ANCC AGACNP - FRANCES 2024
GUIDE REVIEW
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
Your patient with VAP is on broad spectrum coverage including levaquin,
cefepime, and vancomycin. Your culture comes back growing pseudomonas. What
do you do now? - ANSWERS-Narrow the spectrum (d/c vanc)
QUESTION 2
Which of the following does not cause hypoxemia?
a. hyperventilation
b. hypoventilation
c. decrease in atmospheric O2
d. right to left shunt - ANSWERS-a. hyperventilation
QUESTION 3
What is the initial finding in pulmonary embolism?
a. respiratory acidosis
b. respiratory alkalosis
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, ANCC AGACNP - FRANCES 2024
GUIDE REVIEW
c. metabolic acidosis
d. metabolic alkalosis - ANSWERS-b. respiratory alkalosis
QUESTION 4
Your 32 yo male patient has a history of MVR and c/o wheezing with exercise.
What is your order?
a. pulmonary consult
b. PO steroids
c. PFTs
d. SABA - ANSWERS-c. PFTs
QUESTION 5
The mother of a 19 yo female calls you with concerns about her daughter's asthma
attack. She tells you that she is SOB and has difficulty speaking in sentences. She
adds that her usual medicine, alupent, is not working. Which of the following
should the mother administer to treat the asthma attack?
a. metaproterenol
b. albuterol
c. aqueous epinephrine
d. ipratroprium bromide - ANSWERS-d. ipratroprium bromide (anticholinergic)
END OF
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, ANCC AGACNP - FRANCES 2024
GUIDE REVIEW
Alupent is albuterol, metaproterenol acts the same way and aqueous epinephrine
should only be used if the patient won't cooperate
QUESTION 6
A 36yo patient who has a history of asthma comes to the Ed in a fatigued state. She
has difficulty speaking d/t respiratory distress but is able to explain that she is
recovering from a cold, but her s/s are so severe that she came into the ED. HR is
118, FVC WDL, FEV 1 45% of expected value. You order metaproterenol 0.3 mL
in 5% solution, but the patient does not respond. Now what?
a. aqueous epinephrine
b. albuterol
c. methylprednisolone
d. montelukast - ANSWERS-c. methylprednisolone
QUESTION 7
Your patient with asthma has decreased breath sounds on presentation. You give a
nebulizer treatment. Now the SaO2 is decreased to 86% and there are no breath
sounds. What do you do?
a. stat nebulizer
b. abg's
c. epinephrine
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, ANCC AGACNP - FRANCES 2024
GUIDE REVIEW
d. intubate - ANSWERS-d. intubate
QUESTION 8
A 51 year old male is admitted to the ED with severe dyspnea. The patient's history
indicates emphysema. The NP orders O2, since the patient SaO2 dropped from
96% to 90%. However the NP also advises the attending RN to continue
monitoring the patient because
a. He has lost his hypoxemic respiratory drive
b. He has lost his hypercapnic respiratory drive - ANSWERS-b. he has lost his
hypercapnic respiratory drive
QUESTION 9
What is the earliest sign of Pna in the elderly patient?
a. dyspnea/SOB
b. tachypnea
c. fever
d. hypoxia - ANSWERS-b. tachypnea
END OF
PAGE 4
GUIDE REVIEW
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
Your patient with VAP is on broad spectrum coverage including levaquin,
cefepime, and vancomycin. Your culture comes back growing pseudomonas. What
do you do now? - ANSWERS-Narrow the spectrum (d/c vanc)
QUESTION 2
Which of the following does not cause hypoxemia?
a. hyperventilation
b. hypoventilation
c. decrease in atmospheric O2
d. right to left shunt - ANSWERS-a. hyperventilation
QUESTION 3
What is the initial finding in pulmonary embolism?
a. respiratory acidosis
b. respiratory alkalosis
END OF
PAGE 1
, ANCC AGACNP - FRANCES 2024
GUIDE REVIEW
c. metabolic acidosis
d. metabolic alkalosis - ANSWERS-b. respiratory alkalosis
QUESTION 4
Your 32 yo male patient has a history of MVR and c/o wheezing with exercise.
What is your order?
a. pulmonary consult
b. PO steroids
c. PFTs
d. SABA - ANSWERS-c. PFTs
QUESTION 5
The mother of a 19 yo female calls you with concerns about her daughter's asthma
attack. She tells you that she is SOB and has difficulty speaking in sentences. She
adds that her usual medicine, alupent, is not working. Which of the following
should the mother administer to treat the asthma attack?
a. metaproterenol
b. albuterol
c. aqueous epinephrine
d. ipratroprium bromide - ANSWERS-d. ipratroprium bromide (anticholinergic)
END OF
PAGE 2
, ANCC AGACNP - FRANCES 2024
GUIDE REVIEW
Alupent is albuterol, metaproterenol acts the same way and aqueous epinephrine
should only be used if the patient won't cooperate
QUESTION 6
A 36yo patient who has a history of asthma comes to the Ed in a fatigued state. She
has difficulty speaking d/t respiratory distress but is able to explain that she is
recovering from a cold, but her s/s are so severe that she came into the ED. HR is
118, FVC WDL, FEV 1 45% of expected value. You order metaproterenol 0.3 mL
in 5% solution, but the patient does not respond. Now what?
a. aqueous epinephrine
b. albuterol
c. methylprednisolone
d. montelukast - ANSWERS-c. methylprednisolone
QUESTION 7
Your patient with asthma has decreased breath sounds on presentation. You give a
nebulizer treatment. Now the SaO2 is decreased to 86% and there are no breath
sounds. What do you do?
a. stat nebulizer
b. abg's
c. epinephrine
END OF
PAGE 3
, ANCC AGACNP - FRANCES 2024
GUIDE REVIEW
d. intubate - ANSWERS-d. intubate
QUESTION 8
A 51 year old male is admitted to the ED with severe dyspnea. The patient's history
indicates emphysema. The NP orders O2, since the patient SaO2 dropped from
96% to 90%. However the NP also advises the attending RN to continue
monitoring the patient because
a. He has lost his hypoxemic respiratory drive
b. He has lost his hypercapnic respiratory drive - ANSWERS-b. he has lost his
hypercapnic respiratory drive
QUESTION 9
What is the earliest sign of Pna in the elderly patient?
a. dyspnea/SOB
b. tachypnea
c. fever
d. hypoxia - ANSWERS-b. tachypnea
END OF
PAGE 4
