NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS A, Exams of Nursing

Download NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS A and more Exams Nursing in PDF only on Docsity! NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 1 | 34 Question 1 Which statement is correct about fluoroquinolones? Fluoroquinolones are recommended treatment in uncomplicated skin infections fluoroquinolones are not associated with tendon rupture fluoroquinolones are never indicated in the treatment of pediatric infections Question 2 A 42 year old year old women was admitted to the ICU with a severe asthmatic exacerbation. On rounds today, the patients T is 102.2. Her central IV line site is red, tender, and warm. Your remove the central line and order blood cultures along with IV cefepime. MRSA has been prevalent in this ICU. What additional medication should you order? po vancomycin IV gentamycin IV vancomycin IV pipercillin Question 3 A 66-year-old male involved in a motor vehicle collision is admitted to the trauma unit with multiplesbone fractions and left hemothorax with chest tube placement. Current vital signs are BP 88/52 HR 120 T 98.4 RR 22. Past medical history is positive for end stage renal disease requiring hemodialysis three times a week. How should the NP manage his renal disease? Hemodialysis Peritoneal dialysis Continuous renal replacement therapy NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 2 | 34 No intervention until his blood pressure stabilizes Question 4 What crucial feature of a penicillin is involved in its mechanism of action? Carboxylic acid β ring Acyl side chain Thiazolidin e ring Question 5 Which drug should the APRN select to treat a patient with an infected post operative surgical wound infected with a positive culture result for MRSA? gentamycin ampicillin/sulbac t am vancomycin amphoteracin Question 6 Mr. D is a 56 year old male with newly diagnosed multiple myeloma who is admitted through the ER with back pain after falling against a bookcase at home. Chest x-ray shows a rib fracture. Electrolytes reveal a serum calcium of 12.7 mg/dl. How would you treat Mr. D? Normal saline and loop diuretics Normal saline and thiazide diuretics Kayexalate enema Glucose, insulin, and magnesium Question 7 A 13-year-old thin, female comes to your office with a 6-month history of nondeliberate weight loss, polyuria and polydypsia. She has no other significant illnesses. There are no abnormalities on physical examination except a random venous blood sugar of 237. -lactam NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 5 | 34 What other finding would you expect on this patient? Decreased anion gap Decreased respirations Decreased urine output Increased serum ketones of CAD, peripheral vascular disease, and acute myocardial infarction Have insulin resistance Have more problems with ketosis than patients with Type 1 diabetes mellitus Obesity is found in the majority of patients Question 14 The NP is managing a male patient with bilateral lower extremity swelling, erythema, and draining blisters. The patient states the blisters have been there about a week but now there is redness around the blisters and moving up the leg. He has been having chills and thinks he has been running a temperature but does not own a thermometer. Vital signs are within normal limits except for an elevated temperature of 101.1 The patient has no known drug allergies. What medication should the NP prescribe? IV Vancomycin IV Cefazolin IV piperacillin IV ciprofloxin Question 15 Amy calls the office and states that her fasting blood sugar has been over 225 for the past three mornings. What adjustments should the AGACNP make? Increase her basal insulin dose at bedtime Decrease her basal insulin dose at bedtime Increase her regular insulin dose before dinner Add a dose of regular insulin before bedtime NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 6 | 34 Question 16 Which statement is correct about macrolide antibiotics? nausea and vomiting macrolide resistance is not a concern due to infrequent use of this category prolonged QT intervals are an adverse effect associated with macrolides use of macrolides during pregnancy is associated with elevated renal function tests Question 17 Cicely is a known diabetic with COPD who admitted to the hospital for pneumonia and acute COPD exacerbation. What treatment would the ACNP prescribe to manage her blood sugars? Continue her BID day dose of 70/30 insulin Every four hour BS readings with sliding scale insulin administration Administer Lantus at bed time and timed administration of regular insulin before meals Continue her 70/30 coverage but increase the dose by 10% to account for the stress of the illness Question 18 A 22 year old female patient with type 1 diabetes presents with abdominal pain and T 100.1. Arterial blood gases reveal pH 7.2, pCO2 of 24, HCO3 12. What other finding would you expect on this patient? Decreased anion gap Decreased respirations Decreased urine output NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 7 | 34 Increased serum ketones Question 19 A patient with end stage renal disease misses three dialysis appointments. Which of the following arterial blood gases would indicate the patient is in metabolic acidosis? PHof7.43,PCO2of3 6,HCO3of26 PHof7.41,PCO2of4 9,HCO3of30 PHof7.3 , PCO2of35,HCO3of1 7 PHof7.25,PCO2of5 6,HCO3of28 Question 20 The most common cause of low serum sodium and high serum osmolality is: a Hyperglycemia . b Hypothyroidism . c Adrenal insufficiency . NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 10 | 34 bedtime. Give 24 units of Lantus subcutaneously prior to dinner Give 42 units of Lantus subcutaneously prior to bedtime. Question 24 When prescribing sildenafil (Viagra) to a patient, the patient should be screened for which of the following? Select all that apply. Use of a statin medication Use of a nitrate medication History of coronary artery disease Use of opiods History of priapism Question 25 The NP is assessing a patient receiving benzodiazepines who is experiencing confusion, dizziness, slurred speech, and difficulty breathing. What medication should the NP order to counter the effects? Ropivacaine Naloxone Bromaze pa m Question 26 The AGACNP orders a renal angiogram for a patient with suspected renal artery stenosis. Which of the following medications would be contraindicated for the patient? a Calcium channel . blockers b . Alpha Flumazenil NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 11 | 34 c blockers. Beta. blockers d ACE inhibitors Question 27 The AGACNP is assessing a patient in the urgent care area. The patient is a 44 year old women in her third round of chemotherapy for breast cancer. She presents today with complains of generalize malaise and fever that has gradually increased over the past 12 hours, BP 110/62 P 96 T 102.6 RR 18 WBC 4.2 ANC 300 The best initial treatment by the AGACNP is: NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 12 | 34 Begin oral cephlosporin until causative organism is identified Monitor in the observation area for 12 hours to see if temperature is sustained before starting treatment Broad spectrum empiric antibiotic coverage Culture blood, sputum, and urine. Treat with tylenol until culture and sensitivity results are available Question 28 Mrs. J, age 62, is brought to the hospital by ambulance. She is severely dehydrated, does not respond to verbal stimuli, and withdraws from painful stimuli. BP is 90/60 with a heart rate of 130 bpm. Serum blood glucose level is 1000 mg/dl and there are no ketones in the initial urine analysis. HHS is suspected. Mrs. J's lab values would include which finding? Serum sodium of 120 mEq/l of 380 mOsm/l Urine sodium of 50 mEq/l Bicarbonate of 15 mEq/l Question 29 The NP is caring for a patient with intra renal acute kidney injury (AKI). Which of the following would cause this? Acute glomerulonephritis Ureter obstruction Acute pyelonephritis Hypovolemia due to hemorrhage uestion 30 What should be considered prior to prescribing a sulfonamide? sulfonamides are effective against gram positive organisms only Serum osmolality NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 15 | 34 Question 34 A patient with COPD and asthma is intubated and becomes hypotensive. High levels of auto-peep are noted. What changes should be made in the ventilator settings to address the auto peep? NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 16 | 34 Increase tidal volume decrease the tidal volume decrease the respiratory rate Both 2 and 3 Question 35 Mrs. J, age 62, is brought to the hospital by ambulance. She is severely dehydrated, does not respond to verbal stimuli, and withdraws from painful stimuli. BP is 90/60 with a heart rate of 130 bpm. Serum blood glucose level is 1000 mg/dl and there are no ketones in the initial urine analysis. HHS is suspected. Which statement about HHS is INCORRECT? Hyperglycemia occurs because of a total insulin deficiency Cerebral impairment is a factor Ketogenesis does not occur Severe dehydration results from an osmotic diuresis Question 36 A 56-year-old woman comes to the emergency department because she has had increasing swelling of the right ankle over the past two days, since she sustained an injury while playing outdoors with her grandchildren. She says she has been taking over-the- counter ibuprofen 400 to 800 mg every four to six hours to relieve the pain. Medical history includes mild hypertension, which is currently controlled with lisinopril. Results of laboratory studies show elevated levels of serum creatinine and blood urea nitrogen. Acute renal failure induced by use of nonsteroidal anti-inflammatory drugs is suspected. If this suspected diagnosis is correct, which of the following additional abnormal laboratory results would the AGACNP expect to see ? a Decreased serum chloride level . b Decreased . serum potassium level c NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 17 | 34 Elevated serum potassium level . d Elevated serum sodium level . Question 37 The NP is treating a patient in septic shock. The patient remains hypotensive despite initial fluid resuscitation. Based on the surviving sepsis guidelines, which of the following is true? Fluid resuscitation requires 20 ml/kg of crystalloids Vasopressors should be used next to target a MAP of 50 The first line vasopressor to use is norepinephrine Vasopressin is contraindicated to use with norepinephrine Question 38 The NP is planning a rapid sequence intubation (RSI) on a 44 year old male. He weighs 88 kg. What medications should be administered prior to the RSI? Etomidate 26 mg IV and Succinylcholine 132 mg IV Etomidate 264 mg IV and Succinylcholine 312 mg IV Etomidate 88 mg IV and Succinylcholine 88 mg IV Etomidate 2 mg IV and Succinylcholine 11 mg IV Question 39 The NP is managing the care of a patient in metabolic acidosis. Which exam finding would indicate that the acidosis is getting worse? De ptendonreflexesdecreasingf rom +2to+1 NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 20 | 34 Arterial blood gas results show pH 7.28 pO2 68 HCO3 24 oxygen saturation 92% . The next step for the NP to order is: Intubate immediately Give naloxone (Narcan) Place on BIPAP Given flumazenil (Romazicon) Question 44 The NP is caring for a patient with prerenal acute kidney injury (AKI). Which of the following would cause this? Acute glomerulonephritis Ureter obstruction Acute pyelonephritis Hypovolemia due to hemorrhage Question 45 Miss Smith arrives in the ER with a blood glucose of 420 and + ketones in her urine. She is a type 1 diabetic weighing 70 kg. She is diagnosed with Diabetic Ketoacidosis. The initial bolus dose of insulin is: 10 units of NPH IV 10 units of Regular Insulin IV 20 units of regular insulin IV 0.1 units of regular insulin/hr via continuous infusion Question 46 An insulin-dependent diabetic patient is seen today with the following blood sugar readings from home 250-280 mg/dL in the morning before breakfast 120-140 before lunch 120-130 before dinner 100-110 at bedtime. 160-180 at 3 am Her current insulin dose is 30 units of NPH insulin and 4 units of Regular insulin and before dinner she takes 18 units of NPH and 4 units of Regular. What is your next plan of action? NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 21 | 34 Switch her over to Lantus insulin by multiplying her evening NPH dose by 1.20 and tell her to give that amount of Lantus at bedtime and call you in a week with the readings. Increase the evening regular insulin dosage by 2 more units and have her call you with the readings in a week. Order a fasting blood glucose test and glycosylated hemoglobin. Increase her evening NPH insulin dosage by 2 units Question 47 A 78-year-old male patient with heart failure develops a bacterial urinary tract infection secondary to an indwelling Foley catheter. The patient has a known history of allergy to penicillin and sulfonamides. The appropriate choice for antimicrobial therapy is: a . Cephalexin (Keflex) b Ciprofloxacin (Cipro) . Doxycycline c . (Vibramycin) d T etracycline . (Sumycin). Question 48 The NP is managing care for a patient with hypoparathyroidism. He complains of numbness and tingling in his fingers and around him mouth. What electrolyte imbalance would you expect? Hyponatrem ia Hypocalcemi a Hyperkalemi a Hypermagne se mia Question 49 Which of the following blood gas values illustrates respiratory acidosis? pH 7.28 PaCO2 22 HCO3 -16 pH 7.38 PaCO2 62 HCO3 -36 pH 7.48 PaCO2 31 HCO3 -24 pH 7.22 PaCO2 62 HCO3 -25 NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 22 | 34 Question 50 The NP is discharging a patient newly diagnosed with end stage renal disease that has been started on hemodialysis. The patient states he has frequent constipation at home. What over the counter product should the NP instruct the patient to AVOID? Bisacodyl (Dulcolax ) sup ository Fibersup nts Doc us a t e m le m e sodiu NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 25 | 34 Question 55 The NP is caring for a patient on BIPAP. His latest arterial blood gases indicate that an increase in tidal volume is needed. What changes in the BIPAP settings would you make to accomplish this? Increase the FIO2 Increase the expiratory pressure (EPAP) while maintaining the inspiratory pressure (IPAP) Decrease the expiratory pressure (EPAP) while maintaining the inspiratory pressure (IPAP) Increase the inspiratory pressure (IPAP) while maintaining the expiratory pressure (EPAP) Question 56 The NP is initiating procedural sedation for insertion of a central venous line. Which of the following is NOT a goal of procedural (moderate) sedation? Guard the patient’s safety and welfare Maintain adequate sedation with minimal risk Allay patient fear and anxiety Produce an unconscious patient Question 57 Your patient has a post operative incision infecion. He has a low grade temperature and is allergic to sulfa. What oral antibiotic would provide empiric coverage for MRSA? TMP / SMX DS Doxycycli ne Augmenti n 3rd generation cephlosporin Question 58 The ACNP suspects her patient has pneumonia. The diagnostic tests that might be most helpful in supporting diagnosis of pneumonia would include: CBC, chest x-ray, and lumbar puncture Chest x-ray, sedimentation rate CBC and chest x ray CBC, electrolytes NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 26 | 34 Question 59 The NP is caring for a patient in the ICU with 45% body burns. He is intubated and ventilated due to inhalation injury. The current ventilator settings are Tidal Volume 10 ml/kg PEEP 5 cm FiO2 70% Rate of 18 The last arterial blood gas results show a pH of 7.23 pCO2 38 and pO2 of 58 The chest xray shows bilateral opacities throughout the lung fields. What change in the ventilator settings would you make to address the hypoxia? Increase respiratory rate to 22 and decrease tidal volume to 6 ml/kg Decrease respiratory rate to 12 and increase tidal volume to 12 ml/kg Administer HCO3 and increase the respiratory rate to 22 Increase the PEEP to 10 and decrease the respiratory rate to 12 Question 60 The NP is managing a patient with chronic renal failure. The patient reports that he has not been eating very much, has had a 10 pound weight loss in 3 months, and has not been able to take his calcium supplements? His serum calcium today is 6.9 What would be the next best action for the NP to take? Ases fordepresedde ptendonreflexes Placeanintravenouscatheterinanticipatio nofadministeringcalcium gluconate Checkaserum albuminlevel Repeat the serum calcium level in the morning Question 61 NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 27 | 34 The NP is admitting a patient from an extended care facility. The patients hematocrit is 55% and serums sodium is 155. Which of the following would be a cause of these findings Overhydra ti on dehydration anemia renal failure Question 62 NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 30 | 34 The NP responds to a rapid response team page regarding a 56 year old female with vomiting and diarrhea. The patient reported feeling very dizzy and had to be assisted to bed. VItal signs are BP 58/32 P 140. What IV fluid should the NP order? NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 31 | 34 D5.45NSat5 0ml / h 0.9NSatano penrate D5W at125ml / hr 0.45NSatop enrate Question 69 When evaluating the arterial blood gases (ABGs) of a patient with a bronchitis, which of these would the healthcare provider expect? 20 year history of chronic Metabolic acidosis, uncompensated Respiratory acidosis, compensated Respiratory alkalosis, uncompensated Metabolic alkalosis, compensated Question 70 A 26 year old female arrives at the ED via EMS. She was found unarousable in her apartment by her roommate. T 101.2 RR 32 HR 110 BP 138/88 Pupils are equal, round, and reactive. There is no sign of NRNP 6566 FINAL EXAM LATEST UPDATED 2024 (REAL EXAM) 100% VERIFIED QUESTIONS AND ANSWERS ASSURED A+,, P a g e 32 | 34 trauma. Labs: NA 140 K 4.0 CL 102 BUN 16 CR 0.8 Arterial blood gas pH 7.20 pCO2 24 pO2 96% Which of the following are true? Compensated metabolic alkalosis Uncompensated anion gap metabolic acidosis normal anion gap metabolic acidosis partially compensated anion gap metabolic acidosis Question 71 The NP is planning to repair multiple arm and leg lacerations on a multiple trauma patient in the ICU. What is the maximum number of ml of lidocaine with epinephrine this 92 kg patient can receive? 6 4 5 0