NURS 6550 MIDTERM EXAM 2023
ACTUAL EXAM 2 LATEST
VERSIONS A&B EACH FORM
CONTAINS 100 QUESTIONS AND
CORRECT DETAILED
ANSWERS|AGRADE
VERSION A
- 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
1 out of 1 points
analysis. While evaluating the fluid analysis, the AGACNP knows that a fluid identified as
a(n) is the least worrisome type.
Response
Feedback
:
“A” is the correct answer. A transudate is essentially just water and 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 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?
0 out of 1 points
Response
Feedback
:
“D” is the correct answer. It is the most widely used diagnostic tool as it
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
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ltrasound 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
1 out of 1 points
deterioration and long-term care placement. Which of the following is not considered a
high risk factor for long term care placement?
Response
Feedback:
“A” is the correct answer; men are at higher risk for long-term care
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
0 out of 1 points
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
Feedback
:
“C” is the correct answer. If bleeding is successfully stopped with 20
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
0 out of 1 points
membrane with bullous myringitis. The AGACNP knows that antibiotic therapy must be
selected to cover:
Response
Feedback
:
“D” is the correct answer. Streptococcus pneumoniae is the most common
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
1 out of 1 points
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
Feedback
:
“D” is the correct answer. This patient presents from the outpatient
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?
0 out of 1 points
Response
Feedback
:
“B” is the correct answer. Vascular dementia is a consequence of vascular
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
1 out of 1 points
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
Feedback
:
“A” is the correct answer. According to the Joint National Committee (JNC)
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 damage. “C” is not correct—it may indicate carotid plaque, but this
is not a consequence of hypertension. “D” is not correct as a 1+ palpable
pulse may be a normal finding–it must be taken in the context of the rest
of the examination. - Question 9
0 out of 1 points
Because of the commonly recognized adverse effects of atypical antipsychotics, annual
laboratory assessment for patients taking these medications should include a:
Response “C” is the correct answer. The atypical antipsychotics such as olanzapine