NURS5463 Exam4: (Latest Update )
Adult Gerontology Acute Care | Questions &
Answers | Grade A | 100% Correct
1. **Pneumothorax: Causes** ANS Iatrogenic: Result of medical treatment
(positive pressure ventilation, thoracic needle biopsies, CVC placement, and
thoracentesis). Tension pneumothorax: a complication of approximately 1 to
2% of primary spontaneous pneumothoraces. Catamenial: occur in women,
the endometrium seeding into other areas of the body.
2. **Hypertensive Urgency: Treatments** ANS Long-term BP control, oral
medication to reduce BP within 24-48 hours, compliance with medications,
close primary care follow-up. Avoid rapid reduction of BP.
3. **Aortic Stenosis: Definition** ANS Is the obstruction of blood flow
across or through the aortic valve.
4. **Cardiac Ischemia on EKG: Septal Wall** ANS Leads: V1-V2. Coronary
Artery Affected: LAD.
5. **Pleural Effusion: Workup (Fluid Analysis)** ANS Normal pleural fluid
is clear, alkaline with minimal protein content, an LDH < 50% of the plasma,
< 1000 WBCs, and the glucose content is similar to the plasma. Lights
Criteria: a set of lab variables to differentiate exudative fluid from
trANSudative fluid. The fluid is exudative if any of the following criteria are
met: the ratio of pleural fluid protein to serum protein > 0.5, the ratio of
1
,pleural fluid LDH to serum LDH > 0.6, the pleural fluid LDH > 2/3 of the
upper limits of the normal serum LDH value.
6. **Pulmonary Hypertension: Therapies** ANS O2 therapy, medication
management (diuretics, anti-arrhythmics, anti-coags), vasodilator testing, lung
trANSplantation.
7. **Mitral Valve Regurgitation: Exam Findings** ANS A systolic murmur
heard best at the apex of the heart with radiation to the left axilla, chest pain
radiating to the neck, jaw, shoulders, or upper extremities, nausea, and
diaphoresis, fatigue, dyspnea on exertion, orthopnea, paroxysmal nocturnal
dyspnea, weight gain, widening of pulse pressure, apical holosystolic murmur
with radiation to the axilla, JVD.
8. **Post CABG: Management** ANS Admitted to ICU, hemodynamics (BP,
HR, CO/CI, SVR, CVP), EKG (Brady, PVCs, PACS, Afib, ST elevation),
pacer settings, IV meds (vasopressors, inotropes), ETT settings, pleural and
mediastinal chest tubes, neuro exam, indwelling urinary cath, labs (BMP,
CBC, GLU, PT/INR), rewarming.
9. **Aortic Regurgitation: Causes** ANS Infective endocarditis, chest
trauma, ascending aortic dissection (type A dissection), bioprosthetic valve,
degenerative disease, congenital bicuspid valves, rheumatic fever, systemic
lupus erythematosus, rheumatoid arthritis, syphilis.
10. **Pneumonia vs ARDS: Causes** ANS Pneumonia: Bacterial, viral,
fungal. ARDS: Direct Lung Injury: Pneumonia, aspiration, inhalation of
toxins, drowning, or trauma. Indirect Lung Injury: Sepsis, pancreatitis, severe
trauma, massive transfusion, or shock.
11. **Cardiac Tamponade: Treatment** ANS O2, volume expansion, and bed
rest with legs elevated, pericardial decompression via needle
2
, pericardiocentesis, emergency department resuscitative thoracotomy, AVOID
VENT.
12. **Hypertensive Crisis: Causes** ANS Pregnancy, use of NSAIDs, abrupt
withdrawal from HTN medication, cocaine use, head trauma.
13. **Symptoms of Atrial Fibrillation** ANS Palpitations, chest pain,
shortness of breath, increased lower extremity swelling, dyspnea on exertion,
dizziness.
14. **BIPAP: Initial Settings** ANS The goal is to achieve tidal volumes of
5-7 ml/kg. IPAP: 10 (aim for 6 ml/kg of IBW) (Tidal Volume), EPAP: 5
(PEEP), RR: 8-10, FIO2: 40-50%, I time: 1.0 sec. Two pressures: Inspiratory
Positive Airway Pressure (IPAP), Expiratory Positive Airway Pressure
(EPAP).
15. **Pericarditis: Treatment** ANS NSAIDs, ASA, corticosteroids,
colchicine, indomethacin, antibiotics, pain management, monitor for
tamponade.
16. **Define Endocarditis** ANS The inflammation of the inner lining of the
heart.
17. **Pulmonary Fibrosis: Identification** ANS There are specific diagnostic
parameters that must be present on the HRCT Chest for IPF to be diagnosed.
There must be a UIP pattern: honeycombing, bronchiectasis (damaged
airways), presence of ground glass opacification, 6 min walk test to assess
functional exercise capacity, and an echocardiogram to assess for pulmonary
hypertension. A CXR lacks the specificity to diagnose a patient with IPF.
18. **Post CABG: Rewarming (prevent the effects of Hypothermia)** ANS
Always followed with hypothermia, predisposes the patient to ventricular
3
Adult Gerontology Acute Care | Questions &
Answers | Grade A | 100% Correct
1. **Pneumothorax: Causes** ANS Iatrogenic: Result of medical treatment
(positive pressure ventilation, thoracic needle biopsies, CVC placement, and
thoracentesis). Tension pneumothorax: a complication of approximately 1 to
2% of primary spontaneous pneumothoraces. Catamenial: occur in women,
the endometrium seeding into other areas of the body.
2. **Hypertensive Urgency: Treatments** ANS Long-term BP control, oral
medication to reduce BP within 24-48 hours, compliance with medications,
close primary care follow-up. Avoid rapid reduction of BP.
3. **Aortic Stenosis: Definition** ANS Is the obstruction of blood flow
across or through the aortic valve.
4. **Cardiac Ischemia on EKG: Septal Wall** ANS Leads: V1-V2. Coronary
Artery Affected: LAD.
5. **Pleural Effusion: Workup (Fluid Analysis)** ANS Normal pleural fluid
is clear, alkaline with minimal protein content, an LDH < 50% of the plasma,
< 1000 WBCs, and the glucose content is similar to the plasma. Lights
Criteria: a set of lab variables to differentiate exudative fluid from
trANSudative fluid. The fluid is exudative if any of the following criteria are
met: the ratio of pleural fluid protein to serum protein > 0.5, the ratio of
1
,pleural fluid LDH to serum LDH > 0.6, the pleural fluid LDH > 2/3 of the
upper limits of the normal serum LDH value.
6. **Pulmonary Hypertension: Therapies** ANS O2 therapy, medication
management (diuretics, anti-arrhythmics, anti-coags), vasodilator testing, lung
trANSplantation.
7. **Mitral Valve Regurgitation: Exam Findings** ANS A systolic murmur
heard best at the apex of the heart with radiation to the left axilla, chest pain
radiating to the neck, jaw, shoulders, or upper extremities, nausea, and
diaphoresis, fatigue, dyspnea on exertion, orthopnea, paroxysmal nocturnal
dyspnea, weight gain, widening of pulse pressure, apical holosystolic murmur
with radiation to the axilla, JVD.
8. **Post CABG: Management** ANS Admitted to ICU, hemodynamics (BP,
HR, CO/CI, SVR, CVP), EKG (Brady, PVCs, PACS, Afib, ST elevation),
pacer settings, IV meds (vasopressors, inotropes), ETT settings, pleural and
mediastinal chest tubes, neuro exam, indwelling urinary cath, labs (BMP,
CBC, GLU, PT/INR), rewarming.
9. **Aortic Regurgitation: Causes** ANS Infective endocarditis, chest
trauma, ascending aortic dissection (type A dissection), bioprosthetic valve,
degenerative disease, congenital bicuspid valves, rheumatic fever, systemic
lupus erythematosus, rheumatoid arthritis, syphilis.
10. **Pneumonia vs ARDS: Causes** ANS Pneumonia: Bacterial, viral,
fungal. ARDS: Direct Lung Injury: Pneumonia, aspiration, inhalation of
toxins, drowning, or trauma. Indirect Lung Injury: Sepsis, pancreatitis, severe
trauma, massive transfusion, or shock.
11. **Cardiac Tamponade: Treatment** ANS O2, volume expansion, and bed
rest with legs elevated, pericardial decompression via needle
2
, pericardiocentesis, emergency department resuscitative thoracotomy, AVOID
VENT.
12. **Hypertensive Crisis: Causes** ANS Pregnancy, use of NSAIDs, abrupt
withdrawal from HTN medication, cocaine use, head trauma.
13. **Symptoms of Atrial Fibrillation** ANS Palpitations, chest pain,
shortness of breath, increased lower extremity swelling, dyspnea on exertion,
dizziness.
14. **BIPAP: Initial Settings** ANS The goal is to achieve tidal volumes of
5-7 ml/kg. IPAP: 10 (aim for 6 ml/kg of IBW) (Tidal Volume), EPAP: 5
(PEEP), RR: 8-10, FIO2: 40-50%, I time: 1.0 sec. Two pressures: Inspiratory
Positive Airway Pressure (IPAP), Expiratory Positive Airway Pressure
(EPAP).
15. **Pericarditis: Treatment** ANS NSAIDs, ASA, corticosteroids,
colchicine, indomethacin, antibiotics, pain management, monitor for
tamponade.
16. **Define Endocarditis** ANS The inflammation of the inner lining of the
heart.
17. **Pulmonary Fibrosis: Identification** ANS There are specific diagnostic
parameters that must be present on the HRCT Chest for IPF to be diagnosed.
There must be a UIP pattern: honeycombing, bronchiectasis (damaged
airways), presence of ground glass opacification, 6 min walk test to assess
functional exercise capacity, and an echocardiogram to assess for pulmonary
hypertension. A CXR lacks the specificity to diagnose a patient with IPF.
18. **Post CABG: Rewarming (prevent the effects of Hypothermia)** ANS
Always followed with hypothermia, predisposes the patient to ventricular
3
