NURS 6550 MIDTERM EXAM 1 – QUESTION AND ANSWERS. (GOLD LEVEL EXPERT RECOMMENDS) DOWNLOAD TO SCORE A+

NURS 6550 MIDTERM EXAM 1 – QUESTION AND ANSWERS 1. The AGACNP is caring for a patient who is quite ill and has developed, among other things, a large right sided pleural effusion. Thoracentesis is sent for pleural fluid analysis. While evaluating the fluid analysis, the AGACNP knows that a fluid identified as a(n) __________ is the least worrisome type. Answer: A, a trasdutate is essential as it shows 2. Mrs. Miller is transported to the emergency department by paramedics. She is having profound, unremitting chest pain, is diaphoretic and pale. She has jugular venous distention and a widened pulse pressure. Suspecting ascending aortic aneurysm, the AGACNP order which test to confirm the diagnosis? Ans: D is the answer- CT( not radiography or MRI or us) 3. Certain subgroups of the elderly population are at an increased risk for rapid deterioration and long-term care placement. Which of the following is not ….a high risk factor for long term care placement? ANS: A- men ( others are 80, live alone, bowel and bladder incontinence, hx of fall, dysfunctional coping and intellectual impairment). 4. A patient with anterior epistaxis has been ….with 20 minutes of direct pressure to the cartilaginous portion of the nose. Following pressure the patient is ….to gently blow the nose. Expected findings in the patient who has been successfully ….include all of the following except a: Ans: C, bld and clot formation occurs if bleeding stop within 20 min of directed pressure and can be removed by gentle suction and gentle blowing of nose. 5. Kevin is a 14-year-old male who presents for evaluation of a fever of 102.5° F and significant right ear pain. He appears quite ill and says he feels nauseous. Otoscopic evaluation reveals pain to palpation, a very erythematous and bulging tympanic membrane with bullous myringitis. The AGACNP knows that antibiotic therapy must be selected to cover: Ans: D, streptococcus pneumonaie commonly bacteria present in head and neck infection of immunocompetent patients, and primarily treatment target for otitis media, bacterial sinusitis, and bacterial pharyngitis. 6. P.M. is a 71-year-old gay male patient who presents as an outpatient for evaluation of increasing shortness of breath. The diagnostic evaluation ultimately supports a diagnosis of community acquired pneumonia. The AGACNP appreciates right middle lobe consolidation on chest radiography. Pending sputum cultures, empiric antibiotic therapy must be initiated to cover which organism? Ans: D- streptococcus pneumonaie from out patient population and targeted treatment empirically. 7. Which of the following is the greatest risk factor for vascular dementia? Ans- B, vascular disease in target organ damage in DM, hyperlipidemia and HTN 8. J.R. is a 55-year-old male who presents for a commercial driver’s license physical examination with a blood pressure of 170/102 mm Hg. He has no medical history and is without complaint. Which of the following findings constitutes hypertensive urgency? 9. Because of the commonly recognized adverse effects of atypical antipsychotics, annual laboratory assessment for patients taking these medications should include a: 10. K.R. presents for an evaluation of eye discomfort. He works in a fabricating shop for a custom automobile restoration company and while working he felt like something flew into his eye. He was wearing eye protection at the time but still has the sensation that something is there. Physical examination is significant for some tearing and he reports a persistent sense of something in his eye. Which of the following is not …..in the diagnostic evaluation? 11. D.E. is a 41-year-old female who had lumbar surgery two days ago to repair a ….nucleus pulposus. She has been doing well postoperatively but today is complaining of resting fatigue and some shortness of breath at rest. In ruling out a pulmonary embolus the AGACNP first orders a: 12. Mr. Nixon is being ….with unfractionated heparin infusion for acute pulmonary embolus. In order to avoid a potentially fatal complication of heparin infusion, the AGACNP monitors: 13. Differentiating vertigo from near-syncope and ataxia is one of the goals of history-taking when a patient presents as “dizzy.” The AGACP knows that vertigo is the problem when the patient reports the primary symptom as: 14. Mr. Banks has been ….for surgical resection of a metastatic tumor, during surgery it is discovered that he has widespread, diffuse metastasis throughout the abdomen. Surgery is no longer an option, and his oncologist says that chemotherapy is unlikely to produce any meaningful benefit. Mr. Banks is concerned that his sons will not support a transfer to comfort care. The AGACNP advises that he: 15. Mr. Wilkerson is a 77-year-old male who is being ….and treated for his cardiogenic pain. His vital signs are as follows: Temperature of 99.1° F, pulse of 100 bpm, respirations of 22 bpm, and blood pressure of 168/100 mm Hg. A 12-lead ECG reveals deep ST segment depression in leads V3-V6. The AGACNP recognizes which of the following as a contraindication to rTPA therapy? 16. A 71-year-old patient is recovering from a particularly severe exacerbation of chronic obstructive pulmonary disease. He has been in the hospital for almost two weeks and was on mechanical ventilation for 7 days. While discussing his discharge plan he tells you that he is really going to quit smoking this time. He acknowledges that he has been “sneaking” cigarettes in the hospital for two days, but he has established a timeline to decrease the number of cigarettes daily. According to his plan his last cigarette will be the last day of the month. This patient’s behavior is consistent with which stage of the Transtheoretical Model of Change? 17. While assessing a patient with a known psychiatric history, the AGACNP knows that the primary difference between a psychotic and neurotic disorders is: 18. L.T. is an 85-year-old male who is admitted for evaluation of profound diarrhea that has produced significant dehydration. He also complains of being very tired lately, and feeling like he is going to vomit all of the time. His vital signs are significant for a pulse of 41 b.p.m. and a blood pressure of 90/60 mm Hg. A gastrointestinal evaluation including stool for blood, white blood cells, and ova and parasites is negative. He insists that he has not started any new medications or made any diet changes; the only thing new is that he got new eye drops for his glaucoma. The AGACNP correctly assumes that his new eye drops are: 19. Janice is a 19-year-old female who presents to the emergency department via ambulance. She is pale, diaphoretic, agitated, and convinced she is having a stroke. Her vital signs include a temperature of 98.9° F, pulse of 114 beats per minute, respirations of 32 breaths per minute, and a blood pressure of 110/74 mm Hg. Diagnostic evaluation is negative and Janice is diagnosed with an acute panic attack. The initial treatment of choice is: 20. Lorraine is a 41-year-old female who presents for an asthma follow-up visit. She says she feels very well, has almost no daytime symptoms, and is using her inhaled corticosteroid medication daily as prescribed. Her PEFR is 85% of her personal best. The best approach to this patient is to: 21. Mr. Owen is a 37-year-old patient who has been admitted for surgical resection of a malignant tumor in his lung. His physical recovery has been uneventful and he is being prepared for discharge. While discussing his ongoing cancer therapy with Mr. Owen, the AGACNP determines that he has experienced persistent, excessive anxiety and worry almost every day for more than one year. What other aspect of Mr. Owen’s psychosocial history would be ….to made a diagnosis of generalized anxiety disorder? 22. Kevin T. is a 49-year-old male who is being ….after hospitalization for an acute inferior wall myocardial infarction. This is his first hospitalization and his first chronic medical diagnosis. Aside from his elevated cardiac isoenzymes and troponins, his laboratory profile was essentially within normal limits. The only apparent cardiac risk