AG-ACNP - Common Problems in Acute Care/ ACNP Board
Review Complete Questions and Guide Answers, 100%
Verified Graded A+
1. Cutaneous Pain
Answer: -localized on the skin or body surface
-eg bad sunburn or blister
2. Visceral Pain
Answer: -poorly localized such as with internal organs eg. gallbladder
pain, PUD pain
3. Somatic Pain
Answer: -non localized
-originates in muscle, bone, nerves, blood vessels eg. soft
tissue injury
4. Neuropathic pain
Answer: involves nerve pathway injury or compression
,5. WHO Pain Ladder
Answer: Step 1 ASA, NSAIDs, tylenol +/- adjuvant (eg is a TCA like amitryptiline for migraine) Step 2 step 1 + codeine,
hydrocodone, oxycodone, tramadol +/- adjuvants
Step 3 morphine, hydromorphone, methadone, fentanyl plus non-opiods plus adjuvants
6. Break-through cancer pain
Answer: use of fentanyl patch for sustained release
7. Stage 1 pressure ulcer
Answer: intact skin w erythema that does NOT blanch
8. Stage 2 pressure ulcer
Answer: partial thickness loss of skin w exposed dermis can present as intact or
ruptured serum filled blister
9. stage 3 pressure ulcer
Answer: full thickness skin loss, visible adipose tissue
10. stage 4 pressure ulcer
Answer: full thickness skin & tissue loss w exposed or palpable fascia, muscle, tendon, ligament or bone
11. unstageable pressure ulcer
Answer: obscured by slough or eschar
12. causes of non-infectious post op fever
, Answer: # 1 is post-op atelectasis
2. increase basal metabolic rate
3. dehydration
4. drug reactions (increase eosonophils, drug fever comes on insidiously and tends to linger; drugs inlcude ampthericin B, bactrim,
procainamide, beta-lactam abx and others
13. Risperidone toxicity (anti-psychotic)
Answer: neuroleptic malignant syndrome tx w dantrolene
14. most commonly cultured organisms inpatient
Answer: staph epi (on your skin) & staph aureus
15. infectious causes of post-op fever
Answer: -usually w increase in WBC and left shift (neutrophils go up in bacterial infxn up to like 85% normal range is 57-
67% on ditterential)
-if WBC >30k usually not infxn
-surgical incision site- red, pus from suture line
-point of entry from catheter
, -urinary tract
-lungs
-sinusitis from NGT
16. Initial Tx of post-op fever
Answer: no indicators for infection, hydrate and measures to promote lunge expansion
17. tension headache
Answer: -single most common type
-vise like pain
-neck/back common area
-no focal neuro deficits
-tx ots OTCs and relaxation
18. Classic migraine
Answer: migraine with aura
19. Common migraine
Answer: migraine without aura
20. Migraine Patho
Answer: related to dilation and excessive pulsation of branches of the external carotid artery
Review Complete Questions and Guide Answers, 100%
Verified Graded A+
1. Cutaneous Pain
Answer: -localized on the skin or body surface
-eg bad sunburn or blister
2. Visceral Pain
Answer: -poorly localized such as with internal organs eg. gallbladder
pain, PUD pain
3. Somatic Pain
Answer: -non localized
-originates in muscle, bone, nerves, blood vessels eg. soft
tissue injury
4. Neuropathic pain
Answer: involves nerve pathway injury or compression
,5. WHO Pain Ladder
Answer: Step 1 ASA, NSAIDs, tylenol +/- adjuvant (eg is a TCA like amitryptiline for migraine) Step 2 step 1 + codeine,
hydrocodone, oxycodone, tramadol +/- adjuvants
Step 3 morphine, hydromorphone, methadone, fentanyl plus non-opiods plus adjuvants
6. Break-through cancer pain
Answer: use of fentanyl patch for sustained release
7. Stage 1 pressure ulcer
Answer: intact skin w erythema that does NOT blanch
8. Stage 2 pressure ulcer
Answer: partial thickness loss of skin w exposed dermis can present as intact or
ruptured serum filled blister
9. stage 3 pressure ulcer
Answer: full thickness skin loss, visible adipose tissue
10. stage 4 pressure ulcer
Answer: full thickness skin & tissue loss w exposed or palpable fascia, muscle, tendon, ligament or bone
11. unstageable pressure ulcer
Answer: obscured by slough or eschar
12. causes of non-infectious post op fever
, Answer: # 1 is post-op atelectasis
2. increase basal metabolic rate
3. dehydration
4. drug reactions (increase eosonophils, drug fever comes on insidiously and tends to linger; drugs inlcude ampthericin B, bactrim,
procainamide, beta-lactam abx and others
13. Risperidone toxicity (anti-psychotic)
Answer: neuroleptic malignant syndrome tx w dantrolene
14. most commonly cultured organisms inpatient
Answer: staph epi (on your skin) & staph aureus
15. infectious causes of post-op fever
Answer: -usually w increase in WBC and left shift (neutrophils go up in bacterial infxn up to like 85% normal range is 57-
67% on ditterential)
-if WBC >30k usually not infxn
-surgical incision site- red, pus from suture line
-point of entry from catheter
, -urinary tract
-lungs
-sinusitis from NGT
16. Initial Tx of post-op fever
Answer: no indicators for infection, hydrate and measures to promote lunge expansion
17. tension headache
Answer: -single most common type
-vise like pain
-neck/back common area
-no focal neuro deficits
-tx ots OTCs and relaxation
18. Classic migraine
Answer: migraine with aura
19. Common migraine
Answer: migraine without aura
20. Migraine Patho
Answer: related to dilation and excessive pulsation of branches of the external carotid artery
