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Final Exam Part 2: Nursing 112 GBCC

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GBCC
Tess Nicholson
Quiz by Tess Nicholson, updated more than 1 year ago
Tess Nicholson
Created by Tess Nicholson almost 9 years ago
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Resource summary

Question 1

Question
GH deficiency in Adults can cause symptoms such as:
Answer
  • reduced bone density, insulin resistance, Increase in LDL/Cholesterol/triglycerides
  • polyuria dilute urine, tachycardia, fatigue
  • Increased temp, HR, BP; loose stools, increased apetite and consumption of food but loosing weight

Question 2

Question
Acromeagaly is a condition associated with what hormone? Too much of the hormone or too little?
Answer
  • ADH; too much
  • LH: too little
  • GH: too much
  • GH: too little

Question 3

Question
Select all approrpiate answers associated with ADH deficiency:
Answer
  • Medical Terminology: SIADH
  • Medical terminology: Diabetes Insipidus
  • Can be caused by head trauma/pituitary tumor
  • Is treated with iodine therapy
  • Symptoms include polyuria and polydipsia

Question 4

Question
If you were to compare the urine of a pt with diabetes insipidus and the urine of a pt with uncontrolled diabetes mellitus, the differences would be?
Answer
  • DI pt. would have more protein in urine
  • DI pt. would have extremely dilute urine and the DM pt. would have sugar in the urine
  • The DM pt. would have very concentrated urine and the DI pt. would have cloudy urine
  • The DI pt. would have concentrated urine while the DM pt. would have dilute urine

Question 5

Question
What would be the most likely specific gravity result of a pt. with Diabetes Insipidus?
Answer
  • 1.070
  • 1.080
  • 1.002
  • 1.010

Question 6

Question
Which lung sounds would be associated with Syndrome of Inappropriate ADH?
Answer
  • rhonci
  • wheezes
  • crackles
  • diminished in the bases

Question 7

Question
Select the test results that would be helpful in diagnosing SIADH
Answer
  • low specific gravity
  • high specific gravity
  • dilute serum osmolality
  • Increased BUN
  • increased urine Sodium
  • hypokalemia
  • hypernatremia

Question 8

Question
Central pontine Myelinolysis is very serious iatrogenic reaction to what....
Answer
  • Potassium replacement that is too quick
  • ADH replacement
  • Sodium replacement that is too quick
  • DDAVP administration in too high a dose

Question 9

Question
You are preparing a room for a pt. coming from the PACU after a thyroidectomy. What items, unique to this pt., should you make sure are in his room.
Answer
  • Narcan
  • Calcium Chloride
  • Glucagon
  • Tracheotomy kit
  • EEG equipment

Question 10

Question
Signs and Symptoms of HyPERthyroid include:
Answer
  • Increased temp, BP, & HR
  • palpitations
  • bradycardia
  • nervousness
  • heat and exercise intolerance
  • Not eating a lot but still gaining weight

Question 11

Question
A 50yr old is admitted with thyrotoxicosis. His wife is asking you, the nurse, how you are going to help him. You reply
Answer
  • "I am going to give him DDVAP through his nose to help him retain water."
  • " I am going to make sure he is breathing well, and cool him down while we wait for the doctor to decide on medication."
  • " I am going to watch him, he will be fine with time."
  • " I am going to take his blood and then talk to the doctor about getting an antibiotic prescribed."

Question 12

Question
A pt you have is on the following list of medication: furosemide (lasix) ultram (tramadol) Methimazole (tapazole) benztropine mesylate (cogentin) Which medication is being used to treat Grave's Disease?
Answer
  • benztropine mesylate (cogentin)
  • Methimazole (tapazole)
  • furosemide (lasix)
  • ultram (tramadol)

Question 13

Question
Radioactive Iodine Therapy (RAI) would be a poor treatment choice for a mother of 3 small children beacause....
Answer
  • it takes 4-6 weeks for effect
  • small children should be avoided for 2-4 days post therapy
  • oral contraceptives and RAI are contraindicated
  • She may become depressed and not have enough energy to take care of her kids

Question 14

Question
You are on a mission trip to Zambia and do not have the resources to test blood. How would you assess a pt. for acute hypocalcemia
Answer
  • Ask the pt. about how much calcium they get in there diet
  • Check capillary refill in there toes
  • tap zygomatic arch between the corner of the mouth and ear and watch for chvostek's sign
  • Ask pt. to flex half and watch for trousseau's sign

Question 15

Question
Which of the following is NOT a symptom of HypOthyroidism
Answer
  • extreme fatigue
  • decreased body temp
  • weight gain
  • exopthalmos

Question 16

Question
In a pt. with hashimoto's you would expect to see a ________ in TH and a(n) _______ in TSH
Answer
  • increase, decrease
  • decrease, increase
  • decrease, decrease

Question 17

Question
hypoparathyroidism manifests: (4 correct)
Answer
  • blood calcium falls
  • blood calcium rises
  • phosphorus rises
  • tetany
  • prominent tongue
  • tingling, hyperexcitability

Question 18

Question
All of the following are autoimmune disease associated with the endocrine system EXCEPT:
Answer
  • Addison's Disease
  • Grave's Disease
  • Hashimoto's Disease
  • Cretinism

Question 19

Question
Primary adrenal insufficiency is also known as Addison's Disease and its odd symptom is hyperpigmentation
Answer
  • True
  • False

Question 20

Question
A student nurse is trying to find something to do a teaching plan on besides a incentive spriometer. A nurse overhears her bitching and lets her know there is a pt. with a new diagnosis of Addison's Disease on the floor. What are all the things a student nurse could teach this pt?
Answer
  • High salt diet, no fasting
  • Hydrocortisone (cortef) Side effects
  • Dexamathasone kit
  • levothyroxine (synthroid) therapy
  • call the doctor to get a medication increase in times of stress
  • How to properly administer Nasal spray DDAVP

Question 21

Question
A young girl with Cushing's Disease could be a risk for body image issues because cushing's is known for the visible symptoms of: (pick 4)
Answer
  • abnormal distribution of fat, trunkal fat and thin limbs
  • excessive hair growth
  • prominent tongue
  • edema
  • hyperpigmentation
  • purplish striae

Question 22

Question
After a transphenoidal hypophysectomy for the treatment of pituitary tumor causing Cushing's Disease... nasal drainage should be monitored for the presence of what substance?
Answer
  • Protein
  • glucose
  • potassium
  • blood

Question 23

Question
A nurse is taking care of a pt who has been on countless medications for hypertension. Nothing has worked. The pt. verablized to the nurse that when she came in for surgery and received morphine sulfate for pain control she felt much worse also she became very sick last year after drinking red wine at her sons wedding. What rare condition should the pt. be assessed for...
Answer
  • Pheochromocytoma
  • Cushing's Disease
  • Cushing's Syndrome
  • Addison's Disease
  • ACTH-secreting pituitary adenoma

Question 24

Question
The ductus arteriosus is...
Answer
  • where the blood bypasses the liver in fetal circulation
  • fistula between the aorta and pulmonary artery in fetal circulation
  • a connection through the right and left atria that allows for blood to bypass the nonfunctional lungs in fetal circulation
  • Something i would like to feed to Mary's cat

Question 25

Question
All of the following are characteristics of a normal newborn that make the newborn more at risk for injury/illness than adults.... EXCEPT
Answer
  • low ability to excrete drugs and process fluid
  • Presence of surfactant maintaining respiratory stability
  • bacteria are not normally found in the digestive tract, bacteria that produce Vit K not found (blood coagulation)
  • large body surface to body mass, thin layer subq fat

Question 26

Question
You are performing the 5 min after birth APGAR for baby Ellen. She is crying and squawking her brains out while breathing well, has a heart rate of 96, has pink trunk but cyanosis evident fingers and toes, good reflexes, and spontaneously moves all limbs. Baby Ellen's APGAR Score would be?
Answer
  • annoying, i fucking hate APGAR
  • 8: infant do well in normal newborn nursery
  • 10: prognosis is grave
  • 7: infant do well in normal newborn nursery

Question 27

Question
If a newborn weighs 8.8lbs at birth, the newborn's stomach capacity would be approximately (step 1 find weight in kg Step 2 find capacity in mls Step 3 convert mls to ounces)
Answer
  • .8 oz
  • 1.6 oz
  • 1 oz
  • .5 oz

Question 28

Question
In which state should the nurse encourage the parents to hold the infant to increase bonding
Answer
  • Light sleep State: eyes closed, may fuss briefly, easy to startle and wake
  • Drowsy Alert State: eyes are closed, wake with more stimulus or go back to sleep
  • Quiet Alert State: minimal body movements but gazes at things/environment
  • Crying State: continous and lust cries, active body movements, resp irregular and rapid

Question 29

Question
An umbilical cord should have 2 veins and 1 artery if it doesnt it may be associated with chromosomal anomalies and renal defects
Answer
  • True
  • False

Question 30

Question
Which of the following are used when trying to assess gestational age and completing a Ballard Score (pick 4)
Answer
  • Popliteal angle
  • Temperature
  • genitals: rugae, labia
  • Presence of lanugo
  • scarf sign
  • Blood pressure

Question 31

Question
A nurse is reading report and finds the following conflicting results on a Ballard Score: square window (wrist bend) is 45 degrees, Popliteal angle (thigh on abdomen) fully extends; scarf sign fails to reach midline, plentiful lanugo, plantar creases over entire foot, ears do not keep stiff nature, clitoris and minora are greater than the majora. Which results are consistent with a preterm infant
Answer
  • square window (wrist bend) is 45 degrees
  • Popliteal angle (thigh on abdomen) fully extends
  • scarf sign fails to reach midline
  • plentiful lanugo
  • plantar creases over entire foot
  • clitoris and minora are greater than the majora
  • Ears do not keep stiff nature

Question 32

Question
37.7 degrees Celsius is what temperature in Fahrenheit ?
Answer
  • 99.9 Degrees
  • 52.9 degrees
  • 101.6 degrees
  • 99.0 degrees

Question 33

Question
A nurse can initiate warming interventions such as a radiant warmer or skin to skin for a newborn with a below than normal temperature. Based on temperature all taken 4 hours after birth which baby should the nurse consider implementing these interventions on?
Answer
  • Baby A: 35.6 C
  • Baby B: 36.6 C
  • Baby C: 38.9 C

Question 34

Question
An LNA takes a newborns vital signs who was born 4 hours ago. BP: 70/40 HR: 150 BPM Respirations: 50 breaths/min Temperature: 99.3 Which results are normal?
Answer
  • HR, Respirations and temperature are normal
  • Respirations, temperature and BP are normal
  • Only BP is normal
  • All finding are within normal ranges

Question 35

Question
A mother is asking you how much weight her baby is expected to lose within the first few days of life. Her baby weighed 8 lbs at birth and was a normal height of 20 inches. You tell her...
Answer
  • Your baby shouldnt lose any weight and should gain 1/2oz per day
  • Your baby was a AGA and should lose about a pound
  • Your baby may loose as much .8 lbs in the first few days and still be healthy
  • Your baby may loose as much as 1.6 lbs in the first few days and still be healthy

Question 36

Question
Bowel sounds should be auscultated 1 hour after birth.
Answer
  • True
  • False

Question 37

Question
Vitamin K (aquamephyton) injections and erythromycin opthalmic ointment should be administered within ________ after birth/
Answer
  • 5 hours
  • 24 hours
  • 1 hour
  • 30 minutes

Question 38

Question
A is ? B is ?
Image:
d1990792-655c-4874-9835-fa82a921b00c (image/jpg)
Answer
  • A is Caput succedaneum (localized edema ) B is Cephalhematoma (collection of blood)
  • A is Cephalhematoma (collection of blood) B is Caput Seccedaneum (localized edema)

Question 39

Question
The placement of the urethra is......
Image:
1939a9bc-8f29-402d-9af9-fb0a73274d7c (image/jpg)
Answer
  • normal
  • epispadias
  • hypospadias

Question 40

Question
Which of the following are used to check for hip dysplasia?
Answer
  • ortolani maneuver
  • Barlow Maneuver
  • chovetsky's sign
  • Leopold's Maneuver

Question 41

Question
A baby on the first day of birth has a blood sugar of 38. What should the nurse do?
Answer
  • Feed and recheck in 30 min
  • Give sugarwater in a bottle and recheck in 60 min
  • feed and recheck in 2 hours
  • Let baby rest and recheck in an hour

Question 42

Question
Appropriate treatment for a neonate with early breastfeeding jaundice would be
Answer
  • switch to formula
  • increase feedings so baby can eliminate meconium
  • do genetic testing
  • Use donor milk instead of mother's milk

Question 43

Question
Your pt. assigned for the day has Bipolar 1. You know that the difference between bipolar 1 and bipolar 2 is that...
Answer
  • Bipolar 1 alternates between major depressive episodes and mania while bipolar 2 clients have never had full blown mania
  • Bipolar 2 pts have only had symptoms for 1-2 months
  • Bipolar 1 clients meet all the criteria for depression and mania at the same time
  • Bipolar 1 pts have never experience mania

Question 44

Question
Symptoms of Mania include which of the following (pick 4)
Answer
  • hyperphasia
  • agitation, activity increased
  • guilt
  • impulsive acts
  • flight of ideas
  • distractable
  • visual hallucinations

Question 45

Question
A highly agitated pt. paces the unit and states, "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior?
Answer
  • Pt won't sit still and is experiencing magical thinking.
  • Mood labile. Exhibiting delusions of reference. Hyperactive
  • Mood euthymic. Exhibiting magical thinking. Restless
  • Pt appears agitated and is pacing the unit. Mood labile, exhibiting grandiosity.

Question 46

Question
A manic pt with a lithium level of .4 is... What other labs would you want to look at for this pt because they are taking lithium? ( 4 answers)
Answer
  • Within therapeutic range
  • subtherapeutic range
  • at risk for toxicity
  • Potassium
  • BUN
  • Creatinine
  • Thyroid
  • Rbc

Question 47

Question
Select all the Side effects associate with lithium therapy (not toxicity) (pick 4)
Answer
  • polydypsia/polyuria
  • weight gain
  • fine hand tremors
  • giddiness
  • dystonia
  • GI upset

Question 48

Question
A pt comes into the ED with confusion, psychomotor retardation, excessive urine output and tremors (ataxia). The client is on Lithium therapy what would you expect the Lithium level to be?
Answer
  • Between .6-1.2
  • Between 1.5-2.0
  • Between 2.0-3.5
  • >3.5

Question 49

Question
Anticonvulsants used to treat bipolar disorder that need to have blood levels drawn include
Answer
  • divalproex sodium (depakote)
  • lamotrigine (lamictal)
  • Carbamazepine (tegretol)
  • gabapentin (neurontin)

Question 50

Question
Depakote is to alopecia as Lamictal is to __________
Answer
  • liver toxicity
  • sedation
  • Steven's Johnson Syndrome
  • Cogwheeling

Question 51

Question
Which Medication is not an antipsychotic?
Answer
  • Perphenazine (trilafon)
  • Haloperidol (haldol)
  • gabapentin (neurontin)
  • olanzapine (zyprexa)
  • lurasidone (latuda)

Question 52

Question
A pt. is on benzotropin mesylate (cogentin), Fluoxetine (prozac), thioridazine (mellaril) and aripiprazole (abilify). The pt asks you which medication is helping make his voices quieter... the best answer would be?
Answer
  • Cogentin helps the most
  • Prozac makes you not as depressed so you dont hear voices
  • Mellaril is a atypical antipsychotic that helps make all your voices go away
  • Abilify is a medication that treats both the positive symptoms like hearing voices and the negative symptoms of schizophrenia.

Question 53

Question
Dystonia and pseudo-parkinsonism are both side effects of antipsychotics that can be treated with anticholinergic medication
Answer
  • True
  • False

Question 54

Question
A shizophrenic pt. on holoperidol comes into the office and is moving his mouth repetitvely like he is chewing on his tongue. When asked about it he says he can't stop. You would document this Side effect as?
Answer
  • akathisia
  • neuroleptic malignant syndrome
  • dystonia
  • Tardive dyskinesia

Question 55

Question
Physostigimine (antilirium) is to anticholenergics as ________________ is to benzodiazepines
Answer
  • N-acetylcysteine (Mucomyst)
  • naloxone (Narcan)
  • flumazenil (Romazicon)
  • Protamine Sulfate

Question 56

Question
Which antipsychotic is associated with agranulocytosis : high fever, sore throat, lethargy, necrosis
Answer
  • Risperidone (risperdal)
  • ziprasidone (geodon)
  • clozapine (clozaril)
  • olanzapine (zyprexa)

Question 57

Question
olanzapine (zyprexa) would not be a good choice for a pt. with what condition?
Answer
  • high cholesterol
  • Diabetes inspipidus
  • bipolar disorder
  • pt who is a night owl

Question 58

Question
You know the pt. understood you explanation on insulin resistance when she said which of the following
Answer
  • "If i just stop eating all carbs i will be cured"
  • "insulin resistance is when i don't make enough insulin"
  • "insulin resistance is when i make too much insulin but my body doesn't use it right"

Question 59

Question
Select which types of diabetes are always treated with insulin therapyT
Answer
  • Type 1
  • LADA
  • Type 2

Question 60

Question
The hallmark symptoms of both type 1 and type 2 diabetes include:
Answer
  • Low serum sodium
  • Polydypsia
  • frequent urination
  • fever
  • polyphagia which means the desire to keep moving all the time
  • Polyphagia which means increased apetite

Question 61

Question
To get the best clinical picture of the average blood sugars over the past 90 days for pt. a healthcare professional would look at ?
Answer
  • Glucose tolerance Testing
  • Fasting blood sugar
  • hbA1C
  • Urine microalbumin

Question 62

Question
A pt.had a fasting blood sugar of 160 and a Glucose Tolerance Test result of 204 at 2 hours. What is the appropriate action ....
Answer
  • Tell the pt. he has diabetes and let him express his feelings r/t diagnosis
  • Run each test for a second time and if the results are congruent with the first set of results make a diagnosis of prediabetes
  • Get a hbA1c
  • Run each test for a second time and if the results are congruent with the first set of results make a diagnosis of diabetes

Question 63

Question
Goal of an adult for fasting blood sugar is _______ goal for a1c is < _______
Answer
  • 80-120, <5
  • 70-99, <12
  • 70-99, <6.5
  • 50-80, <6

Question 64

Question
An example of a good 12-15g carb snack for a diabetic would be 1 cup of 1%milk or a small banana
Answer
  • True
  • False

Question 65

Question
Check all that are associated with hypoglycemia: (pick 4)
Answer
  • low and wet
  • cause: glucagon
  • Blood sugar <65
  • Symptoms: rapid pulse + RR
  • Tx: insulin
  • Tx: rule of 15 (15g carb recheck in 15 min)

Question 66

Question
Select all that are associated with hyperglycemia (pick 6)
Answer
  • High and dry
  • Cause: glucagon, skipped insulin, infection
  • Blood sugar >250
  • Tx: rule of 15
  • faintness, cold clammy sweats,
  • excessive urination, thirst, hunger
  • kussmaul, ketones in urine
  • Tx: insulin, increase activity

Question 67

Question
A type 1 Diabetic is presenting in the ER with symptoms that started 6 hours ago. Pt is tachycardia, hypotensive and is experiencing palpitations. Last blood sugar was 380 and urine dip was positive for ketones. What is this condition? What does this pt need for tx? (pick 3)
Answer
  • Diabetic Ketoacidosis
  • Hyperglycemic- Hyperosmokar nonketotic syndrome
  • hypoglycemia
  • hydration, insulin
  • blood sugars every hour
  • blood sugars every 15 min till stable

Question 68

Question
Type 2 Diabetic presents in the ER with a blood sugar of 840. Blood tests show high serum osmolality, normal electrolytes, increase PH and increased Bicarb. Urine dip shows no ketones. What is happening with this pt? what does this pt need? (pick 4)
Answer
  • DKA
  • HHNS
  • IV insulin slowly decrease serum glucose
  • vitals and blood sugars every 15-60 min
  • fluid therapy with 1/2 NS
  • electrolyte replacement

Question 69

Question
Biguanide drug, choice for type 2 diabetes, stops liver from releasing extra glucose and makes muscle cells more sensitive to insulin
Answer
  • Duloxetine (cymbalta)
  • Metformin (Glucophage)
  • Insulin Detemir (levemir)
  • NPH ( Isophate Insulin Suspension)

Question 70

Question
Long acting insulins such as lantus and levemir can be mixed with shorter acting insulins to be injected at one time...
Answer
  • True
  • False

Question 71

Question
Insulin Lispro (humalog) should be given when?
Answer
  • in the morning before breakfast and again 24 hours later so it can provide steady long term coverage
  • When the pt. calls down for the tray since it is intermediate and takes 2-4 hours to start working
  • When dietary gets on the floor because it is very rapid acting and only takes <15 min to start working

Question 72

Question
In a hypoglycemic Emergency what can be administered to an unconscious pt.?
Answer
  • Insulin Detemir
  • Glucagon
  • Metformin (glucophage)
  • Pregabalin (Lyrica)
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