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ACNP III Exam 3 – Questions & Accurate Solutions
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ACNP III Exam 3 – Questions & Accurate Solutions
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ACNP III Exam 3 – Questions & Accurate SolutionsWhat class of medications listed below should be avoided when dealing with
geriatric patients who have suffered musculoskeletal injuries due to concern
for adverse events?
a. NSAIDs.
b. antibiotics.
c. anti-hypertensives.
d. diabetic medications. Right Ans - a. NSAIDs.
What is the first test that should be performed when a patient presents with
signs and symptoms of an acute stroke?
a. CBC.
b. non-contrast CT head scan.
c. EKG.
d. diffusion weighted perfusion MRI brain. Right Ans - b. non-contrast CT
head scan.
You are rounding on a patient admitted to observation after experiencing a
TIA. The risk of stroke after a TIA is around 10 to 15% in the first three
months, with most events occurring in the first two days after an ischemic
stroke. Which of the following medication regimens have demonstrated the
ability to reduce the risk of stroke in patients who experienced a TIA?
a. Aspirin and Plavix
b. Aspirin and warfarin
c. Apixaban
d. Rivaroxaban Right Ans - a. Aspirin and Plavix
A geriatric male presents with a history of hypertension and falls and is
diagnosed with atrial fibrillation following a transient ischemic attack. He is
currently on antihypertensive and antiarrhythmic therapy. On discharge,
which of the following should be added to the treatment plan?
a. electrical cardioversion.
b. oral warfarin.
c. enteric coated aspirin.
,d. pacemaker placement. Right Ans - b. oral warfarin.
Glucocorticoids impair fracture healing by which of the below mechanisms:
a. they reduce bone density and impair bone metabolism.
b. they induce osteoclast apoptosis.
c. they induce osteoblast survival.
d. they increase intestinal calcium absorption and decrease renal calcium
excretion. Right Ans - a. they reduce bone density and impair bone
metabolism.
Complex Regional Pain Syndrome, or Reflex Sympathetic Dystrophy, is a
complex disorder that can occur post fracture, with or without nerve injury,
and is characterized by ALL the below EXCEPT:
a. pain.
b. vasomotor instability.
c. swelling.
d. increase bone mineralization. Right Ans - d. increase bone
mineralization.
A patient has been admitted to the ICU post intracerebral hemorrhage and
you are the ACNP on duty; presently vital signs are BP 165/86, HR 98, RR 24,
T 36.0 C. As the provider on duty, you know it is extremely important to
maintain the following parameters:
a. SBP between 130-140 mmHg
b. SBP between 150-220 mmHg
c. SBP between 100-120 mmHg
d. SBP between 90-120 mmHg Right Ans - a. SBP between 130-140 mmHg
You are caring for a patient with ALS, the patient is currently taking Riluzole
100 mg/day. The patient asks you if this will cure ALS. What is the most
appropriate response?
a. Riluzole will not cure ALS, however, it has shown to delay respiratory
failure and ventilator dependence, and lengthen the time of survival by 2-3
months
b. Riluzole, if taken daily, will prevent respiratory failure and cure ALS
,c. There is no benefit to taking Riluzole
d. Riluzole will not cure ALS, however, it has shown to delay respiratory
failure and ventilator dependence, and lengthen the time of survival by 2-3
years Right Ans - a. Riluzole will not cure ALS, however, it has shown to
delay respiratory failure and ventilator dependence, and lengthen the time of
survival by 2-3 months
Which statement is TRUE regarding Amyotrophic Lateral Sclerosis (ALS)?
a. Riluzole 50 mg every 12 hours has been shown to slow progression of
disease.
b. management of ALS is geared towards a curative outcome.
c. MRI is diagnostic for the upper motor neuron alterations seen in ALS.
d. familial ALS is more predominant in occurrence than sporadic ALS. Right
Ans - a. Riluzole 50 mg every 12 hours has been shown to slow progression of
disease.
Most strokes are due to ischemic cerebral infarction instead of brain
hemorrhage.
a. true.
b. false. Right Ans - a. true.
In a situation where a patient has increasing intracranial pressure and an
impending cerebral herniation, the Cushing triad of symptoms may be
present. Which set of symptoms below represents the Cushing triad of
symptoms?
a. increasing systolic blood pressure (widening pulse pressure), decreasing
respiratory rate and bradycardia.
b. decreasing systolic blood pressure with increasing diastolic blood pressure
(narrowing pulse pressure), decreasing respiratory rate and bradycardia.
c. increasing systolic blood pressure (widening pulse pressure), decreasing
respiratory rate and tachycardia.
d. decreasing systolic blood pressure, increasing respiratory rate and
bradycardia. Right Ans - a. increasing systolic blood pressure (widening
pulse pressure), decreasing respiratory rate and bradycardia.
, A 24-year-old male presents to the ED complaining of right knee pain with
decreased ROM and inability to weight bear after falling while playing
basketball. You have placed an order for an x-ray and as the ACNP on duty you
know to always obtain:
a. anterior-posterior (a/p) films to rule out fractures or dislocations.
b. posterior-anterior (p/a) films to rule out fractures or dislocations.
c. both a/p and p/a films to rule out fractures or dislocations.
d. a/p and lateral films to rule out fractures or dislocations. Right Ans - d.
a/p and lateral films to rule out fractures or dislocations.
Which of the following is MOST likely to cause a calcaneal fracture?
a. running.
b. fall from height.
c. osteomyelitis.
d. malignant tumor. Right Ans - b. fall from height.
A 35-year-old is working on a roof when he suddenly falls off and lands on his
feet. The patient never hit his head and did not lose consciousness. He is
brought to the ED 2 hours after falling and presents with pain in his heels and
inability to bear weight. What should be included in his workup?
a. radiographs of his heels.
b. radiographs of his heels and back.
c. c-reactive protein and erythrocyte sedimentation rate.
d. radiographs of the heels and knees. Right Ans - b. radiographs of his
heels and back.
A 38-year-old male sustained a fracture of the left distal tibia following a 25-
foot fall and is taken to the OR for an ORIF of the distal tibia. 16 hours post-up,
the patient develops sustained pain, not relieved by narcotics. On passive
ROM of the toes the patient "yells" in agony. The patient also states that the
top of his foot has decreased sensation. On physical examination the ACNP on
duty notes that the leg is swollen, and the foot is cool to touch. Based upon this
information what diagnostic testing should be done?
a. x-ray of the lower leg and ankle.
b. doppler studies.
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