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NRNP 6566 WEEK 11 KNOWLEDGE CHECK

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NRNP 6566 WEEK 11 KNOWLEDGE CHECK How would you differentiate between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS)? Correct Answer: Both of these conditions will include high levels of blood glucose readings. DKA will exhibit acidosis and urinary ketones while HHS will not. Treatment for each condition is similar with fluid bolus and infusion as well as insulin bolus and infusion. • Question 2 Juan is a 42 year old male with complaints of nausea and vomiting for 3 days and has been unable to keep anything down in that time. He has not taken any of his medications due to the nausea and vomiting. Your assessment reveals the following data: Significant History Type 2 DM x 4 years, HTN Medications Lisinopril 10 mg daily Metformin 1000 mg po daily Glipizide 5 mg po daily Physical Exam Pale, lethargic gentleman Skin is very dry VS 94/64 P 112 RR 30 T 99.4 wt 195 pounds ht 5’11 » Lungs clear bilaterally, rapid respiration CV : RRR, no murmurs or gallops Abd: soft, non-tender, positive bowel sounds Labs: Hb 146 Hct 58% Cr 4.9 Bun 53 Cholesterol 238 Na 126 K 5.6 CL 95 Ca 8.8 Gluc 722 Phosphorus 5.8 Ketone Moderate AST 248 Alk Phos 132 ABG’s ph 7.01 Pco2 20 Po2 100 Sat 98% (on room air) HCO3 7.5 What are the appropriate initial orders to treat this patient? Correct Answer: Admission to the ICU Normal saline IV bolus to counter the vascular dehydration that has occurred. Bolus insulin dose followed by an insulin drip Electrolyte and blood glucose monitoring frequently fluid resuscitation and insulin administration. Bicarbonate is typically not administered unless the pH is below 7 Assess the patient for presence of any infection that may have precipitated this event • Question 3 Juan is a 42 year old male with complaints of nausea and vomiting for 3 days and has been unable to keep anything down in that time. He has not taken any of his medications due to the nausea and vomiting. Your assessment reveals the following data: Significant History Type 2 DM x 4 years, HTN Medications Lisinopril 10 mg daily Metformin 1000 mg po daily Glipizide 5 mg po daily Physical Exam Pale, lethargic gentleman Skin is very dry VS 94/64 P 112 RR 30 T 99.4 wt 195 pounds ht 5’11 » Lungs clear bilaterally, rapid respiration CV : RRR, no murmurs or gallops Abd: soft, non-tender, positive bowel sounds Labs: Hb 146 Hct 58% Cr 4.9 Bun 53 Cholesterol 238 Na 126 K 5.6 CL 95 Ca 8.8 Gluc 722 Phosphorus 5.8 Ketone Moderate AST 248 Alk Phos 132 ABG’s ph 7.01 Pco2 20 Po2 100 Sat 98% (on room air) HCO3 7.5 What is the “ corrected” sodium level for the hyperglycemia? What does this mean and how would it impact your treatment plan for this patient?

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NRNP 6541 MIDTERM EXAM 1
– QUESTION AND ANSWERS

Test Week 6 - Midterm
Exam
Started 7/12/20 6:29 PM
Submitted 7/12/20 7:24 PM
Due Date 7/13/20 1:59 AM
Status Completed
Attempt Score 96 out of 100 points
Time Elapsed 54 minutes out of 3
hours and 20
minutes
Results Displayed Submitted Answers
• Question 1
0 out of 0 points
When completing this quiz, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?


Selected Ye
Answer: s

• Question 2
1 out of 1 points
Which of the following statements regarding adolescent substance use is true?


Selected a.
Answer: Tobacco is the most commonly abused substance
during adolescence.

• Question 3
1 out of 1 points
You see a 4-year-old for a well-child visit. He has received four diphtheria,
tetanus, and acellular pertussis vaccines (DTaP); three injected polio
vaccines (IPV); one measles, mumps, and rubella vaccine (MMR); one
varicella vaccine; and two hepatitis B (Hep B) vaccines. What do you
order today?
Selected
d.
Answer: DTaP, IPV, MMR, and
Varivax

• Question 4
1 out of 1 points

, The parents of a 7-year-old are concerned their son does not want to attend school.
Which of the historical findings are not usually associated with the diagnosis of school
phobia?

Selected
c.
Answer: Chronic medical
illness

• Question 5
1 out of 1 points
Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action
is contraindicated?


Selected b.
Answer: Flushing the ear with
water.

• Question 6
1 out of 1 points
You see a 7-year-old with complaints of "having accidents at night." Physical exam and
history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His
parents ask about the best treatment for this problem. The best response is


Selected c.
Answer: Fluid restriction and voiding prior to the night may
be effective.

• Question 7
1 out of 1 points
You are doing a kindergarten physical on a 5-year-old girl. Which of the following
scenarios would suggest the child is not ready to start kindergarten in the fall?


Selected d.
Answer: Counts to 4 and draws a person
with three parts.

• Question 8
1 out of 1 points
Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots.
What do you suspect?


Selected c.
Answer: Down
syndrome

• Question 9
1 out of 1 points
I like to use my pincer grasp that involves the ablitily to pick up a small object
such as a raisin or piece of cereal with the thumb and forefinger, and that is
mastered around what age?

, Selected b.
Answer: 9
month
s

• Question 10
1 out of 1 points
Mark, a 10-year-old, has a lot of ear pain. He does not want anyone to touch it and is
crying in pain. The ear canal is swollen and exudate is preswent. The TM is normal. What
is the proper management for his patient?


Selected b.
Answer: Topical
Fluoroquiolone

• Question 11
1 out of 1 points
The diagnostic criteria for autism spectrum disorder include all of the following except

Selected
d.
Answer: Tolerance of flexibility with
routines

• Question 12
1 out of 1 points
Luke, a 17-month-old, failed treatment with amoxicillin for otitis media.
At the two- week recheck, his TM was still erythematous and you cannot
see the landmarks. He has persistent nasal congestion, he is not sleeping
at night, and he has a 101°F fever. What is the next best step for Luke?
Selected
d.
Answer: A 10 day course
of Augmentin

• Question 13
1 out of 1 points
Which of the following would not suggest an eating disorder with a purging component?

Selected
d.
Answer: Diarrh
ea

• Question 14
1 out of 1 points
Role-play with equipment during the course of the physical exam would be the
most beneficial with which age group?
Selected
d.
Answer: Preschool
ers

• Question 15

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