NURS 332 – MIDTERM | NURSING THEORY AND CLINICAL APPLICATION ––200 PRACTICE CORRECT ANSWERS COVERING MOST TESTED QUESTIONS

NURS 332 – MIDTERM | NURSING THEORY AND CLINICAL
APPLICATION ––200 PRACTICE CORRECT ANSWERS
COVERING MOST TESTED QUESTIONS
NURS 332 MIDTERM #2 FOCUSES ON INTERMEDIATE-LEVEL NURSING
KNOWLEDGE, INCLUDING CLINICAL ASSESSMENTS, PATIENT CARE PLANNING,
PATHOPHYSIOLOGICAL CONCEPTS, AND EVIDENCE-BASED INTERVENTIONS.
THIS EXAM EVALUATES A STUDENT’S ABILITY TO APPLY THEORETICAL
PRINCIPLES TO REAL-WORLD CLINICAL SCENARIOS, SUPPORTING
DEVELOPMENT IN CRITICAL THINKING AND PROFESSIONAL NURSING
JUDGMENT.


How is acute kidney injury identified? - CORRECT ANSWER-oliguria and elevated serum BUN
(3.0-6.5=N) and creatinine (60-110=N)

Together, elevation of BUN and creatinine= azotemia



What are some of the risk factors for acute kidney infection? - CORRECT ANSWER--proteinuria

-history of renal problems

-use of nephrotoxic agents

-exposure to heavy metals or organic solvents

-recent hypotensive episode

-tumor or vascular obstruction



What are some drugs that alter renal perfusion? - CORRECT ANSWER--ACE inhibitors

-ARB's

-NSAIDs

-cyclosporine



What is prerenal injury caused by? - CORRECT ANSWER--inadequate blood flow resulting in
renal hypoperfusion/ischemia

-often reversible

,What are some of the causes of prerenal injury? - CORRECT ANSWER--increased vascular
capacity

-drugs that alter renal hemodynamics

-decreased cardiac output



symptoms of acute subdural hematoma - CORRECT ANSWER--drowsiness

-headache

-confusion

-slowed thinking

-agitation

-unilateral pupillary abnormality



symptoms of chronic subdural hematoma - CORRECT ANSWER--headache

-lethargy

-absent-mindedness

-vomiting

-seizures

-stiff neck

-pupil changes

-hemiparesis



epidural hematoma - CORRECT ANSWER--occurs in space between dura mater and the skull

-common with high impact to the temporal area resulting in shearing of small arteries

-classic presentation: brief loss of consciousness followed by an episode of being alert and oriented,
and so on

-dilated and fixed pupil on the same side as impact area is hallmark of an epidural hematoma



intracerebral hematoma - CORRECT ANSWER--bleeding directly into the cerebral tissue
resulting in destruction of cerebral tissue, cerebral edema, & increased ICP

-results from: uncontrolled HTN, ruptured aneurysm, trauma with high-impact blow to the head

, clinical manifestations of an intracerebral hematoma - CORRECT ANSWER--headache with
decreased LOC

-unilateral pupil dilation

-hemiplegia



contusion - CORRECT ANSWER--bruising of soft tissue and is considered a moderate to severe
head injury

-commonly seen in traumatic brain injury & usually r/t acceleration-deceleration injuries

-manifestations r/t area of brain affected

-can be focal & superficial or spread to deeper layers

-GCS useful in determining severity



diffuse head injuries - CORRECT ANSWER--involves the brain more globally (occurs in several
areas of brain)

-concussion

-diffuse axonal injury

-subarachnoid hemorrhage



diffuse axonal injury - CORRECT ANSWER-involves stretching, shearing, or tearing of axons d/t
movement of the brain inside cranium at time of impact

-commonly caused by acceleration-deceleration and rotational forces

-mild (coma <24 hours)

-moderate (coma >24 hours with transient flexor or extensor posturing)

-severe (coma prolonged, fever, diaphoretic, & severe extensor posturing)



subarachnoid hemorrhage - CORRECT ANSWER-accumulation of blood/hematoma between the
arachnoid layer of the meninges and the brain

-can be focal with little consequence or massive/diffuse

-S&S: intracranial hypotension, neck stiffness, *severe headache*



Pharmacological management of TBI - CORRECT ANSWER-Osmotic Diuretics:

-mannitol