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Carolyn C. has a history of Crohn’s disease and has been managed with immunologic agents,
with moderate success. Today she presents with severe abdominal pain that comes and goes in
waves; it started shortly after she ate a little bit of cottage cheese and crackers. This has never
happened before with her Crohn’s disease. She has difficulty localizing the pain but seems to
indicate the general area of the umbilicus. She had one episode of diarrhea this morning.
Abdominal examination is nonspecific, producing mild tenderness on palpation. Plain abdominal
films reveal a dilated small bowel with air fluid levels. The AGACNP suspects: C A. Perforated small bowel
F B. Ulceration through the thickness of small bowel
C C. Small bowel obstruction (" D. Gastroenteritis

 
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A. Is having anterior wall ischemia B. Is having an anterior wall infarction C. Has a history of anterior wall NSTEMI D. Has a history of anterior wall STEMI

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Question 66 Mr. Thornton is a 55—year—old man who is having an outpatient cardiac workup for the evaluation
of exertional chest pain. He is not having chest pain now, but over the last several months he has
had episodes of intermittent chest tightness and shortness of breath with mild to moderate
exertion, such as when carrying heavy bags of groceries from the car to the house. His 12—lead
ECG today reveals Q waves that range from 2 to 3 mm wide and 3—4 mm deep in leads V1
through V5. There are no other abnormal findings. This suggests that Mr. Thornton: Page 19 of 31 www.0nlineNursingPagers.com

 
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Question 71 K. W. is a 50—year—old woman who presents for surgical resection of the liver for treatment of
metastatic colon cancer. Preoperatively, the surgeon tells her that he is planning to remove 50 to
75% of her liver. The patient is concerned that she will not be able to recover normal liver
function with that much removed. The AGACNP counsels her that: {7′ A. Such a high—volume resection is utilized only in people with markedly compromised
hepatic function r B. Major regeneration occurs within 10 days, and the process is complete by 5 weeks If“ C. Liver function will probably recover to 50% baseline, but that is enough for normal
function F D. Up to 95% of the liver can be removed without any apparent consequence to the

 
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QIIESLIIHI I.) S. R. is a 51-year-old male patient who is being evaluated for fatigue. Over the last few mon
he has noticed a marked decrease in activity tolerance. Physical examination reveals a variet
ecchymoses of unknown origin. The CBC is significant for a Hgb of 10.1 g/dL, an MCV of ‘
fL and a platelet count of 65,000pr; the remainder of the CBC is normal. Coagulation studi are normal, but bleeding time is prolonged. The AGACNP recognizes that initial manageme1
this patient will include: A. Avoidance of elective surgery and nonessential medications B. Prednisone 60 mg daily until platelets normal
C. Monoclonal antibody therapy such as rituximab o o o ‘3 D. Splenectomy

 
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