CE TEST QUESTIONS
AJN1014A
Calciphylaxis: An Unusual Case with an Unusual Outcome GENERAL PURPOSE: To present information about calciphylaxis through a case study of a patient with the unusual presentation of normal renal and parathyroid function. LEARNING OBJECTIVES: After reading this article and taking this test, you will be able to • recognize the pathophysiology of and risk factors for calciphylaxis. • identify treatment strategies for calciphylaxis.
1. Which of the following types of reac tions describes calciphylaxis? a. a localized cytotoxic reaction b. a systemic autoimmune reaction c. a localized enzymatic reaction d. a systemic hypersensitivity reaction 2. With calciphylaxis, deposits of cal cium and what other mineral form in the small arteries of the skin? a. phosphorus b. magnesium c. potassium d. iron 3. Mineral deposits result in vascular calcification with a. superimposed large-vessel thrombosis. b. medial arterial hypertrophy. c. superimposed small-vessel thrombosis. d. adventitial venous hypertrophy. 4. Calciphylaxis is characterized by iso lated or multiple lesions that first present with signs that include which of the following? a. bullae b. plaques c. nodules d. macules 5. Eventually, the initial lesions pro gress to which of the following? a. bullae b. plaques c. nodules d. macules
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AJN ▼ October 2014
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6. Calciphylaxis has a prognosis that is a. excellent. b. good. c. variable. d. poor. 7. Risk factors for calciphylaxis include a. male sex. b. hypoparathyroidism. c. systemic use of corticosteroids. d. decreased erythrocyte sedimentation rate. 8. According to Maldonado, symptoms of hypoactive delirium include a. episodes of staring. b. elevated temperature. c. photophobia. d. hypervigilance. 9. Treatment options for calciphylaxis include a. thyroidectomy. b. chemical debridement. c. radioactive iodine. d. surgical debridement. 10. According to the article, which of the following solutions is often used for wound irrigation and cleansing in patients who have calciphylaxis? a. acetic acid b. chlorhexidine c. povidone–iodine d. hydrogen peroxide 11. Current evidence favors the use of which of the following types of dressings for wound healing? a. wet-to-dry b. alginate c. wet-to-moist d. collagen 12. Hyperbaric oxygen therapy is thera peutic for patients who have calci phylaxis because it can a. help prevent dehydration. b. break down necrotic tissue. c. revascularize damaged tissue. d. restore perfusion to compromised areas.
Vol. 114, No. 10
13. According to Broussard, the most common adverse effect of hyper baric oxygen therapy is a. atelectasis. b. claustrophobia. c. hearing loss. d. migraine headaches. 14. In noncontact ultrasound therapy, an ultrasonic device delivers sound waves in which of the following fre quency ranges? a. 10 to 25 kHz b. 25 to 40 kHz c. 40 to 100 kHz d. 100 to 200 kHz 15. The greatest risk of mortality from calciphylaxis is a. infection. b. necrosis. c. seizures. d. stroke. 16. Whirlpool baths containing a potas sium permanganate solution may be used to decrease bacterial load. To ease a patient’s pain, which of the following might also be added? a. sodium bicarbonate b. epsom salts c. boric acid d. table salt 17. According to the article, there are reports of a strong association be tween the development of calciphy laxis and low serum a. albumin. b. hepcidin. c. amylase. d. lectin. 18. Which of the following methods was used to ensure that the patient in the case study received adequate calories and nutrition? a. total parenteral nutrition b. continuous nighttime feeding via a nasojejunal tube c. intermittent feeding via a gastrojejunal tube d. percutaneous endoscopic gastrostomy ▼
ajnonline.com
CE
Earn CE Credit online: Go to www.nursingcenter.com/ce/ajn and receive a certificate within minutes.
TEST INSTRUCTIONS • To take the test online, go to our secure Web site at www.nursingcenter.com/ce/ajn. • To use the form provided in this issue, record your answers in the test answer section of the CE enrollment form below. Each question has only one correct answer. You may make copies of the form. • Complete the registration information and course evaluation. Mail the completed enrollment form and registration fee to: Lippincott Williams and Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. You will receive your certificate in four to six weeks. For faster service, include a fax number and we will fax your certificate within two business days of receiving your enrollment form. You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.
DISCOUNTS AND CUSTOMER SERVICE • Send in together two or more tests from any nursing journal published by Lippincott, Williams and Wilkins (LWW), and deduct $0.95 from the price of each test. • We also offer CE accounts for hospitals and other health care facilities online at www.nursingcenter.com. Call 1-800-787-8985 for details. PROVIDER ACCREDITATION LWW, publisher of AJN, will award the number of contact hours indicated for each continuing nursing education activity. LWW is accredited as a provider of continuing nursing education by the Commission on Accreditation of the American Nurses Credentialing Center (ANCC). These activities are also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for the number of contact hours indicated. LWW is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. Your certificate is valid in all states. The ANCC’s accreditation status of the LWW Department of Continuing Education refers to its continuing nursing educational activities only and does not imply Commission on Accreditation approval or endorsement of any commercial product.
• Registration deadline is October 31, 2016.
ENROLLMENT FORM A
Registration Information:
❑ LPN ❑ RN ❑ CNS ❑ NP ❑ CRNA ❑ CNM ❑ other_____________
Last name______________________ First name___________________MI____
Job Title______________________Specialty____________________________ Type of facility__________________________Are you certified? ❑ Yes ❑ No
Address__________________________________________________________
Certified by_______________________________________________________
City_______________________________State_________________Zip_______
State of License (1)__________License #_______________________________
Telephone___________________Fax______________E-mail________________ ❑ Please fax my certificate to me.
State of License (2) __________License #_______________________________ ❑ Please check here if you do not wish us to send promotions to your e-mail address. ❑P lease check here if you do not wish us to release your name, address, or e-mail address to a third-party vendor.
B
Test Answers: Darken one circle for your answer to each question. Title 1_________________________________ Test Code AJN1014A
Title 2_________________________________ Test Code AJN1014B
Contact Hours: 2.5
Contact Hours: 2
a 1. ❍ 2. ❍ 3. ❍ 4. ❍ 5. ❍ 6. ❍ 7. ❍ 8. ❍ 9. ❍
C
b ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
c ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
Fee: $24.95 d ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
a 10. ❍ 11. ❍ 12. ❍ 13. ❍ 14. ❍ 15. ❍ 16. ❍ 17. ❍ 18. ❍
b ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
c ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
d ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
D
Course Evaluation:
1. Did this CE activity’s learning objectives relate to its general purpose? A ❑ Yes ❑ No B ❑ Yes ❑ No 2. Was the journal home study format an effective way to present the material? ❑ Yes ❑ No 3. Was the content relevant to your nursing practice? A ❑ Yes ❑ No B ❑ Yes ❑ No 4. How long in minutes did it take you to read the article A____ B____ ; study the material A____ B____ ; and take the test A____ B____? 5. Suggestion for future topics_____________________________________
42
AJN ▼ October 2014
a 1. ❍ 2. ❍ 3. ❍ 4. ❍ 5. ❍ 6. ❍ 7. ❍ 8. ❍ 9. ❍
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Vol. 114, No. 10
b ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
c ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
Fee: $21.95 d ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
a b 10. ❍ ❍
c ❍
d ❍
11. ❍
❍
❍
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12. ❍
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15. ❍
❍
❍
❍
16. ❍
❍
❍
❍
Two Easy Ways to Pay:
❑ Check or money order enclosed (payable to Lippincott Williams and Wilkins) ❑ Charge my ❑ MasterCard ❑ VISA ❑ American Express Card #____________________________________ Exp. Date_________ Signature___________________________________________________
ajnonline.com
AJN1014A
Calciphylaxis: An Unusual Case with an Unusual Outcome GENERAL PURPOSE: To present information about calciphylaxis through a case study of a patient with the unusual presentation of normal renal and parathyroid function. LEARNING OBJECTIVES: After reading this article and taking this test, you will be able to • recognize the pathophysiology of and risk factors for calciphylaxis. • identify treatment strategies for calciphylaxis.
1. Which of the following types of reac tions describes calciphylaxis? a. a localized cytotoxic reaction b. a systemic autoimmune reaction c. a localized enzymatic reaction d. a systemic hypersensitivity reaction 2. With calciphylaxis, deposits of cal cium and what other mineral form in the small arteries of the skin? a. phosphorus b. magnesium c. potassium d. iron 3. Mineral deposits result in vascular calcification with a. superimposed large-vessel thrombosis. b. medial arterial hypertrophy. c. superimposed small-vessel thrombosis. d. adventitial venous hypertrophy. 4. Calciphylaxis is characterized by iso lated or multiple lesions that first present with signs that include which of the following? a. bullae b. plaques c. nodules d. macules 5. Eventually, the initial lesions pro gress to which of the following? a. bullae b. plaques c. nodules d. macules
32
AJN ▼ October 2014
▼
6. Calciphylaxis has a prognosis that is a. excellent. b. good. c. variable. d. poor. 7. Risk factors for calciphylaxis include a. male sex. b. hypoparathyroidism. c. systemic use of corticosteroids. d. decreased erythrocyte sedimentation rate. 8. According to Maldonado, symptoms of hypoactive delirium include a. episodes of staring. b. elevated temperature. c. photophobia. d. hypervigilance. 9. Treatment options for calciphylaxis include a. thyroidectomy. b. chemical debridement. c. radioactive iodine. d. surgical debridement. 10. According to the article, which of the following solutions is often used for wound irrigation and cleansing in patients who have calciphylaxis? a. acetic acid b. chlorhexidine c. povidone–iodine d. hydrogen peroxide 11. Current evidence favors the use of which of the following types of dressings for wound healing? a. wet-to-dry b. alginate c. wet-to-moist d. collagen 12. Hyperbaric oxygen therapy is thera peutic for patients who have calci phylaxis because it can a. help prevent dehydration. b. break down necrotic tissue. c. revascularize damaged tissue. d. restore perfusion to compromised areas.
Vol. 114, No. 10
13. According to Broussard, the most common adverse effect of hyper baric oxygen therapy is a. atelectasis. b. claustrophobia. c. hearing loss. d. migraine headaches. 14. In noncontact ultrasound therapy, an ultrasonic device delivers sound waves in which of the following fre quency ranges? a. 10 to 25 kHz b. 25 to 40 kHz c. 40 to 100 kHz d. 100 to 200 kHz 15. The greatest risk of mortality from calciphylaxis is a. infection. b. necrosis. c. seizures. d. stroke. 16. Whirlpool baths containing a potas sium permanganate solution may be used to decrease bacterial load. To ease a patient’s pain, which of the following might also be added? a. sodium bicarbonate b. epsom salts c. boric acid d. table salt 17. According to the article, there are reports of a strong association be tween the development of calciphy laxis and low serum a. albumin. b. hepcidin. c. amylase. d. lectin. 18. Which of the following methods was used to ensure that the patient in the case study received adequate calories and nutrition? a. total parenteral nutrition b. continuous nighttime feeding via a nasojejunal tube c. intermittent feeding via a gastrojejunal tube d. percutaneous endoscopic gastrostomy ▼
ajnonline.com
CE
Earn CE Credit online: Go to www.nursingcenter.com/ce/ajn and receive a certificate within minutes.
TEST INSTRUCTIONS • To take the test online, go to our secure Web site at www.nursingcenter.com/ce/ajn. • To use the form provided in this issue, record your answers in the test answer section of the CE enrollment form below. Each question has only one correct answer. You may make copies of the form. • Complete the registration information and course evaluation. Mail the completed enrollment form and registration fee to: Lippincott Williams and Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. You will receive your certificate in four to six weeks. For faster service, include a fax number and we will fax your certificate within two business days of receiving your enrollment form. You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.
DISCOUNTS AND CUSTOMER SERVICE • Send in together two or more tests from any nursing journal published by Lippincott, Williams and Wilkins (LWW), and deduct $0.95 from the price of each test. • We also offer CE accounts for hospitals and other health care facilities online at www.nursingcenter.com. Call 1-800-787-8985 for details. PROVIDER ACCREDITATION LWW, publisher of AJN, will award the number of contact hours indicated for each continuing nursing education activity. LWW is accredited as a provider of continuing nursing education by the Commission on Accreditation of the American Nurses Credentialing Center (ANCC). These activities are also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for the number of contact hours indicated. LWW is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. Your certificate is valid in all states. The ANCC’s accreditation status of the LWW Department of Continuing Education refers to its continuing nursing educational activities only and does not imply Commission on Accreditation approval or endorsement of any commercial product.
• Registration deadline is October 31, 2016.
ENROLLMENT FORM A
Registration Information:
❑ LPN ❑ RN ❑ CNS ❑ NP ❑ CRNA ❑ CNM ❑ other_____________
Last name______________________ First name___________________MI____
Job Title______________________Specialty____________________________ Type of facility__________________________Are you certified? ❑ Yes ❑ No
Address__________________________________________________________
Certified by_______________________________________________________
City_______________________________State_________________Zip_______
State of License (1)__________License #_______________________________
Telephone___________________Fax______________E-mail________________ ❑ Please fax my certificate to me.
State of License (2) __________License #_______________________________ ❑ Please check here if you do not wish us to send promotions to your e-mail address. ❑P lease check here if you do not wish us to release your name, address, or e-mail address to a third-party vendor.
B
Test Answers: Darken one circle for your answer to each question. Title 1_________________________________ Test Code AJN1014A
Title 2_________________________________ Test Code AJN1014B
Contact Hours: 2.5
Contact Hours: 2
a 1. ❍ 2. ❍ 3. ❍ 4. ❍ 5. ❍ 6. ❍ 7. ❍ 8. ❍ 9. ❍
C
b ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
c ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
Fee: $24.95 d ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
a 10. ❍ 11. ❍ 12. ❍ 13. ❍ 14. ❍ 15. ❍ 16. ❍ 17. ❍ 18. ❍
b ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
c ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
d ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
D
Course Evaluation:
1. Did this CE activity’s learning objectives relate to its general purpose? A ❑ Yes ❑ No B ❑ Yes ❑ No 2. Was the journal home study format an effective way to present the material? ❑ Yes ❑ No 3. Was the content relevant to your nursing practice? A ❑ Yes ❑ No B ❑ Yes ❑ No 4. How long in minutes did it take you to read the article A____ B____ ; study the material A____ B____ ; and take the test A____ B____? 5. Suggestion for future topics_____________________________________
42
AJN ▼ October 2014
a 1. ❍ 2. ❍ 3. ❍ 4. ❍ 5. ❍ 6. ❍ 7. ❍ 8. ❍ 9. ❍
▼
Vol. 114, No. 10
b ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
c ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
Fee: $21.95 d ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍ ❍
a b 10. ❍ ❍
c ❍
d ❍
11. ❍
❍
❍
❍
12. ❍
❍
❍
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13. ❍
❍
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14. ❍
❍
❍
❍
15. ❍
❍
❍
❍
16. ❍
❍
❍
❍
Two Easy Ways to Pay:
❑ Check or money order enclosed (payable to Lippincott Williams and Wilkins) ❑ Charge my ❑ MasterCard ❑ VISA ❑ American Express Card #____________________________________ Exp. Date_________ Signature___________________________________________________
ajnonline.com
