47. A patient on the medical floor is receiving his first dose of intravenous nafcillin for treatment of bacteremia when he acutely complains of itching and a sense of his throat closing. On exam, he has urticaria noted on his trunk and tongue and lip swelling with audible stridor. His vital signs are BP 90/60, HR 120, and RR 22. Based on these findings, you are concerned for an anaphylactic reaction. Which of the following is the next best step?

46. Why is hypokalemia concerning in the setting of refeeding syndrome?

45. Which of the following electrolyte abnormalities is the hallmark and catalyst for the pathophysiology of refeeding syndrome?

68. A patient with a history of heart failure arrives at the emergency department exhibiting shortness of breath and lower extremity swelling. Both patient’s symptoms are a result of:  

63. T.W. is a 36 y/o male patient who just returned from the operating room post open cholecystectomy. He is morbidly obese and the surgery was complicated by an iatrogenic pneumothorax and a nicked spleen. He suffered a significant amount of fluid loss and requires close supervision during recovery.  An ABG shows the following: pH 7.48, pCO2 55mmHg, HCO3 33mEq/L. Which of the following acid-base imbalances would you anticipate?  

55. What intravenous medication can be administered to stabilize cardiac cells in the setting of the above issue (#54)?

99. The NP is called to the bedside by nursing for your patient admitted for COPD exacerbation.  This is her 3rd admission to the hospital this year however she has never required intubation. The patient’s shortness of breath has become considerably worse. She is now on a Nonrebreather at 100% FIO2 with sats 91%. She is A&O x3 but has increased work of breathing. She can barely answer any of your questions on assessment in more than 3-4 words without appearing breathless.  She is tachypneic at 27.   After 1-hour on Bipap, 10/6 40%, ABGs are as followed   7.33/PCO2 56/PAO2 74/HCO3 30 sats 93%.  What should the provider do next?

40. At what level is practice authority granted?

100. A 39-year-old patient presents to the ED with a one-day history of right upper quadrant pain, nausea and one episode of vomiting. The pt has no prior medical history. A right upper quadrant ultrasound is indicative of cholecystitis.  Labs are the following WBC 11, Bun 40, Cre 1.1  ALT 189  AST 275.  The pt undergoes an ERCP.  Overnight the patient developed a low grade 100.9 and complains of increased epigastric pain that is now band like in nature. What is the most appropriate lab to obtain for this patient?

76. When serving as a nurse researcher, the adult-gerontology acute care nurse practitioner is guided by which ethical principle to ensure that research participants are protected from harm or exploitation?