NURS 642 Exam 3 ACTUAL UPDATED
Exam Questions and CORRECT Answers
Symptoms of SVC syndrome - CORRECT ANSWER - 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 - CORRECT ANSWER - Back pain,
radiculopathy Dexamethasone, radiation, surgical decompression
These 3 cancers are most likely to mets to the brain - CORRECT ANSWER - Lung,
breast, melanoma
Bony lytic lesions ("moth eaten") are concerning for ___. This patient will also have this
electrolyte disturbance ____. - CORRECT ANSWER - Multiple myeloma, hypercalcemia
Treatment for a patient with hypercalcemia and AKI from multiple myeloma ____ - CORRECT
ANSWER - Fluids, diuresis, calcitonin
Calcitrol and parathyroid hormone both _____ calcium levels - CORRECT ANSWER -
Increase
Solid organ tumors (lung, breast, head, neck, renal) produce PTH-rP, which can cause _____ -
CORRECT ANSWER - Hypercalcemia
PTH levels will be high in primary hyperparathyroidism. It will be suppressed in ______, due to
bone mets - CORRECT ANSWER - Hypercalcemia
Malignant lymphomas produce calcitriol, which not only elevates calcium, but also elevates
_____ - CORRECT ANSWER - Serum phosphate
,Treatments of hypercalcemia (4) - CORRECT ANSWER - 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. - CORRECT ANSWER - High urine
osmolality, lower serum osmolality. Sodium (euvolemic hyponatremia)
Management of SIADH - CORRECT ANSWER - Fluid restriction. Hypertonic saline to
correct sodium at 0.5-1 meq/hr.
WBC >100,000. Name and treatment. - CORRECT ANSWER - Leukostasis.
Chemotherapy and leukapheresis.
Lab diagnosis of DIC - CORRECT ANSWER - Elevated D-dimer, decreased antithrombin
3 and 2 indicators of end-organ damage (LDH, Cr, decreased pH or PaO2)
Management of DIC - CORRECT ANSWER - Platelets if below 50k, cryopreciptitate if
fibrinogen is below 100 mg/dL.
Electrolyte/metabolic disorders with TLS. (5) - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 - CORRECT ANSWER - 500. 38.3 (101), 38.0 (100.4)
Three required labs in neutropenic fever - CORRECT ANSWER - CBC, transaminase,
creatinine
2 measurements for CKD - CORRECT ANSWER - Urine Albumin: creatinine ratio
(ACR). eGFR
To diagnose CKD, three readings of _____ need to be made in <90 days - CORRECT
ANSWER - 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. - CORRECT ANSWER - 45, >3, 5
3 types of drugs that increase AKI - CORRECT ANSWER - Diuretics, ACEI's, NSAID's
Common medications found for patients with CKD - CORRECT ANSWER - Phosphate
binders for hyperphosphatemia, 6-8 tabs of bicarb tablets for acidosis Allopurinol for gout,
Antihistamines for pruritis
ADH is secreted when plasma osmolality _____ - CORRECT ANSWER - Increases
s/s of hyponatremia - CORRECT ANSWER - Polydipsia, cramps, headaches, obtundation,
seizure, coma
Pseudohyponatremia is caused by _____, and patients are usually _____ - CORRECT
ANSWER - Hyperglycemia, hyperproteinemia. Euvolemic
Euvolemic, hypotonic, hyponatremia is usually caused by _____, but can also be caused by
hypothyroidism, and _____ - CORRECT ANSWER - SIADH, glucocorticoid deficiency
Exam Questions and CORRECT Answers
Symptoms of SVC syndrome - CORRECT ANSWER - 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 - CORRECT ANSWER - Back pain,
radiculopathy Dexamethasone, radiation, surgical decompression
These 3 cancers are most likely to mets to the brain - CORRECT ANSWER - Lung,
breast, melanoma
Bony lytic lesions ("moth eaten") are concerning for ___. This patient will also have this
electrolyte disturbance ____. - CORRECT ANSWER - Multiple myeloma, hypercalcemia
Treatment for a patient with hypercalcemia and AKI from multiple myeloma ____ - CORRECT
ANSWER - Fluids, diuresis, calcitonin
Calcitrol and parathyroid hormone both _____ calcium levels - CORRECT ANSWER -
Increase
Solid organ tumors (lung, breast, head, neck, renal) produce PTH-rP, which can cause _____ -
CORRECT ANSWER - Hypercalcemia
PTH levels will be high in primary hyperparathyroidism. It will be suppressed in ______, due to
bone mets - CORRECT ANSWER - Hypercalcemia
Malignant lymphomas produce calcitriol, which not only elevates calcium, but also elevates
_____ - CORRECT ANSWER - Serum phosphate
,Treatments of hypercalcemia (4) - CORRECT ANSWER - 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. - CORRECT ANSWER - High urine
osmolality, lower serum osmolality. Sodium (euvolemic hyponatremia)
Management of SIADH - CORRECT ANSWER - Fluid restriction. Hypertonic saline to
correct sodium at 0.5-1 meq/hr.
WBC >100,000. Name and treatment. - CORRECT ANSWER - Leukostasis.
Chemotherapy and leukapheresis.
Lab diagnosis of DIC - CORRECT ANSWER - Elevated D-dimer, decreased antithrombin
3 and 2 indicators of end-organ damage (LDH, Cr, decreased pH or PaO2)
Management of DIC - CORRECT ANSWER - Platelets if below 50k, cryopreciptitate if
fibrinogen is below 100 mg/dL.
Electrolyte/metabolic disorders with TLS. (5) - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 - CORRECT ANSWER - 500. 38.3 (101), 38.0 (100.4)
Three required labs in neutropenic fever - CORRECT ANSWER - CBC, transaminase,
creatinine
2 measurements for CKD - CORRECT ANSWER - Urine Albumin: creatinine ratio
(ACR). eGFR
To diagnose CKD, three readings of _____ need to be made in <90 days - CORRECT
ANSWER - 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. - CORRECT ANSWER - 45, >3, 5
3 types of drugs that increase AKI - CORRECT ANSWER - Diuretics, ACEI's, NSAID's
Common medications found for patients with CKD - CORRECT ANSWER - Phosphate
binders for hyperphosphatemia, 6-8 tabs of bicarb tablets for acidosis Allopurinol for gout,
Antihistamines for pruritis
ADH is secreted when plasma osmolality _____ - CORRECT ANSWER - Increases
s/s of hyponatremia - CORRECT ANSWER - Polydipsia, cramps, headaches, obtundation,
seizure, coma
Pseudohyponatremia is caused by _____, and patients are usually _____ - CORRECT
ANSWER - Hyperglycemia, hyperproteinemia. Euvolemic
Euvolemic, hypotonic, hyponatremia is usually caused by _____, but can also be caused by
hypothyroidism, and _____ - CORRECT ANSWER - SIADH, glucocorticoid deficiency
