NUR 642 Exam 2025 Questions and Answers
Symptoms of SVC syndrome
Intracranial tension and brain edema: neck and face edema, periorbital, dyspnea and cough,
congestion, dysphagia, head pressure, epistaxis, hemoptysis. Worsen with bending forward of
lying down
Spinal cord compression: Symptoms Management
Back pain, radiculopathy Dexamethasone, radiation, surgical decompression
These 3 cancers are most likely to mets to the brain
Lung, breast, melanoma
Bony lytic lesions ("moth eaten") are concerning for ___. This patient will also have this
electrolyte disturbance ____.
Multiple myeloma, hypercalcemia
Treatment for a patient with hypercalcemia and AKI from multiple myeloma ____
Fluids, diuresis, calcitonin
Calcitrol and parathyroid hormone both _____ calcium levels
Increase
Solid organ tumors (lung, breast, head, neck, renal) produce PTH-rP, which can cause _____
Hypercalcemia
PTH levels will be high in primary hyperparathyroidism. It will be suppressed in ______, due
to bone mets
Hypercalcemia
Malignant lymphomas produce calcitriol, which not only elevates calcium, but also elevates
_____
,Serum phosphate
Treatments of hypercalcemia (4)
Fluids 2-300 ml/hr to maintain UO of 100-150/hr. Bisphosphonates to inhibit bone
resorption/osteoclasts. Calcitonin (for <48hrs). Dialysis.
Hyponatremia in SIADH shows inappropriately high _____ when compared to _____. They
also have high urine _____ without volume depletion.
High urine osmolality, lower serum osmolality. Sodium (euvolemic hyponatremia)
Management of SIADH
Fluid restriction. Hypertonic saline to correct sodium at 0.5-1 meq/hr.
WBC >100,000. Name and treatment.
Leukostasis. Chemotherapy and leukapheresis.
Lab diagnosis of DIC
Elevated D-dimer, decreased antithrombin 3 and 2 indicators of end-organ damage (LDH, Cr,
decreased pH or PaO2)
Management of DIC
Platelets if below 50k, cryopreciptitate if fibrinogen is below 100 mg/dL.
Electrolyte/metabolic disorders with TLS. (5)
Hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, lactic acidosis
In TLS, _____ caused by release of intracellular phosphate leads to ______ which results in
tetany and neuromuscular irritability. Calcium phosphate can deposit into renal tubules and
cause AKI
Hyperphosphatemia, hypocalcemia
, Cairo-Bishop is lab diagnostics criteria for TLS, says two or more of these lab changes THREE
days prior or SEVEN days after chemo
Uric acid >8, K>6, Phos >1.45, Calcium <7
Neutropenia is neutrophil count less than _____. Fever is one single temp more than ____ , or
more than 38.0 for >1hour
500. 38.3 (101), 38.0 (100.4)
Three required labs in neutropenic fever
CBC, transaminase, creatinine
2 measurements for CKD
Urine Albumin: creatinine ratio (ACR). eGFR
To diagnose CKD, three readings of _____ need to be made in <90 days
eGFR <60 ml/min. (abstain from eating meat for 12 hours r/t false Cr)
People over 75 at risk for CKD have 1. eGFR < _____. 2. Proteinuria (ACR > _____ mg/mmol. 3.
eGFR falling more than _____ /year.
45, >3, 5
3 types of drugs that increase AKI
Diuretics, ACEI's, NSAID's
Common medications found for patients with CKD
Phosphate binders for hyperphosphatemia, 6-8 tabs of bicarb tablets for acidosis Allopurinol for
gout, Antihistamines for pruritis
ADH is secreted when plasma osmolality _____
Increases
s/s of hyponatremia
Symptoms of SVC syndrome
Intracranial tension and brain edema: neck and face edema, periorbital, dyspnea and cough,
congestion, dysphagia, head pressure, epistaxis, hemoptysis. Worsen with bending forward of
lying down
Spinal cord compression: Symptoms Management
Back pain, radiculopathy Dexamethasone, radiation, surgical decompression
These 3 cancers are most likely to mets to the brain
Lung, breast, melanoma
Bony lytic lesions ("moth eaten") are concerning for ___. This patient will also have this
electrolyte disturbance ____.
Multiple myeloma, hypercalcemia
Treatment for a patient with hypercalcemia and AKI from multiple myeloma ____
Fluids, diuresis, calcitonin
Calcitrol and parathyroid hormone both _____ calcium levels
Increase
Solid organ tumors (lung, breast, head, neck, renal) produce PTH-rP, which can cause _____
Hypercalcemia
PTH levels will be high in primary hyperparathyroidism. It will be suppressed in ______, due
to bone mets
Hypercalcemia
Malignant lymphomas produce calcitriol, which not only elevates calcium, but also elevates
_____
,Serum phosphate
Treatments of hypercalcemia (4)
Fluids 2-300 ml/hr to maintain UO of 100-150/hr. Bisphosphonates to inhibit bone
resorption/osteoclasts. Calcitonin (for <48hrs). Dialysis.
Hyponatremia in SIADH shows inappropriately high _____ when compared to _____. They
also have high urine _____ without volume depletion.
High urine osmolality, lower serum osmolality. Sodium (euvolemic hyponatremia)
Management of SIADH
Fluid restriction. Hypertonic saline to correct sodium at 0.5-1 meq/hr.
WBC >100,000. Name and treatment.
Leukostasis. Chemotherapy and leukapheresis.
Lab diagnosis of DIC
Elevated D-dimer, decreased antithrombin 3 and 2 indicators of end-organ damage (LDH, Cr,
decreased pH or PaO2)
Management of DIC
Platelets if below 50k, cryopreciptitate if fibrinogen is below 100 mg/dL.
Electrolyte/metabolic disorders with TLS. (5)
Hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, lactic acidosis
In TLS, _____ caused by release of intracellular phosphate leads to ______ which results in
tetany and neuromuscular irritability. Calcium phosphate can deposit into renal tubules and
cause AKI
Hyperphosphatemia, hypocalcemia
, Cairo-Bishop is lab diagnostics criteria for TLS, says two or more of these lab changes THREE
days prior or SEVEN days after chemo
Uric acid >8, K>6, Phos >1.45, Calcium <7
Neutropenia is neutrophil count less than _____. Fever is one single temp more than ____ , or
more than 38.0 for >1hour
500. 38.3 (101), 38.0 (100.4)
Three required labs in neutropenic fever
CBC, transaminase, creatinine
2 measurements for CKD
Urine Albumin: creatinine ratio (ACR). eGFR
To diagnose CKD, three readings of _____ need to be made in <90 days
eGFR <60 ml/min. (abstain from eating meat for 12 hours r/t false Cr)
People over 75 at risk for CKD have 1. eGFR < _____. 2. Proteinuria (ACR > _____ mg/mmol. 3.
eGFR falling more than _____ /year.
45, >3, 5
3 types of drugs that increase AKI
Diuretics, ACEI's, NSAID's
Common medications found for patients with CKD
Phosphate binders for hyperphosphatemia, 6-8 tabs of bicarb tablets for acidosis Allopurinol for
gout, Antihistamines for pruritis
ADH is secreted when plasma osmolality _____
Increases
s/s of hyponatremia
