NUR 2392 / NUR2392: Multidimensional Care II
MDC 2 Exam 2 2023 Rasmussen College 1. A patient is brought into the ED with respiratory depression. The patient has a history of COPD. What acid-base imbalance is most likely? - Respiratory Acidosis. The patient likely has a build-up of CO2, causing respiratory acidosis. 2. The nurse is evaluating the lab work of a patient who has uncontrolled metabolic acidosis. Which lab result would result from this condition? Serum potassium 5.7 mEq/L. Serum potassium increases during acidosis to try to buffer the acidic conditions. 3. The nurse is reviewing the standing orders for a patient who was admitted for evaluation of chest pain. The patient has a history of (COPD) and his laboratory results and assessment reveal that he has mild respiratory acidosis. The nurse would question which order? Oxygen therapy at 4 L/min as needed - Oxygen therapy at 4L/ Min as needed. Oxygen therapy is often ordered for =respiratory acidosis. However, COPD patients have a difficult time off-loading carbon dioxide and giving too much oxygen can cause these patients to have a decrease in respiratory drive, leading to respiratory arrest. 4. A client has acute alcohol intoxication. What acid-base imbalance is the client at risk for? Metabolic Acidosis 5. A client comes into the ED with respiratory acidosis. What type of medication would the nurse likely administer? Bronchodilators 6. A client comes into the ED with a high fever and is hyperventilating. His ABG results are pH 7.51, PaCO2 28 mm Hg, and HCO3 24 mEq/L. The nurse should identify that the client has which acid-base imbalance? Respiratory Alkalosis . Because the client is breathing rapidly, he is exhaling excessive amounts of carbon dioxide. This loss of carbon dioxide decreases the hydrogen ion levels of the blood, causing the pH to increase and resulting in respiratory alkalosis. 7. A nurse is caring for a client who has metabolic alkalosis. As the client compensates for this acid-base imbalance, which of the following mechanisms should the nurse expect the client's body to use? Hypoventilation. 8. A nurse is inserting an NG tube for a client who is beginning enteral feedings. What action should the nurse take to verify tube placement before administering initial feeding? Verify tube placement with radiography 9. Which patient statement alerts the nurse to perform a thorough GI history and focused assessment? "I take ibuprofen three times daily for arthritis.” large amounts of aspirin or NSAIDs can cause peptic ulcer disease and GI bleeding. 10. After abdominal surgery, which question should the nurse ask the patient to determine whether peristaltic movement is returning? "Have you passed flatus?" 11. When administering a new GI medication to an older patient, the nurse anticipates what? Close monitoring is needed because toxic levels may develop. 12. A patient in the ED has been experiencing upper abdominal pain after meals for the past several months. She reports pain after napping or sleeping at night. She has been taking OTC antacids with some relief. The nurse understands that which assessment finding places the patient at risk for peptic ulcer disease? use of NSAIDS to control arthritis pain - NSAID use and H. Pylori bacteria are the most common causes of ulcers. 13. Which diagnostic results does the nurse recognize that support the diagnosis of peptic ulcer disease (PUD)? (SATA) Low hemoglobin (Hgb), Low hematocrit (Hct), Positive for H. pylori bacteria - Low hemoglobin and low hematocrit are signs of bleeding. H. Pylori is a common cause of ulcers 14. An EGD confirms that the patient has PUD. Three hours later, the patient is admitted to the medical unit for workup and further testing. On admission the patient reports midline epigastric tenderness and indigestion (dyspepsia). The patient is prescribed triple therapy. Which drugs does the nurse prepare to administer? Proton pump inhibitor (PPI) and two antibiotics 15. Which patient statement would cause the nurse to suspect that she may have Zollinger- Ellison syndrome (ZES)? "The stomach pain hurts, but the foul-smelling diarrhea is worse." 16. Zollinger-Ellison syndrome - hypersecretion of gastric acid that produces peptic ulcers as a result of pancreatic tumors 17. Zollinger-Ellison syndrome symptoms Peptic ulcers (not responding to tx), Dyspepsia, GERD, Diarrhea, foul smelling, stomach pain 18. As the patient prepares for discharge, the nurse provides education about behaviors that reduce symptoms and aggravate peptic ulcers. Which teaching does the nurse provide? (SATA) Sit upright 30 to 60 minutes after meals., Extreme
MDC 2 Exam 2 2023 Rasmussen College 1. A patient is brought into the ED with respiratory depression. The patient has a history of COPD. What acid-base imbalance is most likely? - Respiratory Acidosis. The patient likely has a build-up of CO2, causing respiratory acidosis. 2. The nurse is evaluating the lab work of a patient who has uncontrolled metabolic acidosis. Which lab result would result from this condition? Serum potassium 5.7 mEq/L. Serum potassium increases during acidosis to try to buffer the acidic conditions. 3. The nurse is reviewing the standing orders for a patient who was admitted for evaluation of chest pain. The patient has a history of (COPD) and his laboratory results and assessment reveal that he has mild respiratory acidosis. The nurse would question which order? Oxygen therapy at 4 L/min as needed - Oxygen therapy at 4L/ Min as needed. Oxygen therapy is often ordered for =respiratory acidosis. However, COPD patients have a difficult time off-loading carbon dioxide and giving too much oxygen can cause these patients to have a decrease in respiratory drive, leading to respiratory arrest. 4. A client has acute alcohol intoxication. What acid-base imbalance is the client at risk for? Metabolic Acidosis 5. A client comes into the ED with respiratory acidosis. What type of medication would the nurse likely administer? Bronchodilators 6. A client comes into the ED with a high fever and is hyperventilating. His ABG results are pH 7.51, PaCO2 28 mm Hg, and HCO3 24 mEq/L. The nurse should identify that the client has which acid-base imbalance? Respiratory Alkalosis . Because the client is breathing rapidly, he is exhaling excessive amounts of carbon dioxide. This loss of carbon dioxide decreases the hydrogen ion levels of the blood, causing the pH to increase and resulting in respiratory alkalosis. 7. A nurse is caring for a client who has metabolic alkalosis. As the client compensates for this acid-base imbalance, which of the following mechanisms should the nurse expect the client's body to use? Hypoventilation. 8. A nurse is inserting an NG tube for a client who is beginning enteral feedings. What action should the nurse take to verify tube placement before administering initial feeding? Verify tube placement with radiography 9. Which patient statement alerts the nurse to perform a thorough GI history and focused assessment? "I take ibuprofen three times daily for arthritis.” large amounts of aspirin or NSAIDs can cause peptic ulcer disease and GI bleeding. 10. After abdominal surgery, which question should the nurse ask the patient to determine whether peristaltic movement is returning? "Have you passed flatus?" 11. When administering a new GI medication to an older patient, the nurse anticipates what? Close monitoring is needed because toxic levels may develop. 12. A patient in the ED has been experiencing upper abdominal pain after meals for the past several months. She reports pain after napping or sleeping at night. She has been taking OTC antacids with some relief. The nurse understands that which assessment finding places the patient at risk for peptic ulcer disease? use of NSAIDS to control arthritis pain - NSAID use and H. Pylori bacteria are the most common causes of ulcers. 13. Which diagnostic results does the nurse recognize that support the diagnosis of peptic ulcer disease (PUD)? (SATA) Low hemoglobin (Hgb), Low hematocrit (Hct), Positive for H. pylori bacteria - Low hemoglobin and low hematocrit are signs of bleeding. H. Pylori is a common cause of ulcers 14. An EGD confirms that the patient has PUD. Three hours later, the patient is admitted to the medical unit for workup and further testing. On admission the patient reports midline epigastric tenderness and indigestion (dyspepsia). The patient is prescribed triple therapy. Which drugs does the nurse prepare to administer? Proton pump inhibitor (PPI) and two antibiotics 15. Which patient statement would cause the nurse to suspect that she may have Zollinger- Ellison syndrome (ZES)? "The stomach pain hurts, but the foul-smelling diarrhea is worse." 16. Zollinger-Ellison syndrome - hypersecretion of gastric acid that produces peptic ulcers as a result of pancreatic tumors 17. Zollinger-Ellison syndrome symptoms Peptic ulcers (not responding to tx), Dyspepsia, GERD, Diarrhea, foul smelling, stomach pain 18. As the patient prepares for discharge, the nurse provides education about behaviors that reduce symptoms and aggravate peptic ulcers. Which teaching does the nurse provide? (SATA) Sit upright 30 to 60 minutes after meals., Extreme
