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Question 66
While on call, the AGACNP is asked to evaluate a deteriorating patient. The patient was
admitted for exacerbation of pneumonia and congestive heart failure (CHF). The systolic
blood pressure is < 90 mm Hg, and the urine output is < 10 mL/hr. A 12-lead ECG
reveals no acute processes but reveals previously noted changes that are consistent
with bilateral atrial and ventricular enlargement and a marked left axis deviation. You
insert a pulmonary artery (PA) line and anticipate which of the following pressures? (CI,
cardiac index; PAOP, pulmonary artery occlusion pressure ; RAP, right atrial pressure)
A.CI 1.3 L/min, PAOP 27 mm Hg, RAP 18 mm Hg
B. CI 1.9 L/min, PAOP 12 mm Hg, RAP
6 mm Hg C. CI 2.4 L/min, PAOP 18 mm Hg, RAP 8 mm Hg
D.CI 1.4 L/min, PAOP 7 mm
Hg, RAP 4 mm Hg

 
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Question 61 S. is a 46-year-old female with metastatic breast cancer. She is currently off cycle for
chemotherapy and generally is feeling well. Today, however, she presents feeling
acutely unwell. She says that she has had coldlike symptoms over the last few days,
including cough, nasal congestion, headache, and a hoarse voice in the mornings. Today
she became acutely concerned because she feels as though her face and even
shoulders look swollen and a bit discolored—bluish. She denies any nausea or vomiting
but admits to feeling generally fatigued; she attribute it to her cancer. Recognizing the
likely diagnosis, the AGACNP knows that treatment will likely include: A.Radiation B. Surgery C. Fibrinolytics D. Expansile stents

 
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Question 63 Heart transplant is the surgical option for patients with congestive heart failure for
whom medical therapies have failed. All of the following are contraindications to transplant except: A.New York Heart Association (NYHA) class IV status B. Obesity C. Elevated
pulmonary vascular resistance D.Recent malignancy

 
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Question 65
K. is a 39-year-old female who was admitted for evaluation of progressive activity
intolerance, and chest radiography revealed a large right lower lobe pleural effusion. A
pleural fluid tap was performed, but fluid analysis results were inconclusive and the
cause of the effusion could not be identified. The AGACNP knows that which diagnostic
inadequate?
study is most appropriate to identify the cause of pleural effusion when fluid analysis is
A. Scalene biopsy
B. Video-assisted thoracoscopic surgery (VATS)
C. Pleural
needle biopsy D.Open surgical biopsy

 
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