AGACNP AACN Exam Boards with
Accurate Solutions
3 steps of pain management - ANSWER-1. aspirin, tylenol, NSAIDs
2. codeine, hydrocodone, oxycodone, tramadol (only with NSAIDS)
3. morphine, hydromorphone, methadone, fentanyl
Breakthrough cancer pain management - ANSWER-fentanyl
Metastatic bone pain management - ANSWER-bisphosphonates
Tension headache symptoms & management - ANSWER-symptoms - tight, back of
head/neck
management - OTC analgesics and rest
Migraine headache types and treatments - ANSWER-classic - WITH aura
common - WITHOUT aura
treatment - sumatriptan and analgesics
Cluster headache symptoms and management - ANSWER-symptoms - occur at night,
ipsilateral congestion, rhinorrhea, and eye redness
Albumin levels <3.5 - ANSWER-protein malnutrition
Albumin <2.7 - ANSWER-Edema
Complications of enteral nutrition - ANSWER-aspiration, refeeding, dehydration
Complications of parenteral nutrition - ANSWER-pneumothorax, hemothorax
Urine sodium >20 - ANSWER-renal salt wasting (kidney is the problem)
Urine sodium <10 - ANSWER-kidney isn't the problem
isotonic hyponatremia serum osmolality and causes - ANSWER-serum osmolality - 284-
295
causes - extreme hyperlipidemia or nhyperproteinemia
hypotonic hyponatremia serum osmolality and types - ANSWER-serum osmolality <280
hypovolemic w/ sodium <10
hypovolemic w/ sodium >20
,hypervolemic
hypovolemic w/ urine sodium <10 causes - ANSWER-dehydration, diuresis, vomiting
hypovolemic w/ urine sodium >20 - ANSWER-diuretics, ACE, mineralocorticoid
deficiency
hypervolemic hypotonic hyponatremia - ANSWER-edema, CHF, liver disease, renal
failure
must restrict fluids
hypertonic hyponatremia serum osmolality and causes - ANSWER-serum osmolality
>290
causes - HHS
hypokalemia causes, signs/symptoms, treatment - ANSWER-causes - diuretics, GI
losses, renal loss, alkalosis
signs/symptoms - weakness, fatigue, cramps, broad T waves, u waves
treatment - oral replacement if >2.5, 40mEq/L/hr IV if severe
hyperkalemia causes, signs/symptoms, treatment - ANSWER-causes - renal failure,
drugs, hypoaldosteronism
signs/symptoms - weakness, flaccid paralysis, abdominal distension, diarrhea, peaked
T waves
treatment - ion resin exchange (kayexalate), insulin, D5W
hypocalcemia causes, signs/symptoms, treatment - ANSWER-causes - pancreatitis,
renal failure, trauma, massive transfusions
symptoms - increased DTRs, cramps, convulsions, prolonged QT, Chvostek's and
Trousseau's sign
treatment - check for alkalosis, IV calcium gluconate if acute, oral supplements if
chronic
hypercalcemia causes, signs/symptoms, treatment - ANSWER-causes - vitamin D
intoxication, immobilization, thiazide diuretics
symptoms - fatigue, muscle weakness, constipation, coma, death
treatment - calcitonin if renal/card involvement, NS, loop diuretics, dialysis if severe
respiratory acidosis causes, signs/symptoms, treatment - ANSWER-causes -
hypoventilation (pH<7.35, pCO2>45)
symptoms - somnolence, confusion, coma, myoclonus with asterixis
treatment - narcan if unknown cause, increased ventilator rate
respiratory alkalosis causes, signs/symptoms, treatment - ANSWER-causes -
hyperventilation (pH>7.45, pCO2<35)
symptoms - lightheadedness, tingling, tetany if severe
, treatment - paper bag breathing, decreased ventilator rate
metabolic acidosis types, causes, treatment - ANSWER-types:
increased anion gap - DKA, alcoholic ketoacidosis, lactic acidosis
normal anion gap - diarrhea, ileostomy, renal tubular acidosis, DKA recovery
treat with fluids
metabolic alkalosis causes, signs/symptoms, treatment - ANSWER-causes - saline
responsive, NG suction, vomiting, diuretics
treatment - d/c diuretics, give NaCl and KCl, H2 blockers if GI loss
Gram positive bacteria - ANSWER-streptococci, staphylococcus, enterococci, bacilli
Gram negative bacteria - ANSWER-E. coli, klebsiella, pseudomonas, acinetobacter,
enterobacter
anti-rejection meds following transplant - ANSWER-1. steroids
2. antimetabolites
3. calcineurin inhibitors OR mTOR inhibitor
Herpes Zoster (shingles) characteristics and treatment - ANSWER-characteristics -
grouped vesicle eruption, with erythema and exudate, along dermatomal pathway
treatment - "cyclovir"; vaccine x2 if >50 years old
Actinic keratosis characteristics and treatment - ANSWER-characteristics - sun-
exposed, asymptomatic, small patches, rough, flesh colored/pink
treatment - liquid nitrogen
Squamous Cell Carcinoma characteristics and treatment - ANSWER-characteristics -
firm, irregular papule/nodule, keratotic, scaly, bleeding
treatment - biopsy and surgical excision
Seborrheic keratosescharacteristics and treatment - ANSWER-characteristics - benign,
beige/brown/black
treatment - nothing or liquid nitrogen
Basal cell carcinoma characteristics and treatment - ANSWER-characteristics - most
common*, slow growing, waxy, pearly, central depression
treatment - shave/punch biopsy and surgical resection
Malignant melanoma characteristics and treatment - ANSWER-characteristics -
asymmetrical, irregular border, elevated, >6mm, highest mortality rate
treatment - biopsy and surgical resection
Accurate Solutions
3 steps of pain management - ANSWER-1. aspirin, tylenol, NSAIDs
2. codeine, hydrocodone, oxycodone, tramadol (only with NSAIDS)
3. morphine, hydromorphone, methadone, fentanyl
Breakthrough cancer pain management - ANSWER-fentanyl
Metastatic bone pain management - ANSWER-bisphosphonates
Tension headache symptoms & management - ANSWER-symptoms - tight, back of
head/neck
management - OTC analgesics and rest
Migraine headache types and treatments - ANSWER-classic - WITH aura
common - WITHOUT aura
treatment - sumatriptan and analgesics
Cluster headache symptoms and management - ANSWER-symptoms - occur at night,
ipsilateral congestion, rhinorrhea, and eye redness
Albumin levels <3.5 - ANSWER-protein malnutrition
Albumin <2.7 - ANSWER-Edema
Complications of enteral nutrition - ANSWER-aspiration, refeeding, dehydration
Complications of parenteral nutrition - ANSWER-pneumothorax, hemothorax
Urine sodium >20 - ANSWER-renal salt wasting (kidney is the problem)
Urine sodium <10 - ANSWER-kidney isn't the problem
isotonic hyponatremia serum osmolality and causes - ANSWER-serum osmolality - 284-
295
causes - extreme hyperlipidemia or nhyperproteinemia
hypotonic hyponatremia serum osmolality and types - ANSWER-serum osmolality <280
hypovolemic w/ sodium <10
hypovolemic w/ sodium >20
,hypervolemic
hypovolemic w/ urine sodium <10 causes - ANSWER-dehydration, diuresis, vomiting
hypovolemic w/ urine sodium >20 - ANSWER-diuretics, ACE, mineralocorticoid
deficiency
hypervolemic hypotonic hyponatremia - ANSWER-edema, CHF, liver disease, renal
failure
must restrict fluids
hypertonic hyponatremia serum osmolality and causes - ANSWER-serum osmolality
>290
causes - HHS
hypokalemia causes, signs/symptoms, treatment - ANSWER-causes - diuretics, GI
losses, renal loss, alkalosis
signs/symptoms - weakness, fatigue, cramps, broad T waves, u waves
treatment - oral replacement if >2.5, 40mEq/L/hr IV if severe
hyperkalemia causes, signs/symptoms, treatment - ANSWER-causes - renal failure,
drugs, hypoaldosteronism
signs/symptoms - weakness, flaccid paralysis, abdominal distension, diarrhea, peaked
T waves
treatment - ion resin exchange (kayexalate), insulin, D5W
hypocalcemia causes, signs/symptoms, treatment - ANSWER-causes - pancreatitis,
renal failure, trauma, massive transfusions
symptoms - increased DTRs, cramps, convulsions, prolonged QT, Chvostek's and
Trousseau's sign
treatment - check for alkalosis, IV calcium gluconate if acute, oral supplements if
chronic
hypercalcemia causes, signs/symptoms, treatment - ANSWER-causes - vitamin D
intoxication, immobilization, thiazide diuretics
symptoms - fatigue, muscle weakness, constipation, coma, death
treatment - calcitonin if renal/card involvement, NS, loop diuretics, dialysis if severe
respiratory acidosis causes, signs/symptoms, treatment - ANSWER-causes -
hypoventilation (pH<7.35, pCO2>45)
symptoms - somnolence, confusion, coma, myoclonus with asterixis
treatment - narcan if unknown cause, increased ventilator rate
respiratory alkalosis causes, signs/symptoms, treatment - ANSWER-causes -
hyperventilation (pH>7.45, pCO2<35)
symptoms - lightheadedness, tingling, tetany if severe
, treatment - paper bag breathing, decreased ventilator rate
metabolic acidosis types, causes, treatment - ANSWER-types:
increased anion gap - DKA, alcoholic ketoacidosis, lactic acidosis
normal anion gap - diarrhea, ileostomy, renal tubular acidosis, DKA recovery
treat with fluids
metabolic alkalosis causes, signs/symptoms, treatment - ANSWER-causes - saline
responsive, NG suction, vomiting, diuretics
treatment - d/c diuretics, give NaCl and KCl, H2 blockers if GI loss
Gram positive bacteria - ANSWER-streptococci, staphylococcus, enterococci, bacilli
Gram negative bacteria - ANSWER-E. coli, klebsiella, pseudomonas, acinetobacter,
enterobacter
anti-rejection meds following transplant - ANSWER-1. steroids
2. antimetabolites
3. calcineurin inhibitors OR mTOR inhibitor
Herpes Zoster (shingles) characteristics and treatment - ANSWER-characteristics -
grouped vesicle eruption, with erythema and exudate, along dermatomal pathway
treatment - "cyclovir"; vaccine x2 if >50 years old
Actinic keratosis characteristics and treatment - ANSWER-characteristics - sun-
exposed, asymptomatic, small patches, rough, flesh colored/pink
treatment - liquid nitrogen
Squamous Cell Carcinoma characteristics and treatment - ANSWER-characteristics -
firm, irregular papule/nodule, keratotic, scaly, bleeding
treatment - biopsy and surgical excision
Seborrheic keratosescharacteristics and treatment - ANSWER-characteristics - benign,
beige/brown/black
treatment - nothing or liquid nitrogen
Basal cell carcinoma characteristics and treatment - ANSWER-characteristics - most
common*, slow growing, waxy, pearly, central depression
treatment - shave/punch biopsy and surgical resection
Malignant melanoma characteristics and treatment - ANSWER-characteristics -
asymmetrical, irregular border, elevated, >6mm, highest mortality rate
treatment - biopsy and surgical resection
