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Which patient is at the greatest risk for septic shock?
An 84 year old woman with a long term foley catheter, a stage four pressure ulcer on her coccyx and insulin dependent diabetes.
A 55 year old woman with pneumonia.
A 38 year old woman with asthma and status post day 2 appendectomy.
A 63 year old man who had bypass surgery two weeks ago.
The patient at the greatest risk for septic shock would be the 84 year old woman. She has multiple areas of entrance for bacteria.
Which cranial nerve is tested to assess the gag reflex?
The cranial nerve that is tested to assess the gag reflex in a person is the Glossopharyngeal nerve. Assessment of the vagus nerve identifies the symmetry of the arch of the tongue (the “ahh” test). One would test the trigeminal nerve to assess the ability to swallow and bilateral facial sensation. Testing the trochlear nerve identifies the ability of the patient to move their eyes.
Mrs. C has been admitted to the hospital for exacerbation of heart failure three
times in the last 14 months. What nursing action might decrease the likelihood of being readmitted so quickly?
Ask the patient to see their doctor more often
Allow the patient to stay in the hospital an extra 36 hours as an inpatient.
Increase the diuretic dose on discharge
Provide adequate patient education information about the disease and management principles and follow up with the patient within one week
The nursing action that might decrease the likelihood of Mrs. C being readmitted so quickly is adequate discharge information and follow-up care. Discharge care begins at admission so the more information and understanding Mrs. C has about her disease and the management of it, the more likely she will be able to appropriately take care of herself and identify the warning signs when she needs to call her doctor.
Which of the following scenarios reflects the greatest need for mechanical ventilation?
A patient with a respiratory rate of 26 and an oxygen saturation of 89% on 1 Liter of oxygen.
A patient who is visiting with visitors with an oxygen saturation level of 87%.
An alert and oriented patient who is slightly diaphoretic and is having difficulty breathing.
A patient who has a history of sleep apnea and continues to wake up because of missed breaths.
The scenario that reflects the greatest need for mechanical ventilation is the patient who is having difficulty breathing. Mechanical ventilation is appropriate when the patient‟s ability to oxygenate and exchange carbon dioxide is impaired.
Which part of the heart usually shows the signs of deterioration in heart failure?
Left ventricular function
Right ventricular function
The part of the heart that typically shows the deterioration is the left ventricular function. Heart failure is disease of the ventricles of the heart, usually affecting the left ventricle before the right ventricle.
A patient is admitted to the intensive care unit with a diagnosis of exacerbation of
heart failure. Her heart rate is 145/minute and she is breathing rapidly; her oxygen saturation is 90% on 2 L of oxygen. She has been taking beta blockers at home for her heart failure. Which medication would be the drug of choice to increase the
contractility of her heart?
The medication that would be the drug of choice to increase the contractility of the heart when beta blockers are being used for mainstay management would be Primacor. Dopamine will not work if beta blockers are being used at home because the needed receptor sites are being used.
Medical ACNP Exam (Acute Care Nurse Practitioner) Detailed Information
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