Page |1
NUR 2243 FINAL EXAM ( LATEST 2024
/ 2025 ) | WITH 100% VERIFIED
ANSWERS
Autonomic Dysreflexia - Correct - caused by SCI
- 1st assessment is bladder distension
S/sx of autonomic dysreflexia - Correct - pounding headache
- diaphoresis
- bradycardia
- HTN (systolic BP can reach 300)
when the trigger/stimuli resolves the s/sx will resolve
Hepatitis A is caused by - Correct fecal-oral contamination, usually food
ex: contaminated seafood not fully cooked, fruit/veggies overseas washed with contaminated water
Hepatitis B is caused by - Correct unprotected sex, needle sticks (IV drug user), blood transfusion
Who is most at risk for Hep B infection? - Correct 20 year old with multiple sexual partners
Hepatitis C is caused by - Correct blood contact with infected person; cannot be spread casually
Hep C treatment - Correct ribavirin; take a long time to work so med compliance is key, teach to use pill
organizer
Pt present with hypotension, bradycardia, and dizziness, what would you anticipate administering? - Correct
atropine; pt has symptomatic bradycardia
Primary manifestations of diabetes - Correct 3 P's: polyuria, polyphagia, polydipsia
Pt presents to the ED bleeding profusely from a head wound. What is the first action the nurse should take? -
Correct don gloves/PPE
, Page |2
Manifestations of cirrhosis - Correct - ascites, edema, elevated ammonia levels, proteinuria, low albumin,
esophageal varices
- tx for ammonia is lactulose; diarrhea is expected
Cirrhosis pt with ascites may experience what pulmonary problem? - Correct SOB, too much fluid in
peritoneal cavity
A pt with cirrhosis has developed esophageal varices. What is the nurse's priority - Correct - maintain
airway
- monitor for s/sx of hemorrhage
Teaching pt with cirrhosis - Correct - low sodium to reduce ascites
- watch protein levels to avoid high concentrations of ammonia and hepatic encephalopathy
S/sx of hyperthermia - Correct sweaty red skin, tachypnea, tachycardia
Murmur is best heard on - Correct right side of sternal border
PVC strip - Correct dips after PQRS, occurs before next beat
Teaching for heart failure pt - Correct - restrict salt in diet
- check weight at same time every day
V-tach - Correct - unstable tx: synchronous SHOCK (cardioversion), CPR, O2,
- stable tx: O2
- 150-250 BPM
- can lead to cardiac arrest
V-fib - Correct - tx: asynchronous SHOCK(defib), CPR, O2, antidysrhythmics
- chaotic rapid rhythm
- fatal if not treated in 3-5 mins!
Normal Sinus Rhythm (NSR) - Correct ECG of a healthy heart shows an organized, uniform rhythm; 60-
100 BPM
, Page |3
Pt with heart failure is prescribed enalapril (Vasotec), what would be the primary teaching? - Correct no
salt substitutes; enalapril is potassium sparing so extra potassium can cause hyperkalemia
Subcutaneous emphysema is an indication that - Correct air is escaping into the chest wall from a
damaged lung
A patient has a tracheostomy that is 3 days old. Upon assessment, the nurse notes that the patient's face is puffy
and the eyelids are swollen. What action by the nurse takes priority? - Correct O2 sat, call rapid if pt
unstable
A pt in the ER dies suddenly and unexpectedly. What considerations should the nurse take regarding the family?
- Correct allow them time in a quiet room to say goodbye
Priority interventions for malignant hyperthermia - Correct dantrolene sodium and 10% reg. insulin
The nurse knows a pt's chest tube is properly connected to the water seal and functioning properly when -
Correct there is a fluctuation every time the pt takes a breath
Which finding about a patient who is receiving vasopressin to treat septic shock indicates an immediate need for
the nurse to report the finding to the health care provider? - Correct chest pain; indicates decreased
coronary artery perfusion, possible heart attack
Which med is contraindicated for patients taking Digoxin? - Correct antacids; interfere with Dig
absorption
A pt is taking captopril for their BP, what should the nurse assess for and what can be done to help? - Correct
OH, assist pt in getting out of bed (fall precautions)
Which complication of tachycardia is most concerning to the nurse? - Correct chest pain
A patient is being treated for metabolic acidosis. What is a common cause of met. acid.? - Correct
diarrhea
Treatment for metabolic acidosis - Correct IV bicarb, treat the underlying cause(s), correct sodium and
water deficits
Pt has chronic kidney disease and reports nausea and vomiting when they're getting epoetin and digoxin. -
Correct digoxin toxicity because the drug is not being excreted by the kidneys, review their potassium
levels
Digoxin side effects - Correct - N&V
, Page |4
- diarrhea
- anorexia
- vision changes
Digoxin toxicity assessment - Correct assess apical pulse 1 min
The best way to assess core body temp is - Correct rectally
A person with end-stage cirrhosis is confused. What would you ask the doctor to order? - Correct
lactulose; pt is displaying hepatic encephalopathy too much ammonia in the blood going to the brain
When suctioning the nurse only applies suction - Correct on the way out, PRN, no more than 15 secs
Pt is about to receive dialysis, the nurse knows to hold - Correct water soluble vitamins (B, C),
antihypertensives
A pt is about to undergo rewarming for his frostbitten fingers. What is the nurse's primary intervention? -
Correct give IV morphine, rewarming is extremely painful
Best way to evaluate if rewarming extremities of a frostbitten pt is successful is - Correct normal
capillary refill of injured extremities
A paraplegic patient doesn't want to go to rehab or participate in PT because they won't enable him to walk
again. What is the nurse's best response? - Correct these exercises will help you keep the function you do
have and not deteriorate
A patient presents with PVCs. The nurse knows these are usually benign but can lead to - Correct v-tach
Who is most at risk for temp regulation issues? - Correct premature/low birth infants and elderly: slow
metabolism, low body fat, diminished ability to regulate
Common coagulant given to pts with afib - Correct warfarin (Coumadin)
On a pt's EKG the nurse notes tall peaked T waves. This indicates - Correct hyperkalemia, check
potassium levels
Early s/sx of heart failure - Correct increased HR and RR, little to no increase in BP, edema
Left sided heart failure - Correct LUNGS
- SOB
NUR 2243 FINAL EXAM ( LATEST 2024
/ 2025 ) | WITH 100% VERIFIED
ANSWERS
Autonomic Dysreflexia - Correct - caused by SCI
- 1st assessment is bladder distension
S/sx of autonomic dysreflexia - Correct - pounding headache
- diaphoresis
- bradycardia
- HTN (systolic BP can reach 300)
when the trigger/stimuli resolves the s/sx will resolve
Hepatitis A is caused by - Correct fecal-oral contamination, usually food
ex: contaminated seafood not fully cooked, fruit/veggies overseas washed with contaminated water
Hepatitis B is caused by - Correct unprotected sex, needle sticks (IV drug user), blood transfusion
Who is most at risk for Hep B infection? - Correct 20 year old with multiple sexual partners
Hepatitis C is caused by - Correct blood contact with infected person; cannot be spread casually
Hep C treatment - Correct ribavirin; take a long time to work so med compliance is key, teach to use pill
organizer
Pt present with hypotension, bradycardia, and dizziness, what would you anticipate administering? - Correct
atropine; pt has symptomatic bradycardia
Primary manifestations of diabetes - Correct 3 P's: polyuria, polyphagia, polydipsia
Pt presents to the ED bleeding profusely from a head wound. What is the first action the nurse should take? -
Correct don gloves/PPE
, Page |2
Manifestations of cirrhosis - Correct - ascites, edema, elevated ammonia levels, proteinuria, low albumin,
esophageal varices
- tx for ammonia is lactulose; diarrhea is expected
Cirrhosis pt with ascites may experience what pulmonary problem? - Correct SOB, too much fluid in
peritoneal cavity
A pt with cirrhosis has developed esophageal varices. What is the nurse's priority - Correct - maintain
airway
- monitor for s/sx of hemorrhage
Teaching pt with cirrhosis - Correct - low sodium to reduce ascites
- watch protein levels to avoid high concentrations of ammonia and hepatic encephalopathy
S/sx of hyperthermia - Correct sweaty red skin, tachypnea, tachycardia
Murmur is best heard on - Correct right side of sternal border
PVC strip - Correct dips after PQRS, occurs before next beat
Teaching for heart failure pt - Correct - restrict salt in diet
- check weight at same time every day
V-tach - Correct - unstable tx: synchronous SHOCK (cardioversion), CPR, O2,
- stable tx: O2
- 150-250 BPM
- can lead to cardiac arrest
V-fib - Correct - tx: asynchronous SHOCK(defib), CPR, O2, antidysrhythmics
- chaotic rapid rhythm
- fatal if not treated in 3-5 mins!
Normal Sinus Rhythm (NSR) - Correct ECG of a healthy heart shows an organized, uniform rhythm; 60-
100 BPM
, Page |3
Pt with heart failure is prescribed enalapril (Vasotec), what would be the primary teaching? - Correct no
salt substitutes; enalapril is potassium sparing so extra potassium can cause hyperkalemia
Subcutaneous emphysema is an indication that - Correct air is escaping into the chest wall from a
damaged lung
A patient has a tracheostomy that is 3 days old. Upon assessment, the nurse notes that the patient's face is puffy
and the eyelids are swollen. What action by the nurse takes priority? - Correct O2 sat, call rapid if pt
unstable
A pt in the ER dies suddenly and unexpectedly. What considerations should the nurse take regarding the family?
- Correct allow them time in a quiet room to say goodbye
Priority interventions for malignant hyperthermia - Correct dantrolene sodium and 10% reg. insulin
The nurse knows a pt's chest tube is properly connected to the water seal and functioning properly when -
Correct there is a fluctuation every time the pt takes a breath
Which finding about a patient who is receiving vasopressin to treat septic shock indicates an immediate need for
the nurse to report the finding to the health care provider? - Correct chest pain; indicates decreased
coronary artery perfusion, possible heart attack
Which med is contraindicated for patients taking Digoxin? - Correct antacids; interfere with Dig
absorption
A pt is taking captopril for their BP, what should the nurse assess for and what can be done to help? - Correct
OH, assist pt in getting out of bed (fall precautions)
Which complication of tachycardia is most concerning to the nurse? - Correct chest pain
A patient is being treated for metabolic acidosis. What is a common cause of met. acid.? - Correct
diarrhea
Treatment for metabolic acidosis - Correct IV bicarb, treat the underlying cause(s), correct sodium and
water deficits
Pt has chronic kidney disease and reports nausea and vomiting when they're getting epoetin and digoxin. -
Correct digoxin toxicity because the drug is not being excreted by the kidneys, review their potassium
levels
Digoxin side effects - Correct - N&V
, Page |4
- diarrhea
- anorexia
- vision changes
Digoxin toxicity assessment - Correct assess apical pulse 1 min
The best way to assess core body temp is - Correct rectally
A person with end-stage cirrhosis is confused. What would you ask the doctor to order? - Correct
lactulose; pt is displaying hepatic encephalopathy too much ammonia in the blood going to the brain
When suctioning the nurse only applies suction - Correct on the way out, PRN, no more than 15 secs
Pt is about to receive dialysis, the nurse knows to hold - Correct water soluble vitamins (B, C),
antihypertensives
A pt is about to undergo rewarming for his frostbitten fingers. What is the nurse's primary intervention? -
Correct give IV morphine, rewarming is extremely painful
Best way to evaluate if rewarming extremities of a frostbitten pt is successful is - Correct normal
capillary refill of injured extremities
A paraplegic patient doesn't want to go to rehab or participate in PT because they won't enable him to walk
again. What is the nurse's best response? - Correct these exercises will help you keep the function you do
have and not deteriorate
A patient presents with PVCs. The nurse knows these are usually benign but can lead to - Correct v-tach
Who is most at risk for temp regulation issues? - Correct premature/low birth infants and elderly: slow
metabolism, low body fat, diminished ability to regulate
Common coagulant given to pts with afib - Correct warfarin (Coumadin)
On a pt's EKG the nurse notes tall peaked T waves. This indicates - Correct hyperkalemia, check
potassium levels
Early s/sx of heart failure - Correct increased HR and RR, little to no increase in BP, edema
Left sided heart failure - Correct LUNGS
- SOB
