57. J.T. is a 57-year-old male status post MVA, currently post op day 7 and on high levels of positive pressure ventilation. He is now febrile with worsening leukocytosis. CXR shows increased bilateral diffuse opacifications, increased peak/plateau inspiratory pressures, and increased 02 requirements. This is related to which of the following and what is the most appropriate treatment?

27. A 70-year-old woman presents to your clinic for routine follow-up after an urgent care visit for an abscess on her buttock. After incision and drainage, she was prescribed clindamycin. Now, five days later, the surgical site is well appearing, but the patient has developed low-grade fevers, fatigue, and profuse, watery diarrhea about 12 times per day that is associated with sharp, crampy abdominal pain. Based on her history, you suspect C. difficile colitis. What is the first step in the treatment while awaiting culture results?

95. Which of the following is the correct order for highest to lowest priority of surrogate decision makers for an incompetent adult patient?

79. A patient who has been in the intensive care unit for 17 days develops hypernatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is intubated, and is receiving mechanical ventilation. The serum osmolality is 320 mOsm/L kg H2O. Clinical signs include tachycardia and hypotension. The adult-gerontology acute care nurse practitioner’s initial treatment 

100. A 39-year-old patient presents to the ED with a one-day history of right upper quadrant pain, nausea and one episode of vomiting. The pt has no prior medical history. A right upper quadrant ultrasound is indicative of cholecystitis.  Labs are the following WBC 11, Bun 40, Cre 1.1  ALT 189  AST 275.  The pt undergoes an ERCP.  Overnight the patient developed a low grade 100.9 and complains of increased epigastric pain that is now band like in nature. What is the most appropriate lab to obtain for this patient?

48. Chronic mesenteric ischemia is characterized by which of the following?

72. A patient with a history of atrial fibrillation, who has maintained normal sinus rhythm with sotalol (Betapace), is hospitalized for acute pyelonephritis. The most appropriate antibiotic regimen for this patient is intravenous:

75. A 74-year old male is brought into the emergency department with a chief complaint of substernal chest pressure for the past 30 minutes. This is associated with nausea and diaphoresis. He has a history of angina, which was previously relieved with nitroglycerin (NTG). His pain persists despite nitroglycerin. Physical exam reveals a heart rate of 80 bpm, respiration of 30 bpm, and BP of 104/60 mmg. The EKG demonstrates ST elevation in leads II, III, and aVF. Based on these symptoms and findings, the ACNP knows that which wall of the heart is affected.  

81. A 40-year-old female patient with no previous medical history is admitted with bilateral pulmonary emboli. The workup reveals a positive result for lupus anticoagulant, and anticoagulant therapy is planned. The patient verbalizes concern about her ability to manage the appointments and the follow-up care. The adult-gerontology acute care nurse practitioner’s most effective intervention is to:

2. Of the following, which specific changes will likely be seen on a CXR of an individual with severe COPD?