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? 

33. You are caring for a patient who is immediately postoperative from a total thyroidectomy in the setting of hyperthyroidism. Several hours following surgery, the patient develops numbness and paresthesias in the hands, feet, and circumoral. Which of the following laboratory tests is most appropriate to order to evaluate the etiology of these symptoms?

28. Which of the following pathologies is associated with central diabetes insipidus?

36. Which tracheal abnormality is present in the chest X-ray ABOVE?