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NRNP 6560 Final Exam (Version 1, Latest-2022/2023, 100 Q & A) / NRNP6560 Final Exam / NRNP 6560 Week 11 Final Exam / NRNP6560 Week 11 Final Exam: Walden University | 100% Verified Q & A |$25.49
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Walden University
NRNP 6560 - Advanced Care Of Adults In Acute Setti (NRNP6560)
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NRNP 6560 FINAL EXAM
1. Q ANSWER:
The AGACNP is reviewing a chart of a head-injured patient. Which of the following would alert
the AGACNP for the possibility that the patient is over hydrated, thereby increasing the risk for
increased intracranial pressure?
A. BUN = 10
B. Shift output = 800 ml, shift input =
825 ml Unchanged weight
C. Serum osmolality = 260
2. Q ANSWER:
A patient who has been in the intensive care unit for 17 days develops hyponatremic
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:
A. reduce serum osmolality by infusing a 5% dextrose in 0.2%
reduce serum sodium concentration by infusing a 0.45%
sodium
chloride
solution
sodium chloride solution B.
C. replenish volume by infusing a 0.9% sodium chloride solution D.
replenish volume by infusing a 5% dextrose in water solution.
3. Q ANSWER:
A 16-year-old male presents with fever and right lower quadrant discomfort. He complains of
nausea and has had one episode of vomiting, but he denies any diarrhea. His vital signs are as
follows: temperature 101.9°F, pulse 100 bpm, respirations 16 breaths per minute, and blood
pressure 110/70 mm Hg. A complete blood count reveals a WBC count of 19,100 cells/µL. The
AGACNP expects that physical examination will reveal:
A. + Murphy’s sign
B. + Chvostek’s sign
C. + McBurney’s sign
D. + Kernig’s sign
4. Q ANSWER:
Myasthenia gravis is best described as:
, A. An imbalance of dopamine and acetylcholine in the basal ganglia Demyelination of
peripheral ascending nerves
B. Demyelination in the central nervous system
C. An autoimmune disorder characterized by decreased neuromuscular activation
5. Q ANSWER:
Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal
resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but
throughout the course of day 1 she has complained of a mild abdominal discomfort that has
progressed throughout the day. This evening the AGACNP is called to the bedside to evaluate
the patient for persistent and progressive discomfort. Likely causes of her symptoms include
all of the following except:
A. Colic due to return of
peristalsis
B. Leakage from the
duodenal stump
C. Gastric retention
D. Hemorrhage
6. Q ANSWER:
Mrs. Coates is a 65-year-old female who is on postoperative day 1 following a duodenal
resection for a bleeding ulcer. She had an uneventful immediate postoperative course, but
throughout the course of day 1 she has complained of a mild abdominal discomfort that has
progressed throughout the day. This evening the AGACNP is called to the bedside to
evaluate the patient for persistent and progressive discomfort. Likely causes of her
symptoms include all of the following except: A.
Colic due to return
B. of Leakage from the duodenal stump
C. peristalsis
Gastric retention
D. Hemorrhage
7. Q ANSWER:
When a patient is hospitalized with a possible stroke, the AGACNP recognizes that the stroke
most likely resulted from a subarachnoid hemorrhage when the patient’s family reports that
the patient:
A. Has a history of atrial fibrillation
B. Was unable to be aroused in the morning
C. Had been complaining of a headache before losing consciousness
D. Has had several brief episodes of mental confusion and right arm and leg weakness
8. Q ANSWER:
You are asked to see a 29 year old female complaining of abdominal pain. She states she is
experiencing constant RUQ pain that radiates to her back. The pain is not relieved by bowel
, movements, over the counter antacids or food. Review of initial labs shows elevated
amylase and lipase and you diagnose her with acute pancreatitis. Which test will you order
next to determine the underlying cause of her pancreatitis? serum cholesterol level blood
toxicology
right upper quadrant
ultrasoun endoscopy
d
9. Q ANSWER:
Jake is a 32-year-old patient who is recovering from major abdominal surgery and organ
resection following a catastrophic motor vehicle accident. Due to the nature of his injuries, a
large portion of his jejunum had to be resected. In planning for his recovery and nutritional
needs, the AGACNP considers that:
He will probably be able to transition to oral nutrition but will have lifetime
issues with diarrhea His procedure has put him at significant risk for B12
absorption problems
Most jejunum absorption functions will be assumed by the ileum
Enteral nutrition will need to be delayed for 3 to 6 months to facilitate adaptation
10.Q ANSWER:
A 32-year-old man comes to the clinic because he has had pain in the back for the past 24
hours. The patient says he first noticed the pain when he awoke in the morning and had
difficulty getting out of bed. He had been playing flag football the day before the pain began
but did not sustain any injuries during the game. Acetaminophen has provided only minimal
relief of the patient's pain. On physical examination, pain is elicited on palpation of the back on
the left, lateral to the region of L2-L5. Full range of motion is noted in vertebral flexion,
extension, lateral rotation, and lateral bending, with some hesitancy because of pain on the
left side. Which of the following is the most appropriate initial step?
Anti-inflammatory and muscle relaxant
therap Epidural injection of a
y
corticosteroid
MRI of the lumbar spine
Strict bed rest and application of moist heat to the lower back
11.Q ANSWER:
On postoperative day 7 following hepatic transplant, the patient evidences signs and
symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that
first-line treatment of acute rejection consists of: Cyclosporine Azathioprine
Methylprednis
o
lone Sirolimus
12.Q ANSWER:
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