CMSRN exam questions with complete solution 2023 updated

CMSRN exam questions with complete solution 2023 updatedwhen does alcohol withdrawal occur - correct answer 12-48h after last drink. symptoms can begin after 4h, peak at 24-48h, last up to two weeks sundowner syndrome - correct answer symptoms at night, common in dementia but can occur without dementia, may be due to sensory overload tort - correct answer an action that wrongly causes harm to someone but is not a crime, and is dealt with in civil court. can be intentional (assault and battery) or unintentional (negligence). tort = wrongful act hydroxurea - correct answer has anti-sickle properties what is a big risk factor for sudden cardiac death/dysrhythmias - correct answer left ventricular dysfunction which compensatory mechanism in heart failure leads to inappropriate fluid retention - correct answer neurohormonal response: increases fluid retention (via aldosterone) and increases workload of heart by increasing peripheral vascular resistance what to monitor if patient has thyroidectomy - correct answer hypocalcemia-look at back of neck for signs of bleeding myxedema coma - correct answer untreated hypothyroid; sluggish/drowsy/lethargy/altered LOC, hypotension, bradypnea can be casused by infection, trauma, drugs, exposure to extreme cold what increases the chance of ventricular arrhythmia - correct answer systolic heart failure hypertensive urgency vs emergency - correct answer urgency: no end organ damage. EMERGENCY: evidence of end-organ damage, develops over hrs to days. don't decrease BP by 10% in first hour. **if aortic dissection lower BP asap thoracic aortic aneurysm - correct answer cough, hoarseness, dysphagia, sudden loss of radial/femoral pulses, carotid pulses. if tears, will have tearing pain in chest/back AAA - correct answer dull lower back pain, radiates to flank/groin, pulsation in abdomen. if tears, will have severe abdominal/lower back pain with N/V at which length does an aortic aneurysm need intervention - correct answer when 4.5cm, need BP control cardiac tamponade - correct answer chest pain, hypotension, muffled heart sounds, tachycardia, cyanosis, diaphoresis, narrowed pulse pressure, paradoxical pulse (BP changes 10 on inspiration). may see PEA: pulseless electrical activity beta blockers - correct answer watch renal function, may hide hypoglycemia, may reduce EF even more in heart failure pts ACE inhibitors - correct answer monitor for cough, angioedema, hyperkalemia hctz - correct answer is a diuretic. so are lasix, spironolactone, and diamox what med is first given in hypertensive urgency - correct answer clonidine anticholinergics for copd - correct answer reduce mucus production, inhibit vagal stimulation, prevent smooth muscle contraction in airway. Spiriva, ipratropium non-rebreather vs venturi mask - correct answer non-rebreather is first choice for COPD in emergency, but has risk of CO2 retention. venti is higher flow, used when provider has concern about co2 retention