NURS 6550 Midterm Exam Questions
and Answers (Graded A)
Question 1
1 out of 1 points
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
Feedback: 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
1 out of 1 points
Differentiating vertigo from near-syncope and ataxia is one of the goals of history-taking
when a patient presents as “dizzy.” The AGACP knows that vertigo is the problem when
the patient reports the primary symptom as:
, Response “A” is the correct answer. Dizzy is a layperson’s term and can mean
Feedback: many different things to patients and health care providers. When
the patient identifies the primary symptom as a sense of spinning
this supports vertigo, which is usually an inner ear problem. This
versus ataxia which is neurologic or near-syncope which may be
cardiac, neurological, or neurocardiogenic. “B” is not correct—this
may occur with vertigo, but when it is the primary symptom it is
most likely ataxia and neurological causes should be considered. “C”
is not correct as coincident nausea is not specific and can occur with
any of these complaints. “D” is not correct as it is also not specific;
while ataxia cannot occur when supine near-syncope can.
Question 3
1 out of 1 points
Mr. Banks has been admitted for surgical resection of a metastatic tumor, during surgery
it is discovered that he has widespread, diffuse metastasis throughout the abdomen.
Surgery is no longer an option, and his oncologist says that chemotherapy is unlikely to
produce any meaningful benefit. Mr. Banks is concerned that his sons will not support a
transfer to comfort care. The AGACNP advises that he:
Response “B” is the correct answer. If there is any concern about disagreement
Feedback: among family members, or any concern at all that a patient’s wishes
will not be carried out, the best action is to ensure that there is a
clearly defined legally executed document. “A” is not correct. Living
wills are not legally enforceable documents and when dissention
arises among family members they may not be carried out. “C” is
not correct - while the patient should arrange for his care as long as
he is capable of doing so, if questions arise at such a time that he is
not capable of answering his next of kin will need to do so. “D” is
not correct -- identifying the proxy is not enough without assigning
legal rights and responsibilities. While “A,” “C,” and “D” should all
be done and will support his care, the only way to ensure that one’s
wishes are carried out is to ensure that a legally enforceable direction
is in place.
Question 4
1 out of 1 points
Mr. Wilkerson is a 77-year-old male who is being evaluated and treated for his
cardiogenic pain. His vital signs are as follows: Temperature of 99.1° F, pulse of 100
bpm, respirations of 22 bpm, and blood pressure of 168/100 mm Hg. A 12-lead ECG
reveals deep ST segment depression in leads V3-V6. The AGACNP recognizes which of
the following as a contraindication to rTPA therapy?
Response “D” is the correct answer. rTPA is not indicated in patients with ST
Feedback: segment depression; this is not a ST elevation MI. “A” is not correct
as age > 80 is a relative contraindication. “B” is not correct as a
, temperature of 99.1° F is an expected response to myocardial
necrosis, and “C” is not correct—the blood pressure is not
prohibitive until > 180/110 mm hg.
Question 5
1 out of 1 points
A 71-year-old patient is recovering from a particularly severe exacerbation of chronic
obstructive pulmonary disease. He has been in the hospital for almost two weeks and
was on mechanical ventilation for 7 days. While discussing his discharge plan he tells
, you that he is really going to quit smoking this time. He acknowledges that he has been
"sneaking" cigarettes in the hospital for two days, but he has established a timeline to
decrease the number of cigarettes daily. According to his plan his last cigarette will be
the last day of the month. This patient’s behavior is consistent with which stage of the
Transtheoretical Model of Change?
Response “C” is the correct answer. The Transtheoretical model of change is
Feedback: characterized by 5 stages. “A” is when the patient has no intention to
make a change. “B” is when the patient is intending to make a
change in the next 6 months. “C” is when the patient is ready to take
action or has already taken some action, as this patient has in
establishing his plan to quit by the end of the month. “D” is the overt
action that attains a criterion sufficient to reduce disease risk—in
this patient the action stage would be characterized by actual
smoking cessation. The final phase, not presented in the answer
choices here, is maintenance.
Question 6
1 out of 1 points
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 7
1 out of 1 points
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
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller henryexaminer. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £15.49. You're not tied to anything after your purchase.
