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Question 73
Kelly is a 50- year-old female who had chest radiography as part of a preoperative*
history and physical examination before an elective cosmetic procedure . She has no
significant medical history and takes no daily medications except hormone therapy for
menopausal symptoms . The radiology report of her chest film includes a 4 – mm coin
lesion in the right middle lobe . Kelly reports her health as excellent and has no clear risk
factors for malignancy . The AGACNP knows that the next step in her management
should be :
A. Repeat radiography in 6 months
B . CT scan of the chest
C . Needle biopsy of the
lesion
D. A pulmonologueconsult

 
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Question 39 Mrs. Brownlee is a 63-year-old female who is admitted for surgical replacement of her
aortic valve. She has a history of symptomatic aortic stenosisr osteoarthritis, and
hypothyroidism. She has always been very thin, and her admitting height and weight
are 5’4" and 110 lbs. In considering her postoperative nutritional needs, the AGACNP
recognizes that: A. Postoperative calorie requirements are higher than baseline because of the
hypermetabolic response to physiologic stress B. The parasympathetic response
to thoracic surgery requires a proportionally greater increase in protein calories C. Calorie requirements will not change postoperatively, as the increased stress
response is balanced by bedrest and decreased activity calorie use. D.Nutritional requirements are individualized postoperatively, and it is not possible to
predict postoperative needs in

 
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stop by once or twice a week and help her with some household chores . Mrs .
Knickerson’s only medical diagnosis is hypertension , for which she has taken HCTZ 12. 5
my for as long as she can remember . Today when her son went into the home , he found
her in bed , clearly unwell and a bit disoriented . Upon hospital admission , she is found to
have vital signs as follows : temperature 100. 9 OF, pulse 122 6pm , respirations 22
breaths per minute , and blood pressure 82/53 mm Hy . Her SQ02 on 2 L Of nasal oxygen
is 89%/0 . Chest radiograph is clear , and 12- lead ECG demonstrates sinus tachycardia .
Urinalysis reveals + + + white blood cells , + nitrites , + red blood cells , and + +
bacteriumia . The AGACNP suspects which of the following shock states ?
A. Hypovolemic
B. Cardiogenic
C. Obstructive*
D. Neurogenic

 
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When writing the initial postoperative progress note,

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When writing the initial postoperative progress note, the AGACNP should be sure

to include all of the following except:

A.A summary of the procedure and any significant deviations from normal                                         B. An outline of the plan for postoperative management and follow-up                                               C. The plan for ongoing monitoring                        D.Mechanism of DVT prophylaxis

 
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