CCRN Practice Test Q&A 2022/2023

A patient in hyperosolar hyperglycemic state (HHS) is being admitted with dehydration and a serum glucose level of 836 mg/dL. Which of the following additional laboratory findings should the nurse anticipate? A. decreased BUN, decreased creatinine, and elevated serum osmolality B. decreased BUN, decreased creatinine and decreased serum osmolality C. decreased BUN, elevated creatinine and decreased serum osmolality D. elevated BUN, elevated creatinine and elevated serum osmolality - Answer - D. elevated BUN, elevated creatinine and elevated serum osmolality Serum osmolality 320 mOsm/kg distinguishes HHS from DKA On the fifth day post-admission, a patient with Q waves in V1, V2, and V3 develops hypotension, tachycardia, and a pan-systolic murmur that is loudest at the lower left sternal border. This patient most likely developed A. idiopathic hypertrophic cardiomyopathy B. inferior wall infarction C. cardiac tamponade D. a ruptured inter-ventricular septum - Answer - D. a ruptured inter-ventricular septum (septal wall MI) A patient with a history of chronic pain, asthma, diabetes, and heavy alcohol intake is now experiencing cognitive impairment from medications. Assessment: awake but confused, BP 155/82, HR 84, RR 16 and SpO2 95% on RA. This patient is at high risk for A. Intubation B. needing long-term psychiatric care C. attempting suicide D. over-sedation by staff - Answer - C. attempting suicide (chronic medical illness, heavy alcohol intake, and chronic pain) Which of the following 12-lead ECG changes should be expected in a patient with acute coronary syndrome involving the inferior wall? A. ST segment elevation and deeply inverted T waves in leads V4-V6, I and aVL B. ST segment elevation in leads II, III, and all precordial leads C. ST segment elevation and deeply inverted T waves in leads II, III, aVF D. ST segment depression and T wave elevation in leads II, III, aVL - Answer - C. ST segment elevation and deeply inverted T waves in leads II, III, aVF