NURS 6550 FINAL EXAM 1 – QUESTION AND ANSWERS
QUESTION 1
1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter was inserted intraoperatively and remains in place. His urine output has declined markedly despite continued IV fluid infusion. Today his morning labs r...
nurs 6550 final exam 1 – question and answers question 1 1 mr jeffers was admitted 2 days ago for a carotid endarterectomy a foley catheter was inserted intraoperatively and remains in place his u
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NURS 6550 FINAL EXAM 1 – QUESTION AND ANSWERS
QUESTION 1
1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter was
inserted intraoperatively and remains in place. His urine output has declined markedly despite
continued IV fluid infusion. Today his morning labs reveal a BUN of 19 mg/dL and a creatinine
of 2 mg/dL. A leading differential includes:
A. Foley lodged in the urethra causing post-renal failure
B. Decreased renal perfusion causing prerenal failure
C. Age-related decreased eGFR causing prerenal failure
D. Post-surgical rhabdomyolysis causing intrarenal failure
Answer:
• D. Post-surgical rhabdomyolysis causing intrarenal failure
During surgery, muscles and injured. This can result into rhabdomyolysis, which is the breakdown
of muscles to release proteins. The excess proteins causes an increased level of creatinine.
Mr. Jeffers is from surgery (post-surgical) and his creatinine levels are above normal. The
normal creatinine levels range from 0.6mg/dl to 1.2mg/dl. Thus, the most likely differential is:
Post-surgical rhabdomyolysis causing intrarenal failure.
1 points
QUESTION 2
1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is
weak, diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb black female who is
awake, alert, and oriented, anxious, with moist skin and racing pulse. Her blood pressure is
140/100 mm Hg. Temperature and respiratory rate are within normal limits. The patient admits
to having a “thyroid condition” but she never followed up on it when she was advised to see an
endocrinologist. The AGACNP anticipates a diagnosis of:
A. Hashimoto’s thyroiditis
B. Cushing’s syndrome
C. Grave’s disease
D. Addison’s
disease 1 points
Answer:
,C. Grave's disease
QUESTION 3
1. Systemic lupus erythematosis (SLE) is a multiorgansystem autoimmune disorder that can
prevent with a wide variety of manifestations. Which clinical triad should prompt an evaluation
for SLE?
A. Fever, normal white count, elevated sedimentation rate
B. Hyperkalemia, hyponatremia, low blood pressure
C. Leukocytosis, hyperglycemia, hypokalemia
D. Joint pain, rash,
fever 1 points
QUESTION 4
1. A patient presents with profound vertigo of acute onset yesterday. She can barely turn
her head without becoming very vertiginous; she is nauseous and just doesn’t want to move.
This morning when she tried to get out of bed she felt like she was pushed back down. The
vertigo is reproducible with cervical rotation. The patient denies any hearing loss or tinnitus,
she has no fever or other symptoms. The AGACNP knows that the most helpful intervention
will probably be:
A. Meclizine
B. Diazepam
C. Bed rest
D. Epley’s
maneuvers1 points
Answer:
• D. Epley's maneuvers
The patient is likely suffering from benign paroxysmoly positioning vertigo. This is
indicated byinability to turn her head and to get up from the lying position in bed.
The best intervention for benign paroxysmal positioning vertigo is Epley's
maneuvers. These maneuvers effectively clearthe inner ear to relieve symptoms of
vertigo
,QUESTION 5
1. Mrs. Mireya is an 85-year-old female who is admitted for evaluation of acute mental
status change from the long term care facility. She is normally ambulatory and participates in
lots of facility activities. Today a nursing assistant found her in her room, appearing confused
and disconnected from her environment. When she tried to get up she fell down. Her vital
signs are stable excepting a blood pressure of 90/60 mm Hg. The AGACNP knows that the
most likely cause of her symptoms is:
, A. Osteoarthritis
B. Drug or alcohol toxicity
C. Hypotension
D. Urosepsi
s1 points
QUESTION 6
1. A patient with SIADH would be expected to demonstrate which pattern of
laboratory abnormalities?
A. Serum Na+ 119 mEq/L, serum osmolality 240 mEq/L, urine Na+ of 28 mEq/L, urine
osmolality of 900 mOsm/kg
B. Serum Na+ 152 mEq/L, serum osmolality 315 mEq/L, urine Na+ of 5 mEq/L, urine
osmolality of300 mOsm/kg
C. Serum Na+ 121 mEq/L, serum osmolality 290 mEq/L, urine Na+ of 7 mEq/L, urine
osmolality of850 mOsm/kg
D. Serum Na+ 158 mEq/L, serum osmolality 251 mEq/L, urine Na+ of 20 mEq/L, urine
osmolality of 420 mOsm/kg
Answer:
Syndrome of inappropriate anti diuretic hormone is characterized by
dilutionalhyponatremia.Serum sodium levels lower than 130mmol/L and urine
osmolality less than 100mmol/L.Urine sodium is less than 30mmol/L.Serum level
of sodium is likely to be 121
1 points
QUESTION 7
1. Sean is a 29-year-old male who presents to the emergency department for
evaluation and treatment of foreign body in the eye. Ophthalmic anesthesia is achieved and
removal is attempted unsuccessfully with a moist cotton tipped swab. A wet fluorescein
stain is applied to the lower eyelid, and a corneal abrasion ruled out but the AGACNP notes a
positive Seidel sign. This indicates:
A. Penetration of the cornea with resultant aqueous leak
B. A rust ring remnant due to metal foreign body
C. An elevated intraocular pressure
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