NSG 320 Exam 1 Questions and Answers
Question 1.
In respiratory al-kalosis
Correct Answer: - pH is high and PaCO2 is low - Caused by: * HYPERVENTILATION
* Hypoxemia from acute pulmonary disorders * Pain * Fear/anxiety * Salicylate
or Nicotine overdose * Increased metabolism - Compensation rarely occurs due
to aggressive treatment for hypoxemia
Question 2.
In respiratory aci-dosis
Correct Answer: "When you're on acid, you're relaxing and HYPOventilating" -
pH is low and PaCO2 is high - Caused by: * HYPOVENTILATION * Respiratory
failure * Asthma attacks * COPD * Chest injury or trauma * Pulmonary edema *
Medications * Obstructive sleep apnea - Compensation may occur when kidneys
conserve HCO3 and secrete H into urine
Question 3.
In metabolic al-kalosis
Correct Answer: - pH and HCO3 are high and PaCO2 is high or normal - Caused
by: * Vomiting * Gastric suction * Extracellular fluid deficit * Dehydration *
Circulatory shock * Loop or thiazide diuretic use * Hypokalemia * Ingestion of
baking soda - Compensation occurs if CO2 is retained or HCO3 is excreted
Question 4.
In metabolic aci-dosis
Correct Answer: - Kussmaul respirations - pH and HCO3 are low and the PaCO2 is
low or normal - Caused by: * Fasting/starving * Cardiac arrest * Sepsis * Trauma
* Seizures * Renal failure * Severe diarrhea - Compensation may occur during
exhaling increase CO2
Question 5.
Normal values for ABG
Correct Answer: - pH: 7.35 - 7.45 - PaCO2: 35 - 45 mm Hg - HCO3 (Bicarbonate):
22 - 26 mEq/: - PaO2: 80 - 100 mm HG - SaO2: >95% - Base excess: +/- 2.0 meQ/L
Question 6.
Thyroid hor-mones
Correct Answer: - TSH: Thyroid stimulating hormone - T3: Triiodothyronine
hormone - T4: Thyroxine hormone
Question 7.
,Euthyroid
Correct Answer: - Normal functioning thyroid
Question 8.
Hypothyroidism
Correct Answer: - Deficiency of thyroid hormone that causes a general slowing
of the metabolic rate - Iodine deficiency is most common cause *Thyroid cannot
make T3+T4 WITHOUT iodine*
Question 9.
Primary hypothy-roidism
Correct Answer: - Caused by destruction of thyroid tissue or defective hormone
synthesis - Most common cause is atrophy to thyroid gland which can be caused
by Hashimoto's thyroiditis or Graves' disease
Question 10.
Secondary hy-pothyroidism
Correct Answer: - Caused by pituitary disease TSH secretion or hypothalamic
dysfunction with decreased-releasing hormone (TRH) secretion
Question 11.
Clinical manifes-tations of hy-pothyroidism
Correct Answer: - Slow and low - Decreased body processes - Decreased cardiac
contractility and output - Increased serum cholesterol and triglyceride levels -
Anemia
Question 12.
Diagnostic stud-ies consistent with hypothy-roidism
Correct Answer: - TSH higher than 4.5
Question 13.
Interprofession-al mgmt for hypothyroidism
Correct Answer: - Thyroid replacement - Monitor for CV disease - Monitor HR,
report higher than 100 BMP - Monitor for chest pain, weight loss, nervousness,
tremors, and/or insomnia - Monitor thyroid levels and adjust dosage - Nutrition
therapy for weight loss - Patient and caregiver teaching
Question 14.
Patient and care-giver teaching for hypothy-roidism
Correct Answer: - Discuss importance of thyroid hormone therapy - Discuss need
for lifelong therapy - Take thyroid medication in morning BEFORE food - Do not
switch medication brands - Emphasize need for warm environment due to cold
, intolerance - Teach measures to prevent skin breakdown - Avoid sedatives -
Discuss measures to prevent constipation - Avoid enemas due to vagal
stimulation
Question 15.
Nursing mgmt with hypothy-roidism
Correct Answer: - Diagnoses: * Activity intolerance related to weakness and
fatigue * Constipation related to GI hypomotility * Impaired memory realated to
hypometabolism - Overall goals * Experience relief of symptoms * Maintain a
euthyorid state * Maintain positive self-image * Comply with lifelong thyroid
therapy
Question 16.
Hyperthyroidism
Correct Answer: - Hyperactivity of the thyroid gland with sustained increase in
synthesis and release of thyroid hormones - Causes: * Graves' disease * Toxic
nodular goiter * Thyroiditis * Excess iodine intake * Pituitary tumors * Thyroid
cancer
Question 17.
Graves' disease
Correct Answer: - An autoimmune disease of unknown etiology characterized by
diffuse thyroid enlargement and excess thyroid hormone secretion - May
present with myasthenia gravis, DM, celiac disease, and pernicious anemia -
Precipitating factors: * Insufficient iodine supply * Cigarette smoking * Infection
* Stressful life events may interact with genetic factors - Hereditary - 8x more
likely to be seen in women between the ages of 20-40
Question 18.
Clinical manifes-tations of hyper-thyroidism
Correct Answer: - Goiter (enlarged thyroid) - Exophthalmos (protrusion of the
eyeballs) * May cause corneal ulcers or loss of vision. * Changes in the ocular
muscles may result in muscle weakness causing diplopia - Early signs are weight
loss and increased nervousness - Directly increases metabolism and tissue
sensitivity to stimulation by the sym-pathetic nervous system
Question 19.
RAIU
Correct Answer: - Used to distinguish Graves' disease from other forms of
thyroiditis
Question 20.
Pathophysiology for goiter
Question 1.
In respiratory al-kalosis
Correct Answer: - pH is high and PaCO2 is low - Caused by: * HYPERVENTILATION
* Hypoxemia from acute pulmonary disorders * Pain * Fear/anxiety * Salicylate
or Nicotine overdose * Increased metabolism - Compensation rarely occurs due
to aggressive treatment for hypoxemia
Question 2.
In respiratory aci-dosis
Correct Answer: "When you're on acid, you're relaxing and HYPOventilating" -
pH is low and PaCO2 is high - Caused by: * HYPOVENTILATION * Respiratory
failure * Asthma attacks * COPD * Chest injury or trauma * Pulmonary edema *
Medications * Obstructive sleep apnea - Compensation may occur when kidneys
conserve HCO3 and secrete H into urine
Question 3.
In metabolic al-kalosis
Correct Answer: - pH and HCO3 are high and PaCO2 is high or normal - Caused
by: * Vomiting * Gastric suction * Extracellular fluid deficit * Dehydration *
Circulatory shock * Loop or thiazide diuretic use * Hypokalemia * Ingestion of
baking soda - Compensation occurs if CO2 is retained or HCO3 is excreted
Question 4.
In metabolic aci-dosis
Correct Answer: - Kussmaul respirations - pH and HCO3 are low and the PaCO2 is
low or normal - Caused by: * Fasting/starving * Cardiac arrest * Sepsis * Trauma
* Seizures * Renal failure * Severe diarrhea - Compensation may occur during
exhaling increase CO2
Question 5.
Normal values for ABG
Correct Answer: - pH: 7.35 - 7.45 - PaCO2: 35 - 45 mm Hg - HCO3 (Bicarbonate):
22 - 26 mEq/: - PaO2: 80 - 100 mm HG - SaO2: >95% - Base excess: +/- 2.0 meQ/L
Question 6.
Thyroid hor-mones
Correct Answer: - TSH: Thyroid stimulating hormone - T3: Triiodothyronine
hormone - T4: Thyroxine hormone
Question 7.
,Euthyroid
Correct Answer: - Normal functioning thyroid
Question 8.
Hypothyroidism
Correct Answer: - Deficiency of thyroid hormone that causes a general slowing
of the metabolic rate - Iodine deficiency is most common cause *Thyroid cannot
make T3+T4 WITHOUT iodine*
Question 9.
Primary hypothy-roidism
Correct Answer: - Caused by destruction of thyroid tissue or defective hormone
synthesis - Most common cause is atrophy to thyroid gland which can be caused
by Hashimoto's thyroiditis or Graves' disease
Question 10.
Secondary hy-pothyroidism
Correct Answer: - Caused by pituitary disease TSH secretion or hypothalamic
dysfunction with decreased-releasing hormone (TRH) secretion
Question 11.
Clinical manifes-tations of hy-pothyroidism
Correct Answer: - Slow and low - Decreased body processes - Decreased cardiac
contractility and output - Increased serum cholesterol and triglyceride levels -
Anemia
Question 12.
Diagnostic stud-ies consistent with hypothy-roidism
Correct Answer: - TSH higher than 4.5
Question 13.
Interprofession-al mgmt for hypothyroidism
Correct Answer: - Thyroid replacement - Monitor for CV disease - Monitor HR,
report higher than 100 BMP - Monitor for chest pain, weight loss, nervousness,
tremors, and/or insomnia - Monitor thyroid levels and adjust dosage - Nutrition
therapy for weight loss - Patient and caregiver teaching
Question 14.
Patient and care-giver teaching for hypothy-roidism
Correct Answer: - Discuss importance of thyroid hormone therapy - Discuss need
for lifelong therapy - Take thyroid medication in morning BEFORE food - Do not
switch medication brands - Emphasize need for warm environment due to cold
, intolerance - Teach measures to prevent skin breakdown - Avoid sedatives -
Discuss measures to prevent constipation - Avoid enemas due to vagal
stimulation
Question 15.
Nursing mgmt with hypothy-roidism
Correct Answer: - Diagnoses: * Activity intolerance related to weakness and
fatigue * Constipation related to GI hypomotility * Impaired memory realated to
hypometabolism - Overall goals * Experience relief of symptoms * Maintain a
euthyorid state * Maintain positive self-image * Comply with lifelong thyroid
therapy
Question 16.
Hyperthyroidism
Correct Answer: - Hyperactivity of the thyroid gland with sustained increase in
synthesis and release of thyroid hormones - Causes: * Graves' disease * Toxic
nodular goiter * Thyroiditis * Excess iodine intake * Pituitary tumors * Thyroid
cancer
Question 17.
Graves' disease
Correct Answer: - An autoimmune disease of unknown etiology characterized by
diffuse thyroid enlargement and excess thyroid hormone secretion - May
present with myasthenia gravis, DM, celiac disease, and pernicious anemia -
Precipitating factors: * Insufficient iodine supply * Cigarette smoking * Infection
* Stressful life events may interact with genetic factors - Hereditary - 8x more
likely to be seen in women between the ages of 20-40
Question 18.
Clinical manifes-tations of hyper-thyroidism
Correct Answer: - Goiter (enlarged thyroid) - Exophthalmos (protrusion of the
eyeballs) * May cause corneal ulcers or loss of vision. * Changes in the ocular
muscles may result in muscle weakness causing diplopia - Early signs are weight
loss and increased nervousness - Directly increases metabolism and tissue
sensitivity to stimulation by the sym-pathetic nervous system
Question 19.
RAIU
Correct Answer: - Used to distinguish Graves' disease from other forms of
thyroiditis
Question 20.
Pathophysiology for goiter
