the handgun c. call security to ensure safety
d. to ensure your safety, contact the authorities and report a dangerous weapon to
ANSsecurity. 38 year old female patients has been immobilized for four months. You
observe that dyspnea and tachycardia have occurred when you examined her prior to her
release. You suspect pulmonary embolus, but a ventilation/perfusion lung scan does not
confirm the diagnosis. What is the best next step?
• Another lung scan • Test arterial blood gas
• Pulmonary angiography
• ANSpulmonary angiography using spiral CT 48 year old admitted w/ fever, abdominal pain
and bloody diarrhea. History includes chronic sinusitis, arthritis and recently resolved DVT.
These S/S are the first to occur, especially the bloody diarrhea. Which represents the most
likely diagnosis and appropriate test to order?
• Sigmoidoscopy for diverticulitis • Diverticulitis: stool culture
• Sigmoidoscopy for ulcerative colitis • Ulcerative Colitis: stool culture - ANSulcerative colitis
sigmoidoscopy
54 yo. M s/p AMI treated with NTG, levophed, and epinepherine. BP 160/75 and now
81/50. Which medication would you stop taking? ANSStop NTG 59 yo. M with s/s
suggestive of BPH. UA is negative and PSA 3.2. What should you order next?
a. transrectal ultrasound
b. ct of pelvis
c. KUB - ANStransrectal ultrasound
62 yo. M presents with c/o angina that started after his daily walk. The lipid panel shows
250 LDL, 25 HDL, 350 total cholesterol, and 250 triglycerides. You prescribe niacin. How
would you explain the MOA of niacin to the patient? - ANSniacin lowers LDL and increases
HDL
63 yo. Caucasian M presents for annual physical exam. BP 120/82 at the start. Patient has
no significant PMH. 125/80 second BP What treatment plan would you recommend for this
patient? a. CCB
b. changes in one's lifestyle c. exercise stress test
d. ACE Inhibitor - ANSlifestyle changes
73 year old female presents w/ dizziness, palpitations and an anorexic appearance.
Additionally, the patient states that she frequently experiences feelings of weakness,
exhaustion, and loss of motor control. MCV is 110, HGB is 10, and HCT is 30%, according to
lab testing. Most likely treatment? • Iron deficiency anemia
, • Dangerous anemia • Chronic disease anemia • Folic acid deficiency - ANSpernicious
anemia
A mother comes to your office w/ her 18 year old son, who was stung by a bee and has
subsequently develop respiratory distress and stridor. Which one of the following should you
treat right away? • phenylephrine • Fluids with crystals • Inhaled beta agonists
• ANSepinepherine vasopressors A patient gas his appendix removed and is now
experiencing post-op fever. Which of the following management options should be initiated
for this patient?
• Antibiotic regimen
• Supportive fluid therapy
• Have pt. go on a post-op diet
• Discontinue all meds as this is an allergic reaction to treatment - ANSsupportive fluid
therapy
Adult child of your patient reports that her father has expressed desire to commit suicide
and has a history of depression and ETOH abuse. The best response to the adult child by
the ACNP would be:
a. 5% of depressed patients take their own lives b. ETOH abuse individuals rarely commit
suicide
c. hospitalize the father and start psychotherapy - ANShospitalize the patient and start
psychotherapy
At what age do males start colonoscopy every 10 years? - ANS50
At what age is a PSA screening indicated in a non-African American male with no family
history? - ANS50
Structure, outcomes, and CPI use these three measures to monitor nursing improvement: a.
standards
b. conformity c. processes
d. indicatiors - ANSprocesses
ANSflank pain distinguishing between upper and lower UTIs Elderly pt. takes an herbal root
to help fight cold symptoms, however, he has a history of renal insufficiency. Which of the
following could occur as a result of the patient's ailments and homeopathic treatment? •
Ginseng counteracting warfarin
• Echinacea causing nephrotoxicity
• Ginger impairs renal function • Echinacea causing anaphylaxis - ANSechinacea causing
nephrotoxicity
Elderly woman who has a history of lung dysfunction comes to your office. She presents w/
a number of respiratory symptoms, but one of her main complaints is a severe HA. Which of
the following conditions is most likely to present with these symptoms? • Asthma
• Acute bronchitis
• Pneumonia
• ANSacute bronchitis and emphysema Evan, 37, is in the ED s/p endotracheal intubation
two days prior. He now exhibits fever, chills and purulent sputum. A CXR reveals lung
infiltrates. For the patient's most likely condition, which of the following regimens is most
appropriate? • Cefepime and Ciprofloxacin
• Cephalexin and PCN • Vancomycin, ampicillin-sulbactam and azithromycin
• Tetracycline - ANScefepime and ciprofloxacin
F patient has normal PAP smear and reports that she has not had an abnormal PAP smear
for the past 10 years. At what age is it appropriate to discontinue pap smears in this case?
a. 60-65
