NURS 6550 Advanced Practice Care of Adults in Acute Care Settings I
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NURS 6550 Midterm Exam / NURS 6550N Midterm Exam (Latest)(100 Q & A in Each Version, Verified and 100% Correct Answers)
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NURS 6550 Advanced Practice Care of Adults in Acute Care Settings I
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WALDEN UNIVERSITY
NURS 6550 Midterm Exam / NURS6550 Midterm Exam (Latest): Walden University
Walden University NURS 6550 Midterm Exam / Walden University NURS6550 Midterm Exam
1. The AGACNP is caring for a patient who is quite ill and has developed, among other things, a large right sided pleural effusion. Thoracen...
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NURS 6550 Advanced Practice Care of Adults in Acute Care Settings I
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NURS 6550 Midterm Exam
Question 1
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 can
Feedback: 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 hemorrhagic effusion is blood and typically means traumatic
injury.
Question 2
Mrs. Miller is transported to the emergency department by paramedics. She is having
profound, unremitting chest pain, is diaphoretic and pale. She has jugular venous distention
and a widened pulse pressure. Suspecting ascending aortic aneurysm, the AGACNP order
which test to confirm the diagnosis?
Response “D” is the correct answer. It is the most widely used diagnostic tool as it
, Feedback: rapidly and precisely can outline the thoracic and abdominal aorta. “A” is
not the correct answer—there are radiographic findings that suggest thoracic
aneurysm, but they need confirmation by CT. “B” is not the correct answer
as ultrasound is not nearly as precise as a CT scan. “C” is not correct—MRI
is only indicated when the patient cannot have a contrast CT.
Question 3
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 factors
include age over 80, living alone, bowel or bladder incontinence, history of
falls, dysfunctional coping, and intellectual impairment.
Question 4
A patient with anterior epistaxis has been treated with 20 minutes of direct pressure to the
cartilaginous portion of the nose. Following pressure the patient is instructed to gently blow
the nose. Expected findings in the patient who has been successfully treated include all of
the following except a:
Response “C” is the correct answer. If bleeding is successfully stopped with 20
Feedback: minutes of directed pressure, there will be residual blood and clot formation.
This is evacuated either by gentle suction or having the patient gently blow.
Residual blood and formed clot may present as a sudden gush of dark blood
or discharge with or without a clot—these are all typical expected findings.
However, if bleeding is not stopped, it will continue as a bright red steady
trickle. When this occurs, more invasive measures are indicated.
, Question 5
Kevin is a 14-year-old male who presents for evaluation of a fever of 102.5° F and
significant right ear pain. He appears quite ill and says he feels nauseous. Otoscopic
evaluation reveals pain to palpation, a very erythematous and bulging tympanic membrane
with bullous myringitis. The AGACNP knows that antibiotic therapy must be selected to
cover:
Response “D” is the correct answer. Streptococcus pneumoniae is the most common
Feedback: bacteria that infects the head and neck in immunocompetent persons, and is
the primary treatment target when treating otitis media, bacterial sinusitis,
and bacterial pharyngitis. “A” is not correct—while likely on broken skin
and soft tissue, it is not common in the ear, nose, or throat unless specific risk
factors exist. “B” is not correct—this is much more likely in an
immunocompromised patient or a patient on mechanical ventilation. “C” is
not correct—it is the second most common organism, but strep is the primary
treatment target.
Question 6
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 diagnosis of
community acquired pneumonia. The AGACNP appreciates right middle lobe consolidation
on chest radiography. Pending sputum cultures, empiric antibiotic therapy must be initiated
to cover which organism?
Response “D” is the correct answer. This patient presents from the outpatient
Feedback: population where the most common cause of pneumonia is Streptococcus
pneumoniae, and is the primary treatment target for any patient being treated
empirically. “A” is not correct—while the patient’s sexual orientation is
offered in the provided history, there is no indication that he has HIV/AIDS
or any other condition characterized by immunosuppression that would
, increase his risk for this organism. “B” is not correct, as this organism is not
typically seen in the outpatient population without specific risk, e.g.
immunosuppression or chronic ventilator therapy. “C” is not the correct
answer as this organism is not likely absent specific risk such as
instrumentation or known colonization.
Question 7
Which of the following is the greatest risk factor for vascular dementia?
Response “B” is the correct answer. Vascular dementia is a consequence of vascular
Feedback: disease, and is more likely to occur in patients with risk factors for target
organ damage, such as hypertension, dyslipidemia, and diabetes. “A” is not a
distinct risk factor for vascular dementia; it is a risk for Alzheimer’s
dementia. “C” likewise increases risk for Parkinson’s dementia, but does not
present a risk for vascular dementia. “D” is not a risk factor for vascular
dementia. Although there may be some familial risk for certain vascular
diseases that may lead to vascular dementia, there is no clear familial
tendency for this type of dementia.
Question 8
J.R. is a 55-year-old male who presents for a commercial driver’s license physical
examination with a blood pressure of 170/102 mm Hg. He has no medical history and is
without complaint. Which of the following findings constitutes hypertensive urgency?
Response “A” is the correct answer. According to the Joint National Committee (JNC)
Feedback: report, hypertensive urgency is described as hypertension in the setting of
progressive target organ damage, such as renal involvement with protein
leaking, left ventricular hypertrophy, or retinal changes. “A” is not correct—
the headache may or may not be relevant, but because there are many non-
hypertension causes, a headache alone does not constitute target organ
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