NURS 341 Final Exam – Questions With Clear Solutions
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Terms in this set (312)
What are the priority interventions for a Support airway and breathing: stimulate patient to breathe; if
patient with suspected midazolam inadequate, use bag-valve-mask ventilation. Administer
overdose? flumazenil (benzodiazepine reversal agent) per provider
order. Monitor oxygen saturation and LOC continuously.
Notify anesthesia/surgeon immediately. Prepare for possible
need for advanced airway support.
What does an elevated BUN with normal An elevated BUN with a normal creatinine usually indicates
creatinine typically indicate? dehydration or another non-renal cause of
hemoconcentration, rather than intrinsic kidney disease.
What urinary finding is characteristic of Red blood cells in the urine (hematuria) and proteinuria are
glomerulonephritis? characteristic findings of glomerulonephritis.
How is renal failure severity classified? Renal failure severity is classified by changes in GFR and
kidney function, typically defined as Acute Kidney Injury (AKI)
and Chronic Kidney Disease (CKD).
Describe the pathophysiologic process that Asthma is a chronic inflammatory airway disorder in which
leads to bronchoconstriction, airway exposure to triggers causes airway inflammation,
inflammation, and mucus production in bronchoconstriction, mucus hypersecretion, and airway
asthma. edema.
Explain how PaCO₂ levels change during Early exacerbation: PaCO₂ is low due to hyperventilation.
early and worsening stages of an asthma Worsening asthma: PaCO₂ rises toward normal → then
exacerbation. becomes elevated, indicating air trapping, respiratory muscle
fatigue, and impending respiratory failure.
Discuss the difference between controller Controller medications (daily) include inhaled corticosteroids,
and reliever asthma medications. long-acting beta agonists (LABAs), and leukotriene modifiers.
Reliever medications (rescue) include short-acting beta
agonists (SABAs), e.g., albuterol.
Compare COPD and asthma in terms of Asthma is often reversible, trigger-related, and has
progression, reversibility, and hallmark intermittent symptoms. COPD is progressive, irreversible
symptoms. airflow limitation caused by smoking or chronic exposure, with
hallmark symptoms of chronic cough, sputum, and dyspnea
on exertion.
,Identify nutritional strategies for COPD Eat small, frequent meals. High calorie, high protein to
patients. prevent muscle wasting. Avoid gas-producing foods. Rest
before meals; use bronchodilator pre-meal if needed.
Adequate hydration to thin secretions.
Describe oxygen therapy considerations in COPD patients can retain CO₂; excessive oxygen can reduce
COPD and explain why titration matters. respiratory drive and worsen hypercapnia. Titrate O₂ to
maintain SpO₂ 88-92%.
Explain the diagnostic process for lung Chest CT scan → preferred initial imaging. Biopsy
cancer. (bronchoscopy, needle aspiration) → confirms malignancy.
PET scan / MRI → staging and metastasis evaluation.
Identify priority assessments for patients New or worsening cough, hemoptysis, unexplained weight
with symptoms concerning for lung cancer. loss, hoarseness, dyspnea, wheezing, chest pain, signs of
metastasis.
Discuss the role of targeted therapies in Targeted therapies act on specific molecular mutations such
lung cancer and how genetic mutations as EGFR mutations, ALK rearrangements, and ROS1 mutations.
guide treatment.
Summarize postoperative respiratory care Incentive spirometry every hour, pain control to allow deep
strategies following lung surgery. breathing, early ambulation, monitor for tracheal deviation,
assess breath sounds and chest tube drainage, maintain airway
clearance.
Describe atypical pneumonia symptoms in Older adults often present without classic fever/cough,
older adults. instead showing confusion or acute delirium, weakness, falls,
poor appetite, incontinence.
Explain when airborne precautions can be Airborne precautions may be discontinued when the patient
discontinued for tuberculosis. has three negative sputum AFB smears, has been on effective
anti-TB therapy, and is clinically improving.
Describe manifestations of dehydration in Older adults show dry mucous membranes, poor skin turgor,
older adults and why risk increases with age. orthostatic hypotension, weak pulses, elevated Hct/serum
osmolarity, confusion, and decreased urine output.
Explain which assessment findings indicate Signs of improvement include stable blood pressure,
effective rehydration. improved mental status, moist mucous membranes, urine
output ≥ 30 mL/hr, decreasing Hct/Na/osmolality toward
normal.
Discuss safety considerations when Used ONLY for severe hyponatremia. Administer slowly via
administering hypertonic saline. pump—rapid correction can cause osmotic demyelination.
Frequent neuro checks, seizure precautions.
Describe neurologic changes associated Hypernatremia causes brain cell shrinkage, leading to altered
with worsening hypernatremia. mental status, agitation, restlessness, seizures, confusion, and
possible intracranial bleeding.
Unsafe practices Giving IV push potassium, infusing too rapidly, giving K+
without verifying urine output, mixing improperly or not using
a pump.
Dangers of unsafe potassium practices Cardiac arrest, severe dysrhythmias, tissue necrosis if
infiltrated.
, Signs of hypocalcemia Tetany, muscle spasms, Chvostek's & Trousseau's signs,
seizures, laryngospasm/stridor, paresthesias.
Physiologic basis of hypocalcemia signs Low Ca²⁺ increases neuronal excitability, causing hyperactive
nerve and muscle responses.
Neuromuscular effects of hypomagnesemia Low Mg²⁺ leads to tetany, tremors, seizures, hyperreflexia,
dysrhythmias.
ABG pattern for metabolic acidosis ↓ pH, ↓ HCO₃⁻.
ABG pattern for metabolic alkalosis ↑ pH, ↑ HCO₃⁻.
ABG pattern for respiratory acidosis ↓ pH, ↑ PaCO₂.
ABG pattern for respiratory alkalosis ↑ pH, ↓ PaCO₂.
Effects of aging on total body water Decreased total body water, decreased renal blood flow,
reduced GFR, impaired urine-concentrating ability.
Contribution of increased venous High venous hydrostatic pressure pushes fluid out of
hydrostatic pressure to edema capillaries into interstitial space, exceeding lymphatic return.
Aldosterone's role in sodium and water Increases Na⁺ reabsorption, increases water retention,
regulation promotes K⁺ excretion.
Calcium-phosphate relationship Ca²⁺ and phosphate are inversely related: when Ca²⁺ rises,
phosphate falls, and vice versa.
Phosphate's role in ATP production Essential for ATP, providing energy for muscle contraction and
cellular processes.
ECG finding associated with hypokalemia Flattened or inverted T waves, presence of U waves, ST
depression, and PVCs.
ECG finding associated with hyperkalemia Tall, peaked T waves, widened QRS, prolonged PR interval,
sine-wave pattern in severe cases.
Priority treatment for symptomatic Atropine 0.5 mg IV, repeat q3-5 min (max 3 mg).
bradycardia
Hallmark signs of atrial fibrillation Irregularly irregular rhythm, absence of P waves, risk of
thromboembolism.
Treatment priority for ventricular tachycardia Amiodarone or synchronized cardioversion depending on
with a pulse stability.
Dysrhythmia treated with defibrillation Pulseless VT, ventricular fibrillation.
Labs confirming myocardial infarction Troponin I or T (most specific), CK-MB (less commonly used).
Priority treatment for chest pain MONA: Oxygen (if SpO₂ < 90%), Aspirin (chew), Nitroglycerin,
Morphine if pain not relieved.
ECG change indicating acute STEMI ST segment elevation in two or more anatomically contiguous
leads.
Save
Students also studied
Sherpath Chapter 29- Chest and Abdominal Tr... HESI 366 STUDY GUIDE
348 terms 130 terms
Preview anaphylacticshock Preview FutureRN0911 Preview
Terms in this set (312)
What are the priority interventions for a Support airway and breathing: stimulate patient to breathe; if
patient with suspected midazolam inadequate, use bag-valve-mask ventilation. Administer
overdose? flumazenil (benzodiazepine reversal agent) per provider
order. Monitor oxygen saturation and LOC continuously.
Notify anesthesia/surgeon immediately. Prepare for possible
need for advanced airway support.
What does an elevated BUN with normal An elevated BUN with a normal creatinine usually indicates
creatinine typically indicate? dehydration or another non-renal cause of
hemoconcentration, rather than intrinsic kidney disease.
What urinary finding is characteristic of Red blood cells in the urine (hematuria) and proteinuria are
glomerulonephritis? characteristic findings of glomerulonephritis.
How is renal failure severity classified? Renal failure severity is classified by changes in GFR and
kidney function, typically defined as Acute Kidney Injury (AKI)
and Chronic Kidney Disease (CKD).
Describe the pathophysiologic process that Asthma is a chronic inflammatory airway disorder in which
leads to bronchoconstriction, airway exposure to triggers causes airway inflammation,
inflammation, and mucus production in bronchoconstriction, mucus hypersecretion, and airway
asthma. edema.
Explain how PaCO₂ levels change during Early exacerbation: PaCO₂ is low due to hyperventilation.
early and worsening stages of an asthma Worsening asthma: PaCO₂ rises toward normal → then
exacerbation. becomes elevated, indicating air trapping, respiratory muscle
fatigue, and impending respiratory failure.
Discuss the difference between controller Controller medications (daily) include inhaled corticosteroids,
and reliever asthma medications. long-acting beta agonists (LABAs), and leukotriene modifiers.
Reliever medications (rescue) include short-acting beta
agonists (SABAs), e.g., albuterol.
Compare COPD and asthma in terms of Asthma is often reversible, trigger-related, and has
progression, reversibility, and hallmark intermittent symptoms. COPD is progressive, irreversible
symptoms. airflow limitation caused by smoking or chronic exposure, with
hallmark symptoms of chronic cough, sputum, and dyspnea
on exertion.
,Identify nutritional strategies for COPD Eat small, frequent meals. High calorie, high protein to
patients. prevent muscle wasting. Avoid gas-producing foods. Rest
before meals; use bronchodilator pre-meal if needed.
Adequate hydration to thin secretions.
Describe oxygen therapy considerations in COPD patients can retain CO₂; excessive oxygen can reduce
COPD and explain why titration matters. respiratory drive and worsen hypercapnia. Titrate O₂ to
maintain SpO₂ 88-92%.
Explain the diagnostic process for lung Chest CT scan → preferred initial imaging. Biopsy
cancer. (bronchoscopy, needle aspiration) → confirms malignancy.
PET scan / MRI → staging and metastasis evaluation.
Identify priority assessments for patients New or worsening cough, hemoptysis, unexplained weight
with symptoms concerning for lung cancer. loss, hoarseness, dyspnea, wheezing, chest pain, signs of
metastasis.
Discuss the role of targeted therapies in Targeted therapies act on specific molecular mutations such
lung cancer and how genetic mutations as EGFR mutations, ALK rearrangements, and ROS1 mutations.
guide treatment.
Summarize postoperative respiratory care Incentive spirometry every hour, pain control to allow deep
strategies following lung surgery. breathing, early ambulation, monitor for tracheal deviation,
assess breath sounds and chest tube drainage, maintain airway
clearance.
Describe atypical pneumonia symptoms in Older adults often present without classic fever/cough,
older adults. instead showing confusion or acute delirium, weakness, falls,
poor appetite, incontinence.
Explain when airborne precautions can be Airborne precautions may be discontinued when the patient
discontinued for tuberculosis. has three negative sputum AFB smears, has been on effective
anti-TB therapy, and is clinically improving.
Describe manifestations of dehydration in Older adults show dry mucous membranes, poor skin turgor,
older adults and why risk increases with age. orthostatic hypotension, weak pulses, elevated Hct/serum
osmolarity, confusion, and decreased urine output.
Explain which assessment findings indicate Signs of improvement include stable blood pressure,
effective rehydration. improved mental status, moist mucous membranes, urine
output ≥ 30 mL/hr, decreasing Hct/Na/osmolality toward
normal.
Discuss safety considerations when Used ONLY for severe hyponatremia. Administer slowly via
administering hypertonic saline. pump—rapid correction can cause osmotic demyelination.
Frequent neuro checks, seizure precautions.
Describe neurologic changes associated Hypernatremia causes brain cell shrinkage, leading to altered
with worsening hypernatremia. mental status, agitation, restlessness, seizures, confusion, and
possible intracranial bleeding.
Unsafe practices Giving IV push potassium, infusing too rapidly, giving K+
without verifying urine output, mixing improperly or not using
a pump.
Dangers of unsafe potassium practices Cardiac arrest, severe dysrhythmias, tissue necrosis if
infiltrated.
, Signs of hypocalcemia Tetany, muscle spasms, Chvostek's & Trousseau's signs,
seizures, laryngospasm/stridor, paresthesias.
Physiologic basis of hypocalcemia signs Low Ca²⁺ increases neuronal excitability, causing hyperactive
nerve and muscle responses.
Neuromuscular effects of hypomagnesemia Low Mg²⁺ leads to tetany, tremors, seizures, hyperreflexia,
dysrhythmias.
ABG pattern for metabolic acidosis ↓ pH, ↓ HCO₃⁻.
ABG pattern for metabolic alkalosis ↑ pH, ↑ HCO₃⁻.
ABG pattern for respiratory acidosis ↓ pH, ↑ PaCO₂.
ABG pattern for respiratory alkalosis ↑ pH, ↓ PaCO₂.
Effects of aging on total body water Decreased total body water, decreased renal blood flow,
reduced GFR, impaired urine-concentrating ability.
Contribution of increased venous High venous hydrostatic pressure pushes fluid out of
hydrostatic pressure to edema capillaries into interstitial space, exceeding lymphatic return.
Aldosterone's role in sodium and water Increases Na⁺ reabsorption, increases water retention,
regulation promotes K⁺ excretion.
Calcium-phosphate relationship Ca²⁺ and phosphate are inversely related: when Ca²⁺ rises,
phosphate falls, and vice versa.
Phosphate's role in ATP production Essential for ATP, providing energy for muscle contraction and
cellular processes.
ECG finding associated with hypokalemia Flattened or inverted T waves, presence of U waves, ST
depression, and PVCs.
ECG finding associated with hyperkalemia Tall, peaked T waves, widened QRS, prolonged PR interval,
sine-wave pattern in severe cases.
Priority treatment for symptomatic Atropine 0.5 mg IV, repeat q3-5 min (max 3 mg).
bradycardia
Hallmark signs of atrial fibrillation Irregularly irregular rhythm, absence of P waves, risk of
thromboembolism.
Treatment priority for ventricular tachycardia Amiodarone or synchronized cardioversion depending on
with a pulse stability.
Dysrhythmia treated with defibrillation Pulseless VT, ventricular fibrillation.
Labs confirming myocardial infarction Troponin I or T (most specific), CK-MB (less commonly used).
Priority treatment for chest pain MONA: Oxygen (if SpO₂ < 90%), Aspirin (chew), Nitroglycerin,
Morphine if pain not relieved.
ECG change indicating acute STEMI ST segment elevation in two or more anatomically contiguous
leads.
