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FES Exam Questions And Answers

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(blank) are designed to view the lumen either in a front or side viewing manner - ANS Flexible scopes (blank) allow for optimal access to certain areas of the stomach and duodenum and are most commonly utilized during ERCP - ANS side-viewing What is a charge coupled device or complementary metal oxide semioconducter chip based camera? - ANS sends digital message to a digital processor the suction button and the biopsy cap share a **** - ANS common channel The suction/biopsy channel is usually between what position on a clock face - ANS 5 and 7 oclock The (blank) cable connects to the video processing unit either wirelessly or via a separate cable. - ANS umbilical Can you use saline in your water channel? - ANS NO it can crystalize Do not activate (blank) until the functioning end of the device is fully exited from the endoscope channel. - ANS energy sources What scope is a side viewing scope? - ANS A duodenoscope What are external sources of endoscopic illumination? - ANS Xenon Arc, halogen filled tungsten filament lamp, LED What happens when the blue button of the scope handle is depressed? - ANS Provides water to clear the lens If the endoscope does not have a dedicated auxillary channel for irrigation, what channel can be used? - ANS The suction/biopsy channel Informed consent is based on what 2 ethical principles? - ANS Autonomy and self-determination Is routine testing recommended prior to endoscopy? - ANS No When should you do a pregnancy test? - ANS All females of child bearing age Who should get coag tests? - ANS active bleeding, history of bleeding, acquired coagulopathy Who should get a CXR? - ANS Patients with a suspected pulmonary or cardiac decompensation Who should get a chem panel? - ANS pts with impaired renal, hepatic or endocrine function Is there a perfect bowel prep? - ANS nope What would be an ideal prep? - ANS Reliable empties colon No effect on mucosa Short time for ingestion and evacuation No discomfort or signif SE No fluid or electrolyte shifts What is a split dose bowel regiment? - ANS half fluid given in the evening and then half in the morning of the colonoscopy completing at least 3 hours prior to procedure. If you are doing rectum and sigmoid colon endoscopy what can be the prep? - ANS 1 or 2 enemas morning of procedure If your patient is older than 65, what type of bowel prep should you use? - ANS PEG solutions to avoid electrolyte and fluid shifts (blank) are osmotically balanced, non-absorbable electrolyte solutions that effect bowel cleansing by washing out the ingested fluid without producing significant fluid or electrolyte shifts - ANS Isosmotic preparations What fragile patient populations can use isosmotic preps? - ANS Liver and renal failures, CHF, and electrolyte imbalances (Blank) draw plasma water into the bowel lumen to promote the evacuation of colonic contents. They are better tolerated due to lower volume, resulting in better patient compliance. - ANS Hyperosmotic preparations. What is the downside to hyperosomotic solutions? - ANS cause fluid loss, dehydration and are costly. Cant give it to people with any type of failure, ileus, malabsorption or ascites Antibiotics (are vs Are not?) generally recommended before most endoscopic procedures. - ANS Are NOT Who should you give antibiotic prophylaxis to? - ANS All patients before PEJ or PG People undergoing peritoneal dialysis Cirrhotic patients with Gi bleed High risk cardiac conditions like endocarditis or prosthetic valves In patients with liver transplant or suspected biliary obstructions Many endoscopic procedures may be performed safely in the setting of antithrombotics. Cold forceps mucosal biopsies may be obtained while patient is on anticoagulation. T or F? - ANS True T or F When anticoagulation is temporary (e.g. warfarin for VTE), elective endoscopic procedures should be delayed when possible until anticoagulation is no longer necessary. - ANS True Procedures with a high risk of significant bleeding include: - ANS Polypectomy • Biliary sphincterotomy • Pneumatic or bougie dilation • Percutaneous endoscopic gastrostomy (PEG) placement • Endoscopic mucosal resection / endoscopic submucosal dissection (EMD/ESD) • Endosonographic-guided fine needle aspiration and pseudocyst drainage • Laser ablation and coagulation • Treatment of varices Low-risk conditions for embolic event - ANS Deep vein thrombosis • Uncomplicated or paroxysmal nonvalvular atrial fibrillation • Bioprosthetic valve • Mechanical valve in the aortic position High-risk conditions for embolic event - ANS • Atrial fibrillation associated with valvular heart disease • Mechanical valve in the mitral position • Mechanical valve and prior thromboembolic event The risk of major embolism in patients with mechanical heart valves without anticoagulation is(Blank) per 100 person-years, and is reduced to (blank) per 100 person-years in patients with antiplatelet therapy, and to (blank) per 100 person-years in patients with warfarin. - ANS 4 2.2 1 Patients with atrial fibrillation but without valvular disease have a risk of thromboembolism of (blank) per year in the absence of anticoagulation. The risk is higher in the presence of dilated cardiomyopathy, valvular heart disease, or recent thromboembolic events - ANS 5% to 7% The absolute risk of any embolic event in a patient with a low-risk condition in whom anticoagulation is stopped for 4 to 7 days is (blanK) per 1000 patients. - ANS 1 to 2 Pre-procedural management of antithrombotic therapy for procedures with low risk of significant bleed are as follows: •Endoscopic procedures may be performed in patients taking antithrombotic therapy (WITH OR WITHOUT***)any alterations. - ANS Without Pre-procedural management of antithrombotic therapy for procedures with high-risk of significant bleed are as follows: • (blank) does not need to be stopped. • Patients on a single antiplatelet drug, should be switched to (blank) 5-7 days before. • Patients on dual antiplatelet drugs, (blank) should be continued and the second drug should be stopped 5-7 days before. • Patients at high-risk for a thromboembolic event on long-acting anticoagulants should be given (blank). - ANS Aspirin Aspirin Aspirin Bridge Therapy When should you resume antithrombotic therapy? - ANS No consensus In patients with (CIED) Cardiovascular Implantable Electronic Device, what type of device are preferred? - ANS Bipolar and ultrasonic devices How do you know if a patient has a pacemaer? - ANS there should be pacing spikes on EKG in front of P waves When do you place a magnet? - ANS -In non pacing patients to prevent arrythmia detection -In non pacing depending but has pacing ability patients, do need but should be available -in pacing dependent without ICD, place a magnet if procedure above umbilicus -in pacing dependent with an ICD If patients have an CIED, what else should you do besides have a magnet handy? - ANS monitored with either plethysmography or an arterial line and should have transcutaneous patches for emergent defibrillation and/or emergent transcutaneous pacing. Make sure CIED is working before they leave NPO guidelines: CLD? Breast milk? Infant formula? Non human Milk? Light meal? Fried food, fatty foods, meat? - ANS 2 hours 4 hr 6 hr 6 hr 6 hr

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D027 Practice Test #2 Exam Questions
And Answers




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, As an advanced practice nurse, you want to learn more about the CDC's initiatives relative to
asthma care and management in order to advocate for asthma sufferers at the state legislative
level. Your goal is to reduce medications costs to patients. Which CDC recommendation
supports your goal?

a. The CDC recommends that payers and employers promote healthy workspaces to decrease




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environmental trigger exposures.
b. The CDC recommends that providers prescribe the most cost-efficient long-acting inhalers to
lower patient co-pays.




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c. The CDC recommends that providers deviate from the stepwise approach to lessen the
financial impact to the patient.
d. The CDC recommends that co-pays be removed for inhaled corticosteroids and other
prescribed medications - ANS d. The CDC recommends that co-pays be removed for



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inhaled corticosteroids and other prescribed medications

What syndrome, characterized by an absent homologous X chromosome with only a single X
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chromosome, exhibits features that include a short stature, total chromosome count of 45,
webbed neck, and a shield like chest?

a. Cri du chat syndrome
b. Down syndrome
c. Klinefelter syndrome
C

d. Turner syndrome - ANS d. Turner syndrome

A female patient has been recently diagnosed with invasive ductal carcinoma. As an advanced
practice nurse, you understand that she will be undergoing a multi-faceted treatment approach
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that will include one or more medications. Which medication is considered the "gold standard"
endocrine treatment for breast cancer?
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a. Fulvestrant (Faslodex), an antiestrogen indicated for metastatic estrogen receptor-positive
breast cancer in post-menopausal women
b. Tamoxifen (Nolvadex), a prodrug that must be converted to active metabolites in order to
block estrogen receptors in breast tissue
c. Trastuzumab (Herceptin), a monoclonal antibody approved for HER2-positive metastatic
breast cancer
d. Lapatinib (Tykerb), an oral inhibitor of HER2 tyrosine kinase and EGFR tyrosine kinase,
resulting in apoptosis and suppression of tumor cell growth - ANS b. Tamoxifen (Nolvadex),
a prodrug that must be converted to active metabolites in order to block estrogen receptors in
breast tissue

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