NURS 6550 Midterm Review Questions with 100% Correct Answers | Latest Version 2024 | Verified

The least worrisome type of fluid seen as a result of pleural fluid analysis - Transudate pleural fluid What test should be ordered to confirm a suspected ascending aortic aneurysm? - CT Scan with contrast Name risk factors for long-term care placement for the elderly population. - Male gender 80 y.o.+ Living Alone bowel/bladder incontinence Hx of falls dysfunctional coping Intellectual impairment A patient with anterior epistaxis has been treated with direct pressure for 20 minutes. What are expected findings when the patient is instructed to gently blow their nose? - Successful treatment will be indicated by dark residual blood or clots being discharged from the nose. If bleeding has not stopped you will see a bright red steady trickle of blood requiring more invasive measures. What is the most common organism in treating otitis media, bacterial sinusitis, bacterial pharyngitis, AND community-acquired pneumonia? - Streptococcus pneumoniae What is the greatest risk factor for vascular dementia? - Vascular diseases that result in target organ damage such as: hypertension dyslipidemia diabetes Hypertensive urgency vs emergency - - Hypertensive urgency: BP 200/120 w/o sx; Tx with PO furosemide, clonidine or captopril - Hypertensive emergency: BP 200/120 WITH sx or evidence of end organ damage; Tx with IV nitroprusside, labetalol or nicardipine *Both req immediate treatment What annual lab testing should be done for patients taking atypical antipsychotics? - Lipid Panel Name some atypical antipsychotics - OLAnzapine CLOZapine QUETIapine RISPERidone Aripiprazole Ziprasidone "It's ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z" If you are treating a car mechanic for a possible eye injury what test would you avoid? - MRI possible metal in eye What is the least invasive approach to rule out a pulmonary embolus? - D-dimer When treating a patient with an unfractionated heparin infusion, what would you monitor for (to avoid a fatal complication) ? - Heparin-induced Thrombocytopenia (HIT). aka monitor for low platelets. d/c heparin and intiate thrombin inhibitors! What symptom differentiates vertigo from near-syncope and ataxia? - When the primary symptom identified is a sense of spinning this means vertigo and is usually an inner ear problem. Ataxia is neurological near-syncope may be cardiac, neuro or both. When a patient is concerned about a family member not supporting wishes in end-of-life care, what legal document should be used? - advanced directive What is contraindicative of rTPA therapy? - ST segment depression Transtheoretical Model of Change - 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance psychotic disorder vs neurotic disorder - psychotic: distinct alteration in perception of reality Neurotic: remain aware and interactive with reality Cholinergics (Miotics) - Pilocarpine Pilocarpine adverse effects - increased GI motility and bradycardia Initial treatment for a panic attack in the ER - short-acting benzodiazepine for immediate symptom control diazepam or lorazepam Aside from symptom control, medication use and PEFR testing, what should be included as part of the assessment for an asthmatic patient? - validated asthma questionnaire such as the ACT. What is required for a diagnosis of Generalized Anxiety Disorder? - The patient will report both excessive anxiety and worry, and difficulty controlling that worry, for more days than not in the last six months Levels of Prevention - Primary: prevent/promotion Secondary: screen-early detection Tertiary: treat- to prevent further deterioration, rehab For a patient being treated with an SSRI such as fluoxetine for PTSD that shows no improvement in symptoms after two months of treatment, what is the next line thearpy? - atypical antipsychotics What murmur is heard in systole at the second ICS? - Aortic stenosis Ms. ARD Mr. ASS What is the primary risk factor for pulmonary embolus? - 1. DVT DVT risks: polycythemia and stasis. Differentiate between dementia types - Alzheimer's: long trajectory that progresses to confabulations Lewy Body: rapid progression w/angry demeanor Vascular: depressive affect, no confabulations, PMHx of vascular disease Parkinson's: PMHx of parkinson's What testing assesses for macular degeneration? - Amsler Grid- assessment of central vision changes seen in MD. What is the Woods Lamp used for? - Illuminate FUNGI, BACTERIA ,PIGMENTATION and other skin problems Can also be used to detect corneal abrasions. A 55-year-old female presents with acute onset left sided facial pain and an inability to move the left side of her face. She cannot smile, raise her eyebrow or even close her left eye, The immediate approach to this patient should include: - Corticosteroids She has Bell's Palsy A 78-year-old male present for a physical examination. He has no discomfort or complaints other than a general decrease in vision, but it helps when he puts things under a bright light to read. He admits that while driving at night the streetlights appear to be a bit distorted and his night vision is pretty poor. What is his likely diagnosis an expected physical exam findings? - Diminished Red reflex; Dx: Cataracts A patient with HIV/AIDS is being managed for sepsis and was recently extubated 3 days ago. He has an NGT, PICC, and foley. Visual inspection of all tubes are normal (UA neg) with improving pneumonia on Chest XR, but the patient is still having low grade fevers. What should the NP order next? - Maxillofacial CT scan; NGT is a risk factor for HIV patients to develop a sinus infection. What is the last thing that should be assessed when looking at a chest XR? - Lungs are LAST. Correct order: 1. Mediastinum and hila 2. thoracic cage 3. Extrathoracic bones and soft tissues 4. Lungs What is the correct order of interpreting an EKG? - 1. Rate 2. Rhythm 3. Intervals 4. Axis 5.Morphology The Short Confusion Assessment Method (Short-CAM) assesses delirium in hospitalized patients. What is observed with this method? - 1. Acuity of Onset 2. Inattention 3. Disorganized Thinking 4. Level of Consciousness True or False: the Short-CAM was developed to identify causes of delirium. - False; it helps improve identification and recognition of delirium. What should be included for diagnostic evaluation for hospital acquired pneumonia? - Sputum culture ABG Blood cultures. What theory addresses the inevitability of death as a part of the aging process? - Levinson's Theory What genetic risk factors increase a patient's likelihood for pulmonary embolus? - Factor V Protein C & S deficiencies A patient is diagnosed with acute descending aortic aneurysm and hypertension should be immediately started on which medication pending surgical evaluation? - Beta adrenergic antagonist (aka beta blockers): decreases force of contraction, decreases force on aortic aneurysm preventing aortic dissection. When should a patient with asthma be admitted from the ER? - If FEV1 remains below 70% after one hour of emergency care. Patient can be discharged if FEV170% What is an indication for intubating a patient with acute asthma exacerbation? - FEV1 not improving after treatment and approaching 40%. What are the most common causes of pulmonary obstructive shock? - Pulmonary embolus, cardiac tamponade, & pneumothorax What is the best indicator of imminent death following a patient who is extubated but still maintains respirations past 24 hours? - Cessation of urine output as it is a predictor of imminent cardiac arrest What factor rules out major depressive disorder? - Bereavement over a loss 2 months duration. What is the most common form of dementia? - Alzheimer's How does Aricept work? - It increases the levels of acetylcholine which may produce systemic activation of the parasympathetic system. Results in increased GI motility, vomiting and diarrhea, decreased heart rate. What is the primary purpose of using eye ointments or lubricants for patients under general anesthesia on paralytics of in long-term comatose states? - To prevent corneal abrasion. When reading a 12-lead electrocardiogram, the AGACNP knows that all 12 leads are required to provide - Each lead provides a different perspective from which to view the amplitude and direction of electrical activity as it moves through the heart in terms of length, width, and depth; the inferior, lateral, and anterior walls respectively A patient presents with chest tightness and inferior wall ischemia on ECG with improvement of symptoms from sublingual nitroglycerin administration. According to ACS protocol, the patient's assessment is consistent with: - Unstable Angina A 49-year-old male is being managed for an acute myocardial infarction. He develops significant shortness of breath at rest and coarse rales 2/3 up bilaterally. The AGACNP suspects acute pulmonary edema due to papillary muscle rupture and acute mitral valve regurgitation. Which physical finding would support this finding? - A systolic murmur auscultated at the 5th ICS, midclavicular line.