ANCC AGACNP - Frances Guide Review with Questions and Answers

Your patient is an RN with a positive PPD. Her CXR comes back negative. What do you do now? ANSWER Offer 6 months INH Which national measure is most important to prevent VAP? ANSWER Increased HOB 30 degrees Patient with SOB and dry cough. CXR reveals generalized inflammation throughout, numerous poorly defined small (<5mm) opacities throughout both lungs, sometimes sparing the apices and bases ANSWER Pneumonitis What do you see on CXR with airspace disease? ANSWER Ground glass opacities (patchy or diffuse, resemble pulmonary edema) or rarely, as consolidation. A pattern of fine reticulation may also occur What is the diagnosis and treatment when XR reveals blunting of costophrenic angles? ANSWER Pleural effusion, tx: thoracentesis What is the diagnosis when CXR reveals Kerley B lines? ANSWER Pulmonary edema What are the lab values in exudative effusion? ANSWER Higher ratio of pleural protein and LDH to serum levels. Protein: pleural fluid/serum ratio >0.5 LDH: pleural/serum ratio >0.6 Pleural fluid LDH >2/3 upper limit of serum LDH When is the greatest risk for mechanically ventilated patient to contract VAP? ANSWER 48-72 hours