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NSG 430 Exam 2 (Ch. 7,10, 13) questions and answers
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NSG 430 Exam 2 (Ch. 7,10, 13) questions and answers
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NSG 430 Exam 2 (Ch. 7,10, 13) questionsand answers
Which \of \the \following \statements \is \true \about \insulin \and \parenteral \nutrition? \(Select \all \that \apply.)
a.
The \amount \of \parenteral \insulin \is \adjusted \based \on \the \previous \24-hour \laboratory \values.
b.
Insulin \may \be \added \to \a \parenteral \nutrition \solution.
c.
Subcutaneous \insulin \is \used \on \a \sliding \scale \during \parenteral \nutrition.
d.
Supplemental \insulin \is \rarely \required \for \patients \receiving \parenteral \nutrition.
e.
Lingering \hyperglycemia \after \parenteral \nutrition \has \stopped \requires \continuing \insulin. \- \
ANSWERS✔✔ \ANS: \A, \B, \C
Hyperglycemia \is \common \when \receiving \parenteral \nutrition; \insulin \may \be \administered \on \a \
sliding \scale \for \glucose \control \and/or \added \to \the \parenteral \solution. \The \amount \of \insulin \added \
to \the \parenteral \solution \is \calculated \based \on \the \previous \24-hour \laboratory \values. \
Hypoglycemia \can \result \from \continuing \the \insulin \after \the \parenteral \nutrition \is \discontinued.
(Ref. \p.
1. \The \nurse \is \caring \for \a \patient \who \is \on \a \cardiac \monitor. \The \nurse \realizes \that \the \sinus \node \
is \the \pacemaker \of \the \heart \because \it \is
a.the \fastest \pacemaker \cell \in \the \heart.
b.the \only \pacemaker \cell \in \the \heart.
c.the \only \cell \that \does \not \affect \the \cardiac \cycle.
,d.located \in \the \left \side \of \the \heart. \- \ANSWERS✔✔ \ANS: \A
The \cardiac \cycle \begins \with \an \impulse \that \is \generated \from \a \small \concentrated \area \of \
pacemaker \cells \high \in \the \right \atria \called \the \sinoatrial \node \(sinus \node \or \SA \node). \The \SA \node \
has \the \fastest \rate \of \discharge \and \thus \is \the \dominant \pacemaker \of \the \heart. \The \AV \node \has \
pacemaker \properties \and \can \discharge \an \impulse \if \the \SA \node \fails. \The \ventricles \have \
pacemaker \capabilities \if \the \sinus \node \or \the \AV \node \ceases \to \generate \impulses. \(ref. \p. \90)
One \of \the \functions \of \the \atrioventricular \(AV) \node \is \to
a.pace \the \heart \if \the \ventricles \fail.
b.slow \the \impulse \arriving \from \the \SA \node.
c.send \the \impulse \to \the \SA \node.
d.allow \for \ventricular \filling \during \systole. \- \ANSWERS✔✔ \ANS: \B
The \impulse \from \the \SA \node \quickly \reaches \the \atrioventricular \(AV) \node \located \in \the \area \called \
the \AV \junction, \between \the \atria \and \the \ventricles. \Here \the \impulse \is \slowed \to \allow \time \for \
ventricular \filling \during \relaxation \or \ventricular \diastole. \The \AV \node \has \pacemaker \properties \and \
can \discharge \an \impulse \if \the \SA \node \(not \the \ventricle) \fails. \The \electrical \impulse \is \then \rapidly \
conducted \through \the \bundle \of \His \to \the \ventricles \(not \the \SA \node) \via \the \left \and \right \bundle \
branches. \(REF: \p. \90)
The \normal \rate \for \the \SA \node \when \the \patient \is \at \rest \is
a.40 \to \60 \beats \per \minute.
b.60 \to \100 \beats \per \minute.
c.20 \to \40 \beats \per \minute.
,d.more \than100 \beats \per \minute. \- \ANSWERS✔✔ \ANS: \B
The \sinus \node \reaches \threshold \at \a \rate \of \60 \to \100 \times \per \minute. \Because \this \is \the \fastest \
pacemaker \in \the \heart, \the \SA \node \is \the \dominant \pacemaker \of \the \heart. \The \AV \node \has \an \
inherent \rate \of \40 \to \60 \beats \per \minute \and \the \His-Purkinje \system \can \fire \at \a \rate \of \20 \to \40 \
beats \per \minute. \Sinus \tachycardia \results \when \the \SA \node \fires \faster \than \100 \beats \per \minute. \
(REF. \p. \90)
The \nurse \caring \for \patients \with \cardiac \monitoring \understands \that \when \an \electrical \signal \is \
aimed \directly \at \the \positive \electrode, \the \inflection \will \be:
a.negative.
b.upside \down.
c.upright.
d.equally \positive \and \negative. \- \ANSWERS✔✔ \ANS: \C
When \an \electrical \signal \is \aimed \directly \at \the \positive \electrode, \an \upright \inflection \is \visualized. \
If \the \impulse \is \going \away \from \the \positive \electrode, \a \negative \deflection \is \seen; \and \if \the \signal \
is \perpendicular \to \the \imaginary \line \between \the \positive \and \negative \poles \of \the \lead, \the \tracing \
is \equiphasic, \with \equally \positive \and \negative \deflection. \(Ref. \p. \92)
The \patient \is \admitted \with \a \condition \that \requires \cardiac \rhythm \monitoring. \To \apply \the \
monitoring \electrodes, \the \nurse \must \first
a.apply \a \moist \gel \to \the \chest.
b.make \certain \that \the \electrode \gel \is \dry.
c.avoid \soaps \to \avoid \skin \irritation.
d.clip \chest \hair \if \needed. \- \ANSWERS✔✔ \ANS: \D
, Adequate \skin \preparation \of \electrode \sites \requires \clipping \the \hair, \cleansing \the \skin, \and \drying \
vigorously \(moisture \gels \are \not \applied). \Cleansing \includes \washing \with \soap \and \water, \or \alcohol, \
to \remove \skin \debris \and \oils. \Before \application, \the \electrodes \are \checked \to \ensure \that \the \gel \is \
moist. \It \is \difficult \for \electrodes \to \adhere \to \the \chest \in \the \presence \of \chest \hair. \Clipping, \not \
shaving, \is \recommended \since \shaving \may \create \small \nicks \that \can \become \a \portal \for \infection. \
(Ref. \p. \96)
The \nurse \using \cardiac \monitoring \understands \that \each \horizontal \box \on \the \electrocardiogram \
(ECG) \paper \indicates
a.200 \milliseconds \or \0.20 \seconds \duration.
b.40 \milliseconds \or \0.04 \seconds \duration.
c.3 \seconds \duration.
d.millivolts \of \amplitude. \- \ANSWERS✔✔ \ANS: \B
ECG \paper \contains \a \standardized \grid \where \the \horizontal \axis \measures \time \and \the \vertical \axis \
measures \voltage \or \amplitude. \Horizontally, \the \smaller \boxes \denote \0.04 \seconds \each \or \40 \
milliseconds; \the \larger \box \contains \five \smaller \boxes \and \thus \equals \0.20 \seconds \or \200 \
milliseconds. \(Ref. \p. \97)
The \nurse \is \examining \the \patient's \cardiac \rhythm \strip \in \lead \II \and \notices \that \all \of \the \P \waves \
are \upright \and \look \the \same \except \one \that \has \a \different \shape \and \is \inverted. \The \nurse \
realizes \that \the \P \wave \with \the \abnormal \shape \is \probably
a.
from \the \SA \node \because \all \P \waves \come \from \the \SA \node.
b.
from \some \area \in \the \atria \other \than \the \SA \node.
c.
indicative \of \ventricular \depolarization.
d.
normal \even \though \it \is \inverted \in \lead \II. \- \ANSWERS✔✔ \ANS: \B
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