CMSRN Exam Questions with 100% Correct Answers | Verified | Updated 2024, Exams of Advanced Education

Download CMSRN Exam Questions with 100% Correct Answers | Verified | Updated 2024 and more Exams Advanced Education in PDF only on Docsity! CMSRN Exam Questions with 100% Correct Answers | Verified | Updated 2024 Examples of third spacing - Correct Answer-Ascites, edema, burn Dilutional Hyponatremia - Correct Answer-Excessive fluid intake Edema, confusion, weight gain Treatment: decrease fluid intake "swells, rings tight" True Hyponatremia - Correct Answer-Loss of fluid and Na Weight loss, DRY, hypotensive, tachy, DEHYDRATED Tx: replace both sodium and water Hypernatremia Causes - Correct Answer-Fevern unresponsive to traditional interventions, Na IV fluids, DI, tube feeds Hypernatremia Symptoms - Correct Answer-DRY, thirst, tachy, oliguria(compensating) Hypernatremia treatment - Correct Answer-Decrease Na and replace fluids Cl - Correct Answer-Acts like Na Buffer to maintain pH Hyperkalemia Causes - Correct Answer-Cell wall destruction Increased intake K sparing diuretics Renal failure Acidosis Hyperkalemia symptoms - Correct Answer-Irritable muscles Dysrhythmias Hyperactive bowels/bladder- diarrhea, frequency, urgency Hyperkalemia tx - Correct Answer-Limit intake Kayexalate Ca gluconate IV glucose Dialysis Hypokalemia Causes - Correct Answer-Vomiting Diarrhea NG suction Decreased PO Burns K wasting diuretics Hypokalemia Symptoms - Correct Answer-Muscle flaccidity- not there to stimulate Weakness Constipation Alkalosis-resps Shallow Resps Cardiac arrest Hypokalemia Tx - Correct Answer-Supplement Foods high in potassium - Correct Answer-Citrus fruits and dried fruits, bananas, watermelon, potatoes, legumes, tea and peanut butter, avocado Calcium purpose - Correct Answer-Sedative at nerve level Coagulation- look at level with invasive procedures!! Bone/teeth strength Hypercalcemia Causes - Correct Answer-Cancer Metastatic bone disease hyperparathyroidism Thiazide diuretics Excessive vitamin D Hypercalcemia Symptoms - Correct Answer-Sedation Lethargy Hypoactive reflexes Slurred speech Impaired memory Hypercalcemia Tx - Correct Answer-Decrease intake Fluids Loop diuretics Give phosphate Hypocalcemia Causes - Correct Answer-Decrease PO of Ca and Vitamin D Increased Phosphate Renal disease Alcoholism Pregnancy POST PARATHYROIDECTOMY Hypocalcemia Symptoms - Correct Answer-Tetany Viral infection ETOH Pancreatitis signs and symptoms - Correct Answer-Pain N/V Abd distension Fever Hypoactive or silent bowel sounds Grey Turner sign Elevated pancreatic enzymes Pancreatitis treatment - Correct Answer-Rest the pancreas- NPO Pain control Fluid and electrolyte replacement Nutrition support- maybe TPN Surgery Liver functions - Correct Answer-Antibody production Coagulation- prothrombin, fibrinogen, albumin Glucose metabolism Bile salt formation Detox of noxious agents- excretion Hepatitis A - Correct Answer-Fecal oral Hepatitis B - Correct Answer-Body fluids- drug use, sexual intercourse Hepatitis C - Correct Answer-BLOOD TRANSMISSION WITH TRANSFUSION IS RARE Drug use, sexual intercourse High correlation with hepatitis C and liver cancer Stages of Hepatitis - Correct Answer-Prodromal -I wk- 10 days -malaise, fever, anorexia Icteric -Liver unable to convert bilirubin to bile- jaundice -Bile out through urine- tea colored Post-icteric -2-4 mo Recovery -up to one year -Blood tests over 1 yr -Contagious as long as antigen positive in blood Liver failure causes - Correct Answer-Drug toxicity- Tylenol number one trigger Hep B or C Cirrhosis Cancer Liver failure signs and symptoms - Correct Answer-Ammonia- neuro neuro neuro Ascites Portal HTN Encephalopathy GI symptoms Bleeding- clotting factors disrupted- spider angiomas, skin lesions Liver failure diet - Correct Answer-High cal low protein- increase ammonia Low fat low Na Causes of respiratory alkalosis - Correct Answer-Anxiety/pain-hyperventilation PE Mechanical ventilation Salicylate OD Causes of respiratory acidosis - Correct Answer-Hypoventilation Opioid OD Cardiac arrest Pulmonary disease Musculoskeletal disorders- nonambulatory pts Head trauma Causes of metabolic alkalosis - Correct Answer-Diuretics Cushing's r/t corticosteroid therapy Excessive antacids NG suction Vomiting Causes of metabolic acidosis - Correct Answer-DKA Renal failure Poisoning Diarrhea Chronic bronchitis - Correct Answer-Chronic, productive cough SOB Airway remodeling Mucus production- increased infection risk "healthy glow" healthy weight Local crackles Tachypneic Expiratory wheezes Hacking, rasping Empysema - Correct Answer-Little sputum Barrel chest Accessory muscle use Weight loss- decrease appetite from WOB Very hypoxic Tachypneic Fine crackles Considerations for COPDers - Correct Answer-No more than 2 L O2- will eliminate drive to breathe if over oxygenated- drive to breathe is high CO2 and low O2 Teach pursed lip breathing High protein High cal Live at 86%-88% TB risk factors - Correct Answer-Immunosuppressed Jail, overcrowded living conditions Prolonged contact with those already infected TB signs and symptoms - Correct Answer-Persistent, productive cough with hemoptysis Night sweats Fever/Chills Chest pain Anorexia/weight loss TB diagnostic tests - Correct Answer-Chest xray- consolidation Bacilli in sputum Positive blood test PPD not definitive- if positive need quantiferon or T spot- t spot better less false positives TSpot- 48-72 hours for results *Ask where from- Eastern Europe, India, Asia has vaccine TB treatment - Correct Answer-Meds minimum of 6 months Ionazid, Rifampin, Pyrazinamide Need T Spot or 3 neg sputum- latent Chest Tube considerations - Correct Answer-Used to reestablish negative pressure in chest cavity Increase oxygen Physician changes dressing- or we need order OK to disconnect from suction for procedures to walk etc *Fluid in H20 seal will rise and fall with breathing- occasional bubbles OK, continuous bubbles in water seal is a LEAK*