Mr. Starwood is a 61 year old male who was admitted last night for the management

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1)     Mr. Starwood is a 61 year old male who was admitted last night for the management of acute

pancreatitis. He was admitted N.P.O. and started on IV fluids and opiate pain management. This morning he reports significantly better. His C-reactive protein this am is 5 mg/dL, amylase and lipase are both just over 2 x upper limits of normal, and his ransom score is 2. The AGACNP knows that the next step in his care is to

a)     Order an ERCP

b)     Order an abdominal CT

c)      Begin clear liquids as tolerated

d)     Continue the current management for 24 hours

 
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A patient with peptic ulcer disease is admitted to the hospital with significant upper abdominal

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1)     A patient with peptic ulcer disease is admitted to the hospital with significant upper abdominal

discomfort. She has guarding and rebound tenderness on examination. Abdominal radiography demonstrates free air in the abdomen. The AGACNP knows that the immediate priority is to

A)    Obtain a stat surgical consult

B)     Begin an IV proton pump inhibitor

C)     Order and abdominal CT scan

D)    Obtain a stat gastroenterology consult

 
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A 36 year old female presents for evaluation of wheeze while exercising.

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)     A 36 year old female presents for evaluation of wheeze while exercising. She has no significant

medical history and has always been very healthy. During review of systems she does admit to a general decrease in energy. Lately, but nothing specific. Her cardiopulmonary exam is within normal limits and lungs are clear. Vital signs are: Temperature 97.4o F, Pulse 66 bpm. Respiratory rate is 16 bpm. And blood pressure is 88/56 mm Hg. Office spirometry demonstrates normal airflows and volumes. A basic metabolic panel is as follows: Na + 130 mEq/L, Cl-100 mEq/L, CO2 25 mEq/L, glucose is 74 mg/L, BUN 15 mg/dL and creatinine 0.08 mg/dL. The AGACNP considers which of the following potential etiologies?

A)    Hypercotisolism

B)     Hypothyroidism

C)     Hypoadrenalism

D)    Hyperpituitarism

 
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 Mrs.Woodson is a 71 year old female with a long history of hypertensive heart disease.

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)     Mrs.Woodson is a 71 year old female with a long history of hypertensive heart disease. She has been

admitted for an evaluation of increasing fatigue and activity intolerance. She had a near syncopal episode today while walking stairs. Her vital signs reveal a blood pressure of 138/90 mmHg, Pulse of 100 bpm and bounding, respirations of 20 bpm. And her temperature is normal. She has jugular vein distention and + pitting bilateral lower extremity edema to the mid-calf. The AGACNP knows that initial diagnostic testing should include

A)    Chest CT

B)     Blood cultures

C)     A B-type natriuretic peptide

D)    Bilateral lower extremity dopplers

 
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