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[General] Free PDF Quiz Nursing - Trustable Best ACNS Preparation Materials

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【General】 Free PDF Quiz Nursing - Trustable Best ACNS Preparation Materials

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Nursing ANCC Adult Health Clinical Nurse Specialist Certification (ACNS) Sample Questions (Q28-Q33):NEW QUESTION # 28
The Scope of Practice for the CNS is an important concept of the professional role. Which of the following is NOT true regarding it?
  • A. The Scope of practice of pediatric nurse practiitoners (PCNS) is the same as that for gerontological nurse practitiioner (GCNS).
  • B. Broad variation exists from state to state concerning the Scope of CNS Practice.
  • C. Many organizations have completed role delineation studies which attempt to qualify the core behaviors that all advanced practice nurses must possess.
  • D. General scope of practice is specified in many published professional documents like the Scope and Standards of Advanced Practice Registered  Nursing, 1996.
Answer: A
Explanation:
The Scope of Practice for Clinical Nurse Specialists (CNS) is a critical aspect of their professional role, outlining the parameters within which they are authorized to practice. It defines the duties and responsibilities that a CNS is competent to perform, which are based on their education, training, and certification.
Many organizations have completed role delineation studies, which are designed to identify the core competencies necessary for all advanced practice nurses, including CNSs. These studies help ensure that CNSs across various specialties are equipped with a foundational set of skills and knowledge pertinent to advanced nursing practice. However, while role delineation studies establish core behaviors, they do not homogenize the scope of practice across all specialties.
The statement that the Scope of Practice for pediatric Clinical Nurse Specialists (PCNS) is the same as that for gerontological Clinical Nurse Specialists (GCNS) is incorrect. This highlights a fundamental misunderstanding of how specialty areas within nursing influence the scope of practice. Pediatric and gerontological CNSs, while sharing some core skills and knowledge, have distinct areas of expertise and cater to very different populations with unique health needs. PCNSs focus on child health, development, and diseases specific to children and adolescents, whereas GCNSs specialize in the care of elderly populations, addressing complex chronic conditions, geriatric syndromes, and the nuances of aging.
General scope of practice guidelines are often outlined in professional documents like the Scope and Standards of Advanced Practice Registered Nursing. These documents provide a framework but are adapted to the specific requirements and regulations of each state and specialty. This means that the scope of practice can vary significantly, not just between specialties like pediatric and gerontological nursing but also from state to state based on local laws and regulations.
Therefore, it is imperative to recognize the specialized nature of each nursing practice area. Asserting that the scope of practice for different CNS specialties is the same overlooks the specialized training and tailored approaches necessary to address the distinct health concerns of different patient populations effectively. Each specialty area within CNS practice is detailed with specific competencies that align with the needs of the patient demographics they serve. Understanding and respecting these distinctions is crucial for maintaining the integrity and effectiveness of the nursing profession.

NEW QUESTION # 29
A 38 year obese female patient has Type II diabetes and Stage I hypertension. What is the recommended goal for her LDL level?
  • A. <130 mg/dL.
  • B. <100 mg/dL.
  • C. <110 mg/dL.
  • D. >40 mg/dL.
Answer: B
Explanation:
The question pertains to the appropriate goal for low-density lipoprotein (LDL) cholesterol in a 38-year-old obese female with Type II diabetes and Stage I hypertension. Managing LDL cholesterol is crucial in patients with multiple cardiovascular risk factors to prevent complications such as heart disease and stroke.
Patients with diabetes are at a higher risk of cardiovascular diseases, akin to the risk faced by individuals who have already experienced a heart attack. This elevated risk is further compounded by other factors such as obesity and hypertension. Thus, more aggressive management of lipid levels, particularly LDL cholesterol, is warranted.
According to current guidelines, for individuals with diabetes and additional cardiovascular risk factors, the recommended LDL cholesterol level should be less than 100 mg/dL. This target is set to minimize the risk of atherosclerotic events, which can lead to severe cardiovascular complications. Achieving lower LDL levels is associated with a significant reduction in the risk of heart attacks, strokes, and coronary artery disease.
Therefore, for a patient like the one described, who not only has diabetes but is also hypertensive and obese, maintaining an LDL cholesterol level below 100 mg/dL is crucial. This goal is part of a broader strategy aimed at comprehensive cardiovascular risk reduction, which includes managing blood sugar levels, blood pressure, and body weight, alongside improving lipid profiles.
In conclusion, the correct answer to the question of the recommended LDL level for this patient is <100 mg/dL. This target is consistent with the guidelines aiming to provide maximum protection against cardiovascular diseases in high-risk individuals such as those with diabetes and hypertension.

NEW QUESTION # 30
When counseling a patient on side effects of her medication, a question comes up. What is the best way to manage and alleviate a common side effect of trazodone?
  • A. Take this medication at bedtime.
  • B. Eat more fiber while on this medication.
  • C. Take this medication in the morning
  • D. Drink a big glass of water with each dose.
Answer: A
Explanation:
Trazodone is a medication primarily used to treat depression, but it is also commonly prescribed off-label to manage insomnia due to its sedative effects. One of the most common side effects of trazodone is drowsiness or sedation. To effectively manage this side effect, it is recommended that trazodone be taken at bedtime.
By taking trazodone at bedtime, patients can utilize the drowsiness it induces to help them fall asleep, which can be particularly beneficial for those with sleeping difficulties. This timing aligns the peak period of the medication's sedative effects with the patient's sleep schedule, thereby not only maximizing the therapeutic benefit for sleep disturbances but also minimizing the impact of drowsiness on daytime activities and overall quality of life.
Other common side effects of trazodone, such as dizziness or lightheadedness, are also better managed when the medication is taken at night, allowing the patient to sleep through these potentially uncomfortable experiences. Furthermore, taking trazodone with food can help reduce gastrointestinal side effects like nausea or stomach upset, though this is separate from the timing related to its sedative effects.
It is important for healthcare providers to counsel patients on the correct timing of trazodone administration and to tailor this advice based on individual patient needs and lifestyle. For instance, patients who work night shifts or have irregular sleeping patterns might require specific guidance on how to best use trazodone to align with their unique schedules.
In summary, the optimal management of trazodone's side effect of drowsiness is to take the medication at bedtime. This approach not only helps to mitigate the impact of sedation during waking hours but also aids in improving the quality of sleep, thereby enhancing overall treatment outcomes for conditions like insomnia and depression.

NEW QUESTION # 31
You are seeing a young adult female who comes to the clinic and tells you she was raped late last night by her date. The immediate action taken by the CNS is:
  • A. Send her immediately for counseling to help her deal with this situation.
  • B. Perfom a pelvic examination to determine her injuries.
  • C. Accompany her to the emergency department for an exam.
  • D. Call her family so they can be with her.
Answer: C
Explanation:
When a young adult female reports that she was raped, the immediate and appropriate action for the Clinical Nurse Specialist (CNS) is to accompany her to the emergency department for a comprehensive examination. The emergency department is equipped with personnel who are specifically trained in conducting forensic examinations, which are crucial in these situations. These professionals have the expertise to meticulously collect and preserve evidence that is essential for legal proceedings, should the victim choose to pursue them.
Performing the examination in an emergency setting rather than a regular office or clinic is vital because it ensures that the evidence needed for a legal case, should the victim decide to press charges, is collected according to the required legal standards. This includes the collection of physical evidence, documentation of injuries, and possibly the administration of prophylactic treatments for sexually transmitted infections and emergency contraception.
Moreover, the CNS should ensure that the patient is treated with sensitivity and respect throughout the process. It is important that the victim has control over the subsequent steps following their disclosure of the incident. This includes deciding whether or not to notify family or friends. The CNS should also provide information on available rape crisis resources, including counseling and support groups, which can offer the necessary emotional support and guidance moving forward.
While it might seem appropriate to immediately address physical injuries or to provide counseling, these actions should be secondary to ensuring that the victim receives a proper forensic examination at the emergency department. Immediate counseling without addressing the need for a forensic exam might inadvertently compromise the collection of crucial evidence. Therefore, the priority is to first secure the forensic and medical needs at an emergency facility, followed by emotional and psychological support in the aftermath of the incident.
In summary, the CNS's role in this scenario is to provide immediate support by facilitating access to specialized care in the emergency department, preserving the patient's right to choose further actions, and ensuring access to comprehensive services that address both the immediate and long-term needs following an assault.

NEW QUESTION # 32
Mitral valve prolapse is COMMONLY diagnosed by:
  • A. Echocardiography.
  • B. Electro-encephalograph.
  • C. Computed tomography scan.
  • D. Radiograph.
Answer: A
Explanation:
Mitral valve prolapse (MVP) is a condition where the valve between the left atrium and left ventricle of the heart does not close properly. This can cause blood to leak backward into the atrium, a situation commonly referred to as mitral regurgitation. MVP is often symptomless but can sometimes cause symptoms such as palpitations, chest pains, or fatigue. Accurately diagnosing this condition is essential for appropriate management and treatment.
The most commonly used diagnostic tool for identifying mitral valve prolapse is echocardiography, also known as cardiac ultrasound. Echocardiography is a non-invasive imaging technique that uses sound waves to create detailed images of the heart's structures and function. During an echocardiogram, a transducer (a device that sends and receives sound waves) is placed on the chest, and sound waves are directed toward the heart. These waves bounce off the heart structures, sending back echoes that are then converted into visual images displayed on a monitor.
Echocardiography is particularly effective for diagnosing MVP because it can vividly show the movement of the mitral valve and determine whether it is prolapsing into the left atrium during each heartbeat. It can also measure the severity of any mitral regurgitation that might be present. This method allows for the dynamic assessment of the heart's functioning in real-time, providing crucial information about the heart's size, the thickness of its walls, and the functioning of other valves as well.
While other imaging techniques like computed tomography (CT) scans can also be used to diagnose heart issues, they are less commonly employed for MVP specifically. CT scans provide good details about the anatomical structure of the heart but are not as effective as echocardiograms at capturing the real-time movement of the heart's valves. Therefore, although CT scans can be supportive in some contexts, echocardiography remains the primary and most commonly used tool due to its detailed and dynamic assessment capabilities.
In sum, echocardiography is the preferred method for diagnosing mitral valve prolapse due to its ability to provide detailed and actionable images of the mitral valve in motion, thereby enabling a precise assessment of the presence and severity of the prolapse and any associated regurgitation. This makes it an indispensable tool in the cardiological diagnostic process.

NEW QUESTION # 33
......
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