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ACNP I MIDTERM EXAM: QUESTIONS AND A+ ANSWERS
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ACNP I MIDTERM EXAM: QUESTIONS AND A+ ANSWERS
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ACNP I MIDTERM EXAM: QUESTIONS AND A+ ANSWERSDelirium is a diagnosis of what? Right Ans - Exclusion
Significant hypoperfusion can occur in the absence of what? Right Ans -
Significant hypotension
What is the pneumonic ABCDEFG mean for altered mental status physical
exam? Right Ans - Airway/assess consciousness
Breathing
Circulation
Disability (focal neuro changes)
Exposure (mottling)
Finger stick blood glucose
Gas (arterial blood)
When diagnosing AMS we rule out what first? Right Ans - Reversible causes
Thiamine deficiency is a deficiency of what vitamin? Right Ans - B1
If your nitrogen intake is greater than your excretion it indicates what?
Right Ans - growth body building
Negative nitrogen balance occurs when Right Ans - often with illness,
trauma, starvation
intake is less than excretion
Wernicke's encephalopathy Right Ans - (Acute) A brain disorder caused by
thiamine deficiency and characterized by visual nystagmus, paralysis of extra-
ocular muscles, ataxia, somnolence, stupor, and , without thiamine
replacement, death.
Korsakoff Syndrome Right Ans - (chronic) damage to the hippocampus
leads to anterograde and retrograde amnesia, confabulation, apathy
Wrenicke's encaphalopathy can occurr quickly, especially when what?
Right Ans - dextrose is given without thiamine
,ETOH withdrawal occurs after ETOH is stopped within what timeframe and
what type of patient? Right Ans - 12-48hrs in any person who is physically
dependent on ETOH
What are the 3 signs often seen on initial ETOH withdrawal before other s/s
manifest? Right Ans - hyperthermia
hypertension
tachycardia
Benzodiazepines are the mainstay ETOH withdrawal treatment, why is this?
Right Ans - Benzo's act like GABA, which is what ETOH stimulates in the body.
D in the DELIRIUM pneumonic stands for? Right Ans - D-Drugs
E in the DELIRIUM pneumonic stands for? Right Ans - E- Electrolyte and
physiologic abnormalities
L in the DELIRIUM pneumonic stands for? Right Ans - L- Lack of drugs
(withdrawal)
I in the DELIRIUM pneumonic stands for? Right Ans - I- Infection
I- Intracranial problems (CVA, meningitis, seizure)
R in the DELIRIUM pneumonic stands for? Right Ans - R- Reduced sensory
input (blind/deaf)
U in the DELIRIUM pneumonic stands for? Right Ans - U- Urinary retention
and fecal impaction
M in the DELIRIUM pneumonic stands for? Right Ans - M- Myocardial
problems (MI, Arrhythmia, CHF)
Goals of nutrition? Right Ans - Meet metabolic needs
prevent/treat deficiencies
Resting energy expenditure (REE) Right Ans - Amount of energy expended
to digest.
Measured 2 hours post meal.
10% higher than the basal metabolic rate
, The energy to absorb nutrition.
Mechanical ventilation does what to the REE? Right Ans - Decreases it.
Creates rest in work of breathing.
Ulcers and wounds are a sign of what in relationship to nutrition? Right
Ans - deficiency
Nitrogen balance in the body should be what? Right Ans - Zero
A negative nitrogen balance is an indicator of what? Right Ans -
malnutrition
A negative nitrogen balance means what? Right Ans - The body is excreting
more nitrogen than it is taking in.
What three factors help determine the patient nutrition requirements?
Right Ans - Caloric, protein, and electrolyte requirements
The moderately stressed patients (ICU) required how many calories per day?
Right Ans - 25-30 kcal/kg/day
When do you initiate a diet for the best outcomes? Right Ans - within 48hrs
What is the heart healthy diet? Right Ans - low saturated fat, low 2GM
sodium
What is a renal diet? Right Ans - Protein, K, Na, and Phos restriction
What is a constant carb diet? Right Ans - 1800 ADA
What diet should not be used for an extended period of time as it does not
provide enough calories and nutrients? Right Ans - clear liquid and full
liquid, but full liquid is better
How much protein does your usual ICU patient require? Right Ans -
1.5gm/kg/day
Catabolism Right Ans - breaking down
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