NR 574 FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR 574 FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. How often should a CK level be drawn and why Correct Answer least every 6-12 hours to establish a peak level and then subsequently a downward trend. 2. Sylvie is a 26-year-old who presents to the emergency department (ED) after just finishing a full marathon. She complains of feeling lightheaded, nauseous, and has vomited twice since completing the race. Her legs feel tired, weak, and sore which she attributes to running 26.2 miles. She reports that she didn't stop to rehydrate as much as she would have liked because she was intent on finishing with her personal best time. She became very concerned when she went to use the restroom and noticed that her urine was dark - almost like tea. The AGACNP suspects rhabdomyolysis. Which test is needed to confirm the diagnosis Correct Answer serum creatine kinase 3. Sylvie's EKG shows markedly elevated T waves and prolongation of the PR and QRS intervals. The AGACNP should anticipate which of the following results Correct Answer hyperkalemia 4. Risk factors for acute intestinal obstruction Correct Answer Adhesions from previous abdominal surgery Internal or external hernias Foreign bodies Feces Congenital issues (atresia, stenosis, cyst formation, intestinal duplication, and mal- rotation) Trauma (hematoma formation)Inflammation (inflammatory bowel disease, diverticulitis, radiation, and tuberculosis) Neoplasms including carcinomatosis, colon cancer, primary small bowel cancer, and extraintestinal malignancies such as ovarian cancer Endometriosis Volvulus Ischemic injury Intussusception Intraperitoneal abscess 5. Subjective findings of acute intestinal obstruction: colicky abdominal pain (cramping periumbilical pain initially; later becomes constant and diffuse)abdominal pain often more severe with distal obstruction vomiting (more significant with proximal obstruction) abdominal bloatingobstipation 6. What key information should be discussed during H/P, if you are concerned for bowel obstruction Correct Answer History should include essential elements such as previous abdominal or pelvic surgeries, comorbid conditions such as inflammatory bowel disease or malignancy. 7. Objective findings in a patient with intestinal obstruction Correct Answer Key physical exam findings may include: Fever (systemic inflammation or strangulation) High-pitched, tinkling, bowel sounds (may be hypoactive or absent with complete obstruction) Abdominal distention (more significant with distal obstruction due to the greater volume of intraluminal fluid accumulation)Mild abdominal tenderness but no peritoneal findingsTender abdominal or groin masses (can represent incarcerated hernia) Signs of shock (tachycardia, hypotension, oliguria) 8. Significant abdominal tenderness with palpation should increase the NP's suspicion for Correct Answer ischemia, peritonitis, or necrosis. 9. why is a serum lactate useful in dx a bowel obstruction Correct Answer Serum lactate (increased serum lactate should raise concern for strangulated obstruction) 10. what diagnostic imaging should be used for bowel obstruction Correct Answer plain film xray 11. what will a plain film xray show if a patient has a bowel obstruction Correct Answer Obstruction will reveal dilated loops of bowel and visible air fluid levels which should prompt further studies.A horizontal pattern of dilated small bowel loops can be seen with small bowel obstruction (SBO) 12. Should barium contrast be given to a patient with a bowel obstruction Correct Answer NO! Imaging studies requiring administration of barium are contraindicated in cases of high- grade or complete obstruction. 13. What does barium contrast do within the body with a bowel obstruction Correct Answer Bar- ium should NEVER be given orally to a client until the diagnosis of obstruction has been excluded completely as retained barium can cause concretions which create an additional source of blockage which can require surgical intervention in clients who may have otherwise recovered. Retained barium also severely limits the ability to interpret subsequent angiography or cross-sectional imaging. 14. Treatment of bowel obstruction: Gen surg consult, NG tube (intermittent suction) for decompres- sion, fluid rescusitation, electrolyte management as indicated, complete obstruction= immediate surgical intervention 15. Superior Vena Cava Syndrome (SVCS): SVCS is the clinical manifestation of SVC obstruction with severe reduction in venous return from the head, neck, and upper extremities. 16. What is responsible for the majority of SVCS cases Correct Answer malignant tumors, such as lung cancer, lymphoma, and metastatic tumors. 17. Subjective findings with SVCS patients: Commonly: neck and facial swelling (especially around the eyes) dyspnea, and cough other symptoms:hoarseness, tongue swelling, headaches, nasal congestion, epistaxis, hemoptysis, dysphagia, pain, dizziness, syncope, and lethargy. 18. what can cause symptoms of SVCS to become worse Correct Answer bending down, laying supine, position changes. 19. Physical exam findings of SVCS: dilated neck veins increase number of collateral veins covering the anterior chest wall cyanosis edema of the face, arms and chest. typically will be worse when the patient is laying supine 20. treatment of SVCS: symptomatic relief:diuretics w/ low sodium diet head elevation supplemental 02Radiation therapy is the primary treatment for SVCS. obstruction needs to be taken care of to relief symptoms. 21. Abdomen Pain in the RLQ Pain differentials: appendicitis, ectopic pregnancy, nephrolithiasis, 22. ABD PAIN: "RUQ pain" is a red flag for. Correct Answer cholecystitis, pancreatitis (referred pain) PNA/empyema hepatitis