Burns
Which of the following is the most common cause of burns in adults?
A) Chemical exposure
B) Electrical injuries
C) Scalds
D) Flame injuries
D) Flame injuries
Which antibiotic is typically first-line treatment for community-acquired pneumonia in otherwise healthy adults?
A) Amoxicillin
B) Azithromycin
C) Ciprofloxacin
D) Vancomycin
B) Azithromycin
What is the preferred position for a patient undergoing a lumbar puncture?
A) Supine with head elevated
B) Prone with arms extended
C) Lateral decubitus with knees flexed
D) Sitting with legs extended
C) Lateral decubitus with knees flexed
When serving as a nurse researcher, the adult-gerontology acute care nurse practitioner is guided by which ethical principle to ensure that research participants are protected from harm and exploitation?
A. Confidentiality.
B. Justice.
C. Nonmaleficence.
D. Right to self-determination
C. Nonmaleficence.
Which kind of biopsy does the adult-gerontology acute care nurse practitioner perform to evaluate cytology, only, in the tumor?
A. Core.
B. Excisional.
C. Fine needle.
D. Incisional.
C. Fine needle
What is the primary goal in the initial management of a patient with severe burns?
A) Pain control
B) Fluid resuscitation
C) Infection prevention
D) Wound debridement
B) Fluid resuscitation
A 45-year-old patient with a history of chronic obstructive pulmonary disease (COPD) presents with an acute exacerbation. Which antibiotic is most appropriate for treating a suspected bacterial infection in this patient?
A) Amoxicillin
B) Azithromycin
C) Levofloxacin
D) Doxycycline
C) Levofloxacin
During a lumbar puncture, the needle is advanced too far and the patient experiences sudden leg pain. What is the most likely cause of this symptom?
A) Infection
B) Nerve root irritation
C) Hemorrhage
D) Post-dural puncture headache
B) Nerve root irritation
The adult-gerontology acute care nurse practitioner is asked to provide evidence to the hospital administration about the safety of nurse practitioners placing central lines. Which resource provides the strongest level of evidence?
A. A nurse practitioner's journal editorial.
B. A randomized control trial.
C. A systematic review.
D. The American Association of Colleges of Nursing's Nurse Practitioner Competencies.
C. A systematic review.
A patient with a history of atrial fibrillation, who has maintained normal sinus rhythm with sotalol hydrochloride (Betapace), is hospitalized for acute pyelonephritis. The most appropriate antibiotic regimen for this patient is intravenous:
A. cefoxitin (Mefoxin).
B. ceftriaxone (Rocephin).
C. ciprofloxacin (Cipro).
D. levofloxacin (Levaquin).
B. ceftriaxone (Rocephin)
In the "Rule of Nines" used to estimate burn surface area, what percentage is assigned to the entire head and neck in an adult?
A) 4.5%
B) 9%
C) 18%
D) 27%
B) 9%
A patient with a history of methicillin-resistant Staphylococcus aureus (MRSA) infection presents with a new skin and soft tissue infection. Which antibiotic is most appropriate for empiric therapy?
A) Cephalexin
B) Clindamycin
C) Amoxicillin
D) Azithromycin
B) Clindamycin
During the insertion of a central line into the subclavian vein, the patient suddenly develops shortness of breath and decreased breath sounds on one side. What is the most likely diagnosis?
Based on the individual's culture, ethnicity, and personal choices, the adult-gerontology acute care nurse practitioner can optimize the therapeutic partnership with the patient by:
A. assuming most patients want to rely on family members or care providers to make treatment decisions.
B. communicating with the patient using minimal-to-no medical terminology.
C. developing the patient’s communication skills to a more advanced level.
D. tailoring their communication style to the patient’s preference
D. tailoring their communication style to the patient’s preference
Temporal arteritis requires immediate treatment in order to prevent:
A. blindness in the affected eye.
B. facial nerve palsy.
C. transient ischemic attack.
D. trigeminal neuralgia.
A. blindness in the affected eye.
Which of the following is a potential complication of severe burns?
A) Hyperkalemia
B) Hypoglycemia
C) Hypothermia
D) Hypernatremia
C) Hypothermia
A 50-year-old patient with a history of chronic kidney disease presents with acute pyelonephritis. Which antibiotic should be avoided due to potential nephrotoxicity?
A) Ciprofloxacin
B) Amoxicillin
C) Gentamicin
D) Trimethoprim-sulfamethoxazole
C) Gentamicin
A patient with a chest tube in place for a pneumothorax suddenly develops subcutaneous emphysema. What is the most likely cause of this complication?
A) Incorrect tube placement
B) Tube dislodgement
C) Infection
D) Blockage of the tube
B) Tube dislodgement
Which clinical scenario does the adult-gerontology acute care nurse practitioner evaluate for a quality improvement process change?
A. A new case of necrotizing fasciitis in an immunocompromised patient.
B. A projected increase in the number of influenza cases requiring hospitalization.
C. An expected rate of ventilator-associated pneumonia in pulmonary disease patients.
D. An increased incidence of postoperative sternal wound infections.
D. An increased incidence of postoperative sternal wound infections
A patient who has been in the intensive care unit for 17 days develops hypernatremic 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% sodium chloride solution.
B. reduce serum sodium concentration by infusing a 0.45% sodium chloride solution.
C. replenish volume by infusing a 0.9% sodium chloride solution.
D. replenish volume by infusing a 5% dextrose in water solution.
C. replenish volume by infusing a 0.9% sodium chloride solution.
The Parkland formula is used to calculate fluid resuscitation for burn patients. According to this formula, how much fluid should be administered in the first 24 hours for a patient weighing 70 kg with 30% total body surface area (TBSA) burns?
A 35-year-old patient presents with acute appendicitis and signs of perforation. Which antibiotic regimen is most appropriate for empiric therapy to cover both aerobic and anaerobic pathogens, considering the risk of multidrug-resistant organisms?
A) Amoxicillin-clavulanate
B) Ciprofloxacin and Metronidazole
C) Piperacillin-tazobactam
D) Ceftriaxone and Clindamycin
C) Piperacillin-tazobactam
A patient presents with suspected subarachnoid hemorrhage, but the initial CT scan is negative. Which of the following findings in the cerebrospinal fluid (CSF) obtained via lumbar puncture would be most indicative of subarachnoid hemorrhage?
A) Elevated protein levels
B) Xanthochromia
C) Elevated glucose levels
D) Pleocytosis
B) Xanthochromia
A root cause analysis of a crisis situation on the intensive care unit identifies a lack of clinician-family communication as the basis for the resulting adverse outcome. As part of the performance improvement plan, the adult-gerontology acute care nurse practitioner is asked to develop evidence-based policies to establish clinician-family communication standards on the unit. These policies should include:
A. an evaluation tool to assess the healthcare surrogate's decision-making ability and anxiety level.
B. guidelines for having discussions with family members that are geared toward establishing treatment goals.
C. limits on the number of consulting services utilized to prevent sending mixed messages.
D. requirements for a formal family conference within 12 hours of a patient's admission to the intensive care unit.
B. guidelines for having discussions with family members that are geared toward establishing treatment goals.
A 68-year-old patient had surgery three days ago to repair an abdominal aortic aneurysm. The patient remains intubated, is neurologically intact, and has active bowel sounds. The patient's liver function is within normal limits and the patient has no signs or symptoms of heart failure. The patient's laboratory values are: blood urea nitrogen of 12 mg/dL, creatinine of 0.8 mg/dL, PaCO2 of 37 mmHg. The preferred form of nutritional support for this patient is:
A. enteral feeding to the duodenum via a nasogastric small-bore tube.
B. enteral feeding to the stomach via a gastrostomy tube.
C. peripheral parenteral nutrition via an 18-gauge IV catheter.
D. total parenteral nutrition via a central venous line.
A. enteral feeding to the duodenum via a nasogastric small-bore tube.