FINAL EXAM O&A: AND SPRING 2023 (MOD A) WITH CORRECT QUESTION AND
ANSWERS (GRADED A+
A 24 year old Asthmatic patient arrive to ER with Dyspnea. BP 136/94: HR 122: RR 32 O2 sat is
88% on RA: T 100.1F. The patient's skin is cool and clammy. Lung sounds are wheezing.
(Whistling wheeze) The patient is alert and oriented x3. Two word dyspnea. The patient reports
history of asthma since age 14. Denies other history. What should be the nurse's first action?
A. Apply O2 at 4L per NC.
B. Administer a bronchodilator
C. Ask the patient about known allergies.
D. Gain IV access - answer- A
A 24 year old Asthmatic patient arrive to ER with Dyspnea. BP 136/94: HR 122: RR 32 O2 sat is
88% on RA: T 100.1F. The patient's skin is cool and clammy. Lung sounds are wheezing.
(Whistling wheeze) The patient is alert and oriented x3. Two word dyspnea. The patient reports
history of asthma since age 14. Denies other history. What medication should the nurse prepare
to administer?
A. Metoprolol 50mg PO
B. Epinephrine 0.3mg subcutaneous
C. Acetaminophen 650mg Po
D. Albuterol unit dose by HHN - answer- D
The patient above has the following ABG results. pH 7.33: PaO2 80: PaCO2 47: HCO3 23: O2
saturation of 94% on 100% O2. The patient is receiving a HHN with 100% o2 administration.
What is the correct ABG interpretation? Decreased ventilation
A. This is a normal ABG
B. Uncompensated respiratory acidosis
C. Uncompensated respiratory alkylosis
,D. No answer text provided.
E. Partially compensated respitatory acidosis - answer- B
After 15 minutes in the ER the patient about to receiving the second consecutive unit dose of
Albuterol. RR is 24 and labored with audible wheezing. O2 sat 94% on 100% O2 with the HHN.
The patient has growing anxiety. HR is 108. Complains if feeling a little anxious. What would be
an appropriate med adjustment?
A. Discontinue the Albuterol
B. Obtain a chest X-ray
C. Change to Ipratropium/albuterol (duoneb)
D. Increase the Albuterol - answer- C
On Christmas day at 10:30am a patient arrives to the ER with sinus bradycardia at 44bpm. The
patient opens eyes to sound of his name. Patient is orient to person only. States he is in his
basement when asked where he is. States it is night and summertime. The patient does follow
commands. Bilateral Week handgrips and is unable to raise legs off the bed. EMS has
immediately started O2 and gained IV access. What medication should be administered to this
patient?
A. Atenolol
B. Epinephrine
C. Captopril
D. Atropine - answer- D
The nurse is caring for a patient who is exhibiting signs and symptoms of hypovolemic shock
following injuries suffered in a motor vehicle accident. The nurse anticipates that the physician
will promptly order the administration of a crystalloid IV solution to restore intravascular volume.
In addition to normal saline, which crystalloid fluid is commonly used to treat hypovolemic
shock?
A. Lactated Ringers
B. Albumin
C. Dextran
,D. 3% NaCl - answer- A.
A nurse is evaluating a client who is being treated for dehydration. Which assessment result
should the nurse correlate with a therapeutic response to the treatment plan?
a. Increased respiratory rate from 12 breaths/min to 22 breaths/min
b. Decreased skin turgor on the client's posterior hand and forehead
c. Increased urine specific gravity from 1.012 to 1.030 g/mL
d. Decreased orthostatic light-headedness and dizziness - answer- D
A nurse is assessing clients for fluid and electrolyte imbalances. Which client should the nurse
assess first for potential hyponatremia?a.
A 34-year-old on NPO status who is receiving intravenous D5W
B. A 50-year-old with an infection who is prescribed a sulfonamide antibiotic
C. A 67-year-old who is experiencing pain and is prescribed ibuprofen (Motrin)
D. A 73-year-old with tachycardia who is receiving digoxin (Lanoxin) - answer- A
In addition to osmosis, what force is involved in the movement of water between the plasma and
interstitial fluid spaces?
A. Active Tranport
B. Diffusion
C. Facilitated Diffusion
D. Hydrostatic Pressure - answer- D
What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and
coma in hypernatremia?
A.High sodium in the blood vessels pulls water out of the brain cells into the blood vessels,
causing brain cells to shrink.
, B.High sodium in the brain cells pulls water out of the blood vessels into the braincells, causing
them to swell.
C.High sodium in the blood vessels pulls potassium out of the brain cells, whichslows the
synapses in the brain.
D.High sodium in the blood vessels draws chloride into the brain cells followed bywater, causing
the brain cells to swell - answer- A
A 68-year-old woman has chronic kidney disease and a history of type 2 diabetes. Two weeks
ago, she had surgery to place a vascular graft access for hemodialysis.Which precaution will the
nurse follow to ensure the function of the AV graft?
A. Insert an IV and run saline at 10 mL/hr.
B. Keep the patient's arm elevated on two pillows.
C. Monitor blood pressure and radial pulses in both arms.
D. Check for a bruit and thrill by auscultation and palpation over the site. - answer- C
The nurse is assessing a client who received a new medication prescription for Lisinopril one
week ago. What findings by the nurse would require emergency intervention? (Select all that
apply)
A. Swelling of tongue
B. Light headed when rise from bed
C. Changes in T waveon ECG
D. Potasium level of 5.3
E. Calcium level 9.2 - answer- A,C,D
A client with a decreased glomerular filtration rate asks how to prevent further damage to the
kidneys. Which is the nurse's best response?
A. THe diuretics you are taking will prevent further damage
B. Avoid high calcium food and calcium antacid
ANSWERS (GRADED A+
A 24 year old Asthmatic patient arrive to ER with Dyspnea. BP 136/94: HR 122: RR 32 O2 sat is
88% on RA: T 100.1F. The patient's skin is cool and clammy. Lung sounds are wheezing.
(Whistling wheeze) The patient is alert and oriented x3. Two word dyspnea. The patient reports
history of asthma since age 14. Denies other history. What should be the nurse's first action?
A. Apply O2 at 4L per NC.
B. Administer a bronchodilator
C. Ask the patient about known allergies.
D. Gain IV access - answer- A
A 24 year old Asthmatic patient arrive to ER with Dyspnea. BP 136/94: HR 122: RR 32 O2 sat is
88% on RA: T 100.1F. The patient's skin is cool and clammy. Lung sounds are wheezing.
(Whistling wheeze) The patient is alert and oriented x3. Two word dyspnea. The patient reports
history of asthma since age 14. Denies other history. What medication should the nurse prepare
to administer?
A. Metoprolol 50mg PO
B. Epinephrine 0.3mg subcutaneous
C. Acetaminophen 650mg Po
D. Albuterol unit dose by HHN - answer- D
The patient above has the following ABG results. pH 7.33: PaO2 80: PaCO2 47: HCO3 23: O2
saturation of 94% on 100% O2. The patient is receiving a HHN with 100% o2 administration.
What is the correct ABG interpretation? Decreased ventilation
A. This is a normal ABG
B. Uncompensated respiratory acidosis
C. Uncompensated respiratory alkylosis
,D. No answer text provided.
E. Partially compensated respitatory acidosis - answer- B
After 15 minutes in the ER the patient about to receiving the second consecutive unit dose of
Albuterol. RR is 24 and labored with audible wheezing. O2 sat 94% on 100% O2 with the HHN.
The patient has growing anxiety. HR is 108. Complains if feeling a little anxious. What would be
an appropriate med adjustment?
A. Discontinue the Albuterol
B. Obtain a chest X-ray
C. Change to Ipratropium/albuterol (duoneb)
D. Increase the Albuterol - answer- C
On Christmas day at 10:30am a patient arrives to the ER with sinus bradycardia at 44bpm. The
patient opens eyes to sound of his name. Patient is orient to person only. States he is in his
basement when asked where he is. States it is night and summertime. The patient does follow
commands. Bilateral Week handgrips and is unable to raise legs off the bed. EMS has
immediately started O2 and gained IV access. What medication should be administered to this
patient?
A. Atenolol
B. Epinephrine
C. Captopril
D. Atropine - answer- D
The nurse is caring for a patient who is exhibiting signs and symptoms of hypovolemic shock
following injuries suffered in a motor vehicle accident. The nurse anticipates that the physician
will promptly order the administration of a crystalloid IV solution to restore intravascular volume.
In addition to normal saline, which crystalloid fluid is commonly used to treat hypovolemic
shock?
A. Lactated Ringers
B. Albumin
C. Dextran
,D. 3% NaCl - answer- A.
A nurse is evaluating a client who is being treated for dehydration. Which assessment result
should the nurse correlate with a therapeutic response to the treatment plan?
a. Increased respiratory rate from 12 breaths/min to 22 breaths/min
b. Decreased skin turgor on the client's posterior hand and forehead
c. Increased urine specific gravity from 1.012 to 1.030 g/mL
d. Decreased orthostatic light-headedness and dizziness - answer- D
A nurse is assessing clients for fluid and electrolyte imbalances. Which client should the nurse
assess first for potential hyponatremia?a.
A 34-year-old on NPO status who is receiving intravenous D5W
B. A 50-year-old with an infection who is prescribed a sulfonamide antibiotic
C. A 67-year-old who is experiencing pain and is prescribed ibuprofen (Motrin)
D. A 73-year-old with tachycardia who is receiving digoxin (Lanoxin) - answer- A
In addition to osmosis, what force is involved in the movement of water between the plasma and
interstitial fluid spaces?
A. Active Tranport
B. Diffusion
C. Facilitated Diffusion
D. Hydrostatic Pressure - answer- D
What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and
coma in hypernatremia?
A.High sodium in the blood vessels pulls water out of the brain cells into the blood vessels,
causing brain cells to shrink.
, B.High sodium in the brain cells pulls water out of the blood vessels into the braincells, causing
them to swell.
C.High sodium in the blood vessels pulls potassium out of the brain cells, whichslows the
synapses in the brain.
D.High sodium in the blood vessels draws chloride into the brain cells followed bywater, causing
the brain cells to swell - answer- A
A 68-year-old woman has chronic kidney disease and a history of type 2 diabetes. Two weeks
ago, she had surgery to place a vascular graft access for hemodialysis.Which precaution will the
nurse follow to ensure the function of the AV graft?
A. Insert an IV and run saline at 10 mL/hr.
B. Keep the patient's arm elevated on two pillows.
C. Monitor blood pressure and radial pulses in both arms.
D. Check for a bruit and thrill by auscultation and palpation over the site. - answer- C
The nurse is assessing a client who received a new medication prescription for Lisinopril one
week ago. What findings by the nurse would require emergency intervention? (Select all that
apply)
A. Swelling of tongue
B. Light headed when rise from bed
C. Changes in T waveon ECG
D. Potasium level of 5.3
E. Calcium level 9.2 - answer- A,C,D
A client with a decreased glomerular filtration rate asks how to prevent further damage to the
kidneys. Which is the nurse's best response?
A. THe diuretics you are taking will prevent further damage
B. Avoid high calcium food and calcium antacid
