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An advanced practice registered nurse (APRN) is caring for an adult patient who fell off a ladder
and has a T5 compression and a compound fracture of the femur.
The following assessment data is noted:
Vital signs: BP 102/52
Apical pulse: 48
Weak peripheral pulses
Flaccid lower extremities
Severe bruising of the femur
Which type of shock should the APRN suspect?
ANSWER: Neurogenic
An advanced practice registered nurse (APRN) is caring for a patient who experienced a 20%
total body surface area (TBSA) burn injury. Current assessment findings include massive
evaporative water losses, a flux of large amounts of fluid and electrolytes in the tissues,
generalized edema, and circulatory hypovolemia. The APRN needs to take immediate action to
prevent irreversible hypovolemic shock and death.
Which priority action should be taken by the APRN?
ANSWER: Administer up to 30 L of lactated ringer solution over 24 hours
An adult patient has experienced a third-degree burn. An advanced practice registered nurse
(APRN) is attempting to calculate the total body surface area affected using the rule of nines.
The areas involved include the anterior and posterior right arm and leg and the groin.
,What is the estimated total body surface area that will be assigned by the APRN?
ANSWER: 28%
An advanced practice registered nurse (APRN) assesses a school-aged child with sepsis who is
experiencing new symptoms of hyperthermia, tachycardia, and tachypnea.
Which additional diagnosis should the APRN consider?
ANSWER: Systemic inflammatory response syndrome
A female patient presents with abnormal hair growth on the face and body and reports that the
hair on her head is receding. An advanced practice registered nurse (APRN) determines that the
patient has hirsutism.
Which other diagnosis associated with this condition should be considered by the APRN?
ANSWER: Polycystic ovarian syndrome
When discussing sun protection with an older patient, an advanced practice registered nurse
recommends the importance of using sunblock to protect aging skin from ultraviolet exposure
when the patient will be in the sun.
Which pathologic changes due to aging of the integumentary system is this recommendation
based on?
ANSWER: Decreased melanocytes and clearance of oxidative substances from the dermis
An advanced practice registered nurse (APRN) is working with a bedbound patient who has an
area of skin tissue obscured by slough or eschar over the left greater trochanter.
Which way should this pressure injury be staged by the APRN for treatment?
, ANSWER: Unstageable
A five-year-old child presents to a clinic with right inner thigh and groin pain that radiates to the
knee. The parents report to an advanced practice registered nurse (APRN) that activity
aggravates the pain, but rest relieves it. The APRN notes the child's Trendelenburg gait.
Radiographic examination confirms a diagnosis of Legg-Calvé-Perthes disease (LCPD).
What is the pathologic cause of this disorder?
ANSWER: Recurrent interruption of the blood supply to the femoral head
A patient is discussing symptoms of fibromyalgia with an advanced practice registered nurse
(APRN) and is worried about the effect of the condition on life. The APRN suggests treatment to
help control symptoms.
Which treatment should be recommended to this patient?
ANSWER: Antidepressants and acupuncture
A small-framed, older adult patient is having problems with mobility. The patient is treated at a
hospital after a recent fall. During a follow-up visit, an advanced practice registered nurse
(APRN) diagnoses the patient with a fragility fracture of the femur and would like to assess for
additional problems.
Which disease process should the APRN suspect in this patient?
ANSWER: Osteoporosis
An obese, middle-aged patient presents to an advanced practice registered nurse (APRN) with
complaints of heartburn, chronic cough, frequent wheezing, laryngitis, and sinusitis.
Which pathological mechanism is associated with the probable diagnosis?