AGACNP DRT Exam Review with
Accurate Solutions
Celecoxib (Celebrex) - ANS--COX-2 inhibitor
-Last choice treatment for osteoarthritis
-Should not be prescribed to patients with a history of cardiovascular conditions =
increase risk of heart attack
Osteoarthiritis (OA) Treatment - ANS--ASA
-Tylenol
-NSAIDS (ibuprofen, naproxen)
-Celebrex
-Hot and cold therapy
First line management for acetaminophen intoxication? - ANS--Emesis or gastric lavage
-Ipecac used to force emesis- only if patient is not altered
-N-acetylcyesteine with 140mg/kg loading dose
What needs to be reported to the health department? - ANS--Chlamydia
-Syphilis
-Gonorrea
-TB
-HIV
-Lyme Disease
-Animal Bites
-Injuries due to dangerous weapons
-Suspected child abuse
Malpractice - ANS--Failure of a professional to render services with the degree of care,
diligence and precaution that another member of the same profession under similar
circumstances would render to prevent injury to someone else
-Involves: professional misconduct, unreasonable lack of skill, illegal/immoral conduct,
other allegations resulting in harm
Signs and symptoms of partial small-bowel obstruction - ANS--Pronounced abdominal
distention
-Watery, mucous filled diarrhea
-High pitched, tinkling bowel sounds
"Battle sign" is an indication of a: - ANS-Bruising behind the ear at the mastoid process
,Raccoon Eyes - ANS-Bruising around the eyes, indicative of a basilar skull fracture
Pap smear screening - ANS--Start at age 21
-Pap + cytology is age 30-65 every 3 years
-Pap + cytology + HPV is age 30-65 years every 5 years
Migraine Pathophysiology - ANS-Dilation and excessive pulsation of branches of the
external carotid artery
HBsAg, Anti-HBe, IgM, IgG - what is the diagnosis? - ANS-Chronic Hep B
-HBsAg = Hep B
-Anti-HBe = decreased viral load
-IgM = initial response/recent
-IgG = exposure/immunity
HBsAg, HBeAg, Anti-HBc, IgM - ANS-Active Hep B
-HBsAg = Hep B
-HBeAg = increase viral load
-Anti-Hbc = in all 3
-IgM = recent
Mitral stenosis murmur - ANS--Low pitched
-Mid-diastolic
-Apical "creascendo" rumble
-Occurs during S1
-Does not radiate
Herbal agents that can alleviate premenstrual discomforts? - ANS--Evening Primrose
-Black Cohosh
Continuous Positive Airway Pressure Ventilation - ANS--Allows patient to breathe
normally and spontaneously
-Above atmospheric pressure provided throughout inspiration and expiration
Organophosphate (Insecticide) Poisoning Treatment - ANS-1. Wash skin thoroughly
2. If ingested, activated charcoal
3. **Atropine (drug of choice)
Benzodiazepine Overdose Treatment - ANS-1. Respiratory and blood pressure support
2.**Flumazenil (Romazicon) IV
3. Activated charcoal
Diagnostic test to differentiate between intrarenal and postrenal failure? - ANS-Urinary
sediment test
-Granular white cast = intrarenal
-Normal results = postrenal
,Diagnostic test to differentiate between prerenal and intrarenal? - ANS-Serum BUN and
specific gravity tests
-BUN:Creatinine ratio >10:1 = preprenal
-BUN:Creatinine ratio 10:1 - intrarenal
-Specific gravity >1.015 = prerenal
-Specific gravity <1.015 = intrarenal
Side effects of hormone replacement therapy (HRT)? - ANS--Gallstones
-Blood clots
-Stroke
** can help prevent osteoporosis
Signs and symptoms of hypercalcemia - ANS-SLOW/SLUGGISH
-Prolonged immobility
-Weight loss
-N/V
-Fatigue
-Muscle weakness
-Depressin
-Anorexia
-Constipation
Acute pancreatitis expected findings? - ANS--WBC elevation
-Hyperglycemia
-Serum LDH and AST elevation
-Serum amylase and lipase elevation
-BUN and coagulation can be elevated
-Hypocalcemia (Trousseau's or Chvostek's sign)
-Elevated C-reactive protein
***Hypercalcemia can cause pancreatitis
Herpes zoster vaccine can be administered at what age? - ANS-50 years old
Mitral regurgitation murmur - ANS--Presents with an S3
-"Blowing," high pitched, muscial sound
-During systole
-Heard at the hearts apex
-Galloping, additional heart sound
-May radiate to the base or left axilla
Aortic Stenosis murmur - ANS--Systolic
, -Blowing, rough, harsh murmur
-2nd right intercostal space
-Radiating to the neck
Aortic regurgitation - ANS--Diastolic
-Blowing
-2nd left intercostal space
Somogyi Effect - ANS--Nocturnal hypoglycemia develops stimulating a surge of counter
regulatory hormones (Somogyi effect) which raise blood sugar.
-Pt is hypoglycemic at 0300 but rebounds with an elevated blood glucose at 0700
-TX: reduce or omit the at bedtime dose of insulin
Dawn phenomenon - ANS--Results when tissue becomes desensitized to insulin
nocturnally
-Blood glucose become progressively elevated throughout the night, resulting in
elevated blood glucose levels at 0700
-TX: add or increase the at bedtime dose of insulin
DIC labs - ANS--Thrombocytopenia (plt <150,000)
-Hypofibrinogenemia (fibrinogen < 170)
-Fibrinogen normal
-Decreased RBC
-Increased FDP
-Prolonged PT and PTT
-Elevated D-dimer
Hepatotoxicity signs and symptoms - ANS--Jaundice
-Elevated LFTs
-Prolonged PT
-AMS
-Delirium
Ulcerative colitis lab findings - ANS--Hypokalemia
-Anemia
-Caused by bloody diarrhea and leukocytosis secondary to inflammation
TB: Positive skin test should receive 6 months of INH
-Positive 5mm
-Positive 10mm
-Positiven 15mm - ANS--5mm = HIV, known case, positive chest film
Accurate Solutions
Celecoxib (Celebrex) - ANS--COX-2 inhibitor
-Last choice treatment for osteoarthritis
-Should not be prescribed to patients with a history of cardiovascular conditions =
increase risk of heart attack
Osteoarthiritis (OA) Treatment - ANS--ASA
-Tylenol
-NSAIDS (ibuprofen, naproxen)
-Celebrex
-Hot and cold therapy
First line management for acetaminophen intoxication? - ANS--Emesis or gastric lavage
-Ipecac used to force emesis- only if patient is not altered
-N-acetylcyesteine with 140mg/kg loading dose
What needs to be reported to the health department? - ANS--Chlamydia
-Syphilis
-Gonorrea
-TB
-HIV
-Lyme Disease
-Animal Bites
-Injuries due to dangerous weapons
-Suspected child abuse
Malpractice - ANS--Failure of a professional to render services with the degree of care,
diligence and precaution that another member of the same profession under similar
circumstances would render to prevent injury to someone else
-Involves: professional misconduct, unreasonable lack of skill, illegal/immoral conduct,
other allegations resulting in harm
Signs and symptoms of partial small-bowel obstruction - ANS--Pronounced abdominal
distention
-Watery, mucous filled diarrhea
-High pitched, tinkling bowel sounds
"Battle sign" is an indication of a: - ANS-Bruising behind the ear at the mastoid process
,Raccoon Eyes - ANS-Bruising around the eyes, indicative of a basilar skull fracture
Pap smear screening - ANS--Start at age 21
-Pap + cytology is age 30-65 every 3 years
-Pap + cytology + HPV is age 30-65 years every 5 years
Migraine Pathophysiology - ANS-Dilation and excessive pulsation of branches of the
external carotid artery
HBsAg, Anti-HBe, IgM, IgG - what is the diagnosis? - ANS-Chronic Hep B
-HBsAg = Hep B
-Anti-HBe = decreased viral load
-IgM = initial response/recent
-IgG = exposure/immunity
HBsAg, HBeAg, Anti-HBc, IgM - ANS-Active Hep B
-HBsAg = Hep B
-HBeAg = increase viral load
-Anti-Hbc = in all 3
-IgM = recent
Mitral stenosis murmur - ANS--Low pitched
-Mid-diastolic
-Apical "creascendo" rumble
-Occurs during S1
-Does not radiate
Herbal agents that can alleviate premenstrual discomforts? - ANS--Evening Primrose
-Black Cohosh
Continuous Positive Airway Pressure Ventilation - ANS--Allows patient to breathe
normally and spontaneously
-Above atmospheric pressure provided throughout inspiration and expiration
Organophosphate (Insecticide) Poisoning Treatment - ANS-1. Wash skin thoroughly
2. If ingested, activated charcoal
3. **Atropine (drug of choice)
Benzodiazepine Overdose Treatment - ANS-1. Respiratory and blood pressure support
2.**Flumazenil (Romazicon) IV
3. Activated charcoal
Diagnostic test to differentiate between intrarenal and postrenal failure? - ANS-Urinary
sediment test
-Granular white cast = intrarenal
-Normal results = postrenal
,Diagnostic test to differentiate between prerenal and intrarenal? - ANS-Serum BUN and
specific gravity tests
-BUN:Creatinine ratio >10:1 = preprenal
-BUN:Creatinine ratio 10:1 - intrarenal
-Specific gravity >1.015 = prerenal
-Specific gravity <1.015 = intrarenal
Side effects of hormone replacement therapy (HRT)? - ANS--Gallstones
-Blood clots
-Stroke
** can help prevent osteoporosis
Signs and symptoms of hypercalcemia - ANS-SLOW/SLUGGISH
-Prolonged immobility
-Weight loss
-N/V
-Fatigue
-Muscle weakness
-Depressin
-Anorexia
-Constipation
Acute pancreatitis expected findings? - ANS--WBC elevation
-Hyperglycemia
-Serum LDH and AST elevation
-Serum amylase and lipase elevation
-BUN and coagulation can be elevated
-Hypocalcemia (Trousseau's or Chvostek's sign)
-Elevated C-reactive protein
***Hypercalcemia can cause pancreatitis
Herpes zoster vaccine can be administered at what age? - ANS-50 years old
Mitral regurgitation murmur - ANS--Presents with an S3
-"Blowing," high pitched, muscial sound
-During systole
-Heard at the hearts apex
-Galloping, additional heart sound
-May radiate to the base or left axilla
Aortic Stenosis murmur - ANS--Systolic
, -Blowing, rough, harsh murmur
-2nd right intercostal space
-Radiating to the neck
Aortic regurgitation - ANS--Diastolic
-Blowing
-2nd left intercostal space
Somogyi Effect - ANS--Nocturnal hypoglycemia develops stimulating a surge of counter
regulatory hormones (Somogyi effect) which raise blood sugar.
-Pt is hypoglycemic at 0300 but rebounds with an elevated blood glucose at 0700
-TX: reduce or omit the at bedtime dose of insulin
Dawn phenomenon - ANS--Results when tissue becomes desensitized to insulin
nocturnally
-Blood glucose become progressively elevated throughout the night, resulting in
elevated blood glucose levels at 0700
-TX: add or increase the at bedtime dose of insulin
DIC labs - ANS--Thrombocytopenia (plt <150,000)
-Hypofibrinogenemia (fibrinogen < 170)
-Fibrinogen normal
-Decreased RBC
-Increased FDP
-Prolonged PT and PTT
-Elevated D-dimer
Hepatotoxicity signs and symptoms - ANS--Jaundice
-Elevated LFTs
-Prolonged PT
-AMS
-Delirium
Ulcerative colitis lab findings - ANS--Hypokalemia
-Anemia
-Caused by bloody diarrhea and leukocytosis secondary to inflammation
TB: Positive skin test should receive 6 months of INH
-Positive 5mm
-Positive 10mm
-Positiven 15mm - ANS--5mm = HIV, known case, positive chest film
