Acute Care Exam 3 Questions
with Accurate Answers
70 y/o male with a history of diabetes and hypertension, is admitted for
community-acquired pneumonia. Two days after admission, the RN
calls and says he's got a right facial droop and aphasia that started 5
minutes ago. His BP 165/85, awake and able to walk. What is the next
most appropriate step?
Order stat contrast Head CT, labs, EKG, and administer tPA.
Stat capillary blood glucose.
Order stat neurology consult.
Ask the emergency room provider to assess the patient correct answer
Stat capillary blood glucose.
A 14-year-old adolescent who plays soccer is in the clinic reporting pain
and swelling in both knees. The pain is worse when he is playing soccer,
and relieved with rest. A physical examination reveals swelling and
focal tenderness at the tibial tuberosities, with pain worsening when
asked to extend the knees against resistance. What is the treatment for
this condition?
Obtain radiographic studies to rule out fractures or ligament tears.
Begin quadriceps-stretching exercises immediately to prevent further
injury.
Refer to a pediatric orthopedic specialist to evaluate the need for
surgery.
,Apply ice packs to both knees and avoid activities that cause pain.
correct answer Apply ice packs to both knees and avoid activities that
cause pain.
A 16-year-old boy presents to a rural clinic. He was hit by the opposing
team with the helmet directly to his left knee falling backward.The pain
was so severe that he was unable to walk off the field and is unable to
bear weight on his left leg. He states he heard a "pop". On physical
exam, you notice that he is tender to palpation of the physis of his L leg.
The priority differential diagnosis is:
Anterior cruciate ligament tear
Tibial Eminence fracture
Distal femoral physeal fracture
Medial Collateral Sprain correct answer Distal femoral physeal fracture
A 16-year-old male presents to the urgent care center with a sore
throat, fever of 101.5, swollen anterior cervical lymph nodes, and
exudate on his tonsils. What is the most appropriate treatment plan?
Increased humdification, warm salt water gargles, intranasal steroids',
vitamin C
Increased humidifation, prednisone burst, vitamin C, and Echinacea
Vocal rest, warm salt water gargles, Penicillin 500 mg bid, Tylenol for
pain
,Vocal rest, warm salt water gargles, cephalexin 250 mg bid, and Tylenol
for pain correct answer Vocal rest, warm salt water gargles, cephalexin
250 mg bid, and Tylenol for pain
PCN would also be appropriate - oral PCN V 500 mg 2-3x daily for 10
days; amoxicillin 500 mg BID or 1 g once daily for 10 days. Cephalexin
indicated for mild PCN allergy.
A 20-year-old female presents needing emergency uncross-matched
blood for resuscitation. The AG-ACNP knows she needs what kind of
blood?
O positive
O negative
B negative
AB Negative correct answer O negative
A 20-year-old female soccer player presents to the clinic complaining of
left knee pain after a fall 2 days ago in which she planted on her left
foot, twisted, and fell. She denies a history of a previous knee injury.
Physical exam reveals mild swelling, a positive McMurray's test, and
locking over the knee with full extension. The patient's most likely
diagnosis is:
ACL injury
MCL injury
Meniscal injury
, PCL injury correct answer Meniscal injury
A 23-year-old male is admitted to the hospital with an intracranial
hemorrhage stroke. They have an NGT in place but no evidence of
bleed. What is the most appropriate form of GI prophylaxis?
Zantac 150 mg IV bid
Nexium 40 mg PO twice a day
Protonix 40 mg IV daily
Pepcid 20 mg per NGT q 12 hours correct answer Pepcid 20 mg per NGT
q 12 hours
A 24-year-old asymptomatic female is scheduled for an annual physical
exam and PAP smear. This represents:
Primary prevention
Quaternary prevention
Tertiary prevention
Secondary prevention correct answer Primary prevention
A 25-year-old female in involved in a motor vehicle crash (MVC) and
sustains a fractured pelvis and a fractures femur. Her blood pressure is
72/30, pulse is 160, and she has already received 2 liters of crystalloid
as a bolus. What is the next most appropriate intervention by the AG-
ACNP?
with Accurate Answers
70 y/o male with a history of diabetes and hypertension, is admitted for
community-acquired pneumonia. Two days after admission, the RN
calls and says he's got a right facial droop and aphasia that started 5
minutes ago. His BP 165/85, awake and able to walk. What is the next
most appropriate step?
Order stat contrast Head CT, labs, EKG, and administer tPA.
Stat capillary blood glucose.
Order stat neurology consult.
Ask the emergency room provider to assess the patient correct answer
Stat capillary blood glucose.
A 14-year-old adolescent who plays soccer is in the clinic reporting pain
and swelling in both knees. The pain is worse when he is playing soccer,
and relieved with rest. A physical examination reveals swelling and
focal tenderness at the tibial tuberosities, with pain worsening when
asked to extend the knees against resistance. What is the treatment for
this condition?
Obtain radiographic studies to rule out fractures or ligament tears.
Begin quadriceps-stretching exercises immediately to prevent further
injury.
Refer to a pediatric orthopedic specialist to evaluate the need for
surgery.
,Apply ice packs to both knees and avoid activities that cause pain.
correct answer Apply ice packs to both knees and avoid activities that
cause pain.
A 16-year-old boy presents to a rural clinic. He was hit by the opposing
team with the helmet directly to his left knee falling backward.The pain
was so severe that he was unable to walk off the field and is unable to
bear weight on his left leg. He states he heard a "pop". On physical
exam, you notice that he is tender to palpation of the physis of his L leg.
The priority differential diagnosis is:
Anterior cruciate ligament tear
Tibial Eminence fracture
Distal femoral physeal fracture
Medial Collateral Sprain correct answer Distal femoral physeal fracture
A 16-year-old male presents to the urgent care center with a sore
throat, fever of 101.5, swollen anterior cervical lymph nodes, and
exudate on his tonsils. What is the most appropriate treatment plan?
Increased humdification, warm salt water gargles, intranasal steroids',
vitamin C
Increased humidifation, prednisone burst, vitamin C, and Echinacea
Vocal rest, warm salt water gargles, Penicillin 500 mg bid, Tylenol for
pain
,Vocal rest, warm salt water gargles, cephalexin 250 mg bid, and Tylenol
for pain correct answer Vocal rest, warm salt water gargles, cephalexin
250 mg bid, and Tylenol for pain
PCN would also be appropriate - oral PCN V 500 mg 2-3x daily for 10
days; amoxicillin 500 mg BID or 1 g once daily for 10 days. Cephalexin
indicated for mild PCN allergy.
A 20-year-old female presents needing emergency uncross-matched
blood for resuscitation. The AG-ACNP knows she needs what kind of
blood?
O positive
O negative
B negative
AB Negative correct answer O negative
A 20-year-old female soccer player presents to the clinic complaining of
left knee pain after a fall 2 days ago in which she planted on her left
foot, twisted, and fell. She denies a history of a previous knee injury.
Physical exam reveals mild swelling, a positive McMurray's test, and
locking over the knee with full extension. The patient's most likely
diagnosis is:
ACL injury
MCL injury
Meniscal injury
, PCL injury correct answer Meniscal injury
A 23-year-old male is admitted to the hospital with an intracranial
hemorrhage stroke. They have an NGT in place but no evidence of
bleed. What is the most appropriate form of GI prophylaxis?
Zantac 150 mg IV bid
Nexium 40 mg PO twice a day
Protonix 40 mg IV daily
Pepcid 20 mg per NGT q 12 hours correct answer Pepcid 20 mg per NGT
q 12 hours
A 24-year-old asymptomatic female is scheduled for an annual physical
exam and PAP smear. This represents:
Primary prevention
Quaternary prevention
Tertiary prevention
Secondary prevention correct answer Primary prevention
A 25-year-old female in involved in a motor vehicle crash (MVC) and
sustains a fractured pelvis and a fractures femur. Her blood pressure is
72/30, pulse is 160, and she has already received 2 liters of crystalloid
as a bolus. What is the next most appropriate intervention by the AG-
ACNP?
