Free AGACNP Exam Questions That Helps Candidates Pass

The most appropriate initial management for a COPD exacerbation is to administer nebulized bronchodilators (e.g., albuterol) and corticosteroids to relieve bronchospasm and reduce inflammation. Oxygen therapy should be provided to maintain adequate oxygen saturation, especially if the patient is hypoxic. Antibiotics are indicated if there is evidence of bacterial infection, and a chest X-ray may help diagnose complications like pneumonia, but bronchodilator therapy is the priority.

ACE inhibitors can increase potassium levels by inhibiting aldosterone secretion, which leads to potassium retention. Hyperkalemia is a potentially dangerous side effect of ACE inhibitors and should be closely monitored. Hypoglycemia, hypernatremia, and hypercalcemia are not commonly associated with ACE inhibitors.

The patient’s symptoms—polyuria, polydipsia, and fatigue—along with elevated fasting blood glucose and HbA1c levels, are consistent with type 2 diabetes mellitus. This is the most common form of diabetes, often seen in older adults and those with risk factors such as obesity or hypertension. Type 1 diabetes typically presents earlier in life, and diabetes insipidus would present with significant polyuria but normal glucose levels.

ACE inhibitors can lead to hyperkalemia, particularly in patients with CKD. When a patient experiences an elevated potassium level (above 5.5 mEq/L), the ACE inhibitor should be discontinued to prevent life-threatening complications such as arrhythmias. A potassium-wasting diuretic may help lower potassium, but the ACE inhibitor is the primary cause and should be stopped first.

A CT scan of the chest is the next best step to evaluate a lung mass seen on X-ray. CT provides more detailed information about the size, location, and characteristics of the mass. Based on the findings, further interventions such as bronchoscopy or biopsy can be performed. Sputum culture and antibiotics are not appropriate first-line steps for evaluating a lung mass.