AACN AGACNP boards Questions and answers 2023/2024

AACN AGACNP boards Questions and answers 2023/2024 Pericarditis - correct answer Often present w/ friction rub, sharp CP w/ inspiration, low-grade fever, muffled heart tones, hypotension. Tx w/ colchicine. Pulmonary edema - correct answer Pink/frothy sputum. Tachypnea, dyspnea, b/l wheeze. CXR shows alveolar infiltrates, kerley B lines, and pleural effusions. Cardiac tamponade - correct answer Becks Triad= muffled tones, JVD, HoTN. Narrow pulse pressure. Low C.O., low BP, tachy, high RR, JVD, pulsus paradoxus. Diagnose w/ Echo CPGs for hypertensive urgency BP reduction - correct answer 10-25% in the 1st hour, then 160/100 within 6h, then to normal over next 24h. Septal MI - correct answer V1, V2 LAD Anterior MI - correct answer V3, V4 LAD Inferior/posterior MI - correct answer II, III, aVF RCA Lateral MI - correct answer I, aVL, V5, V6 Circumflex Endocarditis - correct answer Echo shows vegetation, abscess, or valve dysfunction. Tx ABX Pulsus paradoxus - correct answer Fall in SBP 10 mmHg during inspiration S4 gallop - correct answer Common in aortic stenosis A-FIb ablation - correct answer 90% pulmonary veins. Anticoags for 2-3 months following. NYHA HF Classification - correct answer Stages of HF: Class I (mild): no sx, no limitations Class II (mild): no sx @ rest, slight limitation, ordinary activity leads to sx Class III (moderate): no sx @ rest, marked limitation w/ physical activity, less than ordinary activity results in sx Class IV (severe): sx @ rest, unable to do any physical activity w/o discomfort Nitroglycerin - correct answer Vasodilator, causes hypotension, HA. AHA guideline statin therapy - correct answer Age 40-75 w/ DM and LDL /= 70 should get moderate to high intensity statin therapy Hyperkalemia ECG changes - correct answer • Tall/peaked T wave • Prolonged PR • ST depression • Wide QRS • Loss of P wave • V-FIb • Ventricular standstill Common complication of carotid endarterectomy - correct answer Hypoglossal nerve damage, tongue deviation ipsilateral side of surgery. Common rhythm w/ TOF - correct answer V-Tach Statin side effect - correct answer Causes painful muscle spasms 2/2 skeletal muscle breakdown, increased CK levels. ACS medications - correct answer Aspirin 1st (antiplatelet), nitroglycerin for ischemia, beta blocker to reduce cardiac workload by reducing HR. Cardiac resynchronization therapy - correct answer Uses 3 leads (RA, RV, LV) to improve ventricular filling and cardiac output. Clopidogrel (Plavix) - correct answer Antiplatelet; Loading dose 300 mg, then 75 mg daily Digoxin toxicity - correct answer Brady, PVCs, LBBB. *Diltiazem known to increase digoxin levels, worsening toxicity. Tx= digibind. SVT - correct answer tachy 100-300 bpm, generally narrow QRS complexes, and P wave often buried in or after the QRS complex. Postural orthostatic tachycardia syndrome (POTS) - correct answer Usually triggered lying to standing. Sx= lightheadedness, fainting, and rapid HR. Tx= increase Na+ and fluids, add beta blocker. Target Temp Management (TTM) - correct answer Reduce mortality and improve neurological outcomes in unresponsive patients who achieve ROSC after cardiac arrest. Contraindications; hemorrhagic stroke, GCS 8, uncontrolled bleeding, uncontrolled hemodynamically unstable rhythms, and cardiac arrest due to trauma.