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NURS 302 Exam 1 Review Questions
With Complete Solutions
Which of the following medications work to lower cholesterol? Select all that apply. Ace Inhibitors Nitroglycerin Statins Bile acid sequestrants Diuretics correct answer: Statins Bile acid sequestrants Define cardiac output. correct answer: the amount of blood ejected by the heart per minute Why does hypocalcemia cause cardiac dysfunction? correct answer: Calcium is an important intracellular signal for cardiac cell contraction. Elevated intracellular calcium increases the contractility of the heart. So, when there is low calcium in the blood (hypocalcemia), the heart can't contract as forcefully. Why does hypertension increase left ventricular size? correct answer: An increase in arterial blood pressure increases the afterload that the heart must work against in order to pump the blood. Like any muscle, the heart will increase in size (hypertrophy) to adapt to greater workloads.
A nurse is teaching a client with iron-deficiency anemia about the diet that he or she has to follow. Which statements made by the client indicate effective learning? Select all that apply. "Consuming orange juice daily will increase iron absorption." "Adding meat to my diet will help improve iron deficiency." "Adding broccoli, beans, and tomato sauce to my diet will help improve iron deficiency." "Drinking a cup of black tea after meals will increase iron absorption." "Consuming grapes everyday will increase iron absorption." correct answer: "Consuming orange juice daily will increase iron absorption." "Adding meat to my diet will help improve iron deficiency." "Adding broccoli, beans, and tomato sauce to my diet will help improve iron deficiency." A nurse is analyzing the report of a 5-year-old client with leukemia, who is receiving chemotherapy. The platelet count is 20,000/microliter. What would be the best intervention for the nurse to include in the client's plan of care?
- Use a soft toothbrush for oral care.
- Monitor vital signs.
- Check temperature every 6 hours
- Use protective isolation precautions correct answer: Use a soft toothbrush for oral care. When would you recommend medical therapy in the treatment of infection? Select all that apply.
- When there is prolonged manifestation of an infection
- When there are no vaccines to prevent the infection
A nurse is caring for a client who has undergone cardiac surgery. What is the best method to assess the client's fluid loss or gain? Measuring body weight and vital signs Recording bp and calorie intake Recording 24 hour fluid intake and output and caloric intake Taking waist measurement and placing a foley catheter correct answer: Measuring body weight and vital signs A client has +3 pitting edema on the feet and also has ascites. What is the most important clinical feature to be monitored given this condition? Hemoglobin Serum Albumin Red blood cells White blood cells correct answer: Serum albumin level A client is running a high temperature and is found to have fluid volume deficit. Which signs and symptoms are likely to appear in the client because of fluid volume deficit? Select all that apply. Orthostatic hypotension Poor Skin turgor Dark Urine with low specific gravity Dyspnea Crackles in lungs correct answer: Orthostatic hypotension Poor Skin turgor Dark Urine with low specific gravity Dyspnea Crackles in lungs
A 55-year-old hypervolemic client has headache, muscle cramp, vomiting, and looks confused. Which condition has the client developed?
- Hyponatremia
- Hypernatremia
- Hypokalemia
- Hypocalcemia correct answer: Hyponatremia A client visits a primary health-care provider and complains of pain. The primary health-care provider diagnoses the pain as neuropathic pain. Which are the symptoms of neuropathic pain? Select all that apply.
- Is burning, tingling and shooting in sensation
- Acute and chronic
- Arises as a result of sustained noxious stimuli
- Occurs in the skin, muscles and bones
- Leads to conditions such as post therapeutic neuralgia and spinal nerve radiculopathy correct answer: - Is burning, tingling and shooting in sensation
- Arises as a result of sustained noxious stimuli
- Leads to conditions such as post therapeutic neuralgia and spinal nerve radiculopathy Which statements are true about pharmacological interventions for weight loss? Select all that apply.
- Weight loss medications are very effective.
- Weight loss is short term.
- Weight loss medications, such as over-the-counter appetite suppressants, have sympathomimetic side effects.
- Why is Daryl's PCO2 value lower than normal?
- Why is Daryl hyperventilating?
- Why is Daryl experiencing hyperkalemia?
- What medical intervention may help Daryl's condition? correct answer: 1. Metabolic acidosis
- Daryl's levels of carbon dioxide are lower than normal as the body attempts to compensate for acidosis. Carbon dioxide is an acid, so by reducing carbon dioxide levels, the body is attempting to raise pH.
- He is hyperventilating as a compensatory mechanism by the body. To increase the pH level, the lungs will respond by increasing his rate and depth of breathing in order to reduce carbon dioxide levels.
- Since there is a high amount of acid in the blood, the body is trying to get rid of hydrogen so hydrogen will move intracellularly. Potassium will move out of the cell and into the blood resulting in hyperkalemia.
- IV sodium bicarbonate a. Give an example of a blood gas result indicating the patient has uncompensated metabolic acidosis. Write a blood gas result. b. List 3 causes of metabolic acidosis correct answer: a) pH <7.35, CO2= 35-45, HCO3 < b) Lactic acidosis, ketoacidosis, renal failure, diarrhea, vomiting (loss of bicarb) A young patient is abusing laxatives in order to lose weight. What electrolyte imbalances may manifest? correct answer: Hyponatremia, hypophosphatemia, hypochloremia, hypokalemia
Provide the method of transmission and body system affected for varicella zoster correct answer: respiratory inhalation, integumentary What does an elevated aPTT indicate? correct answer: An elevated PTT indicates that the intrinsic pathway is involved, the blood is taking awhile to clot and the patient is at risk for bleeding. Requires further testing , coag deficiency, inhibition of factor VII, lupus, pt is on heparin What are the signs and symptoms of peripheral arterial disease and what are the common lab values for a patient with PAD? correct answer: Pallor, coolness, paresthesis, paralysis, pain with activity, absent or faded pedal pulse in the artery that is thickened, BAI of < 0.4 (closer to 0=> PAD), intermittent claudication (leg cramping pain from ischemia). Increase CRP, CHol >200 LDL >130 HDL <40, elevated homocysteine level How do statins work to decrease cholesterol levels? correct answer: block liver enzymes that assist in manufacture of cholesterol and can reverse plaque formation Mr. Dietrich, a 68-year-old male, comes to his primary care office because he experienced severe leg pain while visiting his daughter's family last weekend. Mr. Dietrich had wanted to
- What do you expect the results were for Mr. Dietrich's ABI assessment?
- Why was magnetic resonance angiography ordered? correct answer: 1. Intermittent claudication
- Because intermittent claudication is resolved by rest due to less oxygen required and less blood flow due to inactivity
- Because his left foot is undergoing ischemia from arteriosclerosis causing poor circulation. The poor circulation explains why his foot is cyanotic. The ischemia he is experiencing causes pain known as intermittent claudication. The decreased metabolic demands in the skeletal muscle also contribute to his pain.
- He is > 55 years old and has a history of HTN, hyperlipidemia and type 2 diabetes.
- I expect the results were < 0.4 on his left leg indicating he has PAD and low pulse on his left leg
- MRI was ordered to look at the 3D patency of the artery to determine whether there is atherosclerosis and blood flow to his femoral artery. Name the condition associated with obstruction of a coronary artery correct answer: ACS Explain why: Urine output increases with BNP release. correct answer: BNP (brain natriuretic peptide) is released when a fluid excess occurs. BNP stimulates the kidneys to increase urine output to reduce fluid volume to normal.
Describe Raynaud's disease correct answer: Vasospastic disorder of the arterioles and arteries of the hands and feet. Pain, numbness and coolness of the extremity with tricolor changes, blanching, and cyanosis followed by rubor
