NURS 6531 FINAL EXAM, PART TWO EXAM QUESTIONS WITH CORRECT VERIFIED SOLUTIONS 100% GUARANTEED PASS (LATEST UPDATE)
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NURS 6531
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NURS 6531
NURS 6531 FINAL EXAM, PART TWO EXAM QUESTIONS WITH CORRECT VERIFIED SOLUTIONS 100% GUARANTEED PASS (LATEST UPDATE)NURS 6531 FINAL EXAM, PART TWO EXAM QUESTIONS WITH CORRECT VERIFIED SOLUTIONS 100% GUARANTEED PASS (LATEST UPDATE)NURS 6531 FINAL EXAM, PART TWO EXAM QUESTIONS WITH CORRECT VERIFIED SOL...
NURS 6531 FINAL EXAM, PART TWO EXAM
QUESTIONS WITH CORRECT VERIFIED SOLUTIONS
100% GUARANTEED PASS (LATEST UPDATE)
An asymptomatic pregnant woman has a positive leukocyte esterase and
positive nitrites on a urine dipstick screening. What will the provider do
next?
a. Admit to the hospital
b. Obtain a urine culture
c. Order a renal ultrasound
d. Prescribe trimethoprim-sulfamethoxazole (TMP-SMZ) - ANS ✓ANS: B
Urine culture is the definitive test and should be obtained in all pregnant
women. Admission to the hospital is usually not necessary. Renal
ultrasound is used to identify abnormalities or obstructions that may be
causing recurrent symptoms. TMP-SMZ is contraindicated in pregnant
women.
An asymptomatic female is concerned about having come into contact with
sexually transmitted gonorrhea and asks about antibiotics. What will the
provider recommend?
a. Amoxicillin-clavulanate for 10 days
b. Cultures and treatment if symptoms appear
c. Empirical ceftriaxone and azithromycin
d. Trimethoprim-sulfamethoxazole - ANS ✓ANS: C
Patients with gonorrhea usually have chlamydia as well, so treatment with
both ceftriaxone and azithromycin is recommended. Amoxicillin-
clavulanate and TMP-SMZ are used for urinary tract infections (UTIs). The
patient should be treated empirically. Females are often asymptomatic.
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A patient is in the emergency department with confusion and fatigue and a
corrected serum calcium concentration is 10.8 mg/dL. What is the initial
treatment for this patient prior to admission to the inpatient unit?
a. Administration of furosemide
b. Correction of potassium and magnesium levels
c. Parenteral salmon calcitonin
d. Rapid administration of intravenous normal saline - ANS ✓ANS: D
To help the kidneys excrete calcium, intravenous normal saline should be
given initially.
Furosemide may not be effective as once thought and is used less often
today. Correction of
other electrolytes may be done when these imbalances are assessed.
Parenteral salmon
calcitonin may be used later to enhance calcium losses.
A patient experiences a carpal spasm when a blood pressure cuff is inflated.
Which diagnostic testing will the provider consider evaluating to determine
the cause of this finding?
a. Calcitriol level
b. C-reactive protein
c. Magnesium and vitamin D
d. Protein electrophoresis - ANS ✓ANS: C
The Trousseau's sign indicates neuromuscular irritability, which occurs
with hypocalcemia. Because hypomagnesemia and vitamin D deficiency
may cause hypocalcemia, these should be evaluated to help determine a
cause. Calcitriol levels are used to assess hypercalcemia. Inflammatory
markers are not indicated. Protein electrophoresis is used in the evaluation
of hypercalcemia.
A patient has low serum calcium associated with low serum albumin. What
is the recommended treatment for this patient?
a. Calcium supplementation only
b. Correction of other serum electrolytes
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c. Thiazide diuretics and sodium restriction
d. Vitamin D and calcium supplementation - ANS ✓ANS: B
Patients with hypocalcemia associated with hypoalbuminemia do not
require calcium replacement. Serum pH, potassium, magnesium, and
phosphorus levels should be monitored and corrected if needed. Thiazide
diuretics with sodium restriction may be used to lower urinary calcium
excretion to allow lower dosing of calcium and vitamin D when these are
given.
A high school athlete is brought to the emergency department after
collapsing during outdoor practice on a hot day. The patient is weak,
irritable, and confused. Serum sodium is 152 mEq/L and has dry mucous
membranes and tachycardia. What is the initial approach to rehydration in
this patient?
a. Hypotonic intravenous fluid replacement
b. Intravenous fluid resuscitation with an isotonic solution
c. Loop diuretics and hypotonic intravenous fluids
d. Oral water replacement - ANS ✓ANS: B
This patient is dehydrated and has hypernatremia because of heat
exposure and sweating. Because the patient is confused, oral fluid
replacement is not recommended, although it is the safest in cognitively
intact patients who are able to swallow safely. The initial fluids should
correct the hypovolemia and isotonic solutions such as normal saline
(0.9%) or Ringer's lactate are given. Hypotonic fluids are then given once
vital signs and urine output have normalized in patients with
hypernatremia caused by fluid loss. Loop diuretics are added for patients
who have hypernatremia caused by sodium gain.
An elderly patient who is taking a thiazide diuretic has been ill with nausea
and vomiting and is brought to the emergency department for evaluation.
An assessment reveals oliguria, hypotension, and tachycardia and serum
sodium is 118 mEq/L. What is the treatment?
a. A single infusion of hypertonic saline
b. Addition of spironolactone
c. Emergency volume repletion with 3% NaCl.
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d. Fluid and dietary sodium restriction - ANS ✓ANS: C
This patient has hypovolemic hyponatremia with a sodium less than 120
mEq/L and requires fluid resuscitation with 3% NaCl. Diuretics and fluid
restriction are part of treatment for hypervolemic hyponatremia.
A patient has euvolemic hyponatremia secondary to chronic syndrome of
inappropriate antidiuretic hormone (SIADH) and is hospitalized for fluid
replacement. When preparing to discharge the patient home, what will be
included in teaching?
a. Limiting dietary protein intake
b. Limiting fluids to 500 mL/day for several days
c. Restriction of sodium intake
d. The importance of adherence to vaptan therapy - ANS ✓ANS: B
Patients with chronic hypovolemia secondary to SIADH require fluid
restriction for several days. Sodium and protein are not restricted. Vaptan
therapy is started for those whose serum sodium fails to normalize in 24 to
48 hours.
A patient has new-onset hypertension with a systolic blood pressure of 180
mm Hg. Which test will the provider order to diagnose this patient?
a. ACTH suppression testing
b. Adrenal antibody tests
c. Cortisol excretion studies
d. Fractionated metanephrine levels - ANS ✓ANS: D
Patients with pheochromocytoma may present with new-onset
hypertension with systolicpressure >170 mm Hg. Fractionated
metanephrine will be elevated when the diagnosis is confirmed. ACTH
suppression testing and cortisol excretion studies are performed to
diagnose Cushing's syndrome. Adrenal antibody tests are performed as
part of the evaluation for Addison's disease.
A patient has rapid weight gain, amenorrhea without pregnancy, and mild
hypertension. Once confirmatory tests are performed, what is a possible
treatment for this patient?
NURS 6531
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