ABGs and Respiratory
Cardiac and Shock
Neuro and Sensory
Blood, Immune and Cancer
GI/GU and Reproductive
100

What electrolyte imbalance occurs when the serum potassium level is below 3.5 mmol/L?

Name the condition AND at least 3 signs/symptoms

What is Hypokalemia

Signs/symptoms = accept any 3:

  • Muscle weakness
  • Fatigue
  • Muscle cramps
  • Constipation/decreased GI motility
  • Cardiac dysrhythmias
  • Weak/irregular pulse
  • ECG changes
100

Which assessment finding is commonly associated with developing heart failure?

A. S3 heart sound
B. Hyperactive bowel sounds
C. Bradycardia of 50/min
D. Increased urine output

What is S3 heart sound

100

During an active generalized seizure, which nursing action is appropriate?

A. Restrain the extremities
B. Place something between the teeth
C. Protect the client from injury
D. Give oral fluids

What is C. Protect the pt from injury

(Protect the pt from environmental injury. Do not restrain them or place objects in the mouth)

100

A pt has fatigue, pallor, weakness, Hgb 78 g/L, and Hct 0.24 L/L. Which problem should the nurse recognize?

A. Polycythemia
B. Anemia
C. Leukocytosis
D. Thrombocytosis

What is B. Anemia

(Decreased hemoglobin reduces the blood's oxygen-carrying capacity, commonly producing fatigue, weakness and pallor)

100

Name at least 4 signs/symptoms that may occur when a gallstone obstructs the common bile duct

What is 

  • Jaundice
  • Dark urine
  • Pale/clay-coloured stools
  • Pruritus
  • RUQ/upper abdominal pain
  • Nausea/vomiting
200

What acid-base imbalance can occur when a pt hypoventilates and retains CO₂?

Name the condition AND at least 4 signs/symptoms.

What is Respiratory acidosis

Signs/symptoms =accept any 4:

  • Hypoventilation / slow or shallow respirations
  • Headache
  • Confusion
  • Drowsiness/decreased LOC
  • Restlessness
  • Dyspnea
  • Tachycardia
  • Hypoxemia/cyanosis in more severe cases
200

Name the 5 types of shock covered in PN4003 and give one common cause or example of each.

What is 

  • 1Hypovolemic: hemorrhage, severe fluid loss
  • 1Cardiogenic: MI/severe pump failure
  • Septic: severe systemic infection
  • 1Anaphylactic: severe allergic reaction
  • 1Neurogenic: loss of sympathetic tone, such as following spinal cord injury
200

A middle-aged pt says, "I can read things far away, but the print on my phone is getting harder to see." What age-related change is most likely?

A. Increased intraocular pressure
B. Loss of lens elasticity
C. Retinal detachment
D. Corneal infection

What is B. Loss of lens elasticity

(Age-related loss of lens elasticity causes presbyopia, reducing the ability to focus on nearby objects)

200

A mammogram identifies a suspicious breast mass. The pt asks, "What test will actually tell me if it's cancer?" Which response is correct?

A. Ultrasound
B. Repeat mammogram
C. MRI
D. Biopsy

What is D. Biopsy

(Imaging can identify and characterize suspicious lesions, but tissue sampling is required to establish a definitive pathological diagnosis)

200

Name at least 4 signs/symptoms that may occur with prostate cancer

What is 

  • Difficulty starting urination/hesitancy
  • Weak or interrupted urinary stream
  • Increased urinary frequency
  • Nocturia
  • Difficulty emptying the bladder
  • Hematuria
  • Pain can occur with advanced disease
  • Bone pain can occur with metastatic disease
  • asymptomatic during early stages
300

A patient with pneumonia suddenly becomes restless and confused. RR is 32/min and SpO₂ has fallen from 95% to 86% despite supplemental oxygen. What is the nurse's priority?

A. Encourage oral fluids
B. Perform an immediate respiratory assessment and escalate care
C. Obtain a sputum specimen
D. Administer a PRN antipyretic

What is B. Perform an immediate respiratory assessment and escalate care 

(New confusion, tachypnea and worsening hypoxemia indicate acute respiratory deterioration. Airway and breathing take priority over routine pneumonia interventions.)

300

A pt is experiencing an acute myocardial infarction (MI).

Name at least 5 signs/symptoms the nurse may observe AND identify one important diagnostic test or laboratory marker used in the assessment.

What is 

  • Chest pain/pressure/discomfort
  • Pain radiating to arm, shoulder, jaw, back or epigastric area
  • Dyspnea
  • Diaphoresis
  • Nausea/vomiting
  • Fatigue/weakness
  • Anxiety/restlessness
  • Dizziness/light-headedness

Diagnostic: 12-lead ECG and/or cardiac troponin

300

A pt has a newly applied lower-leg cast. Which finding requires immediate action?

A. Mild swelling during the first several hours
B. Pain rated 3/10
C. Severe pain with passive movement of the toes despite analgesia
D. Client reports the cast feels heavy

What is C. Severe pain with passive movement of the toes despite analgesia

(Severe pain out of proportion to the injury, particularly with passive stretch, can indicate compartment syndrome, which threatens tissue perfusion and requires urgent intervention)

300

Name 5 signs/symptoms or clinical findings associated with systemic lupus erythematosus (SLE)

What are 

  • Fatigue
  • Joint pain/arthralgia
  • Joint swelling
  • Malar ("butterfly") rash
  • Photosensitivity
  • Raynaud phenomenon
  • Leukopenia
  • Thrombocytopenia
300

A pt with impaired renal function has the following laboratory results:

  • K⁺ 6.2 mmol/L
  • Na⁺ 138 mmol/L
  • Hgb 102 g/L
  • Creatinine elevated

Which laboratory finding requires the most immediate attention, and why?

Bonus: name 3 signs of the condition = double points

What is potassium of 6.2mmol/L = hyperkalemia

For double points: Muscle weakness, paresthesias, cardiac dysrhythmias/ECG changes, potentially bradycardia or conduction abnormalities

400

Interpret this ABG:

pH 7.50 | PaCO₂ 36 | HCO₃⁻ 32 | PaO₂ 92 | SaO₂ 95%

A. Uncompensated respiratory alkalosis
B. Partially compensated metabolic alkalosis
C. Uncompensated metabolic alkalosis
D. Fully compensated metabolic alkalosis

What is Uncompensated metabolic alkalosis

400

Four patients require assessment. Who should the nurse see first?

A. pt with HF who has +2 ankle edema
B. pt with stable angina requesting teaching about nitroglycerin
C. pt 24 hours after MI with new crackles and increasing dyspnea
D. pt with hypertension whose BP is 154/88

What is C. pt 24 hours after MI with new crackles and increasing dyspnea

(New crackles and dyspnea following an MI may indicate acute left ventricular failure and pulmonary congestion)

400

An unconscious pt arrives after striking their head. Which history obtained from the family is most concerning?

A. Previous migraines
B. Takes warfarin daily
C. Wears hearing aids
D. Previous tension headaches

What is B. Takes warfarin daily

(Anticoagulation substantially increases concern for intracranial bleeding following head trauma)

400

A pt receiving chemotherapy has the following morning laboratory results:

  • WBC: 1.4 × 10⁹/L
  • Platelets: 82 × 10⁹/L
  • Hgb: 91 g/L

At 1400, the pt reports chills and has a temperature of 38.4°C. Which action is the priority?

A. Give acetaminophen and reassess in one hour
B. Encourage oral fluids and rest
C. Recognize possible infection and promptly escalate care
D. Apply warm blankets for the chills

What is C. Recognize possible infection and promptly escalate care

(A client receiving chemotherapy with significant leukopenia and a new fever may have a serious infection. Immunosuppressed clients can deteriorate rapidly, so fever should not simply be masked with an antipyretic before the cause is evaluated)

400

What is orchitis, and name at least 4 signs/symptoms a client may experience?

What is

  • Testicular pain
  • Testicular swelling
  • Scrotal tenderness
  • Scrotal redness/warmth
  • Fever
  • Malaise
  • Nausea/vomiting

(Mumps can cause orchitis, particularly after puberty, and testicular involvement may affect fertility)


500

What serious respiratory condition can develop following severe illness or injury, including sepsis, pneumonia, or smoke inhalation, and causes severe impairment in oxygenation?

Name the condition AND at least 4 signs/symptoms

What is Acute Respiratory Distress Syndrome (ARDS)

Signs/symptoms = accept any 4:

  • Severe dyspnea
  • Tachypnea
  • Hypoxemia
  • Low oxygen saturation
  • Restlessness/anxiety
  • Cyanosis
  • Crackles
  • Increased work of breathing
  • Respiratory distress
500

A patient's vital signs and findings are as follows:

  • T 39.4°C
  • HR 128/min
  • RR 30/min
  • BP 82/46 mmHg
  • increasing confusion
  • urine output 15 mL/hr

Identify the type of shock AND name at least 3 findings demonstrating impaired tissue/organ perfusion

What is Septic shock

Evidence of poor perfusion includes:

  • Hypotension
  • Altered/decreasing LOC
  • Oliguria/urine output 15 mL/hr
  • Tachycardia can also support hemodynamic compromise
500

What neurological condition can occur with a brain tumour due to increased pressure within the skull?

Name the condition AND at least 5 signs/symptoms associated with it.

What is Increased intracranial pressure (ICP)

Signs/symptoms= accept any 5:

  • Decreased/change in level of consciousness
  • Headache
  • Nausea/vomiting
  • Pupillary changes or unequal pupils
  • Visual changes
  • Confusion/restlessness
  • Seizures
  • Weakness or other neurological deficits
  • Increased systolic BP / widening pulse pressure
  • Bradycardia
  • Irregular respirations

Key late findings: Cushing's triad

  • Bradycardia
  • Widening pulse pressure
  • Irregular respirations
500

A pt is experiencing an acute hemolytic blood transfusion reaction.

Name at least 4 signs/symptoms AND state the nurse's immediate action.

What is:

  • Chills
  • Low back/lumbar pain
  • Pain at the IV site
  • Dyspnea/tachypnea
  • Hypotension
  • Rash
  • Tachycardia
  • Flushing
  • Fever

Immediate action: STOP the blood transfusion immediately.

500

A pt receiving peritoneal dialysis reports increasing abdominal pain. The nurse observes cloudy effluent and the client has a temperature of 38.6°C. What complication should the nurse suspect?

A. Expected response to dialysis
B. Peritonitis
C. Urge incontinence
D. Renal calculi

What is Peritonitis

(Abdominal pain, fever and cloudy dialysate effluent are concerning for peritoneal infection and require prompt assessment and escalation)

M
e
n
u