ANT COMP PREDICTOR EXAM 2024/
2025 WITH A+ GRADED CORRECT
ANSWERS
BACT EPIGLOTTTIS/ACUTE SUPRAGLOTTITIS - CORRECT ANSWER-usually
caused by H. influenza.
-CM: drooling, ag, absence of spont cough; sitting upright w/ chin pointing out, mouth
opened, and tongue protruding (tripod pos); dysphonia (thick/muffled voice and froglike
croaking sound); dysphagia; insp stridor; suprasternal/substernal retractions; sore
throat, high fever, nd restlessness.
-NC: admin corticos and IVFs as rx; admin abs therapy starting w/ IV, then transition to
PO to complete 10d course as rx; droplet iso precautions for first 24hrs after IV abx
initiated.
ACUTE LARYNGOTRACHEOBRONCHITIS AND ACUTE SPASMODIC LARYNGITIS -
CORRECT ANSWER-CAUSATIVE AGENTS: RSV, influenza A and B, and
Mycoplasma pneumonia, parainfluenza types 1, 2, and 3.
-self-limiting illness that can result from allergens + ch by paroxysmal attacks of
laryngeal ob that occur mainly at night = acute spasmodic.
-CM: LGF, restlessness, hoarseness, barky cough, dyspnea, insp stridor, and
retractions. - infants/toddlers will have nasal flaring, intercostal retractions, tachypnea,
and continuous stridor.
-NC: humidity w/ cool mist; admin O2 as needed; admin neb racemic epinephrine as rx;
admin corticosteroids: oral or IM (dexamethasone) or neb (budesonide); encourage oral
intake if tol; admin IVF as rx
INFLUENZA A AND B - CORRECT ANSWER-CM: sudden onset of fever/chills; dry
throat and nasal mucosa, dry cough, flushed face, photophobia, myalgia, and fatigue.
-NC: promote inc fluids, rest, acetaminophen or ibuprofen for fever; give meds as rx.
-AMANTADINE: shortens length of TYPE A - admin within 24-48hrs of cm.
-ZANAMIVIR: tx for types A/B age 7yrs+ or for prophylaxis for kids 5+
-PREVENTION: inactivated influenza vaccine rec for kids 6mos+; live vaccine should
not be used in kids who have heart/lung dis, diabetes or kidney failure, are
immunocomp, have resp conditions, are preg, have a severe allergy to chicken eggs, or
have a hx of Guillain-Barré syndrome.
EPSs - CORRECT ANSWER-commonly r/t first-gen/conventional/typ antipsychotics
(Haldol, chlorpromazine, fluphenazine)
-EPs:
,*ACUTE DYSTONIA: spasms of tongue, neck, face, or back - resp can dec if laryngeal
muscles are affected - crisis!!. few hrs-5d. tx w/ anticholinergics like benztropine IM/IV.
*PARKINSONISM: bradykinesia, rigidity, shuffling gait, drooling, and tremors. observed
later/within 1mos - txs w/ benztropine, diphenhydramine, or amantadine.
*AKATHISIA: pt is unable to sit still - observed w/in 2mos. manage w/ BBs, benzos, or
anticholinergics.
*TD: invol movements of tongue/face - lip-smacking; LATE EPS; admin lowest dosage
poss. if reappear --> lower dosage or switch to atypical. valbenazine for adult pts w/ TD.
NMS - CORRECT ANSWER-sudden high-grade fever, BP fluctuations, dysrhythmias,
muscle rigidity, diaphoresis, tachycardia, and change in LOC --> coma.
-NC: stop antipsychotic; monitor VS; apply cooling blankets; admin antipyretics (ASA,
acetaminophen); inc fluids; admin diazepam to ctrl anxiety; admin dantrolene and
bromocriptine to induce muscle relaxation; admin med as rx to tx dysrhythmias; assist
w/ immediate transfer to intensive care; wait 2wks before resuming therapy - consider
switching to an atypical.
MALIGNANT HYPERTHERMIA - CORRECT ANSWER-inherited musc disorder that
anesthesia induces chemically.
-hypermetab condition causing an alt in calc activity in muscle cells (muscle rigidity,
hyperthermia, and CNS damage).
-triggering agents including inhalation anesthetic agents and succinylcholine.
-inc CO2 lvl, dec SpO2, and tachycardia occur FIRST. followed by dysrhythmias, musc
rigidity, hypotension, tachypnea, skin mottling, cyanosis, and muscle-cell protein in the
urine/myoglobinuria.
-extremely elevated temp is a LATE cm (inc as high as 41.7C/107F).
-NC: assist w/ surg termination; admin IV dantrolene (muscle relaxant); admin 100%
O2; obtain ABGs for metab acidosis and blood tests to check for hyperkalemia; infuse
iced IV 0.9% NaCl; cooling blanket, ice to axillae/groin/neck/and head. and iced lavage;
insert indwelling urinary Cath to monitor output and for myoglobinuria (due to muscle
breakdown); monitor cardiac rhythm and tx dysrhythmias; transfer pt to intensive care.
POST-LAP CHOLE - CORRECT ANSWER-as soon as the pt follows commands,
encourage coughing, DB, and use of IS.
-antiemetic may be used: dopamine antagonist known as prochlorperazine (a
phenothiazine) - antiemetic effects result from blockade of dopamine receptors in the
CTZ. - prevents emesis r/t chemo, toxins, and postop recovery. admin PO, IM, rectal, or
IV.
-amb frequently to min free air pain - common during lap surg - under right clavicle,
shoulder, & scapula.
-report inds of bile leak (pain, vomiting, abd distention ) to HCP.
TRACH CARE - CORRECT ANSWER-keep 2 extra tubes at bedside (one pt's size and
one size smaller, in case of accidental decannulation), the obturator, an O2 source,
suction caths and a source, and a BVM.
-provide communication methods
, -provide emergency call system/light
-provide adequate humidification and hydration to thin secs and reduce risk of mucous
plugs.
-give oral care q2hrs.
-provide trash care q8hrs to reduce risk of inf and skin breakdown. (suction tube, if
necessary, using sterile suctioning supplies. use surg asepsis to remove/clean inner
cannula. use a new inner cannula if disposable. remove soiled dsgs and excess secs.
clean site and then plate. place a fresh split-gauze trach dsg of non raveling material
under and around holder/plate. replace ties if they're wet/soiled. secure new ties before
removing soiled ones!!! if a knot is needed - tie a square knot that's vis on the side of
neck. check that 1-2 fingers fit btwn tie and neck; change non disposable trach tubes
q6-8wks. repos pt q2hrs. tip chin to chest to enable swallowing!!
HIP ARTHROPLASTY: PT EDUCATION - CORRECT ANSWER-use raised toilet seats,
and assistive items (long-handled shoehorn, dsg sticks) to prevent strain on
prosthesis/flexion >90deg.
-use straight chairs w/ arms.
-use an abduction pillow or reg pillow, if rx, btwn the legs while in bed (and w/ turning, if
restless, or in an alt mental state).
-externally rotate the toes
-avoid flexion of hip >90deg.
-avoid low chairs
-do not cross legs or internally rotate toes
-avoid turning to op side, unless rx.
-anticoags can be required for sev wks after surg (ASA, warfarin)
adult health
pharm
phys adaptation - CORRECT ANSWERSTUDY!!!!!!!!
A NURSE IS PROVIDING D/C INSTRUCTIONS TO A PT WHO HAS TB AND IS
BEGINNING TX W/ MULTIDRUG THERAPY. WHICH OF THE FOLLOWING PT
STATEMENTS INDS AN UNDERSTANDING OF THE TEACHING? - CORRECT
ANSWER-3 consecutive negative sputum tests will ind that the pt is no longer
contagious. BUT Mantoux test will always be +.
-pts who have taken meds to tx TB for 2-3 consecutive weeks are no longer contagious.
BUT, pts will need to continue med therapy for at least 6mos.
-meds for TB can damage liver. avoid consuming alc.
-reg follow-up visits needed w/ TB.
A NURSE IS CARING FOR A PT WHO HAS A CLOSED-HEAD INJ AND IS ON
SEIZURE PRECAUTIONS. WHICH OF THE FOLLOWING ACTIONS SHOULD THE
NURSE TAKE? - CORRECT ANSWER-no padded tongue blade (risk of asp and
damage to teeth).
-no side rails raised
-set up suction equipment at bedside.
