A 65-year-old female is scheduled for spinal surgery. She has a past medical history of CAD and HTN, atrial fibrillation. Her pre-op CXR is shown below. CXR4.jpg Which of the following is most helpful in predicting her risk of postoperative of respiratory failure?

The AG-ACNP is seeing a patient who is initiating breaths on SIMV. The SpO2 is 98% on 40% fraction of inspired oxygen. The AG-ACNP notices that the patient’s spontaneous tidal volumes are 130 mL per breath, and the patient is getting mildly tachycardic and is complaining of fatigue. Respiratory muscle fatigue can best be reduced by:

A 45-year-old previously healthy female presents to the emergency department with 3 days of fevers and progressive dyspnea and is admitted to the intensive care unit (ICU) for influenza infection complicated by severe hypoxemia. She is intubated, and chest radiograph following intubation demonstrates an appropriately placed endotracheal tube with bilateral patchy opacities and interstitial markings throughout all lung fields, without effusions. Her bedside echocardiogram reveals a left ventricular ejection fraction of 0.75 with otherwise normal findings. Her ventilator settings are volume control, tidal volume (VT) 500 mL, respiratory rate (RR) 14 breaths per minute, FiO2 1.0, and positive end-expiratory pressure (PEEP) 5 cm H2O. An initial arterial blood gas (ABG) is pH 7.30 PCO2 45 mm Hg and PO2 80 mm Hg. Which of the following therapies has been best shown to improve the survival of patients such as this woman?

A 62-year-old male patient with a history of COPD presents to the office with a complaint of cough and “body aches” for 3 days. He tests positive for influenza A.For this patient, the current CDC recommendation to treat influenza is to begin therapy with:

1. Which of the following nutrients provides the most energy per gram?

A 62-year-old male patient with a history of COPD presents to the office with a complaint of cough and “body aches” for 3 days. He tests positive for influenza A.For this patient, the current CDC recommendation to treat influenza is to begin therapy with:

Which of the following scenarios has the highest recommendation for noninvasive positive pressure ventilation?

__________ is known as the “mother” of death studies. She famously started her career by interviewing dying patients in a hospital with seminarian students. 

A 64-year-old female presents with a 5-day history of exertional dyspnea and orthopnea. Her medical history is significant for SLE and diastolic heart failure. Chest X-ray reveals significant bilateral pleural effusions. The decision is made to perform a thoracentesis.  Which laboratory value would indicate that the effusions are a result of her known diagnosis of SLE?

The AG-ACNP is seeing a 70-year-old female patient with a significant history of COPD and 3 months status post right total knee replacement who woke up this morning with severe dyspnea. The chest x-ray was inconclusive of pertinent findings, therefore a CT of the chest was completed. The CT angiogram of the chest was positive for a pulmonary embolism in the right upper lobe. Two hours later the patient’s vital signs changed and she is now tachycardic to 130s, blood pressure 64/48, respiratory rate 30, SaO2 80%. The AG-ACNP identifies this type of shock as: