PORTAGE LEARNING PATHOPHYSIOLOGY NURS 231 BIOD 331
FINAL EXAM & MODULE 1-10 EXAMS ALL VERSIONS LATEST
UPDATE A GRADE
What are the normal's for the following labs
1) Urine Specific Gravity
2) Serum Osmolality
3) ABG (pH, HCO3, PaCO2, PaO2)
4) troponin I
5) electrolyte panel( Na+, K+, Ca+, Mg+)
6) BUN & Creatinine
7) CBC ( hgb, hct, RBC, WBC, platelets) - correct answer - 1) 1.000-1.030
2) 270-300
3) pH 7.35-7.45// HC03 22-26// PaCO2 35-45// Pa02 80-100
4) troponin I <0.03 ng/mL
5) Na+ 135-145//K+ 3.5-5// Ca+ 9-10.5//Mg+ 1.2-2
6) BUN 10-20//Creat 0.5-1.2
7) hgb 12-18// hct 37-52%// rbc 4.2-6.1// wbc 5,000-10,000// platelets 150,000-400,000
Match the lab profile with the most likely fluid imbalance like A) Fluid Volume Deficit 2) Fluid
Volume Excess
1) ____Na 148; Hct 40% yesterday, 49% today; serum osmolarity 308
2) ____Hgb 13.2 yesterday, 10.1 today; Urine specific gravity 1.001
3) ____BUN 45; Cr 0.7 - correct answer - 1) A
2) B
3) A
,The nurse is preparing to administer lisinopril (Zestril) to a patient with acute coronary
syndrome. Which of the following findings should prompt the nurse to hold the medication and
consult the healthcare provider?
a) Serum sodium level 134
b) Serum potassium 5.6
c) Heart rate 58
d) Blood pressure 125/78 - correct answer - b) Serum potassium 5.6
*ACE inhibitors can cause/exacerbate hyperkalemia.
The nurse is caring for a patient who is in hypovolemic shock following an extensive burn injury.
What is the intravenous fluid of choice for this patient in the emergent phase of treatment?
a) Lactated Ringers
b) 0.45 NS with 20 mEq potassium chloride
c) Fresh Frozen Plasma
d) 5% Dextrose in saline - correct answer - a) Lactated Ringers
*Isotonic solutions (crystalloids) are used to restore fluid volume in patients with shock.
Lactated Ringers is isotonic. Normal saline is also isotonic.
The client on a ventilator is assessed for untoward responses to the therapy. Which of the
following would indicate a possible complication of ventilator therapy?
a) Blood pressure has increased 5mmHg in the last 24 hours
b) Lung sounds absent on one side.
c) Forceful cough periodically
d) Broncho-vesicular breath sounds throughout peripheral lung fields. - correct answer - b)
Lung sounds absent on one side.
*This may indicate a pneumothorax--a complication caused by barotrauma.
,The pressure reading during inspiration on the ventilator of a client receiving mechanical
ventilation is high and alarming intermittently. What is the nurse's first action?
a) Assess the client's oxygenation.
b) Call the RT to check the ventilator settings.
c) Listen for bilateral lung sounds.
d) Determine whether an air leak is present in the client's endotracheal tube cuff. - correct
answer - a) Assess the client's oxygenation.
Which assessment finding best indicates that fluid resuscitation therapy for the patient with
hypertonic dehydration has acheived the desired effect?
a) Peripheral pulses changed from 1+ to 3+
b) Neck veins slightly distended @ 30 degrees
c) Serum sodium level has changed from 151 to 143.
d) Pulse oximetry shows oxygen saturation of 95% - correct answer - c) Serum sodium level has
changed from 151 to 143.
Which intravenous solution should you be prepared to administer to a patient with isotonic
dehydration?
a) 0.45% saline
b) Dextrose 5% in water
c) Dextrose 10% in water
d) 0.9% saline - correct answer - d) 0.9% saline
A patient is receiving dobutamine [Dobutrex] as a continuous infusion in the immediate
postoperative period. The patient also is receiving a diuretic. What adverse drug reactions are
possible in this patient? (select all that apply)
a)Angina
b)Hypotension
, c)Dysrhythmias
d)Oliguria
e)Tachycardia - correct answer - a)Angina
c)Dysrhythmias
e)Tachycardia
*Is a beta1 aderenergic agonist; general anesthetics can increase the likelihood of dysrhythmias.
Dobutamine elevates BP by increasing CO. Diuretics complement the beneficial effects of
dobutamine on the kidney, so urine output would be increased, not decreased.
A patient who has severe sepsis is receiving an intravenous normal saline infusion. She weighs
78 kgs. Which of the following is an indicator that the therapeutic goal has been met?
a) 250 mL of urine in the past 6 hours
b) Arterial blood pressure is 90/42
c) Central Venous Pressure is 2 mm Hg
d) Patient's heart rate is 101 - correct answer - a) 250 mL of urine in the past 6 hours
*Fluid resuscitation goals in sepsis are: MAP > 65, UO . 0.5 mL/kg/hr, and/or CVP 8-12 mm Hg.
The nurse is caring for Mrs. B, who has a pulmonary embolus. She is started on a heparin drip
and 4 hours later the aPTT is 70 seconds (lab control or "normal" value is 40 secs). The nurse
should:
a) Notify the provider and request an order for warfarin (Coumadin).
b) Notify the provider and request a decrease in the heparin dose.
c) Continue the present order for heparin.
d) Hold the heparin and notify the physician. - correct answer - c) Continue the present order
for heparin.
FINAL EXAM & MODULE 1-10 EXAMS ALL VERSIONS LATEST
UPDATE A GRADE
What are the normal's for the following labs
1) Urine Specific Gravity
2) Serum Osmolality
3) ABG (pH, HCO3, PaCO2, PaO2)
4) troponin I
5) electrolyte panel( Na+, K+, Ca+, Mg+)
6) BUN & Creatinine
7) CBC ( hgb, hct, RBC, WBC, platelets) - correct answer - 1) 1.000-1.030
2) 270-300
3) pH 7.35-7.45// HC03 22-26// PaCO2 35-45// Pa02 80-100
4) troponin I <0.03 ng/mL
5) Na+ 135-145//K+ 3.5-5// Ca+ 9-10.5//Mg+ 1.2-2
6) BUN 10-20//Creat 0.5-1.2
7) hgb 12-18// hct 37-52%// rbc 4.2-6.1// wbc 5,000-10,000// platelets 150,000-400,000
Match the lab profile with the most likely fluid imbalance like A) Fluid Volume Deficit 2) Fluid
Volume Excess
1) ____Na 148; Hct 40% yesterday, 49% today; serum osmolarity 308
2) ____Hgb 13.2 yesterday, 10.1 today; Urine specific gravity 1.001
3) ____BUN 45; Cr 0.7 - correct answer - 1) A
2) B
3) A
,The nurse is preparing to administer lisinopril (Zestril) to a patient with acute coronary
syndrome. Which of the following findings should prompt the nurse to hold the medication and
consult the healthcare provider?
a) Serum sodium level 134
b) Serum potassium 5.6
c) Heart rate 58
d) Blood pressure 125/78 - correct answer - b) Serum potassium 5.6
*ACE inhibitors can cause/exacerbate hyperkalemia.
The nurse is caring for a patient who is in hypovolemic shock following an extensive burn injury.
What is the intravenous fluid of choice for this patient in the emergent phase of treatment?
a) Lactated Ringers
b) 0.45 NS with 20 mEq potassium chloride
c) Fresh Frozen Plasma
d) 5% Dextrose in saline - correct answer - a) Lactated Ringers
*Isotonic solutions (crystalloids) are used to restore fluid volume in patients with shock.
Lactated Ringers is isotonic. Normal saline is also isotonic.
The client on a ventilator is assessed for untoward responses to the therapy. Which of the
following would indicate a possible complication of ventilator therapy?
a) Blood pressure has increased 5mmHg in the last 24 hours
b) Lung sounds absent on one side.
c) Forceful cough periodically
d) Broncho-vesicular breath sounds throughout peripheral lung fields. - correct answer - b)
Lung sounds absent on one side.
*This may indicate a pneumothorax--a complication caused by barotrauma.
,The pressure reading during inspiration on the ventilator of a client receiving mechanical
ventilation is high and alarming intermittently. What is the nurse's first action?
a) Assess the client's oxygenation.
b) Call the RT to check the ventilator settings.
c) Listen for bilateral lung sounds.
d) Determine whether an air leak is present in the client's endotracheal tube cuff. - correct
answer - a) Assess the client's oxygenation.
Which assessment finding best indicates that fluid resuscitation therapy for the patient with
hypertonic dehydration has acheived the desired effect?
a) Peripheral pulses changed from 1+ to 3+
b) Neck veins slightly distended @ 30 degrees
c) Serum sodium level has changed from 151 to 143.
d) Pulse oximetry shows oxygen saturation of 95% - correct answer - c) Serum sodium level has
changed from 151 to 143.
Which intravenous solution should you be prepared to administer to a patient with isotonic
dehydration?
a) 0.45% saline
b) Dextrose 5% in water
c) Dextrose 10% in water
d) 0.9% saline - correct answer - d) 0.9% saline
A patient is receiving dobutamine [Dobutrex] as a continuous infusion in the immediate
postoperative period. The patient also is receiving a diuretic. What adverse drug reactions are
possible in this patient? (select all that apply)
a)Angina
b)Hypotension
, c)Dysrhythmias
d)Oliguria
e)Tachycardia - correct answer - a)Angina
c)Dysrhythmias
e)Tachycardia
*Is a beta1 aderenergic agonist; general anesthetics can increase the likelihood of dysrhythmias.
Dobutamine elevates BP by increasing CO. Diuretics complement the beneficial effects of
dobutamine on the kidney, so urine output would be increased, not decreased.
A patient who has severe sepsis is receiving an intravenous normal saline infusion. She weighs
78 kgs. Which of the following is an indicator that the therapeutic goal has been met?
a) 250 mL of urine in the past 6 hours
b) Arterial blood pressure is 90/42
c) Central Venous Pressure is 2 mm Hg
d) Patient's heart rate is 101 - correct answer - a) 250 mL of urine in the past 6 hours
*Fluid resuscitation goals in sepsis are: MAP > 65, UO . 0.5 mL/kg/hr, and/or CVP 8-12 mm Hg.
The nurse is caring for Mrs. B, who has a pulmonary embolus. She is started on a heparin drip
and 4 hours later the aPTT is 70 seconds (lab control or "normal" value is 40 secs). The nurse
should:
a) Notify the provider and request an order for warfarin (Coumadin).
b) Notify the provider and request a decrease in the heparin dose.
c) Continue the present order for heparin.
d) Hold the heparin and notify the physician. - correct answer - c) Continue the present order
for heparin.
