AGACNP Review Dawn Carpenter Latest recent &
frequently tested exam with questions and verified
accurate solutions (detailed & elaborated) GRADED
A+
,Close to half of those adults older than 65 years of age experience poor sleep quality and those with
psychiatric problems have a more than twofold increase of insomnia. Which of the follow ing is
recommended as an intervention for good sleep hygiene?
c. - correct ans:Maximize exposure to light during the day and minimize light at night.
A 28yo m in a high-speed MVA crash arrived in the ED unresponsive, was intubated, and is requiring
moderate ventilator settings. Injuries include grade I splenic laceration and bowel contusion. He was
initially normotensive. Over the next 12 hours, his urine output diminishes to near anuria, despite 8 L of
volume resuscitation. The AG-ACNP
notes his abdomen is becoming distended and firm. His blood pressure drops to 90/65 and he
becomes slightly agitated. PIP climbs to 30 mmHg. Based upon these findings, the AG-ACNP
anticipates which priority intervention: - correct ans:Bladder pressure monitoring with anticipation of
surgical consult
A 33yo f with a 21-year history of insulin-dependent DM presents for routine follow-up. Her blood
pressure has been in the 130 to 155/84 to 95 mmHg range during the past few months. A recent blood
pressure taken by a nurse friend in the morning was 154/94 mmHg. She has mild proliferative
retinopathy and mild sensory neuropathy. PE unremarkable. A urinalysis reveals 2+ proteinuria. What is
the most appropriate first-line treatment of her hypertension? - correct ans:Lisinopril (Prinivil)
A 56yo white m with a past medical history of advanced Huntington's disease presents with several
weeks of coughing, dyspnea, fever, chills, weight loss, and purulent sputum. His chest x-ray reveals
infiltrates with cavitation and air-fluid levels in the bilateral lower lobes. AFB is negative, sputum culture
is obtained, and a CT of the chest is pending. The first differential diagnosis when considering treatment
plans is - correct ans:Lung Abscess
A 39-year-old patient with no personal history of diabetes but a family history of noninsulin dependent
DMII in multiple close relatives has a series of fasting glucose levels greater than 145 mg/dL while in the
hospital for acute pyelonephritis. A HbgA1c was noted to be 8.1%. What is the next best action the AG-
ACNP should initiate for the patient's plan of care? - correct ans:a. Discuss and answer questions about
the test results, diagnosis, needed lifestyle changes, and medical treatments with the patient and/or
family.
A patient admitted with IVH develops acute hydrocephalus and an EVD is placed. Initially 20 mL bloody
fluid is drained and the patient's neurologic exam improves. Over the next 3 hours, the patient becomes
more lethargic, confused, has nausea, and vomits. The AG-ACNP suspects: - correct ans:b. The EVD is
clotted off.
, The treatment of choice for pericarditis chest pain occurring within 1 week post-myocardial infarction is:
- correct ans:a. Aspirin
A79-year-old male with advanced dementia is admitted to the medical unit with recurrent sepsis due to
a UTI. The staff indicates that they are concerned the patient might be aspirating and are reluctant to
feed the patient. The patient's wife indicates that she is worried that her husband is not eating and
would like to have more information about a feeding tube. The AG-ACNP answer to this patient's wife is
based upon which the following correct information: - correct ans:d. Percutaneous tube feedings do not
prolong life and can lead to increased use of restraints.
A 17-yo m presents immediately after playing a football game, with a complaint of sudden onset of right
scrotal pain associated with nausea and vomiting. It is suspected that he is experiencing testicular
torsion. The next most appropriate action is - correct ans:a. Immediately consult an urologist.
A 27 yo police officer is GSW shot in the abdomen at close range with a .45 caliber revolver. The
entrance wound is to the left flank, and the bullet is seen on x-rays to be embedded in the spleen, along
with suspicion of a diaphragmatic injury. She is hemodynamically unstable with a heart rate of 145,
respiration rate 22, blood pressure 80/45, and the abdomen is moderately tender to palpation. The AG-
ACNP understands penetrating intra-abdominal injuries need: - correct ans:d. Exploratory laparotomy by
a surgeon
The mechanism of action of epinephrine given for anaphylactic reaction in a patient with penicillin
allergy is:
Combined alpha and beta adrenergic effects - correct ans:a. Combined alpha and beta adrenergic effects
Which term or concept is defined as the internal conflict experienced when the AG-ACNP knows what
the most ethical action should be but encounters barriers discouraging him/her from carrying out the
action? - correct ans:b. Moral distress
A50-year-oldpatient presents with an anterior myocardial infarction. He received thrombolytic therapy
and is doing well. On day 3 he suddenly becomes acutely tachycardic, drops his blood pressure to 75/30,
has distended neck veins with pulsus paradoxus. Rapid administration of 2 L normal saline increases the
blood pressure to 95/50. The most likely diagnosis is:
a. Cardiac tamponade due to myocardial wall rupture - correct ans:a. Cardiac tamponade due to
myocardial wall rupture
frequently tested exam with questions and verified
accurate solutions (detailed & elaborated) GRADED
A+
,Close to half of those adults older than 65 years of age experience poor sleep quality and those with
psychiatric problems have a more than twofold increase of insomnia. Which of the follow ing is
recommended as an intervention for good sleep hygiene?
c. - correct ans:Maximize exposure to light during the day and minimize light at night.
A 28yo m in a high-speed MVA crash arrived in the ED unresponsive, was intubated, and is requiring
moderate ventilator settings. Injuries include grade I splenic laceration and bowel contusion. He was
initially normotensive. Over the next 12 hours, his urine output diminishes to near anuria, despite 8 L of
volume resuscitation. The AG-ACNP
notes his abdomen is becoming distended and firm. His blood pressure drops to 90/65 and he
becomes slightly agitated. PIP climbs to 30 mmHg. Based upon these findings, the AG-ACNP
anticipates which priority intervention: - correct ans:Bladder pressure monitoring with anticipation of
surgical consult
A 33yo f with a 21-year history of insulin-dependent DM presents for routine follow-up. Her blood
pressure has been in the 130 to 155/84 to 95 mmHg range during the past few months. A recent blood
pressure taken by a nurse friend in the morning was 154/94 mmHg. She has mild proliferative
retinopathy and mild sensory neuropathy. PE unremarkable. A urinalysis reveals 2+ proteinuria. What is
the most appropriate first-line treatment of her hypertension? - correct ans:Lisinopril (Prinivil)
A 56yo white m with a past medical history of advanced Huntington's disease presents with several
weeks of coughing, dyspnea, fever, chills, weight loss, and purulent sputum. His chest x-ray reveals
infiltrates with cavitation and air-fluid levels in the bilateral lower lobes. AFB is negative, sputum culture
is obtained, and a CT of the chest is pending. The first differential diagnosis when considering treatment
plans is - correct ans:Lung Abscess
A 39-year-old patient with no personal history of diabetes but a family history of noninsulin dependent
DMII in multiple close relatives has a series of fasting glucose levels greater than 145 mg/dL while in the
hospital for acute pyelonephritis. A HbgA1c was noted to be 8.1%. What is the next best action the AG-
ACNP should initiate for the patient's plan of care? - correct ans:a. Discuss and answer questions about
the test results, diagnosis, needed lifestyle changes, and medical treatments with the patient and/or
family.
A patient admitted with IVH develops acute hydrocephalus and an EVD is placed. Initially 20 mL bloody
fluid is drained and the patient's neurologic exam improves. Over the next 3 hours, the patient becomes
more lethargic, confused, has nausea, and vomits. The AG-ACNP suspects: - correct ans:b. The EVD is
clotted off.
, The treatment of choice for pericarditis chest pain occurring within 1 week post-myocardial infarction is:
- correct ans:a. Aspirin
A79-year-old male with advanced dementia is admitted to the medical unit with recurrent sepsis due to
a UTI. The staff indicates that they are concerned the patient might be aspirating and are reluctant to
feed the patient. The patient's wife indicates that she is worried that her husband is not eating and
would like to have more information about a feeding tube. The AG-ACNP answer to this patient's wife is
based upon which the following correct information: - correct ans:d. Percutaneous tube feedings do not
prolong life and can lead to increased use of restraints.
A 17-yo m presents immediately after playing a football game, with a complaint of sudden onset of right
scrotal pain associated with nausea and vomiting. It is suspected that he is experiencing testicular
torsion. The next most appropriate action is - correct ans:a. Immediately consult an urologist.
A 27 yo police officer is GSW shot in the abdomen at close range with a .45 caliber revolver. The
entrance wound is to the left flank, and the bullet is seen on x-rays to be embedded in the spleen, along
with suspicion of a diaphragmatic injury. She is hemodynamically unstable with a heart rate of 145,
respiration rate 22, blood pressure 80/45, and the abdomen is moderately tender to palpation. The AG-
ACNP understands penetrating intra-abdominal injuries need: - correct ans:d. Exploratory laparotomy by
a surgeon
The mechanism of action of epinephrine given for anaphylactic reaction in a patient with penicillin
allergy is:
Combined alpha and beta adrenergic effects - correct ans:a. Combined alpha and beta adrenergic effects
Which term or concept is defined as the internal conflict experienced when the AG-ACNP knows what
the most ethical action should be but encounters barriers discouraging him/her from carrying out the
action? - correct ans:b. Moral distress
A50-year-oldpatient presents with an anterior myocardial infarction. He received thrombolytic therapy
and is doing well. On day 3 he suddenly becomes acutely tachycardic, drops his blood pressure to 75/30,
has distended neck veins with pulsus paradoxus. Rapid administration of 2 L normal saline increases the
blood pressure to 95/50. The most likely diagnosis is:
a. Cardiac tamponade due to myocardial wall rupture - correct ans:a. Cardiac tamponade due to
myocardial wall rupture
