NURS 366 FINAL-ED QUESTIONS WITH COMPLETE
SOLUTIONS
Abnormal uterine bleeding Correct Answers Menorrhagia:
excessive or prolonged uterine bleeding at regular intervals
(fibroids, uterine polyps, perimenopause)
Metrorrhagia: uterine bleeding at irregular intervals
(breakthrough bleeding with hormonal contraception, IUD,
cervical polyps, infection, genital tract cancers, physiologic)
Annovulatory bleeding: menarche, menopause, PCOS, thyroid
disorders, stress, weight loss. When you have your period, but
you are still not releasing an egg - can't get pregnant
ALWAYS RULE OUT PREGNANCY
Absence seizures Correct Answers Last 5-10 seconds
Brief loss of consciousness - not noticeable - can happen up to
20x per day.
Motor: lip smacking, twitching of eyes, face, slight hand
movements
Rarely falls, no incontinence
Minimal or no change in muscle tone
Almost always appear in childhood (4-12)
Usually outgrow
Acute glomerulonephritis Correct Answers May be a primary
event or manifestation of a systemic disorder (mild to severe)
Common features: oliguria, edema, HTN, circulatory
congestion, hematuria, and proteinuria
Most cases are post-infectious - acute poststreptococcal
glomerulonephritis is most common in children
,Can occur at any age - primarly affects school-age children.
Peak onset is 6 to 7
More common in males
Latent period of 10 to 21 days occurs between the strep infection
and the onset of clinical manifestations.
More common in winter or spring. Late summer and early fall
when associated with impetigo
Patho: immune complexes deposited into glomerular basement
membrane - glomeruli become edematous - decreased plasma
filtration - excessive accumulation of water and retention of
sodium - circulatory congestion and edema - hypertension
Acute pyelonephritis Correct Answers Very sick. Nausea,
vomiting, chills, nocturia, frequency, urgency, dysuria,
suprapubic or flank pain. Fever, hematuria, pyuria, foul-smelling
urine.
Oral antibiotics if not acutely ill.
Hospitalization for severe infections and complications such as
n/v with dehydration: parenteral antibiotics to establish high
serum levels
Look at page 910
Acute renal failure Correct Answers Abrupt decrease in kidney
function
~10% of kidney functioning
Sudden increase in BUN and creatinine
Urine output <30 mL/hr
One of leading causes for inpatient mortality
Pre renal, (55-70%), intra renal (25-40%), and post renal failure
(~5%)
,Clinical manifestations: oliguric-anuric phase for 1-8 weeks.
Diuretic phase: leveling of BUN - urine output 1000-2000
mL/day. Then, recovery phase (3-12 months): mild
Mortality up to 50% - recovery within 4-10 weeks
Treatment: treat underlying cause, prevent progression to CRF,
maintain fluid and electrolyte balance, prevent infections,
maintain nutritional balance (high-calorie, low protein, low Na,
low Mg, low phosphate, low K), and short-term dialysis:
hemodialysis for renal function replacement
Acute renal failure intra renal conditions Correct Answers
Nephrotoxic agents
Transfusion reaction
Glomerulonephritis
Renal neoplasms
Diseases (DM, HTN)
Infections
Acute renal failure post renal conditions Correct Answers
Prostatic hypertrophy
Neurogenic bladder
Pelvic tumors
Urethral, bladder, ureteral obstruction (calculi, clots, tumors,
stricture)
Acute renal failure pre-renal conditions Correct Answers
Altered peripheral vascular resistance: sepsis, anaphylactic
reactions
Cardiac pump failure: MI, CHF, cardiogenic shock
Hypovolemia: dehydration, blood loss, burns
, Adult neuro assessment Correct Answers Goal: isolate the
lesion - where is the problem?
Establish a neurological baseline for future assessment
Components: comprehensive history (report), a neurological
physical exam, and neurodiagnostic tests (PET scans and MRIs)
Organizing the assessment: vital signs, orientation (LOC),
mental status and speech, cranial/spinal nerves, motor system,
sensory function, reflexes
Aging and nervous system Correct Answers After age 30,
changes in memory. Axon diameters thin and number of
receptors decrease
Alterations in hearing, vision, EOMs, pupillary size, shape, and
reactivity are common
Changes in motor system: move and react more slowly and with
less agility; skeletal muscles decrease in bulk
Benign essential tremor may develop
Some reflexes may change: gag reflex may diminish/weaken,
ankle reflexes may decrease
ALS nursing management Correct Answers Supportive care
Energy conservation
Psychosocial support to patient and family
PT/OT/nutrition/speech therapy
Advance directives - ventilation/nutrition - question of how long
we should keep them alive
Amyotropic Lateral Sclerosis Correct Answers "Lou Gehrig's
disease" - young onset
Fatal paralytic disorder
SOLUTIONS
Abnormal uterine bleeding Correct Answers Menorrhagia:
excessive or prolonged uterine bleeding at regular intervals
(fibroids, uterine polyps, perimenopause)
Metrorrhagia: uterine bleeding at irregular intervals
(breakthrough bleeding with hormonal contraception, IUD,
cervical polyps, infection, genital tract cancers, physiologic)
Annovulatory bleeding: menarche, menopause, PCOS, thyroid
disorders, stress, weight loss. When you have your period, but
you are still not releasing an egg - can't get pregnant
ALWAYS RULE OUT PREGNANCY
Absence seizures Correct Answers Last 5-10 seconds
Brief loss of consciousness - not noticeable - can happen up to
20x per day.
Motor: lip smacking, twitching of eyes, face, slight hand
movements
Rarely falls, no incontinence
Minimal or no change in muscle tone
Almost always appear in childhood (4-12)
Usually outgrow
Acute glomerulonephritis Correct Answers May be a primary
event or manifestation of a systemic disorder (mild to severe)
Common features: oliguria, edema, HTN, circulatory
congestion, hematuria, and proteinuria
Most cases are post-infectious - acute poststreptococcal
glomerulonephritis is most common in children
,Can occur at any age - primarly affects school-age children.
Peak onset is 6 to 7
More common in males
Latent period of 10 to 21 days occurs between the strep infection
and the onset of clinical manifestations.
More common in winter or spring. Late summer and early fall
when associated with impetigo
Patho: immune complexes deposited into glomerular basement
membrane - glomeruli become edematous - decreased plasma
filtration - excessive accumulation of water and retention of
sodium - circulatory congestion and edema - hypertension
Acute pyelonephritis Correct Answers Very sick. Nausea,
vomiting, chills, nocturia, frequency, urgency, dysuria,
suprapubic or flank pain. Fever, hematuria, pyuria, foul-smelling
urine.
Oral antibiotics if not acutely ill.
Hospitalization for severe infections and complications such as
n/v with dehydration: parenteral antibiotics to establish high
serum levels
Look at page 910
Acute renal failure Correct Answers Abrupt decrease in kidney
function
~10% of kidney functioning
Sudden increase in BUN and creatinine
Urine output <30 mL/hr
One of leading causes for inpatient mortality
Pre renal, (55-70%), intra renal (25-40%), and post renal failure
(~5%)
,Clinical manifestations: oliguric-anuric phase for 1-8 weeks.
Diuretic phase: leveling of BUN - urine output 1000-2000
mL/day. Then, recovery phase (3-12 months): mild
Mortality up to 50% - recovery within 4-10 weeks
Treatment: treat underlying cause, prevent progression to CRF,
maintain fluid and electrolyte balance, prevent infections,
maintain nutritional balance (high-calorie, low protein, low Na,
low Mg, low phosphate, low K), and short-term dialysis:
hemodialysis for renal function replacement
Acute renal failure intra renal conditions Correct Answers
Nephrotoxic agents
Transfusion reaction
Glomerulonephritis
Renal neoplasms
Diseases (DM, HTN)
Infections
Acute renal failure post renal conditions Correct Answers
Prostatic hypertrophy
Neurogenic bladder
Pelvic tumors
Urethral, bladder, ureteral obstruction (calculi, clots, tumors,
stricture)
Acute renal failure pre-renal conditions Correct Answers
Altered peripheral vascular resistance: sepsis, anaphylactic
reactions
Cardiac pump failure: MI, CHF, cardiogenic shock
Hypovolemia: dehydration, blood loss, burns
, Adult neuro assessment Correct Answers Goal: isolate the
lesion - where is the problem?
Establish a neurological baseline for future assessment
Components: comprehensive history (report), a neurological
physical exam, and neurodiagnostic tests (PET scans and MRIs)
Organizing the assessment: vital signs, orientation (LOC),
mental status and speech, cranial/spinal nerves, motor system,
sensory function, reflexes
Aging and nervous system Correct Answers After age 30,
changes in memory. Axon diameters thin and number of
receptors decrease
Alterations in hearing, vision, EOMs, pupillary size, shape, and
reactivity are common
Changes in motor system: move and react more slowly and with
less agility; skeletal muscles decrease in bulk
Benign essential tremor may develop
Some reflexes may change: gag reflex may diminish/weaken,
ankle reflexes may decrease
ALS nursing management Correct Answers Supportive care
Energy conservation
Psychosocial support to patient and family
PT/OT/nutrition/speech therapy
Advance directives - ventilation/nutrition - question of how long
we should keep them alive
Amyotropic Lateral Sclerosis Correct Answers "Lou Gehrig's
disease" - young onset
Fatal paralytic disorder
