NURS 6560 WEEK 6 MIDTERM EXAM FALL QTR. (ACCURATE & COMPLETE)
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NURS 6560
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NURS 6560
NURS 6560 WEEK 6 MIDTERM EXAM FALL QTR. (ACCURATE & COMPLETE)
Question 1
S. is a 59-year-old female who has been followed for several years for aortic regurgitation. Serial echocardiography has demonstrated normal ventricular function, but the patient was lost to follow-up for the last 16 mont...
NURS 6560 WEEK 6 MIDTERM EXAM 2024-2025 FALL QTR.
(ACCURATE & COMPLETE)
Question 1
S. is a 59-year-old female who has been followed for several years for aortic regurgitation. Serial
echocardiography has demonstrated normal ventricular function, but the patient was lost to follow-up for
the last 16 months and now presents complaining of activity intolerance and weight gain. Physical
examination reveals a grade IV/VI diastolic aortic murmur and 2+ lower extremity edema to the midcalf. The
AGACNP considers which of the following as the most appropriate management strategy?
- Answer >> Begin an angiotensin converting enzyme (ACE) inhibitor
Question 2
An ascending thoracic aneurysm of > 5.5 cm is universally considered an indication for surgical repair, given
the poor outcomes with sudden rupture. Regardless of the aneurysm’s size, all of the following are
additional indications for immediate operation except:
- Answer >> Crushing chest pain
Question 3
Jasmine is a 31-year-old female who presents with neck pain. She has a long history of injection drug use
and admits to injecting opiates into her neck. Physical examination reveals diffuse tracking and scarring.
Today Jasmine has a distinct inability to turn her neck without pain, throat pain, and a temperature of 102.1°F.
She appears ill and has foul breath. In order to evaluate for a deep neck space infection, the AGACNP orders:
- Answer >> CT scan of the neck
Question 4
Mr. Draper is a 39-year-old male recovering from an extended abdominal procedure. As a result of a
serious motor vehicle accident, he has had repair of a small bowel perforation, splenectomy, and repair of a
hepatic laceration. He will be on total parenteral nutrition postoperatively. The AGACNP recognizes that the
most common complications of parenteral nutrition are a consequence of:
- Answer >> The central venous line used for infusion
Question 5
Mr. Mettenberger is being discharged following his hospitalization for reexpansion of his second
spontaneous pneumothorax this year. He has stopped smoking and does not appear to have any overt risk
factors. While doing his discharge teaching, the AGACNP advises Mr. Mettenberger that his current risk for
another pneumothorax is:
- Answer >> 25-50%
Question 6
One of the earliest findings for a patient in hypovolemic shock is:
- Answer >> Hemoglobin and hematocrit (H&H) < 9 g/dL and 27%
Question 7
Traumatic diaphragmatic hernias present in both acute and chronic forms. Patients with a more chronic
form are most likely to be present with:
- Answer >>Sepsis
Question 8
, The AGACNP is managing a patient in the ICU who is being treated for a pulmonary embolus. Initially the
patient was stable, awake, alert, and oriented, but during the last several hours the patient has become
increasingly lethargic. At change of shift, the oncoming staff nurse appreciates a profound change in the
patient’s mental status from the day before. Vital signs and hemodynamic parameters are as follows: BP
88/54 mm Hg Pulse 110 bpm Respiratory rate 22 breaths per minute SaO2 93% on a 50% mask Systemic
vascular resistance (SVR) 1600 dynes sec/cm5 Cardiac index 1.3 L/min Pulmonary capillary wedge pressure
(PCWP) 8 mm Hg This clinical picture is most consistent with which shock state?
- Answer >>Distributive
Question 9
When counseling patients to prevent postoperative pulmonary complications, the AGACNP knows that with
respect to smoking cessation, the American College of Surgeons and National Surgical Quality Improvement
Program guidelines are clear that patients who stop smoking weeks before surgery have no increased risk
of smokingrelated pulmonary complications.
- Answer >> 4
Question 10
Mitch C. is a 39-year-old male who is brought to the ED by paramedics. According to the report of a
neighbor, Mitch was distraught over a breakup with his fiancée and attempted to commit suicide by mixing
some chemicals from under his kitchen sink and drinking them; afterward he changed his mind and knocked
on his neighbor’s door asking for help. Mitch is awake but stuporous, and the neighbor has no idea what he
drank. Visual inspection of his mouth and oropharynx reveals some edema and erythema. He is coughing
and has large amounts of pooling saliva. Mitch is not capable of answering questions but he appears in pain.
Endoscopy reveals full thickness mucosal injury with mucosal sloughing, ulceration, and exudate. The
AGACNP knows that the appropriate course of treatment must include:
- Answer >>.At least 6 hours of observation in the emergency department
Question 11
Jared V. is a 35-year-old male who presents for evaluation of a dry cough. He reports feeling well overall
but notices that he gets out of breath more easily than he used to when playing soccer. A review of systems
yields results that are essentially benign, although the patient does admit to an unusual rash on his legs.
Physical examination reveals scattered erythematous
nodules on both shins. There is no drainage, discomfort, or itch. Additionally, diffuse, mildly enlarged lymph
nodes are appreciated bilaterally. Results of a comprehensive metabolic panel and complete blood count are
within normal limits. Twelve-lead ECG reveals sinus bradycardia at 58 bpm. Chest radiography reveals
bilateral hilar and mediastinal lymphadenopathy. The AGACNP suspects:
- Answer >> Sarcoidosis
Question 12
Mrs. Miller is a 44-year-old female who is on postoperative day 1 following a total abdominal hysterectomy.
Her urine output overnight was approximately 200 mL. The appropriate response for the AGACNP would be
to order:
- Answer >>A urinalysis and culture
Question 13
All of the following are risk factors for spontaneous pneumothorax except:
- Answer >>Scuba diving
Question 14
The AGACNP is going over preoperative information and instructions with a patient who is having a major
transverse abdominal procedure tomorrow morning. The patient is very nervous and is asking a lot of
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