function Question (qname,
type,
qstring,
response,
comment,
corrects,
explan,
score,
ifcorrect,ifwrong,ifnull,
img)
{this.qname=qname;
this.type=type;
this.qstring=qstring;
this.response=response;
this.comment=comment;
this.corrects=corrects;
this.explan=explan;
this.score=score;
this.ifcorrect=ifcorrect;
this.ifwrong=ifwrong;
this.ifnull=ifnull;
this.img=img;
}

var zin=1,top=0, mycount=0, waitTime=0, qright=0, mycomment;
var global=new Array(3);
var recent, recent2, recdone=false, opera7, opera=CheckOpera56();
function cachewrite(s,idx){global[idx]+=s;}
function CheckOpera56()
{
var version;
if (navigator.userAgent.toLowerCase().indexOf('opera') == -1) return false;
version=parseInt(navigator.appVersion.toLowerCase());
if (version>6) {opera7=true; return false;}
if (version<5) return false;
return true;
}
resp=new Array("approve the patient for the elective surgery.","obtain a kidney-urethra-bladder x-ray.","obtain a renal arteriogram.","obtain an abdominal ultrasound examination.")
corr=new Array("0","0","0","1")
comm=""
valu=""
quest001 = new Question(
"Question 1",
0,
"A patient is scheduled for elective orthopedic surgery. During the preadmission physical examination, the acute care nurse practitioner detects an asymptomatic pulsatile mass in the middle upper abdomen. The nurse practitioner's most appropriate action is to:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("A beta-adrenergic blocking agent","A thiazide diuretic","An alpha-adrenergic blocking agent","An angiotensin-converting enzyme (ACE) inhibitor")
corr=new Array("1","0","0","0")
comm=""
valu=""
quest002 = new Question(
"Question 2",
0,
"A patient whose history includes migraine headaches and a recent myocardial infarction derives the most benefit from taking which type of antihypertensive agents?",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("Gout","Osteoarthritis","Osteoporosis","Rheumatoid arthritis")
corr=new Array("0","1","0","0")
comm=""
valu=""
quest003 = new Question(
"Question 3",
0,
"Which musculoskeletal disease primarily involves the distal joints, hips, knees, and spine, and is characterized by the development of Heberden's and Bouchard's nodes?",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("Addison disease.","heart failure.","hyperglycemia.","syndrome of inappropriate secretion of antidiuretic hormone (SIADH).")
corr=new Array("0","0","0","1")
comm=""
valu=""
quest004 = new Question(
"Question 4",
0,
"A 70-year-old patient who has a history of diabetes mellitus and heart failure is admitted to the hospital with pneumonia. Assessment reveals: Supine blood pressure of 140/70 mm Hg; Supine pulse rate of 72 beats/min; Standing blood pressure of 132/68 mm Hg; Standing pulse rate of 84 beats/min; Temperature of 100.4<sup>o</sup>F (38<sup>o</sup>C); and respirations of 14 breaths/min.<br><br />The physical examination is unremarkable except for decreased breath sounds in the lower posterior left lobe. The following laboratory results are obtained: <p><img src=\"wbqst4_1.PNG\" width=\"366\" height=\"177\" border=\"0\" alt=\"graphic\"/></p><br><br>The patient's hyponatremia is caused by:<br>",
resp,
comm,
corr,
"",
valu,
0,
0,
0,
"");

resp=new Array("advise the woman to follow up with her primary care physician.","refer the woman for a surgical biopsy.","send the woman for a mammogram.","wait two months to see if it resolves.")
corr=new Array("0","0","1","0")
comm=""
valu=""
quest005 = new Question(
"Question 5",
0,
"A 70-year-old woman who was admitted with cholecystitis is found to have a firm 2-cm swelling in the upper outer part of her right breast. The nurse practitioner's initial action is to:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("bicarbonate level of less than 20 mEq/L.","change in pH and partial pressure of carbon dioxide (PaC0<sub>2</sub>) in the same direction.","change in pH and PaC0<sub>2</sub> in opposite directions.","pH greater than 7.4.")
corr=new Array("0","1","0","0")
comm=""
valu=""
quest006 = new Question(
"Question 6",
0,
"The primary indicator of metabolic acidosis is a:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("Cardiogenic","Hypovolemic","Neurogenic","Septic")
corr=new Array("0","0","0","1")
comm=""
valu=""
quest007 = new Question(
"Question 7",
0,
"While receiving chemotherapy for lung cancer, a patient becomes hypotensive and febrile to 104<sup>o</sup>F (40<sup>o</sup>C). A pulmonary artery catheter is inserted and reveals that the patient's cardiac output is 12 L/min and the pulmonary artery wedge pressure is 6 mm Hg. Based on these data, the nurse practitioner suspects which form of shock?",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("antinuclear antibody level.","erythrocyte sedimentation rate.","rheumatoid factor.","serum uric acid level.")
corr=new Array("0","0","0","1")
comm=""
valu=""
quest008 = new Question(
"Question 8",
0,
"A 60-year-old male patient, who has been hospitalized for an extended period after surgery, has not had his outpatient medications reordered. He complains of excruciating pain in the metatarsophalangeal joint of the right great toe. The diagnosis of acute gouty arthritis is confirmed by an elevated:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("Autonomy","Beneficence","Fidelity","Non maleficence")
corr=new Array("0","1","0","0")
comm=""
valu=""
quest009 = new Question(
"Question 9",
0,
"An acute care nurse practitioner is deciding whether to recommend that a patient follow a long-term medication regimen that will help control disease symptoms but may also create troublesome side effects. This decision involves consideration of which ethical principle?",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("calculation of body fat percentage.","complete blood count.","serum prealbumin level determination.","total serum protein level determination.")
corr=new Array("0","0","1","0")
comm=""
valu=""
quest010 = new Question(
"Question 10",
0,
"Laboratory test results for a 78-year-old patient who is being evaluated for an aortic valve replacement, indicate a low serum albumin level. The patient is prescribed a high-protein diet. The acute care nurse practitioner can evaluate the patient's response with a:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("order IV antibiotics.","order povidone-iodine solution (Betadine).","order silver sulfadiazine cream.","unroof blisters and apply normal saline gauze.")
corr=new Array("0","0","1","0")
comm=""
valu=""
quest011 = new Question(
"Question 11",
0,
"The initial treatment for a patient who has a superficial second degree burn over the dorsal aspect of the foot is to:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("obtain a chest x-ray.","obtain a urine culture.","obtain an abdominal ultrasound.","order antipyretics.")
corr=new Array("0","0","1","0")
comm=""
valu=""
quest012 = new Question(
"Question 12",
0,
"A patient who had a left colectomy six days ago complains of vague abdominal discomfort on the right side of the abdomen. The patient's white blood count is elevated and the temperature is 38.9<sup>o</sup>C (102<sup>o</sup>F). The acute care nurse practitioner's most appropriate step is to:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("a total cholesterol of less than 220.","an A1C test result of less than 9.","photocoagulation by laser.","tight control of hyperglycemia.")
corr=new Array("0","0","0","1")
comm=""
valu=""
quest013 = new Question(
"Question 13",
0,
"An intervention aimed at reducing the risk of diabetic retinopathy is:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("Ciprofloxacin (Ciloxan)","Levocabastine (Livostin)","Prednisolone (Predalone)","Timolol (Timoptic)")
corr=new Array("1","0","0","0")
comm=""
valu=""
quest014 = new Question(
"Question 14",
0,
"A 45-year-old patient who requires mechanical ventilation for acute respiratory distress syndrome (ARDS) develops purulent exudate in the right eye and conjunctival injection. Which is the most effective treatment?",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("decrease the cost of patient care.","improve health outcomes.","promote standardized care, through practice guidelines.","standardize health outcomes.")
corr=new Array("0","1","0","0")
comm=""
valu=""
quest015 = new Question(
"Question 15",
0,
"The ultimate goal of improving clinical practice through research is to:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("calls for a neurology consult, for advisement on adjusting doses of neostigmine (Prostigmin) and corticosteroids.","orders an aminoglycoside, which is the drug of choice for treatment of pneumonia in a patient with myasthenia gravis.","orders nerve conduction studies to guide treatment.","prescribes dantrolene to minimize muscle spasticity.")
corr=new Array("1","0","0","0")
comm=""
valu=""
quest016 = new Question(
"Question 16",
0,
"A patient with a history of myasthenia gravis is admitted with left lower lobe pneumonia. The patient reports worsening of diplopia and dysphagia and more trouble breathing, over the past few days. To help the patient with the worsening symptoms of myasthenia gravis, the acute care nurse practitioner:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("every 3 years starting at age 60.","every 3-5 years after the age of 50.","every 4-5 years after the age of 60.","every 10 years starting at age 45.")
corr=new Array("0","1","0","0")
comm=""
valu=""
quest017 = new Question(
"Question 17",
0,
"For a patient with no history of polyps and no heritable risk factors, flexible sigmoidoscopy is recommended:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("calling for a dermatology consultation to evaluate the lesion.","inspecting and excising the lesion.","prescribing a topical steroid preparation.","recommending re-evaluation of the lesion in two weeks.")
corr=new Array("1","0","0","0")
comm=""
valu=""
quest018 = new Question(
"Question 18",
0,
"A 55-year-old man comes to the clinic for his routine follow-up, after a successful autologous bone marrow transplant for multiple myeloma. The patient states he has a skin lesion that has changed in appearance. The acute care nurse practitioner responds by:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("assist-control ventilation.","continuous positive airway pressure (CPAP) ventilation.","high frequency ventilation.","inverse ratio ventilation.")
corr=new Array("1","0","0","0")
comm=""
valu=""
quest019 = new Question(
"Question 19",
0,
"An intubated 56-year-old woman is in acute respiratory failure. The appropriate method of mechanical ventilation for this patient is:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("bilevel positive airway pressure (BiPAP).","continuous positive airway pressure (CPAP).","nonrebreather mask.","venturi mask.")
corr=new Array("1","0","0","0")
comm=""
valu=""
quest020 = new Question(
"Question 20",
0,
"A method of noninvasive ventilation that applies inspiratory and expiratory pressures during the patient's respiratory cycle, using a mask, is:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("birth control.","bleeding tendencies.","sexually transmitted diseases.","smoking cessation.")
corr=new Array("1","0","0","0")
comm=""
valu=""
quest021 = new Question(
"Question 21",
0,
"A 23-year-old woman admitted to the hospital for pyelonephritis is receiving antibiotics. In preparing the patient for discharge, the acute care nurse practitioner counsels the patient regarding:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("assists the physician with intubation.","calls the patient's neighbor to take a copy of the living will.","locates an old hospital chart to find a copy of the living will.","notifies the physician of the conversation with the patient.")
corr=new Array("0","0","0","1")
comm=""
valu=""
quest022 = new Question(
"Question 22",
0,
"An 83-year-old woman arrives in the emergency department in severe respiratory distress. The patient verbalizes a desire not to be intubated nor to have cardiopulmonary resuscitation performed. She states that a neighbor has a copy of her recently signed living will. The acute care nurse practitioner leaves the bedside momentarily and returns to find the physician preparing to intubate the patient. The nurse practitioner first:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("&#147;I understand you have reservations about the placement of a tracheostomy.&#148;","&#147;Not many patients have died while undergoing a tracheostomy.&#148;","&#147;Without a tracheostomy, we cannot transfer this patient to another facility.&#148;","&#147;You know, the patient will die if a tracheostomy is not placed.&#148;")
corr=new Array("1","0","0","0")
comm=""
valu=""
quest023 = new Question(
"Question 23",
0,
"A 24-year-old patient with a closed head injury has been intubated for 12 days. The patient's family has repeatedly refused consent for a tracheostomy and long-term care placement. The surgeon has discussed the risks and benefits of the surgery with the family, on multiple occasions. What is the best statement that the acute care nurse practitioner can verbalize to the family?",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("asking the patient's husband, who speaks better English, to help to explain the information.","explaining the information again to the patient, with gestures, and asking her to nod in understanding.","notifying the hospital ethics committee that the patient is going to surgery without informed consent.","providing the patient with a hospital translator to review the complete information, in the patient's language.")
corr=new Array("0","0","0","1")
comm=""
valu=""
quest024 = new Question(
"Question 24",
0,
"A woman who recently immigrated to the United States and speaks minimal English has signed a consent for a surgical procedure, after having the risks and benefits explained by the surgeon. The acute care nurse practitioner asks the patient to indicate her understanding but she is unable to answer because she speaks only minimal English. The nurse practitioner takes responsibility for ensuring that the patient has informed consent by:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

resp=new Array("digital prostate examination should be performed monthly.","prostate-specific antigen (PSA) should be performed annually.","sigmoidoscopy should be performed every 10 years.","testicular examination should be performed every two years.")
corr=new Array("0","1","0","0")
comm=""
valu=""
quest025 = new Question(
"Question 25",
0,
"A 56-year-old man is seen in a clinic by the acute care nurse practitioner. The patient has a past medical history that is significant for hypertension, metabolic syndrome, and hyperlipidemia. A review of his symptoms indicate nocturia, occasional heartburn, and transient rhinitis. The patient asks about the appropriate interval of certain screening tests for someone his age. The nurse practitioner correctly answers that a:",
resp,
comm,
corr,
"",
valu,
1,
0,
0,
"");

questions = new Array (
quest001,quest002,quest003,quest004,quest005,quest006,quest007,quest008,quest009,quest010,quest011,quest012,quest013,quest014,quest015,quest016,quest017,quest018,quest019,quest020,quest021,quest022,quest023,quest024,quest025)

function doQuestion(quest)
{
var numdo;
var numord=eval(quest+1);
var i=-1, ii, type, myname, gadget;
type=questions[quest].type;
numdo=type>=3?1:questions[quest].response.length;


document.writeln ("<a name=\""+questions[quest].qname+"\"></a>")
document.write("\n")
document.write("       ")
if (questions[quest].img!="") {
document.write("\n")
document.write("          <p><img border=\"0\" src=\"")
document.write(questions[quest].img)
document.write("\"></p>\n")
document.write("       ")
}
document.write("\n")
document.write("       <p><small><font face=\"Verdana,Arial\">")
document.write(numord)
document.write(". ")
document.writeln(questions[quest].qstring)
document.write("</font></small></p>\n")
document.write("       ")
for (i=0; i<numdo; i++) {
myname=questions[quest].qname;
gadget="radio";
if (type>=3) gadget="text";
else if (type==1) {
myname+="_"+(i<9?"0":"")+(i+1);
gadget="checkbox";}
document.write("\n")
document.write("          ")
document.write(type==7?"<textarea name=\""+myname+"\" rows=5 cols=30 class=\"input\">":" <input type="+gadget+" name=\""+myname);
if (type<3) document.write("\" value=\""+i+"\">\n")
else document.write(type==7?"</textarea>":"\" class=\"input\" value=\"\">\n")
document.write(" <small><font face=\"Verdana,Arial\">")
if (type<3) document.write(questions[quest].response[i]);
document.write("</font></small><br>\n")
document.write("       ")
}
document.write("\n")
document.write("    ")
}
function doTest() {
var count, i;

count=questions.length;
for (i=0; i<count; i++) doQuestion(i);
}
function fill(s,l){
s=s+""
for (y=1;y<=l;y++)
if (s.length>=l) break; else s="0"+s;
return s
}
function CheckQName(wapf,ii,i,multi,selection){
var len;
if (!multi) return(wapf.elements[ii].name==questions[i].qname);
len=questions[i].qname.length;
if (wapf.elements[ii].name.substring(0,len)!=questions[i].qname) return false;
if (wapf.elements[ii].name.substring(len,len+1)!="_") return false;
if (eval(wapf.elements[ii].name.substring(len+1,len+3))==(selection+1)) return true;
return false;
}
function errore(uno,due,tre)
{
if (!errori) global[1]="<H3>You have made the following errors</H3>";
++errori;
cachewrite("<p><b>"+uno+"</b><br>"+due+"<br>"+mycomment+tre+"</p>",2);
mycomment="";
}
function testIE5plus(){
var pos=navigator.appVersion.lastIndexOf('MSIE ');
if (pos != -1) {
pos+=5;
if (eval(navigator.appVersion.charAt(pos))>4)
return true;}
return false;}
function correct(wapf)
{
var i, ii, t, re, tmp, selection, multi, multipage=0, type, isnull, iswrong, iscorrect, evaluation=0, total=0, udat;
errori=waitTime=0;
udat=new Array();
for (i=0, ii=0; i<wapf.elements.length; i++)
{tmp=wapf.elements[i];
if (tmp.name.substring(0,13)=="Quiz.UserData"){
t=tmp.name.substring(14,tmp.name.length);
re=new RegExp("_", "g");
t=t.replace(re," ");
udat[ii++]=t+": <i>"+tmp.value+"</i><br>";
if (opera) tmp.value="";}}
global[0]=global[2]="";
global[1]="<h3>Congratulations, you haven't made any errors</h3>";
cachewrite("<html><head><title>Results</title><BASE target='_blank'></head><body bgcolor='#FFFFFF'><font face='Verdana, Arial'><table border=0 cellpadding=0 cellspacing=0 width='100%' bgcolor='#C0C0C0'><tr><td width='100%'><font face='Verdana, Arial' size=5 color='#FFFFFF'><b>&nbsp;Results</b></font></td></tr></table>",0)
now= new Date()
cachewrite("<small><p>"+fill((now.getMonth()+1),2)+"/"+fill(now.getDate(),2)+"/"+now.getYear()+"&nbsp;&nbsp;"+fill(now.getHours(),2)+":"+fill(now.getMinutes(),2)+"</p>",0)
cachewrite("<b>Acute Care Nurse Practitioner</b><br><br>\n",0);
if (udat.length>0) {
cachewrite("<b>Information</b><br>\n",0);
for (i=0; i<udat.length; i++) cachewrite(udat[i],0);}
if (opera7 && multipage) {
for (i=0; i<questions.length; i++) {
id=document.getElementById("q"+(i+1));
id2=document.getElementById("q"+(i+1)+"a");
id.style.display=id2.style.display="block";}}

for (i=0; i<questions.length; i++) {
if (opera && multipage) {
id=document.getElementById("q"+(i+1));
id2=document.getElementById("q"+(i+1)+"a");
id.style.visibility=id2.style.visibility="visible";}
type=questions[i].type;
if (type==1) multi=1;
else multi=0;
isnull=true;
iscorrect=false;iswrong=false;
selection=0;
evaluation=0;
mycomment="";
for (ii=0; ii<wapf.elements.length; ii++) {
if (CheckQName(wapf,ii,i,multi,selection)) {
if (type>=3 && wapf.elements[ii].value!="") {
isnull=false;
if (wapf.elements[ii].value.toLowerCase()==questions[i].corrects.toLowerCase()) iscorrect=true;
else iswrong=true;
++selection;}
else if (wapf.elements[ii].checked) {
if (questions[i].score!="") evaluation+=questions[i].score[selection];
if (isnull) isnull=false;
if (questions[i].corrects[selection]=="1") iscorrect=(iswrong==false)?true:false;
else {
iswrong=true;
if (multi && questions[i].corrects!='') errore(questions[i].qname,"The checkbox  <i>"+questions[i].response[selection]+"</i>  shouldn't have been selected.",questions[i].explan)
}
if (questions[i].comment!="" && questions[i].comment[selection]!="")
mycomment+=((iscorrect || questions[i].corrects=='')?"<b>"+questions[i].qname+"</b><br>":"")+"<small>"+questions[i].comment[selection]+"</small><br>";
} else {
if (questions[i].corrects[selection]=="1") {
iswrong=true;
if (multi && questions[i].corrects!='') errore(questions[i].qname,"The checkbox  <i>"+questions[i].response[selection]+"</i>  should have been selected.",questions[i].explan);
}}
++selection;
}}
if (multi==false && (isnull || iswrong)) {
var okresp="", z;
if (type>=3) okresp=questions[i].corrects;
else {
for (z=0; z<questions[i].corrects.length; z++) {
if (questions[i].corrects[z]==1) {
okresp=questions[i].response[z];
break;
}}}
if (okresp!="") errore(questions[i].qname,"The right answer was <i>"+okresp+".</i>",questions[i].explan);
}
if (mycomment!="") cachewrite(mycomment,2);
if (questions[i].corrects!="") ++qright;
if (isnull) evaluation+=questions[i].ifnull;
else if (iswrong) evaluation+=questions[i].ifwrong;
else if (iscorrect) evaluation+=questions[i].ifcorrect;
total+=evaluation;}
if (qright==0) global[1]="<br>";
if (errori) cachewrite("<br><b>You have made "+errori+" "+(errori==1?"error":"errors")+".</b>",2);
cachewrite("<br><b>Total score: "+total+".</b><br>",2);

cachewrite("</small><hr noshade><center><form>",2)
printest=(((navigator.appName=="Netscape") && (navigator.appVersion.charAt(0)>="4")) || (testIE5plus() == true))? "print()": "alert('This button can be used with Netscape Navigator 4 or Microsoft Internet Explorer 5 only. If you want to print with other browsers, please select the Print command in the File menu.')"
cachewrite("<input type='button' value='Print...' onClick='"+printest+"'>&nbsp;&nbsp;&nbsp;&nbsp;",2)
cachewrite("<input type='button' value='Close' onClick='window.close()'></form></center>",2)
cachewrite(aknw,2)
winr=window.open('','wapres', 'titlebar=1,location=0,directories=0,menubar=1,toolbar=0,scrollbars=1,resizable=1,status=1')
for (i=0; i<3; i++) winr.document.write(global[i]);winr.document.close()
if ((opera || opera7) && multipage) {
document.forms[0].elements[0].value='Print...';
document.forms[0].elements[1].value='Close';
for (i=0; i<questions.length-1; i++) {
id=document.getElementById("q"+(i+1));
id2=document.getElementById("q"+(i+1)+"a");
opera?id.style.visibility=id2.style.visibility="hidden":id.style.display=id2.style.display="none";}}
}
aknw="<br><p align='center'><small><small>Created and managed with <a title='Click here to visit WebQuiz site' href='http://www.smartlite.it/go.asp?OLDLP' target = '_blank'>SmartLite WebQuiz</a></small></small></p>"