ccrn aacn practice Questions and
Answers with Complete Solutions
A patient with a history of bronchogenic carcinoma is admitted with respiratory failure.
the patient is intubated and on mechanical ventilation. the patient develops lethargy,
headache, slight confusion and abdominal cramping urinary output is decreasing and
significant lab data includes
Serum Na+ 127
Serum osmolality 270
urine specific gravity elevated - Answer Initiation of fluid restriction -
this pt has risk factors signs and symptoms of SIADH
fluid restriction slows glomerular filtration and blood flow enhances proximal
reabsorption of sodium and water increases aldosterone secretion and enhances distal
tubule sodium reabsorption. chemo may alleviate some of the water retention caused by
some cancers but non will completely inhibit ADH secretions. three percent saline
administration in severe case only
A pt is being admitted in HHS with dehydration and a serum glucose level of 836 mg/dl.
Which additional laboratory findings should the nurse anticipate? - Answer > elevated
BUN > Elevated creatinine >elevated osmolality
HHNS - Hyperosmolar hyperglycemic nonketonic state
A 49 year old patient male recently admitted with an inferiors wall MI resulting from
100% occlusion of the right coronary artery (RCA). The 12 lead ECG reveals ST
elevation in leads 11, 111, and aVf. you would expect to see reciprocal changes in
which leads? - Answer 1 and aVL the RCA perfuses the inferior wall and the mirror
image or reciprocal changes would be seen in the the high lateral wall, which is
reflected in leads 1 and avl on the 12 lead ECG. Lead v1 and v2 correlate with the
septal area, lead v 3 and v4 correlate with the anterior area of the heart
a patient is admitted following a MVA , Lab data reveal elevated creatinine
phosphokinase and myoglobin. What should the nurse anticipate? - Answer
Rhabdomyolysis -MVA is a risk factor for rhabdomyolysis and lab data consistent with
condition
a patient is admitted with pulmonary hypertension. What should lead the nurse to
suspect pulmonary fibrosis - Answer dyspnea at rest
a patient is admitted 2 days ago with a large subdural hematoma has a rectal temp of
104. the fever is treated with iv acetaminophen and ice packs. Two hours later the fever
increased to 104.9 what should the nurse be most concerned for .... - Answer central
nervous system ischemia - the patient most likely has a neurogenic fever due to injury
of the hypothalamus
Answers with Complete Solutions
A patient with a history of bronchogenic carcinoma is admitted with respiratory failure.
the patient is intubated and on mechanical ventilation. the patient develops lethargy,
headache, slight confusion and abdominal cramping urinary output is decreasing and
significant lab data includes
Serum Na+ 127
Serum osmolality 270
urine specific gravity elevated - Answer Initiation of fluid restriction -
this pt has risk factors signs and symptoms of SIADH
fluid restriction slows glomerular filtration and blood flow enhances proximal
reabsorption of sodium and water increases aldosterone secretion and enhances distal
tubule sodium reabsorption. chemo may alleviate some of the water retention caused by
some cancers but non will completely inhibit ADH secretions. three percent saline
administration in severe case only
A pt is being admitted in HHS with dehydration and a serum glucose level of 836 mg/dl.
Which additional laboratory findings should the nurse anticipate? - Answer > elevated
BUN > Elevated creatinine >elevated osmolality
HHNS - Hyperosmolar hyperglycemic nonketonic state
A 49 year old patient male recently admitted with an inferiors wall MI resulting from
100% occlusion of the right coronary artery (RCA). The 12 lead ECG reveals ST
elevation in leads 11, 111, and aVf. you would expect to see reciprocal changes in
which leads? - Answer 1 and aVL the RCA perfuses the inferior wall and the mirror
image or reciprocal changes would be seen in the the high lateral wall, which is
reflected in leads 1 and avl on the 12 lead ECG. Lead v1 and v2 correlate with the
septal area, lead v 3 and v4 correlate with the anterior area of the heart
a patient is admitted following a MVA , Lab data reveal elevated creatinine
phosphokinase and myoglobin. What should the nurse anticipate? - Answer
Rhabdomyolysis -MVA is a risk factor for rhabdomyolysis and lab data consistent with
condition
a patient is admitted with pulmonary hypertension. What should lead the nurse to
suspect pulmonary fibrosis - Answer dyspnea at rest
a patient is admitted 2 days ago with a large subdural hematoma has a rectal temp of
104. the fever is treated with iv acetaminophen and ice packs. Two hours later the fever
increased to 104.9 what should the nurse be most concerned for .... - Answer central
nervous system ischemia - the patient most likely has a neurogenic fever due to injury
of the hypothalamus
