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ABFM KSA Care of Hospitalized Patients Practice Exam 1 QUESTIONS AND CORRECT ANSWERS (VER, Exams of Nursing

Indiana University Bloomington (IU)Nursing

ABFM KSA Care of Hospitalized Patients Practice Exam 1 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2025

Typology: Exams

2024/2025

Available from 06/27/2025

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ABFM KSA Care of Hospitalized Patients
Practice Exam 1 QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2025
1. A 68-year-old man with a history of hypertension and diabetes is
admitted for community-acquired pneumonia. What is the most
appropriate initial empiric antibiotic therapy?
• Amoxicillin-clavulanate
• Ceftriaxone and azithromycin
• Ciprofloxacin
• Vancomycin
Empiric therapy for community-acquired pneumonia in hospitalized, non-ICU
patients includes a beta-lactam (e.g., ceftriaxone) plus a macrolide (e.g.,
azithromycin).
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Download ABFM KSA Care of Hospitalized Patients Practice Exam 1 QUESTIONS AND CORRECT ANSWERS (VER and more Exams Nursing in PDF only on Docsity!

ABFM KSA Care of Hospitalized Patients

Practice Exam 1 QUESTIONS AND

CORRECT ANSWERS (VERIFIED

ANSWERS) PLUS RATIONALES 2025

  1. A 68-year-old man with a history of hypertension and diabetes is admitted for community-acquired pneumonia. What is the most appropriate initial empiric antibiotic therapy?
  • Amoxicillin-clavulanate
  • Ceftriaxone and azithromycin
  • Ciprofloxacin
  • Vancomycin Empiric therapy for community-acquired pneumonia in hospitalized, non-ICU patients includes a beta-lactam (e.g., ceftriaxone) plus a macrolide (e.g., azithromycin).
  1. A 75-year-old woman is admitted with confusion, UTI, and fever. She has mild leukocytosis. What is the best next step?
  • Start IV vancomycin
  • Start IV ceftriaxone
  • Order lumbar puncture
  • Discharge on oral antibiotics Elderly patients with systemic signs of infection should be treated with broad-spectrum IV antibiotics. Ceftriaxone covers most urinary pathogens.
  1. A 60-year-old patient with CHF is admitted with shortness of breath. BNP is 1800 pg/mL. Chest X-ray shows pulmonary edema. What is the next best step?
  • Administer IV fluids
  • Administer IV furosemide
  • Perform thoracentesis
  • Intubate the patient Elevated BNP and pulmonary edema suggest acute decompensated heart failure. IV diuretics are the first-line treatment.
  1. A hospitalized patient on warfarin has an INR of 6.2 with no bleeding. What is the best next step?
  • Hold warfarin, administer oral vitamin K
  • Give FFP
  • Administer IV vitamin K
  • Resume warfarin at a lower dose An INR >6 without bleeding warrants holding warfarin and giving oral vitamin K to reduce risk of hemorrhage.
  1. A 55-year-old hospitalized patient suddenly develops chest pain and dyspnea. His oxygen saturation drops to 85%. What is the best next step?
  • Order a chest X-ray
  • Give nebulized albuterol
  • Order a CT pulmonary angiogram
  • Start antibiotics Sudden hypoxia and chest pain in a hospitalized patient raises concern for pulmonary embolism. CT angiogram is diagnostic.
  1. Which of the following is a risk factor for delirium in hospitalized older adults?
  • Female sex
  • Urinary catheterization
  • Bedrest
  • NSAID use Indwelling urinary catheters are known contributors to delirium due to infection risk and discomfort.
  1. A hospitalized 65-year-old patient is found to have asymptomatic hyperkalemia (K+ = 5.8). ECG is normal. What is the best next step?
  • Dialysis
  • Administer calcium gluconate
  • Hold potassium supplements and recheck labs
  • Give sodium polystyrene sulfonate In asymptomatic, mild hyperkalemia without ECG changes, the first step is identifying and stopping contributing sources.
  1. Which of the following is the most effective intervention to prevent ventilator-associated pneumonia (VAP)?
  • Intermittent pneumatic compression
  • Aspirin Mechanical prophylaxis is preferred in patients at high risk of bleeding.
  1. Which of the following is a contraindication to placing a central venous catheter in the subclavian vein?
  • Obesity
  • Hypotension
  • Coagulopathy
  • Hypovolemia Coagulopathy increases risk of bleeding with subclavian access due to lack of compressibility.
  1. A hospitalized patient is found to have MRSA bacteremia. What is the antibiotic of choice?
  • Cefazolin
  • Linezolid
  • Vancomycin
  • Clindamycin

Vancomycin is the first-line agent for MRSA bacteremia unless there is renal failure or resistance.

  1. A 70-year-old hospitalized patient on IV morphine develops new-onset constipation. What is the most appropriate action?
  • Stop morphine
  • Start a bowel regimen
  • Order a colonoscopy
  • Administer IV fluids Opioid-induced constipation is common and should be prevented with laxatives.
  1. A patient develops Clostridioides difficile infection after antibiotic use. What is the treatment of choice for an initial mild- moderate episode?
  • Metronidazole
  • Oral vancomycin
  • IV vancomycin
  • Fidaxomicin
  1. Which of the following best reduces hospital readmissions in patients with heart failure?
  • Higher diuretic doses
  • Early outpatient follow-up
  • Daily chest X-rays
  • Continuous telemetry Timely outpatient follow-up reduces readmissions by ensuring close monitoring and medication adjustment.
  1. A patient with chronic kidney disease is admitted with altered mental status and a BUN of 100. What is the best management?
  • Fluids
  • Emergent dialysis
  • Lactulose
  • Intubation Uremic encephalopathy requires dialysis regardless of BUN level.
  1. A patient develops a DVT while hospitalized. What is the most appropriate initial treatment?
  • Oral warfarin only
  • Aspirin
  • IV heparin or low molecular weight heparin
  • Inferior vena cava (IVC) filter Initial DVT treatment requires anticoagulation with heparin. Warfarin takes days to become therapeutic.
  1. A 66-year-old patient hospitalized for pneumonia has sodium of 122, low serum osmolality, and high urine sodium. What is the likely diagnosis?
  • Volume depletion
  • Diabetes insipidus
  • SIADH
  • Adrenal insufficiency SIADH is common in pulmonary disease and presents with euvolemic hyponatremia and high urine sodium.
  1. A patient receiving TPN develops liver enzyme elevation and steatosis. What is the most likely cause?
  • Excess carbohydrates/lipids
  • TPN contamination
  1. What is the most appropriate method to prevent pressure ulcers in immobile patients?
  • Sedation
  • Foley catheter
  • Frequent repositioning
  • Skin biopsy Repositioning every 2 hours prevents pressure-induced ischemia in immobile patients.
  1. A 45-year-old patient with alcohol use disorder is admitted. He becomes confused and ataxic. What is the most likely diagnosis?
  • Delirium tremens
  • Hepatic encephalopathy
  • Wernicke’s encephalopathy
  • Stroke Classic triad of confusion, ataxia, and ophthalmoplegia suggests Wernicke’s encephalopathy, treated with thiamine.
  1. Which test is used to confirm C. difficile diagnosis?
  • Blood culture
  • Stool culture
  • Stool PCR or toxin assay
  • Colonoscopy PCR and toxin testing are standard for C. difficile diagnosis.
  1. What is the most likely electrolyte abnormality in refeeding syndrome?
  • Hyperkalemia
  • Hypophosphatemia
  • Hypermagnesemia
  • Hypernatremia Phosphate is rapidly consumed during refeeding, leading to hypophosphatemia.
  1. A 60-year-old hospitalized patient develops sudden dyspnea and JVD. BP is 85/60. Heart sounds are distant. What is the likely diagnosis?
  • CHF exacerbation
  • Tension pneumothorax
  • Cardiac tamponade
  1. Which of the following is most likely to cause hospital-acquired diarrhea?
  • Proton pump inhibitors
  • Fiber supplements
  • Clostridioides difficile
  • Opioids C. difficile is the leading cause of nosocomial diarrhea.
  1. What is the most appropriate prophylactic measure for stress ulcers in ICU patients?
  • Routine H2 blockers
  • PPIs for patients with risk factors
  • Daily sucralfate
  • No prophylaxis needed Stress ulcer prophylaxis is reserved for high-risk ICU patients (e.g., on ventilation, coagulopathy).
  1. A patient with cirrhosis is admitted with ascites and abdominal pain. What is the next best step?
  • CT abdomen
  • Diagnostic paracentesis
  • Start antibiotics
  • IV albumin Paracentesis confirms spontaneous bacterial peritonitis (SBP), which is common in cirrhosis.
  1. What is the best initial test for suspected upper GI bleed in a hospitalized patient?
  • Abdominal X-ray
  • Colonoscopy
  • Esophagogastroduodenoscopy (EGD)
  • CT scan EGD allows diagnosis and possible treatment of upper GI bleeds.
  1. A hospitalized patient with atrial fibrillation and a CHADS2 score of 3 should receive:
  • Aspirin
  • Anticoagulation with heparin or DOAC
  • No therapy
  • Beta-blocker only
  1. A patient hospitalized for pancreatitis has persistent hypoxia. What is the next best test?
  • Chest X-ray
  • Pulmonary function tests
  • Arterial blood gas (ABG)
  • D-dimer ABG helps evaluate hypoxia severity and guides need for oxygen or ventilation.
  1. What is the most important element of medication reconciliation at discharge?
  • Medication costs
  • Number of pills prescribed
  • Clear patient education and written instructions
  • Automatic prescription transfer Patients must understand discharge medications to prevent errors and readmissions.
  1. What is the most common cause of fever on post-op day 1?
  • Wound infection
  • UTI
  • Atelectasis
  • DVT Atelectasis is a common cause of early post-op fever due to hypoventilation.
  1. Which of the following is true about hospital-acquired hyponatremia?
  • It’s usually caused by diabetes
  • Can result from hypotonic fluids or SIADH
  • Needs rapid correction
  • Usually asymptomatic if Na < 120 SIADH or IV hypotonic fluids are common causes. Rapid correction risks central pontine myelinolysis.
  1. A hospitalized patient’s potassium drops to 2.8 mEq/L. What is the best route for potassium repletion?
  • Oral potassium
  • IV potassium
  • Sodium bicarbonate