NU 414 Final Exam With
Complete Solution
What are the priority assessments for a pt that had a laryngectomy? -
ANSWER -Assess respiratory function: s/s of respiratory distress & hypoxia,
SpO2 , cyanosis
-Assess for hemorrhage: bleeding from the surgical site or within the trachea;
monitor VS for decreased BP, rapid weak pulse
-Assess for infection: increase in temperature, change in wound drainage,
redness, tenderness, odor, increased WBCs
-Assess for wound breakdown: assess the stoma; assess for hemorrhage or
brusing
-Assess for aspiration: assess for residual, drowsiness, impaired swallowing;
have suction readily available
-Assess for tracheostomal stenosis: assess for infection, assess pressure of
cuff, assess for narrowing
What equipment is needed at the bedside for a laryngectomy patient? -
ANSWER Oxygen, intubation equipment, call light, suction, trach tray, &
trach equipment
How will a patient with COPD present upon assessment? - ANSWER "Barrel"
chest, cyanosis of the lips and nails, tripod position, intercostal retractions
What are the classic signs and symptoms of asthma? - ANSWER Symptoms
,commonly occuring at night and in the morning, wheezing, chest tightness
How is acute rhinosinusitis treated? - ANSWER The infection is treated with
antibiotics, saline lavage and decongestants for congestion, home remedies:
hydration, steam, elevated HOB, saline nose drops
What are the signs and symptoms of acute coronary syndrome? - ANSWER
unusual fatigue
shortness of breath
sleep disturbances
anxiety
fleeting chest discomfort
diaphoresis
pallor
What is the most common donor vessel used in a CABG? - ANSWER Greater
saphenous vein
What are the side effects of common medications used to treat angina? -
ANSWER -Nitroglycerin: headache, weakness, dizziness, nausea, hypotension
-Aspirin: nausea, epigastric discomfort, dyspepsia
-Clopidogrel: dizziness, heache, dyspepsia, diarrhea
What are the EKG changes for ischemia? - ANSWER ST segment depression, T
inversion
What are the EKG changes for infarction? - ANSWER ST segment elevation
, What does T wave elevation indicate? - ANSWER Hyperkalemia
How is an Acute Myocardial Infarction treated? - ANSWER M: Morphine
O: Oxygen
N: Nitrates (Nitroglycerin)
A: Aspirin/Antiplatelets (Clopidogrel)
What are the signs and symptoms of right sided heart failure? - ANSWER
-Right HF specific: hepatomegaly, hepatojugular reflux, ascites, JVD
-Typical: dyspnea, cyanosis, cachexia
What are the s/s of left sided heart failure? - ANSWER dyspnea, pulmonary
congestion, crackles, pulmonary edema
What are home management interventions for heart failure? - ANSWER
-restricting sodium
-avoidance of excessive fluid intake
-avoidance of alcohol
-avoidance of smoking
-weight loss
-regular excercising
What are the side effects of common medications used in the treatment of
heart failure? - ANSWER -Inotropes (Digoxin): arrythmias, GI problems
(anorexia), neurologic symptoms (confusion)
-Diuretics: dehydration, electrolyte imabalances, hypovolemia
Complete Solution
What are the priority assessments for a pt that had a laryngectomy? -
ANSWER -Assess respiratory function: s/s of respiratory distress & hypoxia,
SpO2 , cyanosis
-Assess for hemorrhage: bleeding from the surgical site or within the trachea;
monitor VS for decreased BP, rapid weak pulse
-Assess for infection: increase in temperature, change in wound drainage,
redness, tenderness, odor, increased WBCs
-Assess for wound breakdown: assess the stoma; assess for hemorrhage or
brusing
-Assess for aspiration: assess for residual, drowsiness, impaired swallowing;
have suction readily available
-Assess for tracheostomal stenosis: assess for infection, assess pressure of
cuff, assess for narrowing
What equipment is needed at the bedside for a laryngectomy patient? -
ANSWER Oxygen, intubation equipment, call light, suction, trach tray, &
trach equipment
How will a patient with COPD present upon assessment? - ANSWER "Barrel"
chest, cyanosis of the lips and nails, tripod position, intercostal retractions
What are the classic signs and symptoms of asthma? - ANSWER Symptoms
,commonly occuring at night and in the morning, wheezing, chest tightness
How is acute rhinosinusitis treated? - ANSWER The infection is treated with
antibiotics, saline lavage and decongestants for congestion, home remedies:
hydration, steam, elevated HOB, saline nose drops
What are the signs and symptoms of acute coronary syndrome? - ANSWER
unusual fatigue
shortness of breath
sleep disturbances
anxiety
fleeting chest discomfort
diaphoresis
pallor
What is the most common donor vessel used in a CABG? - ANSWER Greater
saphenous vein
What are the side effects of common medications used to treat angina? -
ANSWER -Nitroglycerin: headache, weakness, dizziness, nausea, hypotension
-Aspirin: nausea, epigastric discomfort, dyspepsia
-Clopidogrel: dizziness, heache, dyspepsia, diarrhea
What are the EKG changes for ischemia? - ANSWER ST segment depression, T
inversion
What are the EKG changes for infarction? - ANSWER ST segment elevation
, What does T wave elevation indicate? - ANSWER Hyperkalemia
How is an Acute Myocardial Infarction treated? - ANSWER M: Morphine
O: Oxygen
N: Nitrates (Nitroglycerin)
A: Aspirin/Antiplatelets (Clopidogrel)
What are the signs and symptoms of right sided heart failure? - ANSWER
-Right HF specific: hepatomegaly, hepatojugular reflux, ascites, JVD
-Typical: dyspnea, cyanosis, cachexia
What are the s/s of left sided heart failure? - ANSWER dyspnea, pulmonary
congestion, crackles, pulmonary edema
What are home management interventions for heart failure? - ANSWER
-restricting sodium
-avoidance of excessive fluid intake
-avoidance of alcohol
-avoidance of smoking
-weight loss
-regular excercising
What are the side effects of common medications used in the treatment of
heart failure? - ANSWER -Inotropes (Digoxin): arrythmias, GI problems
(anorexia), neurologic symptoms (confusion)
-Diuretics: dehydration, electrolyte imabalances, hypovolemia
