NU-404 Final Exam Study guide Questions With Complete
Solutions
Addison's disease = 2-3 (signs and symptoms of Addisonian
crisis; priority interventions for Addisonian crisis; medication
treatment for Addison's disease) Correct Answers -autoimmune
-outer layer of adrenal gland
-too little glucocorticoids and mineralcorticoids
-give more glucocorticoids
-crisis: severe weakness, confusion, pain in lower back or legs,
severe abdominal pain, vomiting or diarrhea, leading to
dehydration
-treatment for crisis: IV or IM injection of hydrocortisone
immediately, support BP
ALS=1 (know priorities of care and typical course of the
disease) Correct Answers -need to talk about end of life
-muscles gradually weaken and atrophy
-may need tracheostoma
-riluzole: slow progression
-at the end will not be able to breath on own
Alzheimer's Disease=1-2 (understand basic interventions when
caring for a patient with alzheimer's disease) Correct Answers -
short directions
-repetitiveness
-therapeutic touch
-introduce change slowly
-ask about past
-cholinesterase inhibitors (donepezil)
,Arterial blood gas interpretation for DKA, chronic and acute
respiratory failure (2-3 questions) Correct Answers -DKA:
metabolic acidosis, ketone breath, ph is low and bicarb is also
low
-Chronic respiratory failure: respiratory acidosis
-Acute respiratory failure: respiratory acidosis
Asthma = 2 (understand the medications for asthma
exacerbation; understand how peak expiratory flow is utilized in
asthma—what is its purpose) Correct Answers -Albuterol: for
asthma exacerbation, can give nebulized
-corticosteroid: methylprednisolone
-peak inspiratory flow: helps to understand how well your
asthma is controlled- 80%-100% shows it is under control
Atypical presentation: 1-2 question (recognize high risk
population and diagnoses; atypical presentation signs and
symptoms) Correct Answers -elderly
-depression: lack of sadness, constipation, hyperactivity,
medical problems may mask this
-older adult with thyroid disease: hyper present as apathetic,
fatigue, slowing down, hypo: confusion and agitation
-older with pulmonary edema: food or fluid changes, confusion
-older with MI: no chest pain, nausea, decrease in functional
status
-older with malignancy: back pain, silent assess in bowel
-olde with peritonitis: mild discomfort, constipation, tachypnea,
vague resp sx
-older infection: no fever, change in LOC, falling, decrease
appetite
,Autonomic dysreflexia = 2 (understand the causes; immediate
interventions; signs and symptoms) Correct Answers -massive
imbalance reflex sympathetic discharge, in first year- trigger is
from full bladder, fecal impaction
-severe hypertension
-cause is from spinal cord injury
-remove tight clothing and assess the bladder
Beta Adrenergic agonist and their effect on the respiratory
system =1 Correct Answers relax muscles of airway
-albuterol
Carbon monoxide poisoning qs = 1 (clinical symptoms/vital
signs/physical exam findings & know what the best method is to
monitor these patients) Correct Answers -get an ABG
-replaced oxygen, will not show up on pulse ox
-cannot spell it
-silent killer
Cerebral palsy=1-2 (know the priority goals and nursing
interventions in the care of CP) Correct Answers -does not get
worse but some sx may change over time
-early recognition
-school programs
-monitor functional status
-family support
-upright for meals
-normalize as much as possible
-pharm: reduce hyperreflexia, neuromuscular agent, muscle
relaxant, benzos, anticonvulsant
-risk for injury
, -keep child elevated
Cerebral spinal fluid leak = 2 (know signs and symptoms and
how you would assess for CSF leak) Correct Answers -
draining out of nose
-halo mark on pillow
-clear drainage out of the ear
-ringing in the ears
-neck and shoulder pain
-dizziness
-changes in vision
-assess with CT with contrast
Child abuse = 1 (know signs/symptoms that you may see)
Correct Answers -disconnect from child and parent
-bruises
-child not feeling safe
-not wanting to take off coat
Cirrhosis=1-2 (know signs and symptoms; Correct Answers -
fatigue
-weightloos
-muscle wasting
-abdominal pain and distention
-ascites: fluid accumulation in abdomen
-petchiae
-echhymosis
-spider angiomas
-jaundice
-confusion
-flapping tremor
Solutions
Addison's disease = 2-3 (signs and symptoms of Addisonian
crisis; priority interventions for Addisonian crisis; medication
treatment for Addison's disease) Correct Answers -autoimmune
-outer layer of adrenal gland
-too little glucocorticoids and mineralcorticoids
-give more glucocorticoids
-crisis: severe weakness, confusion, pain in lower back or legs,
severe abdominal pain, vomiting or diarrhea, leading to
dehydration
-treatment for crisis: IV or IM injection of hydrocortisone
immediately, support BP
ALS=1 (know priorities of care and typical course of the
disease) Correct Answers -need to talk about end of life
-muscles gradually weaken and atrophy
-may need tracheostoma
-riluzole: slow progression
-at the end will not be able to breath on own
Alzheimer's Disease=1-2 (understand basic interventions when
caring for a patient with alzheimer's disease) Correct Answers -
short directions
-repetitiveness
-therapeutic touch
-introduce change slowly
-ask about past
-cholinesterase inhibitors (donepezil)
,Arterial blood gas interpretation for DKA, chronic and acute
respiratory failure (2-3 questions) Correct Answers -DKA:
metabolic acidosis, ketone breath, ph is low and bicarb is also
low
-Chronic respiratory failure: respiratory acidosis
-Acute respiratory failure: respiratory acidosis
Asthma = 2 (understand the medications for asthma
exacerbation; understand how peak expiratory flow is utilized in
asthma—what is its purpose) Correct Answers -Albuterol: for
asthma exacerbation, can give nebulized
-corticosteroid: methylprednisolone
-peak inspiratory flow: helps to understand how well your
asthma is controlled- 80%-100% shows it is under control
Atypical presentation: 1-2 question (recognize high risk
population and diagnoses; atypical presentation signs and
symptoms) Correct Answers -elderly
-depression: lack of sadness, constipation, hyperactivity,
medical problems may mask this
-older adult with thyroid disease: hyper present as apathetic,
fatigue, slowing down, hypo: confusion and agitation
-older with pulmonary edema: food or fluid changes, confusion
-older with MI: no chest pain, nausea, decrease in functional
status
-older with malignancy: back pain, silent assess in bowel
-olde with peritonitis: mild discomfort, constipation, tachypnea,
vague resp sx
-older infection: no fever, change in LOC, falling, decrease
appetite
,Autonomic dysreflexia = 2 (understand the causes; immediate
interventions; signs and symptoms) Correct Answers -massive
imbalance reflex sympathetic discharge, in first year- trigger is
from full bladder, fecal impaction
-severe hypertension
-cause is from spinal cord injury
-remove tight clothing and assess the bladder
Beta Adrenergic agonist and their effect on the respiratory
system =1 Correct Answers relax muscles of airway
-albuterol
Carbon monoxide poisoning qs = 1 (clinical symptoms/vital
signs/physical exam findings & know what the best method is to
monitor these patients) Correct Answers -get an ABG
-replaced oxygen, will not show up on pulse ox
-cannot spell it
-silent killer
Cerebral palsy=1-2 (know the priority goals and nursing
interventions in the care of CP) Correct Answers -does not get
worse but some sx may change over time
-early recognition
-school programs
-monitor functional status
-family support
-upright for meals
-normalize as much as possible
-pharm: reduce hyperreflexia, neuromuscular agent, muscle
relaxant, benzos, anticonvulsant
-risk for injury
, -keep child elevated
Cerebral spinal fluid leak = 2 (know signs and symptoms and
how you would assess for CSF leak) Correct Answers -
draining out of nose
-halo mark on pillow
-clear drainage out of the ear
-ringing in the ears
-neck and shoulder pain
-dizziness
-changes in vision
-assess with CT with contrast
Child abuse = 1 (know signs/symptoms that you may see)
Correct Answers -disconnect from child and parent
-bruises
-child not feeling safe
-not wanting to take off coat
Cirrhosis=1-2 (know signs and symptoms; Correct Answers -
fatigue
-weightloos
-muscle wasting
-abdominal pain and distention
-ascites: fluid accumulation in abdomen
-petchiae
-echhymosis
-spider angiomas
-jaundice
-confusion
-flapping tremor
