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ADULT HEALTH lll EXAM & FINAL EXAM LATEST VERSIONS 2024-2025 REAL EXAM QUESTIONS ANSWERS, Exams of Nursing

Vanderbilt University (Vandy)Nursing

ADULT HEALTH lll EXAM & FINAL EXAM LATEST VERSIONS 2024-2025 REAL EXAM QUESTIONS AND CORRECT ANSWERS|GRADED A+ 7 Signs of Cancer (CAUTION) - answers>>(C)hanges in bowel or bladder habits (A)ny sore that doesn't heal (U)nusual bleeding or discharge (T)hickening or lump in breast or elsewhere (I)ndigestion (O)bvious change in wart or mole (N)agging cough or hoarseness A reduction in neutrophils is termed - answers>>neutropenia ( less than 1000 cells/μL (1 × 109/L) Normal range: 2200- 7700 cells/μL -most common cause is chemotherapy/ immunosuppressive therapy in the treatment of cancer and autoimmune disease Adults with diabetes are prone to - answers>>have heart disease , hypertension and stroke before thyroidectomy the patient - answers>>antithyroid drugs, iodine, and β-adrenergic blockers may be given to achieve a euthyroid state(Iodine decreases

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ADULT HEALTH lll EXAM & FINAL EXAM
LATEST VERSIONS 2024-2025 REAL
EXAM QUESTIONS AND CORRECT
ANSWERS|GRADED A+
7 Signs of Cancer (CAUTION) - answers>>(C)hanges in bowel or bladder habits
(A)ny sore that doesn't heal
(U)nusual bleeding or discharge
(T)hickening or lump in breast or elsewhere
(I)ndigestion
(O)bvious change in wart or mole
(N)agging cough or hoarseness
A reduction in neutrophils is termed - answers>>neutropenia ( less than 1000 cells/μL (1
× 109/L)
Normal range: 2200- 7700 cells/μL
-most common cause is chemotherapy/ immunosuppressive therapy in the treatment of
cancer and autoimmune disease
Adults with diabetes are prone to - answers>>have heart disease , hypertension and
stroke
before thyroidectomy the patient - answers>>antithyroid drugs, iodine, and β-adrenergic
blockers may be given to achieve a euthyroid state(Iodine decreases the vascularization
of the thyroid gland, reducing the risk for hemorrhage)
Can NPH be mixed with other insulins? T/F - answers>>True, you can combine rapid
acting or short acting
Cobalamin (vitamin B12) deficiency anemia - answers>>often caused by pernicious
anemia, which results in poor cobalamin absorption through the (GI) tract
-Parenteral or intranasal administration of cobalamin is the treatment of choice
common cause of thrombocytopenia - answers>>is the ingestion of certain drugs
Cushing syndrome is a clinical condition that results - answers>>from chronic exposure
to excess corticosteroids, particularly glucocorticoids
Diagnostic study for addisons disease - answers>>ACTH stimulation test which
baseline corticol and ACTH levels are measured then patient is given IV synthetic
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Download ADULT HEALTH lll EXAM & FINAL EXAM LATEST VERSIONS 2024-2025 REAL EXAM QUESTIONS ANSWERS and more Exams Nursing in PDF only on Docsity!

ADULT HEALTH lll EXAM & FINAL EXAM

LATEST VERSIONS 2024-2025 REAL

EXAM QUESTIONS AND CORRECT

ANSWERS|GRADED A+

7 Signs of Cancer (CAUTION) - answers>>(C)hanges in bowel or bladder habits (A)ny sore that doesn't heal (U)nusual bleeding or discharge (T)hickening or lump in breast or elsewhere (I)ndigestion (O)bvious change in wart or mole (N)agging cough or hoarseness A reduction in neutrophils is termed - answers>>neutropenia ( less than 1000 cells/μL ( × 109/L) Normal range: 2200- 7700 cells/μL

  • most common cause is chemotherapy/ immunosuppressive therapy in the treatment of cancer and autoimmune disease Adults with diabetes are prone to - answers>>have heart disease , hypertension and stroke before thyroidectomy the patient - answers>>antithyroid drugs, iodine, and β-adrenergic blockers may be given to achieve a euthyroid state(Iodine decreases the vascularization of the thyroid gland, reducing the risk for hemorrhage) Can NPH be mixed with other insulins? T/F - answers>>True, you can combine rapid acting or short acting Cobalamin (vitamin B12) deficiency anemia - answers>>often caused by pernicious anemia, which results in poor cobalamin absorption through the (GI) tract
  • Parenteral or intranasal administration of cobalamin is the treatment of choice common cause of thrombocytopenia - answers>>is the ingestion of certain drugs Cushing syndrome is a clinical condition that results - answers>>from chronic exposure to excess corticosteroids, particularly glucocorticoids Diagnostic study for addisons disease - answers>>ACTH stimulation test which baseline corticol and ACTH levels are measured then patient is given IV synthetic

ACTH where ACTH and cortisol levels are checked 30-60 mins after to see a rise in those levels usually pts with addisons DO NOT have a rise or increase Diagnostic test for Cancer - answers>>-Biopsy

  • Bone marrow examination
  • Chest x-ray
  • CBC, tumor markers, liver function studies
  • CT scan; PET scan, mammogram, MRI
  • Cytology Diagnostic tests for leukemia - answers>>peripehral blood evaluation CBC, bone marrow biopsy, PET/CT scan, and lumbar puncture Diet for hypothyroidism - answers>>Low calorie, and high fiber ( for constipation) Effects of RAI show at - answers>>3 months Esophageal varices - answers>>enlarged vein in lower end of esophagus (most life threatning Excerise/nutrtion therapy for obese patients include - answers>>-reduced calories and increased activity 30-60 minutes calorie density is important Explain the pathophysiology of obesity - answers>>it involves an abnormal increase and accumulation of fat cells and increase in number of hyperplosia of adipocytes Folic acid deficient anemia - answers>>a megaloblastic anemia (Folic acid (folate) is needed for DNA synthesis leading to RBC formation and maturation)
  • Folic acid deficiency is treated by replacement therapy of 1mg/day PO
  • Encourage foods high in folic acid - green leafy veggies: liver, meat, fish, legumes, whole grains, orange juice, peanuts, and avocados, fruits For bone marrow biopsy the preferred site it - answers>>posterior iliac crest w local anesthetic and sedation post care
  • monitor vitals
  • assess site for excess drainage or bleeding
  • if bleeding occurs like on that side for 30-60 mins may use towel to provide pressure Health risks that involve obesity - answers>>- CVD problems
  • diabetes
  • treat with diet teaching with food high in iron and how to maximize absorption LAB VALUES TO KNOW - answers>>1.White blood cell- 5,000-10,000/mm 2.Hemoglobin Men= 14-18 g/dl Women = 12-16 g/dl 3.Hematocrit - % RBCs in plasma Men = 42-52% Women = 37-47% 4.Erythrocyte count - evaluate for anemia & hemorrhage Men = 4.5-5. Women = 4.1-5.
  1. Platlets 140 - 150k Leukemia - answers>>mutation of the DNA of certian cells (cancer of the blood) can also be from enviromental influences, chemotherapeutic agents,viruses, immunologic deficiencies, exposure to pesticides,inhertited abnormalities Levothyroxine is - answers>>treatment for hypothyroidism *Carefully monitor patients with CVD who take this drug *Monitor HR - report pulse greater than 100 beats/min or an irregular heartbeat *Promptly report chest pain, weight loss, nervousness, tremors, and/or insomnia long acting insulin names (peak,onset ,duration) - answers>>glargine (Lantus) detemir (Levemir) Onset: 0.8- 4hrs Peak: N/A Duration; 16-24hrs Macrovascular complications from diabetes are - answers>>diseases of the large and medium-sized blood vessels (heart, peripheral vascular system, and brain) metabolic syndrome - answers>>a medical condition associated with obesity, diabetes, high cholesterol, and hypertension Signs include- fasting blood glucose, hypertension, abnormal cholesterol levels and obesity Microvascular complications affect what? - answers>>the tiny vessels of the eyes, kidneys, and nerves. They result from several pathways, all in response to chronic hyperglycemia Example:

Retinopathy-microvascular damage in the retina Nephropathy- damage to the small blood vessels that supply the glomeruli of the kidneys Neuropathy- autonomic/sensory Mild anemia - answers>>Hgb 10-12g/dL

  • may be asymptomatic but palpitations, dyspnea, and mild fatigue may occur Moderate anemia - answers>>Hgb 6-10 g/dL Most cases of hyperthyroidism are the result of - answers>>graves disease myexedema - answers>>a skin and tissue disorder caused by hypothyroidism which alters physical apperance of the skin and subcutaneous tissue with puffiness, facial and orbital edema and a maslike effect myexedema coma - answers>>is a medical emergency that progresses from hypothyroidism and shows decreases in mental status which can be precipitated from infection, drugs, exposure to cold and trauma *CARDIAC MONITORING is important Nursing assesment for addisons disease - answers>>obtain daily weights, give corticosteroids, protect against infection, and help with daily hygiene, monitor signs of fluid deficit and electrolye imbalance Nursing assesments following a thyroidectomy - answers>>1.Monitor air way and respiratory status 2.assess the patient every 2hrs for 24hs for signs o hemorhage or tracheal compression, frequent swallowing or choking 3.assist the patien twith coughing and deep breathing
  1. have suction equipment and trachestomy kit available**** airway obstrution possibility****
  2. assess patient ability to speak
  3. monitor calcium levels 7.place patient in semi fowlers (30-45 degrees) position support head and neck with pillows (avoid neck flexion) nutrtional therapy with patients with hyperthyroidism - answers>>- high calorie diet of 4000 - 5000 a day
  • 1 - 2g/kg of protien a day
  • increase carbs
  • avoid spicy foods, high seasoned, high fiber and caffiene, tea, cola Other diagnostic test that indicates diabetes - answers>>1.Fasting plasma glucose (FPG) level > 126 mg/dL

Rapid acting insulin names (peak,onset ,duration) - answers>>Lispro (Humalog) Aspart (Novolog) Glulisine (Apidra) Onset:10 - 30 mins Peak:30 mins - 3hrs Duration:3-5hrs *given during meals Reasons for thyriodectomy - answers>>(1) a large goiter causing tracheal compression (2) a lack of response to antithyroid therapy (3) thyroid cancer Risk factors of addison's disease - answers>>-cancer

  • anticoagulants
  • chronic infections
  • past adrenal glad surgery
  • autoimmune disease Risk factors of cancer include - answers>>-geneteics promoting factors- smoking , diet and exercise, excessive alcohol use
  • radiation
  • infection/viruses
  • workplace carcinogens
  • tumors Safety alert for neutropenia - answers>>A low-grade fever (100.4) in neutropenic patients is of great significance because it may indicate infection and lead to septic shock and death unless treated promptly
  • Blood cultures should be drawn STAT and antibiotics started within 1 hr
  • neutropenic patient has little or no ability to fight infection. So, minor infections can lead rapidly to sepsis and death*** secondart obesity comes from - answers>>chromosomal or congenital anomolies, metabolic problems,or CNS lesions, disorders or drugs severe anemia - answers>>Hgb <6 g/dL Short acting insulin names (peak,onset ,duration) - answers>>Regular (Humulin R, Novolin R) Onset: 30-1 hr Peak: 2-5 hrs Duration: 5-8 hrs

Side effects of chemotherapeutic agents - answers>>anorexia, fatigue, diarrhea, hepatoxicity, nausea, vomiting, pericarditis, myocarditis, anemia,alopecia, cardiotoxicity, thrombocytopenia, leukopenia Signs and Symptoma of leukemia - answers>>-anemia

  • fever
  • weakness/fatigue
  • loss of apetitie
  • swollen or tender lymph nodes,liver or spleen
  • easy bruising
  • petechiae
  • frequent infections
  • thromobytopenia Signs and symptoms of addisons disease - answers>>Anorexia Nausea and Vomiting Weight loss*** Hypotension*** Hyperpigmentation*** Lethargy Confusion Depression hyponatremia*** hypoglycemia*** hyperkalemia*** signs and symptoms of diabetic ketoacidsos - answers>>-fruity odor**
  • dry mucous membranes
  • tachycardia
  • blood glucose greater than 250
  • lethargy/weakness
  • kussmall respirations
  • ketones in urine
  • orthostatic hypotension
  • sunken eyes
  • abdominal pain
  • nausea/vomiting
  • poor skin turgor check potassium ( DECREASE WILL OCCUR) Signs and symptoms of hyperthyroidism - answers>>-Intolerance to heat **
  • bulging eyes (expothalamus)
  • increased BP
  • edema
  • increase apettite
  • tachycardia

Signs of hypoglycemia - answers>>-cold and clammy skin

  • numbness in fingers/toes and mouth
  • tachycardia
  • nervousness
  • tremors
  • dizziness
  • unsteady gait
  • seizure/coma stages of chemotherapy for leukemia - answers>>1. Induction itherapy (1st stage* agressive)- attempts to bring about remission
  1. post-induction or post-remission therapy- high dose therapy given after induction
  • consolidation therapy- to eliminate remaining leukemic cells
  1. Maintenance therapy- low dose for prolonged period Steriod precautions for addisons - answers>>1. weight gain (report if 2-3lbs increase within a few days)
  2. decreased WBC (sepsis can occur/infection)
  3. hyperglycemia ( increase insulin)
  4. risk for fracture (osteoporosis)
  5. vision disturbances
  6. never abruptly stop meds ( do slowly)
  7. during stress increase dose of steriods The most important risk factor for developing type 2 diabetes is - answers>>obesity The primary diagnostic tests for assessing neutropenia - answers>>is the peripheral WBC count and bone marrow aspiration and biopsy Thrombocytopenia is a reduction of platelets below - answers>>150,000/μL (150 × 109 /L) check CBC patient should avoid aspirin and other drugs that affect platelet function or production Thyroid storm is - answers>>acute severe condition that occurs when an increased amount of thyriod hormone is released in circulation from result of stressors, traumas, and surgeries Signs/symptoms- agitation, delirium, seizures, abdominal pain, vomiting, diarrhea, and coma Treatment for addisons disease - answers>>1. Hydrocortisone, the most common form of hormone therapy, has both glucocorticoid and mineralocorticoid properties
  8. Mineralocorticoid replacement with fludrocortisone acetate (Florinef)
  1. increased dietary salt 4.Replacement of androgens in adrenal insufficiency is only needed for female patients 5.Prednisone treatment of leukemia - answers>>1. Chemotherapy
  2. Interferon-alpha (INFa) therapy
  3. Radiation therapy
  4. Stem cell transplantation (SCT) 5.Bone marrow transplant Treatments for anemia - answers>>1.blood product transfusions 2.drug therapy 3.volume replacement 4.oxygen therapy 5.dietary modifications 6.lifestyle changes type 1 diabetes mellitus - answers>>autoimmune process in which the body's own T cells attack and destroy pancreatic B-cells, which are the source of the body's insulin (occurs at young age) type 1 diabetes symptoms - answers>>Classic symptoms are PPP
  • excessive secretion of urine - polyuria
  • thirst - polydipsia
  • weight loss, tiredness and increased hunger-Polyphasia type 2 diabetes mellitus - answers>>when the body produces insufficient insulin or insulin resistance occurs type 2 diabetes symptoms - answers>>Fatigue, frequent urination, unusual thirst, blurred vision, prolonged wound healing, reccurent infections, and recurrent vaginal yeast infections Types of Anemia - answers>>1. blood loss 2.Iron deficiency 3.vitamin deficiency 4.Aplastic
  1. hemolytic 6.Sickle cell Types of insulin - answers>>rapid acting short acting intermediate acting long acting

What is addisonian crisis? What is your priority during this crisis? - answers>>Severe hypotension and vascular collapse 1st Priority GIVE IV PUSH STERIOD, 0.9 Nacl, dextrose What is anemia? - answers>>low RBC production or low hemoglobin What is ascites? - answers>>the accumulation of fluid in the peritoneal cavity, causing abdominal swelling What is diabetic ketoacidosis? - answers>>life threatning condition caused by a profound deficiency of insulin which mostly occurs in people with type 1 diabetes which can be caused by hyperglycemia, ketosis, acidosis and dehydration

  • causes metablolic acidosis What is hepatic encephalopathy? - answers>>comes from liver failure which impairs ammonia metabolism causing cerebral edema s/s: change in LOC, memory loss, muscle twtiching,hyperventilation w/ resp alkalosis. Give lactulose, low protein diet What is Insulin? - answers>>Insulin is a hormone made by the B cells in the islet of the pancrease which gets released in bloodstream which converts glucose into glycogen (when blood sugar levels are too high) What is methimazole? - answers>>antithyroid drug which decreases symptoms of hyperthyroidism (administer w food) What is portal hypotension? - answers>>a persistent increase in BP in the portal venous system What is RAI? - answers>>RAI is the primary treatment for nonpregnant adults with hyperthyroid disorders such as Graves' disease. RAI damages or destroys the thyroid tissue, thereby limiting thyroid secretion, and can result in hypothyroidism. Clients need to take thyroid supplementation (levothyroxine) for life What is sickle cell anemia? - answers>>is a group of inherited, autosomal recessive disorders characterized by the presence of an abnormal form of Hgb in the erythrocyte

What is the diagnostic test :A1C? - answers>>measures what % of glycosylated hemoglobin protien (HbA1c) in blood from the past 3 months

anything 6.5 or higher is bad What is the most common cause of hypothyroidism? - answers>>iodine deficiency** What is the preferred site of administration for insulin? - answers>>Abdomen bc of fastest absoprtion follwed by arm,thigh and buttox at 90 degree angle or if patient is thin at 45 degrees What is used to prepare the patient for thyroidectomy or for treatment of thyrotoxicosis?

  • answers>>Iodine is used with other antithyroid drugs What maintains blood glucose? - answers>>insulin which decreases high levels of glucose What medication can be given for patient with hyperthyroidism that have hypertension and tachycardia? - answers>>Beta blockers What medication can you give for Hepatic encephalopathy? - answers>>Since hepatic encephalopathy causes high levels of ammonia LACTLUOSE can be given to decrease ammonia by eliminating it in the feces What medications affect the liver? - answers>>aspirin, acetaminophen, and NSAIDs What oral medication is most effective for type 2 diabetes? - answers>>Metformin (glucophage) is a biguanide glucose-lowering agent which reduces glucose production by liver which sould be taken with food to minimize GI side effects What would you educate your diabetic patient about their diet? - answers>>-reduce alcohol intake
  • whole grains, healthy fat, lean protien
  • increase plant based foods
  • limit saturated/trans fats
  • limit carbohydrates When a diabetic wants to excercise they should - answers>>exercise about 1 hour after a meal or have a 10- to 15-g carbohydrate snack and check their blood glucose before exercising When should you give iron supplements? - answers>>(ferrous sulfate) Take on a full stomach, not in the morning, either after lunch or dinner. Don't take at night, sit up or stand for 30 minutes after ingesting. Don't take with milk Which insulin can only be given IV? - answers>>regular insulin (short acting) Which insulin does not combine with others? - answers>>long- acting