NURS 271 EXAM #1 QUESTIONS WITH COMPLETE
SOLUTIONS
*ABG practice problems*
*ACID-BASE IMBALANCES*
*DIABETES*
*Electrolyte Balance*
*FLUID & ELECTROLYTE IMBALANCES*
*Fluid Balance* Correct Answer = when fluid intake is equal
to fluid output
*our bodies work best when fluids & electrolytes are in the
normal range/balance!
*INTEGUMENTARY SYSTEM DISORDERS* Correct
Answer
*NEUROLOGICAL CONDITIONS* Correct Answer
1. Mr. Cowell is admitted to the hospital. He is a kidney dialysis
patient who has missed his last two appointments at the dialysis
center...
pH 7.32, PaCO2 32, HCO3- 18 Correct Answer metabolic
acidosis w partial compensation
2. Mrs. Ahmad is a patient with chronic COPD being admitted
for surgery.
pH 7.35, PaCO2 48, HCO3- 28 Correct Answer respiratory
acidosis w full compensation
,3. Mr. Lone Mountain is a trauma patient with an altered mental
status.
pH 7.33, PaCO2 62, HCO3- 35 Correct Answer respiratory
acidosis w partial compensation
4. Mrs. Lee is a 54-year-old female admitted for a bowel
obstruction. She had been experiencing nausea and vomiting. An
NG tube has been in place for the last 24 hours.
pH 7.43, PaCO2 48, HCO3- 36 Correct Answer metabolic
alkalosis w full compensation
AEDs: Carbamazepine (Tegretol) Correct Answer >
Indication = Partial & General Seizure tx
> MOA = interfere w Na+ movement across the cell membrane
> inactivate/close sodium channels for long periods of time >
decr neuron firing freq
- any seizure dependent on high freq discharge is depressed
> AEs = drowsiness & dizziness, ataxia (inability to coordinate
muscle movement), & nystagmus (rapid involuntary movement
of the eyeball)
> Price = expensive ($300-400/dose)
AEDs: Ethosuximide (Zarontin) Correct Answer > Indication
= drug of choice only for absence seizures!
> PK = administered PO, metabolized by the liver, & excreted
by the kidneys
> MOA = suppresses neurons in the thalamus & decr neuron
firing > stabilizes brain nerve activity
AEDs: List some of the drugs classified as barbiturates. Correct
Answer ex: Phenobarbital (Lumina) & Primidone
,= decr excitability & hyperexcitability to stimulation
> MOA = inhibit impulse conduction in the RAS, depresses the
cerebral cortex, alters cerebellar function, & depresses motor
nerve output
> Indication = hypnotic, sleep inducing, seizure control
(combination tx)
> Routes = PO & IV
> AEs = CNS depression, cardiac arrhythmias, urinary retention,
loss of libido *risk for sedation & coma
> Contraindications = alcohol intake, pregnant/lactating women,
older age, impaired liver/renal function, severe CV problems!
AEDs: List some of the drugs classified as benzodiazepines.
Correct Answer ex: Clobazam, Clonazepam, Diazepam, &
Lorazepam (Ativan)
= decr excitability & hyperexcitability to stimulation
> MOA = potentiate effects of GABA > stabilized nerve
membranes in the CNS
> Indication = long acting anticonvulsant
> Routes = PO, rectal, IV
> AEs = CNS depression, cardiac arrhythmias, urinary retention,
loss of libido, physical dependence/withdrawal
> Contraindications = alcohol intake, pregnant/lactating women,
older age, impaired liver/renal function, severe CV problems!
AEDS: Phenytoin (Dilantin) Correct Answer > Indication =
oldest, non-sedating drug for seizure tx *first-line drug!
- can be administered post seizure for longer term control
> MOA = interfere w Na+ movement across the cell membrane
> inactivate/close sodium channels for long periods of time >
decr neuron firing freq
, - any seizure dependent on high freq discharge is depressed
> AEs = ataxia (inability to coordinate muscle movement),
nystagmus (rapid involuntary movement of the eyeball), &
gingival hyperplasia (excessive gum tissue growth)
> Price = cheaper ($27/month)
AEDs: Valproic Acid (Depakene) Correct Answer >
Indication = all seizure tx!
> MOA...
1) interfere w Na+ movement across the cell membrane >
inactivate/close sodium channels for long periods of time > decr
neuron firing freq
2) suppresses T-type calcium channels AND incr influence of
GABA (neurotransmitter widely spread throughout the brain) >
decr neuronal activity & prevents overfiring of neurons
> AEs = drowsiness & dizziness , hepatotoxic (baseline &
continuous liver enzymes required!)
> Contraindication = liver disorder/failure & pregnant pts
> Price = expensive ($300-400/dose)
Compare rapid, short, intermediate, & long acting. Correct
Answer 1) rapid acting insulin = 5-15 min onset, 30-60 min
peak, 2-5 hr duration
ex: aspart, lispro, glulisine
> injected at the start of the meal
2) regular insulin (aka short acting) = 30 min onset, 1-3 hr peak,
4-8 hr duration
ex: R (clear solution)
> injected 15-30 mins before meal
SOLUTIONS
*ABG practice problems*
*ACID-BASE IMBALANCES*
*DIABETES*
*Electrolyte Balance*
*FLUID & ELECTROLYTE IMBALANCES*
*Fluid Balance* Correct Answer = when fluid intake is equal
to fluid output
*our bodies work best when fluids & electrolytes are in the
normal range/balance!
*INTEGUMENTARY SYSTEM DISORDERS* Correct
Answer
*NEUROLOGICAL CONDITIONS* Correct Answer
1. Mr. Cowell is admitted to the hospital. He is a kidney dialysis
patient who has missed his last two appointments at the dialysis
center...
pH 7.32, PaCO2 32, HCO3- 18 Correct Answer metabolic
acidosis w partial compensation
2. Mrs. Ahmad is a patient with chronic COPD being admitted
for surgery.
pH 7.35, PaCO2 48, HCO3- 28 Correct Answer respiratory
acidosis w full compensation
,3. Mr. Lone Mountain is a trauma patient with an altered mental
status.
pH 7.33, PaCO2 62, HCO3- 35 Correct Answer respiratory
acidosis w partial compensation
4. Mrs. Lee is a 54-year-old female admitted for a bowel
obstruction. She had been experiencing nausea and vomiting. An
NG tube has been in place for the last 24 hours.
pH 7.43, PaCO2 48, HCO3- 36 Correct Answer metabolic
alkalosis w full compensation
AEDs: Carbamazepine (Tegretol) Correct Answer >
Indication = Partial & General Seizure tx
> MOA = interfere w Na+ movement across the cell membrane
> inactivate/close sodium channels for long periods of time >
decr neuron firing freq
- any seizure dependent on high freq discharge is depressed
> AEs = drowsiness & dizziness, ataxia (inability to coordinate
muscle movement), & nystagmus (rapid involuntary movement
of the eyeball)
> Price = expensive ($300-400/dose)
AEDs: Ethosuximide (Zarontin) Correct Answer > Indication
= drug of choice only for absence seizures!
> PK = administered PO, metabolized by the liver, & excreted
by the kidneys
> MOA = suppresses neurons in the thalamus & decr neuron
firing > stabilizes brain nerve activity
AEDs: List some of the drugs classified as barbiturates. Correct
Answer ex: Phenobarbital (Lumina) & Primidone
,= decr excitability & hyperexcitability to stimulation
> MOA = inhibit impulse conduction in the RAS, depresses the
cerebral cortex, alters cerebellar function, & depresses motor
nerve output
> Indication = hypnotic, sleep inducing, seizure control
(combination tx)
> Routes = PO & IV
> AEs = CNS depression, cardiac arrhythmias, urinary retention,
loss of libido *risk for sedation & coma
> Contraindications = alcohol intake, pregnant/lactating women,
older age, impaired liver/renal function, severe CV problems!
AEDs: List some of the drugs classified as benzodiazepines.
Correct Answer ex: Clobazam, Clonazepam, Diazepam, &
Lorazepam (Ativan)
= decr excitability & hyperexcitability to stimulation
> MOA = potentiate effects of GABA > stabilized nerve
membranes in the CNS
> Indication = long acting anticonvulsant
> Routes = PO, rectal, IV
> AEs = CNS depression, cardiac arrhythmias, urinary retention,
loss of libido, physical dependence/withdrawal
> Contraindications = alcohol intake, pregnant/lactating women,
older age, impaired liver/renal function, severe CV problems!
AEDS: Phenytoin (Dilantin) Correct Answer > Indication =
oldest, non-sedating drug for seizure tx *first-line drug!
- can be administered post seizure for longer term control
> MOA = interfere w Na+ movement across the cell membrane
> inactivate/close sodium channels for long periods of time >
decr neuron firing freq
, - any seizure dependent on high freq discharge is depressed
> AEs = ataxia (inability to coordinate muscle movement),
nystagmus (rapid involuntary movement of the eyeball), &
gingival hyperplasia (excessive gum tissue growth)
> Price = cheaper ($27/month)
AEDs: Valproic Acid (Depakene) Correct Answer >
Indication = all seizure tx!
> MOA...
1) interfere w Na+ movement across the cell membrane >
inactivate/close sodium channels for long periods of time > decr
neuron firing freq
2) suppresses T-type calcium channels AND incr influence of
GABA (neurotransmitter widely spread throughout the brain) >
decr neuronal activity & prevents overfiring of neurons
> AEs = drowsiness & dizziness , hepatotoxic (baseline &
continuous liver enzymes required!)
> Contraindication = liver disorder/failure & pregnant pts
> Price = expensive ($300-400/dose)
Compare rapid, short, intermediate, & long acting. Correct
Answer 1) rapid acting insulin = 5-15 min onset, 30-60 min
peak, 2-5 hr duration
ex: aspart, lispro, glulisine
> injected at the start of the meal
2) regular insulin (aka short acting) = 30 min onset, 1-3 hr peak,
4-8 hr duration
ex: R (clear solution)
> injected 15-30 mins before meal
