AANP Emergency and Urgent Care 4

Question 1

A 62-year-old presents with sudden severe eye pain, blurred vision, halos around lights, nausea, and a mid-dilated nonreactive pupil. What is the most appropriate immediate action?

Accepted Answer

Start IOP-lowering therapy and obtain emergent ophthalmology referral

Answer

Acute angle-closure glaucoma is a sight-threatening emergency requiring IOP-lowering agents (e.g., topical beta-blocker, acetazolamide) and emergent ophthalmology care.

Question 2

A patient develops hives, wheezing, and hypotension minutes after a bee sting. Which is the first-line treatment?

Accepted Answer

Intramuscular epinephrine 0.3–0.5 mg in the anterolateral thigh

Answer

IM epinephrine in the anterolateral thigh is the first-line, time-critical treatment for anaphylaxis, with antihistamines and steroids only adjunctive.

Question 3

According to the Ottawa ankle rules, which finding indicates the need for an ankle radiograph?

Accepted Answer

Inability to bear weight for four steps both immediately and in the clinic

Answer

Inability to bear weight for four steps, or bony tenderness at the malleolar zone, indicates the need for imaging under the Ottawa rules.

Question 4

A trauma patient has absent breath sounds on the right, distended neck veins, tracheal deviation, and hypotension. What is the immediate intervention?

Accepted Answer

Needle decompression of the affected hemithorax

Answer

Tension pneumothorax is a clinical diagnosis requiring immediate needle or finger decompression without waiting for imaging.

Question 5

A 70-kg adult has 20% TBSA second- and third-degree burns. Using the Parkland formula, how much fluid should be given in the first 8 hours?

Accepted Answer

2,800 mL

Answer

Parkland is 4 mL × 70 kg × 20 = 5,600 mL over 24 hours, with half (2,800 mL) given in the first 8 hours from time of burn.

AANP - American Association of Nurse Practitioners Practice Test

AANP - American Association of Nurse Practitioners Practice Test

AANP Emergency and Urgent Care 4