Download 4006 MIDTERM EXAM MOCK TEST WITH ANSWER RATIONALES 2026 and more Exams Nursing in PDF only on Docsity!
4006 MIDTERM EXAM MOCK TEST WITH
ANSWER RATIONALES 2026
◉ hypernatremia manifestations. Answer: thirst, dry sticky membranes, decreased urine output, fever, rough dry tongue, if severe lethargy can turn into coma ◉ hypokalemia manifestations. Answer: fatigue, vomiting, anorexia, cardiac arrhythmias, leg cramps, severe is death from cardiac or respiratory arrest ◉ Hyperkalemia manifestations. Answer: diarrhea, nausea, muscle weakness, parenthesis, cardiac arrhythmias ◉ Hypocalcemia manifestations. Answer: Positive Trousseau's or Chvostek's sign, mental changes, laryngeal spasms, seizures, bleeding, cardiac arrhythmias ◉ Hypercalcemia manifestations. Answer: deep bone pain, constipation, polyuria, thirst, pathological fractures, can promote formation of kidney stones
◉ hypomagnesemia manifestations. Answer: tachycardia, cardiac arrhythmias, neuromuscular irritability, parenthesis of extremities, foot and leg cramps, hypertension, positive Trousseau's or Chvostek's sign ◉ hypermagnesemia manifestations. Answer: flushing, warmth, hypotension, lethargy, bradycardia, depressed respirations and coma ◉ the types of distributive shock. Answer: neurogenic, anaphylactic, septic ◉ obstructive shock. Answer: impaired filling of the heart with blood due to mechanical impediement ◉ cardiogenic shock. Answer: decreased force of ventricular contraction leading to inadequate intravascular volume and tissue hypoxia ◉ compensatory stage of shock.
◉ ventilation scan. Answer: inhaling radioactive gas ◉ gallium scan. Answer: determines if any inflammatory conditions exist within the lungs or if abscesses, adhesions, or tumors are present ◉ PET scan. Answer: radioisotopes to differentiate normal and abnormal tissue and view metabolic changes ◉ bronchoscopy. Answer: bronchoscope introduced through nose, mouth, or trach for direct visualization ◉ laryngoscopy. Answer: direct visualization of larynx using laryngoscope ◉ mediastinoscopy. Answer: incision made above sternum and scope inserted for visualization of lymph nodes and biopsy samples ◉ thorascopy.
Answer: small incisions made into pleural cavity through intercoastal space for visualization, aspiration of fluids, or biopsy ◉ thoracentesis. Answer: a needle is inserted through the skin between the ribs and into the pleural space to drain fluid or biopsy ◉ arthroscopy. Answer: internal inspection of a joint. Needle inserted into joint and injects sterile normal saline to distend joint, and inspection for signs of joint injury or damage ◉ arthrocentesis. Answer: aspiration of synovial fluid ◉ bone densitometry. Answer: x-rays or ultrasounds to estimate bone density ◉ risk factors in FRAX. Answer: postmenopausal females or men 50+, pts with osteopenia, pts who have not taken meds for osteoporosis, family history of osteoporosis, history of smoking
◉ aortography. Answer: detects abnormalities such as aneurysms and arterial occlusions. films are taken from abdominal aorta and major arteries in legs ◉ pacemaker of the heart. Answer: SA node ◉ complete heart block. Answer: results in the ventricles depolarizing independently from the atria. Ventricular rate is slow 30-40 bpm. treatment is a pacemaker ◉ premature ventricular contraction (PVC). Answer: a ventricular contraction preceding the normal impulse initiated by the SA node ◉ manifestations of PVC. Answer: pallor, nervousness, sweating, fainting, fluttering sensation in chest ◉ ventricular tachycardia.
Answer: a very rapid heartbeat that begins within the ventricles, same repetitive pattern, 150-200 bmp ◉ Premature Atrial Contraction (PAC). Answer: neural tissue in atrial conduction initiates an early electrical impulse; rhythm is irregular ◉ causes of PAC. Answer: caffeine, nicotine, stress, metabolic disorders, hyperthyroidism ◉ Supraventricular tachycardia. Answer: heart rate has conistent rhythm but beats dangerously fast (>150 bpm) ◉ manifestations of SVT. Answer: chest pain, angina, hypotension, syncope, decreased renal output ◉ atrial flutter. Answer: single atrial impulse outside of SA node that causes atria to contract at a rapid rate (200-400/min)
◉ hematocrit. Answer: 0.35-0. ◉ PaO2. Answer: 80-100 mmHg ◉ K+. Answer: 3.5- 5 ◉ Na+. Answer: 135- 145 ◉ .45NS. Answer: hypotonic ◉ 2.5D5W. Answer: hypotonic ◉ .33NS. Answer: hypotonic ◉ D5W.
Answer: isotonic ◉ D5 1/2. Answer: hypertonic ◉ D5NS. Answer: hypertonic ◉ D5LR. Answer: hypertonic ◉ Calcium levels. Answer: 8.5-10.5 mg/dL ◉ Angina. Answer: A type of chest pain caused by decreased blood flow to the heart ◉ Angina Pain. Answer: Pain is described as constricting, vice-like squeezing, suffocating or crushing heaviness, Pain is located on the left side of the chest, The discomfort may also radiate to your shoulders, arms, neck, jaw, or back, Women can present differently. i.e. nausea,
◉ Diagnostic Tests. Answer: ECG, Stress test, Angiogram, Chest x-ray, & Echocardiogram ◉ Treatment for angina. Answer: Controlling risk factors, such as hypertension, cigarette smoking, high cholesterol levels and excess weight is an essential part of treatment, Medications include: nitrates, beta-blockers, and calcium channel blockers, & May require angioplasty ◉ Myocardial Infarction. Answer: Sudden deprivation of circulating blood , Usually results from rupture or fissuring of an atherosclerotic plaque. With this rupturing there is a release of substances that cause platelet activation and thrombin generation. It is this resulting thrombus that interrupts blood flow and leads to myocardial infarction , & Irreversible damage occurs in 20-40 min ◉ Myocardial Infarction Signs and symptoms. Answer: Pain is severe, crushing, "an elephant on my chest." Denial - many people will deny their symptoms, Pain is substernal, radiates to the left arm, jaw, neck or other areas of the chest, Pain is prolonged and not relieved by rest or nitrates, Nausea, vomiting, diaphoresis, weakness, shortness of breath, Anxiety: the sense of impending doom, Patients might also do tri-pod breathing
◉ What do we do for MI. Answer: Ask OPQRST: Where is your pain? Does it go anywhere? What does it feel like? When did it start? What were you doing when it started? Pain scale, Call for help, Apply O2 at 3-4 L per minute, Get a full set of vitals, Reassure the patient - do not leave them! Bedrest! ◉ Intervention for MI. Answer: Notify physician and expect to: Order ECG STAT , Maintain or have RN initiate IV, Nitro SL or spray q5min x 3, Morphine IV by the RN, ASA ,Lab work: CKMB, Troponin, Portable CXR (Why? And why portable?) There is a certain window in which we will give "clot busters" (thrombolytics). They will receive this in the ER or ICU and be monitored closely for bleeding for 24 hours. ◉ TPN. Answer: tissue plasminogen activators can be only given within 2 hours of MI Our goal is to maintain 0/10 on the pain scale. Repeat interventions as necessary ◉ MI Healing. Answer: 2-3 days: Acute inflammatory response in the area of necrosis, 4-7 days: The center of the infarcted area is yellow/soft. Rupture of the ventricle, interventricular septum, or valve structure is possible at this time. 7th week: Replacement of necrotic tissue. Areas replaced by scar tissue lack the ability to contract and
Answer: Proceeds normally through the conduction pathway but at a slower rate. (<60 beats/min) ◉ Bradycardia Causes. Answer: Healthy athletes, heart disorders, increased ICP, hypothyroidism, digitalis toxicity (digoxin toxicity), The danger is that a slow rate may be insufficient to maintain cardiac output ◉ Medical management Bradycardia. Answer: Atropine Sulfate: a cholinergic blocking agent given IV to increase a dangerously slow rate ◉ Sinus tachycardia. Answer: Proceeds normally through the conduction pathway but at a faster rate (100-150 beats/min) ◉ Sinus tachycardia Causes. Answer: Physiological response to strenuous exercise, anxiety, fear, pain, fever, hyperthyroidism, hemorrhage, shock, hypoxemia ◉ Premature Atrial Contraction (PAC). Answer: Neural tissue in the atrial conduction system initiates an early electrical impulse, which is identified by an irregularity in the underlying rhythm
◉ Premature Atrial Contraction (PAC) Causes. Answer: caffeine, nicotine, or other sympathetic nervous system stimulants; heart disease; metabolic disorders, hyperthyroidism ◉ Supraventricular Tachycardia. Answer: Dysrhythmia in which the heart rate has a consistent rhythm but beats at a dangerously high rate (>150 beats/min), Diastole is shortened, and the heart does not have sufficient time to fill; cardiac output drops dangerously low ◉ Supraventricular Tachycardia Assessment findings. Answer: chest pain, tachycardia, angina, hypotension, syncope (fainting), reduced renal output ◉ Supraventricular Tachycardia Medical management. Answer: digitalis, adrenergic blockers, and calcium channel blockers ◉ Atrial Flutter. Answer: Single atrial impulse outside the SA node causes the atria to contract at an exceedingly rapid rate (200 - 400 contractions/min), o Atrial waves in atrial flutter have a characteristic "saw-tooth" pattern
◉ Atrioventricular Heart Block. Answer: Disorders in the conduction pathway that interfere with the transmission of impulses from the SA node to the AV node to the ventricles, Types: first degree, second degree, or third-degree (complete heart block), First and second-degree heart block: the impulse is delayed, Complete heart block: the atrial impulse never gets through, and the ventricles develop their own rhythm independent of the atrial rhythm; the ventricular rate is slow (30- 40 beats/min) ◉ Heart Block Treatment. Answer: pacemaker insertion ◉ Ventricular. Answer: Types: premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, Premature Ventricular Contraction (PVC), The ventricular contraction that occurs early and independently of the cardiac cycle before the SA node initiates an electrical impulse; no P wave precedes the wide, bizarre-looking QRS complex ◉ Ventricular issue Assessment findings. Answer: pallor, nervousness, sweating, faintness, "fluttering" sensation in the chest
◉ Ventricular issues Medical Management. Answer: Occasional PVCs may be harmless; may be related to anxiety, stress, fatigue, alcohol withdrawal, tobacco use ◉ Precursors of lethal dysrhythmias. Answer: Six or more PVC's per minute, Runs of bigeminy (every other beat is a PVC), Runs of PVCs (three or more in a row), Multifocal PVCs (originating from more than one location), A PVC whose R wave falls on the T wave of the preceding complex (R-on-T Phenomenon), When dangerous PVCs occur patients are given an IV bolus of lidocaine (Xylocaine) followed by a continuous IV infusion ◉ Ventricular Tachycardia. Answer: The single, irritable focus in the ventricle that initiates and then continues the same repetitive pattern; ventricles beat very fast (150 to 250 beats/min), and cardiac output is decreased, Clients may lose consciousness and become pulseless depending on how long the dysrhythmia is present, sometimes ends abruptly without intervention but often requires defibrillation and may progress to ventricular fibrillation ◉ Ventricular Fibrillation.
