An attending physician and an adult-gerontology acute care nurse practitioner (AGACNP) are discussing the plan of care for a patient with acute kidney injury who needs an imaging study with intravenous contrast. The attending physician would like to proceed with the imaging study, however, the AGACNP prefers to wait until the patient’s acute kidney injury resolves. Which of the following actions by the AGACNP demonstrates proper conflict resolution? The AGACNP should discuss the risk versus benefit of ordering the imaging study with contrast with the attending physician in order to reach a consensus The AGACNP should include the patient and ask which option they are amenable to The AGACNP should order the imaging with contrast and ensure the patient receives pretreatment with intravenous fluids prior to and after the scan The AGACNP should wait until the acute kidney injury has resolved and kidney function is at the patient’s baseline

The following are adverse effects of muscle relaxants EXCEPT: Dizziness Increased fracture risk Sedation Hypertension 2. What is common side effect of gabapentin (Neurontin)? Fatigue or sedation Neuropathic pain Weight loss Muscle spasms 3. The following are common side effect of diuretic use EXCEPT: Orthostatic hypotension Dehydration Headache Blunted heart rate 4. A 75-year-old patient reports they are getting a cold and asks you about the best medication to take. Which is the LEAST appropriate response? Review their current medications before recommending an OTC treatment. Tell the patient you cannot make recommendations regarding medications. Tell the patient to talk to their pharmacist or healthcare provider. Educate them that OTC medications can cause medication interactions and adverse effects. 5. Which of the following medications is a beta blocker? Thiazide Verapamil Atenolol Digoxin

All the following statements related to LAs’ CNS toxicity are correct EXCEPT which one? A. The excitatory CNS effects of LAs are characterized by lightheadedness, restlessness, anxiety, apprehension, euphoria, confusion, dizziness, tinnitus, blurred or double vision, twitching, tremors, and rarely convulsions. B. The excitatory manifestations of LAs’ CNS toxicity are prolonged. C. CNS depressant effects of LAs include drowsiness progressing to unconsciousness, respiratory depression, and finally, respiratory arrest. D. LAs’ CNS toxicity may include nausea, vomiting, chills, and miosis.

A 36-year-old male presents to your office being prescribed by his primary care physician (PCP) for the past 3 years an opioid analgesic medication for a work accident. He has chronic pain and is attending a pain clinic. It is determined the best course of treatment for pain is to remain on opioid medication. The patient is also being prescribed clonazepam 1mg BID for “relaxation” and panic attacks.

A 50-year-old white female presents to the emergency room with complaints of increased chest congestion with purulent sputum production for the last 3 days. The patient reports she has had some increased dyspnea and is using her albuterol inhaler which isn’t helping her symptoms. The patient reports a history of tobacco use for last 10 years and a history of COPD which was diagnosed last year.

The patient reports that her primary care provider ordered another medication for the COPD but she couldn’t afford it. The patient denies fever. The patient’s vital signs: BP 148/90, pulse 108, respirations 22, 02 sat 92%, and temp 98.1F. Chest x-ray reveals hyperinflation with flattened diaphragm but is without effusions or infiltrates. In your Case Study Analysis related to the scenario provided, explain the following • The pulmonary pathophysiologic processes that result in the patient presenting these symptoms. • Any racial/ethnic variables that may impact physiological functioning. • How these processes interact to affect the patient