Emergency and Urgent Care Flashcards
6 cards from real AANP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Emergency and Urgent Care flashcards as text
A patient with an open femur fracture and blood pressure of 80/50 mmHg after trauma needs fluid resuscitation. What principle guides initial fluid management?
Answer: Permissive hypotension with 1:1:1 blood product transfusion
Damage control resuscitation for hemorrhagic shock uses permissive hypotension (MAP 50–65 mmHg) and balanced blood products (pRBC:FFP:platelets in 1:1:1 ratio) to prevent dilutional coagulopathy.
A patient presents with a deep laceration requiring irrigation. What is the recommended method to reduce infection risk?
Answer: High-pressure irrigation with normal saline
High-pressure saline irrigation (using a 35 mL syringe with an 18-gauge catheter) mechanically removes bacteria and debris, significantly reducing wound infection rates.
Which acid-base disturbance is most consistent with a patient who has been vomiting profusely for several days?
Answer: Metabolic alkalosis with elevated bicarbonate and low chloride
Persistent vomiting causes loss of hydrochloric acid from the stomach, resulting in metabolic alkalosis with elevated bicarbonate, hypokalemia, and hypochloremia.
A patient presents with bilateral lower extremity edema, elevated JVP, and crackles at lung bases. What is the most likely diagnosis?
Answer: Decompensated congestive heart failure
The triad of bilateral peripheral edema, elevated JVP, and pulmonary crackles is classic for fluid overload from decompensated congestive heart failure.
A patient bitten by a dog requires wound care. Under which circumstance is rabies post-exposure prophylaxis (PEP) NOT necessary?
Answer: The dog is healthy, vaccinated, and available for observation
If the biting dog is healthy, appropriately vaccinated, and can be observed for 10 days with no signs of rabies, PEP is not needed but should be initiated if signs develop.
A patient presents with acute urinary retention. After placement of a Foley catheter, which complication should the NP monitor for?
Answer: Post-obstructive diuresis with electrolyte imbalances
Rapid decompression of a chronically obstructed bladder can cause post-obstructive diuresis with large urine output, leading to dehydration and electrolyte disturbances requiring careful monitoring.