ANCC AGACNP Exam Questions With 100% Correct Answers 2024, Exams of Nursing

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ANCC AGACNP Exam Questions With

100% Correct Answers 2024

You want to get more funding for your hospital's Rapid Response Team. How should you present this issue to the committee? a. Stress importance of the team (look up evidence about how team affects outcomes) b. Describe how to improve and expand the team - Correct Answer-a. stress importance of team What is the best way for the AGACNP to get involved in policy making? a. attend legislative days at the state capitol b. join a hospital committee c. write your local congressman d. review literature and give more in-services - Correct Answer-b. join a hospital committee What is the best way for the AGACNP to demonstrate and advocate for full scope of practice? a. join a hospital committee b. petition the government c. bill for independent services d. start your own practice - Correct Answer-c. bill for independent services Which of the following is considered a high acuity role for the AGACNP? a. primary care clinic b. cardiology office c. community health department d. minute clinic - Correct Answer-b. cardiology office What is the best way to advocate for gay and lesbian population? a. participate in a high state or national level b. join a non-profit advocacy group c. consider lobbying the government d. start at your facility - Correct Answer-d. start at your facility Answers are worded differently. "decrease bias in healthcare" "create in- servises in healthcare" "obtain funding to increase access" Which of the following is most important to evaluate statistical significance when reviewing the literature? a. consider the sample size b. make sure the confidence interval is tight c. see if the p-value is less than the alpha-coefficient d. determine the error rate - Correct Answer-a. consider the sample size

When closing a practice, the NP is required to do all of the following except a. give the patient adequate time to find another provder b. keep all of the patient's records for a minimum of five years c. send a certified letter with a return receipt requested d. provide names of other providers for future care - Correct Answer-c. send a certified letter with a return receipt requested Which of the following components of an evidenced based research process is the most important for NP to participate in? a. specifying methods of data collection b. formulating the hypothesis c. carefully reviewing the literature d. formulating the research problem - Correct Answer-d. formulating the research problem A former pt of an NP is writing blog posts, sending emails, and distributing false, accusatory statements about the NP's practice. Which of the following forms of defamation is this? a. libel b. slander - Correct Answer-a. libel Can you tell the patient's wife, for her protection, that her husband has HIV? - Correct Answer-No, not without his permission How can the ANCP prepare to get involved in future mass casualty event? - Correct Answer-Pre enroll in disaster volunteer program An 80 year old male patient with dementia requires long-term care placement. To which funding agency does the patient apply after "spending down" to qualify? - Correct Answer-Medicaid Your patient is worried about insurance coverage and asks you for advice on Medicaid. You instruct the patient that Medicaid: - Correct Answer-Pays after insurance and 3rd party payers have paid You are giving a dinner presentation to a group. The pharmaceutical rep calls you the night before and wants you to say that their drug is the only one that workds. What ethical principles does this challenge? - Correct Answer-Veracity and fidelity Health literacy - Correct Answer-Average american: 8th grade level Quality assurance - Correct Answer-A process for evaluating the care of patients using established standards of care to ensure quality CPI - Correct Answer-Measures structure, processes, and outcomes

A root cause analysis of a crisis situation in the ICU identified a lack of clinician-family communication as the basis for the resulting adverse outcome. As part of the performance improvement plan, the NP is asked to develop evidence-based policies to establish clinician-family communication standards in the unit. These policies should include: - Correct Answer- Guidelines for having discussions with family members that are geared toward establishing treatment goals Which clinical scenario does the NP evaluate for a quality improvement process change? - Correct Answer-An increased incidence of postoperative sternal wound infections Goals set forth in healthy people 2020 by the US department of Health and Human services include: - Correct Answer-elimination of health disparities (and increased QOL/LOL) Based on the individual's culture, ethnicity, and personal choices, the NP can optimize the therapeutic partnership with the patient by: - Correct Answer-Tailoring his or her communication style to the patient's preference A 70 year old patient with a history of DM, HTN, OAs, and a new diagnosis of CAD, is being discharged. The adult-gerontology acute care NP teaches the patient that the first point of contact for health care needs is the: - Correct Answer-PCP The NP is asked to provide evidence to the hospital administration about the safety of NP placing central lines. Which resource provides the strongest level of evidence? - Correct Answer-A systematic review (meta analysis) What legislation allowed NPs to be recognized Medicare providers in all geographical areas with their own provider number? - Correct Answer- Balanced Budget act True/false: restraining an unwilling patient is grounds for malpractice? - Correct Answer- False, if they are a danger you can restrain Patient presents to the clinic for routine f/u and passes out. You revive the patient and admit overnight. Which of the following would qualify as incident to billing? - Correct Answer-Temperature and weight recording The NP program initiated, primarily, because of what issue in healthcare at the time? - Correct Answer-Pediatric physician shortage Elderly patient takes a turn for the worse. The husband is crying when you enter the room and begins telling you what end-of-life care he prefers. What do you do? - Correct Answer-Ask him to speak candidly with you Patient calls to complain about bills and states he has Medicare, which should cover all costs. You explain: - Correct Answer-Since you are healthy, exams are not covered

Doc calls from another center asking if you can tell him what kind of orders he should give for maintenance of patient... - Correct Answer-No, HIPPA Patient in ER not doing well, primary MD calls: - Correct Answer-Give him info NP working on ESRD research project. A colleague renal specialist asks for patient info on your patients: - Correct Answer-HIPAA breach Who enforces HIPAA? - Correct Answer-Office of Civil Rights/Dept Health and Human Services Who isn't covered by HIPAA? - Correct Answer-Law enforcment/municipal offices, CPS/Schools, employers/workman's comp, life insurance Insurance company calling to verify some patient appointments? - Correct Answer- Answer by picking out that there is already a medical release signed by the patient and give the requested information to them Benchmarking - Correct Answer-How institution compares with similar organizations Managed care - Correct Answer-Know what this is and how it has improved costs, something about putting caps on payments Peer review - Correct Answer-Timely, not anonymous, and NP knows how peer review will impact yearly evaluation Sensitivity vs specificity - Correct Answer-Sensitivity: true positives, specificity: true negatives There was a question where a patient had a multinodular goiter and wanted to know why the NP was not going to do periodic US and fine needle biopsy in monitoring for some kind of cancer or complication. The answer I picked was that these tests were not very specific to detect the cancer Reliability - Correct Answer-When implementing a new study, tested over and over, the consistency of a measurement or the degree to which an instrument measures the same way over time Validity of results in an article - Correct Answer-P-value, probability of falsely rejecting the null hypothesis, want it to be <0. Statistical significance - Correct Answer-Look at sample size and p value Privileging - Correct Answer-May be granted in full or part by the hospital, credentialing committee is made of physicians

Who determines scope of practice? - Correct Answer-State practice acts but institutional bylaws may further restrict practice (facility limited scope of practice) Informed consent - Correct Answer-A state indicating patient has received adequate instruction/information regarding aspects of care to make a prudent, personal choice regarding such, includes risks and benefits, competence: ability to communicate, understand, reason, differentiate good and bad Case management - Correct Answer-Mobilize, mointor, and control resources that a patient uses during course of an illness while balancing quality and cost, "move patients through the system appropriately" 50-60 year old patient ith a new diagnosis of cancer. To appropriately plan for discharge, what should the NP do? a. consult CM b. Consult SW c. refer to Oncology d. refer to Hospice - Correct Answer-a. consult CM Nondisclosure - Correct Answer-Not disclosing patient PHI without permission Negligence - Correct Answer-Failure of individual to do what any reasonable person would do, resulting in injury to the patient When serving as a nurse researcher, the NP is guided by which ethical principle to ensure that research participants are protected from harm or exploitation? - Correct Answer-Nonmaleficence Living will - Correct Answer-Health care proxy/POA NP sees a patient for HF and performs an H&P. What % is expected to be paid? - Correct Answer-Medicare pays 80% of the total bill, pt pays 20%, NP is reimbursed 85% of what the MD is reimbursed for physician services, and for procedure 80% of that 85% Focus of palliative care - Correct Answer-Basic improvement in QOL of anyone with an illness at any stage Hospice - Correct Answer-<6m to live Scope of practice: integration of care across the acute illness continuum with: a. collaboration b. coordination of care c. research based clinical practice - Correct Answer-a. collaboration

Collaboration - Correct Answer-True partnership in which all players have the desire power, share common goals, and recognize/accept separate areas of responsibility/activity Patient is getting d/c'd and need wound care, pulmonary, and follow up. NP's role is to: - Correct Answer-Coordinate services Government is moving towards being cost effective. What is the best way? - Correct Answer-Allow NP to treat a wider variety of patients Protected health information: discussion between the NP and consultant on case - Correct Answer-Considered clinical relevance How should the ACNP stay up to date with current information? - Correct Answer- Evidence based guidelines Which medicare is Hospice covered under? - Correct Answer-Medicare A A patient presents to the Er with c/o CP and SOB. The NP misinterprets the EKG and admits the patient fro further monitoring without consulting cardio. Later in the shift, the patient decompensates and goes into cardiac arrest. The patient was resuscitated but sustained permanent brain damage. What grounds of malpractice is the NP accountable for? - Correct Answer-Lack of skill Healthcare exchange - Correct Answer-Health insurance marketplaces, organizations in each state through which people can purchase health insurance You notice there have been less favorable outcomes and satisfaction surveys in patients treated for sickle cell anemia. How do you approach this problem? a. ask the patients treated how care can be improved b. look back at prior treatment given to see how outcomes can be improved c. form a standardized tx plan for all patients that can be used by all healthcare staff d. form individualized tx plans that can be used by all healthcare staff - Correct Answer- c. form a standardized tx plan for all patients that can be used by all healthcare staff You have transferred a patient to the SNF. The MD in charge at that facility calls for info about the patient's medical care, what do you do? a. direct him to look it up in the EMR b. refuse to share protected health information c. instruct him to call the department head d. share the information he requests - Correct Answer-d. share the information he requests Your patient has refused human blood products based on religious beliefs. He is now rapidly destabilizing. What do you do?

a. administer PRBCs as needed

b. call the ethics committee c. continue to research alternative treatments d. ask the family to give permission now that he's unconscious - Correct Answer-c. continue to research alternative treatments What is the best way to make sure a patient will follow up as instructed? a. instruct the patient to schedule the appointment b. ask the patient the best time they can go to an appointment c. have the office manager to schedule the appointment d. schedule the appointment for the patient - Correct Answer-d. schedule the appointment for the patient Your patient is brain dead on the ventilator. The family wants all possible treatment measures done to preserves life, but states that the patient would not want to be on a ventilator. What should you do? a. consult neurology to come interview the family b. document the situation carefully in the chart c. call a clergy member to offer support d. call the ethics committee - Correct Answer-d. call the ethics committee A patient visits your clinic for sinusitis. She requests a PAP smear since she has not had one in "years". You: a. refer her to a gynecologist b. schedule her to come back next week for the PAP at another appt c. perform the pap today d. do a vaginal exam only, and refer the PAP to a gyno - Correct Answer-b. schedule her to come back next week for the PAP at another appt A patient visits your cardiology clinic. She requests a PAP smear since she has not had one in "years." You: a. refer her to gynecologist b. schedule her to come back c. perform the PAP today d. do a vaginal exam only, and refer the PAP to a gyno - Correct Answer-a. refer to gynecologist Discharge planning is udnerway for a patient who has been very dehabilitated after treatment for end-stage liver cancer. His wife is also debilitated and the children live out of state. What is the best choice? a. hospice b. home health care c. SNF d. private duty RN - Correct Answer-c. SNF Your patient presents to ED w/ R wrist pain. She states, "it's my fault; I should have had dinner ready on time." What do you do?

a. Tell her not to go home bc it's not safe b. XR the wrist c. call the police d. consult psych - Correct Answer-b. XR the wrist Now the husband presents to the ED with drug overdose. What is your action? a. Hand him off to anothe rpractitioner b. call the police c. consult psych d. treat him without prejudice - Correct Answer-d. treat him without prejudice The medical resident obtained consent for an operative procedure. on your visit, the patient is confused/ refusing the procedure a. cancel the surgery b. have the wife sign another consent c. call the resident to clarify the patient was not confused when he signed the first consent d. consult neurology - Correct Answer-c. call the resident to clarify the patient was not confused when he signed the first consent Your HIV positive patient is preparing to discharge when he tells you not only that he has passed the virus to his wife, but also that he plans to kill her when he gets home. How do you respond? a. call the police b. consult psych c. consult social work d. document his statements - Correct Answer-b. consult psych Your clinical student breaks the sterile field. HOw do you handle this situation? a. discuss it with the student b. report it to the charge nurse c. report it to the unit manager d. inform the faculty in charge of the student - Correct Answer-a. discuss it with the student You are the NP on call for the night. The nurse calls you to report the patient is decompensating. Who do you direct her to call? a. the ER physician b. anesthesia c. an NP present on another unit currently d. the attending MD who is at home - Correct Answer-d. the attending MD who is at home A code you are in does not go well, and staff members afterwards are criticizing each other. How do you deal with the situation? a. schedule an in service to discuss common code mistakes

b. meet with each team member individually c. set up exercises to increase collaboration during a code d. meet with all who participated in the code and have a one-time briefing - Correct Answer-d. meet with all who participated in the code and have a one-time briefing Your patient is not doing well and family/wife is at bedside crying. Yo are preparing to talk to the family. What do you do first? a. place a social work consult b. explicitly explain the situation, the outcomes and care involved c. ask if the patient has an advanced directive d. set up a family meeting in a room with a specific time and date - Correct Answer-c. ask if the patient has an advance directive Your patient is not conscious. HIs advance directive states he wants to be a DNR, but his family says they want him to be a full code. How do you respond? a. tell her the decision goes to the next of kin b. call the ethics committee c. comply with her wishes and make him a full code d. tell her you can't go against the advance directive - Correct Answer-d. tell her you can't go against the advance directive A patient comes to the ED at a community hospital who is 29 weeks pregnant. She says her water has broken. Her VS are stable. What do you do? a. transfer her to a tertiary facility b. contact her OB/GYN for treatment advice c. admit to l/d d. consult the nurse midwife - Correct Answer-a. transfer her to a tertiary facility Your 51F patient is getting ready to discharge when she tells you she hasn't had a mammogram in 3 years. What do you do? - Correct Answer-Refer to PCP for outpatient discharge Your patient's imaging reveals he has metastatic cancer. The family, in accordance with their culture, request that you not share the test results to spare him distress. How do you respond? - Correct Answer-Ask the patient what he wants to know about his prognosis 35yo F presents with c/o bilateral wrist pain. You suspect spouse abuse. You notice a handgun in her purse. What would be your next action? - Correct Answer-Call security to ensure safety Adult child of a patient reports that her father has expressed desire to commit suicide and has a hx of ETOH and depression. The best response would be to? - Correct Answer-Hospitalize the patient and start pscyhotherapy

You notice that another NP in your group is frequently contact by pharmacy for prescription errors. How do you handle the situation? - Correct Answer- Address it directly with the NP Your patient voices concerns because he has lost his insurance and worries his children will no longer have coverage for medical expenses. What do you do? - Correct Answer- Consult case management 80yo patient has macular degeneration and is seen on the surgical unit for postoperative care after repair of a hip fracture. To prepare the patient for discharge, the NP: - Correct Answer-Provides verbal reinforcement to the patient on how to keep proper body alignment following hip surgery A 40yo female patient with no PMH is admitted with bilateral PE. W/u reveals a psoitive result for lupus anticoagulant, and anticoagulant therapy is planned. The patient verbalizes concern about her ability to manage the appointments and the follow up care. The NP's most effective intervention si to: - Correct Answer-Arrange follow up appointments for the patient at the warfarin (Coumadin) clinic and PCP after discharge What procedure does the AGACNP perform to evaluate cytology, only, in the tumor? - Correct Answer-Fine needle biopsy A patient has fully recovered from septic shock due to bacteremia and has been accepted to a LTC facility for continuation of abx. ID has not seen the patient in two days. The NP: - Correct Answer-Contacts the ID MD to determine the appropriate abx duration 32yo M presented with a gunshot wound (GSW) to the FA. Injuries are negligible and pt is stable. Pt reports the shot was an accident during hunting. What should the NP do? - Correct Answer-Report to the police. All GSW must be reported What is the most important when assessing status? - Correct Answer-Level of alertness or hx of symptoms A woman of child bearing age c/o abdominal pain. What level of exam do you document? - Correct Answer-Detailed A diabetic patient complains of abd pain. Which type of exam do you conduct? - Correct Answer-Comprehenxive What qualifies patient for HHC - Correct Answer-Home bound, has a prescription, requires care services, wound care, select care Patient is refusing care? - Correct Answer-Let them refuse, educate, and search for alternatives

Guy in ER needs refill on ritalin - Correct Answer-research alternatives Knowledge deficit in ICU, what would you do for nurses? - Correct Answer-In services A patient has advanced dementia, ESRD, and HF, what do you do for him? - Correct Answer-Transfer from acute to palliative care Your 24m patient has been out hiking on vacation. He shows you the following rash, and thinks he has Rocky Mountain Spotted Fever. What is his diagnoses? - Correct Answer- Lyme disease (Erythema migrans/bullseye rash), both are treated with doxycycline Your patient is a Chinese female immigrant living in the US. You notice she is avoiding eye contact. What is this due to? a. shame because she feels the illness is her fault b. embarrassment from the examination c. a sign of respect d. a normal response - Correct Answer-c. a sign of respect Your patient speaks only spanish and you need to evaluate his pain. What do you do? a. ask a family member to translate for you b. utilize the hospital's interpreter service c. call over the Hispanic housekeeper and ask her to translate d. Use a visual pain scale - Correct Answer-D. use a visual pain scale 58yo Japanese male with CP 4/10 for 3 hours, reluctant to answer questions. Which of the following in the Ed warrant admission? a. age b. gender c. pain level d. ethnicity - Correct Answer-d. ethnicity (underestimates pain, taught to be stoic, pain is probably much more severe) A 77yo male patient's wife cares for him at home .Which statement by the wife indicates a need for a SNF? a. my husband needs more help with his ADLs b. I can't lift him out of bed anymore c. he has lost 20 pounds d. he has trouble swallowing and I'm worried he will choke on his food - Correct Answer- a. my husband needs more help with his ADLs Which psychiatric disorder is most commonly diagnosed, yet least commonly treated? a. bipolar disorder b. alzheimer disease c. depression

d. dementia - Correct Answer-c. depression

Your patient with PNA is noted to have a heavy drinking habit. 2 days post admit he becomes combative/agitated. What is tx? a. IV valium b. IV ativan c. PO librium d. lasix - Correct Answer-c. PO librium Your patient has developed a fever of unknown origin. What is the next step? a. PO abx b. IV abx c. do nothing until diagnosis is confirmed d. tylenol - Correct Answer-c. do nothing until diagnosis is confirmed How long will it take to begin to see healing in a pressure ulcer that has a clean, well- vascularized bed? a. 7 days b. 2- weeks c. 2 days d. 4-6 weeks - Correct Answer-c. 2 days The patient has been in a bar fight and has a human bite on his hand. What should you do next? a. order PO abx b. order wound culture c. order IV abx d. measure the wound depth and width - Correct Answer-a. Order PO abx Your patient has a chronic, nonhealing decubitus ulcer. He c/o pain when he moves his leg. What is a potential complication? a. compartment syndrome b. decrease in ROM ability c. septic shock d. osteomyelitis - Correct Answer-d. osteomyelitis What is the strongest predictor of functional impairment prior to discharge of the elderly patient? a. advanced age b. incontinence c. cognitive impairment d. poor balance - Correct Answer-c. cognitive impairment Your patient has been taking Thorazine and now has fever, sweating, lethargy, and a temp of 39.4 (102.2) a. give IVF b.

antipyretic c. abx

d. ice packs to groin and axilla - Correct Answer-a. give IVF (Flush it out, this is neuroleptic malignant sydnrome) You suspect your patient on TPN with a PICC has a CLABSI. What is the first intervention? a. stop the TPN, remove the line, and place a new line for TPN b. start abx c. send cx d. change the guidewire - Correct Answer-a. stop the TPN, remove the line, and place a new line for TPN Your patient has a fever 3 days post op, WBC are 15k, blood cultures negative, and Eos 9%. What is the diagnosis? a. viral infection b. bacterial infection c. malignant hyperthermia d. drug fever - Correct Answer-d. drug fever (eos=allergic reaction, normal is 1-4%) What are protein supplements best used for? a. eliminate the need for lipids b. prevent anasarca (peripheral edema) c. aid in post op healing - Correct Answer-c. aid in post op healing Which macronutrient of TPN significantly increases the osmolality of the solution? a. lipids b. dextrose c. mutivitamin d. potassium - Correct Answer-b. dextrose Protein in nutrition for what reason? - Correct Answer-maintain nitrogen balance along with metabolic needs, adjust protein weekly by measuring urinary urea nitrogen Which electrolyte are you most concerned about monitoring in cachexic patient? a. mag b. ca c. na d. k - Correct Answer-d. k refeeding syndrome, hypokalemia and hypophosphatemia Which electrolyte do you monitor in refeeding syndrome? - Correct Answer- Phosphorous (or potassium) Which lab do you monitor daily in a patient on nutritional

supplements? a. BMP b. cbc

c. abg d. blood culture - Correct Answer-a. BMP (and monitor LFT's weekly) What alternative therapy can you order to relax the patient prior to procedure? a. massage b. aromatherapy c. music d. muscle relaxant - Correct Answer-c. music What alternative therapy can you use to help/distract them from their pain during the procedure? - Correct Answer-Guided imagery Which alternative therapy helps Parkinson's patients with coordination? a. acupuncture b. tai chi c. relaxation techniques d. hypnotherapy - Correct Answer-b. tai chi (also helps prevent falls in elderly) Which 2 headaches are treated with triptans? - Correct Answer-Migraines and cluster What kind of dressing do you use on a decubitus ulcer with necrotic tissue? - Correct Answer-Hydrocolloid 45yo s/p double mastectomy 2 months ago. Now is c/o pain at the incision site - Correct Answer-Neuropathic pain What does the leg/foot look like in a hip fracture - Correct Answer-Internally or externally rotated Pt has a post op fever... - Correct Answer-Give fluids WHO pain ladder... - Correct Answer-Fentanyl patch for breakthrough cancer pain Best pain indicator... - Correct Answer-Patient self report Best alternative therapy to decrease pain in clavicle fracture: - Correct Answer- Therapeutic touch/reiki (hand or palm healing that transfers 'universal energy' has been used for cancer, emotional, or physical healing) Picture of gunshot wound to the R lung area - Correct Answer-The answer is to allow the dressing to be sucked to the chest wall during the negative pressure of expiration Another answer was to let air blow out during inhalation Cocaine induced psychosis - Correct Answer-s/s parnoia, delusions, hallucinations, 'cocaine bugs' under skin, mydriasis

Pt comes in tachycardic, hallucinating, all kinds of other crazy symptoms with dilated pupils - Correct Answer-Sympathomimetic (cocaine or meth) Antidepressant OD - Correct Answer-s/s hallucinations, confusion, tachy/dysrhythmias, hypothermia, blurred vision, urinary retention, hypotension (can't see, can't pee, can't spit, can't shit) Antidepressant OD treatment - Correct Answer-ICU if CNS or cardio toxic, activated charcoal NaHCO3 for dysrhythmias and maintain pH, benzos (valium) for seizure (if serotonin syndrome: dantrium/dantrolene sodium) ASA overdose - Correct Answer-s/s n/v, tinnitus, dehydration, hyperthermia, apnea, cyanosis, metabolic acidosis ASA overdose treatment - Correct Answer-activated charcoal, NaHCO3 for severe acidosis of <7.1, monitor ABGs How do you treat group A strep on skin - Correct Answer-TMP/SMX or Doxy/mino + beta lactam (1st generation cephalosporin, PCN, or amoxil) Pt has cellulitis of lower extremity with a wound, what do you treat with? - Correct Answer-Based on the hospital sensitivity Mallampati grades for visualization of oral cavity: - Correct Answer-1. complete soft palate

2. complete uvula 3. uvula base only 4. none Osteomalacia - Correct Answer-Softening of bones (PEDS rickets), most common cause is vitamin D deficiency (also phos, Ca, UVB light) Hospice vs palliative care - Correct Answer-Pallitiatve care are still receiving treatment. Hospice is no curative treatment, has death dx, and <6m to live Venous stasis ulcer - Correct Answer-Use compression stocking Indication for tetanus shot - Correct Answer-Dirty wound and haven't had a tetanus shot in five years Tdap vaccine is an example of what type of immunity - Correct Answer-Active immunity How often should a woman between the ages of 20-39 have a PAP with HPV

• Correct Answer-Q5y, PAP with cytology q3y

If born on or after what year is it indicated to receive 2 doses of mumps vaccine? - Correct Answer- What age does an individual receive zostavax? - Correct Answer-50 one time dose When should PSA levels be initiated and how often? - Correct Answer-PSA levels every year >50y (and DRE) Annual PSA and DRE are indicated in what group? - Correct Answer-African- american

40 and family hx of prostate cancer Pt has normal PAP smear and reports that she has not had an abnormal PAP for past 10 years. What is the appropriate age to DC? - Correct Answer-65- 70 35yo Asian american is in good health. He is worried about life prolonging measures. What is the most likely cause of death for a man like him? - Correct Answer- Unintentional injury (if he's African american, it's homicide <35 and heart disease at 35) What is the leading cause of death in African american males ages 40- 59? - Correct Answer-CAD What is the leading cause of deaths in hispanics in the US? - Correct Answer-Heart disease The most common cause of hyponatremic hyperosmolality a. hyperglycemia b. hyperthyroidism c. adrenal insufficiency d. k sparing diuretics - Correct Answer-a. hyperglycemia What method should you use to treat hyponatremia related to SIADH? a. bolus 500mL NS b. Bolus 3% hypertonic saline c. NS at 200ml/hr d. 3% hypertonic saline ,calculated - Correct Answer-d. 3% hypertonic saline, calculated What is a potential cause of hyperkalemia? a. carafate b. NSAIDs c. centrally acting HTN meds - Correct Answer-b. NSAIDs Your patient has a Na of 128 and was treated with colloids 3 days ago. What is a treatment? - Correct Answer-Restrict free water A 68yo patient had sx three days ago to repair a AAA. The patient remains

intubated, is neurologically intact, and has active bowel sounds. LFT's are normal, no s/s CHF, the

patient's laboratory values are: blood urea nitrogen of 12 mg/dL, creatinine of 0.8 mg/dL, PaCO2 of 37mmHg. Which is the most appropriate method to deliver nutrition? a. central line b. PIV c. G tube d. enteral feeding to the duodenum via a nasogastric small-bore tube - Correct Answer- d. enteral feeding to the duodenum via a nasogastric small bore tube Your patient has a serum osmolality of 268 mOsm/kg and a serum sodium of 134 mEq/L. His urine has Na less than 10 mEq/L. You know that all of the following are possible explanations except: a. diarrhea b. diuretics c. dehydration d. vomiting - Correct Answer-b. diuretics (Na<10 is nonrenal cause. Diuretics are associated with renal cause, urine na >20) A 61 year old female c/o fatigue, muscle weakness, and constipation. She adds that she had felt her heart beating 'abnormally' and she has been experiencing muscle spasms on occasion. You order and EKG and find decreased amplitude and broad T waves. Occasionally you also note prominent U waves. Of the following, which is the most likely diagnosis? a. hypokalemia b. hyperkalemia c. hypocalcemia d. hypermagnesemia - Correct Answer-a. hypokalemia Your patient has complications from parenteral nutritional support. All of the following are plausible explanations except: a. hypernatremia b. pneumothorax c. HHNK d. GI bleed - Correct Answer-d. GI bleed 65yo male with c/o n/v/constipation x several days and a six pound weight loss. Pt s/p TKR severral weeks ago and reports not getting off the couch. What electrolyte is altered? - Correct Answer-Hypercalcemia secondary to immoblity Pt with s/s of abd distention, weakness and occasional diarrhea. Hx indicates renal failure. You conclude that the patient has a fluid and electorlyte

problem. Which of the following is he most likely experiencing? - Correct Answer-Hyperkalemia ABG reads high HCO3 and pCO2 55mmHg. What electrolyte abnormality is most likely associated with these values? - Correct Answer-Hypokalemia r/t metabolic alkalosis

Pt has a fever and tachycardia, and hx of CHF. There is a box with lab values, and the Na is high. What does it say about their hydration status - Correct Answer-Extracellular dehydration deficit Low serum Na and high serum osmolality - Correct Answer-Hyperglycemia (Probably HHNK) A patient with hypovolemic, hypotonic, hyponatremia and what fluids to give: - Correct Answer-NS Low protein = Low BUN = - Correct Answer-hypoosmolar hyponatremia (probably edematous, expect edema in Albumin <2.7) A patient who has been in ICU for 17 days develops hypernatremic hyperosmolality. The patient weighs 132 lbs (59.9kg), is intubated and is receiving mechanical ventilation. The serum osmolality is 320 mOsm/L kg H2o. Clinical signs include tachycardia and hypotension. The initial treatment is to: - Correct Answer- Replenish the volume by infusing a 0.9% sodium chloride solution Which electrolyte imbalance leads to confusion and lethargy in the ETOH abuse patient? - Correct Answer-Hyponatremia What electrolyte should be monitored prior to administering succinylcholine? - Correct Answer-K ASA overdose, which electrolyte do you monitor? - Correct Answer-K (if low will prevent hte alkalinization of urine, which is the mainstay of treatment) What sx is associated with hepatotoxicity s/p acetaminophen toxicity? - Correct Answer- Delirium Patient at high risk for hyperkalemia? - Correct Answer-NSAIDs then ACEi Tube feeding side effects - Correct Answer-Diarrhea: decrease the osmolality of the tube feeding What patient requires labs to be monitored closely after intiating Tf? - Correct Answer- Alcoholic with decreased intake over the past 2-3 weeks What disorder can be ruled out using the Cosyntropin stimulation test? a. Cushing's b. DI c. Adrenal insufficiency d. SIADH - Correct Answer-c. Adrenal insufficiency

What side effect of levothyroxine is most likely to lead to non-compliance when first initiated? a. alopecia b. dyspepsia c. weight loss d. nevousness - Correct Answer-a. alopecia You are treating a patient for hypothyroidism. Which lab value is monitored for treatment/synthroid effectiveness? a. T3 b. T4 c. TSH d. thyroxin index - Correct Answer-c. TSH What method should you use to treat hyponatremia related to SIADH? a. Bolus 500mL NS b. Bolus 3% hypertonic saline c. NS at 200mL/hr d. 3% hypertonic saline, calculated - Correct Answer-d. 3% hypertonic saline, calculated For the past few months, 29yo Janine has been gaining weight while experiencing amenorrhea and increasingly severe acnes. She has gained more than 20 pounds, and you note that she is carrying her weight around her midline, with bilateral purple-ish striae across both flanks. You suspect CUshing's syndrome. Which of the following findings would not contribute to a diagnosis? a. urine free cortisol=360 ug/day (>50 abnormal) b. glycosuria c. wbc 19 d. after a high dose of dexamethasone, there is a 90% reduction in urinary free cortisol - Correct Answer-d. after a high dose of dexamethasone, there is a 90% reduction in urinary free cortisol In cushing's, pituitary does not respond to dexamethasone. Which of the following is NOT a criteria of metabolic syndrome? a. BP>140/90 b. waist >40 in c. TG>150 d. HDL <40 - Correct Answer-a. BP>140/90 It's 130/85 What are Cushing's labs/symptoms? - Correct Answer-Increased BG, increased Na, decreased K