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NURS 6202 Exam 2 Focused with practice Questions With Complete Solutions
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NURS 6202 Exam 2 Focused with practice Questions With Complete Solutions
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NURS 6202 Exam 2 Focused with practiceQuestions With Complete Solutions
•A patient is in the ICU and the nurse notes the following on
assessment:
•
•RR 12
•Weakness in the left arm
•Dilated pupils
•BP 192/101
•Vomiting
•HR 54
•
•What does this assessment indicate? Correct Answers
Increased ICP
Dilated pupil = pressure on 3rd cranial nerve
Also signs of Cushing's triad
A nursing intervention you can do to decrease ICP is:
A.Give an osmotic diuretic
B.Elevate the head at 90 degrees
C.Give IV Dilantin
D.Administer IV spironolactone Correct Answers A - osmotic
diuretics (Mannitol) decrease pressure in brain
What other interventions decrease ICP??
HOB at 30 degrees
No coughing
,Stay calm
Quiet
Lights low
A patient comes in with a hemorrhagic stroke. You question
when the graduate nurse tells you:
A."The patient has atrial fibrillation"
B."We are calling the neurosurgical team"
C."I am going to give tPA"
D."The patient's airway is patent" Correct Answers C - TPA is
NOT given for hemorrhagic stroke
A patient presents to the ED with slurred speech, confusion,
nausea, muscle weakness and a headache. The daughter tells you
her Mom fell a few weeks ago and has been tired and "her
balance has been off" ever since.What do you suspect is wrong
with this Pt? Correct Answers Subdural hematoma - blood has
leaked out of a torn vessel into the space below the dura
(membrane between brain and skull)
Her symptoms tell us there is pressure on the brain
How is this treated? If the hematoma is large -> possible surgery
(burr hole) to drain the blood through small holes in skull
Small hematomas often are not treated or even found as the
body breaks down the blood over time (2-4 weeks)
Why are elderly Pts more prone to subdural hematomas? (3
times more likely in elderly!) Normal brain shrinkage that
occurs with aging and bridging veins which are more prone to
, injury and rupture. Also they take blood thinners, have other
diseases or damaged blood vessels from HTN.
A patient with a kidney transplant tells you their urine output is
50mL/ 1 hr - what is your response?
•A. "This is normal"
•B "Your labs are more important than your urine output"
•C. "I need to check your BUN and Creatinine level"
•D. "I will call the provider right away" Correct Answers A -
the transplanted kidney should be making a "normal" amount of
urine which is >30mL/hr
Acute cellular rejection in organ failure is caused by[cause1]of
the immune system. Correct Answers cytotoxic T-cells
AML
What is it
Dx
Sx
Tx Correct Answers excessive immature WBC/myeloid cells
(150,000 - 400,000) -
Dx: by bone marrow biopsy
Sx = pallor, fatigue, SOB, weight loss, abnormal bleeding,
fevers/infections
TX = chemo, blood transfusions, Stem cell transplant
An assessment finding in a patient with Cobalamin deficiency
would be:
A.Jaundiced sclera
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