NRSG 265 medical Questions With Complete Solutions
2 Systems that attempt to balance each other to maintain acid
base balance Correct Answer Kidneys and lungs
6 steps to ABG analysis Correct Answer 1. Analyse pH2.
Analyse PaCO23. Analyse HCo34. Match the PaCO2 or HCO3
with the pH5. Does the PaCO2 or HCO2 go in the opposite
direction of the pH? (if yes there is compensation by that
system)6. Analyse PaO2 and SaO2
A 27-year-old male has a severe kidney obstruction leading to
removal of the affected kidney. Which of the following would
the nurse expect to occur in the weeks following removal of the
affected kidney? Correct Answer Compensatory function of
the remaining kidney
A patient who is critically unwell is at risk of developing which
of the following complications? A. Hypokalaemia B.
Hyperkalaemia C. Hypoglycaemia D. Hyperglycaemia Correct
Answer D - this is due to the increased stress response leading
to cortisol release, glucose etc → increases BGL
Acetylsalicylic Acid (Aspirin) is acts to Correct Answer
prevents platelet aggregation thus reducing formation of new
clots
Acid-base Compensation Correct Answer If pH changes
because of a respiratory disorder, the renal system will be
responsible for making corrections to balance blood pH (vice
versa)
,Airway obstruction in asthma is related to: A. The release of
stress hormones B. Increased SNS response C. Exposure to an
allergen causing mast cell degranulation D. Hereditary decrease
in IgE responsiveness Correct Answer C
All of the following are classic clinical manifestations of Type 1
DM, except: A. Weight gain B. Polyuria C. Polydipsia D.
Fatigue Correct Answer Weight gain
All of the following contribute to an increased insulin resistance
and decreased insulin production in Type 2 diabetes, EXCEPT:
Select one:
a.
hypertrophy of the beta cells in the Islet of Langerhans
b.a reduction in the number of insulin binding sites
c.
decreased insulin production in the pancreas
d.a decrease in the amount of insulin binding to the receptors
Correct Answer hypertrophy of the beta cells in the Islet of
Langerhans
AMI complications Correct Answer dysrhythmias, heart
failure, cariogenic shock, papillary muscle dysfunction,
ventricular aneurysm, acute pericarditis
AMI nursing management Correct Answer 12 lead ECGsemi
fowlers positionoxygenIV accessnitroglycerinmorphinehealth
promotionidentification of people at high riskcontrol modifiable
risk factors
,Asthma is characterised by all of the following, EXCEPT:
Select one:
a.
Audible crackles
b.
Reversible bronchoconstriction
c.
Mucous hypersecretion
d.
Oedema of the airways Correct Answer Audible crackles
At what time do you call an ambulance for a seizure patient.
Correct Answer Seizure last for longer than 5 minutes
Remains unresponsive for 5 minutes after the seizure ceases
If the patient is diabetic or pregnant
It is the patients first seizure
Case study question (9 marks) Simon has been diagnosed with
an exacerbation of his COPD, and presented to the hospital with
dyspnoea and a worsening productive cough. His vitals are: PR
120bpm, RR 29bpm, BP 129/88mmHg, SpO2 85% on RA. He
has widespread wheeze and crackles on auscultation and
reduced air entry bilaterally in his lower lobes 1. Develop 1
actual nursing issue for Simon (1 mark) 2. Develop 1 SMART
goal for this nursing issue (1 mark) 3. Outline 4 interventions
with a rationale, to manage this issue and achieve your goal (4
marks) 4. List 3 alterations to Simon's condition which would
indicate you have achieved your goal (3 marks) Correct
Answer 1. Ineffective gas exchange due to COPD exacerbation
as evidenced by SpO2 85% on RA, HR 120 and RR 29.
Reduced A/E to lower bases 2. Restore effective gas exchange
, within 1 hour 3. Administer salbutamol and ipratropium via
MDI and spacer to bronchodilate his airways • Administer
supplemental oxygen to maintain SpO2 between 88-92% •
Monitor vital obs 1/24 to assess status and for signs of
improvement/deterioration • Encourage repositioning to semi-
high Fowler's to allow for maximum chest expansion 4. SpO2
increase between 88-92%, decreased RR , increased A/E
Define asthma Correct Answer chronic airway inflammation,
characterised by wheeze, shortness of breath and variable
expiratory airflow limitation. It has periods of respite
Define sepsis Correct Answer Sepsis is an uncontrolled,
unregulated, and self-sustaining intravascular (in the blood
vessels) inflammation. All characteristics of the septic response
are exaggerations of the normal inflammatory response.
Describe the pathophysiology of DKA, How is it diagnosed?
and how is it treated? Correct Answer Insulin deficiency,
increased insulin counter-regulatory hormones (cortisol,
glucagon, growth hormone, and catecholamines) and peripheral
insulin resistance lead to hyperglycemia, dehydration, ketosis,
and electrolyte imbalance. Accelerated gluconeogenesis,
glycogenolysis, and decreased glucose utilization - all due to
absolute insulin deficiency. Due to increased lipolysis and
decreased lipogenesis, abundant free fatty acids are converted to
ketone bodies:
How is it diagnosed?
Via a urine or blood sample. VBG and ABG, blood pH.
Expected a acidic level and lower pH
2 Systems that attempt to balance each other to maintain acid
base balance Correct Answer Kidneys and lungs
6 steps to ABG analysis Correct Answer 1. Analyse pH2.
Analyse PaCO23. Analyse HCo34. Match the PaCO2 or HCO3
with the pH5. Does the PaCO2 or HCO2 go in the opposite
direction of the pH? (if yes there is compensation by that
system)6. Analyse PaO2 and SaO2
A 27-year-old male has a severe kidney obstruction leading to
removal of the affected kidney. Which of the following would
the nurse expect to occur in the weeks following removal of the
affected kidney? Correct Answer Compensatory function of
the remaining kidney
A patient who is critically unwell is at risk of developing which
of the following complications? A. Hypokalaemia B.
Hyperkalaemia C. Hypoglycaemia D. Hyperglycaemia Correct
Answer D - this is due to the increased stress response leading
to cortisol release, glucose etc → increases BGL
Acetylsalicylic Acid (Aspirin) is acts to Correct Answer
prevents platelet aggregation thus reducing formation of new
clots
Acid-base Compensation Correct Answer If pH changes
because of a respiratory disorder, the renal system will be
responsible for making corrections to balance blood pH (vice
versa)
,Airway obstruction in asthma is related to: A. The release of
stress hormones B. Increased SNS response C. Exposure to an
allergen causing mast cell degranulation D. Hereditary decrease
in IgE responsiveness Correct Answer C
All of the following are classic clinical manifestations of Type 1
DM, except: A. Weight gain B. Polyuria C. Polydipsia D.
Fatigue Correct Answer Weight gain
All of the following contribute to an increased insulin resistance
and decreased insulin production in Type 2 diabetes, EXCEPT:
Select one:
a.
hypertrophy of the beta cells in the Islet of Langerhans
b.a reduction in the number of insulin binding sites
c.
decreased insulin production in the pancreas
d.a decrease in the amount of insulin binding to the receptors
Correct Answer hypertrophy of the beta cells in the Islet of
Langerhans
AMI complications Correct Answer dysrhythmias, heart
failure, cariogenic shock, papillary muscle dysfunction,
ventricular aneurysm, acute pericarditis
AMI nursing management Correct Answer 12 lead ECGsemi
fowlers positionoxygenIV accessnitroglycerinmorphinehealth
promotionidentification of people at high riskcontrol modifiable
risk factors
,Asthma is characterised by all of the following, EXCEPT:
Select one:
a.
Audible crackles
b.
Reversible bronchoconstriction
c.
Mucous hypersecretion
d.
Oedema of the airways Correct Answer Audible crackles
At what time do you call an ambulance for a seizure patient.
Correct Answer Seizure last for longer than 5 minutes
Remains unresponsive for 5 minutes after the seizure ceases
If the patient is diabetic or pregnant
It is the patients first seizure
Case study question (9 marks) Simon has been diagnosed with
an exacerbation of his COPD, and presented to the hospital with
dyspnoea and a worsening productive cough. His vitals are: PR
120bpm, RR 29bpm, BP 129/88mmHg, SpO2 85% on RA. He
has widespread wheeze and crackles on auscultation and
reduced air entry bilaterally in his lower lobes 1. Develop 1
actual nursing issue for Simon (1 mark) 2. Develop 1 SMART
goal for this nursing issue (1 mark) 3. Outline 4 interventions
with a rationale, to manage this issue and achieve your goal (4
marks) 4. List 3 alterations to Simon's condition which would
indicate you have achieved your goal (3 marks) Correct
Answer 1. Ineffective gas exchange due to COPD exacerbation
as evidenced by SpO2 85% on RA, HR 120 and RR 29.
Reduced A/E to lower bases 2. Restore effective gas exchange
, within 1 hour 3. Administer salbutamol and ipratropium via
MDI and spacer to bronchodilate his airways • Administer
supplemental oxygen to maintain SpO2 between 88-92% •
Monitor vital obs 1/24 to assess status and for signs of
improvement/deterioration • Encourage repositioning to semi-
high Fowler's to allow for maximum chest expansion 4. SpO2
increase between 88-92%, decreased RR , increased A/E
Define asthma Correct Answer chronic airway inflammation,
characterised by wheeze, shortness of breath and variable
expiratory airflow limitation. It has periods of respite
Define sepsis Correct Answer Sepsis is an uncontrolled,
unregulated, and self-sustaining intravascular (in the blood
vessels) inflammation. All characteristics of the septic response
are exaggerations of the normal inflammatory response.
Describe the pathophysiology of DKA, How is it diagnosed?
and how is it treated? Correct Answer Insulin deficiency,
increased insulin counter-regulatory hormones (cortisol,
glucagon, growth hormone, and catecholamines) and peripheral
insulin resistance lead to hyperglycemia, dehydration, ketosis,
and electrolyte imbalance. Accelerated gluconeogenesis,
glycogenolysis, and decreased glucose utilization - all due to
absolute insulin deficiency. Due to increased lipolysis and
decreased lipogenesis, abundant free fatty acids are converted to
ketone bodies:
How is it diagnosed?
Via a urine or blood sample. VBG and ABG, blood pH.
Expected a acidic level and lower pH
