Latest Update NU 448-Adult Health III Final exam Questions and 100% Correct solutions

Latest Update NU 448 -Adult Health III Final exam Questions and 100% Correct solutions 1. A patient presents with liver injury due to history of Tylenol misuse. On arrival the patient is unconscious. After giving him 3 liters of IV fluids, the nurse did an assessment. The findings were bilateral 2+ pedal edema, BP 160/90, HR 115. What would be the priority assessment the nurse should do next? Assess lung sounds 2. After intervention and stopping fluids and giving a small dose of Lasix, the patient became a little responsive. ABG labs results came back, the results are as follows: pH 7.28, PaCO2 38, PAO2 89, HCO3 17. Is there a sign of acid base imbalance in these values? Yes What type of acid base imbalance would this be? Metabolic Acidosis 3. A COPD patient is admitted with hypoxemia due to V/Q mismatch. The nurse is anticipating the delivery system that will be used to provide oxygen. What type of oxygen flow would you provide for this patient? low levels of oxygen either via nasal cannula or using a face mask at 24% to 32% oxygen. 4. A trauma patient who has acute heart failure has not gotten out of bed and has not being using his incentive spirometry became very restless. Vital signs reveals signs of decrease cardiac output (low BP, bradycardic with thready pulse). A chest X -ray reveals pneumonia. What would be the priority intervention for this patient? intubate 5. What medication prescribed for this patient would you want to clarify? Azithromycin (due to pt’s heart condition) 6. The patient is found to have fluids in the lungs due to bronchiectasis and requires postural drainage 3X daily. What would be some essential teaching essential teaching necessary for this patient about postural drainage? Three hours after meals to allow food to digest - to prevent aspiration, use of pillows to position client, give bronchodilator (albuterol) before procedure, percuss over a towel (or a pillow case) to ensure it does not feel uncomfortable 7. A patient presents to the ED with complaints of the heart feeling fluttering. The MD orders for the patient to be placed on telemetry. Looking at the strip, how would you calculate the HR? Count up the QRS complex and multiply by 10 (for 6 second strips) 8. the patient is diagnosed with atrial flutter. What are the clinical manifestations the patient would present with? It is associated with CAD, hypertension , mitral valve disorders, pulmonary embolism, chronic lung disease, cor pulmonale, cardiomyopathy, hyperthyroidism, and the use of drugs such as digoxin, quinidine, and epinephrine (page 765) 9. Where on the body should the electrodes be placed? Upper leads (white & black) on clavicle line, lower leads (green & red) right below rib cage, and brown lead on the right of sternum 10. A patient comes in complaining of epigastric pain, lower back pain. On examination the nurse finds a feeling of an abdominal pulsatile mass. Assessing the BP she hears a systolic bruit. What would be the expected diagnosis? Abdominal Aortic Aneurysm 11. After having an abdominal xray the patient is diagnosed with AAA. The nurse turns the patient to assess the skin and finds ecchymosis on the back. What would be the priority action? Obtain informed consent for emergency surgery 12. In preparing the patient for surgery, he was asked why does he have to have an open abdominal repair vs an endovascular graft (EVAR) procedure. What should be the response? EVAR requires adequate vessel supplies to the graft and because the pt’s aneurysm has been ruptured, he has to have open abdominal repair 13. Aneurysm often goes undetected until they dissect. Who is a high risk for a aortic dissection? Pts with Turner syndrome, high blood pressure, heart problems, Marfan syndrome 14. A nurse is teaching a patient at risk for peripheral artery disease. What preventative measure should the nurse teach the patient? Maintain ideal weight, prevent injury to extremities, walk daily, avoid standing for long periods 15. A patient who was diagnosed with MI develops constipation from the medication for pain management. What should the nurse teach the patient regarding constipation? Avoid straining when passing stool 16. The patient with MI is being treated for constipation with Polyethylene glycol (Macrogol, PEG). What should the nurse monitor for that could be a harmful effect on the patient? Diarrhea → electrolyte imbalance → dysrhythmia (monitor heart rhythm) 17. A patient is diagnosed with atrial fibrillation and was discharged on digoxin 4 days ago. The family brought the patient to the ED very lethargic with complains of vomiting and diarrhea. The patient is placed on the monitor, the HR is 50. A digoxin level reveal 2.4 mg/ml. What should the nurse do? Hold the prescribed digoxin 18. A patient in a motor vehicle accident was admitted to the ICU with multiple fractures. She has fracture to rib 3 through 5 and they are fracture in more than one part. What type of chest injury would this be? Flail chest 19. the patient is diagnosed with flail chest. What would be priority management for this patient? Clear airway of secretions 20. There is no visual blood loss but internal blood loss is suspected what assessment findings would be priority? Low BP, bruising, rapid pulse, slow capillary refill 21. A patient has been brought to the ED after falling in an ice pond. What monitoring is necessary while the patient is being re-warm? EKG monitoring