NR574 Final Exam – Questions With Correct
Solutions
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Terms in this set (424)
How often should a CK level be least every 6-12 hours to establish a peak level and
drawn and why? then subsequently a downward trend.
,Sylvie is a 26-year-old who presents serum creatine kinase
to the emergency department (ED)
after just finishing a full marathon. She
complains of feeling lightheaded,
nauseous, and has vomited twice
since completing the race. Her legs
feel tired, weak, and sore which she
attributes to running 26.2 miles. She
reports that she didn't stop to
rehydrate as much as she would have
liked because she was intent on
finishing with her personal best time.
She became very concerned when
she went to use the restroom and
noticed that her urine was dark -
almost like tea. The AGACNP
suspects rhabdomyolysis. Which test
is needed to confirm the diagnosis?
Sylvie's EKG shows markedly elevated hyperkalemia
T waves and prolongation of the PR
and QRS intervals. The AGACNP
should anticipate which of the
following results?
Risk factors for acute intestinal Adhesions from previous abdominal surgery Internal
obstruction? or external hernias Foreign bodies Feces
Congenital issues (atresia, stenosis, cyst formation,
intestinal duplication, and mal- rotation) Trauma
(hematoma formation)Inflammation (inflammatory
bowel disease, diverticulitis, radiation, and
tuberculosis) Neoplasms including carcinomatosis,
colon cancer, primary small bowel cancer, and
extraintestinal malignancies such as ovarian cancer
Endometriosis Volvulus Ischemic injury
Intussusception Intraperitoneal abscess
,Subjective findings of acute intestinal colicky abdominal pain (cramping periumbilical pain
obstruction initially; later becomes constant and
diffuse)abdominal pain often more severe with distal
obstruction vomiting (more significant with proximal
obstruction) abdominal bloatingobstipation
What key information should be History should include essential elements such as
discussed during H/P, if you are previous abdominal or pelvic surgeries, comorbid
concerned for bowel obstruction? conditions such as inflammatory bowel disease or
malignancy.
Objective findings in a patient with Key physical exam findings may include:
intestinal obstruction? Fever (systemic inflammation or strangulation)
High-pitched, tinkling, bowel sounds (may be
hypoactive or absent with complete obstruction)
Abdominal distention (more significant with distal
obstruction due to the greater volume of
intraluminal fluid accumulation)Mild abdominal
tenderness but no peritoneal findingsTender
abdominal or groin masses (can represent
incarcerated hernia) Signs of shock (tachycardia,
hypotension, oliguria)
Significant abdominal tenderness with ischemia, peritonitis, or necrosis.
palpation should increase the NP's
suspicion for?
why is a serum lactate useful in dx a Serum lactate (increased serum lactate should raise
bowel obstruction? concern for strangulated obstruction)
what diagnostic imaging should be plain film xray
used for bowel obstruction?
what will a plain film xray show if a Obstruction will reveal dilated loops of bowel and
patient has a bowel obstruction? visible air-fluid levels which should prompt further
studies.A horizontal pattern of dilated small bowel
loops can be seen with small bowel obstruction
(SBO)
, Should barium contrast be given to a NO! Imaging studies requiring administration of
patient with a bowel obstruction? barium are contraindicated in cases of high- grade
or complete obstruction.
What does barium contrast do within Barium should NEVER be given orally to a client
the body with a bowel obstruction? until the diagnosis of obstruction has been excluded
completely as retained barium can cause
concretions which create an additional source of
blockage which can require surgical intervention in
clients who may have otherwise recovered.
Retained barium also severely limits the ability to
interpret subsequent angiography or cross-
sectional imaging.
Treatment of bowel obstruction Gen surg consult, NG tube (intermittent suction) for
decompression, fluid rescusitation, electrolyte
management as indicated,
complete obstruction= immediate surgical
intervention
Superior Vena Cava Syndrome (SVCS) SVCS is the clinical manifestation of SVC obstruction
with severe reduction in venous return from the
head, neck, and upper extremities.
What is responsible for the majority malignant tumors, such as lung cancer, lymphoma,
of SVCS cases? and metastatic tumors.
Subjective findings with SVCS Commonly: neck and facial swelling (especially
patients around the eyes) dyspnea, and cough other
symptoms:hoarseness, tongue swelling, headaches,
nasal congestion, epistaxis, hemoptysis, dysphagia,
pain, dizziness, syncope, and lethargy.
what can cause symptoms of SVCS to bending down, laying supine, position changes.
become worse?
Solutions
Add to calendar
Play your way to mastery with fun games
Match Blocks Charms NEW
Terms in this set (424)
How often should a CK level be least every 6-12 hours to establish a peak level and
drawn and why? then subsequently a downward trend.
,Sylvie is a 26-year-old who presents serum creatine kinase
to the emergency department (ED)
after just finishing a full marathon. She
complains of feeling lightheaded,
nauseous, and has vomited twice
since completing the race. Her legs
feel tired, weak, and sore which she
attributes to running 26.2 miles. She
reports that she didn't stop to
rehydrate as much as she would have
liked because she was intent on
finishing with her personal best time.
She became very concerned when
she went to use the restroom and
noticed that her urine was dark -
almost like tea. The AGACNP
suspects rhabdomyolysis. Which test
is needed to confirm the diagnosis?
Sylvie's EKG shows markedly elevated hyperkalemia
T waves and prolongation of the PR
and QRS intervals. The AGACNP
should anticipate which of the
following results?
Risk factors for acute intestinal Adhesions from previous abdominal surgery Internal
obstruction? or external hernias Foreign bodies Feces
Congenital issues (atresia, stenosis, cyst formation,
intestinal duplication, and mal- rotation) Trauma
(hematoma formation)Inflammation (inflammatory
bowel disease, diverticulitis, radiation, and
tuberculosis) Neoplasms including carcinomatosis,
colon cancer, primary small bowel cancer, and
extraintestinal malignancies such as ovarian cancer
Endometriosis Volvulus Ischemic injury
Intussusception Intraperitoneal abscess
,Subjective findings of acute intestinal colicky abdominal pain (cramping periumbilical pain
obstruction initially; later becomes constant and
diffuse)abdominal pain often more severe with distal
obstruction vomiting (more significant with proximal
obstruction) abdominal bloatingobstipation
What key information should be History should include essential elements such as
discussed during H/P, if you are previous abdominal or pelvic surgeries, comorbid
concerned for bowel obstruction? conditions such as inflammatory bowel disease or
malignancy.
Objective findings in a patient with Key physical exam findings may include:
intestinal obstruction? Fever (systemic inflammation or strangulation)
High-pitched, tinkling, bowel sounds (may be
hypoactive or absent with complete obstruction)
Abdominal distention (more significant with distal
obstruction due to the greater volume of
intraluminal fluid accumulation)Mild abdominal
tenderness but no peritoneal findingsTender
abdominal or groin masses (can represent
incarcerated hernia) Signs of shock (tachycardia,
hypotension, oliguria)
Significant abdominal tenderness with ischemia, peritonitis, or necrosis.
palpation should increase the NP's
suspicion for?
why is a serum lactate useful in dx a Serum lactate (increased serum lactate should raise
bowel obstruction? concern for strangulated obstruction)
what diagnostic imaging should be plain film xray
used for bowel obstruction?
what will a plain film xray show if a Obstruction will reveal dilated loops of bowel and
patient has a bowel obstruction? visible air-fluid levels which should prompt further
studies.A horizontal pattern of dilated small bowel
loops can be seen with small bowel obstruction
(SBO)
, Should barium contrast be given to a NO! Imaging studies requiring administration of
patient with a bowel obstruction? barium are contraindicated in cases of high- grade
or complete obstruction.
What does barium contrast do within Barium should NEVER be given orally to a client
the body with a bowel obstruction? until the diagnosis of obstruction has been excluded
completely as retained barium can cause
concretions which create an additional source of
blockage which can require surgical intervention in
clients who may have otherwise recovered.
Retained barium also severely limits the ability to
interpret subsequent angiography or cross-
sectional imaging.
Treatment of bowel obstruction Gen surg consult, NG tube (intermittent suction) for
decompression, fluid rescusitation, electrolyte
management as indicated,
complete obstruction= immediate surgical
intervention
Superior Vena Cava Syndrome (SVCS) SVCS is the clinical manifestation of SVC obstruction
with severe reduction in venous return from the
head, neck, and upper extremities.
What is responsible for the majority malignant tumors, such as lung cancer, lymphoma,
of SVCS cases? and metastatic tumors.
Subjective findings with SVCS Commonly: neck and facial swelling (especially
patients around the eyes) dyspnea, and cough other
symptoms:hoarseness, tongue swelling, headaches,
nasal congestion, epistaxis, hemoptysis, dysphagia,
pain, dizziness, syncope, and lethargy.
what can cause symptoms of SVCS to bending down, laying supine, position changes.
become worse?
