Description

1. Question: The AGACNP is called to the bedside for a patient who is in cardiopulmonary arrest. The monitor demonstrates ventricular fibrillation which will not convert despite several attempts to defibrillate at maximal voltage. While being briefed by the staff nurse on the patient medical history, he learns that the patient has a history of Cushing’s syndrome. The AGACNP recognizes that the patient is probably failing to convert due to:
2. Question: 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:
3. Question: 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:
4. Question: Truman is transferred to the emergency department by ambulance. His wife called 911 this morning because he was acting “funny” when he woke up. Both the patient and his wife went to bed last night at approximately 10:30 and everything was normal. This morning he could not communicate orally and seemed confused about how to ambulate. Upon arrival to the emergency department his vital signs are as follows: Temperature 100.9° F, pulse 89 b.p.m., respirations 14 b.p.m. and blood pressure 168/94 mm Hg. A non- contrast CT scan of the head reveals thrombotic CVA. The AGACNP know that immediate management of this patient should include:
5. Question: 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:
6. Question: Lester is a 48-year-old male who is brought to the emergency room by ambulance. Neighbors found him lethargic and confused after an episode of binge drinking. IV fluid hydration was started. He perked up and was able to participate to some extent with history taking. Physical exam revealed an area of erythema on the upper inner aspect of the left thigh. Lester does not remember any trauma or injury, but the area is extremely painful to palpation and the painful region extends several centimeters proximal to the erythema. One hour later when all diagnostic studies are available—Lester says that the pain is markedly worse. Physical exam reveals that the original area of erythema is now almost purple, and there are two erythematous spots proximal to the original site. The AGACNP is suspicious for:
7. Question: 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?
8. Question: When treating a patient with an unknown overdose or toxicity, the AGACNP knows that all of the following should be administered except:
9. Question: When ruling out meningitis in a patient, the AGACP appreciates that the spinal fluid is cloudy and the glucose content is 20 cells/microliter. This is most consistent with:
10. Question: The AGACNP knows that diagnostic findings consistent with rheumatoid arthritis include:
11. Question: 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?
12. Question: When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
13. Question: 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 afternoon and has never happened before. The lower extremities do not appear to be affected. While performing the history the AGACNP asks specific questions about the risk of:
14. Question: Justin is a 23-year-old male who is being managed for an acute manic episode. Justin was diagnosed with bipolar disorder several years ago, but his home life has been unstable and he has not been very adherent to a medication regimen. Most recently he was started on the SNRI venlafaxine by his primary care provider, which he has been taking as prescribed for about 6 weeks, but he began a manic episode a few days ago which peaked this evening. The AGACNP considers that:
15. Question: 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?
16. Question: K. is a 21-year-old patient who presents with large, silvery scales on her elbows. She says it has come, on and off for as long as she can remember—she used to use an ointment, but she doesn’t know what it was. The AGACNP examines the lesions and appreciates a + Auspitz sign. This condition will be best treated with:
17. Question: 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:
18. Question: Oliver is a 71-year-old petite Caucasian female. During a routine dexa screening she was found to have a T-score of -3.0. The AGACNP knows that the first intervention should include:
19. Question: Your patient is complaining of profound nausea and vomiting that started at bedtime last night and kept him awake all night long. Early this morning he started having abdominal cramping and explosive diarrhea. Based upon the character of symptoms you are suspicious of infection with Staphylococcus aureus. To assess risk for exposure to this organism, you ask the patient about which meal?
20. Question:T. presents complaining of acute pain in his left eye, nausea, and one episode of vomiting. He denies any significant medical problems, and says that the only medication that he takes is an occasional over-the-counter sleeping pill. Physical examination reveals a steamy red cornea and conjunctiva with a pupil that is 5 mm and not reactive to light. The AGACNP knows that diagnostic testing should include:
21. Question: 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:
22. Question: Kelly presents with an acute onset macular rash involving her entire trunk. The rash first emerged about 10 days ago on her trunk, and has now spread to the tops of her legs and arms where it stops abruptly. It does not hurt, itch, or burn. There is no edema or other skin changes—just the rash. The AGACNP asks Kelly where it started and she pointed a very distinct point just to the right of her umbilicus. She said it was just a single pale spot when it started. This first lesion was most likely a(n):
23. Question: Classic radiographic features of osteoarthritis include:
24. Question: Which of the following findings is not typically associated with testicular torsion?
25. Question: O. is a 21-year-old female who comes to the emergency department because of a severe headache. Her vital signs and neurological examination are within normal limits. She complains of a pulse-like pain in her right temple and admits that she has almost vomited. Her mother gets the same type of headache and the last time this happened R.O. took one of her mother’s prescription headache pills. They helped a lot, but this time her mother told her she had to come be evaluated. The AGACNP knows that which of the following is the appropriate action?
26. Question:T. is a 41-year-old female patient who presents with a chief complaint of “heartburn.” She says that it doesn’t really seem to be related to meals or food—it occurs at random times. She does note, when asked, that it seems to happen a lot at night and occasionally wakes her up. Her only other symptom complaint is an occasional cough. It does not produce mucus, and she admits to assuming it was a “nervous” cough. The next appropriate action for the AGACNP would be to:
27. Question: Which of the following is a true statement with respect to patching a corneal abrasion?
28. Question: Knickerson is a 77-year-old female admitted for management of urinary tract infection. Her complete blood count reveals a white blood cell differential as follows: Total leukocyte count 57,000 cells/uL, neutrophils of 16%, lymphocytes 77%, monocytes 3%, eosinophils 3% basophils 1%. The AGACNP is suspicious for:
29. Question:T. is a 76-year-old patient admitted with a diagnosis of acute diverticulitis. An abdominal radiograph is negative for free air, and the patient is admitted for medical therapy. The AGACNP orders all of the following except:
30. Question: Crystal K. is a 13-year-old female who arrives in the emergency room with her mother. Mom says she has not felt well for the last day or two, but today she is very weak and feels sick to her stomach. Serum glucose is 529 mg/dL, serum ketones are present, and the bicarbonate level is 8 mEq/dL. Crystal’s pH is 7.14. Crystal was rapidly infused 1 L of normal saline solution. The next step in her care is to:
31. Question: When performing an evaluation of a patient following seizure activity, the AGACNP knows that the most important component of that evaluation is:
32. Question: When performing an evaluation of a patient following seizure activity, the AGACNP knows that the most important component of that evaluation is:
33. Question: Sandoval is a 72-year-old female who presents with a chief complaint of transient verbal confusion. She was speaking with her friend on the phone this morning when she suddenly couldn’t get words out. Her friend went over to her home and found Mrs. Sandoval awake, alert, and oriented, responding appropriately with non-verbal gestures, but she could not properly articulate her thoughts. By the time she arrived at the office this had passed, although during the examination she appeared to have infrequent difficulty finding a single word. The patient denies any contributory medical history, but a 12-lead ECG in the office reveals atrial fibrillation with a ventricular response of 91 b.p.m. The blood pressure is 140/94 mm Hg; remaining vital signs are normal. The AGACNP knows that management should include:
34. Question: An unidentified patient is brought to the emergency department by ambulance after being hit by a motor vehicle. She has multiple injuries and an estimated blood loss of 2 liters. The hematocrit is 19%. The AGACNP expects that the mean cell volume (MCV) would most likely be:
35. Question: Patients with diabetes insipidus will have significant volume loss, but it is usually a self-limiting condition. Many patients are successfully treated with fluid support. For those who need the next level of care, which is the indicated agent?
36. Question: Livingston is a 79-year-old male who presents from a long term care facility with a change in mental status. His medical history is significant for T2DM, CAD, CHF, hypothyroidism, Alzheimer’s dementia and osteoarthritis. He has been stable, but over the last few days the staff say he has been a bit disconnected. This morning he was found in his bed in a stuporous state. His vital signs include a temperture of 98.9° F, pulse of 103 b.p.m., respiratory rate of 20 b.p.m., and a blood pressure of 92/64 mm Hg. His metabolic panel demonstrates a Na+ of 129 mEq/L, K+ of 3.3 mEq/L, Cl- of 100 mEq/L, CO2 of 24 mEq/L, glucose of 644 mg/dL, BUN of 51 mg/dL and creatinine of 1.9 mg/dL. The AGACNP knows that the primary problem is most likely:
37. Question: Karen N. presents with a series of red lesions on her right arm. The one she indicates as first lesion—appeared several days ago, and is now red, painful and fluctuant to palpation. Three smaller ones have erupted and although they don’t hurt yet, she is afraid they will get bigger. The AGACNP knows that which antibiotic is most appropriate after incision and drainage?

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38. Question: Marianne is a 48-year-old female who is hospitalized for stabilization after having a serious dysrhythmia during an outpatient cosmetic procedure. This evening the AGACNP is called to the bedside because the patient is having a seizure. Upon arrival at the bedside, Marianne is indeed having tonic-clonic activity and is not responding verbally. The drug of choice in this circumstance is:
39. Question: Which of the following etiologic organisms is most likely to appear as lobar consolidation on chest radiography?
40. Question:W. is an 18-year-old male who is being managed in the emergency department for an acute asthma exacerbation. He says that he has been using his maintenance inhalers as
41. Question: The diagnostic study of choice in mesenteric ischemia is:
42. Question: Patients with giant cell arteritis are at increased risk of:
43. Question: A patient diagnosed with acute bacterial sinusitis started antibiotic therapy with amoxicillin/clavulanic acid 875/125 mg b.i.d. three days ago. He returns today and reports
44. Question: The AGACNP is evaluating 29-year-old female who presents by ambulance and is unresponsive. There is no witness and no history available; the patient is not wearing any sort of medic alert bracelet. While assessing for toxicity or overdose, the patient is found to have vital signs as follows: Temp of 96.2° F, pulse of 48 b.p.m., respirations of 10 b.p.m., and blood pressure of 84/50 mm Hg. The patient’s pupils are constricted, but do react briskly to light to 1 mm. The AGACNP suspects which type of substance?
45. Question: 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:
46. Question: A 44-year-old male patient presents in a hypertensive crisis. The blood pressure is 240/136 mm Hg, pulse is 128 b.p.m. and the patient is complaining of a severe, pounding headache. His skin is diaphoretic and he is visibly tremulous. The first diagnostic study to evaluate the suspected diagnosis should be a:
47. Question: Maxwell is a 58-year-old male who presents with left foot pain. Physical examination reveals a foot that is normal in appearance with DP and PT pulses that are barely audible by Doppler. The AGACNP has the patient cross the leg with the left foot resting on the right knee; after 30 seconds that left foot is briskly lowered to the floor. Instantly the left foot turns bright red. This is known as:
48. Question: The AGACNP diagnoses a patient with pityriasis rosea. Laboratory testing should include:
49. Question: Felty’s syndrome is a condition of immune neutropenia seen sometimes in patients with:
50. Question: Clinically relevant differences between delirium and dementia include all of the following except:
51. Question: Riley is a 61-year-old male who just had bilateral knee replacements. There was more fluid loss than intended during the procedure. The AGACNP knows that metabolic alkalosis is the most common postoperative acid-base imbalance and is best treated with:
52. Question: All of the following are true statements about post-traumatic stress disorders (PTSD) except:
53. Question:P. is a 76-year-old male admitted for antibiotic management of urosepsis. His medical history is significant for a CVA with resultant right-sided hemiparesis. He is nonverbal, maintained on enteral nutritional support and has an indwelling Foley catheter. The AGACNP knows that which of the following bacteria is the primary treatment target for this patient’s urosepsis?
54. Question: Glassman is a 55-year-old female who presents with a chief complaint of fever. Her vital signs reveal a temperature of 100.0° F, blood pressure of 100/60 mm Hg, pulse of 114 b.p.m. and respirations of 20 b.p.m. Her cardiac auscultation reveals a grade III/VI systolic murmur at the left lower sternal border. Her history is significant for an eyebrow lift 4 months ago. The AGACNP orders which test to confirm the suspected diagnosis?
55. Question: A 27-year-old female patient is newly diagnosed with herpes simplex virus (HSV) 2 following an initial outbreak. In teaching the patient about her disease process, the AGACP tells the patient that:
56. Question: A patient presents with acute onset of vesicular lesions on her vulva. They are surrounded by areas of redness and they hurt. The patient says that she has even more of them now then she did when she woke up this morning. There is also inguinal lymphadenopathy. The AGACNP is suspicious for:
57. Question: Hogle is a 65-year-old male patient who presents with a burning-type discomfort in the epigastrum. He notices it most at night, but says that sometimes he appreciates it when he is really hungry. It actually seems to get better when he eats. His vital signs are all within normal limits. A stool for occult blood is negative. His CBC reveals an Hgb of 10.1 g/dL and hematocrit of 30%. The MCV is 74 fL. The AGACNP knows that the next appropriate step is to order:
58. Question:O. presents complaining of significant left lower quadrant pain. Physical examination reveals a tender left lower quadrant with no rebound or guarding. The patient has a temperature of 100.9° F. Stool is hemoccult negative. The AGACNP knows that the appropriate imaging study to confirm the diagnosis is:
59. Question: In a patient with no exposure to gonorrhea, most common cause of septic joint is:
60. Question: 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 body stiffness, but seems to get better after an hour or so of activity. When considering a diagnosis of polymyalgia rheumatica, laboratory assessment may be expected to reveal:
61. Question: S. is a African-American female who presents for a wellness examination. Her medical history is significant for beta thalassemia minor. Anticipated red blood cell differential would include which of the following patterns?
62. Question: When beginning pharmacotherapy for depression, the AGACNP discusses with the patient that a primary safety consideration includes the:
63. Question: Management of patients in Addisonian crisis must center upon which of the following?
64. Question: Denise is a 45-year-old female who presents with significant lower abdominal pain. It started a few days ago and has just gotten steadily worse. She denies any hematuria or dysuria, but when she voids she feels like “everything is coming out. A physical examination reveals an abdomen that is tender to palpation but there is no guarding or rebound. Her vital signs are stable excepting a temperature of 100.9° F. The next step in the evaluation must include:
65. Question: A 53-year-old male is being evaluated in clinic for a chief complaint of fever and fatigue. Physical examination is non-specific—the vital signs are: Temperature 102.2° F, pulse 121 b.p.m., respiratory rate 28 b.p.m., and blood pressure of 128/84 mm Hg. He is alert and conversant, not acutely distressed, but clearly does not feel well. Lungs auscultate for generally decreased breath sounds diffusely. The cardiac exam is significant only for tachycardia—there is no murmur or extra heart sound. The abdomen is benign. The lower extremities are without pain or edema, but the AGACNP does appreciate scattered discrete violaceous lesions ranging from 0.5 cm to 1 cm on both lower legs. The AGACNP takes which of the following actions?
66. Question: Amy is a 21-year-old female who presents with acute nephrolithiasis. CT scan reveals a 2 mm stone in the left ureter. The AGACNP knows that the appropriate course of action is:
67. Question: Jeff S. is a 40-year-old male who is HIV positive. He has been on a variety of antiretroviral cocktails over the last few years, and has been intermittently compliant. Today he presents for follow-up and reports that he has been adherent with his current cocktail for the last 3 months. Today his CD4+ count is 367 cells/uL and his viral load is 5,500 copies. The appropriate course of action is to:
68. Question:T. is a 49-year-old male being admitted for lung volume reduction surgery. His preoperative pulmonary function tests are as follows: FVC 66% predicted, FEV1 60% predicted, PEFR 69% predicted, TLC 104% predicted, RV 90% predicted….. The AGACNP knows that the pulmonary function studies are consistent with:
69. Question: Which among the following gastrointestinal disorders is most commonly associated with nausea?
70. Question: Lucas is a 14-year-old male who presents with acute onset right sided scrotal pain. Physical examination reveals an adolescent male in severe pain with an edematous right scrotum. He also reports associated nausea and two episodes of vomiting. The cremasteric reflex is absent . The AGACNP knows that immediate intervention must include:
71. Question:Q. is a 45-year-old male who had gastric bypass surgery 18 months ago. A CBC reveals a macrocytic anemia with a Hgb of 9.8 g/dL, HCT of 30%, MCV of 115 and RDW of 19%. The AGACNP suspects which type of anemia?
72. Question: According to the JNC VIII criteria, a patient with a new diagnosis of hypertension who has comorbid chronic kidney disease should be started on which of the following classes of medications?
73. Question: A patient with peptic ulcer disease is admitted to the hospital with significant upper abdominal discomfort. She has guarding and rebound tenderness on examination. Abdominal radiography demonstrates free air in the abdomen. The AGACNP knows that the immediate priority is to:
74. Question: 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:
75. Question: Summer is a 63-year-old female who presents for colicky abdominal pain and distention. Her abdomen is very distended and she appears quite uncomfortable. Her vital signs are stable, but a metabolic panel suggests mild volume contraction. During her history Mrs. Summer admits she has not had a bowel movement in 15 days, and she is not sure when she last passed gas. The radiographic evaluation should begin with
76. Question: According to the World Health Organization’s step-wise approach to pain management, initial approaches to step 2 might include all of the following except:
77. Question: A patient with chronic kidney disease  presents  with  an  eGFR  of  30 mL/min/1.73m2. The AGACNP knows that the most compelling implication of this value is: A Control of risk factors for renal
78. Question: A patient with pelvic inflammatory disease has not responded well to outpatient therapy and is admitted for higher level support. The AGACP expects that the patient’s admitting CBC will demonstrate leukocytosis with:
79. Question: The AGACNP knows that which of the following is an essential component of transient ischemic attack (TIA) diagnosis?
80. Question: A patient is seen in a follow-up 12 weeks after being started on levothyroxine, 75 mcg daily. Today the patient reports feeling well and offers no complaints. Vital signs are normal. Serum TSH is 5.7 mIU/L. The next step in the management of this patient is to:
81. Question: R. is a 54-year-old male patient who was admitted for the management of cellulitis and treated with parenteral antibiotics. He has not been responding as well as anticipated. During today’s exam the AGACNP appreciates a couple of changes. All of the following indicate the need for immediate surgical evaluation except:
82. Question: A patient newly diagnosed with HIV is asking questions about the disease process and the medications that she should be taking. She has been doing some reading and she is concerned about opportunistic infection, and wants to know if she should start taking medication to prevent them. The AGACNP advises that in accordance with CDC recommendations antibiotic prophylaxis should begin:
83. Question: Quigley is a 55-year-old male who has been admitted for management of an acute hypertensive emergency secondary to alcohol withdrawal. After being treated with IV benzodiazepines and antihypertensives his condition has stabilized. This morning’ complete blood count is as follows: Hgb 9.7 g/dL, Hct 29%, MCV 1065 fL, RDW 18%…. The AGACNP knows that appropriate treatment will include:
84. Question: 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?
85. Question: Jan is a 39-year-old female who presents with significant right upper quadrant pain of 18 hours duration. She admits to a few episodes of vomiting. She right upper quadrant pain to palpation but the ultrasound is negative. Jan admits that this has happened before, usually when she “eats a huge meal.” The AGACNP orders which diagnostic study to confirm the diagnosis of cholecystitis?
86. Question:When examining a patient with a skin presentation suggestive of necrotizing fasciitis, the AGACNP knows that the most important and sensitive diagnostic test is:
87. Question: All of the following are required for a diagnosis of systemic inflammatory response syndrome (SIRS) except:
88. Question: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:
89. Question: The “Rule of 2s”—in fracture imaging assessment and management—is commonly employed as a reminder to include certain key acts: “two views” means that at a minimum two views, anterior-posterior and lateral, should be employed to diagnosis fracture. “Two joints” means:
90. Question: Which of the following is a true statement with respect to the assessment or management of a COPD exacerbation?
91. Question: A medical-surgical nurse presents for annual TB screening. A 2-step TB test produces an induration of 12 mm. The AGACNP knows that the next step in her care is:
92. Question: Heather is a 51-year-old female who is admitted for inpatient support of worsening liver function. She has chronic hepatitis B and has been infected now with hepatitis D. She has significant ascites and when you examine her you appreciate a respiratory rate of 28 b.p.m. Heather reports subjective shortness of breath with even minimal exertion such as getting out of bed. Which of the following actions is indicated?
93. Question: 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:
94. Question: Jackson R. is a 42-year-old male who presents for evaluation of headache. Which of the following history of present illness findings suggests that there is an underlying secondary cause of his headache pain?
95. Question: 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?
96. Question: Physical examination findings in a patient with pneumothorax is likely to reveal:
97. Question: Nixon is a 58-year-old male who presents to the emergency department complaining of substernal chest burning and discomfort. He has no significant medical history and takes no daily medications. He gets some relief from a GI cocktail. The 12-lead ECG demonstrates non-specific ST-T wave changes in leads V4-V6 and lead I. The AGACP knows that in accordance with standard of care the next step in the assessment and management of this patient would include:
98. Question: A 71-year-old male patient with lung cancer is admitted for treatment of sepsis related to his chemotherapy-induced immunosuppression. He seems to be improving from an infectious perspective, but during today’s assessment the AGACNP appreciates coarse rales in the lung fields, a blood pressure of 140-100 mm Hg, a bounding pulse, and trace pretibial edema. The urine output via Foley catheter has only been 100 mL in the last 8 hours. Suspicious for syndrome of inappropriate antidiuretic hormone (SIADH), the AGACNP orders a basic metabolic panel anticipating which of the following abnormalities?
99. Question: Which of the following signs is expected in patients with cholecystitis?
100. Question: Differential diagnosis of hematuria include all of the following except:
101. Question: 152: When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?