ANCC AGACNP Certification Exam Questions And
100% Correct Answers
What's important to know about peripheral alpha 1 antagonists? - ANSWER The -sins.
Cause vasodilation. May be used for BPH. MAY CAUSE syncope, orthostasis, headache,
nausea
What's important to know about central alpha-2 agonists? - ANSWER Like clonidine.
Cause vasodilation and slow the heart rate. Do not discontinue abruptly.
What is the fluid resuscitation goals for sepsis in the first hour? - ANWER Broad
spectrum antibiotics. Along with fluid at 30 ml/kg if hypotension or lactate > 4
What are the absolute contraindications for fibrinolytic therapy for acute STEMI? -
ANSWER - previous intracranial hemorrhage
- intracranial mass or neoplasm
- ischemic stroke within 3 months
- suspected aortic dissection
- active bleeding (including menses)
past 3 months significant closed head or facial trauma
intracranial or intraspinal surgery within 2 months
Which of the following lab tests need to be followed in patients on amiodarone?
ANSWER TFTs, LFTs, PFTs thyroid, liver, lungs
What is a pericardial knock? ANSWER What is heard in constrictive pericarditis.
The classic symptom and treatment of pericarditis is pain that improves with leaning
forward.
Indomethacin 50 mg 3x daily plus colchicine
How long should someone be on anticoagulation prior and post cardio version for afib? -
ANSWER 3 weeks prior. 4 weeks post.
,Wolff-Parkinson-White syndrome - ANSWER ventricular preexcitation syndrome.
Accessory conduction pathway from atria to ventricle (bindle of kent) bypassing AV
node. Ventricles partially depolarize early, making a delta wave on EKG-a slow rise in
the initial QRS. May lead to recurrent entry and supraventricular tachycardia.
How does one distinguish cardiac tamponade vs. constructive pericarditis - ANSWER
Cardiac tamponade: pulsus paradoxus (a decrease of BP or an increase in systemic
venous return with inspiration), hypotension, JVD, muffled heart sounds
Constrictive pericarditis: JVD, pericardial knock, Kussmaul's sign: the absence of an
inspiratory decline or increase in CVP)
Which artery is responsible for 80% of all inferior MIs? - ANSWER Right coronary artery
Cullen's sign This refers to the superficial edema and bruising that occurs around the
umbilicus. It would suggest acute pancreatitis or an intraabdominal bleed.
Obturator sign This is the passive internal rotation of the flexed hip producing RLQ pain.
Acute appendicitis can be suspected.
psoas sign -ANSWER pain produced by extension of the hip with the knee in full
extension or by flexing the hip against resistance
retrocecal appendicitis
Murphy's sign -ANSER sharp pain and arrest of inspiration during palpation of the RUQ
while the patient inspires (diagnostic of acute cholecystitis)
Which of the following medications is most commonly associated with hypoglycemia?
-ANSWER Glyburide
What is normal aortic valve diameter vs. severe aortic stenosis? - ANSWER 3-4 cm^2 is
normal. Less than 1 is severe.
,What is a Iridotomy for Glaucoma? - ANSWER Surgical incision made through cornea to
remove portion of iris to facilitate aqueous drainage (closed -angle).
Closed angle acute glaucoma what is it? -ANSWER Symptoms: unilateral headache
worst of lives, ciliary flush, photophobia and nausea. Refer to optho immediately it may
result in blindness.
What is the treatment for Chlamydia? -ANSWER Azithromycin
What is given to treat gonorrhea? -ANSWER Ceftriaxone
Diagnosis and treatment of "strawberry cervix" with green-grey discharge? -ANSWER
Trichimonas vaginitis. Use metronidazole.
What is part of the HITECH Act? - ANWER Meaningful use - e-prescribing, engaging in
health information exchange and submitting information re quality measures
What meds should be given in a carcinoid crisis? - ANWER Octreotide and
glucocorticoids
What murmur is heard with a mitral valve prolapse? - ANWER Late systolic murmur
Which lab is often positive in SLE? - ANWER Antinuclear antibody
What labs are associated with lithium use? - ANS Low sodium
Hypothyroidism
High calcium
, High glucose
Does all states require specialty certification? - ANS NOPE
What medications that cause changes in taste or smell? - ANS Levodopa, metformin,
allopurinol, ACE inhibitors, anticholinergics, anhistamines, CCBs, aldactone,
propranolol
Should you use activated charcoal with lithium? - ANS No
What are some common eye side effects of meds? Digoxin, diphenhydramine, sildenofil,
lovastatin? - ANSWER Dig - yellow vision and halos
Diphen - acute angle glaucoma
Lovastatin - lens opacity
Sildenofil - bluish tinge and ischemic optic neuropathy
What is the treatment for infective endocarditis from a prosthetic valve? - ANSWER
Ampicillin/Sulbactam and gentamicin plus rifampin
What is the most common cause of PNA in the elderly? - ANSWER Strep pneumonia
When do you order galantamine? - ANSWER Mild dementia
What is the A1C goal for adults > the age of 65? - ANSWER
What would you see on blood smear w/ ETOH and homeless? - ANSWER
Hypersegmented PMNs
What is steathorrhea? - ANSWER Loose greasy stools found in chronic pancreatitis
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