Full ANCC - AGACNP, AGACNP FRANCES STUDY GUIDE,
NRSG 519 EKG, NRSG 519 – Neuro EXAM QUESTIONS
WITH CORRECT ANSWERS GRADED A+
Type 1 Error
false POSITIVE; incorrectly rejecting the true null hypothesis
Leukemia - subtypes
- AML
- ALL
- CML
- CLL
What is the earliest sign of PNA in the elderly patient?
-Dyspnea/SOB
-Tachypnea
-Fever
-Hypoxia
Tachypnea
-sign that patient will not initially notice
Your patient is a 79 M Japanese immigrant. What TB induration measurement is diagnostic?
-3 mm
-7 mm
-11 mm
11 mm
Your asthmatic patient is on a SABA and ICS. She has no secretions but her symptoms are still not well
controlled. What do you order next?
-Salmeterol (LABA)
-Ipratropium bromide
-Montekulast
-Metaproterenol
,Salmeterol (LABA)
MUST give SABA then ICS before LABA
Your patient on albuterol has had multiple trips to the ER in the past three months. what should you
add?
An ICS, flovent
What is paradoxical abdominal and diaphragmatic movement?
a. symptoms of anxiety disorder
b. asthma ominous sign
c. respiratory bacterial infection
b. asthma ominous sign
-Inspiration - belly comes in
-expiration - belly goes out
"vacuum"
-Requires emergent intubation
Which of the following is reason to intubate in an asthmatic patient?
a. RR in the 30s
b. bad ABGs
c. SaO2 in the 80s
d. change in behavior
d. change in behavior
-obtunded - hypercapnia - ready to crash
What history do you ask about before you prescribe a sleep aid to your 69 yr old patient?
-Sz
-Depression
-Heart Dz
-OSA
OSA
Your patient is an RN with a positive PPD. Her CXR comes back negative. What do you do now?
Offer 6 months INH
Which national measure is most important to prevent VAP?
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
Pneumonitis
,What do you see on CXR with airspace disease?
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?
Pleural effusion, tx: thoracentesis
What is the diagnosis when CXR reveals Kerley B lines?
Pulmonary edema
What are the lab values in exudative effusion?
Higher ratio of pleural protein and LDH to serum levels.
Protein: pleural fluid/serum ratio >0.5LDH: pleural/serum ratio >0.6Pleural fluid LDH >2/3 upper limit of
serum LDH
When is the greatest risk for mechanically ventilated patient to contract VAP?
48-72 hours
Common bacteria in VAP?
Pseudomonous
Treatment of Pseudomonous pneumonia?
zosyn/cefepime/meropenem
+ fluoroquinolone/azithromycin
+/- gentamycin
37 yo s/p ET intubation 2 days ago has fever, chills, and purulent sputum. CXR shows lung infiltrates.
Which of the following regimen for the patient's condition?
Cefepime and ciprofloxacin
Spontaneous pneumothorax is common in what disorder?
Marphan syndrome
Most important HPI questions in patient with hemoptysis?
Amount of blood, previous episodes, dyspnea
Pathophysiology of PE?
Failure of right ventricle
What is the best non-pharmacologic treatment in a patient with end stage COPD?
Bipap (NIPPV)
, Which med decreases mortality in COPD?
LABA - ICS combo, advair (salmeterol/fluticasone)
Example of a patient most likely to have emphysema?
59 yo with increased AP diameter
Maintstay of COPD treatment?
Symphathomimetics (albuterol)
What PFTs show asthma?
Obstructive: decreases in FEV1, FEV 25-75, PEFR, FVC
Most important in a status asthmatic patient who was extubated?
F/u with asthma specialist in 3-5 days
A patient has TB and lives with 6 other people. Do you treat the 6 other people or test them?
Test them
A patient who has HIV tests positive for TB, what is the treatment?
Culture x 3
38 yo female immobilized for 4 months. Examining her before releasing you not dyspnea and
tachycardia. You suspect PE, but VQ scan does not confirm. What is the next diagnostic test?
Pulmonary angiography
What confirms the diagnosis of pneumonia?
Consolidation in the lungs on CXR
Is the pneumonia vaccine recommended for asthmatics or smokers ages 19-64?
Yes
An elderly woman who has a history of lung dysfunction comes to your office. She presents with a
number of respiratory symptoms. Most severe c/o head ache. What is the most likely respiratory
diagnosis based on headache?
Acute bronchitis
Your patient needs to start treatment with a DMARD for RA. Which is the least expensive?
a. hydroxychloroquine
b. sulfasalazine
c. methotrexate
d. leflunomide
Methotrexate
NRSG 519 EKG, NRSG 519 – Neuro EXAM QUESTIONS
WITH CORRECT ANSWERS GRADED A+
Type 1 Error
false POSITIVE; incorrectly rejecting the true null hypothesis
Leukemia - subtypes
- AML
- ALL
- CML
- CLL
What is the earliest sign of PNA in the elderly patient?
-Dyspnea/SOB
-Tachypnea
-Fever
-Hypoxia
Tachypnea
-sign that patient will not initially notice
Your patient is a 79 M Japanese immigrant. What TB induration measurement is diagnostic?
-3 mm
-7 mm
-11 mm
11 mm
Your asthmatic patient is on a SABA and ICS. She has no secretions but her symptoms are still not well
controlled. What do you order next?
-Salmeterol (LABA)
-Ipratropium bromide
-Montekulast
-Metaproterenol
,Salmeterol (LABA)
MUST give SABA then ICS before LABA
Your patient on albuterol has had multiple trips to the ER in the past three months. what should you
add?
An ICS, flovent
What is paradoxical abdominal and diaphragmatic movement?
a. symptoms of anxiety disorder
b. asthma ominous sign
c. respiratory bacterial infection
b. asthma ominous sign
-Inspiration - belly comes in
-expiration - belly goes out
"vacuum"
-Requires emergent intubation
Which of the following is reason to intubate in an asthmatic patient?
a. RR in the 30s
b. bad ABGs
c. SaO2 in the 80s
d. change in behavior
d. change in behavior
-obtunded - hypercapnia - ready to crash
What history do you ask about before you prescribe a sleep aid to your 69 yr old patient?
-Sz
-Depression
-Heart Dz
-OSA
OSA
Your patient is an RN with a positive PPD. Her CXR comes back negative. What do you do now?
Offer 6 months INH
Which national measure is most important to prevent VAP?
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
Pneumonitis
,What do you see on CXR with airspace disease?
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?
Pleural effusion, tx: thoracentesis
What is the diagnosis when CXR reveals Kerley B lines?
Pulmonary edema
What are the lab values in exudative effusion?
Higher ratio of pleural protein and LDH to serum levels.
Protein: pleural fluid/serum ratio >0.5LDH: pleural/serum ratio >0.6Pleural fluid LDH >2/3 upper limit of
serum LDH
When is the greatest risk for mechanically ventilated patient to contract VAP?
48-72 hours
Common bacteria in VAP?
Pseudomonous
Treatment of Pseudomonous pneumonia?
zosyn/cefepime/meropenem
+ fluoroquinolone/azithromycin
+/- gentamycin
37 yo s/p ET intubation 2 days ago has fever, chills, and purulent sputum. CXR shows lung infiltrates.
Which of the following regimen for the patient's condition?
Cefepime and ciprofloxacin
Spontaneous pneumothorax is common in what disorder?
Marphan syndrome
Most important HPI questions in patient with hemoptysis?
Amount of blood, previous episodes, dyspnea
Pathophysiology of PE?
Failure of right ventricle
What is the best non-pharmacologic treatment in a patient with end stage COPD?
Bipap (NIPPV)
, Which med decreases mortality in COPD?
LABA - ICS combo, advair (salmeterol/fluticasone)
Example of a patient most likely to have emphysema?
59 yo with increased AP diameter
Maintstay of COPD treatment?
Symphathomimetics (albuterol)
What PFTs show asthma?
Obstructive: decreases in FEV1, FEV 25-75, PEFR, FVC
Most important in a status asthmatic patient who was extubated?
F/u with asthma specialist in 3-5 days
A patient has TB and lives with 6 other people. Do you treat the 6 other people or test them?
Test them
A patient who has HIV tests positive for TB, what is the treatment?
Culture x 3
38 yo female immobilized for 4 months. Examining her before releasing you not dyspnea and
tachycardia. You suspect PE, but VQ scan does not confirm. What is the next diagnostic test?
Pulmonary angiography
What confirms the diagnosis of pneumonia?
Consolidation in the lungs on CXR
Is the pneumonia vaccine recommended for asthmatics or smokers ages 19-64?
Yes
An elderly woman who has a history of lung dysfunction comes to your office. She presents with a
number of respiratory symptoms. Most severe c/o head ache. What is the most likely respiratory
diagnosis based on headache?
Acute bronchitis
Your patient needs to start treatment with a DMARD for RA. Which is the least expensive?
a. hydroxychloroquine
b. sulfasalazine
c. methotrexate
d. leflunomide
Methotrexate
