ACPNP Questions with
Accurate Answers
11 y/o w/Hx of asthma, presents w/low grade fever, SOB, hypoxia &
+Covid 19 correct answer PNA, possible effusion, the heart has shifted
from it's normal position
2 of the 4 core principles for family-centered care include:
p. 37 correct answer treat the family with respect, and encourage
family participation in care decisions
2 sets of blood Cx from separate peripheral sites have been sent of a 5
y/o patient with likely bacteremia. 1 of the blood Cx has grown
coagulase-negative Staph. aureus. The 2nd has had no growth for 72
hrs. What's the interpretation?
p. 333 correct answer Likely a contaminant; blood Cx can be repeated
4 y/o was diagnosed w/Streptococcal pneumoniae PNA 4 days ago &
was started on high dose amoxicillin. Today in clinic, he develops new
increased resp. distress & fever. What do you anticipate is the
rationale? correct answer Parapneumonic effusion/empyema
effusion/empyema usually have been recently sick
,5 y/o w/Hx of asthma, presents w/wheezing, fever, & hypoxia
CXR: hyperinflated, flattened diaphragm & peribronchial cuffing,
infiltrates
What's the Dx? correct answer hyperinflated, flattened diaphragm &
peribronchial cuffing, infiltrates...so the patient has PNA
6 y/o girl has had a cough for 2 wks which began following an acute
"choking episode." She has diminshed breath sounds on the right side,
and the lateral decubitus CXR shows hyperinflation of the right lung
when the patient is positioned with the right side down. The most
appropriate next study for this patient would be:
p. 95 correct answer rigid bronchoscopy
A 1 m/o male is intubated w/ventilator settings to include SIMV
w/pressure support in the ICU. The vent rate is 20, PIP pressure is 20 &
PEEP is 8. You're notified of the following blood gas results: pH 7.30,
PaCO2 91, Bicarbonate 24. Which of the following is the most
appropriate vent adjustment? correct answer increase vent rate
to help remove CO2
,A 1 m/o who was opioid-exposed, but didn't need tx, develops nasal
congestion and is having difficulty feeding. What's the best
explanation? correct answer infants are obligatory nose breathers and
wiith congestion, it's hard to breath and feed
A 1 week old presents in profound shock with metabolic acidosis & is
being fluid resuscitated. A strange odor is noted from the child, what
disorder is expected? correct answer organic acid defect
A 1 y/o female infant presents to the ED with generalized weakness ,
diarrhea, and a fever for 2 days. Temp 39 C, HR 102, RR 20, BP 80/39,
SPO2 95% on RA. Physical exam shows a pale, tired-appearing female,
with a diffuse maculopapular rash on her abdomen, trunk, and bilateral
upper extremities w/palmar involvement.
Lab results listed below:
Sodium 136
WBC 6.8 x 10 to the 3rd/uL
Potassium 3.5
Chloride 100
Bicarbonate 21
Hemoglobin 10.5 g/dL
Hematacrit 28.3%
Platelets 90 x 10 to the 3rd/uL
, Blood Urea Nitrogen 22
Creatinine 2.1
Glucose 92
Calcium 8.1
Magnesium 2.4
Phosphorus 4.9
Antibiotics should be selected to cover for which of the following
organisms?
p. 335 correct answer Staph. aureus and Strep. pyogenes
A 1 y/o requires a finger stick lab test. Which of the following is the best
toy to offer after the procedure? correct answer shape sorter
A 1 y/o with head injury develops acute irritability with decreased
sensorium and bradycardia. The most important urgent management
includes intubation and : correct answer brain CT and give hypertonic
saline
A 1.5 y/o s/p Kasai procedure for BA (biliary atresia) presents at 8
weeks of age with congestion, malaise, and frequent stools. On physical
exam, the child is afebrile, weight is down 2 kg (3 percentile for age), no
jaundice, + hepatomegaly, ALT 120, AST 134, total bilirubin 1, CBC WNL.
What additional evaluation is indicated?
Accurate Answers
11 y/o w/Hx of asthma, presents w/low grade fever, SOB, hypoxia &
+Covid 19 correct answer PNA, possible effusion, the heart has shifted
from it's normal position
2 of the 4 core principles for family-centered care include:
p. 37 correct answer treat the family with respect, and encourage
family participation in care decisions
2 sets of blood Cx from separate peripheral sites have been sent of a 5
y/o patient with likely bacteremia. 1 of the blood Cx has grown
coagulase-negative Staph. aureus. The 2nd has had no growth for 72
hrs. What's the interpretation?
p. 333 correct answer Likely a contaminant; blood Cx can be repeated
4 y/o was diagnosed w/Streptococcal pneumoniae PNA 4 days ago &
was started on high dose amoxicillin. Today in clinic, he develops new
increased resp. distress & fever. What do you anticipate is the
rationale? correct answer Parapneumonic effusion/empyema
effusion/empyema usually have been recently sick
,5 y/o w/Hx of asthma, presents w/wheezing, fever, & hypoxia
CXR: hyperinflated, flattened diaphragm & peribronchial cuffing,
infiltrates
What's the Dx? correct answer hyperinflated, flattened diaphragm &
peribronchial cuffing, infiltrates...so the patient has PNA
6 y/o girl has had a cough for 2 wks which began following an acute
"choking episode." She has diminshed breath sounds on the right side,
and the lateral decubitus CXR shows hyperinflation of the right lung
when the patient is positioned with the right side down. The most
appropriate next study for this patient would be:
p. 95 correct answer rigid bronchoscopy
A 1 m/o male is intubated w/ventilator settings to include SIMV
w/pressure support in the ICU. The vent rate is 20, PIP pressure is 20 &
PEEP is 8. You're notified of the following blood gas results: pH 7.30,
PaCO2 91, Bicarbonate 24. Which of the following is the most
appropriate vent adjustment? correct answer increase vent rate
to help remove CO2
,A 1 m/o who was opioid-exposed, but didn't need tx, develops nasal
congestion and is having difficulty feeding. What's the best
explanation? correct answer infants are obligatory nose breathers and
wiith congestion, it's hard to breath and feed
A 1 week old presents in profound shock with metabolic acidosis & is
being fluid resuscitated. A strange odor is noted from the child, what
disorder is expected? correct answer organic acid defect
A 1 y/o female infant presents to the ED with generalized weakness ,
diarrhea, and a fever for 2 days. Temp 39 C, HR 102, RR 20, BP 80/39,
SPO2 95% on RA. Physical exam shows a pale, tired-appearing female,
with a diffuse maculopapular rash on her abdomen, trunk, and bilateral
upper extremities w/palmar involvement.
Lab results listed below:
Sodium 136
WBC 6.8 x 10 to the 3rd/uL
Potassium 3.5
Chloride 100
Bicarbonate 21
Hemoglobin 10.5 g/dL
Hematacrit 28.3%
Platelets 90 x 10 to the 3rd/uL
, Blood Urea Nitrogen 22
Creatinine 2.1
Glucose 92
Calcium 8.1
Magnesium 2.4
Phosphorus 4.9
Antibiotics should be selected to cover for which of the following
organisms?
p. 335 correct answer Staph. aureus and Strep. pyogenes
A 1 y/o requires a finger stick lab test. Which of the following is the best
toy to offer after the procedure? correct answer shape sorter
A 1 y/o with head injury develops acute irritability with decreased
sensorium and bradycardia. The most important urgent management
includes intubation and : correct answer brain CT and give hypertonic
saline
A 1.5 y/o s/p Kasai procedure for BA (biliary atresia) presents at 8
weeks of age with congestion, malaise, and frequent stools. On physical
exam, the child is afebrile, weight is down 2 kg (3 percentile for age), no
jaundice, + hepatomegaly, ALT 120, AST 134, total bilirubin 1, CBC WNL.
What additional evaluation is indicated?
