Pathopharm III Final Questions

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The nurse should anticipate which of the following as the most common complication after an MI?
Group of answer choices
A. Pulmonary Edema
B. Cardiogenic Shock
C. Deep Vein Thrombosis
D. Cardiac Dysrhythmias
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Terms in this set (46)
The nurse should anticipate which of the following as the most common complication after an MI?
Group of answer choices
A. Pulmonary Edema
B. Cardiogenic Shock
C. Deep Vein Thrombosis
D. Cardiac Dysrhythmias
D. Cardiac Dysrhythmias
A patient on the cardiac telemetry unit goes into ventricular fibrillation and is unresponsive. Following the initiation of the emergency call system (Code Blue) , the next priority for the nurse is to:
Group of answer choices
A. Begin cardiopulmonary resuscitation (CPR)
B. Defibrillate with 360 joules.
C. Administer Amiodarone IV
D. Get the crash cart
A. Begin cardiopulmonary resuscitation (CPR)
A nurse is caring for a patient on the telemetry unit. His heart rate is 172. Blood pressure is 100/58. The patient is very anxious and tachypneic. The telemetry is revealing paroxysmal supraventricular tachycardia (PSVT). Adenosine is ordered for this patient. What is the correct dose?
Group of answer choices
A. 100 mg
B. 6 mg IV
C. 1 mg
D. 12 mg
B. 6 mg
The nurse is caring for a patient in the medical telemetry unit. The patient is experiencing anxiety and is tachypneic. Breathing is 38 per minute and heart rate is 172. The telemetry reveals ventricular tachycardia. Amiodarone has been ordered, the nurse knows the correct dose first dose is :
Group of answer choices
a. 100 mg IV
B. 150 mg IV
C. 500 mg IV
D. 300 mg IV
D. 300 mg IV
Which of the following are documented as part of the cardiopulmonary arrest record ?
Group of answer choices
A. Medication for gastric upset
B. Medication administration time
C. output from hemovac
D. Location of gel for AICD pads
B. Medication administration time
Three days after an anterior wall MI, a patient is in the critical care unit. The patient is receiving oxygen at 4 L/min by nasal cannula; nitroglycerin paste, 1-inch q6h; and Lopressor 25 mg PO q12h. The monitor shows that the patient is beginning to have premature ventricular contractions (PVCs). Over the course of the next several hours, the PVCs increase in frequency to more than 15 per minute, with occasional runs of multifocal bigeminal PVCs. The patient's vital signs follow: heart rate, 84 beats/min; sinus rhythm with described PVCs; blood pressure, 124/68 mm Hg; respirations, 20 breaths/min; and SpO2, 92%. Laboratory values are blood pH, 7.44; potassium, 4.4 mEq/L; and magnesium, 1.0 mEq/L. Which of the following orders are inappropriate for this patient?
Group of answer choices
A. Potassium chloride 40 mEq in 250 mL 0.9% saline IV piggyback over a 4-hour period
B. Lidocaine 100 mg IV push
C. Increase oxygen to 6 L/min by nasal cannula
D. Magnesium sulfate 2 g IV piggyback over a 2-hour period
A. Potassium chloride 40 mEq in 250 mL 0.9% saline IV piggyback over a 4-hour period
Initial treatment of asystole and pulseless electrical activity is:
Group of answer choices
A. Administration of Epinephrine
B. Administration of Atropine
C. CPR
D. Defibrillation
C. CPR
The nurse's responsibilities in preparing to administer defibrillation include:
Group of answer choices
A. setting the defibrillator to deliver 50 joules
B. applying gel pads to the patient's chest
C. sedating the patient to midazolam (versed) before defibrillation
D. setting the defibrillator to a synchronized mode
B. applying gel pads to the patient's chest
A patient admitted into the CCU (coronary care unit) has been having chest pain. He is connected to telemetry. His vital signs are: temperature 99.8 ; heart rate 140 ; blood pressure 112/58. Telemetry reveals narrow complex supraventricular tachycardia. The nurse initially vagal manoeuvres and fail to convert the heart rate. What medication is indicated?
Group of answer choices
A. Epinephrine
B. Adenosine
C. Amiodarone
D. Atropine
B. Adenosine
A patient in the emergency room is presenting with substernal chest pain, the pain is rated at 8:10. During the admission interview, the patient becomes unconscious and unresponsive. The nurse checks for a carotid pulse and it is absent. The cardiac monitor reveals electrical activity. The patient is in pulseless electrical activity (PEA). The nurse knows the treatment for PEA is:
Group of answer choices
A. Epinephrine
B. Unsynchronized cardioversion
C. Magnesium
D. Lidocaine
A
As the body continues to try to compensate for hypovolemic shock, there is increased angiotensin II from the activation of the renin-angiotensin- aldosterone system. What physiologic change occurs related to the increased angiotensin II? Group of answer choices A. Vasodilation B. Antidiuretic hormone (ADH) releases increases water reabsorption C. Decreased blood pressure and cardiac output D. Aldosterone release results in sodium and water excretionB. Antidiuretic hormone (ADH) releases increases water reabsorptionA patient with acute pancreatitis has hypovolemic shock. Which order will the nurse implement first? Group of answer choices A. Apply high-flow oxygen (100%) with a non-rebreather mask. B. Start 1000 ml of normal saline at 500 ml/hr C. Obtain blood cultures before starting IV antibiotics D. Draw blood for hematology and coagulation factorsA. Apply high-flow oxygen (100%) with a non-rebreather mask.A patient with hypovolemic shock is receiving Lactated Ringer's solution for fluid replacement therapy. During this therapy, which laboratory result is most important for the nurse to monitor? Group of answer choices A. Hemoglobin and hematocrit B. Serum sodium C. Serum potassium D. Serum pHD. Serum pHWhat hemodynamic monitoring parameter indicates to the nurse that administering large amount of crystalloid fluids to a patient in septic shock has been effective? Group of answer choices A. Cardiac output of 2.6 l/min B. pulmonary artery wedge pressure (PAWP) of 4 mmhg C. Heart rate of 106 bpm D. Central venous pressure (CVP) of 15 mmhgD. Central venous pressure (CVP) of 15 mmhgThe nurse is caring for a patient in cardiogenic shock. What change in hemodynamic monitoring indicates that the metabolic demands of turning and moving the patient exceed the oxygen supply? Group of answer choices A. Cardiac output from 4.2 L/min to 4.8 L/min B. Venous oxygen saturation (SvO2) falls from 62% to 54% C. Systemic vascular resistance from 1300 dyne/sec/cm5 to 1120 dyne/sec/cm5 D. Stroke volume from 52 to 68 ml/beatB. Venous oxygen saturation (SvO2) falls from 62% to 54%What should the nurse assess the patient for during the administration of IV Norepinephrine (Levophed)? Group of answer choices A. Marked diuresis B. Decreased tissue perfusion C. Hypotension D. Metabolic alkalosisB. Decreased tissue perfusionA patient arrives to the telemetry floor with symptoms of chest pain radiating to the jaw. What medication does the nurse anticipate administering to reduce pain and anxiety as well as reducing oxygen consumption? Group of answer choices A. Codeine B. Morphine sulfate C. Dilaudid D. MeperidineB. Morphine sulfateA patient who is post operative , day 1 from a bowel resection, is experiencing pain , rated at 7:10. Vital signs are : pulse of 78 and blood pressure of 126/72. Pulse ox 98 % on 2 liters nasal cannula. The patient is recovering from hypovolemic shock after blood loss in surgery. What stage shock does the nurse recognize this patient is experiencing? Group of answer choices A. Progressive B. Initial C. Compensatory D. IrreversibleC. CompensatoryA patient is decompensating in respiratory stasis with 6 liters of humidified oxygen via nasal cannula. The patient is in progressive shock with an increase in oxygen demand. What does the nurse anticipate will be the next intervention? Group of answer choices A. Intubation and mechanical ventilation B. Administration of oxygen via venture mask C. Thoracotomy with chest tube insertion D. PericardiocentesisA. Intubation and mechanical ventilationThe clinical presentation of shock is due to inadequate tissue perfusion, what signs and symptoms are most consistent with shock? Group of answer choices A. Pulse ox of 93% B. Bilateral course rales in lower bases on ausculatation C. Blood Pressure 88/52 D. Heart Rate 90C. Blood Pressure 88/52A patient has been admitted following a motor vehicle crash. The patient is hypotensive and tachycardic. The nurse knows that with the progression of shock what damage can occur with persistent hypotension? Group of answer choices A. Metabolic Alkalosis B. Pulmonary Edema C. Peripheral Neuropathy D. Inadequate tissue perfusionD. Inadequate tissue perfusionA patient was diagnosed with nonalcoholic fatty liver disease (NAFLD). What treatment measures should the nurse plan to teach the patient about? Group of answer choices A. Hypertension management B. Ulcerative colitis management C. Increased sodium and fluid intake D. Diabetes managementD. Diabetes managementWhich etiologic manifestations occur in the patient with cirrhosis related to esophageal varices? Group of answer choices A. loss of small bile ducts and cholestasis and cirrhosis in patients with other autoimmune disorders B. scarring and nodular changes in the liver lead to compression of the veins and sinusoids, causing resistance of blood flow through the liver from the portal vein C. jaundice, peripheral edema, and ascites from increased intrahepatic pressure and dysfunction D. Development of collateral channels of circulation in inelastic, fragile esophageal veins as a result of portal hypertensionD. Development of collateral channels of circulation in inelastic, fragile esophageal veins as a result of portal hypertensionThe patient is being treated with diuretics for ascites from cirrhosis must be monitored for Group of answer choices A. Increased clotting tendencies B. Gastrointestinal bleeding C. hypernatremia D. renal functionD. renal functionCombined with clinical manifestations, what is the laboratory finding that is most commonly used to diagnose acute pancreatitis? Group of answer choices A. Increased serum calcium B . Increased serum amylase C. Increased urine amylase D. Decreased serum glucoseB . Increased serum amylaseWhat treatment measure is used in managing the patient with acute pancreatitis? Group of answer choices A. Pancreatic enzyme supplements administered with meals B. Nasogastric tube suction to prevent gastric contents from entering the duodenum C. endoscopic pancreatic sphinterotomy using endoscopic retrograde cholangiopancreatography (ERCP) D. Surgery to remove the inflamed pancreasB. Nasogastric tube suction to prevent gastric contents from entering the duodenumThe nurse should assess for an important early indicator of acute pancreatitis. What prolonged and elevated level would the nurse determine is an early indicator? Group of answer choices a. Serum amylase b. serum bilirubin c. serum lipase d. Serum calciuma. Serum amylase or c. serum lipaseA patient who had a recent myocardial infarction was brought to the emergency department with bleeding esophageal varices and is presently receiving fluid resuscitation. What first-line pharmacologic therapy does the nurse anticipate administering to control the bleeding from the varices? Group of answer choices A. epinephrine B. octreotide C. glucagon D. vasopressinB. octreotideThe nurse is administering lactulose to decrease the ammonia level in a patient who has hepatic encephalopathy. What should the nurse carefully monitor for that may indicate a medication overdose? Group of answer choices A. Ringing in the ears B. vomiting C. watery diarrhea D. presence of asterixisC. watery diarrheaThe patient with chronic pancreatitis is more likely than the patient with acute pancreatitis to: Group of answer choices A. need to abstain from alcohol B. Have malabsorption and diabetes mellitus C. acute pain in left upper quadrant D. require a high carbohydrate , high protein and low-fat dietB. Have malabsorption and diabetes mellitusDuring the treatment of the patient with bleeding esophageal varices, it is most important that the nurse: Group of answer choices A. perform guaiac testing on all stools to detect occult blood B. monitor for the cardiac effects of IV vasopressin C. maintaining a patent airway D. prepare the patient for immediate portal shunting surgeryC. maintaining a patent airwayIn addition to promoting the transport of glucose from blood into the cell, what does insulin do? Group of answer choices A. prevents the transport of triglycerides into adipose tissue B. Increases amino acid transport into cells and protein synthesis C. Enhances the breakdown of adipose tissue for energy D. Stimulates hepatic glucogenolysis and gluconeogenesisB. Increases amino acid transport into cells and protein synthesisCortisol, glucagon, epinephrine, and growth hormone are referred to as counterregulatory hormones because they Group of answer choices A. Stimulate glucose output by the liver B. Decrease glucose production C. Increase glucose transport into the cells D. Independently regulate glucose level in the bloodA. Stimulate glucose output by the liverWhich laboratory results indicate the patient has prediabetes? Group of answer choices A. fasting blood glucose result of 80 mg/dl B. Glucose tolerance result of 240 mg/dl C. Glucose tolerance result of 132 mg/dl D. Fasting blood glucose result of 120 mg/dlD. Fasting blood glucose result of 120 mg/dlA patient with type I diabetes uses 20 units of Novolin 70/30 (NPH/Regular) in the morning and at 6 pm. when teaching the patient about this regimen, what should the nurse emphasize? Group of answer choices A. Flexibility in food intake is possible because insulin is available 24 hours a day B. A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia C. Hypoglycemia is most likely to occur before the noon meal D. Premeal glucose checks are required to determine needed changes in daily dosingB. A set meal pattern with a bedtime snack is necessary to prevent hypoglycemiaLispro insulin (Humalog) with NPH (Humulin N) insulin is ordered for a patient with newly diagnosed type I diabetes. When should the nurse administer Lispro insulin? Group of answer choices A. At mealtime or within 15 minutes of meals B. Only once a day C. 30 to 45 minutes before meals D. 1 hour before mealsA. At mealtime or within 15 minutes of mealsAcute Tubular Necrosis (ATN) is the most common cause of intrarenal acute kidney injury (AKI). Which patient is most likely to develop ATN. Group of answer choices A. Patient who tried to overdose on Acetaminophen B. Patient with hypertensive crisis C. Patient with major surgery who required a blood transfusion D. Patient with diabetesC. Patient with major surgery who required a blood transfusionWhat indicates to the nurse that the patient with oliguria has prerenal oliguria? Group of answer choices A. urine testing reveals a high sodium concentration B. Urine testing reveals a low specific gravity C. causative factor is malignant hypertension D. reversal of oliguria occurs with fluid replacementD. reversal of oliguria occurs with fluid replacementMetabolic acidosis occurs in the oliguric phase of AKI as a result of impairment of Group of answer choices A. Excretion of potassium B. excretion of sodium C. excretion of bicarbonate D. excretion of hydrogen ionsD. excretion of hydrogen ionsA 68 year old man with a history of heart failure resulting from hypertension has acute kidney injury resulting from the effects of nephrotoxic diuretics. currently, his serum potassium is 6.2 meq/l with cardiac changes, his BUN is 108 mg/dl, his serum creatinine is 4.1 mg/dl, and his serum bicarbonate is 14 meq/l. He is somnolent and disoriented. which treatment should the nurse expect to be used for him? Group of answer choices A. renal replacement therapy B. insulin and sodium bicarbonate C. Sodium polystyrene sulfonate (Kayexalate) D. loop diureticsA. renal replacement therapyA patient on a medical unit has a potassium level of 6.8 meq/l. What is the priority action that the nurse should take? Group of answer choices A. Place the patient on a cardiac monitor B. Call the laboratory and request a redraw of the laboratory to verify the results C. Teach the patient to avoid high-potassium foods D. Check the patient's blood pressureA. Place the patient on a cardiac monitorIn replying to a patient's questions about the seriousness of her chronic kidney disease (CKD), the nurse knows that the stage of CKD is based on what? Group of answer choices A. serum creatinine and urea levels B. Glomerular filtration rate C. Degree of altered mental status D. Total daily urine outputB. Glomerular filtration rateThe patient with Chronic Kidney Disease (CKD) is brought to the emergency department with Kussmaul respirations. What does the nurse know about CKD that could cause this patient's Kussmaul respirations? Group of answer choices A. there is decreased pulmonary macrophage activity B. Uremic pleuritis is occurring C. pulmonary edema from heart failure and fluid overload is occurring D. they are cause by respiratory compensation for metabolic acidosisD. they are cause by respiratory compensation for metabolic acidosisWhat is the most serious electrolyte disorder associated with kidney disease Group of answer choices A. hypermagnesemia B. hyperkalemia C. hyponatremia D. hypocalcemiaB. hyperkalemiaWhat is the most appropriate snack for the nurse to offer a patient with stage 4 chronic kidney disease? Group of answer choices A. Hard candy B. Dill pickles C. Raisins D. Ice creamA. Hard candyWhich complication of chronic kidney disease is treated with erythropoeitin? Group of answer choices A. Mineral and bone disorder B. Anemia C. Hypertension D. HyperkalemiaB. Anemia