AGACNP ANCC Board Review- Common Problems
Latest recent & frequently tested exam with questions
and verified accurate solutions (detailed & elaborated)
GRADED A+
,Cutaneous Pain - correct ans:-localized on the skin or body surface
-eg bad sunburn or blister
Visceral Pain - correct ans:-poorly localized such as with internal organs
eg. gallbladder pain, PUD pain
Somatic Pain - correct ans:-non localized
-originates in muscle, bone, nerves, blood vessels
eg. soft tissue injury
Neuropathic pain - correct ans:involves nerve pathway injury or compression
WHO Pain Ladder - correct ans:Step 1: ASA, NSAIDs, tylenol +/- adjuvant (eg is a TCA like amitryptiline
for migraine)
Step 2: step 1 + codeine, hydrocodone, oxycodone, tramadol +/- adjuvants
Step 3: morphine, hydromorphone, methadone, fentanyl plus non-opiods plus adjuvants
Break-through cancer pain - correct ans:use of fentanyl patch for sustained release
Stage 1 pressure ulcer - correct ans:intact skin w erythema that does NOT blanch
Stage 2 pressure ulcer - correct ans:partial thickness loss of skin w exposed dermis
can present as intact or ruptured serum filled blister
stage 3 pressure ulcer - correct ans:full thickness skin loss, visible adipose tissue
stage 4 pressure ulcer - correct ans:full thickness skin & tissue loss w exposed or palpable fascia, muscle,
tendon, ligament or bone
, unstageable pressure ulcer - correct ans:obscured by slough or eschar
causes of non-infectious post op fever - correct ans:# 1 is post-op atelectasis
2. increase basal metabolic rate
3. dehydration
4. drug reactions (increase eosonophils, drug fever comes on insidiously and tends to linger; drugs
inlcude ampthericin B, bactrim, procainamide, beta-lactam abx and others
Risperidone toxicity (anti-psychotic) - correct ans:neuroleptic malignant syndrome
tx w dantrolene
most commonly cultured organisms inpatient - correct ans:staph epi (on your skin) & staph aureus
infectious causes of post-op fever - correct ans:-usually w increase in WBC and left shift (neutrophils go
up in bacterial infxn up to like 85% normal range is 57-67% on differential)
-if WBC >30k usually not infxn
-surgical incision site- red, pus from suture line
-point of entry from catheter
-urinary tract
-lungs
-sinusitis from NGT
Initial Tx of post-op fever - correct ans:no indicators for infection, hydrate and measures to promote
lunge expansion
tension headache - correct ans:-single most common type
-vise like pain
-neck/back common area
-no focal neuro deficits
-tx ots OTCs and relaxation
Latest recent & frequently tested exam with questions
and verified accurate solutions (detailed & elaborated)
GRADED A+
,Cutaneous Pain - correct ans:-localized on the skin or body surface
-eg bad sunburn or blister
Visceral Pain - correct ans:-poorly localized such as with internal organs
eg. gallbladder pain, PUD pain
Somatic Pain - correct ans:-non localized
-originates in muscle, bone, nerves, blood vessels
eg. soft tissue injury
Neuropathic pain - correct ans:involves nerve pathway injury or compression
WHO Pain Ladder - correct ans:Step 1: ASA, NSAIDs, tylenol +/- adjuvant (eg is a TCA like amitryptiline
for migraine)
Step 2: step 1 + codeine, hydrocodone, oxycodone, tramadol +/- adjuvants
Step 3: morphine, hydromorphone, methadone, fentanyl plus non-opiods plus adjuvants
Break-through cancer pain - correct ans:use of fentanyl patch for sustained release
Stage 1 pressure ulcer - correct ans:intact skin w erythema that does NOT blanch
Stage 2 pressure ulcer - correct ans:partial thickness loss of skin w exposed dermis
can present as intact or ruptured serum filled blister
stage 3 pressure ulcer - correct ans:full thickness skin loss, visible adipose tissue
stage 4 pressure ulcer - correct ans:full thickness skin & tissue loss w exposed or palpable fascia, muscle,
tendon, ligament or bone
, unstageable pressure ulcer - correct ans:obscured by slough or eschar
causes of non-infectious post op fever - correct ans:# 1 is post-op atelectasis
2. increase basal metabolic rate
3. dehydration
4. drug reactions (increase eosonophils, drug fever comes on insidiously and tends to linger; drugs
inlcude ampthericin B, bactrim, procainamide, beta-lactam abx and others
Risperidone toxicity (anti-psychotic) - correct ans:neuroleptic malignant syndrome
tx w dantrolene
most commonly cultured organisms inpatient - correct ans:staph epi (on your skin) & staph aureus
infectious causes of post-op fever - correct ans:-usually w increase in WBC and left shift (neutrophils go
up in bacterial infxn up to like 85% normal range is 57-67% on differential)
-if WBC >30k usually not infxn
-surgical incision site- red, pus from suture line
-point of entry from catheter
-urinary tract
-lungs
-sinusitis from NGT
Initial Tx of post-op fever - correct ans:no indicators for infection, hydrate and measures to promote
lunge expansion
tension headache - correct ans:-single most common type
-vise like pain
-neck/back common area
-no focal neuro deficits
-tx ots OTCs and relaxation
