Streptococci pneumoniae and Pseudomonas aeruginosa are the most common causative pathogens of erysipelas and cellulitis. True or false? 

A 56-year-old female with type II diabetes mellitus is admitted for elective knee replacement surgery. She is NPO after midnight in preparation for surgery. Her home diabetes regimen includes: Insulin glargine (Lantus) 30 units at bedtime Insulin lispro (Humalog) 8 units with meals Metformin 1000 mg BID On morning labs, her fasting blood glucose is 142 mg/dL. A1c 1 month ago is 8.5 mmol/L. The surgical team asks the AGACNP to manage her diabetes medications. Which is the most appropriate insulin adjustment for this patient on the morning of surgery?

What is the most common cause of hypothyroidism in the United States? 

Which diagnostic value may be used to determine if sufficient ventilation is occuring? 

A 62-year-old male with chronic dyspnea on exertion undergoes pulmonary function testing. Results show: FEV1: 58% of predicted FVC: 82% of predicted FEV1/FVC ratio: 0.62 (62%) DLCO: 65% of predicted Post-bronchodilator FEV1: Increases by 8% (160 mL) These pulmonary function test results are consistent with obstructive lung disease. True or false? 

A 72-year-old woman with 25% TBSA partial-thickness burns is receiving LR per an initial formula-based rate. After 2 hours, urine output is 0.2 mL/kg/hour, heart rate is 128, blood pressure is 102/64, lungs are clear, and repeat assessment suggests TBSA may have been overestimated because large areas are superficial erythema only. What is the best next step?

A 56-year-old with 35% TBSA burns is in the ICU on day 6. Over 12 hours he develops progressive tachycardia, progressive tachypnea, new feeding intolerance, and platelet count drops from 190,000 to 85,000. The wound shows new dark discoloration with rapid conversion of previously viable partial-thickness areas to necrosis. Blood pressure becomes refractory to fluids. What is the most appropriate management strategy?

An 80 kg adult male has 30% TBSA partial-thickness burns from a flame injury. Time from burn is now 2 hours. EMS administered 1 liter of lactated Ringer’s (LR) prior to arrival to the emergency department. Using the American Burn Association consensus approach for initial adult burn shock resuscitation (the ABA updated approach to the traditional Parkland or Baxter model),  what INITIAL infusion rate (without considering possible future rate changes based on perfusion, urine output, or other endpoints) is most appropriate to start upon patient arrival to the ED? Round your answer to the nearest 10.  

A 56-year-old man is admitted to the medical floor for management of acute decompensated heart failure. His wife mentions that he snores loudly at night and she frequently observes him stop breathing for 10-20 seconds, followed by gasping or choking sounds. The patient reports chronic daytime fatigue and falling asleep frequently during the day. His medical history includes hypertension, type 2 diabetes, obesity (BMI 36 kg/m²), and atrial fibrillation. Neck circumference 19 inches. Cardiovascular exam reveals an irregular rhythm and 2+ pitting edema bilaterally. Retrognathia is noted. Oropharyngeal exam shows a crowded airway with enlarged tonsils and low-lying soft palate (Mallampati class IV).  Chest x-ray showing small pleural effusions, otherwise clear lungs. The AGACNP is concerned for repetitive dynamic collapse of the upper airway during sleep. What action by the AGACNP is most appropriate? 

A 71-year-old female with a history of hypertension, congestive heart failure (EF 35%), atrial fibrillation, and hyperlipidemia presents to the emergency department with progressive dyspnea and shortness of breath over the past week. She reports increased lower extremity swelling and orthopnea requiring three pillows to sleep. Physical examination findings: Vital signs: BP 148/88, HR 92, RR 24, SpO2 91% on room air, Temperature 98.90F  General: Mild respiratory distress, speaking in short sentences Cardiac: Regular rhythm, S3 gallop present, JVP elevated at 10 cm Pulmonary: Decreased breath sounds at the right base, dullness to percussion over the right lower lung field Extremities: 2+ pitting edema bilaterally to mid-calf Laboratory Results: WBC: 10.1 × 10³/µL (normal: 4.5-11.0) Hemoglobin: 11.2 g/dL (normal: 12.0-16.0 for females) Platelets: 245 × 10³/µL (normal: 150-400) Sodium: 133 mEq/L (normal: 136-145) Potassium: 3.8 mEq/L (normal: 3.5-5.0) Creatinine: 1.6 mg/dL (baseline 1.0 mg/dL) BUN: 32 mg/dL (normal: 7-20) BNP: 1,850 pg/mL (normal: