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RN 2023 cutie > PREBOARDS 1_NP3 > Flashcards

PREBOARDS 1_NP3 Flashcards

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1
Q

A male client with angina pectoris has noticed a significant increase in the frequency of his pain attacks. He is admitted for observation. While the nurse is interviewing him, he discloses that he has been experiencing chest pain for the past week. (Questions 1-5)
1. Which statement by the client would be of greatest concern to the nurse?

*
1 point
a. “I couldn’t enjoy the dinner party during my wife’s birthday celebration because I got the pain before we got home from the restaurant.”
b. “Last Thursday, I experienced chest pain while walking.”
c. “I felt pain all the way down my left arm after I was playing golf.”
d. “I had chest pain yesterday while I was sitting in the living room watching television.”

A

d. “I had chest pain yesterday while I was sitting in the living room watching television.” = pain at rest

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2
Q

Which of the following medications decreases sinoatrial node automaticity and atrioventricular node conduction?
*
1 point
a. Metoprolol
b. Diltiazem
c. Captopril
d. Alprazolam

A

b. Diltiazem = Calcium Channel Blocker > slows heart rate

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3
Q

The client’s wife asks what the effect of the beta blockers to her husband will be. Which information should the nurse reply?
*
1 point
a. decreases the risk of a blood clot
b. reduces the amount of oxygen needed by the heart muscle
c. increases the volume of blood in the coronary arteries
d. enhances the affinity of oxygen for hemoglobin

A

b. reduces the amount of oxygen needed by the heart muscle

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4
Q

The client’s wife asks what the effect of the beta blockers to her husband will be. Which information should the nurse reply?
*
1 point
a. decreases the risk of a blood clot
b. reduces the amount of oxygen needed by the heart muscle
c. increases the volume of blood in the coronary arteries
d. enhances the affinity of oxygen for hemoglobin

A
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5
Q

The client showed signs of improvement and is about to be discharged. Which statement made by the client warrants further teaching?
*
1 point
a. “I will place my nitroglycerin pills on a plastic pillbox labelled with each day of the week.”
b. “I will always carry nitroglycerin tablets on my bag so that I could take it if ever I would have another episode of chest pain.”
c. “I will renew my nitroglycerin supply every 6 months.”
d. “I will sit down for a few after taking nitroglycerin to avoid syncope.”

A

a. “I will place my nitroglycerin pills on a plastic pillbox labelled with each day of the week.” = it is unstable so it should be carried securely in an original container (capped dark glass bottle/ amber colored bottle)

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6
Q

When the nurse performs an admission assessment on a client, the nurse notes that the client has xanthomas present on both eyelids. The laboratory value that the nurse would want to check based on this assessment finding is
*
1 point
a. triglyceride level
b. homocysteine level
c. cholesterol panel
d. cardiac enzymes

A

c. cholesterol panel

Cholesterol accumulates in tumor nodules on skin

Triglycerides = measure of fats in blood stream

Homocysteine = elevated = considered as an independent risk factor for atherosclerosis

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7
Q

After having an abdominal aortic aneurysm repaired, a patient is brought back to the unit. Which of the following should the nurse position the client?
*
1 point
A. Semi-Fowler’s
B. Flat
C. High-Fowler’s
D. Trendelenburg

A

B. Flat

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8
Q

A client has been diagnosed with pericardial effusion. The nurse would prepare the client for which of the following procedures?
*
1 point
A. Myotomy
B. Pericardiectomy
C. Pericardiostomy
D. Dynamic cardiomyoplasty

A

C. Pericardiostomy = drains pericardial effusion

B = excision
D = improves pumping action of myocardium

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9
Q

Which health teaching would be inappropriate to give a client following coronary artery bypass graft surgery?
*
1 point
A. No driving for 6–8 weeks
B. Avoid smoking or tobacco use for 4–6 weeks
C. No heavy lifting for 6–8 weeks
D. Can resume sexual intercourse in 3–4 weeks

A

B. Avoid smoking or tobacco use for 4–6 weeks - IT SHOULD BE STOPPED ENTIRELY

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10
Q

The nurse observes that the patient’s pulse is weaker distal to the catheter insertion site after the patient has had cardiac catheterization. The nurse needs to:
*
1 point
A. apply warm compresses to the insertion site.
B. elevate the affected extremity.
C. notify the physician of the observation.
D. record the data on the nurse’s notes.

A

D. record the data on the nurse’s notes. - it is normal for the pulse to be weaker for the first few hours after catheterization

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11
Q

Xyra, a 36-year-old patient was about to undergo coronary artery bypass graft procedure. What vein is commonly used in this procedure?
*
1 point
A. greater saphenous vein
B. lesser saphenous vein
C. iliofemoral vein
D. popliteal vein

A

A. greater saphenous vein

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12
Q

Situation: Anya, a 57-year-old client is admitted to the hospital with peripheral vascular disease of the lower extremities. She has several ischemic ulcers on each ankle and lower leg area. Other parts of her skin are shiny and taut with loss of hair. (Questions 12-15)
12. The nurse anticipates that which medication will be prescribed to a patient with intermittent claudication?
*
1 point
A. Ramipril
B. Warfarin
C. Simvastatin
D. Pentoxifylline

A

D. Pentoxifylline - vasoactive agent that improves blood flow by reducing viscosity

Simvastatin = lowers lipoproteins and triglycerides
Warfarin = prevents strokes and heart attack

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13
Q

Anya will start to feel the pain of intermittent claudication when the arterial occlusion reaches:
*
1 point
A. 25%
B. 50%
C. 75%
D. 90%

A

B. 50%

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14
Q

Anya is being instructed by a nurse on how to position her lower extremities correctly. Which response suggests that further teaching needs to be given?
*
1 point
A. “I can watch television while seated in a chair.”
B. “When I lie down, I’ll elevate my legs and feet on pillows.”
C. “I’ll avoid crossing my legs.”
D. “When I’m resting, I should hang my legs over the side of the bed.”

A

B. “When I lie down, I’ll elevate my legs and feet on pillows.”

We should promote venous drainage

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15
Q

What contributes to the brown pigmentation of the lower limbs in clients with venous stasis?
*
1 point
A. Red blood cell degradation in the congested tissues
B. Necrosis of subcutaneous fat due to tissue hypoxia
C. Skin atrophy caused by lack of circulation.
D. Reduced inflammatory and immune response from congested circulation

A

A. Red blood cell degradation in the congested tissues

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16
Q

Situation: Nurse educator Junjunakis, serving as a principled facilitator of learning, is always keen on providing accurate information about the topics of respiratory functions.
16. During his lecture, one of his students asked him about the principles regarding air quality index (AQI). An air quality index (AQI) score of 160 indicates which category of air pollution level?
*
1 point
A. Unhealthy for Sensitive Groups
B. Hazardous
C. Unhealthy
D. Very Unhealthy

A

C. Unhealthy

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17
Q

Nurse educator Junjunakis demonstrates proficient knowledge about the assessment of tactile fremitus if he/she states that:
*
1 point
A. Fremitus is more pronounced in men than in women because of the lower-pitched voice.
B. Assessment is more pronounced with vowel sounds.
C. The vibrations are detected using the radial aspect of the hands.
D. Patients with consolidated lung lobes (such as in pneumonia) exhibits decreased tactile fremitus over the area.

A

A. Fremitus is more pronounced in men than in women because of the lower-pitched voice.

Tactile fremitus is influenced with pitch; lower pitches travel better through normal kung and produce vibrations of chest wall

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18
Q

He also emphasized during his lecture that when caring for a patient hooked to a mechanical ventilator, one must be cognizant with ventilator alarms. In instances where a high-pressure ventilator alarm is generated, the following are the suspected causes, except:
*
1 point
A. The endotracheal tube slips into right main bronchus
B. There is an occurring atelectasis or bronchospasm
C. The client stops spontaneous breathing
D. The client fights the ventilator

A

C. The client stops spontaneous breathing - low pressure alarm

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19
Q

Which of the following complications of tracheostomy constitutes a medical emergency?
*
1 point
A. Trachea-innominate artery fistula
B. Tracheoesophageal fistula
C. Tracheal stenosis
D. Tracheomalacia

A

A. Trachea-innominate artery fistula - it is a life threatening complication as there is heavy bleeding in stoma caused by necrosis

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20
Q

. Which among the options is the particular manifestation of a bacterial pneumonia with Pseudomonas as its etiology?
*
1 point
A. Red currant-jelly sputum
B. Green sputum
C. Rust-colored sputum
D. Foul-smelling and bad-tasting sputum

A

B. Green sputum = Hemophilus and Pseudomonal

A = Klebsiella
C = S pneumoniae
D = Anaerobes

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21
Q

Nurse Embudo knows that smoking contributes to the development of COPD mainly by depressing the activity of scavenger cells, which in turn will lead to what pathophysiologic process?
*
1 point
A. Increased mucus secretion and accumulation
B. Increased alveoli distention and decreased lung capacity
C. Decreased passive surface for O2/CO2 transfer
D. Decreased differentiation in restoring healthy epithelial cell layer

A

B. Increased alveoli distention and decreased lung capacity

A = irritation of goblet cells
C = microvascular cells
D = affectation of basal cells

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22
Q

What clinical picture resembles rapidly-developing hypoxia in a patient diagnosed with COPD?
*
1 point
A. Somnolence
B. Dementia
C. Alcohol intoxication
D. Mild cognitive impairment

A

C. Alcohol intoxication = lack of coordination and judgement

Somnolence = long standing hypoxia

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23
Q

Which short-acting beta agonist (SABA) is used not only as an airway medication, but also in treatment of hyperkalemia?
*
1 point
A. Terbutaline
B. Formoterol
C. Salmeterol
D. Albuterol

A

D. Albuterol

B & C = LABA
A = tocolytic/Cesation of labor contractions

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24
Q

Which object may be allowed inside the room of a patient receiving an oxygen?
*
1 point
A. Television
B. Hair spray
C. Polyester clothes
D. Nail polish remover

A

A. Television = electrical devices are allowed as long as it is kept in a good working order to avoid short circuit

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25
Q

Which type of emphysema possesses the highest risk for development if a person has an alpha-1 antitrypsin deficiency?
*
1 point
A. Paraseptal emphysema
B. Centrilobular emphysema
C. Distal acinar emphysema
D. Panacinar emphysema

A

D. Panacinar emphysema

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26
Q

Nurse Hannah Montano is accurate in stating that which clinical manifestation indicates worsening of an asthma attack?
*
1 point
A. Decreased wheezing
B. Increased emotional restlessness
C. Reports of chest pain
D. Presence of hacking cough

A

A. Decreased wheezing = Decreased airflow. For wheezing to occur = client must be able to move sufficient air to produce breath sounds

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27
Q

Nurse Hannah Montano is also caring for a patient with left tension pneumothorax. She is aware that the clinical finding she would not expect upon assessment is:
*
1 point
a. Tracheal deviation to the right
b. Inward movement during inspiration
c. Hypotension
d. Decreased breath sounds on the left side

A

b. Inward movement during inspiration = Flail Chest

Hypotension is present due to increased thoracic pressure leads to low BP

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28
Q

In treatment of acute asthma exacerbations, the following may be indicated to be administered, except:
*
1 point
A. Levalbuterol HFA
B. Ipratropium
C. Theophylline
D. Prednisolone

A

C. Theophylline - is for long-term control and prevention of asthma (phosphodiesterase inhibitors)

Prednisolone = for short bursts of asthma
Ipratropium = acute bronchospasm

Remember AIM

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29
Q

The patient receives correct health education if he/she states that the use of spacer in a metered-dose inhaler is crucial on the basis of what primary reason?
*
1 point
A. To decrease systemic side effects
B. To facilitate better administration and absorption
C. To deliver accurate dose administration
D. To decrease risk for infection in the mouth

A

D. To decrease risk for infection in the mouth

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30
Q

WHO conducted a cancer country profile in the Philippines by the year 2018. In light of their findings, lung cancer is ranked ___ among the most common cancer cases in terms of mortality rate.
*
1 point
A. 1st
B. 2nd
C. 3rd
D. 4th

A

A. 1st

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31
Q

. A blood donor deferral period is the length of time that an individual is not eligible to donate blood based upon lists of criteria in place. As stipulated by the updated DOH Department Circular No. 2021-0102, administration of mRNA-based COVID-19 vaccines (Pfizer-BioNtech, Moderna) would warrant the vaccinated person to be eligible to donate blood only after what specified time period?
*
1 point
A. Accept anytime, if asymptomatic
B. 7 days after vaccination
C. 14 days after vaccination
D. 28 days after vaccination

A

A. Accept anytime, if asymptomatic

If symptomatic, may donate after 7 days

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32
Q

Nurse Ineme once read that neutropenia results from decreased production of neutrophils elicited by the following causes, except:
*
1 point
A. Myelodysplastic syndrome
B. Radiation therapy
C. Hypersplenism
D. Aplastic anemia

A

C. Hypersplenism = increased destruction of neutrophils

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33
Q

If two people with sickle cell trait (autosomal recessive) both decided to have children, what is the probability of their child being a carrier of the trait?
*
1 point
A. One in four odds
B. Two in four odds
C. Three in four odds
D. None of the options provided

A

B. Two in four odds

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34
Q

What clinical manifestations will Nurse Ineme primarily observe should a vaso-occlusive crisis occur in a person with sickle-cell disease?
*
1 point
A. Profound anemia, hypovolemia, and shock
B. Profound anemia and pallor
C. Anemia, jaundice, and reticulocytosis
D. Fever; painful swelling of hands, feet, joints, or affected area; and abdominal pain

A

D. Fever; painful swelling of hands, feet, joints, or affected area; and abdominal pain

Accumulation of erythrocytes and leucocytes in microcirculation

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35
Q

What clinical manifestations will Nurse Ineme primarily observe should a splenic sequestration occur in a person with sickle-cell disease?
*
1 point
A. Profound anemia, hypovolemia, and shock
B. Profound anemia and pallor
C. Anemia, jaundice, and reticulocytosis
D. Fever; painful swelling of hands, feet, joints, or affected area; and abdominal pain

A

A. Profound anemia, hypovolemia, and shock

Sickled cells are pooled in organs

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36
Q

Situation: Nurse Habibi is caring for group of clients with hematologic conditions. It is imperative for her to be well-informed about the general concepts regarding the disorders.
36. Nurse Habibi is accurate in stating that platelet counts are elevated under the following conditions, except:
*
1 point
A. Collagen disorders
B. Acute infection
C. Post splenectomy
D. Systemic lupus erythematosus

A

D. Systemic lupus erythematosus = below normal; antibodies produced leads to platelet destruction

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37
Q

Among the different oral iron preparations indicated for iron-deficiency anemia, it is indicated for use in iron deficiency anemia in those with inflammatory bowel disease.
*
1 point
A. Ferric maltol
B. Ferrous sulfate
C. Ferric gluconate
D. Ferrous fumarate

A

A. Ferric maltol

C. Ferric gluconate = for kidney disease and given with epoietin

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38
Q

Patient X receives correct health education from Nurse Habibi if he/she states that intake of these food sources will increase the absorption of iron in the stomach, except:
*
1 point
A. Broccoli
B. Greek yogurt
C. Strawberries
D. Bell peppers

A

B. Greek yogurt = low in vitamin C

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39
Q

Nurse Habibi is reviewing possible causes of folic acid deficiency. Which among the options is least likely to be included?
*
1 point
A. Alcoholism
B. Jejunal resection
C. Vegan diet
D. Intake of methotrexate

A

C. Vegan diet = it affects vitamin B12, not B9

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40
Q

For people with pernicious anemia as a result of deficiency of intrinsic factor, vitamin B12 injections are administered _____ initially and then _____ for maintenance (lifelong).
*
1 point
A. Daily; weekly
B. Every other day; weekly
C. Weekly; every two weeks
D. Weekly; monthly

A

D. Weekly; monthly

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41
Q

Each individual blood component is processed and stored differently. Which blood product for transfusion must be stored at room temperature?
*
1 point
A. Platelets
B. Whole blood
C. Red cells
D. Cryoprecipitate

A

A. Platelets = last only for 5 days

B. Whole blood = refrigerated
C. Red cells = refrigerated
D. Cryoprecipitate = frozen

42
Q

ABO blood typing and crossmatching results show that a patient has a type A blood containing RhD factor antigen. Student nurse Chickibawow knows that the patient may receive what type of blood if needed?
*
1 point
a. A+, O+ only
b. A+, A-, O+, O- only
c. A-, O- only
d. A+ only

A

b. A+, A-, O+, O- only

With RhD antigen = can receive both + and -

43
Q

Student nurse Chikibawow knows that the PTT test uses ______ blood to prevent clotting in the tube before the test begins.
*
1 point
A. Heparinized
B. Decalcified
C. Ionized
D. Cascaded

A

B. Decalcified

44
Q

Macrocytic red blood cells are seen in the following conditions, except:
*
1 point
A. Alcoholism
B. Vitamin B12/Folate deficiency
C. Thalassemia
D. Chemotherapy

A

C. Thalassemia: microcytic in nature due to impaired synthesis of the globin protein component of Hgb

45
Q

_______ constitute about 1 to 2% of circulating leukocytes; it contains specific granules where heparin, histamine, and serotonin are bound.
*
1 point
A. Lymphocytes
B. Monocytes
C. Neutrophils
D. Basophils

A

D. Basophils

Nueutrophils: predominant WBCs; body’s first line of defense
Monocytes: phagocytosis; migrate into tissues and become macrophages
Lymphocytes: T&B cells; agranular, mononuclear blood cells

46
Q

Osmolality is the concentration of fluid that affects the movement of water between fluid compartments by osmosis. Serum osmolality reflects the concentration of which of the following? Select all that apply.
I. Potassium

II. Sodium

III. Glucose

IV. Ketones

V. Blood urea nitrogen

VI. Uric acid

*
1 point
A. i, ii, iv
B. ii, iii, v
C. ii, v, vi
D. i, iii, vi

A

B. ii, iii, v

47
Q

The principal physiologic function that depends on the concept of osmolality is the maintenance of stable volume of the body cells. Which among the following factors increases serum osmolality?

i. Adrenal insufficiency

ii. Mannitol therapy

iii. Alcoholism

iv. Acute kidney injury

v. Stroke

vi. Overhydration

*
1 point
A. I, ii, iv, v
B. ii, iii, iv, vi
C. ii, iii, v
D. all of the above

A

C. ii, iii, v

48
Q

You have been assigned by your head nurse to Jio, a patient with congestive heart failure. Chlorthalidone has been prescribed by the physician to manage moderate hypervolemia. As a nurse, you understand that this type of diuretic acts on which part of the kidney?
*
1 point
A. Proximal tubule
B. Distal tubule
C. Ascending loop of Henle
D. Descending loop of Henle

A

B. Distal tubule = Thiazide diuretics

Ascending loop = loop diuretics = furosemide

49
Q

Primarily, IV fluid restores fluid to the intravascular compartment, and some are used to facilitate the movement of fluid between compartments. Some IV fluids have contraindications due to their composition. Which among the following patients cannot receive Lactated Ringer solution?
*
1 point
A. A 36-year-old patient with an AV fistula
B. A 7-year-old child who sustained a third-degree burn
C. A 28-year-old mother who had a massive blood loss after cesarean section
D. Both A and B

A

A. A 36-year-old patient with an AV fistula (has kidney problem)

LR contains potassium which can aggravate hyperkalemia to CKD patients

50
Q

Situation: You are a 4th-year student nurse assigned to the Medical-Surgical ward. With your clinical instructor’s supervision, you are given a chance to handle multiple patients with different conditions. Prior to nurse-patient interaction, you review concepts relating to electrolyte imbalances. The following questions apply.
50. You are assigned to care for Ryan who has been admitted to the ward following a motor vehicular accident (MVA). Ryan’s partner, who had blood stains all over her clothing, told you that Ryan has been bleeding profusely while they are on their way to the emergency room. What is the mechanism behind transient hypocalcemia being caused by massive administration of blood?
*
1 point
A. Citrate binds with protein-bound calcium and temporarily prevents it from interacting with the coagulation
B. Citrate combines with ionized calcium and temporarily removes it from circulation
C. The anticoagulant properties of phosphate from blood products cause calcium to be inactive
D. The anticoagulant properties of phosphate from blood products cause excretion of calcium

A

B. Citrate combines with ionized calcium and temporarily removes it from circulation

Transient hypocalemla can occur with massive administration of citrated blood following a massive hemorrhage or shock because citrate can combine with ionized (physiologically active calcium and temporarily removes it from circulation. Citrate is the major anticoagulant used in blood product collection and storage, NOT phosphate.

51
Q

Few hours after blood administration, the physician ordered for another laboratory test. Ryan’s blood test shows a decreased calcium level. Your clinical instructor asks you, what manifestations reflect the occurrence of Trousseau’s sign?

I. Adducted thumb

II. Extended wrist

III. Flexed distal interphalangeal joints

IV. Extended interphalangeal joints

V. Twitching of facial nerve muscles

Flexed metacarpophalangeal joints

*
1 point
A. v only
B. i, iv, vi
C. i, ii, iv
D. ii, iii, vi

A

B. i, iv, vi

I. Adducted thumb
IV. Extended interphalangeal joints
VI. Flexed metacarpophalangeal joints (flexed wrist)

52
Q

Egay, a patient with complaints of weakness and dizziness, is admitted for observation. Her most recent laboratory result shows a magnesium level of 3.5 mg/L. As a knowledgeable student nurse, you know that the most common cause of this imbalance is?
*
1 point
A. Excessive use of magnesium-based antacids
B. Chronic alcohol abuse
C. Kidney injury
D. Necrosis caused by trauma, shock, or severe burns

A

N Mg: 1.5-2.5

C. Kidney injury

Chronic alcohol Abuse: hypomagnesemia

53
Q

Laboratory results of a 32-year-old patient named Falcon show an elevation in phosphorus level. The physician prescribed calcium acetate. You should teach the patient to take the medication at which conditions? Select all that apply.

i. First thing in the morning

ii. As prescribed

iii. At bedtime

iv. With each meal

v. With an empty stomach

*
1 point
A. i, ii, v
B. ii, iii, v
C. ii, iv
D. i only

A

N Phosphorous: 2.8-4.5
HYPERphospaetmia

Ca Acetate is a phosphate binding med that aids in excreting Phosphate
C. Ii, iv

54
Q

Situation: Acid-base disturbances are commonly encountered in clinical practice, especially in critical care units. Identification of the specific acid-base imbalance is important in determining the underlying cause of the disorder and its appropriate management.

  1. Diagnostic test has been ordered to differentiate between normal anion gap acidosis and high anion gap acidosis in an acutely ill patient. What health problem typically precedes normal anion gap acidosis?
    *
    1 point
    A. Metastases
    B. Excessive potassium intake
    C. Water intoxication
    D. Excessive administration of chloride
A

D. Excessive administration of chloride

Anion gap is due to excessive bicarbonate loss

55
Q

. In an acid-base disorder, the pulmonary or renal system compensates to return the pH to normal. What is the normal ratio of bicarbonate to carbonic acid?
*
1 point
A. 1:10
B. 10:1
C. 1:20
D. 20:1

A

D. 20:1

56
Q

Lucy, a 7-year-old child, was diagnosed with acute gastroenteritis. According to her mother, Lucy started to have symptoms after eating at a fast-food chain. You are asked to assess and monitor Lucy’s condition. What manifestations belong to the acid-base imbalance associated with her diagnosis? Select all that apply.

I. Dizziness

II. Weakness

III. Tingling of fingers and toes

IV. Depressed respirations

V. Constipation

*
1 point
A. i and ii only
B. i, ii, v
C. i. ii, iv, v
D. all of the above

A

D. all of the above

Problem: Vomiting which causes metabolic alkalosis

Alkalosis > Hypokalemia > Constipation

57
Q

Situation: Recent reports show that at least 7 million Filipinos are suffering from chronic kidney disease (CKD) as of 2021. Nurse Coke noticed the increased number of patients being admitted to the hospital due to CKD. Among them is Mr. Chips, a 45-year-old truck driver who undergoes hemodialysis.
57. Upon assessment, Mr. Chips tells you he always feels tired. His wife, who has accompanied him, also noted that he seems to be gaining weight. Nurse Coke calculates that Mr. Chips gained 5 lbs in the past 24 hrs. This indicates that Mr. Chips has retained approximately how much fluid in 24 hrs?

*
1 point
A. 1,300 mL
B. 2,300 mL
C. 3,100 mL
D. 4,000 mL

A

B. 2,300 mL

1 kg weight gain = 1000 mL of Fluid
5 lbs / 2.2 = 2.27 kgs = 2270 mL

58
Q

Nurse Coke determines that Mr. Chips is compliant with dietary management and fluid restriction when the assessment data shows an increase in weight of no more than __ kg between sessions of hemodialysis.
*
1 point
A. 2.5 – 3 kg
B. 2 – 2.5 kg
C. 1.5 – 2 kg
D. 1.0 – 1.5 kg

A

D. 1.0 -1.5kg

59
Q

Nurse Coke understands that the regulation of blood pressure is also an important function of the kidney. Which among the following is an incorrect statement regarding this function?
*
1 point
A. Vasa recta are specialized vessels of the kidney that monitor blood pressure as blood begins its passage into the kidney
B. When the specialized vessels detect a decrease in blood pressure, specialized juxtaglomerular cells secrete aldosterone.
C. All of the above.
D. None of the above.

A

Highlight Kidney
(-)
B. When the specialized vessels detect a decrease in blood pressure, specialized juxteglomerular cells secrete aldosterone

Renin -> Angiotensin 1

60
Q

Mr. Chips, having been diagnosed with CKD, partially loses the ability to regulate changes in pH. The kidneys cause this partial inability through what mechanism? The kidneys:
*
1 point
A. Regulate and reabsorb carbonic acid to maintain a stable pH
B. Regenerate and reabsorb bicarbonate to maintain a stable pH
C. Combine carbonic acid and bicarbonate to maintain stable pH
D. Buffer acids through electrolyte changes

A

B. Regenerate and reabsorb bicarbonate to maintain a stable pH

61
Q

Anemia is a common complication of CKD. Generally, in which stage of CKD do patients become significantly anemic?
*
1 point
A. Stage 2
B. Stage 3
C. Stage 4
D. Stage 5

A

C. Stage 4

62
Q

Intrarenal AKI is the result of actual parenchymal damage to kidney tissue. Which of the following are considered nephrotoxic and can cause intrarenal failure? Select all that apply.

I. Ethylene glycol

II.Lead

III.Gentamicin

IV. Doxycycline

V. Ibuprofen

*
1 point
A. i, ii, iii, iv
B. ii, iv, v
C. i, ii, iii, v
D. all of the above

A

C. i, ii, iii, v

Doxycyline is safe to use

63
Q

A 24-hour urine collection has been ordered for Mr. Pee, a patient with a suspected diagnosis of kidney disorder. The nurse ensures that proper collection will be made by doing which intervention?
*
1 point
A. Strain the urine before pouring it into the container
B. Save all urine, starting with urine voided at the start of the collection
C. Tell Mr. Pee to void at the start time and discard the urine
D. Refrigerate the urine once completed before being picked up by the laboratory

A

C. Tell Mr. Pee to void at the start time and discard the urine

64
Q

Cess, a 20-year-old patient, has been diagnosed with Polycystic Kidney Disease (PKD). Which of the following is true about the management of PKD? Select all that apply.

I. It is self-limiting and cysts usually resolve spontaneously in the 5th or 6th decade of life

II. It is incurable and nursing interventions will be supportive

III. Surgical removal of renal cysts may eventually be required

IV. Lithotripsy can be done to manage PKD

*
1 point
A. i only
B. ii only
C. iii, iv
D. ii, iii

A

II. It is incurable and nursing interventions will be supportive

It cannot be cured through surgery and litotripsy

65
Q

Neri is admitted to the healthcare facility with the diagnosis of Acute Nephritic Syndrome. As a competent nurse, you understand that which of the following does not belong to its sequence of events?
*
1 point
A. Deposition of antigen-antibody complex in the glomerulus
B. Decreased production of epithelial cells lining the glomerulus
C. Thickening of the glomerular filtration membrane
D. None of the above

A

B. Decreased production of epithelial cells lining the glomerulus

It should be increased production of epithelial cells > leukocyte infiltration
Prob: Glomerulonephritis

66
Q

Situation: Jabs, a 42-year-old patient diagnosed with Type 2 Diabetes Mellitus, was admitted to the health care facility. Upon admission, he complained of restlessness. His wife also noted that Jabs seems increasingly confused. You are a nurse assigned to Jabs’ plan of care.
66. Upon history taking, Jabs told you he has been taking acarbose (Precose) as prescribed to manage his condition. Which of the following is the mechanism of action of this type of OHA?
*
1 point
A. Stimulate beta cells of the pancreas to secrete insulin which may improve binding between insulin and insulin receptors
B. Inhibit the production of glucose by the liver and increase body tissue sensitivity to insulin
C. Delay absorption of complex carbohydrates in the intestine and slow entry of glucose into the systemic circulation
D. Increase and prolong the action of incretin, a hormone that increases insulin release and decreases glucagon levels, with the result of improved glucose control

A

OHA is an Alpha-Glucosidase Inhibitors

C. Delay absorption of complex carbohydrates in the intestine and slow entry of glucose into the systemic circulation

A = Sulfonylureas
B = Biguanides (Metformin)
D = Thiazolidinediones

67
Q

Which health teaching would you reinforce to Jabs about taking acarbose (Precose) following an ordered increase in its dose? Select all that apply.

I. Must be taken with an empty stomach

II. Monitor liver function studies every 3 months for 1 year, then periodically

III. Monitor creatinine and BUN level

IV Monitor neutrophil levels

V. Monitor for gastrointestinal side effects such as diarrhea

*
1 point
A. ii, v
B. i, iii, iv
C. i, ii, iii, v
D. all of the above

A

A. Ii, v
Acarbose (Precose)
I. Must be taken w/ meal
Iii. For met Forman
Iv

68
Q

Prior to discharge, Jabs asks you when is it not allowed to perform exercise. What health teaching about exercise precautions will you give?
*
1 point
A. If blood glucose level exceeds 350 mg/dL and ketones are present in the urine
B. If blood glucose level exceeds 300 mg/dL and ketones are present in the urine
C. If blood glucose level exceeds 250 mg/dL and ketones are present in the urine
D. Exercise is allowed throughout the course of Jabs’ condition

A

C. If blood glucose level exceeds 250 mg/dL and ketones are present in the urine

69
Q

You read an evidence-based journal about using insulin pumps for patients with Type 2 DM whose beta-cell function has diminished and require insulin. You understand that which of the following is the most common risk of insulin pump therapy
*
1 point
A. Ketoacidosis
B. Infection
C. Hypoglycemia
D. Allergic reaction

A

A. Ketoacidosis

Hyperglycemia > Ketoacidosis

70
Q

You read an evidence-based journal about using insulin pumps for patients with Type 2 DM whose beta-cell function has diminished and require insulin. You understand that which of the following is the most common risk of insulin pump therapy
*
1 point
A. Ketoacidosis
B. Infection
C. Hypoglycemia
D. Allergic reaction

A

A. Ketoacidosis

71
Q

Situation: Tyron, an agitated 37-year-old male patient, was admitted to the medical unit with complaints of sudden decrease in weight, insomnia, and elevated blood pressure. The physician’s initial diagnosis is Grave’s disease.
71. Upon assessment, the nurse observed Tyron having bulging eyeballs. The nurse anticipates which medication to be prescribed to manage this manifestation?
*
1 point
A. Propylthiouracil
B. Teprotumumab
C. Methimazole
D. Levothyroxine

A

Bulging eyeballs (exopthalmus) -> Hyperthyroidism
B. Teprotumumab -> specific drug for Exoptalmus

72
Q

The nurse further assesses Tyron by inspecting and palpating his thyroid gland. Which finding will the nurse expect?
*
1 point
A. The patient’s thyroid gland is soft
B. The patient’s thyroid gland is firm
C. The patient’s thyroid gland is tender
D. The patient’s thyroid gland is not palpable

A

A. The patient’s thyroid gland is soft

B = could be cancer, hashimoto’s thyroiditis

73
Q

The physician prescribed propylthiouracil (PTU), an antithyroid medication. You will educate Tyron about which information in relation to taking this medication, except?
*
1 point
A. Review CBC and liver profile prior to therapy
B. Administer through a straw to prevent teeth staining
C. Take PTU in the morning on an empty stomach
D. Stop taking the medication if mouth ulcers developed

A

B. Administer through a straw to prevent teeth staining (Potassium Iodine)

74
Q

Which among the following is not considered a thyroid-binding hormone?
*
1 point
A. Thyroxine-binding globulin
B. Transthyretin
C. Albumin
D. None of the above

A

D. None of the above

75
Q

Situation: Pio, a 57-year-old male with a history of medullary thyroid carcinoma, is admitted to the hospital complaining of episodic anxiety, headache, and palpitations. Physical examination is normal except for a blood pressure of 200/100 mm Hg and a resting pulse rate of 110 bpm. Chart review shows that prior blood pressures have always been normal, including one 6 months ago. The physician’s initial diagnosis is pheochromocytoma. You, together with two student nurses, are assigned to Pio’s plan of care.
75. While giving a short teaching session about pheochromocytoma before the nurse-patient interaction, the student nurse curiously asks, in which part of the adrenal gland does the tumor originate?
*
1 point
A. Zona glomerulosa
B. Zona fasciculata
C. Epithelial cells
D. Chromaffin cells

A

D. Chromaffin Cells

A Mineralocorticoids
B. Glucocorticoids

76
Q

Pheochromocytoma is characterized by sympathetic nervous system overactivity caused by catecholamine-secreting tumor. What is not included in the typical triad of symptoms of patients with pheochromocytoma?
*
1 point
A. Headache
B. Diaphoresis
C. Hypertension
D. Palpitations

A

C. Hypertension - it’s a sign, not a symptom

5 H’s

Hypertension (Sign)
Hypermetabolism
Hyperglycemia
Hyperhidrosis
Headache

Usually triad of symptoms: Headache, Diaphoresis, Palpitations

77
Q

Upon transport to bed, Pio suddenly became restless. His blood pressure went up from 180/100 to 200/120. What position should you place Pio
*
1 point
A. Supine position
B. Modified trendelenburg
C. Side lying position
D. Fowler’s position

A

D. Fowler’s position = orthostatic decrease in BP

78
Q

Various tests and procedures are performed to visualize the tumor and confirm the diagnosis of pheochromocytoma. The following diagnostic test results are indicative of pheochromocytoma, except?
*
1 point
A. Plasma values: epinephrine 300 pg/mL; norepinephrine 500 pg/mL
B. Clonidine suppression test: No decrease in plasma catecholamine value
C. High-pressure liquid chromatography: Positive
D. None of the above

A

A. Plasma Vaues

Norepi should be greater than 2000 pg/mL

79
Q

Pio returns from the operating room after bilateral adrenalectomy. Which assessment data needs priority intervention?
*
1 point
A. Potassium of 3.0 mEq/L
B. Sodium of 150 mEq/L
C. Blood pressure of 170/90
D. Blood glucose of 68 mg/dL

A

C. Blood pressure of 170/90 = HYPERTENSIVE CRISIS > Cardiac Dysrhythmias

80
Q

A patient was admitted to the medical unit with a diagnosis of Conn’s syndrome. What signs and symptoms will the nurse expect the patient to manifest? Select all that apply.

I. Acidosis

II. Hyponatremia

III. Hypertension

IV. Tetany

V. Glucose intolerance

VI. Polyuria

*
1 point
A. i, ii, v, vi
B. iii, iv, v, vi
C. i, ii, iii, iv
D. all except iii

A

B. iii, iv, v, vi

Conn’s syndrome = primary aldosteronism > Hypersecretion of aldosterone

Hypertension > most prominent sign
Tetany > Hypokalemia due to Alkalosis
Glucose intolerance > Hypokalemia
Polyuria > Hypokalemia

High Aldosterone = Low Potassium, High Na

Aldosterone conserves sodium and excretes potassium

81
Q

Excessive production of aldosterone causes a distinctive pattern of biochemical changes and a corresponding set of clinical manifestations. The student nurse needs further teaching when she includes which information about aldosteronism? Select all that apply.

I. Hypokalemia is not always present in primary aldosteronism

II. Open adrenalectomy is the recommended treatment for primary aldosteronism

III. Surgery is recommended for patients with bilateral adrenal involvement

IV. Antihypertensive medications are not withheld prior to the diagnostic blood test

V. Spironolactone is recommended as the first-line drug to control hypertension for patients who do not undergo surgery

*
1 point
A. i, ii, iv
B. ii, iv, v
C. i, iv
D. ii, iii

A

D. ii, iii

Laparo > open surgery
Medical mngt > Surgical Mngt

82
Q

Maxine, a patient with a long-standing thyroid disorder, presents to the emergency room with a masklike appearance, subnormal temperature, and reports of fatigue. The nurse should monitor for which most common complication associated with this disorder?
*
1 point
A. Myxedema coma
B. Coronary artery disease
C. Pulmonary embolism
D. Renal failure

A

B. Coronary artery disease

Hypothyroidism > dec metabolism > dec cardiac output

83
Q

Espe, a nurse educator, is planning to conduct a lecture session for the newly hired nurses in their unit. She noticed a need to enhance nurses’ knowledge about various endocrine functions and disorders. While discussing diabetes insipidus (DI), she will not include which of the following information except
*
1 point
A. “DI is the most common disorder of the posterior lobe of the pituitary gland”
B. “Thiazide diuretics are used in severe forms of DI”
C. “The priority nursing diagnosis is fluid volume excess”
D. None of the above

A

A. “DI is the most common disorder of the posterior lobe of the pituitary gland”

Thiazide is used in mild forms
Priority is FVD

84
Q

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) includes excessive ADH secretion from the pituitary gland. Which among the following set of medications are known to cause SIADH?
*
1 point
A. Risperidone, metoclopramide, gentamicin, lisinopril
B. Rifampicin, demeclocycline, albendazole, sertraline
C. Vincristine, chlorpromazine, amitriptyline, thiazide diuretics
D. Penicillin, omeprazole, chloramphenicol, diltiazem

A

C. Vincristine, chlorpromazine, amitriptyline, thiazide diuretics

R: C for Christ hehe

85
Q

Nurse Adie is caring for a patient with a diagnosis of Addison disease. He should monitor which of the following signs and symptoms which may be indicative of progression to Addisonian crisis? Select all that apply.

I. Cyanosis

II. Tachycardia

III. Abdominal pain

IV. Hypertension

V. Diarrhea

VI. Slow breathing

VII. Edema

*
1 point
A. i, ii, iii, v
B. i, iv, v, vi
C. i, iii, iv, vii
D. all of the above

A

A. i, ii, iii, v

primary adrenal insufficiency/ Hypoadrenalism

86
Q

The head nurse asks Nurse Theia about the differences between epidural anesthesia and spinal anesthesia. Nurse Theia needs further teaching when she includes which information?
*
1 point
A. Spinal anesthesia doses are higher than epidural doses
B. Epidural anesthesia is less challenging to administer than spinal anesthesia
C. Spinal anesthesia causes temporary loss of consciousness in contrast with epidural anesthesia
D. All of the above

A

D. All of the above

General anes causes temp lost of consciousness

87
Q

Nurse Theia reviews the proper post-operative position for surgeries that are performed in their unit. Which of the following, when identified by Theia, needs further teaching by the head nurse?
*
1 point
A. Hypophysectomy: Semi-fowler’s
B. Supratentorial craniotomy: Flat on bed
C. Right pneumonectomy: Right side lying
D. Liver biopsy: Right side lying

A

B. Supratentorial craniotomy: Flat on bed = should be 15-30 elevated to promote venous return

Infrantentorial: Flat on bed

88
Q

The operating room contains various instruments fit for accomplishing different surgical procedures. Nurse Theia familiarizes herself with the common surgical instruments and their uses. Which information needs to be corrected?
*
1 point
A. Adson forceps is used for handling dense tissue, such as in skin closures
B. Curved mayo scissors are used for cutting delicate tissue
C. Russian forceps is used for atraumatic tissue grasping during dissection
D. None of the above

A

B. Curved mayo scissors are used for cutting delicate tissue = CUTTING HEAVY TISSUE

Metzenbaum = delicate tissue

89
Q

. The head nurse asks Nurse Theia, “Which forceps are recommended for manipulation of delicate tissue such as viscera or blood vessels?”
*
1 point
A. Bobcock forceps
B. Allis forceps
C. Bonney forceps
D. DeBakey forceps

A

D. DeBakey forceps

A. Bobcock forceps -grasp intentines
B. Allis forceps - grasp intestines
C. Bonney forceps - hold thick tissues

90
Q

The WHO Surgical Safety Checklist was developed to decrease errors and adverse events, and increase teamwork and communication in surgery. Which of the following is not included on the checklist before induction of anesthesia?
*
1 point
A. Is the anesthesia machine check complete?
B. Is the site marked?
C. Is there a risk of >500ml blood loss?
D. Is the patient’s blood pressure within the normal range?

A

D. Is the patient’s blood pressure within the normal range?

91
Q

The International Patient Safety Goals (IPSGs), detailed in the Joint Commission International (JCI) Accreditation Standards for Hospitals, aim to encourage specific improvements in patient safety by focusing on key problematic areas. Which International Patient Safety Goal speaks about ensuring safe surgery?
*
1 point
A. Goal 4
B. Goal 5
C. Goal 6
D. Goal 7

A

Highlight: Safe Surgery
IPSG: 6 goals Only
A. Goal 4

B. Goal 5 - reduce risk of healthcare ass. Infection
C. Goal 6- reduce the risk of patient harm r/t falls
D. Eliminate this

92
Q

Situation: Maeve, 23 years of age, has a chief complaint of severe pain in her mouth. Maeve is scheduled to have her wisdom tooth extracted. The anesthetic agent of choice is thiopental sodium (Pentothal). Nurse Pia prepares to assist in wisdom tooth extraction.
92. Nurse Pia anticipates which route of administration for this medication?
*
1 point
A. Inhalation
B. Intramuscular
C. Sublingual
D. Intravenous

A

D. Intravenous - can also be given rectally

93
Q

How long does it take for the medication to cause unconsciousness after administration?
*
1 point
A. 30 – 40 seconds
B. 60 – 90 seconds
C. 2 – 3 minutes
D. There is no loss of consciousness associated with thiopental sodium

A

A. 30 – 40 seconds

It is a rapid onset short acting barbiturate

94
Q

Prior to administration, Nurse Pia determines the drug interactions that may affect the therapeutic effect of thiopental sodium. Which among the following is incorrect?
*
1 point
A. Enhance hypotensive effect with antipsychotics
B. Decreased anesthetic effect with probenecid
C. Diminished therapeutic effect with aminophylline
D. None of the above

A

B. Decreased anesthetic effect with probenecid = should be increased

95
Q

You are giving preoperative teaching to Sergio. He tells you that his father died 10 years ago when having his gallstones removed. What is the nurse’s best intervention?
*
1 point
A. Explain that surgeries have varying risks and benefits.
B. Assess for risk for malignant hyperthermia
C. Encourage Sergio to further express his concerns
D. Reinforce that surgical complications are caused by many factors and are not inherited

A

B. Assess for the risk for Malignant Hyperthermia
Increasingly High Temp, Muscle Rigidity, Tachycardia (50% mortality rate)

96
Q

During preadmission testing for same-day surgery, Sergio states that he has added two cloves of garlic each day to his diet to help control his blood pressure. You should further inquire about which of the following?
*
1 point
A. The type of surgery the patient is having.
B. His blood pressure before starting to add garlic to the diet
C. The number of garlic he eats
D. His previous surgical experience

A

C. The number of garlic he eats

R: Garlic has anticoagulant properties = prone to bleeding

97
Q

With the PACU room scoring guide, called Aldrete score, the nurse would give a Sergio an admission cardiovascular score of 2 if Sergio’s blood pressure is what percentage of his or her preanesthetic level?
*
1 point
A. 20%
B. 30% to 40%
C. 40% to 50%
D. Greater than 50%

A

A. 20%

98
Q

Yumi, a 30-year-old patient, had a left thoracoscopy as ordered to diagnose pleural effusion. She sustained an injury secondary to the surgery position. The nurse should assess the client for:
*
1 point
A. Lower back spasms
B. Knee swelling and pain
C. Tingling in the arm
D. Absence of the Achilles reflex

A

C. Tingling in the arm > Brachial Plexus Injury

99
Q

Malignant hyperthermia is a hypermetabolic response to potent inhalation agents. Which among the following medications is/are known to trigger the symptoms of malignant hyperthermia? Select all that apply.

I. Halothane

II. Isoflurane

III.Succinylcholine

IV. Pentothal

V.Nitrous oxide

VI. Ketalar

*
1 point
A. i, ii, iv
B. ii, v, vi
C. i, ii, iii
D. i, ii only

A

Commonly caused by Inhalation Anesthetic Agents = triggers malignant Hyperthermia
C. I, Ii, iii

100
Q

Lia, a patient with recurrent ulcer disease, underwent subtotal gastrectomy under epidural anesthesia and is now recovering in the PACU. As her nurse, you anticipate that she is at less risk for a spinal headache due to what reason?
*
1 point
A. A 17G needle is used
B. A subarachnoid injection is made
C. A noncutting needle is used
D. A faster onset occurs.

A

C. A noncutting needle is used

Side angle cutting > more at risk of spinal headache

RN 2023 cutie (11 decks)

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