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How do you know if a patient is having a severe asthma exacerbation?
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peak expiratory flow <70% of personal best  forced vital capacity <80% of predicted  peak expiratory flow <50% of personal best  forced vital capacity <60% of predicted Question 421 pts A patient is having an MI in the ER. She is being evaluated for thrombolytic therapy. The APRN knows which of the following is not an absolute contraindication?   Group of answer choices  Major head trauma 2 months ago  A bleeding gastric ulcer 7 days ago  Bleeding diathesis  A history of hemorrhagic retinopathy Question 431 pts What is the initial treatment of choice for a patient that is experiencing an acute panic attack?   Group of answer choices  Anti-psychotic  An SSRI  Short acting benzodiazepine  Cognitive Behavioral Therapy (CBT) Question 441 pts What lung volume changes would you expect to see in patient with COPD? Group of answer choices  Increased total lung capacity  Increased forced vital capacity  Increased residual volume  Increased small airway flow rates  Both A&C  All the above  Question 451 pts You have a patient presenting to the ER with pleuritic chest pain that lasts only a few seconds at a time and is intensified with coughing. On physical exam you note the patient has a pericardial friction rub. According to these findings, what would be your leading diagnosis? Group of answer choices  Pericarditis  Endocarditis  Congestive heart failure  Stable angina Question 471 pts What is an important recommendation regarding the use of a statin?   Group of answer choices  PT/INR PTT 4 weeks after starting a statin  Renal function tests after starting a statin  Liver function tests 3 months after starting a statin  Baseline liver function tests prior to starting a statin Question 481 pts The APRN is working in the ICU when she gets called to the bedside by the nurse because of a drop in blood pressure on the arterial line. The patient is intubated, and tidal volumes are 500 on the ventilator. The monitor shows normal sinus rhythm with a heart rate of 64, RR of 12, BP of 32/10. The APRN assesses the patient and finds there is no pulse. What is the next course of action? Group of answer choices  Troubleshoot the Aline to get a better blood pressure reading  Initiate high quality CPR  Administer an amp of epinephrine  Administer an amp of bicarb Question 491 pts A patient was found to have ventricular fibrillation. CPR was initiated and the patient was shocked. What is the next step in management after the shock? Group of answer choices  Check a pulse  Resume CPR  Administer epinephrine  Administer amiodarone Question 501 pts High-dose epinephrine (1:1000) should be used in cardiac arrest? True or false Group of answer choices  True  False Question 511 pts A 65-year-old female presents to the ER with new onset Afib with RVR. She has a past medical history of rheumatic heart disease and hypertension. Upon exam you note a decrescendo diastolic murmur with presystolic accentuation and an opening snap. What is the etiology of this murmur?   Group of answer choices  Mitral regurgitation  Aortic regurgitation  Mitral stenosis  Aortic stenosis Question 521 pts An 82 y/o patient was admitted to the cardiac observation unit with shortness of breath. He stated he had a 6 lb. weight gain in the past 5 days despite a decreased appetite. His chest xray shows interstitial edema. Vital signs: O2 Sat 88%, RR-27, HR 115, BP 98/62. What is the appropriate therapy for this patient? Group of answer choices  Furosemide 40 x1 IV  Dopamine drip @ 3mcg/kg/min  Duoneb INH (albuterol/atrovent)  Decadron 10mg IV Question 531 pts What is the preferred first-line treatment in the management of sinusitis? Group of answer choices  Amoxicillin/Clavulanate  Doxycycline  Levofloxacin  Macrolides Question 541 pts What are the indications to start antimicrobials on a patient with COPD? Group of answer choices  Changes in sputum quantity or color  Recent upper respiratory infection  Chest x-ray consistent with pneumonia  Both B and C  All of the above Question 551 pts When prescribing empiric therapy for endocarditis, what is the drug of choice? Group of answer choices  Flagyl  Fluconazole  Meropenem  Vancomycin Question 561 pts 35 y/o female comes to the ER after a syncopal episode. She noted feeling a sudden, sharp pain in her chest prior to the event. She denies any medical history and only takes oral contraceptives. Upon exam she is diaphoretic, tachypneic and appears distressed. HR is 125, RR 32, O2 at 87%, BP 107/79. You note crackles in her lung fields. Ht 5'2, wt 220 lbs. On the list of differential diagnoses, what is at the top and the most likely diagnosis? Group of answer choices  Anxiety attack  Pulmonary embolism  Myocardial infarction  Asthma attack Question 571 pts A patient is s/p percutaneous coronary intervention (PCI) for an ST elevation MI. The patient exhibits understanding of his lipid treatment goals by which statement?   Group of answer choices  "My total cholesterol level should be less than 100 in 6 weeks"  "My HDL cholesterol goal is more than 70 and Lipitor is the best drug to help me reach my goal"  "My LDL cholesterol goal is less than 150 so we may need to increase my dose if it is higher than that in 6 weeks."  "We will know that the dose of Lipitor is correct if my LDL cholesterol is less than 70 when checked in 6 weeks" Question 581 pts Your patient just underwent an aortic valve replacement. You are called to the bedside by the nurse for a heart rate of 170 beats/min. EKG confirms atrial fibrillation. BP is 112/75. The patient states he feels palpitations occasionally but no pain. What is the most appropriate intervention to control the heart rate?  Group of answer choices  Metoprolol 5mg IVP x 1  Digoxin 0.125mg PO  Cardioversion  Evaluation for pacemaker Question 591 pts 78 y/o male patient was admitted for confusion and altered mental status. He has a history of early Alzheimer's and congestive heart failure (CHF). Currently taking donepezil for Alzheimer's and lisinopril and Lasix for CHF. His Lasix was increased last week, and his wife said it is working as he is using the bathroom more. What is the most likely cause of his confusion?  Group of answer choices  Urinary incontinence  Progression of dementia associated with Alzheimer's  Electrolyte imbalance  Depression Question 601 pts 54-year-old male patient who presents to the urgent care for increasing shortness of breath. The diagnostic evaluation including chest x-ray ultimately supports a diagnosis of community acquired pneumonia. Pending sputum cultures, empiric antibiotic therapy must be initiated to cover which organism?  Group of answer choices  Pneumocystis jiroveci   Pseudomonas aeruginosa  Streptococcus pneumoniae  Staphylococcus aureus  SCIENCE HEALTH SCIENCE NURSING NURSING NRP6568