CMSRN PRACTICE TEST 15 COMPREHENSIVE
TEST PAPER QUESTIONS AND SOLUTIONS
◉ laboratory findings consistent with disseminated intravascular
coagulation (DIC)
Answer: Increased D-dimer, prolonged activated partial
thromboplastin time (aPTT), decreased platelet count
◉ DIC
Answer: Disseminated intravascular coagulation is a diffuse
accelerated response to a stimulus that activates the coagulation
cascade and produces clotting and thrombus formation, followed by
bleeding and hemorrhage throughout the circulatory system. There
is a rapid depletion of platelets and clotting factors and excess
production of fibrin degradation products, which act as
anticoagulants.
Signs and symptoms include petechia, purpura, ecchymosis,
hematomas, and prolonged oozing or bleeding from orifices,
venipuncture sites, or incisions. Increased D-dimer, prolonged
activated partial thromboplastin time (aPTT), decreased platelet
count
◉ earliest detectable s/s of ARDS
Answer: tachypnea. Other vital sign measurements reveal increased
blood pressure and tachycardia. Tachypnea is followed by increasing
,respiratory effort and accessory muscle use, and cyanosis ensues.
Breath sounds may be clear or consist of fine inspiratory crackles or
diffuse coarse crackles. Intercostal retractions are a later sign of
respiratory distress.
◉ Which of the following conditions can contribute to bladder
instability and increase the risk of a urinary tract infection (UTI) in
an elderly patient?
Answer: Constipation has been found to contribute to bladder
instability and increases the risk of UTI development. The other
choices are not associated with encouraging UTI development.
◉ aldosterone
Answer: A hormone produced by the adrenal glands that helps
regulate sodium and potassium levels in the blood. It promotes
sodium retention and potassium excretion in the kidneys, playing a
key role in blood pressure and fluid balance.
◉ ADH
Answer: Also known as vasopressin, this hormone is secreted by the
pituitary gland and helps regulate water balance in the body by
increasing water reabsorption in the kidneys, thus concentrating the
urine and reducing urine output.
◉ high/low Na s/s
, Answer: Hyperactive bowel sounds, muscle weakness, increased
urinary output, and decreased specific gravity of the urine would be
noted in a patient who is hyponatremic. - and decreased urine
specific gravity
Extreme thirst and decreased urinary output are associated with
hypernatremia.
◉ most common caused of CKD
Answer: . Type 2 diabetes mellitus (not DI) and hypertension
(particularly with poor control) are two of the most potent risk
factors for the development of CKD. Other risk factors include type 1
diabetes mellitus, cardiovascular disease, increasing age (older than
60 years), history of AKI, family history of CKD, chronic
glomerulonephritis, pyelonephritis, urinary tract obstruction, renal
cell carcinoma, renovascular disease, lupus nephritis, multiple
myeloma, amyloidosis, chronic hypercalcemia and hypokalemia, and
sarcoidosis.
◉ pressure injuries
Answer: This patient has a suspected deep tissue injury; the purple
discoloration over intact skin is due to damage of underlying soft
tissue from pressure and/or shear. The area may be preceded by
tissue that is painful, firm, mushy, boggy, warmer, or cooler
compared with adjacent tissue.
A stage I pressure ulcer is characterized by intact skin with localized
nonblanchable redness, usually over a bony prominence. A stage II
pressure ulcer (partial thickness) presents as a shallow open ulcer
TEST PAPER QUESTIONS AND SOLUTIONS
◉ laboratory findings consistent with disseminated intravascular
coagulation (DIC)
Answer: Increased D-dimer, prolonged activated partial
thromboplastin time (aPTT), decreased platelet count
◉ DIC
Answer: Disseminated intravascular coagulation is a diffuse
accelerated response to a stimulus that activates the coagulation
cascade and produces clotting and thrombus formation, followed by
bleeding and hemorrhage throughout the circulatory system. There
is a rapid depletion of platelets and clotting factors and excess
production of fibrin degradation products, which act as
anticoagulants.
Signs and symptoms include petechia, purpura, ecchymosis,
hematomas, and prolonged oozing or bleeding from orifices,
venipuncture sites, or incisions. Increased D-dimer, prolonged
activated partial thromboplastin time (aPTT), decreased platelet
count
◉ earliest detectable s/s of ARDS
Answer: tachypnea. Other vital sign measurements reveal increased
blood pressure and tachycardia. Tachypnea is followed by increasing
,respiratory effort and accessory muscle use, and cyanosis ensues.
Breath sounds may be clear or consist of fine inspiratory crackles or
diffuse coarse crackles. Intercostal retractions are a later sign of
respiratory distress.
◉ Which of the following conditions can contribute to bladder
instability and increase the risk of a urinary tract infection (UTI) in
an elderly patient?
Answer: Constipation has been found to contribute to bladder
instability and increases the risk of UTI development. The other
choices are not associated with encouraging UTI development.
◉ aldosterone
Answer: A hormone produced by the adrenal glands that helps
regulate sodium and potassium levels in the blood. It promotes
sodium retention and potassium excretion in the kidneys, playing a
key role in blood pressure and fluid balance.
◉ ADH
Answer: Also known as vasopressin, this hormone is secreted by the
pituitary gland and helps regulate water balance in the body by
increasing water reabsorption in the kidneys, thus concentrating the
urine and reducing urine output.
◉ high/low Na s/s
, Answer: Hyperactive bowel sounds, muscle weakness, increased
urinary output, and decreased specific gravity of the urine would be
noted in a patient who is hyponatremic. - and decreased urine
specific gravity
Extreme thirst and decreased urinary output are associated with
hypernatremia.
◉ most common caused of CKD
Answer: . Type 2 diabetes mellitus (not DI) and hypertension
(particularly with poor control) are two of the most potent risk
factors for the development of CKD. Other risk factors include type 1
diabetes mellitus, cardiovascular disease, increasing age (older than
60 years), history of AKI, family history of CKD, chronic
glomerulonephritis, pyelonephritis, urinary tract obstruction, renal
cell carcinoma, renovascular disease, lupus nephritis, multiple
myeloma, amyloidosis, chronic hypercalcemia and hypokalemia, and
sarcoidosis.
◉ pressure injuries
Answer: This patient has a suspected deep tissue injury; the purple
discoloration over intact skin is due to damage of underlying soft
tissue from pressure and/or shear. The area may be preceded by
tissue that is painful, firm, mushy, boggy, warmer, or cooler
compared with adjacent tissue.
A stage I pressure ulcer is characterized by intact skin with localized
nonblanchable redness, usually over a bony prominence. A stage II
pressure ulcer (partial thickness) presents as a shallow open ulcer
