NURS 6550 Midterm
Exam / NURS6550 Midterm
Exam (Latest): Walden
University
,NURS 6550 Midterm Exam / NURS6550 Midterm Exam (Latest): Walden University
Walden NURS 6550 Midterm Exam / Walden NURS6550 Midterm Exam
1. A patient with anterior epistaxis has been treated with 20 minutes of direct pressure to the
cartilaginous portion of the nose. Following pressure the patient is instructed to gently blow the
nose. Expected findings in the patient who has been successfully treated include all of the following
except a:
2. Kevin is a 14-year-old male who presents for evaluation of a fever of 102.5° F and significant right
ear pain. He appears quite ill and says he feels nauseous. Otoscopic evaluation reveals pain to
palpation, a very erythematous and bulging tympanic membrane with bullous myringitis. The
AGACNP knows that antibiotic therapy must be selected to cover:
3. P.M. is a 71-year-old gay male patient who presents as an outpatient for evaluation of increasing
shortness of breath. The diagnostic evaluation ultimately supports a diagnosis of community
acquired pneumonia. The AGACNP appreciates right middle lobe consolidation on chest radiography.
Pending sputum cultures, empiric antibiotic therapy must be initiated to cover which organism?
4. The AGACNP is caring for a patient who is quite ill and has developed, among other things, a
large right sided pleural effusion. Thoracentesis is sent for pleural fluid analysis. While evaluating the
fluid analysis, the AGACNP knows that a fluid identified as a(n) is the least worrisome
type.
5. Mrs. Miller is transported to the emergency department by paramedics. She is having profound,
unremitting chest pain, is diaphoretic and pale. She has jugular venous distention and a widened
pulse pressure. Suspecting ascending aortic aneurysm, the AGACNP order which test to confirm the
diagnosis?
6. Certain subgroups of the elderly population are at an increased risk for rapid deterioration and
long-term care placement. Which of the following is not considered a high risk factor for long term
care placement?
7. Which of the following is the greatest risk factor for vascular dementia?
8. J.R. is a 55-year-old male who presents for a commercial driver’s license physical examination
with a blood pressure of 170/102 mm Hg. He has no medical history and is without complaint. Which
of the following findings constitutes hypertensive urgency?
9. Because of the commonly recognized adverse effects of atypical antipsychotics, annual
laboratory assessment for patients taking these medications should include a:
10. K.R. presents for an evaluation of eye discomfort. He works in a fabricating shop for a custom
automobile restoration company and while working he felt like something flew into his eye. He was
wearing eye protection at the time but still has the sensation that something is there. Physical
examination is significant for some tearing and he reports a persistent sense of something in his eye.
Which of the following is not indicated in the diagnostic evaluation?
11. D.E. is a 41-year-old female who had lumbar surgery two days ago to repair a ruptured nucleus
pulposus. She has been doing well postoperatively but today is complaining of resting fatigue and
some shortness of breath at rest. In ruling out a pulmonary embolus the AGACNP first orders a:
12. Mr. Nixon is being treated with unfractionated heparin infusion for acute pulmonary embolus. In
order to avoid a potentially fatal complication of heparin infusion, the AGACNP monitors:
,13. Differentiatingxvertigoxfromxnear-syncopexandxataxiaxisxonexofxthexgoalsxofxhistory-
takingxwhenxaxpatientxpresentsxasx“dizzy.”xThexAGACPxknowsxthatxvertigoxisxthexproblemxwhenxthexpa
tientxreportsxthexprimaryxsymptomxas:
14. Mr.xBanksxhasxbeenxadmittedxforxsurgicalxresectionxofxaxmetastaticxtumor,xduringxsurgeryxitxisxdisc
overedxthatxhexhasxwidespread,xdiffusexmetastasisxthroughoutxthexabdomen.xSurgeryxisxnoxlongerxanxo
ption,xandxhisxoncologistxsaysxthatxchemotherapyxisxunlikelyxtoxproducexanyxmeaningfulxbenefit.xMr.xB
anksxisxconcernedxthatxhisxsonsxwillxnotxsupportxaxtransferxtoxcomfortxcare.xThexAGACNPxadvisesxthatxh
e:
15. Mr.xWilkersonxisxax77-year-
oldxmalexwhoxisxbeingxevaluatedxandxtreatedxforxhisxcardiogenicxpain.xHisxvitalxsignsxarexasxfollows:xTe
mperaturexofx99.1°xF,xpulsexofx100xbpm,xrespirationsxofx22xbpm,xandxbloodxpressurexofx168/100xmmxH
g.xAx12-leadxECGxrevealsxdeepxSTxsegmentxdepressionxinxleadsxV3-
V6.xThexAGACNPxrecognizesxwhichxofxthexfollowingxasxaxcontraindicationxtoxrTPAxtherapy?
16. Ax71-year-
oldxpatientxisxrecoveringxfromxaxparticularlyxseverexexacerbationxofxchronicxobstructivexpulmonaryxdis
ease.xHexhasxbeenxinxthexhospitalxforxalmostxtwoxweeksxandxwasxonxmechanicalxventilationxforx7xdays.x
Whilexdiscussingxhisxdischargexplanxhextellsxyouxthatxhexisxreallyxgoingxtoxquitxsmokingxthisxtime.xHexack
nowledgesxthatxhexhasxbeenx"sneaking"xcigarettesxinxthexhospitalxforxtwoxdays,xbutxhexhasxestablishedx
axtimelinextoxdecreasexthexnumberxofxcigarettesxdaily.xAccordingxtoxhisxplanxhisxlastxcigarettexwillxbexth
exlastxdayxofxthexmonth.xThisxpatient’sxbehaviorxisxconsistentxwithxwhichxstagexofxthexTranstheoreticalx
ModelxofxChange?
17. Whilexassessingxaxpatientxwithxaxknownxpsychiatricxhistory,xthexAGACNPxknowsxthatxthexprimaryx
differencexbetweenxaxpsychoticxandxneuroticxdisordersxis:
18. L.T.xisxanx85-year-
oldxmalexwhoxisxadmittedxforxevaluationxofxprofoundxdiarrheaxthatxhasxproducedxsignificantxdehydra
tion.xHexalsoxcomplainsxofxbeingxveryxtiredxlately,xandxfeelingxlikexhexisxgoingxtoxvomitxallxofxthextime.x
Hisxvitalxsignsxarexsignificantxforxaxpulsexofx41xb.p.m.xandxaxbloodxpressurexofx90/60xmmxHg.xAxgastroi
ntestinalxevaluationxincludingxstoolxforxblood,xwhitexbloodxcells,xandxovaxandxparasitesxisxnegative.xH
exinsistsxthatxhexhasxnotxstartedxanyxnewxmedicationsxorxmadexanyxdietxchanges;xthexonlyxthingxnewxi
sxthatxhexgotxnewxeyexdropsxforxhisxglaucoma.xThexAGACNPxcorrectlyxassumesxthatxhisxnewxeyexdrop
sxare:
19. Janicexisxax19-year-
oldxfemalexwhoxpresentsxtoxthexemergencyxdepartmentxviaxambulance.xShexisxpale,xdiaphoretic,xagitat
ed,xandxconvincedxshexisxhavingxaxstroke.xHerxvitalxsignsxincludexaxtemperaturexofx98.9°xF,xpulsexofx114x
beatsxperxminute,xrespirationsxofx32xbreathsxperxminute,xandxaxbloodxpressurexofx110/74xmmxHg.xDiag
nosticxevaluationxisxnegativexandxJanicexisxdiagnosedxwithxanxacutexpanicxattack.xThexinitialxtreatmentx
ofxchoicexis:
20. Lorrainexisxax41-year-oldxfemalexwhoxpresentsxforxanxasthmaxfollow-
upxvisit.xShexsaysxshexfeelsxveryxwell,xhasxalmostxnoxdaytimexsymptoms,xandxisxusingxherxinhaledxcortic
osteroidxmedicationxdailyxasxprescribed.xHerxPEFRxisx85%xofxherxpersonalxbest.xThexbestxapproachxtoxt
hisxpatientxisxto:
21. Mr.xOwenxisxax37-year-
oldxpatientxwhoxhasxbeenxadmittedxforxsurgicalxresectionxofxaxmalignantxtumorxinxhisxlung.xHisxphysica
lxrecoveryxhasxbeenxuneventfulxandxhexisxbeingxpreparedxforxdischarge.xWhilexdiscussingxhisxongoingxc
ancerxtherapyxwithxMr.xOwen,xthexAGACNPxdeterminesxthatxhexhasxexperiencedxpersistent,xexcessive
xanxietyxandxworryxalmostxeveryxdayxforxmorexthanxonexyear.xWhatxotherxaspectxofxMr.xOwen'sxpsych
osocialxhistoryxwouldxbexrequiredxtoxmadexaxdiagnosisxofxgeneralizedxanxietyxdisorder?
, 22. KevinxT.xisxax49-year-
oldxmalexwhoxisxbeingxdischargedxafterxhospitalizationxforxanxacutexinferiorxwallxmyocardialxinfarction.x
Thisxisxhisxfirstxhospitalizationxandxhisxfirstxchronicxmedicalxdiagnosis.xAsidexfromxhisxelevatedxcardiacxis
oenzymesxandxtroponins,xhisxlaboratoryxprofilexwasxessentiallyxwithinxnormalxlimits.xThexonlyxapparent
xcardiacxriskxfactorxisxanxLDLxcholesterolxofx200xmg/dL.xInitiatingxanxHMG-
CoAxreductasexinhibitorxisxanxexamplexofxwhichxlevelxofxpreventionxforxKevin?
23. Youxarexevaluatingxaxpatientxwhoxhasxbeenxadmittedxtoxthexemergencyxroomxafterxbeingxarrestedxf
orxstartingxaxfightxinxaxlocalxsports'xbar.xThexpatientxisxnowxbeingxcooperative,xbutxreportsxthatxhexhasxb
eenxinxtreatmentxforxPTSDxforxmonths.xHexhasxbeenxprescribedxfluoxetinexbutxhasxnotxnoticedxanyximp
rovementxinxsymptoms,xandxnowxhasxbeenxarrestedxforxviolence.xThexAGACNPxknowsxthatxthexnextxste
pxinxmedicationxmanagementxisxlikelyxtoxinclude:
24. Mrs.xSalterxisxanx81-year-oldxladyxwhoxpresentsxforxevaluationxofxnear-syncopalxepisodes.xHerx12-
xleadxECG,xcompletexbloodxcount,xandxcomprehensivexmetabolicxpanelxarexallxessentiallyxnormal.xAxuri
nalysisxshowsxsomextracexproteinxbutxisxotherwisexnormal.xAx24-
hourxrhythmxmonitorxdemonstratesxrarexprematurexventricularxcontractions.xMrs.xSalterxhasxbeenxinxg
oodxhealthxandxhadxherxfirstxepisodexatxherxaerobicsxclass.xShexonlyxgetsxlightheadedxwhenxshexexertsxh
erself.xHerxheartxauscultatesxforxaxgradexIII/VIxsystolicxcrescendo-
decrescendoxmurmurxatxthexsecondxintercostalxspace,xrightxsternalxborder.xThexAGACPxconsidersxthatxt
hexlikelyxcausexofxthexsyncopexis:
25. Whoxamongxthexfollowingxpatientsxisxatxgreatestxriskxforxaxpulmonaryxembolus?
26. Mrs.xBirdsongxisxanx85-year-
oldxfemalexwhoxhasxbeenxadmittedxforxsurgicalxrepairxofxaxhipxfracture.xShexisxinxremarkablyxgoodxspirit
sxandxisxquitextalkative.xShexreadilyxanswersxallxofxthexquestionsxonxherxintakexassessment,xandxreadilyx
acknowledgesxinformationxprovidedxduringxherx roomxorientation.xLaterxwhilextalkingxwithxthexpatient'
sxsonxthexAGACNPxlearnsxthatxthexpatientxhasxhadxsignificantxcognitiveximpairmentxforxaxfewxyears.xShe
xhasxvirtuallyxnoxshortxtermxmemory,xbutxcompensatesxbyxconfabulating.xHerxsonxsaysxshexisxgenerallyx
veryxhappyxasxlongxasxtherexisxnoxchangexinxherxdayxtoxdayxroutine.xThisxhistoryxisxmostxconsistentxwithx
whichxformxofxdementia?
27. Mrs.xRadovichxisxanx80-year-
oldxfemalexwithxaxvarietyxofxchronicxmedicalxconditionsxwhichxarexreasonablyxwellxcontrolled.xShexgene
rallyxenjoysxaxgoodxqualityxofxlifexandxisxactivexwithxherxfamily.xTodayxherxonlyxconcernxisxthatxshexisxhav
ingxproblemsxwithxherxvision.xShexnoticesxthatxwhilextryingxtoxlookxatxpicturesxofxherxgreatxgrandchildre
nxshexcan’txseemxtoxfocusxonxtheirxfaces.xShexalsoxreportsxincreasedxtroublexreading—
shexcannotxseemxtoxseexthexwordsxthatxshexisxlookingxat,xandxherxreadingxglassesxdoxnotxhelp.xFurtherxe
valuationxofxMrs.xRadovichxshouldxincludexassessmentxwith:
28. R.J.xisxax55-year-
oldxfemalexwhoxpresentsxwithxacutexonsetxleftxsidedxfacialxpainxandxanxinabilityxtoxmovexthexleftxsidexo
fxherxface.xShexcannotxsmile,xraisexherxeyebrowxorxevenxclosexherxleftxeye,xTheximmediatexapproachxto
xthisxpatientxshouldxinclude:
29. Ax78-year-
oldxmalexpresentxforxaxphysicalxexamination.xHexhasxnoxdiscomfortxorxcomplaintsxotherxthanxaxgeneralx
decreasexinxvision,xbutxitxhelpsxwhenxhexputsxthingsxunderxaxbrightxlightxtoxread.xHexadmitsxthatxwhilexd
rivingxatxnightxthexstreetlightsxappearxtoxbexaxbitxdistortedxandxhisxnightxvisionxisxprettyxpoor.xGivenxthe
xlikelyxdiagnosis,xthexAGACNPxexpectsxwhichxofxthexfollowingxphysicalxfindings?
30. Jasonxisxax46-year-
oldxmalexwhoxisxbeingxmanagedxforxsepsis.xHexhasxHIV/AIDSxandxhasxhadxaxprolongedxhospitalizationx
characterizedxbyxaxvarietyxofxcomplications.xHexwasxextubatedx3xdaysxagoxbutxcontinuesxgastricxdeco
Exam / NURS6550 Midterm
Exam (Latest): Walden
University
,NURS 6550 Midterm Exam / NURS6550 Midterm Exam (Latest): Walden University
Walden NURS 6550 Midterm Exam / Walden NURS6550 Midterm Exam
1. A patient with anterior epistaxis has been treated with 20 minutes of direct pressure to the
cartilaginous portion of the nose. Following pressure the patient is instructed to gently blow the
nose. Expected findings in the patient who has been successfully treated include all of the following
except a:
2. Kevin is a 14-year-old male who presents for evaluation of a fever of 102.5° F and significant right
ear pain. He appears quite ill and says he feels nauseous. Otoscopic evaluation reveals pain to
palpation, a very erythematous and bulging tympanic membrane with bullous myringitis. The
AGACNP knows that antibiotic therapy must be selected to cover:
3. P.M. is a 71-year-old gay male patient who presents as an outpatient for evaluation of increasing
shortness of breath. The diagnostic evaluation ultimately supports a diagnosis of community
acquired pneumonia. The AGACNP appreciates right middle lobe consolidation on chest radiography.
Pending sputum cultures, empiric antibiotic therapy must be initiated to cover which organism?
4. The AGACNP is caring for a patient who is quite ill and has developed, among other things, a
large right sided pleural effusion. Thoracentesis is sent for pleural fluid analysis. While evaluating the
fluid analysis, the AGACNP knows that a fluid identified as a(n) is the least worrisome
type.
5. Mrs. Miller is transported to the emergency department by paramedics. She is having profound,
unremitting chest pain, is diaphoretic and pale. She has jugular venous distention and a widened
pulse pressure. Suspecting ascending aortic aneurysm, the AGACNP order which test to confirm the
diagnosis?
6. Certain subgroups of the elderly population are at an increased risk for rapid deterioration and
long-term care placement. Which of the following is not considered a high risk factor for long term
care placement?
7. Which of the following is the greatest risk factor for vascular dementia?
8. J.R. is a 55-year-old male who presents for a commercial driver’s license physical examination
with a blood pressure of 170/102 mm Hg. He has no medical history and is without complaint. Which
of the following findings constitutes hypertensive urgency?
9. Because of the commonly recognized adverse effects of atypical antipsychotics, annual
laboratory assessment for patients taking these medications should include a:
10. K.R. presents for an evaluation of eye discomfort. He works in a fabricating shop for a custom
automobile restoration company and while working he felt like something flew into his eye. He was
wearing eye protection at the time but still has the sensation that something is there. Physical
examination is significant for some tearing and he reports a persistent sense of something in his eye.
Which of the following is not indicated in the diagnostic evaluation?
11. D.E. is a 41-year-old female who had lumbar surgery two days ago to repair a ruptured nucleus
pulposus. She has been doing well postoperatively but today is complaining of resting fatigue and
some shortness of breath at rest. In ruling out a pulmonary embolus the AGACNP first orders a:
12. Mr. Nixon is being treated with unfractionated heparin infusion for acute pulmonary embolus. In
order to avoid a potentially fatal complication of heparin infusion, the AGACNP monitors:
,13. Differentiatingxvertigoxfromxnear-syncopexandxataxiaxisxonexofxthexgoalsxofxhistory-
takingxwhenxaxpatientxpresentsxasx“dizzy.”xThexAGACPxknowsxthatxvertigoxisxthexproblemxwhenxthexpa
tientxreportsxthexprimaryxsymptomxas:
14. Mr.xBanksxhasxbeenxadmittedxforxsurgicalxresectionxofxaxmetastaticxtumor,xduringxsurgeryxitxisxdisc
overedxthatxhexhasxwidespread,xdiffusexmetastasisxthroughoutxthexabdomen.xSurgeryxisxnoxlongerxanxo
ption,xandxhisxoncologistxsaysxthatxchemotherapyxisxunlikelyxtoxproducexanyxmeaningfulxbenefit.xMr.xB
anksxisxconcernedxthatxhisxsonsxwillxnotxsupportxaxtransferxtoxcomfortxcare.xThexAGACNPxadvisesxthatxh
e:
15. Mr.xWilkersonxisxax77-year-
oldxmalexwhoxisxbeingxevaluatedxandxtreatedxforxhisxcardiogenicxpain.xHisxvitalxsignsxarexasxfollows:xTe
mperaturexofx99.1°xF,xpulsexofx100xbpm,xrespirationsxofx22xbpm,xandxbloodxpressurexofx168/100xmmxH
g.xAx12-leadxECGxrevealsxdeepxSTxsegmentxdepressionxinxleadsxV3-
V6.xThexAGACNPxrecognizesxwhichxofxthexfollowingxasxaxcontraindicationxtoxrTPAxtherapy?
16. Ax71-year-
oldxpatientxisxrecoveringxfromxaxparticularlyxseverexexacerbationxofxchronicxobstructivexpulmonaryxdis
ease.xHexhasxbeenxinxthexhospitalxforxalmostxtwoxweeksxandxwasxonxmechanicalxventilationxforx7xdays.x
Whilexdiscussingxhisxdischargexplanxhextellsxyouxthatxhexisxreallyxgoingxtoxquitxsmokingxthisxtime.xHexack
nowledgesxthatxhexhasxbeenx"sneaking"xcigarettesxinxthexhospitalxforxtwoxdays,xbutxhexhasxestablishedx
axtimelinextoxdecreasexthexnumberxofxcigarettesxdaily.xAccordingxtoxhisxplanxhisxlastxcigarettexwillxbexth
exlastxdayxofxthexmonth.xThisxpatient’sxbehaviorxisxconsistentxwithxwhichxstagexofxthexTranstheoreticalx
ModelxofxChange?
17. Whilexassessingxaxpatientxwithxaxknownxpsychiatricxhistory,xthexAGACNPxknowsxthatxthexprimaryx
differencexbetweenxaxpsychoticxandxneuroticxdisordersxis:
18. L.T.xisxanx85-year-
oldxmalexwhoxisxadmittedxforxevaluationxofxprofoundxdiarrheaxthatxhasxproducedxsignificantxdehydra
tion.xHexalsoxcomplainsxofxbeingxveryxtiredxlately,xandxfeelingxlikexhexisxgoingxtoxvomitxallxofxthextime.x
Hisxvitalxsignsxarexsignificantxforxaxpulsexofx41xb.p.m.xandxaxbloodxpressurexofx90/60xmmxHg.xAxgastroi
ntestinalxevaluationxincludingxstoolxforxblood,xwhitexbloodxcells,xandxovaxandxparasitesxisxnegative.xH
exinsistsxthatxhexhasxnotxstartedxanyxnewxmedicationsxorxmadexanyxdietxchanges;xthexonlyxthingxnewxi
sxthatxhexgotxnewxeyexdropsxforxhisxglaucoma.xThexAGACNPxcorrectlyxassumesxthatxhisxnewxeyexdrop
sxare:
19. Janicexisxax19-year-
oldxfemalexwhoxpresentsxtoxthexemergencyxdepartmentxviaxambulance.xShexisxpale,xdiaphoretic,xagitat
ed,xandxconvincedxshexisxhavingxaxstroke.xHerxvitalxsignsxincludexaxtemperaturexofx98.9°xF,xpulsexofx114x
beatsxperxminute,xrespirationsxofx32xbreathsxperxminute,xandxaxbloodxpressurexofx110/74xmmxHg.xDiag
nosticxevaluationxisxnegativexandxJanicexisxdiagnosedxwithxanxacutexpanicxattack.xThexinitialxtreatmentx
ofxchoicexis:
20. Lorrainexisxax41-year-oldxfemalexwhoxpresentsxforxanxasthmaxfollow-
upxvisit.xShexsaysxshexfeelsxveryxwell,xhasxalmostxnoxdaytimexsymptoms,xandxisxusingxherxinhaledxcortic
osteroidxmedicationxdailyxasxprescribed.xHerxPEFRxisx85%xofxherxpersonalxbest.xThexbestxapproachxtoxt
hisxpatientxisxto:
21. Mr.xOwenxisxax37-year-
oldxpatientxwhoxhasxbeenxadmittedxforxsurgicalxresectionxofxaxmalignantxtumorxinxhisxlung.xHisxphysica
lxrecoveryxhasxbeenxuneventfulxandxhexisxbeingxpreparedxforxdischarge.xWhilexdiscussingxhisxongoingxc
ancerxtherapyxwithxMr.xOwen,xthexAGACNPxdeterminesxthatxhexhasxexperiencedxpersistent,xexcessive
xanxietyxandxworryxalmostxeveryxdayxforxmorexthanxonexyear.xWhatxotherxaspectxofxMr.xOwen'sxpsych
osocialxhistoryxwouldxbexrequiredxtoxmadexaxdiagnosisxofxgeneralizedxanxietyxdisorder?
, 22. KevinxT.xisxax49-year-
oldxmalexwhoxisxbeingxdischargedxafterxhospitalizationxforxanxacutexinferiorxwallxmyocardialxinfarction.x
Thisxisxhisxfirstxhospitalizationxandxhisxfirstxchronicxmedicalxdiagnosis.xAsidexfromxhisxelevatedxcardiacxis
oenzymesxandxtroponins,xhisxlaboratoryxprofilexwasxessentiallyxwithinxnormalxlimits.xThexonlyxapparent
xcardiacxriskxfactorxisxanxLDLxcholesterolxofx200xmg/dL.xInitiatingxanxHMG-
CoAxreductasexinhibitorxisxanxexamplexofxwhichxlevelxofxpreventionxforxKevin?
23. Youxarexevaluatingxaxpatientxwhoxhasxbeenxadmittedxtoxthexemergencyxroomxafterxbeingxarrestedxf
orxstartingxaxfightxinxaxlocalxsports'xbar.xThexpatientxisxnowxbeingxcooperative,xbutxreportsxthatxhexhasxb
eenxinxtreatmentxforxPTSDxforxmonths.xHexhasxbeenxprescribedxfluoxetinexbutxhasxnotxnoticedxanyximp
rovementxinxsymptoms,xandxnowxhasxbeenxarrestedxforxviolence.xThexAGACNPxknowsxthatxthexnextxste
pxinxmedicationxmanagementxisxlikelyxtoxinclude:
24. Mrs.xSalterxisxanx81-year-oldxladyxwhoxpresentsxforxevaluationxofxnear-syncopalxepisodes.xHerx12-
xleadxECG,xcompletexbloodxcount,xandxcomprehensivexmetabolicxpanelxarexallxessentiallyxnormal.xAxuri
nalysisxshowsxsomextracexproteinxbutxisxotherwisexnormal.xAx24-
hourxrhythmxmonitorxdemonstratesxrarexprematurexventricularxcontractions.xMrs.xSalterxhasxbeenxinxg
oodxhealthxandxhadxherxfirstxepisodexatxherxaerobicsxclass.xShexonlyxgetsxlightheadedxwhenxshexexertsxh
erself.xHerxheartxauscultatesxforxaxgradexIII/VIxsystolicxcrescendo-
decrescendoxmurmurxatxthexsecondxintercostalxspace,xrightxsternalxborder.xThexAGACPxconsidersxthatxt
hexlikelyxcausexofxthexsyncopexis:
25. Whoxamongxthexfollowingxpatientsxisxatxgreatestxriskxforxaxpulmonaryxembolus?
26. Mrs.xBirdsongxisxanx85-year-
oldxfemalexwhoxhasxbeenxadmittedxforxsurgicalxrepairxofxaxhipxfracture.xShexisxinxremarkablyxgoodxspirit
sxandxisxquitextalkative.xShexreadilyxanswersxallxofxthexquestionsxonxherxintakexassessment,xandxreadilyx
acknowledgesxinformationxprovidedxduringxherx roomxorientation.xLaterxwhilextalkingxwithxthexpatient'
sxsonxthexAGACNPxlearnsxthatxthexpatientxhasxhadxsignificantxcognitiveximpairmentxforxaxfewxyears.xShe
xhasxvirtuallyxnoxshortxtermxmemory,xbutxcompensatesxbyxconfabulating.xHerxsonxsaysxshexisxgenerallyx
veryxhappyxasxlongxasxtherexisxnoxchangexinxherxdayxtoxdayxroutine.xThisxhistoryxisxmostxconsistentxwithx
whichxformxofxdementia?
27. Mrs.xRadovichxisxanx80-year-
oldxfemalexwithxaxvarietyxofxchronicxmedicalxconditionsxwhichxarexreasonablyxwellxcontrolled.xShexgene
rallyxenjoysxaxgoodxqualityxofxlifexandxisxactivexwithxherxfamily.xTodayxherxonlyxconcernxisxthatxshexisxhav
ingxproblemsxwithxherxvision.xShexnoticesxthatxwhilextryingxtoxlookxatxpicturesxofxherxgreatxgrandchildre
nxshexcan’txseemxtoxfocusxonxtheirxfaces.xShexalsoxreportsxincreasedxtroublexreading—
shexcannotxseemxtoxseexthexwordsxthatxshexisxlookingxat,xandxherxreadingxglassesxdoxnotxhelp.xFurtherxe
valuationxofxMrs.xRadovichxshouldxincludexassessmentxwith:
28. R.J.xisxax55-year-
oldxfemalexwhoxpresentsxwithxacutexonsetxleftxsidedxfacialxpainxandxanxinabilityxtoxmovexthexleftxsidexo
fxherxface.xShexcannotxsmile,xraisexherxeyebrowxorxevenxclosexherxleftxeye,xTheximmediatexapproachxto
xthisxpatientxshouldxinclude:
29. Ax78-year-
oldxmalexpresentxforxaxphysicalxexamination.xHexhasxnoxdiscomfortxorxcomplaintsxotherxthanxaxgeneralx
decreasexinxvision,xbutxitxhelpsxwhenxhexputsxthingsxunderxaxbrightxlightxtoxread.xHexadmitsxthatxwhilexd
rivingxatxnightxthexstreetlightsxappearxtoxbexaxbitxdistortedxandxhisxnightxvisionxisxprettyxpoor.xGivenxthe
xlikelyxdiagnosis,xthexAGACNPxexpectsxwhichxofxthexfollowingxphysicalxfindings?
30. Jasonxisxax46-year-
oldxmalexwhoxisxbeingxmanagedxforxsepsis.xHexhasxHIV/AIDSxandxhasxhadxaxprolongedxhospitalizationx
characterizedxbyxaxvarietyxofxcomplications.xHexwasxextubatedx3xdaysxagoxbutxcontinuesxgastricxdeco
