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ACNP Board (Study Guide) Review: Questions & Expert Verified Solutions
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ACNP Board (Study Guide) Review: Questions & Expert Verified Solutions
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ACNP Board (Study Guide) Review: Questions & ExpertVerified Solutions
An acute care nurse practitioner is deciding whether to recommend a long-
term medication regimen that will help a patient manage disease symptoms
but may also introduce problematic side effects. This decision reflects which
ethical principle?
Autonomy
Beneficence
Fidelity
Justice Right Ans - beneficence
A patient, who has been in the intensive care unit for 17 days, develops
hypernatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is
intubated, and is receiving mechanical ventilation. The serum osmolality is
320 mOsm/L kg H2O. Clinical signs include tachycardia and hypotension. An
acute care nurse practitioner's initial treatment is to:
reduce serum osmolality by infusing a 5% dextrose in 0.2% sodium chloride
solution.
reduce serum sodium concentration by infusing a 0.45% sodium chloride
solution.
replenish volume by infusing a 0.9% sodium chloride solution.
replenish volume by infusing a 5% dextrose in water solution. Right Ans -
replenish volume by infusing a 0.9% sodium chloride solution.
priority is to replenish the volume and the fix the osmolality
A 78-year-old male patient with heart failure develops a bacterial urinary
tract infection secondary to an indwelling Foley catheter. The patient has a
known history of allergy to penicillin and sulfonamides. The appropriate
choice for antimicrobial therapy is:
cephalexin (Keflex).
ciprofloxacin (Cipro).
doxycycline (Vibramycin).
tetracycline (Sumycin). Right Ans - ciprofloxacin (Cipro)
Cephalosporin (ceph) are "cousins" with penicillin (cross-allergy).
, Tetracyclines can cause severe side effects and are not recommended for
elderly.
An acute care nurse practitioner is evaluating a 78-year-old patient for an
aortic valve replacement. Laboratory results indicate a low serum albumin
level. The nurse practitioner prescribes a high-protein diet and evaluates the
patient's response by:
assessing the total serum protein level.
calculating the body fat percentage.
obtaining a complete blood count.
obtaining a serum prealbumin level. Right Ans - obtaining a serum
prealbumin level.
Albumin is relatively insensitive to change of nutritional status. Our body has
a large pool of albumin and it could take up to 14 days for albumin to come
back to normal once the pool is depleted. Albumin level could also be affected
by one's renal function and hydration state.
Prealbumin is one of the earliest indicator for nutritional status now.
Normal level 16-35 mg/dL
A 42-year-old patient with metastatic lung cancer is admitted with severe
intractable pain related to a pathologic fracture of the left femur. The plan is to
stabilize the fracture surgically, and begin local radiation therapy to the site.
For this patient, the most appropriate analgesic regimen is:
-fentanyl (Duragesic) transdermal system applied every 72 hours.
-meperidine (Demerol) 50 mg intramuscularly every three hours around the
clock.
-morphine sulfate (Avinza) IV via a patient-controlled analgesia pump with a
basal rate.
-oxycodone/acetaminophen (Percocet) orally every six hours around the
clock. Right Ans - morphine sulfate (Avinza) IV via a patient-controlled
analgesia pump with a basal rate.
A female patient is receiving adjuvant chemotherapy for breast cancer and has
been given information about her treatment regimen, expected side effects,
and symptom management. Which symptom, if occurring two weeks after
treatment, warrants a prompt call to the acute care nurse practitioner?
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