AANP Emergency and Urgent Care 2

Question 1

A patient with type 1 diabetes presents with Kussmaul respirations, fruity breath, nausea, and blood glucose of 480 mg/dL. What is the most likely diagnosis?

Accepted Answer

Diabetic ketoacidosis (DKA)

Answer

DKA presents with hyperglycemia, Kussmaul breathing (compensating for metabolic acidosis), fruity breath from ketones, and is more common in type 1 diabetes.

Question 2

Which analgesic is contraindicated in a patient with known G6PD deficiency presenting with pain?

Accepted Answer

Aspirin in high doses causing oxidative hemolysis

Answer

High-dose aspirin can cause oxidative hemolysis in G6PD-deficient patients because it increases oxidative stress that G6PD normally protects against; acetaminophen is generally safe.

Question 3

A patient with a bee sting develops urticaria, throat tightness, and hypotension. What is the first-line treatment?

Accepted Answer

Epinephrine 0.3 mg IM in the anterolateral thigh

Answer

IM epinephrine is the life-saving first-line treatment for anaphylaxis; it reverses bronchoconstriction and vasodilation and prevents progression to cardiovascular collapse.

Question 4

In a patient with suspected sepsis, what intervention should be initiated within the first hour per Surviving Sepsis guidelines?

Accepted Answer

Broad-spectrum antibiotics and 30 mL/kg IV crystalloid

Answer

The 1-hour sepsis bundle includes blood cultures, broad-spectrum antibiotics, and 30 mL/kg IV crystalloid for hypotension or lactate ≥4, with reassessment for vasopressors.

Question 5

A patient presents with confusion, fever, neck stiffness, and photophobia. Lumbar puncture is planned. Which action should precede the LP?

Accepted Answer

Obtain CT head to rule out mass effect if indicated, and do not delay antibiotics

Answer

If bacterial meningitis is suspected, antibiotics must NOT be delayed for LP or CT; CT is obtained first only if there is concern for increased ICP (focal deficits, papilledema), and antibiotics should be started immediately.

AANP - American Association of Nurse Practitioners Practice Test

AANP - American Association of Nurse Practitioners Practice Test

AANP Emergency and Urgent Care 2