©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
NURS 487 Final Exam Questions With
Correct Answers
What is an indicator/ symptom that shock is progressing? - answer✔In the early stage of septic
shock, the patient has warm and dry skin. Cool and clammy skin would indicate that the shock is
progressing.
neurogenic shock - answer✔Circulatory failure caused by paralysis of the nerves that control the
size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord
injuries.
What are the hallmark symptoms of Neurogenic shock? - answer✔hypotension and bradycardia.
What are four of the manifestations of septic shock? - answer✔- Increased cardiac output
- warm, flushed skin
- fever and chills
- vasodilation
What is a symptom in anaphylactic shock? - answer✔Angioneurotic edema.
What is one of the hallmark symptoms of ARDS? - answer✔hypoxemia.
What is MODS (multiple organ dysfunction syndrome) - answer✔progressive dysfunction of
two or more organ systems due to pro-inflammatory state such as SIRS or Septic shock
What is an indication that a patient may be going from cardiogenic shock into MODS? -
answer✔The elevated serum creatinine level indicates that the client has renal failure as well as
heart failure.
What are some symptoms of cardiogenic shock? - answer✔Crackles, chest pressure, and cool
extremities are all consistent with cardiogenic shock.
What symptoms are suggestive of ARDS? - answer✔Septicemia and laboured breathing suggest
the onset of ARDS
, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
What is the purpose of prone positioning? - answer✔to improve the client's oxygenation as
indicated by the PaO2 and SaO2.
What is intracellular fluid? - answer✔fluid inside the cell
What is extracellular fluid? - answer✔fluid outside the cell
What is intravascular fluid? - answer✔Fluid WITHIN the blood vessels
What is interstitial fluid? - answer✔Fluid BETWEEN the cells or in the tissues
What is edema? (patho/ steps) - answer✔The accumulation of fluid in interstitial spaces.
- 1. increase in capillary permeability
- 2. increase in loss of fluid and protein
- 3. decreased capillary oncotic pressure
- 4. =EDEMA
What follows sodium? - answer✔CHLORIDE & H2O FOLLOWS SODIUM
What is the purpose of sodium? - answer✔90% of the ECF, works with K+ and Ca++ to conduct
nerve impulses and regulate acid-base balance and membrane transport
Sodium (cation or anion, ECF or ICF, controlled by what? Roles?) - answer✔- primary ECF
cation
- controlled by the kidneys/ aldosterone
- roles: neuromuscular irritability, acid-base balance, membrane transport
What is the purpose of chloride? (cation or anion, ECF or ICF, roles) - answer✔- Primary ECF
anion
- provides electroneutrality
What is the renin-angiotensin-aldosterone system? (steps, overall effect) - answer✔- Body's
response to low BP/ BV
1. ADH is released from the posterior pituitary
2. ADH + Renin = angiotensin I
, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
3. ACE + angiotensin I = angiotensin II
4. Aldosterone & ADH are increased
***OVERALL: increased extracellular fluid/ increased blood volume, increase blood pressure,
vasoconstriction, increased sodium and water retention
What happens when a hypotonic solution is administered? - answer✔When a hypotonic solution
is administered, it puts more water in the serum than is found inside cells. As a result, water
moves into the cells, causing them to swell.
What is a hypotonic solution? (purpose, when is it used, who should you not give it to?) -
answer✔- Fluid goes into the cell
- for patients with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemia.
- DO NOT GIVE TO PATIENTS WITH BRAIN INJURIES (cerebral edema, increased ICP,
burns) because you can deplete their fluid volume.
What happens when a hypertonic solution is administered? - answer✔hypertonic fluids cause an
increased concentration of dissolved solutes in the intravascular space compared to the cells.
This causes the movement of water out of the cells and into the intravascular space to dilute the
solutes in the blood.
What is a hypertonic solution? (purpose, when is it used) - answer✔- pulls the h2o & sodium out
- Used in patients with cerebral edema (drawing fluids out of the cell to increase the solute in the
plasma)
- TREATMENT OF HYPONATREMIA, DECREASED ICP, REPLACEMENT OF
ELECTROLYTES, TREAT SHOCK
What is an isotonic solution? (purpose, when is it used, who should you not give it to?) -
answer✔- Contains equal concentrations of solutes on both sides.
- used to replace extracellular fluid losses (dehydration)
- Indications: to increase the EXTRACELLULAR fluid volume due to blood loss, surgery,
dehydration
What is hyponatremia? (causes, symptoms) - answer✔- A serum sodium level of less than 135
mEq/L
- due to sodium loss, inadequate sodium intake or dilution of the sodium levels by excess water
10/10/2024 11:44 AM
NURS 487 Final Exam Questions With
Correct Answers
What is an indicator/ symptom that shock is progressing? - answer✔In the early stage of septic
shock, the patient has warm and dry skin. Cool and clammy skin would indicate that the shock is
progressing.
neurogenic shock - answer✔Circulatory failure caused by paralysis of the nerves that control the
size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord
injuries.
What are the hallmark symptoms of Neurogenic shock? - answer✔hypotension and bradycardia.
What are four of the manifestations of septic shock? - answer✔- Increased cardiac output
- warm, flushed skin
- fever and chills
- vasodilation
What is a symptom in anaphylactic shock? - answer✔Angioneurotic edema.
What is one of the hallmark symptoms of ARDS? - answer✔hypoxemia.
What is MODS (multiple organ dysfunction syndrome) - answer✔progressive dysfunction of
two or more organ systems due to pro-inflammatory state such as SIRS or Septic shock
What is an indication that a patient may be going from cardiogenic shock into MODS? -
answer✔The elevated serum creatinine level indicates that the client has renal failure as well as
heart failure.
What are some symptoms of cardiogenic shock? - answer✔Crackles, chest pressure, and cool
extremities are all consistent with cardiogenic shock.
What symptoms are suggestive of ARDS? - answer✔Septicemia and laboured breathing suggest
the onset of ARDS
, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
What is the purpose of prone positioning? - answer✔to improve the client's oxygenation as
indicated by the PaO2 and SaO2.
What is intracellular fluid? - answer✔fluid inside the cell
What is extracellular fluid? - answer✔fluid outside the cell
What is intravascular fluid? - answer✔Fluid WITHIN the blood vessels
What is interstitial fluid? - answer✔Fluid BETWEEN the cells or in the tissues
What is edema? (patho/ steps) - answer✔The accumulation of fluid in interstitial spaces.
- 1. increase in capillary permeability
- 2. increase in loss of fluid and protein
- 3. decreased capillary oncotic pressure
- 4. =EDEMA
What follows sodium? - answer✔CHLORIDE & H2O FOLLOWS SODIUM
What is the purpose of sodium? - answer✔90% of the ECF, works with K+ and Ca++ to conduct
nerve impulses and regulate acid-base balance and membrane transport
Sodium (cation or anion, ECF or ICF, controlled by what? Roles?) - answer✔- primary ECF
cation
- controlled by the kidneys/ aldosterone
- roles: neuromuscular irritability, acid-base balance, membrane transport
What is the purpose of chloride? (cation or anion, ECF or ICF, roles) - answer✔- Primary ECF
anion
- provides electroneutrality
What is the renin-angiotensin-aldosterone system? (steps, overall effect) - answer✔- Body's
response to low BP/ BV
1. ADH is released from the posterior pituitary
2. ADH + Renin = angiotensin I
, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
3. ACE + angiotensin I = angiotensin II
4. Aldosterone & ADH are increased
***OVERALL: increased extracellular fluid/ increased blood volume, increase blood pressure,
vasoconstriction, increased sodium and water retention
What happens when a hypotonic solution is administered? - answer✔When a hypotonic solution
is administered, it puts more water in the serum than is found inside cells. As a result, water
moves into the cells, causing them to swell.
What is a hypotonic solution? (purpose, when is it used, who should you not give it to?) -
answer✔- Fluid goes into the cell
- for patients with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemia.
- DO NOT GIVE TO PATIENTS WITH BRAIN INJURIES (cerebral edema, increased ICP,
burns) because you can deplete their fluid volume.
What happens when a hypertonic solution is administered? - answer✔hypertonic fluids cause an
increased concentration of dissolved solutes in the intravascular space compared to the cells.
This causes the movement of water out of the cells and into the intravascular space to dilute the
solutes in the blood.
What is a hypertonic solution? (purpose, when is it used) - answer✔- pulls the h2o & sodium out
- Used in patients with cerebral edema (drawing fluids out of the cell to increase the solute in the
plasma)
- TREATMENT OF HYPONATREMIA, DECREASED ICP, REPLACEMENT OF
ELECTROLYTES, TREAT SHOCK
What is an isotonic solution? (purpose, when is it used, who should you not give it to?) -
answer✔- Contains equal concentrations of solutes on both sides.
- used to replace extracellular fluid losses (dehydration)
- Indications: to increase the EXTRACELLULAR fluid volume due to blood loss, surgery,
dehydration
What is hyponatremia? (causes, symptoms) - answer✔- A serum sodium level of less than 135
mEq/L
- due to sodium loss, inadequate sodium intake or dilution of the sodium levels by excess water
