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CHPN MISC EXAM QUESTIONS AND ACCURATE ANSWERS
Spironolactone - Question What would you be treated with for ascites?
Patient has been optimally treated and is not a candidate for surgical procedure. Patient is in New York heart Association class for which means they have significant symptoms of heart failure may possibly have an ejection fraction of less than 20% - Question Eligibility criteria for Heart disease
Eligibility criteria for stroke and coma: you PS a 40% or less and ability to maintain hydration and caloric intake based on weight loss of 10% in the last six months, serum albumin less than than 2.5, history of pulmonary aspiration or not responsive to speech language path all a G, sequential calorie counts documenting in adequate caloric fluid intake, dysphasia severe enough to prevent the patient from receiving food and fluids necessary to sustain life. Eligibility criteria for stroke
Name my patients who have any of the following : abnormal brain stem response, absent verbal response or absent with drawl response to pain with a serum creatinine less than 1.5 - Answer Eligibility criteria for Coma
Stage seven or beyond on the fast score, unable to ambulate without assistance, unable to dress without assistance, unable to bed without assistance, and Kat and a bowel and bladder, not consistently communicating with meaningful verbal communication; stereo typical frases only or the ability to speak is limited to six or if you were intelligible words. In the past 12 months, the participant shall have experienced any of the following: aspiration pneumonia, pyelonephritis or upper urinary tract infection, septicemia, all Thursdays 3 to 4, inability to maintain sufficient fluid or calorie intake with 10% weight loss, serum albumin less than 2.5. - Answer Eligibility Criteria for Dementia due to Alzheimer's disease
Patient presents with severely compromised respiratory function as evidenced by a vital capacity of less than 30% of normal, dyspnea at rest, patient refused mechanical ventilation. Although patient did meet both rapid ALS disease progression and critical nutritional decline. Should expect a patient to be having both fast ALS disease progression along with severe life-threatening complications such as recurring aspiration pneumonia, upper urinary tract infections, sepsis, stage 3 to 4 ulcers-Answer
Eligibility criteria for ALS
The patient has disabling dyspnea at rest that is poorly or unresponsive to bronchodilators, causing decreased functional capacity. Documented forced expiratory volume during one second. Established progression of severe pulmonary disease as manifested by an increase in the frequency of emergency room visits, pulmonary infections, or respiratory failure; also, an increase in physician visits. A documented serial decrease in FEV greater than 40 mL per year is objective evidence for disease progression but is not necessary to obtain. Hypoxemia at rest on room air, evidence evidence by PO2 less than equal to 55 mm meters/ HG or oxygen saturation less than or equal to 88%. Right-sided heart failure secondary to pulmonary disease or cor pulmonale, unintended progressive weight loss of greater than 10% of body weight over six months, resting tachycardia greater than 100 bpm - Answer Eligibility criteria for pulmonary disease
Acute renal failure- The patient is not claiming dialysis or renal transplant. Creatinine clearance is less than 10 mL per minute based on measurement or calculation or less than 15 mL per minute with a comorbidity of congestive heart failure or diabetes. Serum creatinine is greater than eight. Morbid conditions include those with mechanical ventilation, Malignancy, chronic lung disease, advanced cardiac disease, advanced liver disease, sepsis, Human Immunodeficiency Virus, albumin less than 3.5, cachexia, platelet count less than 25,000; this is disseminated intravascular coagulation, gastrointestinal bleeding.
chronic renal failure- Manifestations associated with uremia, all of urea which is less than 400 mL of urine in 24 hours, and intractable hyperkalemia greater than 7 mEq and not responsive to treatment, uremic pericarditis, hepato-renal syndrome, intractable fluid overload not responsive to treatment - Response Eligibility for renal disease
Prothrombin time prolonged more than five seconds over control or international normalized ratio I and our greater than 1.5 Serum albumin less than 2.5 g/dL And stage liver disease is present and the patient shows at least one of the following: ascites, spontaneous bacterial peritonitis, hepato-renal syndrome, hepatic encephalopathy, refractory to treatment, recurrent variceal bleeding. - Answer Hospice eligibility for liver disease
A CD4 count of less than 25 cells per millimeter or a persistent viral load of more than 100,000 copies per milliliter in addition to one of the following: CNS lymphoma, untreated or persistent despite treatment Wasting - loss of at least 10% of lean body mass, Mile bacterium Ivan complex, bacteremia Progressive multifocal
Fluoxetine, peroxetine - Answer SSRI selective serotonin Reuptake inhibitor's
Inhibits opioid induced decrease gastrointestinal motility and delay and gastrointestinal transit time; given subcutaneously and toast according to weight. - Answer Methylnaltrexone
