D027 PRACTICE EXAM # 2 QUESTIONS
1.During75the75body's75inflammatory75process,75what75causes75edema?
75Vasodilation75of75blood75vessels
Emigration75of75neutrophils
Endothelial75cell75expansion
Increased75capillary75permeability75-75answer--
Increased75capillary75permeability.75The75increased75flow75and75capillary75permeability75
result75in75a75leakage75of75plasma75from75the75vessels75causing75swelling75(edema)75in7
5the75surrounding75tissue75and75is75solely75responsible75for75inflammation75induced75ed
ema
2.A7556-year-
old75diabetic75patient75has75not75taken75his75insulin75in75475days75due75to75him75"feeling7
5well75without75it".75He75is75admitted75to75the75ED75with75an75elevated75blood75sugar.75
What75electrolyte75should75be75assessed75FIRST?75-75answer--Calcium
Sodium
Potassium
Chloride
ANS:75Potassium.75Insulin75facilitates75the75intracellular75transport75of75potassium,75pho
sphate,75and75magnesium.75Without75insulin,75potassium75does75not75get75transported75
to75the75intracellular75environment75and75the75serum75potassium75will75rise.
3.A7546-year-
old75women75is75considering75having75another75child.75The75healthcare75providers75are7
5explaining75to75the75woman75that75children75born75to75women75late75in75life75have75an75
increase75rate75in75having75children75with75which75condition.75-75answer--
Kawasaki's75disease
Down75syndrome
Down75syndrome75risk75increases75with75Maternal75age.
Klinefelter75syndrome
,Turner75syndrome
4.A75patient75with75several75risk75factors75is75concerned75about75developing75type75275di
abetes.75The75healthcare75professional75advises75the75patient75to75lose75weight,75explai
ning75that75obesity75is75an75important75risk75factor75for75type75275diabetes75mellitus75bec
ause75it75causes75what?75-75answer--Reduced75insulin75production75by75the75pancreas
Increased75resistance75to75insulin75in75the75cells
People75with75type75275diabetes75mellitus75suffer75from75insulin75resistance.75Obesity75c
auses75this75resistance75so75their75cells75have75difficulty75using75insulin.75Obesity75does
75not75lead75to75reduced75insulin75production,75obstructed75insulin75outflow,75or75stimulat
ion75of75glucose75production.
Obstructed75outflow75of75insulin75from75the75pancreas
Stimulation75of75glucose75production75by75the75liver
5.When75evaluating75a75patient75for75hypertensive75target75organ75damage,75the75APRN
75looks75for75evidence75of:75-75answer--Lipid75abnormality
Insulin75resistance
Left75ventricular75hypertrophy
Clotting75disorders
6.On75ultrasound75a75patient75had754-
chamber75dilation75with75an75ejection75fraction75of7515%75and75a75pleural75effusion75on7
5chest75x-
ray.75Elevated75liver75function75tests,75hypokalemia,75and75hypomagnesema75are75seen
75on75lab75results.75Blood75pressure75is75115/6075and75heart75rate75is7511075bpm75with75
regular75rate75and75rhythm,75respiratory75rate753075bpm75and75O275saturation75is7588%7
5on75room75air.75Initial75therapy75should75include75all75of75the75following75except:75-
75answer--Diuretic
ACE75Inhibitor
Digoxin
Beta75Blocker
7.A75patient75in75the75emergency75department75is75suspected75of75having75a75myocardi
al75infarction75(MI).75The75initial75cardiac75troponin75175level75was75negative.75What75acti
, on75by75the75healthcare75professional75is75best?75-75answer--
Administer75thrombolytic75therapy.
Discharge75the75patient.
Schedule75repeat75troponin75within75a75few75hours.
Several75cardiac75biomarkers75exist75including75the75most75specific,75cardiac75troponin75
175(cTnI),75cTnI75begins75to75rise75within75275to75475hours75after75cardiac75injury,75so75if7
5the75initial75result75is75normal,75the75test75should75be75repeated75within75675to75975hours
75and75again75at751275to752475hours.75It75is75not75known75yet75if75the75patient75has75had7
5an75MI75so75treatment75with75thrombolytic75therapy75and/
or75catheterization75would75be75premature.75The75patient75should75not75be75discharged7
5since75the75professional75suspected75an75MI.
Prepare75the75patient75for75cardiac75catheterization.
8.Which75patient75would75the75healthcare75professional75assess75for75elevated75levels75
of75antidiuretic75
hormone75(ADH)75secretion?75-75answer--
Being75treated75for75small75cell75carcinoma75of75the75stomach
Taking75high75dose75acetaminophen75(Tylenol)75for75arthritis
Had75a75hip75replacement75operation751475days75ago
Has75long-standing75kidney75disease75from75diabetes
9.A75post-
operative75patient75with75gallbladder75surgery75has75an75epidural75infusion75of75Astramo
rph.75The75patients75respiratory75rate75starts75to75decline75to75975breaths/
minute.75Which75medication75should75the75healthcare75provider75anticipate75administeri
ng75to75this75patient?
Protamine75sulfate
Mucomyst
Naloxone
Naloxone75is75a75narcotic75antagonist75that75can75reverse75the75effect75of75both75advers
e75and75therapeutic75use75of75opioid75narcotic75analgesics.
Solu-Medrol75-75answer--
1.During75the75body's75inflammatory75process,75what75causes75edema?
75Vasodilation75of75blood75vessels
Emigration75of75neutrophils
Endothelial75cell75expansion
Increased75capillary75permeability75-75answer--
Increased75capillary75permeability.75The75increased75flow75and75capillary75permeability75
result75in75a75leakage75of75plasma75from75the75vessels75causing75swelling75(edema)75in7
5the75surrounding75tissue75and75is75solely75responsible75for75inflammation75induced75ed
ema
2.A7556-year-
old75diabetic75patient75has75not75taken75his75insulin75in75475days75due75to75him75"feeling7
5well75without75it".75He75is75admitted75to75the75ED75with75an75elevated75blood75sugar.75
What75electrolyte75should75be75assessed75FIRST?75-75answer--Calcium
Sodium
Potassium
Chloride
ANS:75Potassium.75Insulin75facilitates75the75intracellular75transport75of75potassium,75pho
sphate,75and75magnesium.75Without75insulin,75potassium75does75not75get75transported75
to75the75intracellular75environment75and75the75serum75potassium75will75rise.
3.A7546-year-
old75women75is75considering75having75another75child.75The75healthcare75providers75are7
5explaining75to75the75woman75that75children75born75to75women75late75in75life75have75an75
increase75rate75in75having75children75with75which75condition.75-75answer--
Kawasaki's75disease
Down75syndrome
Down75syndrome75risk75increases75with75Maternal75age.
Klinefelter75syndrome
,Turner75syndrome
4.A75patient75with75several75risk75factors75is75concerned75about75developing75type75275di
abetes.75The75healthcare75professional75advises75the75patient75to75lose75weight,75explai
ning75that75obesity75is75an75important75risk75factor75for75type75275diabetes75mellitus75bec
ause75it75causes75what?75-75answer--Reduced75insulin75production75by75the75pancreas
Increased75resistance75to75insulin75in75the75cells
People75with75type75275diabetes75mellitus75suffer75from75insulin75resistance.75Obesity75c
auses75this75resistance75so75their75cells75have75difficulty75using75insulin.75Obesity75does
75not75lead75to75reduced75insulin75production,75obstructed75insulin75outflow,75or75stimulat
ion75of75glucose75production.
Obstructed75outflow75of75insulin75from75the75pancreas
Stimulation75of75glucose75production75by75the75liver
5.When75evaluating75a75patient75for75hypertensive75target75organ75damage,75the75APRN
75looks75for75evidence75of:75-75answer--Lipid75abnormality
Insulin75resistance
Left75ventricular75hypertrophy
Clotting75disorders
6.On75ultrasound75a75patient75had754-
chamber75dilation75with75an75ejection75fraction75of7515%75and75a75pleural75effusion75on7
5chest75x-
ray.75Elevated75liver75function75tests,75hypokalemia,75and75hypomagnesema75are75seen
75on75lab75results.75Blood75pressure75is75115/6075and75heart75rate75is7511075bpm75with75
regular75rate75and75rhythm,75respiratory75rate753075bpm75and75O275saturation75is7588%7
5on75room75air.75Initial75therapy75should75include75all75of75the75following75except:75-
75answer--Diuretic
ACE75Inhibitor
Digoxin
Beta75Blocker
7.A75patient75in75the75emergency75department75is75suspected75of75having75a75myocardi
al75infarction75(MI).75The75initial75cardiac75troponin75175level75was75negative.75What75acti
, on75by75the75healthcare75professional75is75best?75-75answer--
Administer75thrombolytic75therapy.
Discharge75the75patient.
Schedule75repeat75troponin75within75a75few75hours.
Several75cardiac75biomarkers75exist75including75the75most75specific,75cardiac75troponin75
175(cTnI),75cTnI75begins75to75rise75within75275to75475hours75after75cardiac75injury,75so75if7
5the75initial75result75is75normal,75the75test75should75be75repeated75within75675to75975hours
75and75again75at751275to752475hours.75It75is75not75known75yet75if75the75patient75has75had7
5an75MI75so75treatment75with75thrombolytic75therapy75and/
or75catheterization75would75be75premature.75The75patient75should75not75be75discharged7
5since75the75professional75suspected75an75MI.
Prepare75the75patient75for75cardiac75catheterization.
8.Which75patient75would75the75healthcare75professional75assess75for75elevated75levels75
of75antidiuretic75
hormone75(ADH)75secretion?75-75answer--
Being75treated75for75small75cell75carcinoma75of75the75stomach
Taking75high75dose75acetaminophen75(Tylenol)75for75arthritis
Had75a75hip75replacement75operation751475days75ago
Has75long-standing75kidney75disease75from75diabetes
9.A75post-
operative75patient75with75gallbladder75surgery75has75an75epidural75infusion75of75Astramo
rph.75The75patients75respiratory75rate75starts75to75decline75to75975breaths/
minute.75Which75medication75should75the75healthcare75provider75anticipate75administeri
ng75to75this75patient?
Protamine75sulfate
Mucomyst
Naloxone
Naloxone75is75a75narcotic75antagonist75that75can75reverse75the75effect75of75both75advers
e75and75therapeutic75use75of75opioid75narcotic75analgesics.
Solu-Medrol75-75answer--
