Respiratory
Acid Base/Electrolyte
Fluid and Electrolyte
Cardiac
Cardiac II
Immunity
100
Pneumonia management may include what?
1. antibiotics
2. supplemental o2
3. Turning and repositioning in at risk patients
4. Pursed lip breathing
100
Interpret this ABG
pH 7.35
CO2 67
HCO3 30
FULLY COMPENSATED RESPIRATORY ACIDOSIS
The pH is now normal. The deviation likely moved up. CO2 is significantly elevated. Bicarb moved to compensate.
100
What are some reasons a patient can develop Hyperkalemia?
1. Kidney Problem
2. ACE Inhibitors
3. Hemolysis (Make sure you can think of which diseases/injuries can cause this)
4. Certain foods, salt substitutes
sickle cell, trauma
4. Acidosis
Are we missing any more?
100
Symptoms of a DVT are?
pain, swelling, warmth, unilateral
100
When caring for a patient with congestive heart failure, what is something important for the nurse to teach the patient regarding diet and over the counter drugs?
Limit the use of NSAIDS (worsen HTN, promote fluid retention).
Limit Salt intake
100
The charge nurse observes the primary nurse interacting with a client. Which action by the primary nurse warrent immediate intervention by the RN charge nurse?
1. The nurse explains the IVP diuretic will make the client urinate
2. The nurse dons nonsterile gloves to remove the client's dressing
3. The nurse administers a medication without checking for allergies
4. The nurse asks the UAP for help moving a client up in bed.
3. Checking for allergies is of the rights of medication administration. Is it the right drug? Even if the drug is the one the HCP ordered, it is not the right drug if the client is allergic to it . The nurse should always assess client allergies prior to administration.
Test taking Hint: The tem asks the test taker to determine which is the incorrect action, an "except" question. Three answers are actions the nurse should take
200
What are some ways to diagnose Tuberculosis?
1. Chest X-ray
2. Sputum Culture (AFB)
3. Mantoux skin test
4. Gold top (quantiFERON blood test)
200
Interpret this ABG
pH 7.19
CO2 40
HCO3 - 18
Metabolic Acidosis
200
A dehydrated patient will likely have which lab abnormalities
Sodium ____
Urine Specific Gravity ____
BUN _____
Elevated
Elevated
Elevated!!!
Know the normal values
200
Complications of unmanaged/untreated HTN are?
1. Renal Failure
2.Heart Failure
3. Aneurysms
4. Stroke
200
A Deep Venous Thrombosis manifests as ______ s/s?
unilateral leg pain,
erythema
swelling
+ homan's sign
200
The client is known to be HIV positive. Which data indicates that the client has now progressed to the diagnosis of AIDS?
1. The client's CD4+ count is 189
2. The client has an Hgb of 9.4 and Hct of 29.1
3. The client's chest xray shows infiltrate
4. The client reports a headache unreleived by acetaminophen
1. The diagnosis of AIDS is determined by predefined criteria: Positive HIV, a CD4 count less than 200, and one or more of the following AIDS defining illnesses" fungal infection candidiasis of the bronchi, lungs, esophagus, or PJP disseminated extrapulmonary coccidioidomycosis, disseminated extrapulmonary histoplasmosis, CMVdisease other than liver, spleen or nodes, toxoplasmosis, Kaposi sarcoma,etc.
300
What precautions should the nurse advocate for with a patient who presents to the hospital with a complaint of fever, night sweats, weight loss, hemoptysis?
1. Airborne/Droplet
TB patients need to be put in isolation to minimize spread of disease.
300
What are some causes of Acidosis?
Hypoxemia
DKA
Toxicity/OD
Can you name others?
300
A patient has been taking Spironolactone for the past 3 months. What complication should the nurse anticipate?
Hyperkalemia
300
A 64 year old male presents to the ER with a complaint of chest pain. What are some important diagnostic tests the nurse should anticipate?
ECG
Cardiac Troponin I
300
A patient with a BP of 210/120 WITH an elevated BUN and creatinine and ECG changes is said to have __________________
Hypertensive Emergency.
300
The 26-year-old female client reports a low grade-fever, arthralgias, fatigue and a facial rash. which laboratory tests should the nurse expect the HCP to order if SLE is suspected?
1. Comprehensive metabolic panel and liver functions tests.
2. Complete blood count and antinuclear antibody tests
3. Cholesterol and lipid profile tests
4. Blood urea nitrogen and glomerular filtration rate test
2. No single laboratory tests diagnoses SLE but the client usually presents with moderate to severe anemia, thrombocytopenia, leukopenia, and a positive antinuclear antibody test.
400
1 37 year old M presents to the ER with a c/o productive cough (green phlegm) x 3 days. The patient has the following VS
T - 101.9
RR - 20
O2 93%
BP 118/76
What is the likely cause of the patient's symptoms?
Pneumonia
Difference between CAP and HAP??
400
Symptoms of hypernatremia include?
- Muscle weakness/twitching
- Restlessness.
- Extreme thirst.
- Confusion.
- Lethargy.
- Irritability.
- Dry/flushed skin
- Seizures.
- Unconsciousness
400
A patient taking Loop Diuretics may develop
Hypokalemia
Hypotension
Dehydration
400
A patient who develops chest pain at rest and is not relieved with 3 doses of Nitroglycerin has likely developed ________________ and needs to _____
Unstable Angina/ACS
Call 911
400
If Hypertension goes unmanaged for years what will likely happen?
1. Renal Dx
2. CHF
3. Stroke
400
The client comes to the ED reporting dyspnea and wheezing after eating at a seafood restaurant. The client cannot speak and has a bluish color around the mouth. Which intervention should the nurse implement first?
1. Initiate an IV with normal saline
2. Prepare to intubate the client
3. Administer 100% oxygen
4. Ask the client about an iodine allergy
3. The client is cyanotic with dyspnea and wheezing. The nurse should administer should administer oxygen first.
500
Having the patient use Incentive Spirometry, cough, managing their pain, ambulating after surgery or during hospitalization are good ways nurses help patient prevent getting ______
Pneumonia
500
Central pontine myelinolysis is a complication from
correcting hyponatremia too quickly
500
A patient with Hyperkalemia received Kayexalate. How does this medication work?
As the resin passes along the intestine or is retained in the colon after administration by enema, the sodium ions are partially released and are replaced by potassium ions. For the most part, this action occurs in the large intestine, which excretes potassium ions to a greater degree than does the small intestine.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/011287s022lbl.pdf
500
A 45 year old Female with epigastric pain, nausea, and vomiting should be assessed with ________ to r/o_______ as these symptoms are called _____________
ECG
STEMI!!!
Atypical MI symptoms/Anginal Equivalents
500
DVT prophylaxis management is with _____________
Sub Q Lovenox (enoxaparin)
SubQ Heparin
500
The client is diagnosed with mild intermittent asthma . Which medications should the nurse discuss with the client?
1. Daily inhaled corticosteroids.
2. Use of a rescue inhaler
3. Use of systemic steroids
4. Leukotriene agonists
2. Clients diagnosed with intermittent asthma will have exacerbations treated with rescue inhalers. Therefore, the nurse should teach about rescue inhalers.
Test taking strategies: In the stem, two words are giving the test taker a clue about the correct answer. "Mild" and " intermittent" indicate the client is not experiencing frequent or escalating symptoms. Steroid medications can have multiple side effects.
600
Nursing diagnosis associated with a patient with pneumonia include ....
Ineffective airway clearance
Impaired Tissue Perfusion
Activity Intolerance
Know the implications and reasoning behind these
600
A patient given Spironolactone and Metoprolol for heart failure is expected to have
a. normal K, HR 67
b. Hyper K, HR 90
c. Hypo K, HR 59
d. Hyper Na, HR 100
A
600
A patient with a serum sodium of 173mg/dl who is symptomatic would likely develop what medical problem? What would be the appropriate intervention?
Pt has Hypernatremia
Can develop Seizures
Need to administer Hypotonic saline (0.45 NS or water)
600
What is the difference between hypertension and hypertensive Emergency?
Hypertensive Emergency shows evidence of end organ damage
1. Renal - Elevated BUN/Creatinine
2. Cardiac - ECG changes/BNP/Troponin leak
600
Risk factors for developing a DVT is
1. Prolonged immobility
2. Smoking
3. Hip or prolonged surgery
600
A home health nurse knows that a 70-year-old male client who is convalescing at home following a hip replacement is at risk for developing pressure ulcers. Which physical characteristic of aging puts the client at greatest risk?
