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BOARD EXAM questions –
Random Questions with
Accurate Answers
- What kind of biopsy does the adult-gerontology acute care nurse practitioner perform to evaluate cytology, only, in the tumor? Core. Excisional. Fine needle. Incisional. correct answer 39 y/o with no hx of DM but family hx of noninsulin DMII has a fasting glucose level > 145 while in hospital for acute pyelonephritis. A HbgA1c = 8.1. What is the next best action in pt's plan of care? correct answer Discuss lab results, new dx, needed lifestyle changes, and medical treatments ... and answer questions. 62y/o male is postop day #1 after CABG. Has HTON, pulsus paradoxus, no UOP. POCUS echo shows R systolic collapse. Diagnosis is? a. barotrauma b. dissecting AAA c. hemorrhage d. cardiac tamponade correct answer d. cardiac tamponade 74 y/o woman fell on ice, landing on butt. c/o tailbone pain. Xray confirms dx of nondisplaced coccyx fracture. Best treatment is? a. admit for emergent ORIF to ortho service
b. D/c home with analgesic and bedrest for 3-4 wks with hips flexed and abducted c. ortho consult with hare splint application d. admit to ortho service for eval and treatment correct answer b. D/c home with analgesic and bedrest for 3-4 wks with hips flexed and abducted
- usually heals on own. f/u with ortho if pain continues A 15-year-old patient with type 1 diabetes mellitus reports elevated blood glucose levels in the morning. The adult-gerontology acute care nurse practitioner determines that the patient's hyperglycemia is due to the dawn phenomenon and: a. increases the insulin dosage at bedtime. b. reduces the insulin dosage at bedtime. c. tests the blood glucose level at 3 a.m. every morning. d. tests the blood glucose level in the evening. correct answer a. increases the insulin dosage at bedtime. A 32-year-old patient who underwent an open splenectomy for a ruptured spleen is preparing for discharge. An adult-gerontology acute care nurse practitioner reviews the potential complications with the patient. The nurse practitioner emphasizes which instruction to the patient? Continue antibiotics for 14 days. Follow up with primary care provider for vaccinations. No international travel for five years. No weight lifting restrictions. correct answer A 40-year-old female patient with no previous medical history is admitted with bilateral pulmonary emboli. The workup reveals a positive result for lupus anticoagulant, and anticoagulant therapy is planned. The patient verbalizes concern about her ability to manage the appointments and the follow- up care. The adult-gerontology acute care nurse practitioner's most effective intervention is to: arrange follow-up appointments for the patient at the warfarin (Coumadin) clinic and with the primary care provider after discharge.engage in active listening and reassure the patient that the patient will be able to manage her own care.reassure the patient that warfarin (Coumadin) therapy is quite
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: a. cephalexin (Keflex). b. ciprofloxacin (Cipro). c. doxycycline (Vibramycin). d. tetracycline (Sumycin). correct answer b. ciprofloxacin (Cipro). A patient has fully recovered from septic shock due to bacteremia. The patient has been accepted to a long-term acute care facility for continuation of antibiotic therapy. The infectious disease physician has not seen the patient in two days. The adult-gerontology acute care nurse practitioner: a. contacts the physician to determine the appropriate duration of antibiotic therapy. b. notifies medical staff services that the physician has not seen the patient. c. waits for the physician to come see the patient. d. writes transfer orders for the patient. correct answer A patient has fully recovered from septic shock due to bacteremia. The patient has been accepted to a long-term acute care facility for continuation of antibiotic therapy. The infectious disease physician has not seen the patient in two days. The adult-gerontology acute care nurse practitioner: contacts the physician to determine the appropriate duration of antibiotic therapy. notifies medical staff services that the physician has not seen the patient. waits for the physician to come see the patient. writes transfer orders for the patient. correct answer A patient has hyperactive reflexes of the lower extremities. The adult-gerontology acute care nurse practitioner assesses for ankle clonus by:
a. applying a low-pitched tuning fork firmly to the lateral malleolus. b. sharply dorsiflexing and maintaining the foot in this position while supporting the knee. c. striking the Achilles tendon with the percussion hammer after flexing the leg at the knee and rotating it externally. d. stroking the lateral aspect of the sole with the sharp end of the percussion hammer from the heel to the ball of the foot. correct answer b. sharply dorsiflexing and maintaining the foot in this position while supporting the knee. 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. The adult- gerontology 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. correct answer A patient with a history of atrial fibrillation, who has maintained normal sinus rhythm with sotalol (Betapace), is hospitalized for acute pyelonephritis. The most appropriate antibiotic regimen for this patient is intravenous: cefoxitin (Mefoxin).ceftriaxone (Rocephin).ciprofloxacin (Cipro).levofloxacin (Levaquin). correct answer A patient with a history of heart failure arrives at the emergency department exhibiting shortness of breath and lower extremity swelling. Both of the patient's symptoms are a result of: a. a decrease in plasma oncotic pressure. b. an increase in capillary hydrostatic pressure.
An 80-year-old patient has macular degeneration and is seen on the surgical unit for postoperative care after repair of a hip fracture. To prepare the patient for discharge, the adult-gerontology acute care nurse practitioner: gives the patient illustrative pictures that instruct him or her on body alignment during activity. has the patient watch a video about surgeries and preoperative care for hip fractures. provides the patient with an audio tape for care of hip fractures and range-of-motion activities. provides verbal reinforcement to the patient on how to keep proper body alignment following hip surgery. correct answer Appraisal of clinical trials includes assessment for systematic errors. Reasons for systematic errors include? a. multiple measurements b. increased sample size c. random chance d. study design flaws correct answer d. study design flaws -random errors can be introduced by chance. variations d/t chance can occur in most situations. multiple measurements and larger samples minimize chance of errors. Appropriate documentation is key to reimbursement. Complicated pt care requires more detailed documentation to include interval hx, exam, and medical decision making. Components to be included for highest reimbursement are? correct answer a. number of Diagnoses, complexity, risks of complications, morbidity, mortality -these pts will have more diagnoses that should be addressed with a plan that has data and discussion about risk factors and reflect all thought processes Based on the individual's culture, ethnicity, and personal choices, the adult-gerontology acute care nurse practitioner can optimize the therapeutic partnership with the patient by:
assuming most patients want to rely on family members or care providers to make treatment decisions. communicating with the patient using minimal to no medical terminology. developing the patient's communication skills to a more advanced level. tailoring his or her communication style to the patient's preference. correct answer Family friend notices AG-ACNP in cafeteria during her lunch break and asks if she is caring for someone they know. How to respond? correct answer NOPE can't tell you - unable to share data. HIPAA! Goals set forth in Healthy People 2020 by the United States Department of Health and Human Services include the: elimination of health disparities. empowerment of health care delivery systems. increase in life span of older adults. treatment of acute diseases. correct answer HIV pt is admitted with unrelated medical issue. Pt indicates that family in not aware of HIV dx and tells nurse she does not want info disclosed. Nurse asks NP for advice. Best advice is? correct answer Pt's request for confidentiality will be respected In addition to smoking cessation and vaccinations that include influenza and pneumococcal, which should be included in mgmt of pt with mild or global strategy for the Dx, Mgmt, Prevention of COPD stage I? a. SABA, LABA, prednisone b. SABA, ICS, prednisone c. SABA, ICS, LABA, O d. SABA correct answer d. SABA (albuterol) Mary has been feeling depressed for a while but is trying to find ways to improve her mood. Her friends have called and invited her to go out. Mary doesn't feel much like being social. Which of the following
neutrophils, lymphocytes, monocytes, eosinophils, basophils Temporal arteritis requires immediate treatment in order to prevent: a. blindness in the affected eye. b. facial nerve palsy. c. transient ischemic attack. d. trigeminal neuralgia. correct answer a. blindness in the affected eye. The adult-gerontology acute care nurse practitioner is asked to provide evidence to the hospital administration about the safety of nurse practitioners placing central lines. Which resource provides the strongest level of evidence? A nurse practitioner's journal editorial. A randomized control trial. A systematic review. The American Association of Colleges of Nursing'sNurse Practitioner Competencies. correct answer What legislation allowed nurse practitioners to be recognized Medicare providers in all geographical areas with their own provider number? a. Affordable Care Act. b. Balanced Budget Act. c. Civilian Health and Medical Program of the Uniformed Services. d. Omnibus Budget and Reconciliation Act. correct answer b. Balanced Budget Act. What legislation allowed nurse practitioners to be recognized Medicare providers in all geographical areas with their own provider number? Affordable Care Act. Balanced Budget Act.
Civilian Health and Medical Program of the Uniformed Services. Omnibus Budget and Reconciliation Act. correct answer When discharging an 85-year-old patient with stasis dermatitis, the adult-gerontology acute care nurse practitioner includes instructions to: a. keep legs elevated while seated. b. maintain systolic blood pressure greater than 120 mmHg. c. soak legs in warm water daily. wear d. compression stockings of 65 mmHg below the knee. correct answer d. compression stockings of 65 mmHg below the knee. When serving as a nurse researcher, the adult-gerontology acute care nurse practitioner is guided by which ethical principle to ensure that research participants are protected from harm or exploitation? Confidentiality. Justice. Nonmaleficence. Right to self-determination. correct answer Which clinical scenario does the adult-gerontology acute care nurse practitioner evaluate for a quality improvement process change? A new case of necrotizing fasciitis in an immunocompromised patient. A projected increase in the number of influenza cases requiring hospitalization. An expected rate of ventilator-associated pneumonia in pulmonary disease patients. An increased incidence of postoperative sternal wound infections. correct answer
