NURS 400 FINAL EXAM – Questions With Verified
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Terms in this set (123)
You are working on a burn unit and d. hypovolemia
the patient experiences third spacing.
You should expect the patient to Rationale: Third-spacing fluid shift occurs when fluid
exhibit signs and symptoms of what moves out of the intravascular space but NOT into
imbalance? the intracellular space, and can cause hypovolemia
a. metabolic alkalosis
b. hypermagnesemia
c. hypercalcemia
d. hypovolemia
A nurse is caring for a patient with d. Inability of the liver to use vitamin K
liver failure and is performing an
assessment in the knowledge of the Rationale:
patient's increased risk of bleeding. decreased production of several clotting factors may
The nurse recognizes that this risk is be partially d/t deficient absorption of vitamin K from
related to the patient inability to the GI tract
synthesize prothrombin in the liver.
What factor most likely contributes to
this loss of function?
a. alterations in glucose metabolism
b. retention of bile salts
c. inadequate production of albumin
by hepatocytes
d. inability of the liver to use vitamin K
,A patient with portal HTN has been c. daily weights and abdominal girth measuring
admitted to the medical floor. The
nurse should prioritize which of the Rationale:
following assessments related to the Obstruction of blood flow through the damaged
manifestations of this health problem? liver results in increased BP throughout the portal
venous system. This can result in varices and ascites
a. assessment if blood pressure and in the abdominal cavity.
assessment for headaches and visual
changes
b. assessments for signs and
symptoms of venous
thromboembolism
c. daily weights and abdominal girth
measurement
d. blood glucose monitoring q4hr
A nurse educator is teaching a group a. Immunization
of recent nursing graduates about b. Use of standard precautions
their occupational risks for contracting
hepatitis B. What preventative
measures should the educator
promote? Select all that apply.
a. Immunization
b. use of standard precautions
c. consumption of a vitamin-rich diet
d. annual vitamin K injections
e. annual vitamin B12 injections
,A patient diagnosed with hemorrhagic c. how to correctly modify the home environment
stroke has been admitted to the
neurologic ICU. The nurse knows that
teaching for the patient and family
needs to begin as soon as the patient
is settled on the unit and will continue
until the patient is discharged. What
will family education need to include?
a. how to differentiate between
hemorrhagic and ischemic stroke
b. risk factor for ischemic stroke
c. how to correctly modify the home
environment
d. techniques for adjusting the
patients medication dosages at home
What is a nonmodifiable risk factor for c. advanced age
a stroke?
a. female gender
b. asian american race
c. advanced age
d. smoking
A family member brings the patient to b. stop smoking as soon as possible
the clinic for a follow-up visit after a
stroke. The family member asks the
nurse what he can do to decrease his
chance of having another stroke. What
would be the nurse's best answer?
A) "Have your heart checked
regularly."
B) "Stop smoking as soon as possible."
C) "Get medication to bring down
your sodium levels."
D) "Eat a nutritious diet."
, A nurse is reviewing the medication c. aspirin
administration record of a female
patient who possesses numerous risk Rationale: low-dose aspirin can reduce risk of stroke
factors for stroke. Which of the in women who are at risk
womens medications carries the
greatest potential for reducing her risk
of a stroke?
a. naproxen
b. calcium carbonate
c. aspirin
d. lorazepam
The pathophysiology of an ischemic 236145
stroke involves the ischemic cascade,
which includes the following steps:
1. change in pH
2. blood flow decreases
3. a switch to anaerobic respiration
4. membrane pumps fail
5. cells cease to function
6. lactic acid is generated
As a member of the stroke team, the b. recent intracranial pathology
nurse knows that thrombolytic therapy d. current anticoagulation therapy
carries the potential for benefit and e. symptom onset greater than 3 hours prior to
for harm. The nurse should be admission
cognizant of what contraindications
for thrombolytic therapy? Select all
that apply.
A) INR above 1.0
B) Recent intracranial pathology
C) Sudden symptom onset
D) Current anticoagulation therapy
E) Symptom onset greater than 3
hours prior to admission
Solutions
Save
Terms in this set (123)
You are working on a burn unit and d. hypovolemia
the patient experiences third spacing.
You should expect the patient to Rationale: Third-spacing fluid shift occurs when fluid
exhibit signs and symptoms of what moves out of the intravascular space but NOT into
imbalance? the intracellular space, and can cause hypovolemia
a. metabolic alkalosis
b. hypermagnesemia
c. hypercalcemia
d. hypovolemia
A nurse is caring for a patient with d. Inability of the liver to use vitamin K
liver failure and is performing an
assessment in the knowledge of the Rationale:
patient's increased risk of bleeding. decreased production of several clotting factors may
The nurse recognizes that this risk is be partially d/t deficient absorption of vitamin K from
related to the patient inability to the GI tract
synthesize prothrombin in the liver.
What factor most likely contributes to
this loss of function?
a. alterations in glucose metabolism
b. retention of bile salts
c. inadequate production of albumin
by hepatocytes
d. inability of the liver to use vitamin K
,A patient with portal HTN has been c. daily weights and abdominal girth measuring
admitted to the medical floor. The
nurse should prioritize which of the Rationale:
following assessments related to the Obstruction of blood flow through the damaged
manifestations of this health problem? liver results in increased BP throughout the portal
venous system. This can result in varices and ascites
a. assessment if blood pressure and in the abdominal cavity.
assessment for headaches and visual
changes
b. assessments for signs and
symptoms of venous
thromboembolism
c. daily weights and abdominal girth
measurement
d. blood glucose monitoring q4hr
A nurse educator is teaching a group a. Immunization
of recent nursing graduates about b. Use of standard precautions
their occupational risks for contracting
hepatitis B. What preventative
measures should the educator
promote? Select all that apply.
a. Immunization
b. use of standard precautions
c. consumption of a vitamin-rich diet
d. annual vitamin K injections
e. annual vitamin B12 injections
,A patient diagnosed with hemorrhagic c. how to correctly modify the home environment
stroke has been admitted to the
neurologic ICU. The nurse knows that
teaching for the patient and family
needs to begin as soon as the patient
is settled on the unit and will continue
until the patient is discharged. What
will family education need to include?
a. how to differentiate between
hemorrhagic and ischemic stroke
b. risk factor for ischemic stroke
c. how to correctly modify the home
environment
d. techniques for adjusting the
patients medication dosages at home
What is a nonmodifiable risk factor for c. advanced age
a stroke?
a. female gender
b. asian american race
c. advanced age
d. smoking
A family member brings the patient to b. stop smoking as soon as possible
the clinic for a follow-up visit after a
stroke. The family member asks the
nurse what he can do to decrease his
chance of having another stroke. What
would be the nurse's best answer?
A) "Have your heart checked
regularly."
B) "Stop smoking as soon as possible."
C) "Get medication to bring down
your sodium levels."
D) "Eat a nutritious diet."
, A nurse is reviewing the medication c. aspirin
administration record of a female
patient who possesses numerous risk Rationale: low-dose aspirin can reduce risk of stroke
factors for stroke. Which of the in women who are at risk
womens medications carries the
greatest potential for reducing her risk
of a stroke?
a. naproxen
b. calcium carbonate
c. aspirin
d. lorazepam
The pathophysiology of an ischemic 236145
stroke involves the ischemic cascade,
which includes the following steps:
1. change in pH
2. blood flow decreases
3. a switch to anaerobic respiration
4. membrane pumps fail
5. cells cease to function
6. lactic acid is generated
As a member of the stroke team, the b. recent intracranial pathology
nurse knows that thrombolytic therapy d. current anticoagulation therapy
carries the potential for benefit and e. symptom onset greater than 3 hours prior to
for harm. The nurse should be admission
cognizant of what contraindications
for thrombolytic therapy? Select all
that apply.
A) INR above 1.0
B) Recent intracranial pathology
C) Sudden symptom onset
D) Current anticoagulation therapy
E) Symptom onset greater than 3
hours prior to admission
