325 Exam 3 Practice Qs Flashcards
what is an expected symptom of captopril? why?
cough bc its an ace inhibitor (-pril)
who can’t have propranolol, a beta blocker?
-people with asthma due to it causing bronchospasms/constriction
other choices:
-55 year old man with 2 MI
-someone who has angina
-Pt who has migraines
what does dark/amber urine mean?
-dehydration
other choices:
-renal failure
-toxicity from drug
-common symptom of hypervolemia
What systems are involved in gas exchange?
-pulmonary, cardiovascular, neurological
other choices:
-endocrine
-immune
exercise recommendation
-walk until you experience dyspnea
other choices:
-breath in and out of mouth while exercising
-avoid exercise
what does clear, odorless urine mean?
overhydration
what is intermittent claudication?
-leg cramping, lower extremity skeletal muscle pain
other choices: leg swells when standing
-SOB when walking up stairs
How should you position a patient with COPD when having difficulty breathing?
-feet on the ground, lean over with hands supporting upper body (tripod position)
other choices:
-left lateral and 45 degree bed angle
-lying supine
-sitting with arms crossed over chest and legs crossed
CASE STUDY: GI problems, breathing problems. History of pneumonia as a kid. Fluid in lungs. Increased dyspnea (trouble or pain with breathing)
what is he at risk for?
-hypoxia
CASE STUDY: GI problems, breathing problems. History of pneumonia as a kid. Fluid in lungs. Increased dyspnea (trouble or pain with breathing)
what are some appropriate nursing interventions?
-respiratory therapy
-more oxygen
what NOT to do:
IV fluids because they already have fluid overload
CASE STUDY: GI problems, breathing problems. History of pneumonia as a kid. Fluid in lungs. Increased dyspnea (trouble or pain with breathing)
nursing interventions complete. what shows the symptoms have improved?
-RR, BP improved, increased cognition
other choices:
-pale color
-obvious
CASE STUDY: GI problems, breathing problems. History of pneumonia as a kid. Fluid in lungs. Increased dyspnea (trouble or pain with breathing)
which 3 assessment findings are concerning?
-GI/GU
-lung sounds
-obvious 3rd choice
other choices:
-vital signs
pick the spot for a rectal exam on an image
bottom of colon, right above anus
what do you tell an elderly woman who suffers from urinary incontinence with uti but wants to visit her grandson?
-tell her there are incontinence helpers (diapers)
other choices:
-pessary
-indwelling urinary catheter
-it will go away
what is stress incontinence?
urine incontinence caused by increased intrabdominal pressure
You palpate a patient’s abdomen and it is slightly distended and they report needing to urinate. What should you do?
-take them to the bathroom
other choices:
-insert catheter
-obtain urine sample
What are some nonpharmacological interventions for hypertension?
-exercise
-diet
-weight control
NOT drugs or multivitamin
what is some primary prevention for impaired breathing?
-COVID vaccine
-incentive spirometer
-exercise
NOT O2 therapy or TB test
fractured rib =
pain on inhalation
what is a common symptom with alpha beta blockers?
bradycardia
You want to prescribe an angiotensin receptor blocker (ARB), what should you give?
lostartan (-artan)
which patient gets assessed first?
-COPD at 90% o2
-Stat antibiotics
-pt who’s O2 dropped from 98 to 92%
o2
How does sulfasalazine work for ulcerative colitis?
-reduces inflammation
NOT
-treats infection
-immunity
What should you recommend to a patient taking psyllium and it’s not working?
-drink 8oz water with admin
NOT consult provider about taking a different laxative
Which patients should not get loperamide?
-Cdiff
-bowel obstruction
-HR of 88 and allergy to sulfa can take loperamide
what should you look for in a patient before giving a diuretic, specifically furosemide (lasix)?
normal potassium levels, hypokalemia?
not hypernatremia or diarrhea
what do you measure before giving hydralazine?
HR
Which oxygen delivery device is for low flow?
nasal cannula
where is the posterior tibial pulse?
back of the heel/ankle
How do you explain to a patient why they have hypertension?
-vascular changes
NOT
-bad diet
-you would’ve gotten it eventually
-you don’t exercise enough
When should you give bisacodyl (senna)?
at night
What should you do when taking a calcium channel blocker, Nifedipine?
avoid eating grapefruit
what are some unexpected findings of chronic central perfusion?
-clubbing, cap refill over 3 seconds, uneven hair on lower extremities
What demonstrates good perfusion?
O2 above 95%
How do you know a patient is drug resistant to antihypertensive meds after 3 months?
-their BP is gradually rising
How would you explain to an anemic why they are feeling fatigued?
-less hemoglobin in blood –> less o2 being delivered to tissues
which vital signs need attention?
-BP 180/68
others are all within range
ACE inhibitors may also cause…
angioedema, swollen face and lips
question about your heart and being fatiqued, SATA
-syncope episodes (fainting)
-other choice
NOT
-stairs
-working nights
What makes hypertension worse?
coffee
SATA impaired perfusion
-2 obvious answers
-petechiae
COPD
contraindications vs helpful
contraindication:
-increase o2
helpful:
-draw blood for CBC
-elevate HOB
-sputum culture
MC what is good for a COPD diet?
-whole grains and veggies
What would you expect from a patient who is constipated?
-mildly bloated
NOT
-perineal skin breakdown
-soft tender distended stomach
-decreased intake of fluids
a patient is on a -pril medication (ACE inhibitor) and reports having a peristent cough, what do you tell them?
normal
what is an expected finding of COPD?
-Barrell chest
What is a good diet suggestion for someone who has hypertension?
replace whole milk with skim milk
PAD relevant choices
-hypertension and diabetes
impaired elimination choices
UTI, constipation, 2 obvious GI/GU
Irrelevant dropdown choices for case study
-crackles in lungs and pneumonia
