Endocrine – Disk 1 (Endocrine/Hematology/Gastrointestinal/Renal/Integumentary = 20% Endocrine – Disk 1 (Endocrine/Hematology/Gastrointestinal/Renal/Integumentary = 20% !"at is t"e e##ect o# $DH on
!"at is t"e e##ect o# $DH on urine #ormationurine #ormation $&
$& RetentRetention o# sodion o# sodium and 'aium and 'ater ter e)crete)cretion o# *otion o# *otassiassiumum +&
+& E)cretE)cretion o# sodion o# sodium and 'aium and 'ater ter e)crete)cretion o# *otion o# *otassiassiumum ,&
,& RetentRetention o# ion o# 'ater'ater co concentrncentration ation o# urio# urinene D&
D& E)cretE)cretion o# ion o# 'ater'ater di dilutilution o# uron o# urineine -"e releasing stimulus #or $DH is normally. -"e releasing stimulus #or $DH is normally.
$&
$& DecreDecreased serased serum 'alum 'all myocal myocardial irdial in#arctn#arctionion +&
+& IncIncreasreased seed serum orum osmosmolarlarityity ,&
,& $n e$n eleateleated cid circulatrculating cing cortiortisol sol leelleel D&
D& IncreaIncreased sed serum serum *otas*otassium sium leelleelss -"e normal range o# serum osmolarity is. -"e normal range o# serum osmolarity is.
$ $&& 1111 + +&& 2200002200 , ,&& 22332244 D D&& 55225533
6I$DH is mani#est clinically as a. 6I$DH is mani#est clinically as a.
$&
$& Hy*Hy*eroserosmolmolar ar stastatete +&
+& 7o7o' o' outut*u*ut st statatete ,&
,& 8y8y)e)ededema sma statatete D&
D& !!aater intter into)io)icatcation stion stateate
In addition to its e##ect on 9ody 'ater e:
In addition to its e##ect on 9ody 'ater e:uili9rium $uili9rium $DH is also a.DH is also a. $&
$& ;;aasoso*r*resessosor r +&
+& ,a,ardrdioiototoninicc ,&
,& +e+eta ta ststimimulaulatotor r D&
D& ,ar,ar9oni9onic an"yc an"ydradrase in"se in"i9ii9iter ter
-"e sym*tomatology you 'ould assess in t"e
-"e sym*tomatology you 'ould assess in t"e *atient 'it" 6I$DH results #rom.*atient 'it" 6I$DH results #rom. $&
$& EleEleateated *otd *otassassium lium leeleelss +&
+& !!aater ter intinto)io)icatcationion ,&
,& IncIncreasreased sed seruerum osm osmolmolalialityty D&
D& <re<reci*ici*itattating #acing #actortors o# 6I$DHs o# 6I$DH -"e cardinal sign o# 6I$DH is. -"e cardinal sign o# 6I$DH is.
$&
$& DilDilutiutionaonal "y*l "y*onatonatremremiaia +&
+& >ri>rinary nary outout*ut *ut o# 1o# 10l *0l *er der dayay ,&
,& HyHy*o*otetensnsioionn D&
D& 6y6yststememic ic ededememaa
!"ic" o# t"e #ollo'ing la9oratory #indings 'ould 9e
!"ic" o# t"e #ollo'ing la9oratory #indings 'ould 9e *resent in a *atient 'it" 6I$DH*resent in a *atient 'it" 6I$DH $&
$& 7o7o' s' sererum um sosodidiumum +&
+& 6er6erum oum osmosmolallality ity o# o# 5050 ,&
,& >ri>rine s*ene s*eci#ci#ic gric graiaity o# 1ty o# 1&00&0055 D&
D& DecDecreareased urised urinary osnary osmolmolariarityty
-"e *atient 'it" 6I$DH may *resent 'it". -"e *atient 'it" 6I$DH may *resent 'it".
$&
$& IncIncreasreased ured urinainary oury out*ut*utt +
$s a sta## nurse in I,> you are assigned to a *atient recently admitted 'it" di& !"ic" o# t"e #ollo'ing *atients 'ould 9e likely to deelo* di
$& $n elderly *atient receiing t"ia?ides +& $ young 'omen 'it" seere *neumonia
,& $ 0 y/o man 'it" eso*"ageal arices on <itressin D& $ "ead trauma *t 'it" a skull #racture
During your assessment '"ic" o# t"e #ollo'ing #indings 'ould 9e *resent in a *atient 'it" DI $& 6erum osmolality o# 20
+& 6erum sodium leel o# 1@
,& >rinary out*ut o# less t"an @00cc in 2 "ours D& >rine s*eci#ic graity o# 1&02
-"e nurse understands a maAor com*lication o# DI is. $& Hy*oolemic s"ock
+& 6ei?ures
,& ,ongestie "eart #ailure D& ,ardiac arr"yt"mias
Ealuation o# la9oratory #indings in a *atient 'it" DI 'ould s"o'. $& Increased urine osmolality
+& >rine s*eci#ic graity 9et'een 1&001 to 1&00 ,& Decreased serum sodium
D& Decreased serum osmolarity
-"e most dangerous com*lication o# DI is. $& Dilutional "y*onatremia
+& Hy*oolemia
,& ,ongestie "eart #ailure D& !ater into)ication syndrome
Dia9etes insi*idus is c"aracteri?ed 9y all 9ut '"ic" o # t"e #ollo'ing $& >rine s*eci#ic graity o# 1&01
+& -ac"ycardia
,& >rinary out*ut o# 2000 cc in t"ree "ours D& +< 40/0
!"ic" o# t"e #ollo'ing is c"aracteristic o# DI $& 7o' urinary osmolarity
+& 6erum osmolarity increased ,& 6erum sodium eleated D& $ll o# t"e a9oe
$ @@ yo is admitted 'it" a 9lood sugar o# 1200 s"e is seerely de"ydrated res*irations are 1B *er minute and s"allo'. you 'ould #irst sus*ect
$& Hy*erosmolar coma +& Dia9etic ketoacidosis ,& Eit"er o# t"e a9oe D& Ceit"er a or 9
It is im*ortant #or t"e nurse to identi#y t"ose *atients at risk #or deelo*ing HHC& !"ic" condition 'ould not *redis*ose a *atient to deelo* HHC
$& <ancreatitis
+& -"ia?ide o# steroid t"era*y ,& -<C t"era*y
D& ,ere9roascular accident
Conketotic "y*erosmolar coma (HHC is not usually associated 'it". $& De#ects in $DH secretion
+& 8ild dia9etes o# recent onset ,& lder age
D& >se o# diuretics steroids and "y*ertonic solutions
-"e nurse understands t"at t"e *rimary cause o# t"e classical mani#estations in HHC is. $& Ra*id decrease in *lasma osmolarity
+& 8arkedly eleated serum glucose ,& Intraascular de"ydration
D& 6erum electrolyte a9normality
-"e altered mental status in a *atient in HHC results #rom. $& Hy*erosmolaity o# *lasma
+& Intracere9ral de"ydration
,& 6eere osmotic diuresis #rom "y*erglycemia D& Intraascular de"ydration
!"ic" o# t"e #indings 'ould not 9e *resent in HHC $& ussmaulFs res*irations o# 2B/min
+& 6erum glucose leel a9oe @0 and o#ten greater t"an 1000 ,& 6erum osmolarity a9oe 50
D& 6eere de"ydration and t"e a9sence o# ketoacidosis
Ealuation o# a *atientFs la9oratory alues 'it" HHC 'ould include. $& $ serum sodium o# 125
+& $ serum osmolarity o# 50 ,& $ urinary sodium o# @0 D& $ 9icar9onate leel o# 12
urt"er assessment o# diagnostic data in a *atient 'it" HCC 'ould re#lect. $& $+G 'it" a *H o# 3&10
+& our *lus ketone in t"eir urine ,& $?otemia
D& Hematocrit o# 24%
!"ic" o# t"e #ollo'ing la9oratory #indings is not likely to 9e seen in *atients 'it" D$ $& <" 3&14
+& <co2
,& +ase de#icit 1 D& 6erum k &
!"ic" o# t"e #ollo'ing diagnostic data in a *atient 'it" HHC 'ould re#lect. $& $+G 'it" a *H o# 3&10
+& our *lus ketone in t"eir urine ,& $?otemia
Ceuro – Disk 2 (86/Ceuro/<syc"osocial = 15%
-"e single most im*ortant inde) o# neurological state is t"e. $& 7eel o# consciousness
+& <u*illary reaction
,& E)tremity moement and strengt" D& ;ital signs
uick rotation o# t"e "ead 9ack and #ort" '"ile "olding t"e eyes o*en causing t"e eyes o# t"e comatose *atient to rotate o**osite t"e side to'ard '"ic" t"e "ead is turned is a *ositie res*onse kno'n as.
$& E)traocular o*"t"almo*legia
+& Intranuclear e)traocular o*"t"almo*legia ,& culoce*"alic re#le)
D& DysconAugate lateral re#le)
-"e res*onse elicited '"en t"e neck is #le)ed *roducing #le)ion o# 9ot" t"ig"s at t"e "i*s as 'ell as #le)ion moements o# ankles and knees is called.
$& ernigs sign +& +a9inskis sign ,& +rud?inskis sign D& -rousseaus sign
-"e res*iratory *attern seen in u**er 9rainstem lesions (mid9rain is. $& Hy*erentilation
+& $ta)ia ,& ,luster D& $*neustic
$ 2@year old male is com*laining o# seere "eadac"e& n assessment "e "as nuc"al rigidity and a *ositie ernigs sign& !"ic" o# t"e #ollo'ing conditions is most likely *resent
$& E*idural "ematoma +& 6u9dural "ematoma
,& 6u9arac"noid "emorr"age D& Increased intracranial *ressure
-"e classic cardioascular signs o# increasing intracranial *ressure kno'n as ,us"ings triad include $& Decreasing *ulse 'idening *ulse *ressure *eri*"eral asoconstriction
+& Decreasing *ulse increasing systolic +< 'idening *ulse *ressure ,& Decreasing *ulse decreasing +< 'idening *ulse *ressure
D& Decreasing systolic +< central cyanosis !<<
;entricular #luid *ressure is t"e most sensitie indicator o# increased intracranial *ressure& -"e normal entricular #luid *ressure is.
$& 1@0 mmHg +& 010 mmHg ,& 1@1 mmHg D& $9oe @0 mmHg
$ *atient "as a su9arac"noid scre' inserted to monitor "is intracranial *ressure (I,< and cere9ral *er#usion *ressure (,<<& -"e I,< and ,<< are 9ot" 5 mmHg& -"is means t"at t"e *atients.
$& Intracranial enous *ressure is decreased +& ,ondition is sta9le
!"ic" o# t"e #ollo'ing *arameters are graded '"en using t"e Glasgo' ,oma 6cale in t"e assessment o# t"e *atient 'it" an altered state o# consciousness
$& Eye o*ening sensory leel and er9al res*onse +& 8otor res*onse *u*illary signs and orientation ,& <u*illary signs orientation and +<
D& Eye o*ening motor res*onse and er9al res*onse
+lindness is one "al# o# 9ot" isual #ields #ollo'ing a ,;$ is re#erred to as. $& Homonymous "emiano*ia
+& $stereognosis
,& Homonymous "emignosia D& *tic "emiano*ia
<atients 'it" inAury to t"e le#t cere9ral "emis*"ere may e)" i9it. $& 7e#t "emi*aresis or "emi*legia
+& Deiation o# t"e eye to t"e le#t ,& 7e#t "omonymous "emiano*ia D& $ll o# t"e a9oe
<in*oint *u*ils t"at react to lig"t i# ie'ed 'it" a magni#ying glass are indicated o#. $& $ lesion in t"e *ons
+& $ lesion in t"e 9asal ganglia ,& culomotor dys#unction
D& 6ym*at"etic nerous stimulation
-"e nurse caring #or a *atient 'it" a su*ratentorial "erniation understands t"at t"e earliest sign 'ould 9e. $& Decere9rate *osturing
+& !ide and #i)ed *u*ils ,& 7et"argy and stu*or D& I*silateral dilated *u*il
!"ic" o# t"e #ollo'ing treatment modalities 'ould t"e nurse consider to 9e ina**ro*riate #or t"e entilator de*endent *atient 'it" increased intracranial *ressure
$& 8aintaining t"e ,2 leel 9et'een 2455 +& eeding t"e *atient ia an
CG-,& $dministering D! at 3 cc an "our D& 7og roll '"en turning t"e *atient
!"ile assessing t"e la9oratory data o# a *atient 'it" "ead trauma '"ic" #inding necessitates noti#ication o# t"e *"ysician
$& $ serum osmolarity o# 23 +& $ serum sodium leel o# 15B ,& $ urine s*eci#ic graity o# 1&00 D& $ urine osmolarity o# 00
$ 9asal skull #racture a##ecting t"e middle #ossa may cause '"ic" o# t"e #ollo'ing $& ,ranial nere inAuries
+& +attles sign
,& ,6 otorr"ea or r"inorr"ea D& $ll o# t"e a9oe
!"at s"ould t"e nurse do '"en "is/"er *atient 'it" a 9asilar skull #racture 9egins to "ae clear #luid draining #rom one ear
$& <ack t"e e)ternal auditory canal 'it" sterile cotton and noti#y t"e doctor +& $**ly a loose sterile dressing oer t"e ear and call t"e doctor
,& $**ly an occlusie sterile dressing oer t"e ear and c"ange it #re:uently D& 6uction t"e ear 'it" a sterile cat"eter
-o determine i# 9loody "ead drainage contained ,6 a nurse 'ould *ut some on a gau? e and o9sere. $& $9sence o# a clear line o# demarcation 9et'een t"e serum and 9lood
+& $ 9lood clot in t"e middle 'it" a yello' ring around it ,& $ yello' ring 'it" t'o 9loody rings around it
D& $9sence o# t"e clot 9ut one 9loody ring at t"e center o# t"e gau?e
$ *atient '"o "as a neurological inAury t"at results in i*silateral motor loss and contralateral loss o# *ain and tem*erature is said to "ae.
$& $ total transection
+& $nterior cord syndrome ,& +ro'n6e:uard syndrome D& ,entral cord syndrome
E)amination o# t"e ,6 in 9acterial meningitis 'ill reeal all 9ut '"ic" o# t"e #ollo'ing $& ,loudiness
+& Increased '"ite 9lood cells ,& Decreased *rotein
D& Increased *ressure and decreased glucose
!"ic" statement is accurate regarding t"e di##erentiation o# ,6 in 9acterial and iral meningitis $& Hig"er leel o# *rotein in 9acterial meningitis t"an iral
+& 7o' sugar content seen in 9acterial meningitis usually normal in iral ,& ,6 is *urulent and tur9id in 9acterial may 9e clear in iral
Gastrointestinal Disk 2 J 1.0@ K Disk 5
In order to most accurately esta9lis" t"at your *atient " as no 9o'el sounds you must listen in eac" :uadrant #or at least.
$& 50 seconds +& 1 #ull minutes ,& 11/2 minutes D& 2 minutes
-"e usual order #or carrying out *" ysical assessment o# a9domen is. $& <al*ation ins*ection auscultation *ercussion
+& $uscultation *ercussion *al*ation ins*ection ,& Ins*ection auscultation *ercussion *al*ation D& <ercussion auscultation ins*ection *al*ation
-"e #unction o# t"e lier includes all o# t"e #ollo'ing e)ce*t. $& ormation o# ammonia to remoe urea #rom t"e 9lood +& He*atocytes secrete 9ile
,& 6ynt"esi?es amino acids and al9umin
D& 6ynt"esi?es *rot"rom9in #i9rinogen and al9umin
Cursing interentions #or t"e *atent 'it" "e*atic #ailure include. $& Restrict *rotein in t"e diet
+& $oid use o# narcotics sedaties and tran:uili?ers ,& $dminister lactulose and neomycin as *rescri9ed D& $ll o# t"e a9oe
-"e underlying cause o# most 9leeding eso*"ageal arices is. $& $cid *e*sin erosion secondary to gastroeso*"ageal re#lu) +& <ortal "y*ertension due to lier disease
,& Hig" enous *ressure at t"e eso*"agogastric Aunction due to systemic "y*ertension D& -raumatic eso*"ageal damage
-"e rationale #or t"e use o# neomycin in t"e setting o# lier #ailure is to.
$& <reent t"e likeli"ood o# se*sis in t"e eent o# seere gastrointestinal 9leed +& <romote t"e manu#acture o# *rot"rom9in actiating itamin
,& In"i9it t"e *roduction o# ammonia 9y intestinal 9acteria D& Esta9lis" a 9lood leel o# anti9iotic in antici*ation o# surgery
-"e administration o# aso*ressin s"ould 9e most care#ully monitored in *atients '"o "ae. $& Dia9etes Insi*idus
+& ,oronary artery disease
,& Hy*otension secondary to G&I& +leeding D& Dia9etes 8ellitus
>rea is #ormed 9y t"e lier to rid t"e 9ody o#. $& ,reatinine
+& +icar9onate ,& +iliru9in D& $mmonia
-"e ina9ility o# t"e lier to conAugate '"at su9stance is a *rimary contri9utor to "e*atic co ma $& $mmonia
+& >rea
,& atty $cids D& +iliru9in
!"ic" o# t"e #ollo'ing may *reci*itate t"e onset o# "e*atic ence*"alo*at"y in *atients 'it" seere lier dys#unction
$& Diuretics
+& $cute in#ection ,& GI +leeding D& $ll o# t"e a9oe
!"ic" o# t"e #ollo'ing may contri9ute to t"e *reci*itation o# ence*"alo*at"y in t"e *atient 'it" lier #ailure $& GI +leeding
+& Hy*okalemia ,& Hy*otension D& $ll o# t"e a9oe
Ecc"ymosis around t"e um9ilicus indicatie o# *eritoneal 9leeding is called. $& ,"osteks sign
+& Grey -urners sign ,& ,ullens sign D& -rousseaus sign
<ulmonary com*lications o# acute *ancreatitis may include. $& $dult res*iratory distress syndrome
+& Eleation o# t"e dia*"ragm and 9ilateral 9asilar rales ,& $telectasis es*ecially o# t"e le#t 9ase
D& $ll o# t"e a9oe
!"ic" o# t"e #ollo'ing analgesics is t"e drug o# c"oice in managing t"e *ain o# acute *ancreatitis $& Demerol
+& 8or*"ine ,& ,odeine D& Dilaudid
$ 9luis"green 9ro'n discoloration in t"e #lank and groin due to retro*eritoneal 9leeding is called. $& Grey-urners sign
+& ,ullens sign ,& ernigs sign D& !elc"s sign
<atient assessment #indings indicatie o# a 9o'el in#arction 'ould include. $& Hy*oactie 9o'el sounds and leukocytosis
+& Hy*erresonance and a9dominal tenderness ,& $9sence o# dullness in t"e lier area
Renal 6ystem –Disk 5 (J52.00
$ 'eig"t gain o# one kilogram in 2 "ours may indicate #luid retention o# at least. $& 20 ml
+& 00 ml ,& 1000 ml D& 2000 ml
6igns o# ra*idlydeelo*ing alkalosis may include $77 +>- !HI,H o# t"e #ollo'ing. $& Cerous irrita9ility
+& 9tundation ,& 8uscle tremors D& 6ei?ures
!"ic" o# t"e #ollo'ing drugs actually remoes *otassium #rom t"e 9ody in "y*erkalemic *atients in acute renal #ailure
$& 6odium 9icar9onate +& ,alcium c"loride
,& Glucose and insulin in#usion D& aye)alate and 6or9ital
-"e electrolyte a9normality t"at *roduces a > 'ae a de*ressed 6- segment and entricular irrita9ility is. $& Hy*ernatremia
+& Hy*erkalemia ,& Hy*okalemia D& Hy*ocalcemia
!"ic" EG #inding 'ould not 9e o9sered in t"e *resence o# "y*erkalemia $& <rolonged <R interal
+& $9sence o# < 'aes ,& ;entricular irrita9ility D& !idened R6 com*le)es
-"e glomerular #iltration rate (GR can 9e 9est measured 9y ealuating t"e *atients. $& 6erum creatinine
+& +lood urea nitrogen ,& 6erum osmolality D& ,reatinine clearance
$**ro)imately @0B0% o# sodium and 'ater rea9sor9ed #rom t"e glomerular #iltrate at t"e. $& <ro)imal tu9ule
+& 7oo* o# Henle ,& Distal -u9ule D& ,ollecting tu9ules
-"e maAor #unction o# t"e loo* o# Henle is t"e. $& Rea9sor*tion o# electrolytes
+& ,oncentration or dilution o# urine
,& Rea9sor*tion o# 'ater under t"e control o# $DH D& 6ecretion o# "ydrogen ion ammonia and *otassium
!"ic" o# t"e #ollo'ing actiities is *er#ormed at t"e distal conoluted tu9u le $& ,oncentration o# urine
+& $ctie rea9sor*tion o# Ca,l 'it" *assie 'ater rea9sor*tion ,& !ater rea9sor*tion under $DH control
D& Rea9sor*tion o# glucose amino acids *"os*"ates uric acid and *otassium
$ *atient "as a urinary out*ut o# 1000 cc in 2 "ours 'it" a urine sodium leel o# 2 mE:/liter& -"ese #indings *ro9a9ly indicate.
$& -"e *atient is on a salt#ree diet
+& -"e *atients kidneys "ae a decreased 9lood *er#usion ,& -"e *atient is in t"e 9eginning o# renal #ailure
D& -"e *atient is *rogressing to t"e *rerenal *"ase
Isc"emia inAury to t"e kidney 'ill usually commence '"en t"e mean arterial 9lood *ressure #alls 9elo'. $& 100 mmHg #or 50 minutes
+& 40 mmHg #or 2 "ours ,& @0 mmHg #or 0 minutes D& @0 mmHg #or 2 "ours
-"e t'o most common causes o# acute renal #ailure or ($-C are. $& Ce*"roto)ic su9stances and isc"emia
+& Isc"emia and urologic o9structions ,& Ce*"roto)ic drugs and "eay metals
D& Im*aired renal *er#usion and "e*atorenal causes
-"e *atient 'it" acute tu9ular necrosis is di##erentiated #rom a *atient 'it" decreased renal *er#usion 9ecause C7L in decreased renal *er#usion.
$& -"e urine olume is lo' and t"e kidneys #ail to res*ond to 7asi) +& -"e urine osmolality is greatly reduced
,& -"e urine sodium is 0 to 100 mE:/7 D& -"e +>C to creatinine ratio is at least 20.1
-"e oliguric stage o# acute renal #ailure !>7D C- include '"ic" o# t"e #ollo'ing. $& +>C 20mg%
+& ,reatinine 4mg% ,& 6igns o# ,H
D& <otassium 3 mE:/7
In $-C caused 9y ne*"roto)ic drugs 7asi) 'ill. $& Increase to)icity
+& ,ause diuresis t"us correcting oliguria ,& Increase 9lood #lo' to t"e kidneys D& Im*roe t"e *atients renal status
Hematological – Disk 5 (J1.21 + cells are res*onsi9le #or.
$& Humoral immunity +& ,ellular immunity
,& -y*e I "y*ersensitiity reactions D& ,ellmediated "y*ersensitiity
-"e most common immunoglo9ulin '"ose *rimary e##ect against 9acterial disease is. $& Ig8
+& IgE ,& Ig$ D& IgG
!"ic" o# t"e #ollo'ing statements regarding cellular immunity s -R>E $& It #unctions in concert 'it" immunoglo9ulins
+& It is im*ortant in deelo*ment o# autoimmune disease K gra#t reAection ,& $ signi#icant res*onse *roduces leuko*enia
D& $ll o# t"e a9oe
-"e immediate administration o# '"ic" o# t"e #ollo'ing is E66EC-I$7 in t"e initial management o# ana*" yla)is $& E*ine*"rine 0& – 1 ml o# 1.1000 solution
+& )ygen
,& ;olume re*letion
D& ,orticosteroids and amino*"ylline
!"ic" o# t"e #ollo'ing 9lood *roducts contains only #actors ;III #i9rinogen and MIII and is utili?ed in "emo*"ilia $ and DI,
$& <latelet concentrate +& <lasmanate
,& res" #ro?en *lasma D& ,ryo*reci*itate
Disseminated intraascular coagulo*at"y is. $& >sually a *rimary disorder
+& $ "emorr"agic e*isode #rom an initial lack o# clotting mec"anisms ,& !ides*read ina**ro*riate clotting t"at triggers 9leeding
D& Diagnosed 9y an increase leel o# clotting #actors
-"e *at"o*"ysiology o# disseminated intraascular coagulation includes. $& In"i9ition o# t"rom9inolysins
+& En"anced *roduction o# intraascular t"rom9in resulting in increased #i9rin and *latelet aggregation ,& Diminis"ed *latelet ad"esieness and aggregation
D& En"ancement o# intraascular clots due to an oer*roduction o# clotting #actors !"ic" o# t"e #ollo'ing la9oratory diagnostic #indings is C- likely to 9e seen in DI,
$& <- and <-- *rolonged +& <latelet count decreased ,& i9rinogen increased
!"ic" o# t"e #ollo'ing la9oratory diagnostic #indings 'ill 86- 7IE7L 9e seen in DI, $& <- and <-- *rolonged
+& i9rinogen increased ,& -"rom9in time decreased D& <latelet count increased
-"e intrinsic system o# 9lood clot initiation is. $& $ctiated 9y tissue t"rom9o*lastin +& +est ealuated 9y *rot"rom9in time ,& De*endent u*on calcium and itamin D& $ctiated 9y endot"elial inAury
Release o# '"at su9stance into t"e circulation secon dary to retained dead #etus a9ru*tion *lacenta and stress may cause DI,
$& i9rinolysin
+& -issue t"rom9o*lastin ,& He*arin
D& i9rin s*lit *roducts
-"e 9ene#icial e##ects o# "e*arin in DI, are t"oug"t to 9e due to its. $& 6timulating e##ect on *latelet manu#acture
+& Ceutrali?ing o# #reecirculating t"rom9in ,& $nti#i9rinolysin actiity
,ardioascular – Disk and (1B%
$ *atient 'it" a HR o# com*lains o# di??iness and cool clammy e)tremities& !"at is t"e #irst drug o# c"oice $& $tro*ine 0&mg 1mg
+& E*ine*"rine 1mg i *us"
,& Isu*rel in#usion 210mcg/kg/min D& $denosine @ mg i *us"
Lou are treating a *atient 'it" a slo' "eart9eat& or '"ic" o# t"e #ollo'ing *atient 'ould atro*ine 9e e##ectie $& $ y/o male 'it" seere c"est *ain and sinus 9radycardia at 5 9*m
+& $ y/o male 'it" 'eakness and 5rd degree H+
,& $ y/o male 'it" #atigue and a "eart trans*lant @ mont"s ago
D& $ y/o male 'it" 'eakness and acute sym*toms o# nausea/omiting 'it" a sinus HR o# 5
!"ic" o# t"e #ollo'ing t"era*ies is t"e most im*ortant interentions #or ;/*ulseless ;- 'it" t"e greatest e##ect o# surial to "os*ital disc"arge
$& E*ine*"rine +& De#i9rillation ,& )ygen D& $miodarone
$ 3y/o *atient 'it" ra*id $ a**ro)imately 1@0 *er minute and irregular c/o *al*itations #or a 'eek& Co eidence o# cardiac or circulatory #ailure& !"ic" 'ould 9e included in t"e initial orders
$& )ygen i monitor +& Immediate cardioersion ,& Co t"era*y is indicated
D& E*ine*"rine 1mg i eery 5 min
6ame *atient& His ital signs remain unc"anged +< 100/30 irregular HR o# 1@0& !"ic" o# t"e #ollo'ing 'ould 9e t"e most a**ro*riate treatment #or $
$& I; digo)in
+& I; diltia?em to slo' entricular res*onse ,& I; amiodarone to conert $ to 6R D& 6ync"roni?ed cardioersion
2 y/o 'oman is 'it" <6;- *rior medical HM con#irmed reentry tac"ycardia no !<!& HR 1B09*m s"e is so9 and re*orts *al*itations& !"ic" 'ould 9e t"e ne)t most a**ro*riate interention
$& Dc cardioersion +& I; diltia?em ,& I; *ro*ranolol D& I; adenosine
y/o m 'it" HM ,H K 7+++ deelo*s sustained 'ide com*le) tac"ycardia a#ter an e*isode o# ,< relieed 9y C-G& !"ic" o# t"e #ollo'ing is t"e most a**ro*riate initial med
$& I; lidocaine +& I; adenosine ,& I; amiodarone D& I; era*amil
!"ic" o# t"e #ollo'ing *ressures are 'it"in normal limits $& <$< 5/2 <,!< 12
!"ic" o# t"e #ollo'ing 'ould cause an eleated *ulmonary artery *ressure and normal 'edge *ressure $& <ulmonary "y*ertension
+& <ulmonary edema ,& 7e#t entricular #ailure D& ,onstrictie *ericarditis
$ large 'ae a**ears on t"e <,!< tracing o# a *atient 'it" an in#erior 'all myocardial in#arction& -"is #inding is consistent 'it".
$& ,ardiogenic s"ock +& ,ongestie "eart #ailure ,& 8itral regurgitation D& <ericarditis
6- eleation and a9sence o# an R 'ae in ;1; 'ould 9e indicatie o#. $& $nteriorse*tal 'all in#arction
+& In#erior 'all isc"emia
,& $nterior se*tal 'all isc"emia D& $nterior lateral 'all in#arction
!"ic" o# t"e #ollo'ing "emodynamic *arameters 'ould ind icate le#t entricular #ailure in a *atient 'it" co*d $& <a* /22 <,!< 1 ,;< B
+& <a* B/2@ <,!< 1@ ,;< @ ,& <a* 22/12 <,!< 2@ ,;< 1@ D& <a* B/2@ <,!< 20 ,;< 1@
-"e reci*rocal c"anges t"at occur 'it" an in#erior 'all mi are seen as 6- de*ression in leads. $& II III $;
+& ;1; ,& II $;1 D& I $;1
!"ic" o# t"e #ollo'ing com*lications is most likely to occur in acute in#erior myocardial in#arction $& 8o9it? ty*e I "eart 9lock ('enc"e9ac"
+& <aro)ysmal atrial tac"ycardia (*at ,& Rig"t 9undle 9ranc" 9lock (R+++ D& ,ardiogenic s"ock
Lour *atient 'it" an in#erior 'all mi also "as a rig"t entricular in#arction K deelo*s rig"t entricular #ailure& !"ic" data o9tained 'ould correlate 'it" t"is *atientFs condition
$& <a* 2B/10 <,!< 10 ,;< 1B +& <a* 5B/22 <,!< 20 ,;< @ ,& <a* /2B <,!< 1 ,;< 1 D& <a* 25/B <,!< 14 ,;< 20
-"e treatment modality #or a *atient 'it" R; #rom an in#erior 'all mi 'ould include. $& Ci*ride and lo' dose do*amine
+& Cormal saline #luid c"allenge ,& 7asi) and *reload reducers
$& +< BB/@0 *a 1B/B <,!< 12 +& +< 30/0 *a 50/20 <,!< 22 ,& +< 40/@0 *a 2/1B <,!< 2 D& +< 4/@ *a 0/22 <,!< 20
,linical mani#estations o# cardiogenic s"ock #ollo'ing an anterior 'all mi include all o# t"e #ollo'ing e)ce*t. $& Distended neck eins
+& <ulmonary congestion rales ,& <resence o# an s5
D& 7o' ,;< reading
>nloading t"era*y 9y nitro*russide is 9ene#icial 9ecause it. $& En"ances entricular em*tying
+& Diminis"es *eri*"eral ascular resistance or a#terload
,& Reliees *ulmonary congestion 9y *romoting enous *ooling o# 9lood D& $ll o# t"e a9oe
!"ic" o# t"e #ollo'ing is an e)*ected outcome #rom I$+< $& Decreased mean systemic +<
+& Increased cardiac out*ut ,& Increased <,!<
D& $ll o# t"e a9oe
-o 9e o*erating correctly t"e I$+< is timed to 'ork in '"ic" manner $& In#late during systole de#late during diastole
+& In#late '"en t"e mean aortic *ressure #alls 9elo' a *reset limit ,& In#late '"en t"e "eart rate #alls 9elo' a *reset limit
D& In#late during diastole de#late during systole
$9solute contraindications to intraaortic 9alloon counter *ulsation include. $& 8itral insu##iciency
+& $ortic insu##iciency ,& 6e*sis
D& emoral artery aneurysm
$ll *osto*eratie cardiac surgery *atients deelo*. $& <ericarditis
+& Electrolyte im9alances ,& Hy*o)ia
D& $telectasis
!"ic" o# t"e #ollo'ing kinds o# s"ock is c"aracteri?ed 9y increased enous ca*acitance and *ooling $& Hy*oolemic s"ock
+& ,ardiogenic s"ock
,& Distri9utie s"ock (se*tic D& 9structie s"ock
Early stages o# se*tic s"ock are c"aracteri?ed 9y. $& ;asoconstriction 'it" t"e release o# "istamine
+& Increased cardiac out*ut 'it" *eri*"eral asoconstriction ,& ;asodilation 'it" #luid loss and t"e release o# leukocytes D& Increased cardiac out*ut 'it" decreased ascular resistance
+& 6e*tic
,& Hy*oolemic D& ,ardiogenic
$ *atient admitted to t"e I,> in t"e early stages o# se*tic s"ock *resents 'it". $& !eak t"ready *ulses and lo' +<
+& Decreased > ,& !arm #lus"ed skin
D& Hy*er*nea 'it" *ulmonary congestion
!"ic" o# t"e #ollo'ing signs is not c"aracteristic o# cardiac tam*onade $& !idening *ulse *ressure
+& Rising ,;<
,& !ide mediastinum on MR$L
D& $ #all in systolic +< o# more t"an 10mm"g during ins*iration -"e *lacement o# mcl electrodes is.
$& N electrode t" I,6 r sternal 9order electrode 9elo' outer 5rd o# l claicle +& N electrode t" I,6 r sternal 9order electrode l lo'er $+D
,& N electrode l s"oulder electrode r s"oulder
D& N electrode l mida)illary line t" I,6O electrode 9elo' outer 5rd o# le#t claicle -"e most serious EG #inding associated 'it" anterior 'all mi is.
$& ascicular 9locks and tac"ycardia +& R+++ and second degree 9locks ,& e' entricular ecto*ic 9eats D& Ra*id su*raentricular r"yt"ms
-"e "emodynamic *arameter t"at clinically measures a#terload is. $& ,;<
+& 8a* ,& 6;R
D& 7e#t entricular enddiastolic *ressure
$ll o# t"e #ollo'ing su**ort t"e diagnosis o# cardiac tam*onade e)ce*t. $& !idening *ulse *ressure
+& <ulsus *arado)us
,& Enlarged "eart on MR$L
D& E:uali?ation o# rig"t and le#t "eart *ressures
$ *atient 'it" +< o# 200/12 'ould "ae '"ic" o# t"e #ollo'ing #orms o# H-C $& Essential H-C
+& $ccelerated H-C ,& 8alignant H-C
!"ic" o# t"e #ollo'ing statements regarding esicular 9reat" sounds is true $& -"ese are medium intensity sound "eard oer t"e large mainstem 9ronc"i +& -"ey are "eard longer on e)"alation
,& -"ey are decreased or a9sent '"en air#lo' to t"e area o# lung is diminis"ed D& -"ey are auscultated o# t"e trac"
!"ic" o# t"e #ollo'ing c"est auscultation #indings is a9normal $& ;esicular 9reat" sounds oer lung *eri*"ery
+& +ronc"ial 9reat" sounds "eard oer large air'ay
,& ;esicular 9reat" sounds "eard during ins*iration and e)*iration D& +ronc"oesicular sounds adAacent to t"e sternum
!"ic" o# t"e #ollo'ing *atient #indings 'ill contri9ute a s"i#t to t"e le#t 'it" im*aired tissue unloading o# o)ygen $& <" 3&B
+& -em* 105# ,& <$,2 0mm"g
D& Increased "emoglo9in 2 5 D<G
!"ic" o# t"e #ollo'ing *atient #indings 'ill contri9ute to a s"i#t to t"e rig"t 'it" im*roed unloading o# o)ygen at t"e tissues
$& <" 3&@ +& -em* 4@# ,& <$,2
D& Decreased "emoglo9in 2 5 D<G
<atient in ,,> *ost cardiac arrest. I2 0&B <H 3&51 <,2 2 <2 @0 2 6$- B% and H,5 1B. $& ,om*ensated meta9olic acidosis
+& >ncom*ensated res*iratory acidosis ,& >ncom*ensated meta9olic acidosis D& >ncomensated meta9olic acidosis
<atient *resents 'it" agitation and tingling o# t"e #ingers. I2 R$ <H 3&4 <,2 2 2 6$- 4B% H,5 22. $& Cormal acid9ase 9alance
+& >ncom*ensated res*iratory alkalosis ,& >ncom*ensated res*iratory acidosis D& >ncom*ensated meta9olic alkalosis
Ce'ly admitted mi *atient on t"ia?ide diuretics at "ome #or "y*ertension "as an $+G. I2 0&@ <H 3&B <,2 5@ <2 30 2 6$- 40% H,5 5
$& >ncom*ensated meta9olic alkalosis +& >ncom*ensated res*iratory alkalosis ,& >ncom*ensated meta9olic acidosis D& ,om*ensated meta9olic alkalosis
<ulmonary consolidation (lo9ar *neumonia 'ill cause '"ic" o# t"e #ollo'ing *"ysical #indings oer t"e diseased area
$& Dull *ercussion note +& Decreased tactile #remitus ,& +ronc"ial 9reat" sounds D& +ot" a and c
+& -enaciousness ,& ,o*ious nature D& $9sence
$n ominous #inding in t"e *atient 'it" status ast"maticus 'ould 9e. $& $ res*iratory rate o# 5
+& 7oud e)*iratory '"ee?ing ,& $ ,2 o#
D& >se o# accessory muscles
$ *atient 'it" status ast"maticus is admitted& His 9reat" sounds are diminis"ed t"roug"out "is lung #ields& RR=0& $#ter giing your *atient an aerosol 9ronc"odilator your *atient sounds 'orse as t"ey are no' louder& -"is
indicates.
$& -"e *atient "as gotten 'orse
+& -"e need #or anest"esia to 9e *resent stat ,& -"e *atient is getting 9etter
D& -"e *atient does not "ae ast"ma
!"en adAusting t"e initial settings on a olume entilator #or an adult in res*iratory #ailure t"e tidal olume is usually set at.
$& $t least 10ml *er kg or t'ice normal +& 120 ml *er kg or t'ice normal ,& 00 ml #or all *atients
D& 50000 ml
$ 30 kg *atient entilated 'it" I2 o# % ;- o# B00 I8; o# B& <atients res*irations are 10/min& $9g results. 2 B% ,2 '"at entilator *arameter s"ould 9e c"anged
$& I2 +& I8; ,&
;-D& $ll o# t"e a9oe
-"e normal $a gradient (aleolar to arterial gradient #or o)ygen #or an adult 9reat"ing room air is less t"an. $& 10 mmHg
+& 20 mmHg ,& 100 mmHg D& 200 mmHg
$dministration o# 100% 2 'ill not im*roe t"e <$2 in "y*o)ia caused 9y. $& ;/ im9alance
+& Rig"t to le#t s"unting ,& $leolar "y*oentilation D& Im*aired di##usion
!"ic" o# t"e #ollo'ing diseases states does not cause "y*o)ia due to a *rimary mec"anism o# /: mismatc"ing $& +ronc"os*astic disease
+& <ulmonary em*"ysema
,& $dult res*iratory distress syndrome D& <ulmonary em9oli?ation
+& 6"unting
,& Hy*oentilation D& Decreased I2
!"ic" o# t"e #ollo'ing statements regarding $RD6 is true $& -"ere is decreased ca*illary *ermea9ility
+& -"ere is damage to ty*e II *neumocytes 'it" a decreased o# sur#actant ,& -"ere is an increase in lung com*liance
D& -"ere is an increase in #unctional residual ca*acity
$ssessment #indings indicatie o# $RD6 in t"e early stage 'ould include all o# t"e #ollo'ing e)ce*t. $& -ac"y*nea
+& Cormal <,!<
,& Res*iratory alkalosis D& Hy*erca*nia
-"e "allmark o# adult res*iratory distress syndrome ($RD6 is. $& Re#ractory "y*erca*nia
+& Re#ractory "y*o)emia
,& 7o' #unctional residual ca*acity D& Increased com*liance secondary
-"e nurse considers '"ic" interention to 9e ina**ro*riate '"ile caring #or t"e *atient 'it" ards $& $dminister small doses 7asi) as ordered 9y md
+& In#usion o# normal saline ra*idly in order to maintain "ydration ,& <ulmonary toileting
D& re:uent *osition c"anges&
-"e *lan o# t"era*eutic attack in t"e care o# $RD6 *atients may include. $& >se o# ent 'it" "ig" *ressure and "ig" #lo' c"aracteristics +& Diuretics and #luid restriction
,& >se o# *ee* D& $ll o# t"e a9oe
<al*ation o# trac"eal s"i#t to t"e le#t may indicate. $& $ tension *neumot"ora) on t"e rig"t +& 8assie atelectasis to t"e rig"t
,& $ tension *neumot"ora) on t"e le#t D& Di##use air'ays o9struction
Initial nursing assessment #indings in t"e *atient 'it" an acute *ulmonary e m9olism includes. $& ,"est *ain 6- c"anges *ulmonary edema
+& Rales r"onc"i tac"ycardia ,& ,"est *ain dys*nea coug" D& -ac"y*nea 9radycardia rales
!"ic" assessment #inding 'ould not 9e *resent in t"e *atient 'it" a massie *ulmonary em9olism $& Increased ,;< reading
+& <ulmonary rales ,& Distended neck eins D& 7ier enlargement
