NURS 6550 MIDTERM EXAM 100 QUESTIONS AND ANSWERS.
Question 1
1 out of 1 points
The AGACNP is caring for a patient who is quite ill and has developed, among other things, a large right sided pleural effusion. Thoracentesis is sent for pleural fluid analysis. While evaluating the fluid analysis, t...
nurs 6550 midterm exam 100 questions and answers question 1 1 out of 1 points the agacnp is caring for a patient who is quite ill and has developed
a large right sided pleural ef
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NURS 6550 MIDTERM EXAM 100 QUESTIONS AND
ANSWERS.
Question 1
1 out of 1 points
The AGACNP is caring for a patient who is quite ill and has developed, among other things,a
large right sided pleural effusion. Thoracentesis is sent for pleural fluid analysis. While
evaluating the fluid analysis, the AGACNP knows that a fluid identified as a(n)
is the least worrisome type.
Response “A” is the correct answer. A transudate is essentially just water and
Feedback: can occur as a consequence of increased hydrostatic pressure in the
pulmonary vessels. It typically implies that the some condition has
produced an imbalance in colloid-hydrostatic pressures, such as CHF
or hypoalbuminemia. While it can represent a serious problem, it
may also represent a transient imbalance. Conversely, “B” is not
correct as an exudate has more protein in it and implies a condition
characterized by protein leaking from vessels, such as a malignancy
or some serious systemic stressor. “C” is not correct—a chyliform
effusion is characterized by fat and indicates a pathology causing
massive triglyceride degradation. “D” is not correct as a
hemorrhagiceffusion is blood and typically means traumatic injury.
Question 2
1 out of 1 points
Differentiating vertigo from near-syncope and ataxia is one of the goals of history-
taking when a patient presents as “dizzy.” The AGACP knows that vertigo is the problem
whenthe patient reports the primary symptom as:
Response “A” is the correct answer. Dizzy is a layperson’s term and can mean
Feedback: many different things to patients and health care providers. When
thepatient identifies the primary symptom as a sense of spinning
this supports vertigo, which is usually an inner ear problem. This
versus ataxia which is neurologic or near-syncope which may be
cardiac, neurological, or neurocardiogenic. “B” is not correct—this
may occur with vertigo, but when it is the primary symptom it is
most likely ataxia and neurological causes should be considered.
“C” is not correct as coincident nausea is not specific and can occur
with any of these complaints. “D” is not correct as it is also not
specific; while ataxia cannot occur when supine near-syncope can.
, Question 3
1 out of 1 points
Mr. Banks has been admitted for surgical resection of a metastatic tumor, during
surgery it is discovered that he has widespread, diffuse metastasis throughout the
abdomen.
Surgery is no longer an option, and his oncologist says that chemotherapy is unlikely
to produce any meaningful benefit. Mr. Banks is concerned that his sons will not
support atransfer to comfort care. The AGACNP advises that he:
Response “B” is the correct answer. If there is any concern about
Feedback: disagreementamong family members, or any concern at all that a
patient’s wishes will not be carried out, the best action is to ensure
that there is a clearly defined legally executed document. “A” is not
correct. Livingwills are not legally enforceable documents and when
dissention arises among family members they may not be carried
out. “C” is notcorrect - while the patient should arrange for his care
as long as he is capable of doing so, if questions arise at such a time
that he is not capable of answering his next of kin will need to do
so. “D” is not correct -- identifying the proxy is not enough without
assigning legalrights and responsibilities. While “A,” “C,” and “D”
should all be done and will support his care, the only way to ensure
that one’s wishes are carried out is to ensure that a legally
enforceable directionis in place.
Question 4
1 out of 1 points
Mr. Wilkerson is a 77-year-old male who is being evaluated and treated for his
cardiogenic pain. His vital signs are as follows: Temperature of 99.1° F, pulse of 100
bpm, respirations of 22 bpm, and blood pressure of 168/100 mm Hg. A 12-lead ECG
reveals deep ST segment depression in leads V3-V6. The AGACNP recognizes which ofthe
following as a contraindication to rTPA therapy?
Response “D” is the correct answer. rTPA is not indicated in patients with ST
Feedback: segment depression; this is not a ST elevation MI. “A” is not correct
as age > 80 is a relative contraindication. “B” is not correct as a
temperature of 99.1° F is an expected response to myocardial
necrosis, and “C” is not correct—the blood pressure is not
prohibitive until > 180/110 mm hg.
Question 5
1 out of 1 points
A 71-year-old patient is recovering from a particularly severe exacerbation of
chronic obstructive pulmonary disease. He has been in the hospital for almost two
weeks and was on mechanical ventilation for 7 days. While discussing his discharge
plan he tells
,you that he is really going to quit smoking this time. He acknowledges that he has
been"sneaking" cigarettes in the hospital for two days, but he has established a
timeline to decrease the number of cigarettes daily. According to his plan his last
cigarette will be the last day of the month. This patient’s behavior is consistent with
which stage of the Transtheoretical Model of Change?
Response “C” is the correct answer. The Transtheoretical model of change is
Feedback: characterized by 5 stages. “A” is when the patient has no intention
tomake a change. “B” is when the patient is intending to make a
change in the next 6 months. “C” is when the patient is ready to
take action or has already taken some action, as this patient has in
establishing his plan to quit by the end of the month. “D” is the
overtaction that attains a criterion sufficient to reduce disease
risk—in thispatient the action stage would be characterized by
actual smoking cessation. The final phase, not presented in the
answer choices here, is maintenance.
Question 6
1 out of 1 points
Certain subgroups of the elderly population are at an increased risk for
rapid
deterioration and long-term care placement. Which of the following is not considered a
high risk factor for long term care placement?
Response “A” is the correct answer; men are at higher risk for long-term care
Feedback: placement than women. In addition to male gender, other risk
factorsinclude age over 80, living alone, bowel or bladder
incontinence, history of falls, dysfunctional coping, and intellectual
impairment.
Question 7
1 out of 1 points
P.M. is a 71-year-old gay male patient who presents as an outpatient for evaluation
of
increasing shortness of breath. The diagnostic evaluation ultimately supports a
diagnosisof community acquired pneumonia. The AGACNP appreciates right middle
lobe consolidation on chest radiography. Pending sputum cultures, empiric antibiotic
therapymust be initiated to cover which organism?
Response Feedback:
, “ from the outpatientpopulation where the most common cause
D of pneumonia
”
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