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AGACNP 106 FINAL EXAM| ACTUAL 150+QUESTIONS&ANSWERS|A+
GRADE. NEWEST UPDATE 2025 SPRING. RATED A+
What disease conditions do you see Telangiectasia in? Differential? Physical Exam? - ANS:->>>--("spider veins") dilated or broken blood vesselslocated near the surface of the skin or mucous membranes.
- Rosasea
- Liver dx
- Scleroderma
- Lupus
- Corticosteriod use
- Raynauds
- Basal cell Skin CA
- Differential: PVD
- PE: Hemosiderans deposition (staining) Type 1 Error - ANS:->>>--False positive
- Incorrectly rejecting the true null hypothesis (occurs if the null hypothesis is rejectedwhen it is true)
- Rejection of the null hypothesis when it is actually true. Type 2 Error - ANS:->>>--False negative
- Failing to reject a null hypothesis which is false (occurs if the null hypothesis is not rejected when it is false)
National mandate to prevent VAP? - ANS:->>>-Elevate the HOB Credentials - ANS:->>>-1. Encompass required education, licensure andcertification
- Establish minimal levels of acceptable performance
- Necessary to: ensure the safe healthcare is provided by qualified individuals and comply with federal and state laws relating to advanced practice nursing
- Scope of practice
- Mandates accountability
- Enforces professional standards of practice What is credentialing or priviliging? - ANS:->>>--Process by which a NP is grantedpermission to practice in an inpatient setting
- Credentialing with hospital privileges is granted by a Hospital Credentialing Committee comprised of MDs who hold privileges at the given hospital where the NP has made request
- Privileges may be granted in part or full; stipulations regarding the allowance of future privileges may be made by the Credentialing Committee Licensure - ANS:->>>--Establishes that a person is qualified to perform in aparticular profession.
- Granted as defined by rules and regulations set forth by a governmental regulatory body Who gives licensure? - ANS:->>>-State board of nursing What is sensitivity? - ANS:->>>--True positives
- The degree to which those who have a disease screen/test positive What is specificity? - ANS:->>>--True negatives
cefepime/ceftazidine or imipenem/meropenem or aztreonam
- Gram neg with antipseudomonal coverage: non-beta lactam-based agents = levofloxacin/cipro or amikacin/gentamicin/tobramycin or colistin/polymyxin B Right flank pain radiating to the back could indicate? - ANS:->>>-Pancreatitis What is treatment for cardiac tamponade? - ANS:->>>-Pericardiocentesis toremove the blood and fluid from around the heart Scope of Practice NP - ANS:->>>--Based on legal allowances in each state
- According to and delineated by individual State Nurse Practice Acts
- Provides guidelines for nursing practice; varies from state to state Vaccines after splenectomy most important? Others? - ANS:->>>--Meningococcal: conjugate (MenACWY) and serogroup B(MenB) and pneumococcal conjugate (PCV13) and polysaccharide (PPSV23)
- Hib
- Influenza each year
- Tdap
- Zoster
- HPV
- MMR
- Varicella Addisons Disease Addisons lab findings?
Test to rule out Cushing's? - ANS:->>>--Adrenocorticotropic hormone (ACTH) hypersecretion- too much steroid
- Hyperglycemia, hypernatremia, hypokalemia, glycosuria, leukocytosis (WBC > 10), elevated plasma cortisol in the AM, serum ACTH elevated, elevated urine free cortisol(normal is
- Dexamethasone suppression test What ethnicity like to have DM and not seek treatment? - ANS:->>>-Hispanics Steps in the Research Process - ANS:->>>-1. Formulating the research problem2. Reviewing related literature
- Formulating the hypotheses 4. Selecting the research design
- Identifying the population to be studied6. Specifying methods of data collection 7. Designing the study
- Conducting the study9. Analyzing the data
- Interpreting the results
- Communicating the findings Arcus Senilis - ANS:->>>--A cloudy appearance of the cornea with a gray/whitearc or circle around the limbus
- Due to deposition of lipid material
- No effect on vision
- Permanent color change of the eye
- Underlying issue = HLD Ventilatory settings for ARDS - ANS:->>>--Peep = 10 (manage pulmonaryshunting by adding PEEP)
- Tidal volume 6-8 mL/kg ideal body weight (low tidal volume to prevent acute lung injury) Medicare Part A covers? - ANS:->>>--Inpatient/hospitalization
- Skilled nursing facility services
- Home health services
- Hospice (inpatient) Medicare Part B covers? - ANS:->>>--Physician services
- Outpatient hospital services
- Labs and diagnostic procedures
- Medical equipment
- Some home health services
- Hypomagnesemia
- Hypocalcemia
- Thiamine Def What labs do you check for with TPN? - ANS:->>>--Albumin
- Glucose? Pt says don't tell my daughter about my diagnosis, what ethical principle is this honoring? - ANS:->>>-Fidelity
- The duty to be faithful ICU pt, 2 days post extubation fails swallow study. Keep in ICU or transfer to floor? - ANS:->>>-Transfer to step down Veracity - ANS:->>>-The duty to be truthful DNR with advanced directives, family asking for everything to be done? - ANS:->>>- We don't go against advanced directives
Pt comes in with CHF and dementia, first thing NP should do? - ANS:->>>-Assesscognition Side effect Levothyroxine (Synthroid)? - ANS:->>>-Alopecia What pt most likely to have angioedema with ACE? - ANS:->>>-African American Labs for salicylate (ASA) overdose? - ANS:->>>--Hyperkalemia
- Elevated liver enzymes
- Metabolic acidosis What should you watch for with CA pts with bone mets? - ANS:->>>-Hypercalcemia Treatment for ethylene glycol (antifreeze) ingestion? - ANS:->>>-Fomepizole(antizole) GCS Level/severity for TBIs - ANS:->>>-- 13 - 15 = mild
- 9 - 12 = moderate
- 3 - 8 = severe Initial treatment for respiratory distress with wheezing and stridor secondary to anaphylaxis? - ANS:->>>-Sub Q epinephrine (0.3-0.5mg of 1 mg/ml) Causes pre-renal failure - ANS:->>>-Outside kidney
- Impaired renal perfusion (shock, dehydration, cardiac failure, burns, diarrhea, sepsis/vasodilation) Can pre-renal failure be reversed? - ANS:->>>-Can only be reversed when theunderlying cause of hypoperfusion is corrected
Thalassemia minor is what? - ANS:->>>--Microcytic, hypochromic anemia
- Decreased alpha/beta Hgb chains
- Abnormal Hgb production
- TIBC/ferritin are normal
- Minor = heterozygous Iron Deficiency Anemia, what type of anemia? Labs/Diagnostics? - ANS:->>>-- Microcytic, hypochromic anemia
- Low Hgb
- Low Hct
- Low MVC
- Low MCHC
- Low RBC
- Low serum iron
- Low serum ferritin
- High TIBC
- High RDW Pernicious anemia, what type of anemia? S/S? - ANS:->>>--Macrocytic, normochromic anemia (megaloblastic)
- Positive neuro findings: paresthesia, loss of vibratory sense, loss of fine motor control,
positive Romberg, positive Babinski S/S of meth overdose? - ANS:->>>--Mydriasis - dilated pupils
- Hallucinations
- Hyperthermia Mainstay treatment of COPD? - ANS:->>>-Ipratropium bromide orsympathomimetics Emergent tx bleeding duodenal ulcer w/stable labs? - ANS:->>>--IV PPIcontinuous
- GI consult for endoscopy When do you give thrombolytic for an MI? - Revascularization What would make it contraindicated? - ANS:->>>--Unrelieved chest pain (>30 minutes and < hours) WITH ST segment elevation > 0.1 V in two or more contiguousleads
4: medium dose ICS +LABA Step 5: high dose ICS+LABA Step 6: high dose ICS+LABA + Oral corticosteroid Ulcerative Colitis Treatment - ANS:->>>-1. Mesalamine (Canasa) suppositories orenemas for 3 to 12 weeks
- Hydrocortisone suppositories and enema Diverticulitis Treatment - ANS:->>>-1. NPO2. IVF to maintain hydration
- Significant GI bleeding is present, treat like PUD
- 20 - 30% of patients will require surgical management: Surgical consult UpToDate: ATB cipro/flagyl or levo/flagyl surgical consult on admit SIADH Labs/Diagnostics - ANS:->>>--Hyponatremia (yet euvolemic)
- Decreased serum osmolality (<280)
- Increased serum urine osmolality (>100)
- Urine sodium >
- Renal, cardiac, thyroid function normal DI Labs/Diagnostics - ANS:->>>--Hypernatremia
- Elevated BUN/Creatinine
- Serum osmolality >
- Urine osmolality <
- Urine specific gravity low <1. What side effect to watch for Metoclopramide (Reglan)? - ANS:->>>--EPS - tardivedyskinesia
- Black Box warning What is a contraindication for using Succinylcholine? - ANS:->>>-Hyperkalemia Collaborative Practice - ANS:->>>--Enhance quality of care
- Improve patient outcome
- Collaboration = true partnership in which all parties have desire and power, sharecommon goals, accept separate areas of responsibilities and activities Pericarditis Treatment? Test to identify? What is a complication to watch for? - ANS:->>>--Inflammation of the pericardium
AAA Screening - ANS:->>>-- 65 - 75 who have/currently smoke
- Selective screening for those that have never smoked Colorectal Screening - ANS:->>>-- 45 - 75 yrs
- Stool based test every 3 years
- Flexible sigmoid every 5yrs
- Colonoscopy every 10 yrs PSA/DRE Screening - ANS:->>>--Start at 40 yrs for men with family history or AA
- Annually for everyone else > Mammogram Screening - ANS:->>>--Annually for aged 45- 54
- Every 2 years after age 50 - 74
- For aged 75 years and older, no specific recommendations to D/C PAP Smear Screening - ANS:->>>--Begin at age 21
- Pap + cytology: age 21 - 65 every 3 years
- Cytology + HPV co-test: age 30- 65 every 5 years HPV Vaccine - ANS:->>>--Age 9 - 14 yrs, series of two 6 months apart
- Age 15-45, series of three at 0, 2, 6 months What electrolyte abnormality do you see with metabolic alkalosis? - ANS:->>>- Hypokalemia Levels of Evidence Hierarchy (highest to lowest) - ANS:->>>-1. Meta analysis2. Systematic Review
- RCTs (quantitative designs)
- Quasi-experimental (lack randomization or a control group)5. Qualitative cohort Studies
- Case controlled studies7. Editorial/expert opinion Quality Assurance (QA) - ANS:->>>--Process for evaluating the care of patientsusing established standards of care to ensure quality
- Management process of monitoring, evaluating, continuous review, and improving thequality in providing health care Continuous Quality Improvement (CQI) - ANS:->>>--Systemic process of identifying and analyzing problems and then testing, implementing, learning from andrevision solutions
- Quality can be improved by continually monitoring structure, process and outcome standards
- Structures: inputs into care such as resources, equipment, or numbers and qualifications of staff
