AGACNP - NU 665 Advanced Practice Specialty Procedures & Skills - Updated Final Exam Guide, Exams of Nursing

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NU 665

Advanced Practice

Specialty Procedures &

Skills

UPDATED FINAL EXAM GUIDE

1. Multiple Choice: Which of the following is a common indication for performing a thoracentesis procedure in acute care settings? a) Pneumonia b) Pulmonary embolism c) Pleural effusion d) Acute respiratory distress syndrome

Correct Answer: c) Pleural effusion

Rationale: Thoracentesis is commonly performed to drain fluid from the pleural space in patients with pleural effusion.

2. Fill-in-the-Blank: In the context of central venous catheter (CVC) insertion, the preferred site for access in adult patients is the ___________ vein.

Correct Answer: subclavian

Rationale: Subclavian vein access is preferred due to lower infection rates and reduced risk of thrombosis compared to jugular or femoral access.

3. True/False: Ultrasound guidance is recommended for the insertion of central venous catheters to improve accuracy and reduce complications.

Correct Answer: True

6. True/False: Arterial blood gas (ABG) sampling is commonly used in acute care to assess oxygenation, ventilation, and acid-base status.

Correct Answer: True

Rationale: ABG sampling provides valuable information about a patient's respiratory and metabolic status, helping guide treatment in acute care settings.

7. Multiple Choice: Which of the following conditions may require emergent pericardiocentesis in acute care practice? a) Atrial fibrillation b) Pericarditis with cardiac tamponade c) Myocardial infarction d) Valvular heart disease

Correct Answer: b) Pericarditis with cardiac tamponade

Rationale: Pericardiocentesis is indicated in patients with pericarditis causing cardiac tamponade, a life-threatening condition requiring urgent intervention.

8. Fill-in-the-Blank: In the context of advanced wound care procedures, negative pressure wound therapy (NPWT) promotes healing by creating a ___________ environment at the wound site.

Correct Answer: moist

Rationale: NPWT maintains a moist wound environment, enhances granulation tissue formation, and promotes wound healing through controlled suction.

9. True/False: In acute care settings, transesophageal echocardiography (TEE) is often used to assess cardiac function and detect structural abnormalities with higher resolution compared to transthoracic echocardiography.

Correct Answer: True

Rationale: TEE provides detailed images of cardiac structures with improved resolution and is valuable for assessing cardiac function and detecting pathology in acute care patients.

10. Multiple Choice: Which of the following imaging modalities is commonly used for the visualization of vascular structures in acute care settings? a) Magnetic resonance imaging (MRI) b) Computed tomography (CT) c) Ultrasound d) Positron emission tomography (PET)

Correct Answer: c) Ultrasound

Rationale: Ultrasound is frequently used for vascular imaging in acute care due to its real-time visualization capabilities and non-invasive nature.

Correct Answer: b) Pneumothorax

Rationale: Pneumothorax is a known complication of central line insertion due to inadvertent puncture of the pleura, leading to air entering the pleural space.

14. Fill-in-the-Blank: In advanced airway management, cricothyroidotomy is a surgical procedure performed to establish an emergency ___________ when conventional airway techniques are unsuccessful.

Correct Answer: airway

Rationale: Cricothyroidotomy provides a patent airway by creating a direct opening through the cricothyroid membrane in situations where conventional airway methods fail.

15. True/False: Intraosseous (IO) access is a rapid, alternative route for administering medications and fluids in critically ill patients when venous access is challenging.

Correct Answer: True

Rationale: IO access allows for rapid administration of fluids and medications directly into the bone marrow cavity, serving as an alternative route in patients with difficult venous access.

16. Multiple Choice: Which of the following is a primary diagnostic indicator for the initiation of mechanical ventilation in acute respiratory failure? a) PaO2/FiO2 ratio < 300 mmHg

b) Respiratory rate > 10 breaths per minute c) Oxygen saturation < 90% d) pH < 7.

Correct Answer: a) PaO2/FiO2 ratio < 300 mmHg

Rationale: A PaO2/FiO2 ratio < 300 mmHg indicates severe hypoxemia and is a key indicator for starting mechanical ventilation in patients with acute respiratory failure.

17. Fill-in-the-Blank: In the context of advanced hemodynamic monitoring, mean arterial pressure (MAP) is calculated by the formula MAP = ___________.

Correct Answer: (SBP + 2DBP) / 3

Rationale: MAP reflects the perfusion pressure in the arterial system and is calculated by adding twice the diastolic blood pressure to the systolic blood pressure, then dividing the sum by 3.

18. True/False: In acute care settings, transvenous pacemaker insertion may be indicated for patients with symptomatic bradycardia or heart block refractory to medical management.

Correct Answer: True

Rationale: Transvenous pacemaker insertion is used in acute care to provide temporary or permanent pacing for patients with hemodynamically unstable bradycardia or heart block.

Correct Answer: True

Rationale: Paracentesis is indicated for draining ascitic fluid in patients with liver disease, heart failure, or other conditions causing significant abdominal fluid accumulation.

22. Multiple Choice: Which of the following is a potential complication of peripherally inserted central catheter (PICC) placement in acute care practice? a) Atrial fibrillation b) Thrombophlebitis c) Hypocalcemia d) Hyperkalemia

Correct Answer: b) Thrombophlebitis

Rationale: Thrombophlebitis is a common complication of PICC placement, characterized by inflammation and thrombus formation in the vein where the catheter is inserted.

23. Fill-in-the-Blank: In the context of advanced pain management techniques, an epidural catheter is commonly used for the administration of ___________ medications in patients requiring prolonged analgesia.

Correct Answer: opioid

Rationale: Epidural catheters deliver opioids locally to provide effective pain relief for postoperative or chronic pain management in acute care settings.

24. True/False: In the management of acute decompensated heart failure, inotropic agents are typically used to improve cardiac contractility and output in patients with reduced ejection fraction.

Correct Answer: True

Rationale: Inotropic agents enhance myocardial contractility and cardiac output, often used in acute heart failure management to improve hemodynamics in patients with reduced ejection fraction.

25. Multiple Choice: Which of the following is a key consideration when performing a nasogastric tube (NGT) insertion in acute care settings? a) Confirming proper tube placement by auscultating for gurgling sounds b) Advancing the NGT quickly to minimize discomfort for the patient c) Securing the NGT with adhesive tape to the nose d) Checking gastric pH to verify tube placement in the stomach

Correct Answer: a) Confirming proper tube placement by auscultating for

gurgling sounds Rationale: Auscultating for gurgling sounds and checking pH are methods to confirm correct NGT placement in the stomach, ensuring safe and effective enteral feeding.

26. Fill-in-the-Blank: During an advanced cardiovascular assessment, the presence of a ___________ is indicative of aortic regurgitation.

29. Fill-in-the-Blank: In advanced neurological assessment, the Glasgow Coma Scale (GCS) evaluates a patient's level of consciousness based on ___________ assessments.

Correct Answer: verbal, motor, eye

Rationale: The GCS consists of three components – eye opening, verbal response, and motor response – used to assess a patient's level of consciousness and neurological function in acute care. Multiple Choice: Which of the following is a primary goal of acute care management? A) Preventive care B) Long-term rehabilitation C) Stabilization and treatment D) Palliative care

Correct Answer: C) Stabilization and treatment

Rationale: Acute care management focuses on stabilizing and providing treatment for patients with urgent medical needs. Fill-in-the-Blank: The acronym FAST is used to assess patients suspected of having a stroke.

Correct Answer: stroke

Rationale: FAST stands for Face, Arms, Speech, Time, and is a quick tool to assess potential stroke symptoms.

True/False: In acute care settings, advanced practitioners can independently diagnose and treat patients without physician oversight.

Correct Answer: False

Rationale: Advanced practitioners in acute care settings work collaboratively with physicians and adhere to established protocols and guidelines. Multiple Choice: Which of the following is a common indicator of sepsis in acute care patients? A) Hypertension B) Bradycardia C) Hypothermia D) Tachypnea

Correct Answer: D) Tachypnea

Rationale: Tachypnea (rapid breathing) is a common sign of sepsis in acute care patients. Fill-in-the-Blank: The acronym ABCDE is used in acute care to prioritize patient assessment.

Correct Answer: assessment

Correct Answer: increase

Rationale: Vasopressors are used to increase blood pressure in patients with hypotension. True/False: In acute care, the RACE acronym is used to remember the steps in performing cardiopulmonary resuscitation.

Correct Answer: False

Rationale: The RACE acronym is commonly used in fire safety (Rescue, Alarm, Contain, Extinguish), not for CPR. Multiple Choice: Which of the following is a key principle of wound care management in acute care? A) Delayed debridement B) Infection promotion C) Moist wound healing D) Air exposure

Correct Answer: C) Moist wound healing

Rationale: Moist wound healing is a key principle in wound care to promote healing and prevent infection.