Mrs. Bowers is a 41-year-old patient who requires surgical management

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Mrs. Bowers is a 41-year-old patient who requires surgical management of

osteomyelitis. She has a long history of methamphetamine use and has a BMI of 17.9 kg/m2 . She clearly is nutritionally depleted and volume contracted, but she has no clear chronic medical history except for unmedicated hypertension, which may be due to her chronic stimulant use. She denies alcohol use but admits to a 1½ pack a day cigarette habit. A primary postoperative concern for Mrs. Bowers is:

A.Excess bleeding     B. Thromboemboli development     C. Poor wound healing      D.Renal failure

 
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The congenital diaphragmatic hernia that occurs more often in women

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The congenital diaphragmatic hernia that occurs more often in women and does

not usually produce symptoms until midlife is known as:

A.Zenker’s hernia     B. Bochdalek’s hernia     C. Morgagni’s hernia     D.Atraumatic hernia

 
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V. is a 37-year-old female who is admitted via the emergency room

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V. is a 37-year-old female who is admitted via the emergency room after her

roommate called emergency medical services (EMS). She has no significant medical history and does not know what is wrong with her. She has been feeling generally unwell for the last few days, and today she had an episode of confusion that scared her roommate to the extent that the roommate called EMS. Her physical examination reveals a temperature of 101.9°F, pulse of 110 bpm, respiratory rate of 20 breaths per minute, and blood pressure of 92/58 mm Hg. A comprehensive metabolic panel reveals a slightly elevated blood urea nitrogen (BUN)/creatinine but otherwise is normal. A white blood cell differential reveals a leukocyte count of 14,000 cells/µL with neutrophils of 83%. The AGACNP knows that these values are consistent with:

A. Systemic inflammatory response syndrome (SIRS)

B. High-output septic shock

C. Neurogenic shock

D.Multiple organ dysfunction syndrome (MODS)

 
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B. is a 41-year-old male being admitted for surgical reduction of an open femur

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B. is a 41-year-old male being admitted for surgical reduction of an open femur

fracture sustained in a multiple vehicle collision. Preoperative assessment reveals that he is on beta-adrenergic antagonists after having been diagnosed with coronary artery disease approximately 1 month ago. He admits that he feels a little better but says he still gets pain in his chest when he exerts himself. He is pain free now. Vital signs are as follows: temperature 98.1°F, pulse 88 bpm, respiratory rate 18 breaths per minute, and blood pressure 142/86 mm Hg. The AGACNP knows that which of the following is the most important action before R. B. goes to the operating room?

A.A cardiology consultation

B. Blood pressure control

C. Resuming beta-adrenergic antagonists

D. Pain control

 
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