AGACNP FINAL EXAM REVIEW 2026 /ACTUAL EXAM W
n n n n n n n
ITH 100% CORRECT VERIFIED AND DETAILED ANSWE
n n n n n n
RS /LATEST UPDATE/A+ GRADE
n n n
nn TxnofninfectiousnPost-opnfevern-nCorrectnAnswer-
#1nSupportivenfluidntherapynandnAPAPn#2nTreatnunderlyingnsource
#3nGramnstainnandnCn&nSnallninvasivenlinesnorncathetersnasnindicated.
Whatnisnthenbestninterventionnfornfevernofnunknownnorigin?n-nCorrectnAnswer-
Nothingnuntilnthendiagnosisnisnconfirmed.
Majornsyndromesncausingnfevern-nS/SnofneachnandnTXn-nCorrectnAnswer-
Serotoninnsyndromen-
SSRInuse,nclonus,nhyperreflexia,nataxia,nmentalnstatusnchanges,nrestlessness,nconfusion,
n
agitation,ncoma,nseizure,ndiaphoresis,nhyperthermia,nmydriasis,nlabilenbp
n
- tx:ndantrolenensodium,nclonazepamnfornrigor,ncoolingnblankets
MalignantnHyperthermian-
happensninnthenOR;nafternsuccinylcholinenIVnthennfrynbrainnton104nF.nIVF,npacknthemnwithnic
n
enthennsendntonPACUnwithnDantrolene
NeurolepticnMalignantnSyndromen-nassociatednwithndopaminenantagonistsn-
bradykinesia,n"lead-pipe"nmusclenrigidity
n
- onnantinpsychotic;nIVFnpriorityntonflushntoxinsnout,nandnthisnisntruentoneveryntoxic
Othernrandoncausesnofnfeverntonconsidern-nCorrectnAnswer-Temporalnarteritisn-
highnESR,nnormalnWBC,nfevernasnhighnasn104!!!n-
n
,HA,nscalpntenderness,nvisualncomplaints.n-n15%nofnallncasesnofnFUOninnptsn>n65nyears
n
Ptnw/nvise-
like,ntight,ngeneralizednHAnthatnisnmostnintenseninnthennecknornbacknofnthenhead,nw/nnonfoca
lnsymptomsnandnthatnlastsnfornseveralnhours.nWhatnisnitn/nwhatndonyoundo?n-
CorrectnAnswer-TensionnHA.nNondxnfornthis.nManagenw/nOTCnanalgesicsnandnrelaxation.
n
Femalenw/nunilateralnepisodicnHAnthatnisndullnornthrobbing,nbuildsnupngraduallynandnlastsnfor
severalnhours.nHasnsomenfieldndefects,nvisualnhallucinationsnsuchnasnstars,nsparks,nandnzi
n
gzagnlights,nAPHASIA,nnumbness,ntingling,nclumsinessnandnweakess,nalsonn/v,nandnphotop
hobianandnphonophobia.nWhatnisnitn/nwhatndonyoundo?n-nCorrectnAnswer-
ClassicnMigrainen(migrainenwithnaura)n(NOTnCOMMONnMIGRAINE).nThisnisnr/tndilationnan
dnpulsationnofnbranchesnofnexternalncarotidnandnfollowsnthentrigeminalnnervenpathway.
IfnnewnorndifferentnthannpreviousnHA'sn--nHeadnCT!!!
,BMP,nCBC,nVDRL,nESR,nandnanythingnelsenindicatednbynhxnandnphysicalnexam
IfnMigrainenconfirmed,nthen....
#1navoidntriggers
#2nrelax/managenstress
#3nProphylacticntherapynisnATTACKSn>n2-3xnPERnMONTHn(Eleviln-
monitornQTninterval;nDepakote,nInderalnTofranol,nCatapres,nVeramapil,nTopamax,nNeuro
n
ntin,nMethysergide,nMagnesium).
InnACUTEnATTACK:nrest,ntakenASAnrightnawayn(somenrelief),nSumitriptann6mgnSQnorn25m
gnPOnatnonsetn(STANDARDnABORTIVEnTX),nSQnmaynbenrepeated.
Middle-
agednmalenw/nunilateral,nperiorbitalnHA,nnonfamilynhxnofnHAnornmigraine,nbutnpossiblenETO
Hnuse.nDescribesnpainnasn"severe"nandnreportsnsuicidalnthoughtsnwhennthenpainncomesnon
.nAlsoncausesnhimnnasalncongestion,nrhinorrhea,nandneyenredness.nWhatn isnitn/nwhatndonyo
undo?n-nCorrectnAnswer-
ClusternHA.nNondiagnostics.nEyenwillnbenred,nandnhenwillnhavenrhinorrhea.
POnmedsnineffective.
Given100%no2n(sonaboutn12-15Lnonnnon-
rebreathernfornaboutn15nmin).nSubqnSumitriptann6mg
InhalationnErgostat
Albuminnlevelnfornproteinnmalnutritionn/nAlbuminnlevelnfornedema?n-nCorrectnAnswer-<
, 3.5n/n<n2.7n(willnseenfallingnoutnhair,nridgednnails,nmusclenwasting,ndrynmucousnmembranes
,nslownhealing).
Nutritionalnconsiderationsnfornthenacutelynill:n-nCorrectnAnswer-
Inntimesnofnphysiologicalnstress,nptsncaloricnneedsndoublenfromnbaselinend/tntheirnhypercata
bolicnstate
Goalnofnnutritionalntherapynisntonsustainnptsnexistingnweight,nevennifnptnisnobese
Typicalncaloricnrequirementnisntonsustainnexistingnweightnisn30-
35kcal/kgnornbodynweightndaily,nsonhospitalnpatientsnwillnrequiren60-70nkcal/kgndaily
Ptngettingnfeedingsnwithnduontube,nNDntube,nNGntube,nornPEGnwhatnshouldnyounwatchnoutnf
or?n-nCorrectnAnswer-ComplicationsnofnEnteralnnutritionnsupportnrelatedntonthensolution.
-aspiration
-diarrhea
-emesis
-GInbleedingn(didn'tnknownthat,nd/tnPEG?)
-mechanicalnobstructionnofntube
-hypernatremian(knownthis!!)
-dehydrationn(knownthis!!)
n n n n n n n
ITH 100% CORRECT VERIFIED AND DETAILED ANSWE
n n n n n n
RS /LATEST UPDATE/A+ GRADE
n n n
nn TxnofninfectiousnPost-opnfevern-nCorrectnAnswer-
#1nSupportivenfluidntherapynandnAPAPn#2nTreatnunderlyingnsource
#3nGramnstainnandnCn&nSnallninvasivenlinesnorncathetersnasnindicated.
Whatnisnthenbestninterventionnfornfevernofnunknownnorigin?n-nCorrectnAnswer-
Nothingnuntilnthendiagnosisnisnconfirmed.
Majornsyndromesncausingnfevern-nS/SnofneachnandnTXn-nCorrectnAnswer-
Serotoninnsyndromen-
SSRInuse,nclonus,nhyperreflexia,nataxia,nmentalnstatusnchanges,nrestlessness,nconfusion,
n
agitation,ncoma,nseizure,ndiaphoresis,nhyperthermia,nmydriasis,nlabilenbp
n
- tx:ndantrolenensodium,nclonazepamnfornrigor,ncoolingnblankets
MalignantnHyperthermian-
happensninnthenOR;nafternsuccinylcholinenIVnthennfrynbrainnton104nF.nIVF,npacknthemnwithnic
n
enthennsendntonPACUnwithnDantrolene
NeurolepticnMalignantnSyndromen-nassociatednwithndopaminenantagonistsn-
bradykinesia,n"lead-pipe"nmusclenrigidity
n
- onnantinpsychotic;nIVFnpriorityntonflushntoxinsnout,nandnthisnisntruentoneveryntoxic
Othernrandoncausesnofnfeverntonconsidern-nCorrectnAnswer-Temporalnarteritisn-
highnESR,nnormalnWBC,nfevernasnhighnasn104!!!n-
n
,HA,nscalpntenderness,nvisualncomplaints.n-n15%nofnallncasesnofnFUOninnptsn>n65nyears
n
Ptnw/nvise-
like,ntight,ngeneralizednHAnthatnisnmostnintenseninnthennecknornbacknofnthenhead,nw/nnonfoca
lnsymptomsnandnthatnlastsnfornseveralnhours.nWhatnisnitn/nwhatndonyoundo?n-
CorrectnAnswer-TensionnHA.nNondxnfornthis.nManagenw/nOTCnanalgesicsnandnrelaxation.
n
Femalenw/nunilateralnepisodicnHAnthatnisndullnornthrobbing,nbuildsnupngraduallynandnlastsnfor
severalnhours.nHasnsomenfieldndefects,nvisualnhallucinationsnsuchnasnstars,nsparks,nandnzi
n
gzagnlights,nAPHASIA,nnumbness,ntingling,nclumsinessnandnweakess,nalsonn/v,nandnphotop
hobianandnphonophobia.nWhatnisnitn/nwhatndonyoundo?n-nCorrectnAnswer-
ClassicnMigrainen(migrainenwithnaura)n(NOTnCOMMONnMIGRAINE).nThisnisnr/tndilationnan
dnpulsationnofnbranchesnofnexternalncarotidnandnfollowsnthentrigeminalnnervenpathway.
IfnnewnorndifferentnthannpreviousnHA'sn--nHeadnCT!!!
,BMP,nCBC,nVDRL,nESR,nandnanythingnelsenindicatednbynhxnandnphysicalnexam
IfnMigrainenconfirmed,nthen....
#1navoidntriggers
#2nrelax/managenstress
#3nProphylacticntherapynisnATTACKSn>n2-3xnPERnMONTHn(Eleviln-
monitornQTninterval;nDepakote,nInderalnTofranol,nCatapres,nVeramapil,nTopamax,nNeuro
n
ntin,nMethysergide,nMagnesium).
InnACUTEnATTACK:nrest,ntakenASAnrightnawayn(somenrelief),nSumitriptann6mgnSQnorn25m
gnPOnatnonsetn(STANDARDnABORTIVEnTX),nSQnmaynbenrepeated.
Middle-
agednmalenw/nunilateral,nperiorbitalnHA,nnonfamilynhxnofnHAnornmigraine,nbutnpossiblenETO
Hnuse.nDescribesnpainnasn"severe"nandnreportsnsuicidalnthoughtsnwhennthenpainncomesnon
.nAlsoncausesnhimnnasalncongestion,nrhinorrhea,nandneyenredness.nWhatn isnitn/nwhatndonyo
undo?n-nCorrectnAnswer-
ClusternHA.nNondiagnostics.nEyenwillnbenred,nandnhenwillnhavenrhinorrhea.
POnmedsnineffective.
Given100%no2n(sonaboutn12-15Lnonnnon-
rebreathernfornaboutn15nmin).nSubqnSumitriptann6mg
InhalationnErgostat
Albuminnlevelnfornproteinnmalnutritionn/nAlbuminnlevelnfornedema?n-nCorrectnAnswer-<
, 3.5n/n<n2.7n(willnseenfallingnoutnhair,nridgednnails,nmusclenwasting,ndrynmucousnmembranes
,nslownhealing).
Nutritionalnconsiderationsnfornthenacutelynill:n-nCorrectnAnswer-
Inntimesnofnphysiologicalnstress,nptsncaloricnneedsndoublenfromnbaselinend/tntheirnhypercata
bolicnstate
Goalnofnnutritionalntherapynisntonsustainnptsnexistingnweight,nevennifnptnisnobese
Typicalncaloricnrequirementnisntonsustainnexistingnweightnisn30-
35kcal/kgnornbodynweightndaily,nsonhospitalnpatientsnwillnrequiren60-70nkcal/kgndaily
Ptngettingnfeedingsnwithnduontube,nNDntube,nNGntube,nornPEGnwhatnshouldnyounwatchnoutnf
or?n-nCorrectnAnswer-ComplicationsnofnEnteralnnutritionnsupportnrelatedntonthensolution.
-aspiration
-diarrhea
-emesis
-GInbleedingn(didn'tnknownthat,nd/tnPEG?)
-mechanicalnobstructionnofntube
-hypernatremian(knownthis!!)
-dehydrationn(knownthis!!)
