Pt demonstrating AMS and free water restriction with euvolemia. Urine osmolality 270, BUN 14/0.6, urine Na 30. You suspect hyponatremia. What is the most
... [Show More] likely cause?
SIADH
45 yo. F s/p double mastectomy 2 months ago. Now complaining of pain at the incision site. What type of pain is she experiencing?
Neuropathic pain caused by nerve damage during the double mastectomy.
31 M presents with blowing murmur occurring during S1 and a galloping additional heart sound. Murmur is heard best at the base of the heart. What is most likely?
Mitral Regurgitation
25 yo. F with no significant PMH asks you as the ACNP how often she should come in for a physical examination. You would tell her?
q5-6 years
65 yo. M presents with complaints of nausea, vomiting, and constipation x several days and a 6 lb weight loss. Pt is s/p total knee replacement several weeks ago and reports not really getting off the couch. What electrolyte abnormality is most likley?
Hypercalcemia related to immobility s/p TKR
34 yo. M presents to ED with mother who reports that patient "downed an entire bottle of Tylenol". PMH significant for schizophrenia. What is the initial management in this patient?
OGT and GI lavage r/t AMS and ARF aspiration.
Then followed by N-Acetyclcystine (Mucomyst) 140 mg loading dose.
53 yo. M presents with complaints of dribbling and nocturia. You suspect BPH. PSA level is elevated. What confirms this diagnosis?
Transrectal ultrasound is confirmation of BPH in presence of elevated PSA level.
Your 52 yo. F patient expresses concerns for side effects associated with hormonal replacement therapy (HRT). What are the associated side effects?
Gallstones
Blood clots
CVA
Hormonal replacement therapy (HRT) has been shown to improve what dx?
Osteoporosis
What diagnostic is used to distinguish intrarenal or postrenal etiology of acute renal failure?
Urinary sediment
Intrarenal - urinary sediment has granular white casts
Postrenal - urinary sediment is normal
25 yo. M presents with mid-diastolic, apical "crescendo" murmur. You know this murmur occurs during which heart sound?
Mitral Stenosis. S1. AV valves close
32 yo. M presents to ED with GSW to forearm. Injuries are negligible and patient is hemodynamically stable. Pt reports he was hunting with friends and the gunshot was an accident and there was no foul play. You as the ACNP would do what next?
Report the GSW to the Health Department. ALL GSW must be reported.
When is the greatest risk for a mechanically ventilated patient to contract VAP?
48-72 hrs
What is the DIC confirmatory diagnostic?
Increased fibrin degradation product
What signs are clinically significant for distal SBO?
High pitched, tinkling bowel sounds
Episodic vomiting
Profuse vomiting and variable epigastric pain are two symptoms that are clinically significant for?
PROXIMAL SBO
Ionized calcium is 11.5 mg/dL. What is not an etiology?
Pancreatitis. Pancreatitis is associated with HYPOcalcemia.
In addition to a positive serum ANA, what diagnostic is supportive of diagnosing a patient with SLE?
Leukopenia
What is the confirmatory test for diagnosing syphillis?
Fluorescent treponemal antibody absorption (FTA-ABS)
What two herbs are associated with relieving premenstrual symptoms in women?
Evening Primrose
Black cohash
28 yo. F presents to ED with fever, malaise, rash across back, and splinter hemorrhages. Hgb 10 mg/dL, positive ANA, UA revealed proteinuria and elevated ESR. What is the suspected diagnosis?
SLE
ENDOCARDITIS does not have proteinuria.
49 yo. M presents with complaints of abdominal swelling that continues to progress for the past two days. Patient also reports multiple episodes of mucous-filled diarrhea and abdominal pain. Physical exam significant for profound abdominal distention. You suspect distal SBO. What type of bowel sounds are associated with distal SBO?
High pitched, tinkling bowel sounds [Show Less]