NUR 445 IN-DEPTH MEDICAL NURSING EXAM GUIDE | OVER 200 QUESTIONS AND CORRECT ANSWERS GRADED A+

Heart failure- Placing the client in high Fowler's position is the first priority to reduce - Answer pulmonary congestion and improve oxygenation. After positioning, the nurse should administer IV furosemide to reduce fluid overload. The first step in the management of a snake bite is to - Answer clean the bite site gently with soap and water to reduce the risk of infection. The nurse should expect IV morphine to be prescribed first for a client with acute - Answer decompensated heart failure experiencing severe shortness of breath, tachypnea, tachycardia, and anxiety. Pacemaker and feeling dizzy -The nurse should first perform an electrocardiogram (ECG) to assess the pacemaker's function and determine if there are any issues with - Answer the pacemaker or the client's heart rhythm. Dizziness and near fainting could be signs that the pacemaker is malfunctioning or that there is an issue with the heart rate. To increase the client's preload, the nurse should expect the health care provider to - Answer order a fluid bolus or resuscitation. Vasodilators/ nitroglycerin, nitroprusside) decrease - Answer systemic vascular resistance (SVR), reducing afterload and easing the workload on the heart. Cardiac output is dependent on heart rate and stroke volume. Positive inotropic medications/ dobutamine, dopamine) improve - Answer myocardial contractility, enhancing stroke volume and increasing cardiac output. In cardiogenic shock, the central venous pressure (CVP) is typically - Answer elevated, often in the range of 12-18 mmHg or higher Clients recovering from CABG surgery are at high risk for atelectasis and deconditioning due to prolonged bed rest and pain. Diminished breath sounds, tachypnea, and fatigue suggest - Answer impaired oxygenation and lung expansion. Early ambulation and deep breathing exercises help prevent respiratory complications and improve circulation. An expanding hematoma and hypotension suggest an arterial bleed, a serious complication of - Answer cardiac catheterization. The priority is to apply firm pressure to the site to control bleeding The nurse should anticipate administering oral lactulose to reduce serum ammonia levels and improve mental status in a client with - Answer hepatic encephalopathy. Clients with liver failure are at risk for fluid retention and ascites, so a low-sodium diet is - Answer recommended. Protein should be moderated, but not completely avoided, as the body still requires it for muscle maintenance. In clients with cirrhosis and massive ascites, paracentesis is performed - Answer to remove excess fluid, relieve respiratory distress, and improve comfort. The most appropriate statement After a liver transplant is, - Answer "You will be on immunosuppressive therapy for the rest of your life." patients must take immunosuppressive medications to prevent organ rejection. After a liver biopsy, the client should lie on the right side for several hours to apply pressure to the biopsy site to - Answer prevent bleeding. Clients are usually NPO for a few hours before the procedure, not 24 hours. Light activity is typically allowed after the first day Clients with late-stage hepatitis are at risk for bleeding due to - Answer impaired liver function and decreased clotting factor production. Fresh frozen plasma (FFP) and vitamin K help improve clotting and reduce bleeding risk. AKI is most often caused by sudden events that impair kidney perfusion, such as - Answer hypovolemia from blood loss, dehydration, vomiting and diarrhea, Sepsis and persistent hypotension A low-potassium diet is essential for clients with CKD, as the kidneys cannot effectively excrete - Answer potassium, leading to hyperkalemia, which can cause life-threatening cardiac dysrhythmias. High phosphorus and increased dairy intake should be avoided due to the risk of worsening mineral imbalances in CKD. "I will palpate for a thrill prior to utilizing the AV fistula." Palpating for a thrill is essential for assessing the fistula's patency and ensuring - Answer proper blood flow. A thrill is a vibration or pulsation felt when palpating over the fistula, which indicates that blood is flowing effectively CRRT is a continuous, slow process used in critically ill clients to avoid rapid fluid shifts and hemodynamic instability. It is not exclusive to - Answer long-term dialysis, does not immediately raise blood pressure, and is often required for several days rather than a one-time treatment. Clients with a renal transplant should not restrict fluid intake unless - Answer specifically advised by their provider. Adequate hydration is essential for kidney function. Intubated and on Propofol drip with HR116 and RR24 BP152/88 RASS+1. Titrate up or down? - Answer Titrate up Ischemic stroke intubated for airway protection with Respiratory Rate: 16 breaths/min • Temperature: 99.1°F (37.3°C) • Heart Rate: 84 beats/min • Blood Pressure: 132/78 mmHg • Oxygen Saturation: 98% • RASS Score: -3 (Moderate sedation). Titrate up or down? - Answer Titrate down. Severe TBI that is intubated • Respiratory Rate: 16 breaths/min • Temperature: 98.7°F (37.1°C) • Heart Rate: 88 beats/min • Blood Pressure: 130/76 mmHg • Oxygen Saturation: 97% • RASS Score: -2 (Light sedation). Titrate up or down? - Answer Maintaining the current rate is ideal Increased ICP can compress brain structures, affecting neurological function. One of the first signs of this pressure buildup is a change in - Answer the client's mental status, such as confusion, agitation, or drowsiness. Hypotonic saline should be questioned in a client with increased intracranial pressure (ICP). Hypotonic solutions, such as 0.45% sodium chloride, can cause water to - Answer shift into brain cells, worsening cerebral edema and increasing ICP. A new onset of a dilated, non-reactive pupil may indicate - Answer increased intracranial pressure (ICP) or herniation, which is a medical emergency requiring immediate intervention. Guillain-Barré Syndrome (GBS) can lead to progressive weakness and paralysis, and one of the most concerning complications is - Answer respiratory failure. Shortness of breath when lying flat may indicate difficulty breathing due to paralysis of the respiratory muscles, which could lead to respiratory compromise. Trigeminal neuralgia is characterized by severe, sudden, unilateral facial pain along the distribution of the trigeminal nerve, often triggered by - Answer touch, chewing, or speaking. The nurse should question the prescription for oxycodone/acetaminophen ALS - Difficulty swallowing (dysphagia) and a weak cough indicate bulbar muscle involvement, which increases the risk of - Answer aspiration and respiratory failure—potentially life-threatening complications of ALS. Myasthenia Gravis (MG) is characterized by muscle weakness that worsens with - Answer activity and improves with rest, with ptosis (drooping eyelid) being a common early sign. A client receiving alteplase (tPA) should not be prescribed anticoagulants like - Answer warfarin simultaneously, as this increases the risk of life-threatening hemorrhage. ischemic stroke, indicated - 12-lead ECG, bedside swallow testing, Monitoring electrolyte levels. Not indicated - - Answer maintaining systolic BP