MSN 570 HESI QUESTIONS AND ANSWERS- COMPLETE SOLUTIONS

Romberg test - ANSWER-used to evaluate cerebellar function and balance mitral valve prolapse - ANSWER-systolic click heard at apical area, pt asymptomatic, need echo w/ doppler to confirm dx Treatment for patient w/ HF - ANSWER-ACE & ARBS in combination w/ beta blocker & diuretic paroxysmal atrial tachycardia - ANSWER-rapid, regular contractions of the atria that begins and ends quickly Side effect of Calcium Channel Blockers - ANSWER-headache, heart blocks, bradycardia apical pulse difference - ANSWER-done when both radial and apical pulses are checked at same time For pt w/ emphysema - ANSWER-do not give beta blockers because it decreases response to bronchodilators pluses paradoxus - ANSWER-Decrease in systolic blood pressure (by 10mmHG) during inspiration S2 sounds - ANSWER-caused by closure of semilunar valve aortic stenosis murmur - ANSWER-harsh and high pitched, best heard at the 2nd right intercostal space w/ radiation to carotid arteries Addisson's disease - ANSWER-findings: hyperpigmentation , hyperkalemia, hyponatremia and decrease serum cortisol levels Hashimoto's disease - ANSWER-an autoimmune disease in which the body's own antibodies attack and destroy the cells of the thyroid gland; an enlarged thyroid is first sign of disease Somogyi phenomenon - ANSWER-A rebound phenomenon that occurs in clients with type 1 diabetes mellitus. Normal or elevated blood glucose levels are present at bedtime; hypoglycemia occurs at about 2 to 3 am. Counterregulatory hormones, glucagon (converted to glucose )produced to prevent further hypoglycemia, result in hyperglycemia Treatment includes decreasing the evening (predinner or bedtime) dose of intermediate acting insulin or increasing the bedtime snack. Regular insulin - ANSWER-short acting; onset 15-20 mins peak 1.5 hrs duration 3-4 hours NPH insulin - ANSWER-intermediate acting insulin; onset 1.5-3 hrs, peak 4-12 hours, duration 18-24 hours low free T4 - ANSWER-requires start of Synthroid TSH (thyroid stimulating hormone) - ANSWER-stimulates thyroid gland; best screening for hypothyroidism Meniere's disease - ANSWER-disorder of inner ear causing episodic vertigo, tinnitus, and hearing loss, sense of ear fullness Hemoglobin A1c - ANSWER-4-6% = good glucose control 6.6 =DM 2 Tretment goal 7 Cushing's syndrome - ANSWER-a condition caused by prolonged exposure to high levels of cortisol newly diagnosed DM 2 - ANSWER-strenuous exercise is contraindicated because of risk of hypoglycemia Hashimoto's thyroiditis - ANSWER-an autoimmune disease in which the body's own antibodies attack and destroy the cells of the thyroid gland; test w anti-thyroid peroxidase myxedema - ANSWER-caused by extreme deficiency of thyroid secretion; also known as adult hypothyroidism Obturator sign - ANSWER-RLQ pain on internal rotation of right thigh indicative of appendicitis Diverticulitis Treatment - ANSWER-rest, liquid or low-fiber diet, and antibiotics. Severe cases may need hospital care and surgery. Doctors may recommend a high-fiber diet after recovery to prevent future episodes iliopsosas muscle test - ANSWER-active flexion of thigh at hip, if pain = appendicitis Celiac Sprue Disease - ANSWER-diet= avoid wheat, rye & barley; may have rice Cullen's sign - ANSWER-bruising in the skin around the umbilicus; associated with acute pancreatitis Grey Turner's sign - ANSWER-bruising in flank area (lower back area); highly suggestive of acute pancreatitis Murphy's sign - ANSWER-pain with palpation of the RUQ during inspiration, indicative of cholecystitis ulcerative colitis - ANSWER-chronic inflammation of the colon with ulcerations; bloody stools w/ mucus and pus, system = low grade fever & fatigue Zollinger-Ellison syndrome - ANSWER-malignant islet cell tumor secreting gastrin; peptic ulcers; left untreated causes sever ulceration of stomach McBurney's point - ANSWER-Pain in RLQ with appendicitis Rosving's sign - ANSWER-palpation of LLQ causes RUQ pain seen in appendicitis gastrectomy - ANSWER-surgical removal of part or all of the stomach; results decrease intrinsic factor needed for Vit B 12 absorption l/t b12 deficiency anemia Urea breath test - ANSWER-very sensitive test for H. pylori Bronchiolitis - ANSWER-viral infect; caused by RSV, sympt= inspiratory and expiratory wheezing, non-prod couch, fever croup - ANSWER-acute viral infection of infants and children with obstruction of the larynx, accompanied by BARKING COUGH peak expiratory flow rate - ANSWER-measure of the fastest flow of exhaled air after a maximal inspiration; not determined by weight Hemoglobin electrophoresis - ANSWER-helps to identify abnormal hemoglobin which may help diagnose disorders such as sickle cell anemia and beta thalassemia; gold standard test RBC w/ pernicious anemia - ANSWER-will be microcytic and normochromic symptoms of Vitamin B12 anemia - ANSWER-Tingling, numbness of both feet multiple myeloma - ANSWER-malignancy of plasma cells RBC of folate deficiency anemia - ANSWER-microcytic and normochromic Koilonychia - ANSWER-Soft spoon nails with a concave shape that appear scooped out; associated with iron deficiency anemia