CEN Exam chapter 004 Test Bank practice ACTUAL Questions
& Answers 2023/2024 VERIFIED
"Adrenergic" is associated with the ______ system correct answers Sympathetic
"Cholinergic" is associated with the ______ system correct answers Parasympathetic
Activation of the RAAS system leads to...? correct answers Increased water and sodium reabsorption
(decreased UO)
Beta-one receptors stimulate the...? correct answers Heart
Beta-two receptors stimulate the...? correct answers Lungs
What is hematologic factors are high in renal failure? correct answers The 3 Ps!
Potassium
Phosphorous
Positive Ions (Acidosis)
(Sodium and calcium are low)
Potassium is closely related with what electrolyte? correct answers Mg
Magnesium is closely related with what electrolyte? correct answers K+
Calcium is inversely related to? correct answers Phosphate and potassium
Phosphate is inversely related to?
closely related to? correct answers Inverse: Calcium
Direct: Potassium
What medication do we never give in thyroid storm? correct answers ASA
What are the s/s of hyponatremia? correct answers swelling, confusion, apathy, sense of doom, *muscle
cramps*
What are we worried about when correcting hyponatremia? correct answers Correcting sodium too
rapidly can cause central pontine myelinolysis (flaccid paralysis, dysarthria, dysphagia, hypotension)
What are the s/s of hypernatremia? correct answers AMS (fatigue, lethargy, confusion, coma), weakness,
diarrhea
(think of how you feel after eating McDonalds^^^)
What are the early s/s of hyperkalemia? correct answers muscular excitability, irritability, N/V/D
,What are the late s/s hyperkalemia? correct answers *fatigue*, weakness, distal limb paresthesia, tetany,
respiratory depression, ascending paralysis
What are the cardiovascular s/s of hyperkalemia? correct answers 1. Peaked T wave
2. Elongated PR interval
3. Absent P wave
4. Enlarging QRS complex
5. Sin wave (very bad sign)
How do we treat hyperkalemia? correct answers 1. Stabilize cardiac membrane with CaCl or Ca
Gluconate
2. Shift potassium into the cells with high dose albuterol (15-25mg) and Insulin 10units IV push with
100mL of 50% dextrose IV push
3. Remove potassium from the cells (HD, NS and furosemide, Ion exchange resin like kayexalate)
What are the s/s of hypokalemia? correct answers Frequently asymptomatic. Weakness, hyporeflexia,
latent tetany, paralysis to the lower extremities, respiratory failure, paresthesia. Prominent U wave on
the ECG causing a "camel-hump" appearance to the T-wave, ST depression
**treat hypokalemia with magnesium too since they often coincide
What are the s/s of hypermagnesemia? correct answers Neuromuscular depression, decreased DTR,
constipation, N/V, fatigue, tall T waves, depressed ST segmants
How do we treat hypermagnesemia? correct answers 1. Reduce serum mag (fluids and loop diuretics)
2. Reduce ingestion of magnesium (dark leafy greens, nuts, seeds, fish, beans, whole grains, avocados,
yogurt, bananas, dried fruit, dark chocolate
3. Dialysis (give calcium while awaiting dialysis)
What are the s/s of hypomagnesemia? correct answers Mild to moderate is usually asymptomatic
Severely low causes *neuromuscular excitability*: tetanic contractions, perioral or finger paresthesia,
positive Chvostek's sign, positive trousseaus's sign, seizures. Prolonged PR interval, widened QRS
complex
What are the s/s of hypocalcemia? correct answers *The same as hyperphosphatemia*
Neuromuscular excitability (positive Chvosteks and trousseaus), shortened ST segment, and widened T
wave
How do we treat hypocalcemia? correct answers 1-2 amps of 10% calcium gluconate mixed with D5W
over 10-20 minutes
(Remember potassium rises with low calcium!)
How do we treat hyperphosphatemia? correct answers Limit phosphate intake, give oral phosphate
binding agents such as aluminum hydroxide (antacids), increased excretion (IV fluids, diuretics)
,What are the s/s of hypercalcemia? correct answers *Same as hypohosphatemia*
Neuromuscular depression (Decraed DTRs, constipation, N/V), prolonged ST, and QT intervals
How do we treat hypercalcemia? correct answers Treat underlying cause, NS infusion, *glucocorticoids,
calcitonin*
how do we treat hypophosphatemia? correct answers High phosphate diet, oral potassium phosphate,
IV sodium phosphate (Watch for hypocalcemia!)
What is azotemia? correct answers Elevated BUN and creatinine, seen in renal failure
What are the low and high functions of the thyroid known as? correct answers Low: hypothyroidism
Severely low: myxedema coma
High: hyperthyroidism
Severely high: thyroid storm
What are the low and high functions of the pancreas known as? correct answers Low: DKA
Severely low: HHS
High: hypoglycemia
What are the low and high functions of the adrenal gland known as? correct answers Low: Addison's
disease
Severely low: Addison's crisis
High: Cushing's
How do we treat thyroid storm? correct answers •Reverse hyperthermia (acetaminophen, NOT ASA)
•Beta-blockers to decrease HR
Treating the thyroid:
1. Inhibit thyroid hormone synthesis with PTU (propylthiouracil) or Methimazole (Tapazole)
2. Slow thyroid hormone release with Iodine (Lugol's solution) one hour later
What is the treatment for hypoglycemia? correct answers •Conscious with a gag reflex: administer 15g
of rapid-acting carbohydrate and repeat if the patient does not improve within ten minutes
•Unconscious patient: IV dextrose 25-50ml (50% for adults, 25% for children, 10-12.5% for neonates). IV
of D5W
•Patient without IV: IM glucagon (**May stimulate vomiting!)
What electrolyte imbalances are seen in DKA and HHS? correct answers Low NA, Cl, and Bicarb
High potassium
, What fluid issues do DKA and HHS patients have? correct answers They are tissue dehydrated and
vascular overhydrated
When do we start replacing potassium in DKA/HHS patients? correct answers When it drops below 5mEq
What are the s/s of addison's crisis? correct answers Low BG, low NA, high K
dehydration, weakness, fatigue, hypotension
What are the s/s of cushing's? correct answers High BG, high NA, low K
Immunocompromised, poor wound healing
How do we treat cushing's? correct answers Decrease steroid use
How do we treat Addison's? correct answers Hypovolemia-> oxygen, vasopressors, fluid
Hyperkalemia->calcium, albuterol, kayexalate, insulin/dextrose (D/t hypoglycemia in these patient's,
insulin may not be apporpirate)
Hyponatremia/Hypochloremia->IV NS
Hypoglycemia->Dextrose 50%
Low aldosterone and cortisol-> IV hydrocortisone (solu-cortef) and IV Dexamethasone (decadron)
What are the names for decreased and elevated...
RBC
WBC
Platelets
? correct answers Decreased - Increased
RBC: anemia - polycythemia
WBC: leukopenia - leukocytosis
Platelet: thrombocytopenia - thrombocytosis
What are the s/s of sickle cell? correct answers Acute, severe pain described as throbbing, achy, sharp, or
dull.
Destruction of sickled cells (anemia, weakness, pallor, jaundice)
Priapism
What are the treatments for sickle cell? correct answers NSAIDs, APAP, Ultram, Hydroxyurea (stimulates
production of healthy new cells), rehydration, consider blood transfusions
What is the treatment for thrombocytosis? correct answers Low dose ASA
Treat underlying cause
What is the treatment for thrombocytopenia? correct answers Prednisone for immune causes
D/C drug-induced causes (chemo)
If >30,000, discharge with avoiding high-risk activities
If <30,000 admission with platelet transfusion
What drugs can we administer to stimulate neutrophil production in immunocompromised patients?
correct answers -Granulocyte colony-stimulating factor (neupogen)
