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WALDEN NURS 6550 - Midterm Exam

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Question 1Question 2Question 3Question 4Question 5Question 6Question 7Question 8Question 9Question 10Question 11Question 12Question 13Question 14Question 15Question 16Question 17Question 18Question 19Question 20Question 21Question 22Question 23Question 24Question 25Question 26Question 27Question 28Question 29Question 30Question 31Question 32Question 33Question 34Question 35Question 36Question 37Question 38Question 39Question 40Question 41Question 42Question 43Question 44Question 45Question 46Question 47Question 48Question 49Question 50Question 51Question 52Question 53Question 54Question 55Question 56Question 57Question 58Question 59Question 60Question 61Question 62Question 63Question 64Question 65Question 66Question 67Question 68Question 69Question 70Question 71Question 72Question 73Question 74Question 75Question 76Question 77Question 78Question 79Question 80Question 81Question 82Question 83Question 84Question 85Question 86Question 87Question 88Question 89Question 90Question 91Question 92Question 93Question 94Question 95Question 96Question 97Question 98Question 99Question 100NURS 6550 MID TERM EXAMQuestion 11 out of 1 pointsThe 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 asa(n) __________ is the least worrisome type.ResponseFeedback:“A” is the correct answer. A transudate is essentially just water and can occur as a consequence of increased hydrostatic pressure in the pulmonaryvessels. 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 20 out of 1 pointsMrs. Miller is transported to the emergency department by paramedics. She is having profound, unremitting chest pain, is diaphoretic and pale. She has jugular venous distention and a widened pulse pressure. Suspecting ascending aortic aneurysm, the AGACNP order which test to confirm the diagnosis?ResponseFeedback:“D” is the correct answer. It is the most widely used diagnostic tool as it rapidly and precisely can outline the thoracic and abdominal aorta. “A” is not the correct answer—there are radiographic findings that suggest thoracic aneurysm, but they need confirmation by CT. “B” is not the correctanswer as ultrasound is not nearly as precise as a CT scan. “C” is not correct—MRI is only indicated when the patient cannot have a contrast CT.- Question 31 out of 1 pointsCertain 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 Feedback:“A” is the correct answer; men are at higher risk for long-term care placement than women. In addition to male gender, other risk factors include age over 80, living alone, bowel or bladder incontinence, history offalls, dysfunctional coping, and intellectual impairment.- Question 40 out of 1 pointsA patient with anterior epistaxis has been treated with 20 minutes of direct pressure toNURS 6550 MID TERM EXAMthe cartilaginous portion of the nose. Following pressure the patient is instructed to gently blow the nose. Expected findings in the patient who has been successfully treated include all of the following except a:ResponseFeedback:“C” is the correct answer. If bleeding is successfully stopped with 20 minutes of directed pressure, there will be residual blood and clot formation. This is evacuated either by gentle suction or having the patient gently blow. Residual blood and formed clot may present as a sudden gushof dark blood or discharge with or without a clot—these are all typical expected findings. However, if bleeding is not stopped, it will continue as abright red steady trickle. When this occurs, more invasive measures are indicated.- Question 50 out of 1 pointsKevin is a 14-year-old male who presents for evaluation of a fever of 102.5° F and significant right ear pain. He appears quite ill and says he feels nauseous. Otoscopic evaluation reveals pain to palpation, a very erythematous and bulging tympanic membrane with bullous myringitis. The AGACNP knows that antibiotic therapy must be selected to cover:ResponseFeedback:“D” is the correct answer. Streptococcus pneumoniae is the most common bacteria that infects the head and neck in immunocompetent persons, and is the primary treatment target when treating otitis media, bacterial sinusitis, and bacterial pharyngitis. “A” is not correct—while likely on broken skin and soft tissue, it is not common in the ear, nose, or throat unless specific risk factors exist. “B” is not correct—this is much more likelyin an immunocompromised patient or a patient on mechanical ventilation. “C” is not correct—it is the second most common organism, but strep is theprimary treatment target.- Question 61 out of 1 pointsP.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 lobeconsolidation on chest radiography. Pending sputum cultures, empiric antibiotic therapy must be initiated to cover which organism?ResponseFeedback:“D” is the correct answer. This patient presents from the outpatient population where the most common cause of pneumonia is Streptococcus pneumoniae, and is the primary treatment target for any patient being treated empirically. “A” is not correct—while the patient’s sexual orientationis offered in the provided history, there is no indication that he has HIV/AIDS or any other condition characterized by immunosuppression that would increase his risk for this organism. “B” is not correct, as this organism is not

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