NURS 6550 FINAL EXAM (VERSION -2)
, NURS 6550 FINAL EXAM
QUESTION 1
1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley
catheter was inserted intraoperatively and remains in place. His urine output has
declined markedly despite continued IV fluid infusion. Today his morning labs
reveal a BUN of 19 mg/dL and a creatinine of 2 mg/dL. A leading differential
includes:
A. Foley lodged in the urethra causing post-renal failure
B. Decreased renal perfusion causing prerenal failure
C. Age-related decreased eGFR causing prerenal failure
D. Post-surgical rhabdomyolysis causing intrarenal failure
Answer:
D. Post-surgical rhabdomyolysis causing intrarenal failure
During surgery, muscles and injured. This can result into rhabdomyolysis, which is
the breakdown of muscles to release proteins. The excess proteins causes an
increased level of creatinine.
Mr. Jeffers is from surgery (post-surgical) and his creatinine levels are above
normal. The normal creatinine levels range from 0.6mg/dl to 1.2mg/dl. Thus, the
most likely differential is: Post-surgical rhabdomyolysis causing intrarenal
failure.
1 points
QUESTION 2
1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and
she is weak, diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb
black female who is awake, alert, and oriented, anxious, with moist skin and racing
pulse. Her blood pressure is 140/100 mm Hg. Temperature and respiratory rate are
within normal limits. The patient admits to having a “thyroid condition” but she
never followed up on it when she was advised to see an endocrinologist. The
AGACNP anticipates a diagnosis of:
,A. Hashimoto’s thyroiditis
B. Cushing’s syndrome
C. Grave’s disease
D. Addison’s disease
1 points
Answer:
C. Grave's disease
QUESTION 3
1. Systemic lupus erythematosis (SLE) is a multiorgansystem autoimmune
disorder that can prevent with a wide variety of manifestations. Which clinical
triad should prompt an evaluation for SLE?
A. Fever, normal white count, elevated sedimentation rate
B. Hyperkalemia, hyponatremia, low blood pressure
C. Leukocytosis, hyperglycemia, hypokalemia
D. Joint pain, rash, fever
1 points
QUESTION 4
1. A patient presents with profound vertigo of acute onset yesterday. She can
barely turn her head without becoming very vertiginous; she is nauseous and just
doesn’t want to move. This morning when she tried to get out of bed she felt like
she was pushed back down. The vertigo is reproducible with cervical rotation. The
patient denies any hearing loss or tinnitus, she has no fever or other symptoms. The
AGACNP knows that the most helpful intervention will probably be:
A. Meclizine
B. Diazepam
C. Bed rest
D. Epley’s maneuvers
, 1 points
Answer:
D. Epley's maneuvers
The patient is likely suffering from benign paroxysmoly positioning vertigo. This
is indicated by inability to turn her head and to get up from the lying position in
bed. The best intervention for benign paroxysmal positioning vertigo is Epley's
maneuvers. These maneuvers effectively clear the inner ear to relieve symptoms
of vertigo
QUESTION 5
1. Mrs. Mireya is an 85-year-old female who is admitted for evaluation of
acute mental status change from the long term care facility. She is normally
ambulatory and participates in lots of facility activities. Today a nursing assistant
found her in her room, appearing confused and disconnected from her
environment. When she tried to get up she fell down. Her vital signs are stable
excepting a blood pressure of 90/60 mm Hg. The AGACNP knows that the most
likely cause of her symptoms is:
A. Osteoarthritis
B. Drug or alcohol toxicity
C. Hypotension
D. Urosepsis
1 points
QUESTION 6
1. A patient with SIADH would be expected to demonstrate which pattern of
laboratory abnormalities?
A. Serum Na+ 119 mEq/L, serum osmolality 240 mEq/L, urine Na+ of 28
mEq/L, urine osmolality of 900 mOsm/kg
B. Serum Na+ 152 mEq/L, serum osmolality 315 mEq/L, urine Na+ of 5
mEq/L, urine osmolality of 300 mOsm/kg
, NURS 6550 FINAL EXAM
QUESTION 1
1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley
catheter was inserted intraoperatively and remains in place. His urine output has
declined markedly despite continued IV fluid infusion. Today his morning labs
reveal a BUN of 19 mg/dL and a creatinine of 2 mg/dL. A leading differential
includes:
A. Foley lodged in the urethra causing post-renal failure
B. Decreased renal perfusion causing prerenal failure
C. Age-related decreased eGFR causing prerenal failure
D. Post-surgical rhabdomyolysis causing intrarenal failure
Answer:
D. Post-surgical rhabdomyolysis causing intrarenal failure
During surgery, muscles and injured. This can result into rhabdomyolysis, which is
the breakdown of muscles to release proteins. The excess proteins causes an
increased level of creatinine.
Mr. Jeffers is from surgery (post-surgical) and his creatinine levels are above
normal. The normal creatinine levels range from 0.6mg/dl to 1.2mg/dl. Thus, the
most likely differential is: Post-surgical rhabdomyolysis causing intrarenal
failure.
1 points
QUESTION 2
1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and
she is weak, diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb
black female who is awake, alert, and oriented, anxious, with moist skin and racing
pulse. Her blood pressure is 140/100 mm Hg. Temperature and respiratory rate are
within normal limits. The patient admits to having a “thyroid condition” but she
never followed up on it when she was advised to see an endocrinologist. The
AGACNP anticipates a diagnosis of:
,A. Hashimoto’s thyroiditis
B. Cushing’s syndrome
C. Grave’s disease
D. Addison’s disease
1 points
Answer:
C. Grave's disease
QUESTION 3
1. Systemic lupus erythematosis (SLE) is a multiorgansystem autoimmune
disorder that can prevent with a wide variety of manifestations. Which clinical
triad should prompt an evaluation for SLE?
A. Fever, normal white count, elevated sedimentation rate
B. Hyperkalemia, hyponatremia, low blood pressure
C. Leukocytosis, hyperglycemia, hypokalemia
D. Joint pain, rash, fever
1 points
QUESTION 4
1. A patient presents with profound vertigo of acute onset yesterday. She can
barely turn her head without becoming very vertiginous; she is nauseous and just
doesn’t want to move. This morning when she tried to get out of bed she felt like
she was pushed back down. The vertigo is reproducible with cervical rotation. The
patient denies any hearing loss or tinnitus, she has no fever or other symptoms. The
AGACNP knows that the most helpful intervention will probably be:
A. Meclizine
B. Diazepam
C. Bed rest
D. Epley’s maneuvers
, 1 points
Answer:
D. Epley's maneuvers
The patient is likely suffering from benign paroxysmoly positioning vertigo. This
is indicated by inability to turn her head and to get up from the lying position in
bed. The best intervention for benign paroxysmal positioning vertigo is Epley's
maneuvers. These maneuvers effectively clear the inner ear to relieve symptoms
of vertigo
QUESTION 5
1. Mrs. Mireya is an 85-year-old female who is admitted for evaluation of
acute mental status change from the long term care facility. She is normally
ambulatory and participates in lots of facility activities. Today a nursing assistant
found her in her room, appearing confused and disconnected from her
environment. When she tried to get up she fell down. Her vital signs are stable
excepting a blood pressure of 90/60 mm Hg. The AGACNP knows that the most
likely cause of her symptoms is:
A. Osteoarthritis
B. Drug or alcohol toxicity
C. Hypotension
D. Urosepsis
1 points
QUESTION 6
1. A patient with SIADH would be expected to demonstrate which pattern of
laboratory abnormalities?
A. Serum Na+ 119 mEq/L, serum osmolality 240 mEq/L, urine Na+ of 28
mEq/L, urine osmolality of 900 mOsm/kg
B. Serum Na+ 152 mEq/L, serum osmolality 315 mEq/L, urine Na+ of 5
mEq/L, urine osmolality of 300 mOsm/kg
