NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST, Exams of Nursing

Download NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION 100% CORRECTLY/VERIFIED ANSWERS LATEST and more Exams Nursing in PDF only on Docsity!

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

• Question 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 1 out of 1 points analysis. While evaluating the fluid analysis, the AGACNP knows that a fluid identified as a(n) is the least worrisome type. Resp onse Feed back : “A” is the correct answer. A transudate is essentially just water and can occur as a consequence of increased hydrostatic pressure in the pulmonary vessels. It typically implies that the some condition has produced an imbalance in colloid- hydrostatic pressures, such as CHF or hypoalbuminemia. While it can represent a serious problem, it may also represent a transient imbalance. Conversely, “B” is not correct as an exudate has more protein in

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

i t a n d i m plies a condition characterized by protein leaking from vessels, such as a malignancy or some serious systemic stressor. “C” is not correct—a chyliform effusion is characterized by fat and indicates a pathology causing massive triglyceride degradation. “D” is not correct as a hemorrhagic effusion is blood and typically means traumatic injury.

• Question 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? 0 out of 1 points Resp onse Feedback :

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

“ D ” i s t h e correct answer. It is the most widely used diagnostic tool as it rapidly and precisely can outline the thoracic and abdominal aorta. “A” is not the correct answer—there are radiographic findings that suggest thoracic aneurysm, but they need confirmation by CT. “B” is not the correct answer as ultrasound is not nearly as precise as a CT scan. “C” is not correct— MRI is only indicated when the patient cannot have a contrast CT.

• Question 3 Certain subgroups of the elderly population are at an increased risk for rapid 1 out of 1 points

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

deterioration and long-term care placement. Which of the following is not considered a high risk factor for long term care placement? Resp onse Feed back: “A” is the correct answer; men are at higher risk for long-term care placement than women. In addition to male gender, other risk factors include age over 80, living alone, bowel or bladder incontinence, history of falls, dysfunctional coping, and intellectual impairment.

• Questi on 4 0 out of 1 points A patient with anterior epistaxis has been treated with 20 minutes of direct pressure to the cartilaginous portion of the nose. Following pressure the patient is instructed to gently blow the nose. Expected findings in the patient who has been successfully treated include all of the

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

following except a: Resp onse Feed back : “C” is the correct answer. If bleeding is successfully stopped with 20 minutes of directed pressure, there will be residual blood and clot formation. This is evacuated either by gentle suction or having the patient gently blow. Residual blood and formed clot may present as a sudden gush of dark blood or discharge with or without a clot—these are all typical expected findings. However, if bleeding is not stopped, it will continue as a bright red steady trickle. When this occurs, more invasive measures are indicated.

• Question 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

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

appears quite ill and says he feels nauseous. Otoscopic evaluation reveals pain to palpation, a very erythematous and bulging tympanic 0 out of 1 points membrane with bullous myringitis. The AGACNP knows that antibiotic therapy must be selected to cover: Resp onse Feed back : “D” is the correct answer. Streptococcus pneumoniae is the most common bacteria that infects the head and neck in immunocompetent persons, and is the primary treatment target when treating otitis media, bacterial sinusitis, and bacterial pharyngitis. “A” is not correct— while likely on broken skin and soft tissue, it is not common in the ear, nose, or throat unless specific risk factors exist. “B” is not correct—this is much more likely in an immunocompromised patient or a patient on mechanical ventilation. “C” is not correct—it is the second most common

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

o r ganism, but strep is the primary treatment target.

• Question 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 1 out of 1 points 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?

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

Resp onse Feed back : “D” is the correct answer. This patient presents from the outpatient population where the most common cause of pneumonia is Streptococcus pneumoniae, and is the primary treatment target for any patient being treated empirically. “A” is not correct—while the patient’s sexual orientation is offered in the provided history, there is no indication that he has HIV/AIDS or any other condition characterized by immunosuppression that would increase his risk for this organism. “B” is not correct, as this organism is not typically seen in the outpatient population without specific risk, e.g. immunosuppression or chronic ventilator therapy. “C” is not the correct answer as this organism is not likely absent specific risk such as instrumentation or known colonization.

• Question 7 Which of the

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

following is the greatest risk factor for vascular dementia? 0 out of 1 points Resp onse Feed back : “B” is the correct answer. Vascular dementia is a consequence of vascular disease, and is more likely to occur in patients with risk factors for target organ damage, such as hypertension, dyslipidemia, and diabetes. “A” is not a distinct risk factor for vascular dementia; it is a risk for Alzheimer’s dementia. “C” likewise increases risk for Parkinson’s dementia, but does not present a risk for vascular dementia. “D” is not a risk factor for vascular dementia. Although there may be some familial risk for certain vascular diseases that may lead to vascular dementia, there is no clear familial tendency for this type of dementia.

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

• Question 8 J.R. is a 55-year-old male who presents for a commercial driver’s license physical 1 out of 1 points examination with a blood pressure of 170/ mm Hg. He has no medical history and is without complaint. Which of the following findings constitutes hypertensive urgency? Resp onse Feed back : “A” is the correct answer. According to the Joint National Committee (JNC) report, hypertensive urgency is described as hypertension in the setting of progressive target organ damage, such as renal involvement with protein leaking, left ventricular hypertrophy, or retinal changes. “A” is not correct— the headache may or may not be relevant, but because there are many non- hypertension causes, a headache alone does not constitute target organ damage. “C” is not correct—it may indicate carotid

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

p l a q u e, but this is not a consequence of hypertension. “D” is not correct as a 1+ palpable pulse may be a normal finding--it must be taken in the context of the rest of the examination.

• Questi on 9 0 out of 1 points Because of the commonly recognized adverse effects of atypical antipsychotics, annual laboratory assessment for patients taking these medications should include a: Response (^) “C” is the correct answer. The atypical antipsychotics such as olanzapine

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

Feed back : (Zyprexa), clozapine (Clozaril), and quetiapine (Seroquel) are classically associated with dyslipidemia and annual lipid panels should be performed in patients of all ages who take these medications. “A” is incorrect—this is the appropriate annual screening tool for patients on lithium due to lithium-related iodine suppression of the thyroid gland. There are no specific indications for “B” and “D” unique to patients taking atypical antipsychotics. Those laboratory assessments should only be ordered as indicated by any other significant patient history.

• Question 10 K.R. presents for an evaluation of eye discomfort. He works in a fabricating shop for a 1 out of 1 points custom automobile restoration company and while working he felt like something flew into his eye.

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

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 indicated in the diagnostic evaluation? Resp onse Feed back : “B” is the correct answer. The patient’s history is consistent with a metal injury and so an MRI should be avoided. “A” may or not be indicated as the history progresses, but there is no contraindication to it should the examiner determine the need to rule out an abrasion. “C” and “D” are both mechanisms to visualize behind the cornea which may be necessary if a penetration injury (which may occur with a high- velocity injury) is suspected.

• Questio n 11

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

0 out of 1 points D.E. is a 41-year-old female who had lumbar surgery two days ago to repair a ruptured 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: Resp onse Feed back : “B” is the correct answer. The D-dimer is a highly sensitive serology and is the least invasive mechanism by which a pulmonary embolus may be ruled out; a negative D- dimer virtually eliminates pulmonary embolus from the differential diagnosis. “A” is not correct—while it can be used to make the diagnosis it is more invasive and less specific than other options. “D” is not correct—there is no indication that the patient is on warfarin, and in any event it would not be used to rule in or out

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

p u l monary embolus “C” is not accurate when after surgery, as it will be positive after surgery.

• Question 12 Mr. Nixon is being treated with unfractionated heparin infusion for acute pulmonary embolus. In order to avoid a potentially fatal complication of heparin infusion, the AGACNP monitors: 0 out of 1 points

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

Resp onse Feed back : “D” is the correct answer. An uncommon but potentially serious consequence of heparin infusion is heparin-induced thrombocytopenia. Some patients make autoantibodies in response to exogenous heparin that activate their own platelets. When this occurs, heparin must be immediately discontinued and thrombin inhibitors started. “A” is not correct —this is not affected by heparin, but is monitored in those on Coumadin. “B” is not correct—this is also unaffected by heparin, but monitored on Coumadin. “C” is not correct—this is monitored to assess therapeutic efficacy, but not for complications.

• Questio n 13 1 out of 1 points Differentiating vertigo from near-syncope and

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

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: Resp onse Feed back : “A” is the correct answer. Dizzy is a layperson’s term and can mean many different things to patients and health care providers. When the patient identifies the primary symptom as a sense of spinning this supports vertigo, which is usually an inner ear problem. This versus ataxia which is neurologic or near-syncope which may be cardiac, neurological, or neurocardiogenic. “B” is not correct—this may occur with vertigo, but when it is the primary symptom it is most likely ataxia and neurological causes should be considered. “C” is not correct as coincident nausea is not specific and can occur with any of these complaints. “D” is not correct as it is also not specific; while

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

a t axia cannot occur when supine near- syncope can.

• Questio n 14 1 out of 1 points Mr. Banks has been admitted 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: Resp onse Feed back : “B” is the correct answer. If there is any concern about disagreement among family members, or any concern at all that a patient’s wishes will not be carried out,

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

t h e b e s t a c t i o n i s to ensure that there is a clearly defined legally executed document. “A” is not correct. Living wills are not legally enforceable documents and when dissention arises among family members they may not be carried out. “C” is not correct - while the patient should arrange for his care as long as he is capable of doing so, if questions arise at such a time that he is not capable of answering his next of kin will need to do so. “D” is not correct -- identifying the proxy is not enough without assigning legal rights and responsibilities. While “A,” “C,” and “D” should all be done and will support his care, the only way to ensure that one’s wishes are carried out is to ensure that a legally enforceable direction is in place.

• Question 15

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

1 out of 1 points Mr. Wilkerson is a 77-year-old male who is being evaluated 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 V 3 -V 6. The AGACNP recognizes which of the following as a contraindication to rTPA therapy? Resp onse Feed back : “D” is the correct answer. rTPA is not indicated in patients with ST segment depression; this is not a ST elevation MI. “A” is not correct as age > 80 is a relative contraindication. “B” is not correct as a temperature of 99.1° F is an expected response to myocardial necrosis, and “C” is not correct—the blood pressure is not prohibitive until > 180/110 mm hg.

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

• Question 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 1 out of 1 points 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? Resp onse Feed back

:

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

“ C ” i s t h e c o r rect answer. The Transtheoretical model of change is characterized by 5 stages. “A” is when the patient has no intention to make a change. “B” is when the patient is intending to make a change in the next 6 months. “C” is when the patient is ready to take action or has already taken some action, as this patient has in establishing his plan to quit by the end of the month. “D” is the overt action that attains a criterion sufficient to reduce disease risk— in this patient the action stage would be characterized by actual smoking cessation. The final phase, not presented in the answer choices here, is maintenance.

• Questio n 17 1 out of 1 points While assessing a patient with a known psychiatric history, the AGACNP knows that the primary difference between a psychotic and neurotic

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

disorders is: Resp onse Feed back : “B” is the correct answer. Patients with psychotic disorders are characterized by a distinct alteration in their perception of reality which may be manifest by visual or auditory hallucinations or impaired thought processes. Neurotic disorders, while many times very serious, are seen in patients who remain aware and interactive with the reality. “A” is incorrect as neurotic disorders may be characterized by a tendency or actual act of harm, such as the self-mutilating actions classic of a borderline personality, suicide by a depressed patient, or even murder or torture committed by an antisocial personality. While dangerous, none of those disorders include a dis-connect from reality as part of the presentation. “C” is incorrect as antipsychotic medications are used to manage a variety of neurotic

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

disorders such as depression or oppositional defiant disorder. “D” is incorrect as lack of conscience and remorse is typical of antisocial personalities.

• Questio n 18 0 out of 1 points 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

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE

DOWNLOAD A+ GRADE 2023/2024 WALDEN UNIVERSITY

are: Resp onse Feed back : “B” is the correct answer. The accelerated GI motility and bradycardia are cholinergic adverse effects. Ophthalmic medications are readily absorbed into systemic circulation. All of these medications are used to treat glaucoma and may cause class-related adverse effects, but cholinergic drops are the only ones shown that will slow heart rate and accelerate GI motility.

• Question 19 Janice is a 19-year-old female who presents to the emergency department via 1 out of 1 points 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

NURS6550Midterm exam (100Q & As) BEST EXAM SOLUTION

100% CORRECTLY/VERIFIED ANSWERS LATEST UPDATE