CCRN AACN Practice Questions And Answers, Exams of Nursing

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A patient with a history of bronchogenic carcinoma is admitted with respiratory failure. the patient is intubated and on mechanical ventilation. the patient develops lethargy, headache, slight confusion and abdominal cramping urinary output is decreasing and significant lab data includes Serum Na+ 127 Serum osmolality 270 urine specific gravity elevated - - - correct answer ✅Initiation of fluid restriction - this pt has risk factors signs and symptoms of SIADH fluid restriction slows glomerular filtration and blood flow enhances proximal reabsorption of sodium and water increases aldosterone secretion and enhances distal tubule sodium reabsorption. chemo may alleviate some of the water retention caused by some cancers but non will completely inhibit ADH secretions. three percent saline administration in severe case only A pt is being admitted in HHS with dehydration and a serum glucose level of 836 mg/dl. Which additional laboratory findings should the nurse anticipate? - - - correct answer ✅> elevated BUN > Elevated creatinine >elevated osmolality HHNS - Hyperosmolar hyperglycemic nonketonic state

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A 49 year old patient male recently admitted with an inferiors wall MI resulting from 100% occlusion of the right coronary artery (RCA). The 12 lead ECG reveals ST elevation in leads 11, 111, and aVf. you would expect to see reciprocal changes in which leads? - - - correct answer ✅1 and aVL the RCA perfuses the inferior wall and the mirror image or reciprocal changes would be seen in the the high lateral wall, which is reflected in leads 1 and avl on the 12 lead ECG. Lead v1 and v2 correlate with the septal area, lead v 3 and v correlate with the anterior area of the heart a patient is admitted following a MVA , Lab data reveal elevated creatinine phosphokinase and myoglobin. What should the nurse anticipate? - - - correct answer ✅Rhabdomyolysis -MVA is a risk factor for rhabdomyolysis and lab data consistent with condition a patient is admitted with pulmonary hypertension. What should lead the nurse to suspect pulmonary fibrosis - - - correct answer ✅dyspnea at rest a patient is admitted 2 days ago with a large subdural hematoma has a rectal temp of 104. the fever is treated with iv acetaminophen and ice packs. Two hours later the fever increased to 104.9 what should the nurse be most concerned for .... - - - correct answer

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✅central nervous system ischemia - the patient most likely has a neurogenic fever due to injury of the hypothalamus A patient is at greatest risk for developing critical illness polyneuropathy? a patient with - - - correct answer ✅Lactate of 4.6 - sepsis has a strong link to the development of critical illness polyneuropathy When caring for a patient in status asthmaticus newly intubated on a ventilator, which ABG results demonstrates adequate values? - - - correct answer ✅ph 7.31 paco2 60 pao2 70 sao2 93% hco2 20 permissive hypercapnia upt to 50-60 and spo2 of >92% A patient with hx of bronchogenic carcinoma is admitted with resp failure. the patient is intubated and on mechanical ventilation. the patient develops lethargy, headache, slight confusion, and abdominal cramping. urinary output is decreasing lab results are serum na+ 127 serum osmolarity 270 urine specific gravity elevated - - - correct answer ✅initiate fluid restrictions sign and symptoms of SIADH

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P waves are not related to QRS in what type of AV block? - - - correct answer ✅third degree heart block A patient presents with chest pain. While obtaining a history recent cocaine use was discovered. The nurse should consult with the provider regarding the administration of a ..... - - - correct answer ✅beta blocker cocaine use constricts the blood vessels and increases the HR, BP and temp. Cocaine use puts the patient at risk for coronary vasospasm due to alpha adrenergic receptor activity a patient states i have pain radiating down my back and legs upon assessment bp is 190/105distal peripheral pulses are weak and there is a loud systolic murmur - - - correct answer ✅descending aortic dissection usually presents with pain radiating down the back and legs, hypertension fleeing distal pulses limb ischemia or a new murmur indicative of new aortic regurgitation One day following aortic valve replacement the patient develops atrial fibrillation with ventricular heart rate of 100. which should the nurse initially anticipate - - - correct answer ✅admin of betablocker

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beta blockers is the most effective pharmacological agent to prevent and manage atrial dysrhythmia after cardiac surgery a patient develops lethargy lab data reveals k+ 7.2 bp is 100/60 an ecg reveals the image ( monomorphic ventricular tachycardia ) - - - correct answer ✅calcium to stabilize the cardiac membranes the membranes needs to be stabilized with calcium to prevent ventricular fibrillation, calcium increases the ventricular threshold until hyperkalemia can be treated Pt Hx of uncontrolled HTN, ESRD and mitral valve stenosis is scheduled for a TAVR. The nurse should place a priority on which postoperative intervention - - - correct answer ✅frequent neurological assessment postop management include hemodynamic status and fluid balance and observe for signs of stroke and kidney injury