NRNP 6566 FINAL EXAM FORM B QUESTIONS AND ANSWERS VERIFIED 100% CORRECT |AGRADE (WALDEN UNIVERSITY)

NRNP 6566 FINAL EXAM FORM B QUESTIONS AND ANSWERS VERIFIED 100% CORRECT |AGRADE (WALDEN UNIVERSITY) • Question 1 The NP is managing a 39-year-old-male with hypoxic respiratory failure. The patient has been on the ventilator for 3 days. Today the patient's peak inspiratory pressure and heart rate suddenly increase. The oxygen saturation is decreasing. After increasing the FIO2, the next most appropriate step is to check the: • Question 2 The NP is managing the care of a patient in metabolic acidosis. Which exam finding would indicate that the acidosis is getting worse? • Question 3 The NP is caring for a patient in the ICU with 45% body burns. He is intubated and ventilated due to inhalation injury. The current ventilator settings are Tidal Volume 10 ml/kg PEEP 5 cm FiO2 70% Rate of 18 The last arterial blood gas results show a pH of 7.23 pCO2 38 and pO2 of 58 The chest xray shows bilateral opacities throughout the lung fields. What change in the ventilator settings would you make to address the hypoxia? • Question 4 The NP is managing the care of a patient admitted with a serum sodium level of 115. The patient has been receiving 3% normal saline 50 ml/hour for the past 16 hours. On rounds this morning, the patient complains of shortness of breath and fatigue. What is the priority intervention? • Question 5 The NP is managing a 66 year old female admitted to the ICU with a serum potassium level of 8.9 mEg/L. Hemodialysis will be started as soon as the on-call staff can arrive. What intervention should the NP order now? • Question 6 The NP is managing the care of a patient with diabetic ketoacidosis. The patients anion gap is now normal, hydration status appears normal, and serum blood sugar was 182. Normal saline IV fluids have been decreased to 50 cc/ hour and insulin drip was stopped. 6 hours ago. The NP is notified that the serum blood sugar prior to dinner was 332. How would you explain this rise in blood sugar? • Question 7 A 26 year old female arrives at the ED via EMS. She was found unarousable in her apartment by her roommate. T 101.2 RR 32 HR 110 BP 138/88 Pupils are equal, round, and reactive. There is no sign of trauma. Labs: NA 140 K 4.0 CL 102 BUN 16 CR 0.8 Arterial blood gas pH 7.20 pCO2 24 pO2 96% Which of the following are true? • Question 8 Your patient has a post operative incision infecion. He has a low grade temperature and is allergic to sulfa. What oral antibiotic would provide empiric coverage for MRSA? • Question 29 The NP is initiating procedural sedation for insertion of a central venous line. Which of the following is NOT a goal of procedural (moderate) sedation? • Question 10 The NP is assessing a patient with a serum potassium level of 2.9 What EKG finding would you expect to see based on this lab? • Question 11 A 44 year old female is in acute respiratory distress syndrome. She is intubated and mechanically ventilated. Her ideal body weight is 60 Kg . Current ventilator settings include FIO2 100% Tidal volume 450 RR 22 PEEP 10 Current arterial blood gas results are pH 7.45 pCO2 34 pO2 75 Chest xray shows bilateral infiltrates. Which of the following interventions will increase her chance of survival? • Question 12 The NP is planning to repair multiple leg lacerations on a 13 year old girl in the ED. What is the maximum number of ml of lidocaine in this 60 kg patient can receive? • Question 13 Cicely is a known diabetic with COPD who admitted to the hospital for pneumonia and acute COPD exacerbation. What treatment would the ACNP prescribe to manage her blood sugars? • Question 14 The AGACNP is conducting a physical assessment on a patient who is status post parathyroidectomy. The AGACNP performs the Trousseau’s sign. Which of the following indicates a positive response? • Question 15 Which antibiotics would NOT be appropriate to empirically treat an E. Coli infection? • Question 16 The AGACNP is assessing a patient in the urgent care area. The patient is a 44 year old women in her third round of chemotherapy for breast cancer. She presents today with complains of generalize malaise and fever that has gradually increased over the past 12 hours, BP 110/62 P 96 T 102.6 RR 18 WBC 4.2 ANC 300 The best initial treatment by the AGACNP is: • Question 17 A 78-year-old male patient with heart failure develops a bacterial urinary tract infection secondary to an indwelling Foley catheter. The patient has a known history of allergy to penicillin and sulfonamides. The appropriate choice for antimicrobial therapy is: • Question 18 The ACNP suspects her patient has pneumonia. The diagnostic tests that might be most helpful in supporting diagnosis of pneumonia would include: • Question 19 A 32 year old women presents to the ER after being found clumped over the wheel unconcious in an automobile. Analyze the following ABG results: ph 7.28, PaO2 60, PaCO2 70, HCO 33, BE +5 • Question 20 A 42-year-old female with anuric end stage renal disease is admitted to the ICU with pulmonary edema. She has been noncompliant with her diet and missed her last dialysis session. BP is 90/50 mm Hg and HR 70. ECG shows prolonged PR interval, widened QRS, and peaked T waves. Based on the above information, you suspect: