N5354 Final Exam 2024-2025. Questions and Correct Verified Answers. Graded A, Exams of Health sciences

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N5354 Final Exam 2024-2025. Questions and

Correct Verified Answers. Graded A

• lead I, +aVF? - ANSRight Deviation -I, +aVF, slurred S wave in lateral leads & R prime in V1-V2? - ANSRight BBB

• deflection @ J point (extra wave) - ANSOsborn waves in Hypothermia
• lead I, - lead aVF, - lead II - ANSLeft Deviation +I, -aVF, S wave in septal leads, R prime in lateral leads? - ANSLeft BBB

2 fragments? - ANScomminuted fracture 10-14 days suture removal? - ANSscalp and lower body 14-21 days suture removal? - ANSover joints 1997 & 1995 medicare guidelines? - ANScan use 1997 extended HPI guideline with other elements of 1995 guidelines 1997 extended HPI guidelines? - ANS4 elements OR status of at least 3 chronic conditions

2% lidocaine? - ANSears, extremities, nail beds 4-0 or 5-0 suture selection? - ANSHands 4-0 suture selection? - ANSscalp, upper body, hand, lower body, over joints 4-5 days suture removal? - ANSface 6 month prognosis? - ANSqualifies for Hospice 7-10 days suture removal? - ANSupper body and hands absorbable synthetic braided suture? - ANSVicryl Absorbable synthetic monofilament suture? - ANSMonocryl admin just before ventilator withdrawn? - ANSprophylactic IV opioid and benzo (morphine & lorazepam) admin which short-acting bronchodilator? - ANSAlbuterol or Ipratropium and wait 15 minutes to repeat spirometry air in pleural space > intralveolar pressure? - ANSlung collapses- Pneumothorax

air in sigmoid & rectum, >2 dilated small bowel, dilated sigmoid or rectum - ANSIleus air on both sides of bowel wall? - ANSRigler's sign alleviates distressing symptoms and improves quality of life? - ANSpalliative care Ant & middle compression, post distraction? - ANSChance Fracture approach most common in shoulder joint aspiration? - ANSposterior- below acromion process approach most used in knee joint aspiration? - ANSlateral- 45 degree angle Avoiding iatrogenic complications? - ANSOOB, avoid restraints, PT/OT, removing foley, lifting restrictions on diet, stop IVF, review meds daily best for high tension wounds, palms, feet, over joint areas? - ANSInterrupted Horizontal mattress- everting that spreads tension along wound edge best for loose or thin skin? - ANSInterrupted Vertical mattress- everting edges with greater closure strength and wound tension distribution blunting of costophrenic angle? - ANSMeniscus sign in Pleural effusion

bowel perforation from inflammatory bowel, trauma, foreign body ingestion, gas- producing infection? - ANSretroperitoneal air- streaky, linear appearance outlining extraperitoneal structures braided sutures? - ANSMultifilament- strength, less stiff, infection risk braided sutures? - ANSMultifilament- strength, less stiff, infection risk burst fracture of ant and post arches of C1 - ANSJefferson Fracture check what distal to the injury? - ANSmovement, circulation, and sensation Colles fracture? - ANSdistal radial- dominant fracture of wrist from falls comminuted fracture with part of shaft isolated fragment? - ANSSegmental fracture common fracture in younger individuals- ankle, elbow, & hip? - ANSavulsion fracture connects muscle to bone? - ANSTendons considering who could be harmed by a decision supports? - ANSNonmaleficence

contraindications for joint aspiration/injections? - ANScellulitis, dermatitis, skin infection, osteomyelitis, coagulopathy, joint prosthesis, suspected bacteremia if septic arthritis not suspected COPD severity? - ANSmild- moderate- severe- very severe

80%- 50-80%- 30-50%- <30% CPT codes represent? - ANSpatient type, setting of service, and level of E/M service performed Cr rise 25-50% within 48 hours? - ANScontrast induced nephropathy current procedural terminology (CPT)? - ANSbilling that represents patient type, setting of service, and level of E/M service performed decision-making model in North America? - ANSShared- physician and patient decisional capacity? - ANSdetermined by physician or other clinician decisional competence determined by? - ANSlegal designation made by a court delayed primary closure- in a few days to decrease infection risk? - ANSTertiary intention Dens fracture? - ANSodontoid process fracture of C

diameter of sutures? - ANSsmaller the #, larger the strand Ex 2-0 = large difference between H&P and consultation documentation? - ANSchief complaint versus reason for consultation & assessment/plan #1 is reason for consultation not prioritize don't anticoagulants in? - ANScutaneous surgery, dental extractions, minor oral procedures, or cataract surgery dose related response? - ANSPhysiochemotoxic reaction- n/v, h/a, dizzy, htn, pulmonary edema, seizure drowsy, decreased UOP, dysphagia, transient improvement, confusion? - ANSdays- weeks before death E/M documentation? - ANSdocumentation guidelines for billing Medicare- may use either version 1995 or 1997, no a combo of the two; except with extended HPI early beat from ventricles? caused by hypokalemia, hypoxia, hypercapnia, MI, or myopathy? - ANSPVCs ECHO pre-op? - ANSdyspnea, valvular disease (not 1 in the past year) ectopic focus in atria other than SA node? - ANSPACs, AFib, Aflutter elective surgery after drug-eluting stent? - ANS365 days later

elicits values of patient, prevents unnecessary suffering, preserving patient's dignity at end of life? - ANSAdvanced Care Planning established patient code? - ANSonly consider 2 key components (MDM should be one) Euthanasia versus physician-assisted suicide? - ANSphysician intentionally administers meds to cause death versus patient self-administer medication at end of life example of advanced care planning? - ANSAdvance Directive face suture selection? - ANS5-0 or 6- fairness in decisions & distribution of resources and treatment? - ANSJustice fastest type of wound closure, high for wound infection? - ANSPrimary closure (primary intention) flow-volume curve: concave dip? - ANSobstructive flow-volume curve: normal curve but left shift due to reduced volumes? - ANSrestrictive flow-volume curve: steeple pattern? - ANSsevere obstructive

fluffy patchy airspace- bat-winged or butterfly appearance? - ANSpulmonary edema fluffy, homogeneous density? - ANSpneumonia for accurate spirometry results? - ANSfree of respiratory infection, clinically stable, hold SABA/SAMA for 6 hours, hold LABA and LAMA for 12-24 hours, corticosteroids? (improve FEV1) force directed perpendicular to bone? - ANStransverse fracture fracture affects knee joint stability? - ANStibial plateau fracture (proximal tibia) fracture in weight-bearing bones? - ANSstress fracture fracture lines on x-ray? - ANSlucent/black HPI >4 elements, ROS 2-9 elements, PFSH 1? - ANSDetailed history hyperkalemia can cause? - ANSleft BBB, peaked T waves >5mm in limb or >10mm in pericardial, & flattened p waves hypokalemia can cause? - ANSPVCs, prolonged QT, 1st degree AV block impossible to achieve physiologic effect? - ANSphysiologic futility

improves post bronchodilator in asthma? - ANSFEV1 >12% and >200ml improvement incident to billing? - ANSprivate office/home visit only, 100% reimbursement, physician doesn't have to have face-to-face Inferior leads? - ANSII, III, aVF- RCA inferior wall MI can cause? - ANSLeft Deviation: -30 to -90 degrees informing patient of all risks and benefits to make a decision supports? - ANSautonomy intervention hasn't worked in similar patients? - ANSquantitative futility irregular breathing, death rattle, mottling, no UOP? - ANShours-days before death isolated 1 iliac wing stable fracture? - ANSDuverney fracture L1, T9-L5 fracture- retropulsion into spinal cord? - ANSBurst fracture landmark for lateral elbow joint aspiration? - ANSAnconeus triangle lateral leads represent? - ANSleft circumflex artery

lateral leads? - ANSI, aVR, aVL, V5, V Lateral wall MI can cause? - ANSRight Deviation: +90 to +180 degrees length of oral presentation? - ANS3-5 minutes level of E/M service is determined by? - ANScomplexity of history, exam, and medical decision making; OR time if counseling/coordination >50% of total time limb lead order? - ANSaVR, aVL, aVF low QRS voltage < 5mm limb or <10mm pericardial? - ANSPleural Effusion lucency? - ANSdark- less dense Medical Decision Making? - ANScomplexity of establishing a diagnosis and/or selecting a management option medical ineffectiveness? - ANSmedical futility mixed airway pattern? - ANSFEV1 and FVC reduced, need pulmonary fxn testing most common after cardiac surgery? - ANSDelirium

most common ankle fracture? - ANSlateral malleolus (fibula) most common carpal bone fracture? - ANSScaphoid Fracture- radial wrist fracture most common patella fracture? - ANStransverse most common reason for inconsistent readings in spirometry? - ANSpatient technique most important intraop risk factor for delirium? - ANSBlood loss most mobile joint in the body? - ANSshoulder mottled, blotch appearance of air. streaky, linear appearance outlining structures?

• ANSRetroperitoneal Air natural nonabsorbable suture? - ANSSurgical silk needle gauge for joint injections? - ANS18-20-------14-18 in shoulder nephrogenic systemic fibrosis? - ANSGadolinium contrast in MRI new onset BBB? - ANSMI? new patient code - ANSmust consider all 3 key components

newly admitted patients oral presentation length? - ANS8-10 minutes no air in sigmoid & rectum, dilated loops or small or large? - ANSbowel obstruction Non-braided suture? - ANSMonofilament- more resistant to infection, more loose due to lack of grip nonabsorbable synthetic suture? - ANSNylon & Polyprolene normal lung function on volume-time curve? - ANSrise rapidly and smoothly & plateau in 3-4 seconds not dose related reactions? - ANSallergic-like reaction- anaphylactic, urticaria, bronchospasm, edema ORS >.12 sec, R prime waves, not a problem unless HF pathology? - ANSBBB P waves most prominent in which leads? - ANSII, III, & aVF (Inferior leads- RCA) pars interarticularis of C2 on both sides? - ANSHangman fracture Pathologic Q waves? - ANS>.04 sec in at least 2 contiguous leads patient's right to make decisions? - ANSautonomy

patients physiology may improve, but no patient-centered benefit? - ANSqualitative futility Per-op Eval? - ANS1) specialist? 2) RCRI or ACS NSQIP risk >2 or >1%? 3) METS >4?

4. proceed or don't proceed with surgery perforated peptic ulcer & rupture of air-containing loop of bowel, abdominal surgery? - ANScause of intraperitoneal air- air below diaphragm, Rigler's sign, falciform ligament seen Plain lidocaine? - ANSears, hands/feet, nail beds PNA with air bronchogram>? - ANSlobar PNA posterior neck or concave surfaces? - ANSVertical Mattress predicted values based on? - ANSsex, height, age, ethnicity primary care spirometry? - ANSelectronic desktop spirometer- calibration versus manufacturer check- portable and quick use progress note? - ANSDaily SOAP note, label with service providers do all they can to do good? - ANSBeneficence

providers staying updated on knowledge, skills, and best practice & considering each individuals circumstances supports? - ANSBeneficence providers upholding the law and legislation when making choice supports? - ANSJustice rare fracture- associated with hip dislocations? - ANSfemoral head fracture reduced in obstructive pattern? - ANSFEV1 < 80%, ratio <0. reduced in restrictive pattern? - ANSFVC <80%, ratio normal >0. relief of symptoms in imminent death patients? - ANSComfort care requires aggressive treatment due to arrhythmias? - ANSsevere allergic-like reaction restricts active ROM and localized to specific area? - ANSPeriarticular processes- bursitis, cellulitis, contusion, tendonitis restricts both active and passive ROM, circumferential pain and swelling? - ANSArticular process ROS added in? level of history? - ANSExpanded problem-focused history

S wave in lead I, Q wave and inverted T wave in lead III? - ANSPulmonary Embolism s/s minutes-hours before death? - ANSabnormal terminal patterned breathing seatbelt fracture- lumbar spine? - ANSChance fracture seen in pulmonary function labs? - ANSbellow/rolling spirometer- regular calibration Septal/Anterior leads? - ANSV1-V4- LAD simple screening & acute dx spirometry? - ANShand-held spirometer small bowel size? - ANS<2.5cm spirometry fraction in severe airflow obsturctions? - ANSFEV1/FEV spirometry fraction? - ANSFEV1/FVC = 0.7 to 0.8 L split/shared billing? - ANSnot in consults, new outpatient, SNF, or nursing home spontaneous reversion to NSR from afib post-op? - ANS6 weeks after surgery- anticoags beyond 48hrs

ST depression or inverted T waves? - ANSmyocardial ischemia ST elevation in most leads? - ANSPericarditis stabilizes shoulder joint? - ANSglenoid labrum Stress dose steroids in pts - ANSon Prednisone >20mg/day >1 week and known adrenal insufficiency student signature? - ANSName RN, AGACNP-S thoracic anterior and lateral vertebrae fracture? - ANSWedge fracture To do no harm? - ANSNonmaleficence transverse fracture of 5th metatarsal? - ANSJones fracture treat N/V at end of life? - ANSGlucocorticoids if high ICP, metoclopramide if gastroparesis, Scopolamine or Promethazine if vestibular origin ultrasound stopped by? - ANSair & cant penetrate bone visceral pleura line visible? - ANSPneumothorax- absence lung marking peripheral to visceral pleural line

volume-time curve: fast rise, reduced volumes? - ANSrestrictive volume-time curve: slow rise, normal or reduced volume? - ANSobstructive weakest part of hip? - ANSfemoral neck- risk of avascular necrosis weakness/debility & anorexia? - ANSweeks-months before death wound granulation without closure? - ANSSecondary intention xray to detect free air and air-fluid levels in bowel? - ANSupright xray- horizontal xray beam