Nurs 511 Revised Final Exam 2025

NURS 511 REVISED FINAL EXAM 2025 The patient taking desiccated thyroid (e.g., Armour Thyroid) should be switched to what medication? levothyroxine, the synthetic form of T4, as the preferred treatment for hypothyroidism. The hormone content in desiccated thyroid can vary between batches, leading to inconsistent therapeutic effects and potential overtreatment or undertreatment. Levothyroxine provides a stable, standardized, and predictable dose, ensuring better control of thyroid hormone levels. who should definitely not receive desiccated thyroid medications? They should not be used for patients with underlying cardiac disease, given the varied concentrations of highly active T3, which poses a greater risk of overreplacement and iatrogenic thyrotoxicosis. For a patient experiencing unpredictable blood glucose readings and an increase in hypoglycemic episodes while using Novolin N (NPH insulin) twice daily, a good alternative would be a ? a long-acting basal insulin such as insulin glargine (Lantus, Basaglar) The oral diabetic agent most likely causing hypoglycemia is ? a sulfonylurea, such as glipizide Haloperidol given for psychotic-like crisis can cause ? involuntary muscle contractions of his neck, jaw, and tongue muscles RUQ location problems gallbladder liver right kidney LLQ PROBLEMS Sigmoid, left ovary/tube LUQ problems Spleen stomach pancreas RLQ PROBLEMS appendix, cecum, right ovary-tube NURS 511 NURS 511 rebound tenderness may suggest peritoneal irritation like with perforated appendicitis murphys sign pain with palpation of RUQ DURING inhalation suggesting cholecystisits rovsings sign pain in RLQ while palpating LLQ suggesting appendicitis tenderness to percussion means peritonitis tympany means bowel obstruction or pneumoperitoneum elevated amylase/lipase may suggest pancreatitis ct scan first line for diagnosing appendicitis, diverticulitis, and bowel obstruction x-ray can help diagnose? (abdominal) can help diagnose free air(perforation) a patient recently has an ileostomy for UC. what should we teaCH HIM ragarding food blockages? massage the peristomal area TRUE OR FALSE there is no such thing as a normal pattern of defecation TRUE Best treatment for traverlers diarrhea? supportive care what percent of gastric ulcers are benign? 95% anatacids contain BLANK which may cause diarrhea magnesium a patient has been diagnosed with irritable bowel, constipation, and diverticulosis following a colonoscopy. which agent should we recommend? bulk laxative NURS 511 NURS 511 a patient has acute gastroenteritis symptoms after a camping trip where he only ate canned vegetables. what is the cause? clostridium botulinum what should we ask a 4 year old patient to determine if he is nauseous? are you hungry? IBS TX Loperamide (Imodium) or diphenoxylate (Lomotil) 2.5-5.0 mg every 6 hours. What is the most common form of anemia in older adults? anemia of chronic disease Anemia caused by a deficiency in vitamin B12 is known as. This type of anemia occurs when the body cannot absorb vitamin B12 properly. pernicious enamia. This type of anemia occurs when the body cannot absorb vitamin B12 properly and can be treated with vitamin b 12 injections most common symptoms of anemia? fatigue Sickle cell anemia genetic disorder that affects the shape of red blood cells, causing them to become rigid and shaped like a sickle, which can lead to various complications. Hemolytic Anemia characterized by the destruction of red blood cells due to an autoimmune response or other factors, leading to a decrease in red blood cell count. A deficiency in __________ can lead to megaloblastic anemia, which is characterized by the production of large, abnormal red blood cells. vitamin b 12 or folate the primary treatment for iron-deficiency anemia is typically.... iron supplements. blood transfusions only in severe cases. will see decrease in serum iron levels. The __________ test is used to assess the size and shape of red blood cells, which can help in diagnosing different types of anemia "mean corpuscular volume (MCV) test." NURS 511 NURS 511 If the patient has received the primary series but has not had a booster within the last blank, a tetanus booster should be administered. 5 years. For patients with an absent or incomplete primary immunization, administer 250 units of tetanus immunoglobulin in addition to the primary vaccination. For high-risk bite wounds, the first-line antibiotic treatment is blank. This antibiotic is effective against the common pathogens associated with bite wounds. amoxicillin/clavulanate (Augmentin). doxy for allergy cat bites most common pathogen and tx Pasteurella multocida. Infections from cat bites can develop rapidly, often within 12 to 24 hours after the bite occurs. tx Amoxicillin/clavulanate (Augmentin). Cleanse the bite wound thoroughly with mild soap and water. For high-risk wounds, consider using a 1% povidone iodine solution for additional antiseptic action assessment and diagnosis of carpal tunnel syndrome Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm, becomes compressed within the carpal tunnel—a narrow passageway at the base of the hand. Symptoms: Common symptoms include: Tingling or numbness in the thumb, index, and middle fingers.Pain that may radiate to the forearm. Symptoms often worsen at night or with repetitive hand movements. diagnosis: Phalen Test: The patient flexes their wrists for 60 seconds to see if symptoms occur, indicating median nerve compression. Tinel Test: Tapping over the median nerve at the wrist to elicit tingling or pain in the fingers. risk factors for vertebral fractures Advanced Age: Older adults are at a higher risk due to decreased bone density and strength. Chronic Glucocorticoid Use: Long-term use of glucocorticoids can lead to osteoporosis, increasing the likelihood of fractures. NURS 511 NURS 511 Osteoporosis: This condition weakens bones, making them more susceptible to fractures, even with minimal trauma. Assessment of vertebral fractures These fractures typically occur at the T7-T8 and T12-L1 vertebrae DUE TO AN AXIAL LOAD Symptoms: Patients may present with a midline fracture that can lead to pain and discomfort. There may be involvement of spinal nerve roots or spinal cord impingement, which can result in neurological symptoms. Assessment of Cervical Spondylosis Assess for symptoms such as neck stiffness, pain, and any neurological signs (e.g., tingling, numbness, or weakness in the arms). Consider the patient's history, including any trauma (e.g., motor vehicle accidents) or poor posture that may contribute to symptoms. Physical Examination: Conduct a thorough physical exam to evaluate the range of motion in the neck and identify any areas of tenderness or muscle spasm. Management of Cervical Spondylosis Conservative Treatment: Physical Therapy: A structured physical therapy program can help improve neck strength and flexibility. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to manage pain and inflammation. Surgical Intervention: In severe cases where conservative measures fail, surgical options may be considered to relieve nerve compression or stabilize the spine assessment of spinal stenosis Symptom Evaluation: Assess for symptoms such as:Back pain that may worsen with activity.Leg pain or neurogenic claudication, which refers to pain that occurs with walking and is relieved by rest.Patients may also report numbness or tingling in the legs. NURS 511 NURS 511 Physical Examination: Evaluate the patient's gait: A wide-based, stooped posture is often indicative of spinal stenosis. Check deep tendon reflexes (DTRs) and sensory function to identify any neurological deficits. Assessment of Herniated Disc Symptom Evaluation: Assess for symptoms such as:Back pain that may radiate to the legs (sciatica).Numbness or tingling in the legs or feet.Weakness in the lower extremities. Physical Examination: Evaluate the patient's gait: Look for any abnormalities, such as limping or difficulty walking. Check deep tendon reflexes (DTRs) and sensory function to identify any neurological deficits. Perform a straight leg raise test to assess for nerve root irritation. Neers and Hawkins Tests These tests help identify impingement syndrome Drop Arm Test: This can indicate a rotator cuff tear. What does a positive McMurray's sign diagnose meniscus tear in the knee Positive Lachman and anterior drawer test- what does it diagnose? anterior cruciate ligament (ACL) injury What test is necessary when finding a positive Spurling maneuver and decreased biceps reflex Further investigation with imaging, specifically an MRI scan or CT scan, is necessary to assess for cervical radiculopathy or nerve root compression. Meaning of a Positive Thompson test and how to manage strongly suggests a ruptured Achilles tendon. mmobilization (cast or walking boot) or surgery diagnosing varicocele NURS 511 NURS 511 Pain: Patients may experience a dull ache or discomfort in the scrotum, which can worsen with prolonged standing or physical activity. Swelling: There may be noticeable swelling in the scrotum. "Bag of worms" Feeling: On examination, the affected area may feel like a "bag of worms" due to the engorged veins. Tortuous Veins: Varicoceles are characterized by the presence of tortuous veins above the testes, which can often be seen when the patient is standing. Valsalva maneuver (forceful exhalation against a closed airway) to increase intra abdominal pressure. This maneuver can cause the veins to engorge further, making the varicocele more prominent. Cremasteric Reflex The absence of the cremasteric reflex (the reflex contraction of the cremaster muscle that raises the testis) on the affected side is a key indicator of testicular torsion. Phimosis a condition where the foreskin cannot be fully retracted over the glans penis Signs and symptoms that diagnose epididymitis Unilateral Scrotal Pain: Patients typically present with sudden onset of pain in one side of the scrotum, which may be severe. Swelling and Tenderness: The affected side may appear swollen and tender to the touch. The scrotum may also feel warm. Positive Prehn Sign: Pain relief upon elevating the scrotum is known as a positive Prehn sign, which is often associated with epididymitis. Management of hypospadias surgical repair, often performed between 6 and 24 months of age, to correct the abnormal placement of the urethral opening and address any associated penile curvature. Assessment, diagnosis and management of acute and chronic bacterial prostatitis NURS 511 NURS 511 Symptoms: Patients typically present with sudden onset of:Fever and chills Dysuria (painful urination)Pelvic painPerineal painUrinary retention may occur due to swelling of the prostate. Diagnosis Clinical Examination: A digital rectal exam may reveal a tender, swollen prostate. Urine Culture: Culturing urine helps identify the causative organism, which is often E. coli or other uropathogens. Management Antibiotics:Trimethoprim/sulfamethoxazole (TMP/SMX) is commonly used, or fluoroquinolones (like ciprofloxacin or levofloxacin) should be used cautiously d