NRNP 6560 Final Exam (3 Versions, Latest-2022/2023, 300 Q & A) / NRNP 6560N Final Exam, Exams of Nursing

Download NRNP 6560 Final Exam (3 Versions, Latest-2022/2023, 300 Q & A) / NRNP 6560N Final Exam and more Exams Nursing in PDF only on Docsity! NRNP 6560 Final Exam (3 Versions, Latest-2022/2023, 300 Q & A) / NRNP 6560N Final Exam / NRNP6560 Final Exam / NRNP-6560N Final Exam: Walden University | 100% Verified Q & A 1. Q ANSWER: The AGACNP is reviewing a chart of a head-injured patient. Which of the following would alert the AGACNP for the possibility that the patient is over hydrated, thereby increasing the risk for increased intracranial pressure? A. BUN = 10 B. Shif output = 800 ml, shif input = 825 ml Unchanged weight C. 2. Q ANSWER: A patient who has been in the intensive care unit for 17 days develops hyponatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is intubated, and is receiving mechanical ventilation. The serum osmolality is 320 mOsm/L kg H2O. Clinical signs include tachycardia and hypotension. The adult-gerontology acute care nurse practitioner's initial treatment is to: A. reduce serum osmolality by infusing a 5% dextrose in 0.2% sodium chloride solution B. chloride solution C. replenish volume by infusing a 0.9% sodium chloride solution D. replenish volume by infusing a 5% dextrose in water solution. 3. Q ANSWER: Serum osmolality = 260 reduce serum sodium concentration by infusing a 0.45% sodium A 16-year-old male presents with fever and right lower quadrant discomfort. He complains of nausea and has had one episode of vomiting, but he denies any diarrhea. His vital signs are as follows: temperature 101.9°F, pulse 100 bpm, respirations 16 breaths per minute, and blood pressure 110/70 mm Hg. A complete blood count reveals a WBC count of 19,100 cells/µL. The AGACNP expects that physical examination will reveal: A. + Murphy’s sign B. + Chvostek’s sign C. D. + Kernig’s sign 4. Q ANSWER: Myasthenia gravis is best described as: A. An imbalance of dopamine and acetylcholine in the basal ganglia Demyelination of peripheral ascending nerves B. Demyelination in the central nervous system C. 5. Q ANSWER: Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but throughout the course of day 1 she has complained of a mild abdominal discomfort that has progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate the patient for persistent and progressive discomfort. Likely causes of her symptoms include all of the following except: + McBurney’s sign An autoimmune disorder characterized by decreased neuromuscular activation 10.Q ANSWER: A 32-year-old man comes to the clinic because he has had pain in the back for the past 24 hours. The patient says he first noticed the pain when he awoke in the morning and had difficulty getting out of bed. He had been playing flag football the day before the pain began but did not sustain any injuries during the game. Acetaminophen has provided only minimal relief of the patient's pain. On physical examination, pain is elicited on palpation of the back on the lef, lateral to the region of L2-L5. Full range of motion is noted in vertebral flexion, extension, lateral rotation, and lateral bending, with some hesitancy because of pain on the lef side. Which of the following is the most appropriate initial step? Anti-inflammatory and muscle relaxant therapy Epidural injection of a corticosteroid MRI of the lumbar spine Strict bed rest and application of moist heat to the lower back 11.Q ANSWER: On postoperative day 7 following hepatic transplant, the patient evidences signs and symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that first-line treatment of acute rejection consists of: Cyclosporine Azathioprine Methylpredniso lone Sirolimus 12.Q ANSWER: H. W. is a 33-year-old female who is being evaluated afer a fall from a tree. Anteroposterior and lateral radiographs of the thoracolumbosacral spine are significant for transverse process fractures at T6 and T7. The AGACNP knows that treatment for this likely will include: Observation Hyperextension casting Jewet brace Surgical intervention 13.Q ANSWER: Acute hepatitis A is usually diagnosed by: By the constitutional symptoms Within 2 weeks of exposure Detection of IgM-Anti-HAV Jaundice 14.Q ANSWER: A 30-year-old male patient presents for evaluation of a lump on his neck. He denies pain, itch, erythema, edema, or any other symptoms. He is ^concerned because it won't ^ go away. He says, “I noticed it a few months ago, then it seemed to disappear, and now it is back.” The AGACNP proceeds with a history and physical exam and concludes which of the following as the leading differential diagnosis? Subclinical infection Non- Hodgkin's lyphoma Catscratch disease Syphilis 15.Q ANSWER: P. E. is a 61-year-old female who presents for a postoperative visit following a gastric resection afer a perforation of peptic ulcer. She reports feeling beter, although it is taking longer than she expected. However, she says she is feeling beter each day, her appetite is returning, and her incision is healing well. She is being discharged from surgical care and advised to continue her routine health promotion follow-up with her primary care provider. As part of her surgical discharge teaching, the AGACNP counsels P. E. that as a result of her gastric resection she will need lifelong follow-up of: Blood group substances Electrolyt es Vitamin B12 Gastric pH 16.Q ANSWER: T. O. is a 31-year-old male patient who is transported to the emergency department via emergency services. He was in a multivehicle accident and was trapped in a crushed car for more than 3 hours. On examination, his right lower extremity is found to be tensely swollen, with 3+ nonpitting edema. The lower leg is profoundly painful with passive range of motion. Given the history and physical findings, the AGACNP recognizes that treatment centers around: Fasciotomy Thrombolytics Surgical reduction Casting 17.Q ANSWER: While consulting on a patient who is admited with a chief complaint of abdominal pain, the AGACNP notes that the initial assessment described the pain as “colicky.” This means that the pain: A homeless patient with a 9mm PPD skin test A patient with intravenous drug abuse (IVDA) who has an A healthcare worker who has a 6mm PPD skin test 23.Q ANSWER: When the patient with jaundice is evaluated, a careful history and physical exam ofen can help differentiate prehepatic, hepatic, and posthepatic causes. When the patient reports dark discoloration of the urine and light discoloration of the stool, the AGACNP is most suspicious for: Viral hepatitis Chronic alcoholism Extrahepatic obstruction Cholestasis 24.Q ANSWER: Jack R. is a 63-year-old male who is being seen today on rounds afer being admited for profound upper abdominal pain, nausea, and vomiting. He had markedly elevated serum amylase and lipase; he was diagnosed with pancreatitis and admited for pain management and bowel rest. Today he feels beter, but he is upset because he knows that pancreatitis is known as the “alcoholic’s disease.” He makes it clear that he is a religious man and that his religion forbids alcohol; he says he has never had an alcoholic drink in his life. The AGACNP reassures 11mm PPD skin test Jack that approximately 40% of cases of pancreatitis are caused by as well as a variety of other things, and that he will have a thorough diagnostic evaluation. hyperlipidemia gallstone disease genetic predisposition hypercalcemia 25.Q ANSWER: In neurogenic shock, patients are subjected to an abnormal dilation of venules and arterioles in response to failure of the autonomic nervous system. Treatment for neurogenic shock may include all of the following except: Trendelenburg Intravenous fluids Vasodilators Vasoconstrics 26.Q ANSWER: Which of the following is a true statement with respect to the use of corticosteroids in postransplant patients? High-dose initial steroids are tapered to off over a period of 4 to 6 weeks postransplant There is a strong interest in developing corticosteroid-free postransplant protocols Beter results are demonstrated in corticosteroid-free protocols for second- transplant recipients Evidence supports corticosteroid-free rejection protocols 27.Q ANSWER: The comprehensive serologic assessment of a patient with Cushing’s syndrome is likely to produce which constellation of findings? Low potassium, high glucose, high white blood High sodium, polycythemia, low BUN Low sodium, low potassium, high BUN High sodium, high chloride, high RBCs 28.Q ANSWER: A patient admited for management of sepsis is critically ill and wants to talk with a hospital representative about donating her organs if she dies. She has a fairly complex medical history that includes traumatic brain injury, breast cancer, and dialysis-dependent renal failure. The patient is advised that she is ineligible to donate due to her: Renal failure Traumatic brain injury Systemic infection Breast cancer 29.Q ANSWER: Elmer is a 61-year-old male who is admited vomiting bright red blood. He has no known medical history—he has not been in the health care system for most of his adult life. He has lost a lot of volume, and his vital signs are borderline unstable with a blood pressure of 88/58 mm Hg, pulse of 118 bpm, respiratory rate of 12 bpm, and a temperature of 97.6°F. The AGACNP recognizes that the leading differentials include all of the following except: Peptic ulcer Portal hypertension cell count Josh is a 14-year-old male patient who presents for evaluation of blurred vision. His only significant injury is that over the weekend he was playing baseball and was hit in the side of the head by a flying ball. The hit was hard enough to knock him down, but he did not lose consciousness and had no remarkable symptoms. Now on Wednesday he presents with a dull headache that seems to be getting worse, and his mom wants to have him evaluated. Neurologic examination reveals a sluggish pupillary response. CT scan of the head reveals a 1 cm epidural hematoma. The AGACNP knows that the best approach to management would be: Cautious observation An osmotic diuretic Surgical consultation Emergency evacuation 35.Q ANSWER: Mary W. is a 39-year-old female who presents with persistent abdominal discomfort. She denies actual pain but says she has this persistent sense of fullness in her abdomen that feels like it would go away if she could have a bowel movement. This finding is known as: Somatic pain Gas stoppage sign Small bowel obstruction Large bowel obstruction 36.Q ANSWER: Tim is an 20 year old junior at Notre Dame and injured his right knee during an intramural football game and comes to the ER complaining of severe pain. Tim tells you that he was setting up to pass the football when he was tackled and he immediately felt his knee "pop" and buckle as he fell. You, as the AGACNP, know the most important information to obtain from Tim is: Insurance information Family history Social history What exactly was he doing when he got hurt 37.Q ANSWER: Mrs. Nguyen is an 84-year-old female who suffered a fall in her long-term care facility. Afer assessing possible reasons for her fall, a physical examination is performed to look for injuries. Mrs. Nguyen has significant pain in her lef upper arm and limited range of motion in her lef shoulder; a shoulder trauma series is ordered to evaluate for which type of injury that frequently occurs in these circumstances? Shoulder dislocation Scapular fracture Proximal humerus fracture Nursemaid’s elbow 38.Q ANSWER: A general principle in surgical oncology is that the best approach to curative surgery in a fixed tumor requires: Adjuvant therapies Neoadjuvant therapies Elective lymph node dissection En bloc resection 39.Q ANSWER: Intracranial pressure monitoring is instituted for a patient with a head injury. The patient’s arterial blood pressure is 92/50 mm Hg, and her intracranial pressure is 18 mm Hg. Using these values to calculate the patient’s cerebral pressure (CPP) the AGACNP determines: The CPP is adequate for normal cerebral blood flow The CPP is high and that ischemia and neuronal death are imminent to prevent cerebral hypoxia Lowering the patients blood pressure will reduce the intracranial pressure, increasing cerebral blood flow 40.Q ANSWER: Mr. Jefferson is a 59-year-old male who presents to the emergency department complaining of severe abdominal pain. His medical history is significant for dyslipidemia, and he takes 40 mgof simvastatin daily. He admits to drinking 6 to 10 botles of beer nightly and to smoking 1½ packs of cigaretes a day. He denies any history of chest pain or cardiovascular disease. He was in his usual state of good health until a couple of hours ago, when he developed this acute onset of severe pain in the upper abdomen. He says that he tried to wait it out at home but it was so bad he finally came in. His vital signs are as follows: temperature 99.1°F, pulse 129 bpm, respirations 22 breaths per minute, and blood pressure 137/84 mm Hg. The abdomen is diffusely tender to palpation with some guarding but no rebound tenderness. The AGACNP anticipates that which of the following laboratory tests will be abnormal? A complete blood count and RBC differential Liver function enzymes Serum amylase, lipase, and glucose A basic metabolic panel 41.Q ANSWER: The blood pressure should be increased An open fracture is considered an orthopedic emergency. Emergency room management of open fracture must include: Immediate covering with iodine-soaked gauze Cefriaxone and tetanus prophylaxis Proximal and distal exploration of the wound Removal of all bone fragments 46.Q ANSWER: Grant Pass is a 20 year old downhill skier for the U. S Olympic team. He was on a practice run in Salt Lake City and caught a ski tip on a mogul and became airborn and crashed into the padded barriers on the side of the course. He was momentarily stunned, but was walking around unassisted and was conversant when the ski patrol paramedics arrived. The paramedics placed him on a backboard and began to slowly ski down to the end of the course where an ambulance was waiting to take him to the local trauma center. When Grant was placed in the ambulance, the paramedics noted that Grant was somnolent and not responsive to verbal commands. They noted that his lef pupil was dilated and sluggish to respond to light. Based on the above information, you, as the ACNP in the ER, suspect that Grant suffered which of the following? Basilar skull fracture Subdural hematoma Epidural hematoma Contra-coup injury 47.Q ANSWER: Mrs. Maroldo is an 81-year-old female who presents for evaluation of pain in her lef lower quadrant. She has had this pain before and says she usually takes antibiotics and it goes away. However, this time it seems worse, and she has had it for 4 days even though she says she started taking her lefover antibiotics from the last episode. She denies any nausea or vomiting but says she simply isn’t hungry. She had a litle diarrhea yesterday but no bowel movements today. She has a temperature of 100.9°F and a pulse of 104 bpm, respirations of 20 breaths per minute, and a blood pressure of 94/60 mm Hg. She has some discomfort to deep palpation in the lef lower quadrant. The AGACNP suspects: Irritable bowel syndrome Inflammatory bowel disease Diverticulitis Appendicitis 48.Q ANSWER: T. G. is a 48-year-old female who presents with biliary colic. She has had previous episodes but has resisted operation because she is afraid of anesthesia. Today her physical exam reveals a clearly distressed middle-aged female with right upper quadrant pain, nausea, and vomiting. Which of the following findings suggests a complication that requires a surgical evaluation? A temperature of 101.5°F A leukocyte count of 18,000/µL A palpable gallbladder A positive Murphy’s sign 49.Q ANSWER: Tim is an 20 year old junior at Notre Dame and injured his right knee during an intramural football game and comes to the ER complaining of severe pain. Tim tells you that he was setting up to pass the football when he was tackled and he immediately felt his knee "pop" and buckle as he fell. What physical exam tests would you perform to confirm your differential diagnosis? Talar tilt test Tinel's test Valgus/varus stress test McBurney's test 50.Q ANSWER: The AGACNP rounds on his brain injury patient and recognizes the development of progressive bradycardia, hypertension, and irregular respiratory patern. This is known as Cushing’s triad and suggests: Uncal herniation Increased intracranial pressure Brainstem compression Subarachnoid hemorrhage 51.Q ANSWER: Sara S. is a 41-year-old patient who has just had a bone marrow transplant. The AGACNP knows that which medication will be used to decrease her risk of graf-versus-host reaction? Immune globulin Cyclosporine Prophylactic antibiotics Systemic corticosteroids 56.Q ANSWER: The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla? Alpha-adrenergic antagonists Beta- Intravenousadren rgic antagonists vasodilators Arteriolar dilators 57.Q ANSWER: A 41-year-old male physician has a 6-week history of persistent painful, swollen, and stiff proximal interphalangeal joints, wrists, and ankles. Using a step wise progression model, which would be the first diagnostic test the AGACNP would order? Radiography of hand and wrist Check HLA – B27 Hepatitis B serology testing Rheumatoid factor and anti-nuclear antibody Joint aspirate for microcrystals 58.Q ANSWER: Mr. S., a 49-year-old male, is brought to the emergency room by his roommate who relates that the patient has been vomiting bright red blood for two days. He has a history of alcohol abuse. Current vital signs are as follows: Temp 99.2o F, heart rate 110 bpm (sinus tachycardia), blood pressure 90/60 mm Hg, resp 32 bpm. He is alert but lethargic and denies current abdominal pain. Which of the following is not indicated in the initial management of this patient? Immediate IV access Laboratory screening, type and crossmatch Endoscopy Crystalloid infusion 59.Q ANSWER: A 38-year-old patient presents with symptoms of L5 nerve root impairment that have been ongoing for 3 weeks despite conservative treatment. All of the following statements regarding this case are true EXCEPT: Normal findings on plain radiographs should be followed up with a CT Scan or MRI immediately The L5 level is one of the most likely levels for disk herniation Sensory findings may include diminished pain on the dorsum of the distal region of the foot Motor findings may include weakness on extension of the great toe Tendon reflexes are expected to be normal at the knee and ankle 60.Q ANSWER: R. R. is a 71-year-old female who presents with lef lower quadrant pain that started out as cramping but has become more constant over the last day. She reports constipation over the last few days but admits that for as long as she can remember she has had variable bowel habits. Her vital signs are normal, but physical examination reveals some tenderness in the lef lower quadrant. Which diagnostic test is most likely to support the leading differential diagnosis? CT scan with IV, oral, and rectal contrast CBC with WBC differential Colonoscopy Barium enema 61.Q ANSWER: A patient with chronic hepatic encephalopathy is being discharged home. Discharge teaching centers upon long-term management strategies to prevent ammonia accumulation. Teaching for this patient includes instruction about: Lactulose taken 20 g PO daily Spironolactone taken 100 mg PO daily daily Zolpidem taken 10 mg PO qhs. 62.Q ANSWER: Ms. Carpenter is a 28-year-old female who presents in significant pain; she indicates that the discomfort is in the right lower quadrant. The discomfort is colicky in nature and has the patient in tears. Which of the following associated findings increases the index of suspicion for ureteral colic? Protein intake of 50 g Liver function will probably recover to 50% baseline, but that is enough for normal function Up to 95% of the liver can be removed without any apparent consequence to the patient 68.Q ANSWER: Joshua is a 31-year-old man who presents for evaluation of acute numbness and tingling and decreased strength in his arms. It happened rather suddenly this afernoon and has never happened before. The lower extremities do not appear to be affected. While performing the history the AGACNP asks specific Q ANSWERs about the risk of: Cervical radiculopathy Hyperextension injury Panic atack Poison ingestion 69.Q ANSWER: The AGACNP is taking report on a head injured patient. The report includes scoring on the Glasgow Coma Scale of E2 M3 V5. How would you interpret this information? The patient’s eyes open to sound, they are orientated are able to obey commands The patient’s eyes open to pressure, they can uter some words but do not form sentences, and they are able to localise to trapezius pinch. The patient’s eyes open spontaneously; they are orientated and able to obey commands The patient's eyes do not respond, they are confused and do not follow commands. 70.Q ANSWER: L. S. is a 49-year-old female with a history of colorectal cancer for which she has had surgical resection and chemotherapy. She presents with profound abdominal pain. She has not vomited, and she is not certain when she had her last normal bowel movement; her bowel habits have been irregular for some time. A CBC demonstrates a mild microcytic anemia but is otherwise normal; her WBC differential is normal. Results of a metabolic panel support minor volume contraction but show no significant electrolyte abnormalities. Abdominal radiographs demonstrate dilation of the proximal colon, air fluid levels, and a complete absence of air in the rectum. The AGACNP diagnoses the patient with: Perforated colon Paralytic ileus Complete bowel obstruction Intestinal volvulus 71.Q ANSWER: Tim is an 20 year old junior at Notre Dame and injured his right knee during an intramural football game and comes to the ER complaining of severe pain. Tim tells you that he was setting up to pass the football when he was tackled and he immediately felt his knee "pop" and buckle as he fell. Which of the following diagnostics would the AGACNP order first? Plain radiographs MRI of his knee CT scan Diagnostic arthroscopy 72.Q ANSWER: Jane S. is a 35-year-old female patient who is at 30 weeks’ gestation. She is being followed regularly for prenatal care and has always been healthy; she just had an office visit and was told everything was fine. Tonight she presents to the emergency room complaining of significant pain in the upper abdomen. Her vital signs reveal a temperature of 98.4°F, pulse of 110 bpm, respirations of 20 breaths per minute, and blood pressure of 144/90 mm Hg. A urinalysis reveals proteinuria, and a metabolic panel is significant for increased transaminases. Her hemogram is normal, but the CVC reveals platelets of 85,000. The AGACNP knows that which of the following must be evaluated as a cause of her abdominal pain? HELLP syndrome Placental abruption Spontaneous hepatic rupture Preterm labor 73.Q ANSWER: A 52-year-old male comes to the clinic in preparation for an overseas trip next year. He has already searched the internet and knows that Hepatitis A and Hepatitis B are endemic in the country that he will be visiting. What will you recommend to this patient? No immunizations are needed. It is highly unlikely that he’ll be exposed to hepatitis since he’s traveling with a tour group. Recommend Hepatitis C IgG to prevent getting an acute illness. Recommend two doses of Hepatitis A and 3 doses of Hepatitis Recommend one dose of Hepatitis A and Hepatitis B vaccine. B vaccine. However, she is now in significant pain and is afraid something is “really wrong.” She describes what started out as a dull discomfort in the upper part of her stomach a few hours ago but has now become more profound and centered on the right side just under her ribcage. She has not vomited but says she feels nauseous. Physical exam reveals normal vital signs except for a pulse of 117 bpm. She is clearly uncomfortable, and palpation of the abdomen reveals tenderness with deep palpation of the right upper quadrant. The AGACNP orders which imaging study to investigate the likely cause? Abdominal radiographs CT scan of the abdomen with contrast Right upper quadrant ultrasound A HIDA scan 79.Q ANSWER: The AGACNP knows that early diagnostic findings consistent with rheumatoid arthritis include: metacarpals Radiographic joint space narrowing Heberden's nodes Subungal hemorrhages 80.Q ANSWER: The ethical principle of veracity refers to: Telling the patient the truth Sof tissue swelling of the Ensuring that the patient gets what he deserves The patient’s right to self determination The duty to do no harm 81.Q ANSWER: Mr. Huckabee is a 51-year-old male who had a CT scan of the abdomen to evaluate refractory lef lower quadrant discomfort. The scan reported an incidental finding of cholelithiasis with calcified gallbladder. While counseling Mr. Huckabee about the results, the AGACNP advises that the appropriate approach to these findings is: No further evaluation indicated A surgical evaluation To treat with oral emulsification agents To follow annually with ultrasound 82.Q ANSWER: Mr. Miller is a 56-year-old male who is being managed for portal hypertension. The AGACNP knows that of the many causes of portal hypertension, alcoholic liver disease typically is the cause when the patient has: Elevated hepatic vein pressures Elevated transaminases Decreased prothrombin time phosphatase 83.Q ANSWER: Neoadjuvant chemotherapy treatment for cancer is given to facilitate surgical resection. When the outcomes of cancer therapies are evaluated, the terms complete response and partial response ofen are used. Partial response means that: 50% of the patients treated with a given regimen demonstrate remission 50% of the patients treated survive to the 5year point 50% In 50% of cases, the tumor converts from unresectable to resectable In a patient with a perforated duodenal ulcer, the most likely source of peritonitis is amylase gastric contents liver enzymes breaking down the mesentry blood 84.Q ANSWER: Ms. Teller presents with a chief complaint of weight loss. She reports an unplanned 10 lb weight loss over the last 5-6 months. She has no significant medical history, but review of systems reveals bilateral shoulder discomfort and some impaired range of motion -- she has trouble pulling clothing over her head. Over the last few months she has generalized upper Decreased alkaline The tumor mass has reduced by > tenderness. On exam he appears to be moderately ill, with a temperature of 39.3°C, pulse of 105/min and a blood pressure of 115/60mmHg. His cardiopulmonary and abdominal exam are negative. A urine dip in the office reveals 2+ blood, 2+ leukocytes and negative nitrates. Of the following tests, which is most likely to lead to the correct diagnosis? Urine culture Renal ultrasound Blood cultures CT scan of the abdomen 89.Q ANSWER: S. R. is a 51-year-old male patient who is being evaluated for fatigue. Over the last few months he has noticed a marked decrease in activity tolerance. Physical examination reveals a variety of ecchymoses of unknown origin. The CBC is significant for a Hgb of 10.1 g/dL, an MCV of 72 fL and a platelet count of 65,000/µL; the remainder of the CBC is normal. Coagulation studies are normal, but bleeding time is prolonged. The AGACNP recognizes that initial management of this patient will include: Splenectomy Monoclonal antibody therapy such as rituximab platelets normal Avoidance of elective surgery and nonessential medications 90.Q ANSWER: Elliot is a 47-year-old male who is being treated for throat cancer with combination therapy that includes radiation. He is asking Q ANSWERs about what adverse effects he may anticipate. The AGACNP advises Elliot that the most significant toxic effects in the acute / early postradiation period are: Prednisone 60 mg daily until A product of mucositis and include yeast superinfection, desquamation, and pain Nephrotic syndrome and organ failure More commonly permanent than toxic effects of other cancer treatments Atrophy and burn, with subsequent dysfunction of the area surrounding targeted tissues 91.Q ANSWER: The AGACNP knows that when evaluating a patient with suspected acute pyelonephritis, which of the following is not a common feature? Pyur ia Feve r CVA tenderness Gross hematuria 92.Q ANSWER: G. D. is a 13-year-old male patient who has a history of recurrent fever and flank pain. His parents traditionally are not believers in the health care system, and he has not been seen by a health care provider for many years. Today he has fever, chills, and costovertebral angle tenderness. Urinalysis reveals findings consistent with acute urinary infection. The AGACNP treats the patient for pyelonephritis and considers which study to evaluate for vesicoureteral reflux? Bilateral renal ultrasound CT scan of the abdomen and pelvis Voiding cystourethrograpy Radioisotope scanning 93.Q ANSWER: Maxine is being seen in follow-up afer removal of an aldosteronoma. The AGACNP expects specifically that which of the following aldosterone-related abnormalities will be cured? Hypertensi on Hyponatre mia Hypokalem ia Hypoglyce mia 94.Q ANSWER: Acute hepatitis B is diagnosed by: Presence of HAV-IgM Detection of HbsAg Anti-HBc- IgM B and C 95.Q ANSWER: A 19-year-old woman presents to your office with a 3-day history of dysuria and foul-smelling urine. She also notes some suprapubic pressure and noted some chills and she thinks she had a fever yesterday. She reports no vaginal bleeding or discharge and reports no nausea or vomiting. She denies any significant past medical history. On exam she has a temperature of