NSG3313 Adult Health 1 Final Exam Review Questions
With Complete Solutions
Pt. is in resp. failure after starting Bipap, the ABG's are pH 7.3,
CO2 47, HCO3 22, What is the pH imbalance?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
A. Respiratory Acidosis
Rationale:
The pH (7.35 - 7.45) is 7.3 indicating acidosis, CO2 (35 - 45) is
47 which is high, HCO3 (22 - 26) is 22 which is WNL.
R - respiratory
O - opposite
M - metabolic
E - equal
Pt. is NPO and receiving IV fluids. What assessments will assess
hydration status? (SATA)
A. Apical HR
B. Pain
C. Peripheral pulses
D. Cap refill
,A. Apical HR
C. Peripheral pulses
D. Cap refill
Pt. has been receiving IV fluids for 36 hr. What are your priority
assessment for this pt.? (SATA)
A. Lung Sounds
B. Jugular Veins
C. Pulses
D. Creatine
A. Lung Sounds
B. Jugular Veins
C. Pulses
A pt.'s K+ is 3.5, What medications are you going to question?
(SATA)
A. Spironolactone
B. Sodium polystyrene (Kayexalate)
C. Lasix (Furosemide)
D. Hydrochlorothiazide
B. Sodium polystyrene
C. Lasix
D. Hydrochlorothiazide
Rationale:
K+ Levels: 3.5-5.0
,Sodium Polystyrene (Kayexalate) is used to lower K+, Lasix
(Furosemide) & Hydrochlorothiazide are loop & thiazide
diuretics that will cause K+ to be eliminated with fluid.
Spironolactone is a K+ sparing diuretic
Pt. admitted with sepsis & hypovolemia, serum lytes are WNL,
V.S.: BP 100/64, HR 126, RR 15, What intervention is best?
A. No IV fluids
B. Hypotonic fluids
C. Isotonic fluids
D. Hypertonic fluids
C. Isotonic fluids
Rationale:
Isotonic fluids;
- 0.9% NaCl
- Ringer Lactate
- D5W
are the go to if pt. is hemodynamically unstable (HR, BP,
Cap refill, LOC, Urine production, sin color, turgor, All
things perfusion that can be assessed)
Relatively same pH & # of solutes as blood
A pt. is on the cardiac monitor and starts having frequent PVCs
and palpitations. What electrolyte will be priority?
A. Calcium
B. Potassium
, C. Magnesium
D. Sodium
B. Potassium
Rationale:
Ventricular dysrhythmias premature ventricular complex (PVC):
•An impulse that starts in the ventricle and is conducted before
the next NSR complex
•Ventricular rate - depends on underlying rhythm
•Irregular rhythm due to early QRS
•QRS is 0.12 sec or longer and shape is abnormal
•P wave - visibility depends on timing of PVC
•PRi is than 0.12 sec
Ratio is 0:1, or 1:1
- Normally due to low electrolytes K and Mag
- Check BMP
- They are not serious, but if frequent can be tx by amiodarone
or sotalol
- Pts may not even feel
- If not treated or left alone can progress to VT with any run
longer that 3 beats in a row
Pts will feel palpitations or CP
Dr. orders 0.9% NaCl 250 mL IV bolus to be given over 30 min.
What are you going to set the pump rate as? (mL/hr)
A. 250
B. 750
With Complete Solutions
Pt. is in resp. failure after starting Bipap, the ABG's are pH 7.3,
CO2 47, HCO3 22, What is the pH imbalance?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
A. Respiratory Acidosis
Rationale:
The pH (7.35 - 7.45) is 7.3 indicating acidosis, CO2 (35 - 45) is
47 which is high, HCO3 (22 - 26) is 22 which is WNL.
R - respiratory
O - opposite
M - metabolic
E - equal
Pt. is NPO and receiving IV fluids. What assessments will assess
hydration status? (SATA)
A. Apical HR
B. Pain
C. Peripheral pulses
D. Cap refill
,A. Apical HR
C. Peripheral pulses
D. Cap refill
Pt. has been receiving IV fluids for 36 hr. What are your priority
assessment for this pt.? (SATA)
A. Lung Sounds
B. Jugular Veins
C. Pulses
D. Creatine
A. Lung Sounds
B. Jugular Veins
C. Pulses
A pt.'s K+ is 3.5, What medications are you going to question?
(SATA)
A. Spironolactone
B. Sodium polystyrene (Kayexalate)
C. Lasix (Furosemide)
D. Hydrochlorothiazide
B. Sodium polystyrene
C. Lasix
D. Hydrochlorothiazide
Rationale:
K+ Levels: 3.5-5.0
,Sodium Polystyrene (Kayexalate) is used to lower K+, Lasix
(Furosemide) & Hydrochlorothiazide are loop & thiazide
diuretics that will cause K+ to be eliminated with fluid.
Spironolactone is a K+ sparing diuretic
Pt. admitted with sepsis & hypovolemia, serum lytes are WNL,
V.S.: BP 100/64, HR 126, RR 15, What intervention is best?
A. No IV fluids
B. Hypotonic fluids
C. Isotonic fluids
D. Hypertonic fluids
C. Isotonic fluids
Rationale:
Isotonic fluids;
- 0.9% NaCl
- Ringer Lactate
- D5W
are the go to if pt. is hemodynamically unstable (HR, BP,
Cap refill, LOC, Urine production, sin color, turgor, All
things perfusion that can be assessed)
Relatively same pH & # of solutes as blood
A pt. is on the cardiac monitor and starts having frequent PVCs
and palpitations. What electrolyte will be priority?
A. Calcium
B. Potassium
, C. Magnesium
D. Sodium
B. Potassium
Rationale:
Ventricular dysrhythmias premature ventricular complex (PVC):
•An impulse that starts in the ventricle and is conducted before
the next NSR complex
•Ventricular rate - depends on underlying rhythm
•Irregular rhythm due to early QRS
•QRS is 0.12 sec or longer and shape is abnormal
•P wave - visibility depends on timing of PVC
•PRi is than 0.12 sec
Ratio is 0:1, or 1:1
- Normally due to low electrolytes K and Mag
- Check BMP
- They are not serious, but if frequent can be tx by amiodarone
or sotalol
- Pts may not even feel
- If not treated or left alone can progress to VT with any run
longer that 3 beats in a row
Pts will feel palpitations or CP
Dr. orders 0.9% NaCl 250 mL IV bolus to be given over 30 min.
What are you going to set the pump rate as? (mL/hr)
A. 250
B. 750
