final exam

tuberculosis symptoms are
a. weight loss
b. fever
c. persistant cough for 2-3 weeks
d. all of the above

all of the above

which assessment finding indicates an arterial thrombus in the lower extremity?
a. pedal edema
b. pedal cyanosis
c. pedal pulses present
d. pedal rubor

pedal cyanosis

which of the following serum electrolyte values is abnormal?
a. magnesium 2.0 mEq/L
b. calcium 15.0 mEq/L
c. sodium 138 mg/dL

calcium

laryngotracheobronchitis is typically manifested by
a. hoarse voice and barking cough
b. drooling and difficultly
c. wheezing and dyspnea
d. sore and scratchy throat with fever

hoarse voice and barking cough

which of the following is a modifiable risk factor for coronary artery disease?
a. smoking
b. age
c. family history
d. gender

smoking

a patient presents to the emergency department complaining of severe chest pain. Upon examination, you note a temperature of ....... and a pericardial friction rub. you should expect which of the following?
a. infective endocarditis
b. pericarditis
c. myocarditis
d. cardiac tamponade

pericarditis

hypoventilation, aspiration of foreign bodies, and sleep apnea may cause
a. respiratory acidosis
b. metabolic alkalosis
c. respiratory alkalosis
d. metabolic acidosis

respiratory acidosis

a distinguishing feature of influenza is
a. abrupt-onset symptoms of fever, chills, and general malaise
b. sore throat and profuse watery nasal discharge
c. fever and headache
d. dry and nonproductive cough

abrupt onset symtoms

a patient comes to the ED complaining of coughing and difficulty breathing. the patient's diagnosis is heart failure. he asks you how difficulty breathing could be a heart problem. what is the best response?
a. the left side of your heart is weak and pumps blood too quickly
b. the left side of your heart has weakened and the blood has entered your lungs
c. the right side of your heart has weakened and the blookd as entered your lungs
d. the right side of your heart has enlarged and cannot effectively pump blood

the left side of your heart has weakened and blood has entered your lungs

a patient presents to the ED with a stab wound to the chest. you note on assessment that the paitent is experincing difficulty breathing and asymmetrical chest movement. you should suspect which of the following problems:
a. traumatic pneumnothorax
b. atelectasis
c. chylothorax
d. tension pneumnothorax

traumatic pneumnothorax

cystic fibrosis is
a. an abnormal recessive disorder affecting exocrine glands
b. a restrictive disorder characterized by proteolytic destruction of alveoli
c. caused by chronic exposure to second hand smoke
d. an allergic disorder triggered by specific antigens

an abnormal recessive disorder affecting exocrine glands

raynaud's phenomenon is characterized by ____ while thromboangitis obliterans is chracterized by _____ of the arterial vessels in the hands and/or feet
a. vasospasm, inflammation
b. thrombophlebitis, vasospasm
c.inflammation, compression
d. arhterosclerosis, inflammation

vasospasm, inflammation

the body compensates for metabolic acidosis by
a. decreasing arterial carbon dioxide
b. increasing bicarbonate ion excretion
c. hypoventilation
d. hyperventilation

hyperventilation

classify the following arterial blood gas: pH=7.52, PaCO2 = 30 mmHg, HCO3- = 24 mEq/l
a. resipratory acidosis
b. respiratory alkalosis
c. metabolic alkalosis
d. metabolic acidosis

respiratory alkalosis

aldosterone primarily affects which of the following?
a. salt and water metabolism
b. protein and water metabolism
c. protein and fat metabolism
d. carbohydrate metabolism

salt and water metabolism

which of the following patients would have the highest priority when triaged in the ED?
a. 6 month old female with fever, audible inspiratory stridor, and restlessness
b. 40 year old female with fever, severe body aches, and nasal congestion
c. 25 yr old male with nasal drainage and hoarseness

6 month old

an individual with heart failure and renal impairement has 3+ pitting edema in his feet, a bounding pulse, and severe shortness of breath. he is probably experiencing which of the of following
a. hypokalemia
b. fluid volume excess
c. hyperkalemia
d. fluid volume deficit

fluid volume excess

decreased neuromuscular excitability can be seen in which two electrolyte disorders?
a. hypocalcemia and hypokalemia
b. hyponatremia and hyperkalemia
c. hypocalcemia and hypokalemia
d. hypercalcemia and hypermagesemia

hypercalcemia and hypermagnesemia

the mechanism of death following cardiac tamponade is
a. impaired cardiac contraction due to inflammation surrounding a myocardial infarction
b. overdistension of the ventricles due to heart failure
c. spasm of coronary arteries
d. compression of the heart by the blood in the pericardial sac, which impairs filing in diastole

compression of the heart by the blood in the pericardial sac, which impairs filing in diastole

which of the following orders would you prioritize for the patient suspected to be expericing an acute myocardial infarction?
a. order a low cholestrol diet
b. chew one extra strength tylenol
c. nitroglycerin spray sublingual
d. demerol 50 mg intravenous push

nitroglycerin spray sublingual

a patient presents to the clinic for an initial visit with dyspnea, bright pink skin and barrel appearance to the chest. while tkain g the patients history, you note that the patient is a current smoker. these findings are consisten t with which of the following diseases?
a. emphysema
b. interstital lung disease
c. brochiectasis
d. chronic bronchitis

emphysema

the most likely place for a thrombosis to form postoperatively is
a. the left side of the heart
b the legs
c. anywhere in the body
d. the lungs

the legs

several employees at a factory develop legionnaires. disease. which of the following is important to include in the education you give to the employees regarding this disease?
a. that it is spread by drinking warm water
b. that it is highly contagious
c. that the disease it is usually spread through air ventilation systems
d. that the bacteria is often found on surfaces like door knobs and telephones

that the disease it is usually spread through air ventilation system

which one of the following statements is true as it relates to acid base balance?
a. the body uses respiratory mechanisms to prevent large changes in pH resulting from respiratory disease
b. pH provides an accurate measure of serum bicarbonate and carbonic acid levels
c. the acid base buffer systems of the body consist of a weak acid and strong base
d. renal mechanisms for correcting an acid base imbalance are less rapid than repiratory mechanism,but they continue to function until pH has been returned to a normal or near normal range

d. renal mechanisms for correcting an acid base imbalance are less rapid than repiratory mechanism, but they continue to function until pH has been returned to a normal or near normal range

which of the following diseases or conditions does not cause metabolic acidosis?
a. overproduction of lactic acid
b. inadequate pulmonary ventilation
c. renal insufficiency
d. overproduction of ketone bodies

b. inadequate pulmonary ventilation

the GRS wave of an electrocardiogram is produced by
a. depolarization of the ventricles
b. repolarization of the atria
c. depolarization of the ventricles
d. repolarization of the ventricles

c. depolarization of the ventricles

when an infusion of a hypertonic solution is ordered, you know that an appropriate intravenous solution to administer would be
a. 5% dextrose lactate ringers (D5LR)
b. normal saline (0.9% NS)
c. ringers lactate (RL)
d. 1/2 normal saline (0.45% NS)

a. 5% dextrose lactate ringers (D5LR)

angina pectoris is usually a manifestation of which of the following?
a. atherosclerosis of coronary arteries
b. hypertension
c. infective bacterial endocarditis
d. aortic aneurysm

a. atherosclerosis of coronary arteries

the order of impulse conduction in the heart is from the

SA node to AV node to bundle of His to Purkinje system

a patient admitted for the treatment of cystic fibrosis begins having systemic edema, increased fatigue, and a weight gain of 6 pounds in the last 24 hours. you should suspect which of the following complications?
a. pulmonary embolism
b. cor pulmonale
c. malaborption
d. metastasis

b. cor pulmonale

why does severe hypoxia develop with pneumonia?
a. acidosis depresses respirations
b. hyperventilation increases the rate of gas exchange
c. infection reduces effective compensation by the heart
d. inflammatory exudate absorbs oxygen from the alveolar air

d. inflammatory exudate absorbs oxygen from the alveolar air

you asses which patient for nosocomial pneumonia?
a. the patient recieving mechanial ventilation
b. the patient in traction for a fractured femur who also has a cold
c. the patient with acquired immunodeficiency syndrome
d. the patient with type 2 diabetes who has a 50 pack year smoking history

a. the patient recieving mechanial ventilation

the most common cause of bacterial pneumonia is
a. histoplasmosis
b. neisseria meningitis
c. escherichia coli
d. streptococcus pneumonae

d. streptococcus pneumonae

which of the following accurately describes the pathophysiology of chronic obstructive pulmonary disease?
a. inflammation leads to lung fibrosis and a loss of elasticity
b. obstruction of the trachea and larynx
c. excess fluid compresses the lung lining expansion
d. obstructed airflow in the bronchi during inspiration

. inflammation leads to lung fibrosis and a loss of elasticity

a 12 year old girl presents to the emergency room wheezing with prolonged expiration and chest tightness lasting for 45 minutes and unrelieved by her usual treatment. you recognze that these findings are consistent with
a. epiglottis
b. spasmodic croup
c. acute bronchitits
d. status asthematicus

d. status asthematicus

which type of valvular heart disease causes obstruction of the ejection of blood from the left atrium to the left ventricle?
a. mitral stenosis
b. aortic regurgitation
c. mitral regurgiation
d. aortic stenosis

a. mitral stenosis

a 80 y/o patient in the icu with an overwhelming systemic infection begins to exhibit splinter hemorrhages under her fingernails, hematuria, and petechai. what would be the likely culprit?
a. dilated cardiomyopathy
b. infective endocarditis
c. cardiac tamponade
d. pericarditits

b. infective endocarditis

lung compliance refers to the ease with which
a. the lungs can be inflated or the amount of pressure needed to change their volume
b. air can be moved through the airway
c. sputum can be expectorated from the lungs
d. air can be exhaled from the lungs

a. the lungs can be inflated or the amount of pressure needed to change their volume

which of the following signs would indicate a fluid deficit?
a. physical weakness, weight gain, bradycardia, and decreased urine output
b. acute weight loss and increase in blood pressure
c. dry fissured tongue, rapid respiration, weight gain and confusion or delirium
d. tachycardia, acute loss of body weight, weakness, and dry mucous membranes

d. tachycardia, acute loss of body weight, weakness, and dry mucous membranes

classify the following arterial blood gas pH= 7.30, PaCO2= 55 mmHg, HCO3- = 24 mEq/L
a. respiratory acidosis
b. metabolic acidosis
c. respiratory alkalosis
d. metabolic alkalosis

a. respiratory acidosis

while assessing a patient admitted to the hospital for congestive heart failure treatment, you note decreased breath sounds over the left lobe and asymmetrical chest expansion. you report this finding to the physcian who in turnns orders a chest xray. the chest xray revealed an increased collection of fluid in the pleural cavity. you recognize that these finding are consistent with
a. pleural effusion
b. pulmonary edema
c. medistinal shift
d. pneumonia'

a. pleual effusion

a severely obese patient presents to the clinic with edema of the right lower extremity that is impairing ambulaiton. upon inspection, you note that the edema does not indent with pressure, the skin on the right lower extremity is thick and rough and distal pulses are present and equal bilateral. you should expect which of the following?
a. peripheral vasucular disease
b. congested heart failure
c. deep vein thrombosis
d. lymphedema

d. lymphedema

the renin-angiotensin aldosterone pathway
a. is activated by renin
b. acts to decrease loss of sodium in urine
c. increases in activity in response to blood loss
d. can be blocked to help lower blood pressure
e. all of the abouve

e. all of the abouve

respiratory acidosis occurs most commonly in which disease or condition?
a. potassium depletion
b. emphysema
c. uncontrolled diabetes mellitus
d. renal insufficiency

b. emphysema

what differentiates asthma from chronic obstructive pulmonary disease is that
a. the FEV1/FVC ration is reduced in asthma
b. asthma is a reversible disease
c. smoking makes asthma worse
d. asthma is an obstructive disease

b. asthma is a reversible disease

early signs of hypovolemic shock include
a. decreased blood pressure and unconsciousness
b. decreased blood pressure and apathy
c. increased heart rate and increased pulse pressure
d. thirst and increased heart rate

d. thirst and increased heart rate

which type of cardiomyopathy is characterized by progressive cardiac hypertrophy, dilation, and impaired pumping with heart enlargement and thinning walls?
a. restrictive
b. dilated
c. peripartum
d. hypertrophic

b. dilated

a major risk factor for chronic obstructive pulmonary disease is
a. genetic predisposition
b. male sex
c. smoking
d. diet high in saturated fats

c. smoking

two factors that predispose people to the development of varicose veins are
a. obesity and standing for long periods of time
b. weight loss and increased use of the skeletal muscle pumps
c. immobility and aging
d. menopause and hypertension

a. obesity and standing for long periods of time

if you observed tall, peaked T waves on the electrocardiogram of a person with heart failure, which of the following is your best action to take?
a. preparing to give a potassium finger
b. nothing. this is a normal finding for individuals with heart failure
c. preparing ot give sodium bicarbonate to correct the acidosis
d. checking the serum potassium level

d. checking the serum potassium level

which endocrine gland produces epinephrine and norepinephrine and is responsible for our fight or flight response?

adrenal glands

during the neurological assessment of a patient you note that the patients arms wrists and fingers have become flexed and there is internal rotation and plantar flexion of the legs. how do you document these findings?

Decorticate posturing

diabetes insipidus is a result of hypopituitaryism and excess fluid loss due to a deficiency in

anti-dieuretic hormone

a patient has arrived by ambulance at the ED after a cervical spinal cord injury. which assessment is a priority for you to perform at this time?

respiratory pattern and airway

in taking the history of a person suspected of having bacterial meningitis, which question is most important for you to ask?

do you live in a crowded residence?

what are the characteristic changes in the brain of a patient with alzheimers disease?

a. Cortical atrophy with plaques and neurofibrillary tangles, impairing conduction

an individual on an intensified insulin regimen consistently has a fasting blood glucose level between 70 and 80 mg/dL and a hemoglobin A1c level of 5.5%. which is your interpretation of these findings?
a. Increased risk for developing ketoacidosis
b. Increased risk for developing hyperglycemia
c. Signs of insulin resistance
d. Good control of blood glucose

d. Good control of blood glucose

syndrome of inappropriate antidieuretic hormone ...

is a result of hyperpituitarism
causes fluid retension due to excess antidieuretic hormone
will have decrease, thick, concentrated urinary output

which of the following factors predispose an individual to a CVA?
1. Hypertension
2. Smoking cigarettes
3. History of coronary artery disease
4. Diabetes mellitus

1 2 3 4

which of the following is not a risk factor for type ii diabetes?

none of the above

signs and symptoms of diabetes melitus includes all except

swollen ankles

which alteration in assessment findings is indicative of hypothyroidism?

which of the following diseases is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dancelike movement and dementia?

Huntington's disease

a patient is admitted to an emergency department. you document that the patient is postical upon transfer as evidenced by which obersvation?

recently experienced a seizure and is in a drowsy or confused state

brain injury where the brain is injured when it bounces off the skull due to sudden acceleration or deceleration is referred to as a/an

d. contrecoup injury

you monitor for which laboratory disorder in the person recieving IV insulin for hyperglycemia?

d. Serum potassium level of 2.5 mmol/L

which of the followign is the most common cause of brain damage in children with cerebral palsy

c. Hypoxia

when taking the blood pressure of a patient after a parathyroidectomy to treat hyperparathyroidism, you note that the paitent's hand has gone into flexion contractions. which does the nurse determine may be the cause of this symptom?

hypocalcemia

which of the following statement is false about the parathyroid gland?

parathyroid hormone is secreted when calcium levels are increased

the hypothalamus

connects the endocrine system to teh nervous system to monitor hormones, nutrients, and ion levels

which statements about the pituitary gland are TRUE

considered the master gland
can be influenced by the hypothalamus
influences the thyroid by production of thyroid stimulating hormone

which of the following are common early manifestations of Parkinson's disease?

tremors at rest in the hands and repetitve motion of the hands

which of the following does not occur in Addison's disease?

exophthalmos

a patient has been diagnosed with Cushing Syndrome. Which of the following statements made by the patient is FALSE in their understanding of this condition?

i will need to take daily steroids to manage this disease process

you asses a person with a diagnosis of thyroid storm. which classic signs and symptoms associated with thyroid storm indicate the priority need for immediate intervention?

fever, tachycardia, and systolic hypertension

your patient has acromegaly. you would expect

your patient to have an overactive pituitary gland

what characteristic is common to all individuals with cerebral palsy?

some degree of motor disability

which deficit will you expect to find in a person who has experienced an injury to the frontal lobe of the brain?

impaired judgement

which dietary modification will you provide for the person with hyperthyroidism?

increased calories, proteins and carbohydrates

which teaching intervention is most appropriate for the patient with Parkinson's disease?

fall precautions

which of the following are common early signs of multiple sclerosis?

all of the following are typical signs of hydrocephalus in the neonate except

headache and paralysis

an incoherent female with a history of hypothyroidism is brought to the ED by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. knowing that these findings suggest severe hypothyroidism, you prepare to take emergency action to prevent the potential complication of

myxedema coma

an individual has a hormone deficiency. which deficiency is the highest priority?

thyroid stimulating hormone

when performing an assessment, you detect a fruity odor on the individuals breath. which will you do next?

assess their blood sugar levels

a patient makes an appointment with their doctor to discuss a recent enlargement of a painless nodule growing in their neck region. which statement made by the patient would indicate correct understanding of this condition?

this could indicate an issue with my thyroid and i will need further testing

what is the primary cause of type 1 diabetes?

destruction of pancreatic cells by an autoimmune reaction

a patient who experienced a spinal cord injury 1 hour ago is brough to the emergency room. which medication will you prepare to administer to this patient?

Methylprednisolone (Medrol)

a patient is admitted to the ED for head trauma is diagnosed with an epidural hematoma. the underlying cause of epidural hematoma is usually related to which of the following conditions?

laceration of the middle meningeal artery

typical signs of a TIA include:

transient muscle weakness in a hand or leg

the greatest risk factor for hemorrhagic stroke include

acute hypertension

which statement does NOT apply to the pathophysiology of multiple sclerosis

progressive random degeneration of peripheral nerves

you correlate which process with the brain damage that results from increased intracranial pressure secondary to cerebral edema?

cerebral tissue hypoxia and ischemia from compression of blood vessels

Which of the following is NOT a symptom of Cushing syndrome?

anorexia

which of the following statements does NOT apply to myasthenia gravis?

d. Dementia develops in the later stage.

which of the following are typical early signs of Alzheimer's disease?
1. Behavioral changes
2. Reduced ability to reason and problem solve
3. Decreased verbal responses
4. Urinary incontinence

1, 2

which of the following is a typical early sign of amyotrophic lateral sclerosis (ALS)

weakness and muscle atrophy in upper limbs

what are significant signs of acute bacterial meningitis?

Severe headache, nuchal rigidity, and photophobia

dwarfism results from a progressive disorder caused by

hypopituitarism

which of the following is FALSE regarding Addison's Disease?

patients will exhibit bulding eyes and clubbing of fingernails