NUR 4090 EXAM 1 QUESTIONS WELL ANSWERED LATEST UPDATE 2026
pharmacogenomics - Answers the study of how a person metabolizes medications based on his or
her genetic makeup
when conducting a genetic assessment, the nurse should... - Answers obtain a three-generation
family history
ventilation - Answers the process of bringing in O2 (inhalation)
perfusion - Answers are the tissues receiving oxygenated blood?
-strength of myocardium
-MAP
-patency of the vessels
-circulating volume
shunt - Answers perfusion without ventilation
-blockage in airway (secretions, blood, fluid)
dead space - Answers ventilation without perfusion
-blockage in circulatory system (PE, DVT)
arterial blood gas - Answers measures adequacy of alveolar ventilation
how well the lungs are bringing in O2 and excreting CO2
mixed venous blood gas (SVO2) - Answers measures tissue oxygen delivery
can determine if cardiac output and oxygen delivery is high enough to meet pts demands
drawn from pulmonary catheter
normal pH - Answers 7.35-7.45
normal PO2 (mmHg) - Answers >80 mmHg
normal PCO2 (mmHg) - Answers 35-45
normal HCO3 (mEq/L) - Answers 22-26
normal SaO2 - Answers >94%
why is venous blood more acidic than arterial blood? - Answers it carries more CO2 (more waste
excreted by the cells)
what does it mean if the SVO2 is greater than 100? - Answers TOO MUCH OXYGEN; needs to be
weaned down
normal SVO2 - Answers 65-75
types of blunt chest trauma (3) - Answers -sternal/rib fractures
-flail chest
-pulmonary contusion
penetrating chest trauma - Answers -gunshot/stab wounds
-pneumothorax
-hemothorax
-cardiac tamponade
-subcutaneous emphysema
s/s rib/sternal fracture - Answers -anterior chest pain
-tenderness
-ecchymosis
-swelling
treatment rib/sternal fracture - Answers -no "real treatment," manage symptoms
-chest binder
-pain relief; PCA pump, ice, analgesia, intercostal nerve block
flail chest - Answers -complication of rib fracture
-3 or more continuous ribs all fractured at 2+ places
-AKA free-floating rib fragments
s/s flail chest - Answers -paradoxical chest movement
-severe pain
-atelectasis
-dead space (ventilation w/out perfusion)
-potential respiratory acidosis
pulmonary contusion (bruised lung) - Answers -bruise on lung tissue w/ localized edema
-accumulation of blood in the bronchioles & chest wall
-mortality rate 50%
, s/s pulmonary contusion - Answers -hypoxia
-BLOODY SPUTUM
-co2 retention
-decreased breath sounds
**mirrors ARDS = cyanosis, agitation, productive cough w/ bloody secretions**
simple/closed pneumothorax - Answers -air enters pleural space via a breach in the parietal or
visceral pleura
-may occur spontaneously in a healthy person r/t air-filled bleb
**PLEURAL CAVITY PRESSURE IS LESS THAN ATMOSPHERIC PRESSURE**
tension pneumothorax - Answers -air drawn into the pleural space via small hole in chest wall
-air that enters the pleural cavity is trapped (positive pressure increases)
-one-way valve; the air that enters cannot escape
-causes mediastinal shift to the unaffected side (trachea will NOT BE MIDLINE)
**PLEURAL CAVITY PRESSURE IS GREATER THAN ATMOSPHERIC PRESSURE**
tension pneumothorax s/s - Answers -jugular venous distention
-hypotension
-tracheal deviation
-tachypnea
traumatic/open pneumothorax - Answers -air escapes & enters from a laceration in the lung itself
-"sucking chest wound"
**PLEURAL CAVITY PRESSURE = ATMOSPHERIC PRESSURE**
what is a late sign of traumatic/open pneumothorax? - Answers mediastinal shift/trachea shifted
from the midline
treatment for pneumothorax - Answers -large-bore needle aspiration (14g) @ 2nd intercostal space
to withdraw fluid/air/blood
-chest tube @ 2nd intercostal space to extract air/fluid/blood & reintroduce negative pressure
what is the purpose of a chest tube? - Answers reintroduces negative pressure into the pleural cavity
& assists in drainage of blood/fluid/air
what are the 3 chambers of a chest tube? - Answers 1. suction control chamber (dry/wet)
2. water seal chamber
3. drainage collection chamber
how do you know if the chest tube is working properly? - Answers -tidaling present upon respiration
in water seal chamber (intermittent bubbling for pneumothorax pts is normal)
-gentle bubbling in suction control chamber
-drain must be below the heart
what do you do if the chest tube is pulled out of the patient's chest? - Answers put a sterile gauze
dressing on the hole of the chest wall & tape 3 sides
what do you do if the whole chest tube system breaks? - Answers insert the non-pt side of the tubing
into 1 inch of sterile water/saline to maintain negative pressure suction
what does it mean if the water in the water seal chamber stops tidaling? - Answers this likely
indicates the lung has re-inflated/is back to normal
should occur ~3 days after insertion
PRIORITY intervention: assess the client's lung sounds to see if they re-inflated
OR...there is a kink in the tubing
why is the water seal chamber the "most important" chamber of the chest tube? - Answers allows air
to exit the pleural space but prevents air from entering the lungs
DNA transcription - Answers -DNA inside the nucleus is transcribed into mRNA
-mRNA moves into the cytoplasm & ribosomes within the cytoplasm conversation the mRNA into
amino acids
- amino acid chains code for proteins
-proteins are created
germline - Answers the type of mutation that arises from inherited DNA in the gametes (sex cells) & is
duplicated in every cell
diagnostic genetic testing - Answers confirms or rules out diagnosis; symptoms are already present
carrier genetic testing - Answers determines if someone is a carrier of a recessive or an x-linked
disorder
pharmacogenomics - Answers the study of how a person metabolizes medications based on his or
her genetic makeup
when conducting a genetic assessment, the nurse should... - Answers obtain a three-generation
family history
ventilation - Answers the process of bringing in O2 (inhalation)
perfusion - Answers are the tissues receiving oxygenated blood?
-strength of myocardium
-MAP
-patency of the vessels
-circulating volume
shunt - Answers perfusion without ventilation
-blockage in airway (secretions, blood, fluid)
dead space - Answers ventilation without perfusion
-blockage in circulatory system (PE, DVT)
arterial blood gas - Answers measures adequacy of alveolar ventilation
how well the lungs are bringing in O2 and excreting CO2
mixed venous blood gas (SVO2) - Answers measures tissue oxygen delivery
can determine if cardiac output and oxygen delivery is high enough to meet pts demands
drawn from pulmonary catheter
normal pH - Answers 7.35-7.45
normal PO2 (mmHg) - Answers >80 mmHg
normal PCO2 (mmHg) - Answers 35-45
normal HCO3 (mEq/L) - Answers 22-26
normal SaO2 - Answers >94%
why is venous blood more acidic than arterial blood? - Answers it carries more CO2 (more waste
excreted by the cells)
what does it mean if the SVO2 is greater than 100? - Answers TOO MUCH OXYGEN; needs to be
weaned down
normal SVO2 - Answers 65-75
types of blunt chest trauma (3) - Answers -sternal/rib fractures
-flail chest
-pulmonary contusion
penetrating chest trauma - Answers -gunshot/stab wounds
-pneumothorax
-hemothorax
-cardiac tamponade
-subcutaneous emphysema
s/s rib/sternal fracture - Answers -anterior chest pain
-tenderness
-ecchymosis
-swelling
treatment rib/sternal fracture - Answers -no "real treatment," manage symptoms
-chest binder
-pain relief; PCA pump, ice, analgesia, intercostal nerve block
flail chest - Answers -complication of rib fracture
-3 or more continuous ribs all fractured at 2+ places
-AKA free-floating rib fragments
s/s flail chest - Answers -paradoxical chest movement
-severe pain
-atelectasis
-dead space (ventilation w/out perfusion)
-potential respiratory acidosis
pulmonary contusion (bruised lung) - Answers -bruise on lung tissue w/ localized edema
-accumulation of blood in the bronchioles & chest wall
-mortality rate 50%
, s/s pulmonary contusion - Answers -hypoxia
-BLOODY SPUTUM
-co2 retention
-decreased breath sounds
**mirrors ARDS = cyanosis, agitation, productive cough w/ bloody secretions**
simple/closed pneumothorax - Answers -air enters pleural space via a breach in the parietal or
visceral pleura
-may occur spontaneously in a healthy person r/t air-filled bleb
**PLEURAL CAVITY PRESSURE IS LESS THAN ATMOSPHERIC PRESSURE**
tension pneumothorax - Answers -air drawn into the pleural space via small hole in chest wall
-air that enters the pleural cavity is trapped (positive pressure increases)
-one-way valve; the air that enters cannot escape
-causes mediastinal shift to the unaffected side (trachea will NOT BE MIDLINE)
**PLEURAL CAVITY PRESSURE IS GREATER THAN ATMOSPHERIC PRESSURE**
tension pneumothorax s/s - Answers -jugular venous distention
-hypotension
-tracheal deviation
-tachypnea
traumatic/open pneumothorax - Answers -air escapes & enters from a laceration in the lung itself
-"sucking chest wound"
**PLEURAL CAVITY PRESSURE = ATMOSPHERIC PRESSURE**
what is a late sign of traumatic/open pneumothorax? - Answers mediastinal shift/trachea shifted
from the midline
treatment for pneumothorax - Answers -large-bore needle aspiration (14g) @ 2nd intercostal space
to withdraw fluid/air/blood
-chest tube @ 2nd intercostal space to extract air/fluid/blood & reintroduce negative pressure
what is the purpose of a chest tube? - Answers reintroduces negative pressure into the pleural cavity
& assists in drainage of blood/fluid/air
what are the 3 chambers of a chest tube? - Answers 1. suction control chamber (dry/wet)
2. water seal chamber
3. drainage collection chamber
how do you know if the chest tube is working properly? - Answers -tidaling present upon respiration
in water seal chamber (intermittent bubbling for pneumothorax pts is normal)
-gentle bubbling in suction control chamber
-drain must be below the heart
what do you do if the chest tube is pulled out of the patient's chest? - Answers put a sterile gauze
dressing on the hole of the chest wall & tape 3 sides
what do you do if the whole chest tube system breaks? - Answers insert the non-pt side of the tubing
into 1 inch of sterile water/saline to maintain negative pressure suction
what does it mean if the water in the water seal chamber stops tidaling? - Answers this likely
indicates the lung has re-inflated/is back to normal
should occur ~3 days after insertion
PRIORITY intervention: assess the client's lung sounds to see if they re-inflated
OR...there is a kink in the tubing
why is the water seal chamber the "most important" chamber of the chest tube? - Answers allows air
to exit the pleural space but prevents air from entering the lungs
DNA transcription - Answers -DNA inside the nucleus is transcribed into mRNA
-mRNA moves into the cytoplasm & ribosomes within the cytoplasm conversation the mRNA into
amino acids
- amino acid chains code for proteins
-proteins are created
germline - Answers the type of mutation that arises from inherited DNA in the gametes (sex cells) & is
duplicated in every cell
diagnostic genetic testing - Answers confirms or rules out diagnosis; symptoms are already present
carrier genetic testing - Answers determines if someone is a carrier of a recessive or an x-linked
disorder
