Author: Anonymous

A 68-year-old man with hospital-acquired pneumonia is started on meropenem. Which of the following best explains why carbapenems are generally reserved for severe infections?

A 72-year-old woman with advanced chronic kidney disease is admitted for evaluation of altered mental status. Her laboratory results reveal a total serum calcium of 8.2 mg/dL (reference range: 8.5–10.5 mg/dL), albumin of 2.0 g/dL (reference range: 3.5–5.0 g/dL), and ionized calcium of 1.10 mmol/L (reference range: 1.20–1.40 mmol/L). Which of the following statements best describes the physiological significance of her calcium results?

The AGACNP is evaluating a patient in the ED with chronic low back pain and considering additional pharmacologic treatment prior to discharge. Balancing control of a patient’s chronic pain with prevention of potential opioid overdose is important. Which of the following is true? 

Which parameter is the best indicator of adequate tissue perfusion in a shock patient? 

A 78-year-old woman is admitted for acute heart failure exacerbation. Over the past 48 hours, her weight has increased by 2.5 kg. On examination, she has elevated jugular venous pressure, bilateral lower extremity pitting edema, and rales at the lung bases. Her vital signs are: BP 110/70 mm Hg, HR 98 bpm, RR 22/min, SpO₂ 94% on room air. Urine output has decreased to 0.4 mL/kg/hr. Which of the following findings is the most specific clinical indicator of fluid overload in this patient?

A 64-year-old man with diabetes and chronic kidney disease is brought to the ED with confusion and Kussmaul respirations. He has been on metformin therapy. Vitals: BP 88/54, HR 118, RR 28, SpO₂ 95% on room air. Labs: Na 138 mEq/L, K 5.5 mEq/L, Cl 102 mEq/L, HCO₃ 12 mEq/L, BUN 48 mg/dL, Cr 3.2 mg/dL. Arterial blood gas: pH 7.21, PaCO₂ 25 mmHg. Lactate is 8 mmol/L.Which of the following is the most likely underlying cause of his metabolic acidosis?

A 65-year-old man with sepsis is started on broad-spectrum antibiotics (vancomycin and piperacillin-tazobactam). Cultures later grow methicillin-sensitive Staphylococcus aureus (MSSA). Which of the following is the most appropriate next step?

A patient presents with muscle cramps, perioral numbness, and a positive Trousseau sign. Another patient presents with polyuria, constipation, and confusion. Which of the following laboratory and clinical findings best differentiates hypocalcemia from hypercalcemia, and what is the most appropriate initial diagnostic evaluation for each?

During bouts of joint attention, what should adults do to supports children’s language learning? (2 points)

A 30-year-old woman presents with high fever, hypotension, diffuse erythematous rash, and multisystem involvement including renal and hepatic dysfunction. She recently had prolonged tampon use. Blood cultures are pending. Which of the following is the most appropriate initial management?