A 35 year old male with known anxiety, depression, and poly-substance abuse presents to the emergency department after a friend found him on his cough and could barely wake him up. He reports he found vomit down the side of the couch.    Vitals: Pulse 75, BP 98/52, RR 35, O2 94% on 2L NC, Temp 99.9F   Labs: WBC 11K, H&H 17.9 & 41.2, Plt 179K. Na+ 132, K+ 2.9, glucose 71, anion gap 22, BUN 23, Cr 1.2, Mg+ 1.2.  Serum drug screen: + THC and tricyclic antidepressants acetaminophen:

When using an interpreter to discuss a poor prognosis with a patient, the matter and manner of the issue is whose responsibility? 

A 29 year old male presents to the emergency department with his significant other who complains that the patient “isn’t acting right”. On triage exam, the registered nurse notes rapid deep breathing, mild lethargy, and reports the patient appears inebriated.  Vital signs: Pulse 135, BP 101/54, RR 38, O2 95% on room air, Temp 99.1F The triage nurse categorizes the patient as a level 2 and moves the patient to an exam room.  The AGACNP interviews and examines the patient. The patient and significant other deny any major medical problems. He reports he smokes cigarettes though he denies alcohol consumption or drug use. He works as a mechanic at an auto body shop.  Chest x-ray: no acute findings Labs: WBC 6K, H&H 17.6 & 42.3, Plt 456K. Na+ 136, K+ 3.9, glucose 87, BUN 29, Cr 2.5, Mg+ 1.7. Lactic acid 5.5. Procalcitonin 0.5.  ABG: pH 7.22, CO2 18, O2 80, HCO3 8 Drug screen: negative except for THC The AGACNP then interviews the patient and significant other again and asks more about psychiatric history. The significant other states they have “an on-and-off relationship” and recently broke up again. The significant other had gone to the patient’s home to retrieve some belongings when the patient was not acting normally.  What substance or substances should the AGACNP ask, and possibly assume, if the patient consumed? 

True or false. Acute grief typically requires pharmaceutical treatment. 

A 23 year old male with known schizophrenia is brought to the crisis stabilization unit by his parents who complain “he is having one of his episodes again”. Vitals signs and lab work is stable. The patient is admitted to the unit. It is 2am and the AGACNP is covering the needs of the crisis stabilization unit until the psychiatric team returns at 7am.    What is the most appropriate regimen to stabilize this patient? 

Sodium bicarbonate bolus followed by continuous infusion is indicated for which type of overdose? 

Polypharmacy is defined as the prescription of ____ or more simultaneous drugs.    Fill in the blank 

Which type of dementia may be reversible or progression slowed? 

Match the serum chemical concentrated with its associated toxicity level. 

Which of the following are direct oral factor Xa inhibitors (DOACs)? Select all that apply.