A 77-year-old patient with a significant history of COPD was admitted for a workup before an elective laparoscopic cholecystectomy who is exhibiting some mild lethargy. The nurse practitioner was asked for advice on perioperative management of the patient’s severe lung disease.  On room air, the patient’s ABG was as follows: pH: 7.31; PCO2: 76; PO2: 71; HCO3: 38: BE: 8.8. Based on these results, the AGACNP interprets the ABG as:

A victim of a household fire presents with headache, confusion, and severe lactic acidosis.  While in the ED, he has a witnessed seizure.  He is suspected of having cyanide poisoning.  Serum cyanide levels are collected and sent for analysis.  Empiric treatment is recommended to be started and optimal clinical management will include: 

A 58-year-old male presents with acute onset dyspnea and pleuritic chest pain. He has a heart rate of 110 bpm, no signs of DVT, no infectious symptoms, and no recent surgery or immobilization. He has a history of lung cancer currently under treatment. A traditional Wells Criteria score is calculated to be 5.5 for this patient.  The AGACNP knows this to mean: 

The nurse practitioner suspects severe tracheobronchial tree injury in a smoke inhalation patient with noncardiogenic pulmonary edema and respiratory failure who is recovering from the acute phase. The optimal management of this patient will include:

The Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) was called to the emergency department to evaluate a newly admitted victim of a household fire. The victim was a 23-year-old patient with second-degree facial burns and singed eyebrows and nasal hairs. The patient appeared obtunded and responsive only to painful stimuli. Upon examination, slight inspiratory stridor was discovered. The AGACNP should prioritize patient care by:

A 68-year-old male presents to the emergency department with a 3-day history of productive cough, fever, pleuritic chest pain, and shortness of breath. He has a history of hypertension and type 2 diabetes. On exam, he is febrile (38.9°C), tachypneic (RR 26), and has crackles in the right lower lung field. SpO2 monitoring reveals an oxygen saturation of 90% on room air.  Chest X-ray shows a right lower lobe infiltrate. What is the most appropriate next step in management?

A 55-year-old male presents to the clinic for routine follow-up of coronary artery disease and ischemic cardiomyopathy.  Interpret his EKG and include the specific site of his previous MI. Rate: Rhythm: Axis: Block: Infarction: Interpretation: Treatment: 

What is the first step in being an effective reader?

A 28-year-old patient is being evaluated by a respiratory therapist after a trauma. The patient is receiving VC ventilation with the following settings: . FIO2 0.65 Mandatory rate 14 VT 450 mL PEEP 8 cm H2O The therapist notes the following pressure-volume tracing:  The therapist should recommend decreasing the    

A 189-cm (6-ft 2-in), 92-kg (202-lb), 32-year-old male was injured in a motor vehicle crash. She is intubated at the scene with a 6.0-mm ID endotracheal tube. On arrival to the ED, PC, A/C ventilation is initiated, and the following data are noted: FIO2 0.40   PEEP 5 cm H2O Mandatory rate 12   PIP 40 cm H2O VT 525 mL   Pplat 22 cm H2O Inspiratory flow 55 L/min       The patient is exhibiting increased work of breathing, and is breathing dyssynchronously with the ventilator. A respiratory therapist should recommend