A Carotid Endarterectomy

QUESTION 1

1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter was inserted intraoperatively and remains in place. His urine output has declined markedly despite continued IV fluid infusion. Today his morning labs reveal a BUN of 19 mg/dL and a creatinine of 2 mg/dL. A leading differential includes:

A.

Foley lodged in the urethra causing post-renal failure

B.

Decreased renal perfusion causing prerenal failure

C.

Age-related decreased eGFR causing prerenal failure

D.

Post-surgical rhabdomyolysis causing intrarenal failure

QUESTION 2

1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is weak, diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb black female who is awake, alert, and oriented, anxious, with moist skin and racing pulse. Her blood pressure is 140/100 mm Hg. Temperature and respiratory rate are within normal limits. The patient admits to having a “thyroid condition” but she never followed up on it when she was advised to see an endocrinologist. The AGACNP anticipates a diagnosis of:

A.

Hashimoto’s thyroiditis

B.

Cushing’s syndrome

C.

Grave’s disease

D.

Addison’s disease

QUESTION 3

1. Systemic lupus erythematosis (SLE) is a multiorgansystem autoimmune disorder that can prevent with a wide variety of manifestations. Which clinical triad should prompt an evaluation for SLE?

A.

Fever, normal white count, elevated sedimentation rate

B.

Hyperkalemia, hyponatremia, low blood pressure

C.

Leukocytosis, hyperglycemia, hypokalemia

D.

Joint pain, rash, fever

QUESTION 4

1. A patient presents with profound vertigo of acute onset yesterday. She can barely turn her head without becoming very vertiginous; she is nauseous and just doesn’t want to move. This morning when she tried to get out of bed she felt like she was pushed back down. The vertigo is reproducible with cervical rotation. The patient denies any hearing loss or tinnitus, she has no fever or other symptoms. The AGACNP knows that the most helpful intervention will probably be:

A.

Meclizine

B.

Diazepam

C.

Bed rest

D.

Epley’s maneuvers

QUESTION 5

1. Mrs. Mireya is an 85-year-old female who is admitted for evaluation of acute mental status change from the long term care facility. She is normally ambulatory and participates in lots of facility activities. Today a nursing assistant found her in her room, appearing confused and disconnected from her environment. When she tried to get up she fell down. Her vital signs are stable excepting a blood pressure of 90/60 mm Hg. The AGACNP knows that the most likely cause of her symptoms is:

A.

Osteoarthritis

B.

Drug or alcohol toxicity

C.

Hypotension

D.

Urosepsis

QUESTION 6

1. A patient with SIADH would be expected to demonstrate which pattern of laboratory abnormalities?

A.

Serum Na+ 119 mEq/L, serum osmolality 240 mEq/L, urine Na+ of 28 mEq/L, urine osmolality of 900 mOsm/kg

B.

Serum Na+ 152 mEq/L, serum osmolality 315 mEq/L, urine Na+ of 5 mEq/L, urine osmolality of 300 mOsm/kg

C.

Serum Na+ 121 mEq/L, serum osmolality 290 mEq/L, urine Na+ of 7 mEq/L, urine osmolality of 850 mOsm/kg

D.

Serum Na+ 158 mEq/L, serum osmolality 251 mEq/L, urine Na+ of 20 mEq/L, urine osmolality of 420 mOsm/kg

QUESTION 7

1. Sean is a 29-year-old male who presents to the emergency department for evaluation and treatment of foreign body in the eye. Ophthalmic anesthesia is achieved and removal is attempted unsuccessfully with a moist cotton tipped swab. A wet fluorescein stain is applied to the lower eyelid, and a corneal abrasion ruled out but the AGACNP notes a positive Seidel sign. This indicates

A.

Penetration of the cornea with resultant aqueous leak

B.

A rust ring remnant due to metal foreign body

C.

An elevated intraocular pressure

D.

Paradoxical pupil dilation in response to light

QUESTION 8

1. Mrs. Lowen is an 82-year-old female who comes to the emergency department for evaluation of a fever of 102.9° F. She complains of a headache in the right side of her temple and some right-sided jaw pain. A urinalysis, chest radiograph, complete blood count (CBC) and 12-lead ECG are all non-contributory. A comprehensive metabolic panel is significant only for a slightly elevated BUN and creatinine. The AGACNP appreciates distinct right temple tenderness to percussion. Which laboratory test is necessary to support the suspected diagnosis?

A.

An erythrocyte sedimentation rate

B.

A white blood cell differential

C.

Two sets of blood cultures

D.

Echocardiography

QUESTION 9

1. Ms. Schiebel, a 31-year-old female who is brought to the emergency department by police after being arrested for disruptive behavior in a public establishment. The differential diagnosis includes drug and alcohol ingestion/toxicity, central nervous system disease, severe trauma, and psychotic illness; ultimately the alcohol and toxicology screen as well as head imaging are negative. When considering psychotic illness, the AGACP knows that this is a physiologic imbalance that typically involves an excess of:

A.

Serotonin

B.

Norepinephrine

C.

Acetylcholine

D.

Dopamine

QUESTION 10

1. Mr. Lincoln is a 55-year-old male who was admitted for management of sepsis secondary to pneumonia. He has declined rapidly, and today chest radiography demonstrates a diffuse, bilateral “white-out” appearance. His paO2 is 55 mm Hg. In order to increase his oxygenation the AGACNP knows that which of the following interventions is indicated?

A.

Increased FiO2

B.

Increased respiratory rate

C.

Increased tidal volume

D.

Increased PEEP

QUESTION 11

1. A 29-year-old female patient presents with a complaint of palpitations. Physical examination reveals an essentially healthy female with no significant medical history and no maintenance medications; the only thing she can report is that she had a head cold a week or so ago. The vital signs include a blood pressure of 139/90 mm Hg, pulse of 105 b.p.m, respiratory rate of 16 b.p.m. and a temperature of 98.6° F. The only abnormal finding on physical examination is diffuse anterior neck tenderness with thyroid palpation. The AGACNP considers which medication for symptom control?

A.

Ibuprofen

B.

Pseudoephedrine

C.

Propranolol

D.

Methimazole

QUESTION 12

1. Jennifer is an 18-year-old homeless female who was found unresponsive. She was admitted to the hospital for management of severe bleeding after a spontaneous abortion escalated to a uterine hemorrhage. An underlying infection and dehydration were corrected and nutritional supplements were started. Her volume status is stable, morning labs were all within normal limits and she is to be discharged today. When the AGACNP enters the room to prepare the patient for discharge, she finds her agitated, pale, and diaphoretic with vital signs to include a pulse of 105 bpm, respirations of 24 bpm, blood pressure of 110/76 mm Hg and a temperature is 97.9° F. The most appropriate action would be to:

A.

Order a CBC to assess for recurrent bleeding

B.

Request and abdominal CT to assess for bleeding

C.

Evaluate the patient for anxiety/panic attack

D.

Prescribe alprazolam 1 mg now

QUESTION 13

1. Physical examination findings in a patient with pneumothorax is likely to reveal:

A.

Increased tactile fremitus

B.

Low grade temperature

C.

Hyperresonance to percussion

D.

Egophany

QUESTION 14

1. Mr. Parker brings his 73-year-old wife to a clinic appointment because he is worried about her. She has a long history of hypertension and dyslipidemia, but he says she has taken medication for years and everything has been OK. His concern today is that for a long time she has been very forgetful, and he has tried to help her by keeping a strict routine around the house. Over the past few months, she just seems more and more forgetful, does not seem interested in doing anything, and now seems to be forgetting how to do simple everyday tasks. Yesterday she could not figure out which dollar bills to use at the store to pay the cashier. The AGACNP knows Mrs. Parker should first be screened for:

A.

Depression

B.

A brain tumor

C.

Hypothyroidism

D.

Adrenal dysfunction

QUESTION 15

1. M.R. is a 40-year-old female who has a known history of peptic ulcer disease. She has been admitted through the emergency room with a diagnosis of GI bleeding—she is vomiting dark blood and had a nasogastric tube placed. When attached to low intermittent suction it initially drained 400 cc of dark brown/black drainage, but now it is starting to drain lighter red colored blood. The AGACNP knows that immediate priorities of care include:

A.

Ensuring hemodynamic stability

B.

Beginning a parenteral proton pump inhibitor

C.

Beginning gastric lavage

D.

Ordering a gastrointestinal consult

QUESTION 16

1. A patient with sharp, stabbing chest pain directly over the precordium has a 12-lead ECG that demonstrates concave ST-T wave elevations in leads II, III, avR, avL, avF, and all six precordial leads. The AGACNP expects which physical finding?

A.

A grade IV/VI systolic murmur with radiation to the axilla

B.

A split S2 that increases with inspiration

C.

A pericardial friction rub

D.

An S4 heart sound

QUESTION 17

1. J.Q. is a 45-year-old male who had gastric bypass surgery 18 months ago. A CBC reveals a macrocytic anemia with aHgb of 9.8 g/dL, HCT of 30%, MCV of 115 and RDW of 19%. The AGACNP suspects which type of anemia?

A.

Iron deficiency

B.

Sickle cell anemia

C.

Pernicious anemia

D.

Anemia of chronic disease

QUESTION 18

1. Megan K. is a 21-year-old female who presents complaining of irritated eyes. She says this happens a couple of times a year and this time it is really a problem. Both eyes are itchy and red and she has a lot of stringy discharge, especially at the end of the day. Her visual acuity is 20/25 OS, OD, and OU with her glasses on. Physical exam reveals injected conjunctiva bilaterally but there is no photophobia. Pupils are equal, round, briskly reactive, and accommodate. The AGACNP knows that immediate treatment should include ophthalmic application of:

A.

Steroids

B.

Antihistamine

C.

Antibiotic

D.

Cycloplegic

QUESTION 19

1. Ellen is a 61-year-old female who presents with a chief complaint of neck pain. The history of present illness reveals that Ellen felt as though a bug bit her behind the neck a few days ago. A day or two later it started to hurt, and when she began to pick at it she felt drainage come out. She is here now for evaluation. Physical exam reveals an 8 cm x 8 cm draining abscess in the right post auricular region with posterior cervical lymphadenopathy. Ellen has a temperature today of 101.9° F. The AGACNP knows that in addition to incision and drainage of the abscess, effective management must include:

A.

Systemic antibiotics

B.

Tetanus immune globulin

C.

Tetanus toxoid

D.

Antipyretics

QUESTION 20

1. A 13-year-old male presents with a chief complaint of ear drainage. The patient and his mother both indicate that the patient has not had any pain or any systemic complaints, but the pus-like discharge from the ear is very persistent. According to Mom they went to a retail clinic two weeks ago and the patient was prescribed both oral antibiotics and ear drops, but it didn’t help. Physical exam of the ear reveals a painless pinna; otoscope exam reveals only a large amount of mucopurulent drainage—the tympanic membrane could not be visualized. The AGACNP knows the diagnosis is most likely:

A.

Acute otitis media

B.

Acute otitis externa

C.

Cholesteatoma

D.

Otitis media with effusion

Nursing homework help.

Mypaperwriterspro.com

Order NOW to get 15% Discount!

Pages
{{total || ""}}

Why Choose Us

Top Quality and Well-Researched Papers

Keeping in mind your instructions and guidelines, our writers ensure to do extensive research before beginning to write. Unique and quality paper is our top priority.

Professional and Experienced Academic Writers

Our team of writers and editors have many years of experience in academic writing. They are native English speakers and able to handle any academic task with ease.

Free Unlimited Revisions

We offer free unlimited revision to our clients. Whenever you feel the need to revise your work submit to our able editors. Our editors will ensure that your paper will be revised to meet your guidelines.

Prompt Delivery and 100% Money-Back-Guarantee

As a team we work hard to ensure a timely delivery of your papers. All you need to do is specify the time frame that you want you paper be submitted. We will work round the clock to beat the deadline.

Original & Confidential

We value your confidentiality and all our payment method are secure. We also use high end writing tools to ensure that all papers delivered are unique.

Customer Support 24/7

Our customer support team are available 24/7 to accept your orders and queries. We are committed to provide you with the best customer experience.

What Our Paper Writing Service Guarantees

You do not have to worry on what to expect because at mypaperwriterspro.com we guarantee you;

High Quality Academic Papers

Our team of writers and editors is composed of people with diverse writing experiences. All of them have a Ph.D. They are all Ph.D. or M.A. graduates with extensive experience in academic and essay writing. We offer high-quality, original academic writing at an affordable cost.

Every order is written from scratch. We ensure that your papers conform to English conventions and the requirements of your discipline. To ensure originality, we also perform originality checks on all academic papers. Our success rate is 99% and many of our clients achieves their desired grades.

Zero-plagiarism policy

Mypaperwriterspro has a strict anti-plagiarism policy. To ensure that your paper is not flagged as plagiarism, we take extra precautions when writing it. Professional plagiarism detection software is used by our custom paper experts.

Privacy Policy

Mypaperwriterspro takes the privacy of clients' information very seriously. Mypaperwriterspro does not disclose any information about our transactions with third-party services. Nobody will ever know that you have hired our paper writing service to help with your paper.

Our website offers online security for our customers. Your passwords and personal information are protected and cannot be accessed by anyone else. Our customers are assured that their accounts will not be compromised by hackers. Learn more about the data that we store and how it is used in our privacy statement.

Free revision

When you order our paper service, you get unlimited free revisions and unlimited drafts. We will ensure that you submit flawless papers. Our paper help website allows you to request multiple revisions.

If the order form indicates that modifications or adjustments are required, only those should be made. These guidelines include, but are not limited to:

  • Revision instructions should not conflict with your original instructions.
  • You can request a modification before the purchase is approved. However, there is a 14-day grace period in which you can do this.
  • You should not extend your deadline by more than one day from the original deadline.
  • 24/7 Customer Support

    You can reach us by email, phone, and live chat. We are always interested in hearing from our customers. We welcome any feedback regarding our paper assistance service. Our customer service representatives are available 24/7, even on holidays and weekends. They can help you place orders, check the status of your order, answer questions, or simply provide information.

    Chat with your paper specialist via our live chat. Our professionals are available for unlimited chats. All your questions will be answered within minutes

    Money-back guarantee

    Do you still feel dissatisfied with your final paper? Don't worry. Mypaperwriterspro is committed to customer satisfaction.

    Although it is rare, you can request a partial or full refund if your final paper is not written to your satisfaction. Mypaperwriterspro views our money-back guarantee more as a right than a benefit.

    We believe that our clients deserve the best paper services available online. We offer a simple and straightforward refund process if you are not satisfied with the paper.

    Open chat
    You can now contact our live agent via Whatsapp via +1(954) 751-1024
    You will get free custom written paper ready for submission to your Blackboard