Mr. Comstock is a 71-year-old male who presents with a general sense of feeling

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Mr. Comstock is a 71-year-old male who presents with a general sense of feeling

weak and unwell; he thinks he has the flu even though he received a flu vaccination this year. He describes a vague collection of symptoms, including weakness, nausea, dizziness, and “getting out of breath” very easily. He says he can barely climb the steps anymore without stopping to rest. Of the possible differential diagnoses, coronary artery disease (CAD) is high among the probabilities because of his age and gender. His physical examination is unremarkable except that he appears weak. His vital signs are as follows: temperature 98.0°F, pulse 100 bpm, respiratory rate 16 b.p.m., and BP 178/100 mm Hg. A chest radiograph is within normal limits with no acute pulmonary infection. A 12-lead ECG reveals inverted T waves in leads V1 to V5. The AGACNP is suspicious that most of his symptoms are:

A. Psychosomatic     B. Early congestive heart failure (CHF)      C. Anginal equivalents             D.Normal age-related changes

 
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Mrs. Carpenter is a 59-year-old female who presents with an acute myocardial

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Mrs. Carpenter is a 59-year-old female who presents with an acute myocardial

infarction. She is acutely short of breath and has coarse rales on auscultation. Physical examination reveals a grade V/VI systolic murmur, loudest at the point of maximal impulse with radiation to the midaxillary line. The AGACP recognizes:

A. Acute mitral valve regurgitation     B. Acute aortic valve regurgitation                                              C. Acute cardiac tamponade     D. Acute pulmonary embolus

 
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Mrs. McCallum is a 48-year-old female who presents for evaluation of a vague

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Mrs. McCallum is a 48-year-old female who presents for evaluation of a vague

set of gastrointestinal symptoms. She feels generally well and has always been healthy, but lately she has had a lot of heartburn and a sense of reflux in her throat. Most recently she has had a recurring sense of food getting stuck in her throat. The AGACNP knows that which diagnostic study should be performed first?

A.Barium swallow     B. Upper endoscopy     C. Esophageal manometry                                  D.Ambulatory pH monitoring

 
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Mr. Key is a 53-year-old male patient who developed empyema following a serious

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Mr. Key is a 53-year-old male patient who developed empyema following a serious

bout of bacterial pneumonia. He presented as septic and was started immediately on intravenous antibiotics and drainage of the sinus cavity. Forty-eight hours later, he is much improved clinically and drainage has receded. The next step in his care would be:

A.A CT scan      B. Eloesser’s procedure     C. Decortication     D.Reexpansion

 
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