NURS 2003 Exam
80% of heart failure cases are caused by what three things? - correct answer--ischemic
heart disease
-chronic hypertension
-myocardial infarction
Anuria - correct answer-100ml or less in a 24 hour period
Asthma - correct answer-hyper-responsive inflammatory disorder of the airway
Asthma diagnostics - correct answer--spirometry test
-peak expiratory flow rate measurement
-chest x-ray
-ABGs
-oximetry (O2 sat)
-allergy testing
-blood levels of eosinophils
-sputum culture and sensitivity (need for antibiotic)
Can DKA happen with DM2? - correct answer-Yes!
-rarely (more commonly HHS)
-if severe stress, illness, infection and pancreas can't keep up
Causes of cirrhosis - correct answer--hepatitis
-chronic alcohol abuse (most common)
-fatty liver disease (high fat diet)
-primary biliary cirrhosis
-primary sclerosing cholangitis
-cardiac cirrhosis (blood backing up from heart into body tissues such as the liver and
depriving of oxygen; secondary to right-sided heart failure)
Causes of GERD - correct answer--weakness of lower esophageal sphincter when laying
down
-decreased esophageal clearance secondary to delayed esophageal motility and gastric
emptying
-increase HCl production
Causes of hypothyroidism - correct answer-Primary: (insufficient T3 & T4 due to thyroid
atrophy)
-hashimotos disease
Secondary: (poor hypothalamus or anterior pituitary function)
-decreased TRH or TSH secretion
-effect of treating grave's disease (hyperthroidism) w/ iodine
-rebound hypothyroidism from discontinuing T3/T4 treatment
,Causes of MS - correct answer-Genetics:
-1 in 8 patients has family history
-human leukocyte antigen gene
-women
-30+
Geography:
-further distance from equator (less vitamine D from sunlight)
Infection:
-epsteine-barr virus
-herpes simplex VI
Chronic bronchitis - correct answer-Mucus gland hyperplasia by goblet cells and structural
airway changes (diagnosed clinically and is reversible)
Chronic bronchitis and emphysema - correct answer-Together called COPD
chronic obstructive pulmonary disease (COPD) - correct answer-characterized by:
1) progressive airflow obstruction from mucus, edema, and bronchospasms
2) systemic manifestations
3) exacerbations of increasing frequency and severity
Clinical examinations for PUD - correct answer--vitals (low BP = hemorrhage, shallow resps/
low O2 = pain, high temp = peritinitis)
-abdominal assessment (bloating, distension, peristalsis)
-conjunctival pallor (anemia)
-epigastric pain/tenderness
-positive Guaiac stool test (blood loss)
-Melena (black or maroon stool from GI bleed, old blood)
-Peritoneal signs (abdominal guarding, tenderness, rigidity)
Clinical manifestations of Crohn's disease - correct answer--diarrhea (usually not bloody
unless severe)
-abdominal pain in areas of inflammation
-arthritis, clubbing, uveitis, increased peristalsis, kidney stones
Clinical manifestations of ulcerative colitis - correct answer--lower abdominal pain
-bloody diarrhea (up to 20+ per day if severe)
-incomplete evacuation
-always feeling the need to evacuate
-fever, malaise, anorexia, bloating with severity
-significant weight loss and dehydration if severe
Collaborative care for asthma - correct answer--action plan
-reducing exposure to triggers
-medications (bronchodilators)
, -patient education
-self-management
Complicated UTI - correct answer-Present when underlying factors such as catheterization
or obstruction predispose to ascending bacterial infection
Complication of hypothyroidism - correct answer-Myxedema coma (medical emergency)
-severe hypothyroidism
-greatly impaired neurological function
-extremely slow movement and registering of stimuli
-puffy eyes (periorbital edema)
-pretibial edema
-tongue out
-requires very slow intravenous replacement to prevent coma
Complications of cirrhosis - correct answer-Hepatic encephalopathy:
-metabolized protein = ammonia
-liver cannot convert ammonia to urea
-accumulation of ammonia in vascular system
-can cross blood-brain barrier & cause major neurological changes
-emotional highs and lows (irritation)
-memory loss, confusion, non-oriented
-yawning, drowsiness, insomnia
-slurred speech
-flapping tremors (asterixis)
-fetor hepaticus
-coma in severe cases
-no protein diet & lactulose to rid ammonia
Portal hypertension:
-scar tissue blocks blood that is being delivered
-increases portal pressure, volume, and lymphatic flow
-backs up into mesenteric veins, rectal veins, splenic veins
-causes caput medusae, umbelical hernia, and hemorrhoids
-causes splenomegaly
-spleen destroys RBCs (anemia), platelets, WBCs (leukopenia)
-formation of collateral circulation
-esophageal varicies from back up in esophagus
Hyperbilirubinaemia:
-unconjugated bilirubin comes from breakdown of RBCs
-unconjugated bilirubin needs to bind to albumin
-no albumin means no entry into liver
-high levels of unconjugated bilirubin remain in blood
-causes yellow colour
Hyperestrogenemia:
-gynacomastia
80% of heart failure cases are caused by what three things? - correct answer--ischemic
heart disease
-chronic hypertension
-myocardial infarction
Anuria - correct answer-100ml or less in a 24 hour period
Asthma - correct answer-hyper-responsive inflammatory disorder of the airway
Asthma diagnostics - correct answer--spirometry test
-peak expiratory flow rate measurement
-chest x-ray
-ABGs
-oximetry (O2 sat)
-allergy testing
-blood levels of eosinophils
-sputum culture and sensitivity (need for antibiotic)
Can DKA happen with DM2? - correct answer-Yes!
-rarely (more commonly HHS)
-if severe stress, illness, infection and pancreas can't keep up
Causes of cirrhosis - correct answer--hepatitis
-chronic alcohol abuse (most common)
-fatty liver disease (high fat diet)
-primary biliary cirrhosis
-primary sclerosing cholangitis
-cardiac cirrhosis (blood backing up from heart into body tissues such as the liver and
depriving of oxygen; secondary to right-sided heart failure)
Causes of GERD - correct answer--weakness of lower esophageal sphincter when laying
down
-decreased esophageal clearance secondary to delayed esophageal motility and gastric
emptying
-increase HCl production
Causes of hypothyroidism - correct answer-Primary: (insufficient T3 & T4 due to thyroid
atrophy)
-hashimotos disease
Secondary: (poor hypothalamus or anterior pituitary function)
-decreased TRH or TSH secretion
-effect of treating grave's disease (hyperthroidism) w/ iodine
-rebound hypothyroidism from discontinuing T3/T4 treatment
,Causes of MS - correct answer-Genetics:
-1 in 8 patients has family history
-human leukocyte antigen gene
-women
-30+
Geography:
-further distance from equator (less vitamine D from sunlight)
Infection:
-epsteine-barr virus
-herpes simplex VI
Chronic bronchitis - correct answer-Mucus gland hyperplasia by goblet cells and structural
airway changes (diagnosed clinically and is reversible)
Chronic bronchitis and emphysema - correct answer-Together called COPD
chronic obstructive pulmonary disease (COPD) - correct answer-characterized by:
1) progressive airflow obstruction from mucus, edema, and bronchospasms
2) systemic manifestations
3) exacerbations of increasing frequency and severity
Clinical examinations for PUD - correct answer--vitals (low BP = hemorrhage, shallow resps/
low O2 = pain, high temp = peritinitis)
-abdominal assessment (bloating, distension, peristalsis)
-conjunctival pallor (anemia)
-epigastric pain/tenderness
-positive Guaiac stool test (blood loss)
-Melena (black or maroon stool from GI bleed, old blood)
-Peritoneal signs (abdominal guarding, tenderness, rigidity)
Clinical manifestations of Crohn's disease - correct answer--diarrhea (usually not bloody
unless severe)
-abdominal pain in areas of inflammation
-arthritis, clubbing, uveitis, increased peristalsis, kidney stones
Clinical manifestations of ulcerative colitis - correct answer--lower abdominal pain
-bloody diarrhea (up to 20+ per day if severe)
-incomplete evacuation
-always feeling the need to evacuate
-fever, malaise, anorexia, bloating with severity
-significant weight loss and dehydration if severe
Collaborative care for asthma - correct answer--action plan
-reducing exposure to triggers
-medications (bronchodilators)
, -patient education
-self-management
Complicated UTI - correct answer-Present when underlying factors such as catheterization
or obstruction predispose to ascending bacterial infection
Complication of hypothyroidism - correct answer-Myxedema coma (medical emergency)
-severe hypothyroidism
-greatly impaired neurological function
-extremely slow movement and registering of stimuli
-puffy eyes (periorbital edema)
-pretibial edema
-tongue out
-requires very slow intravenous replacement to prevent coma
Complications of cirrhosis - correct answer-Hepatic encephalopathy:
-metabolized protein = ammonia
-liver cannot convert ammonia to urea
-accumulation of ammonia in vascular system
-can cross blood-brain barrier & cause major neurological changes
-emotional highs and lows (irritation)
-memory loss, confusion, non-oriented
-yawning, drowsiness, insomnia
-slurred speech
-flapping tremors (asterixis)
-fetor hepaticus
-coma in severe cases
-no protein diet & lactulose to rid ammonia
Portal hypertension:
-scar tissue blocks blood that is being delivered
-increases portal pressure, volume, and lymphatic flow
-backs up into mesenteric veins, rectal veins, splenic veins
-causes caput medusae, umbelical hernia, and hemorrhoids
-causes splenomegaly
-spleen destroys RBCs (anemia), platelets, WBCs (leukopenia)
-formation of collateral circulation
-esophageal varicies from back up in esophagus
Hyperbilirubinaemia:
-unconjugated bilirubin comes from breakdown of RBCs
-unconjugated bilirubin needs to bind to albumin
-no albumin means no entry into liver
-high levels of unconjugated bilirubin remain in blood
-causes yellow colour
Hyperestrogenemia:
-gynacomastia
