Endocrine and Gastrointestinal Disorders, Exams of Nursing

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NUR 519A Exam 3 Questions and Answers

Which is the most common STI? A. HPV B. chlamydia C. gonorrhea D. syphilis - CORRECT ANSWER B. chlamydia Chlamydia is transmitted via: A. bodily secretions B. genital to genital contact C. genital to genital AND mother to baby D. bodily secretions AND genital to genital contact - CORRECT ANSWER A. bodily secretions This STI can infect every organ in the body in a subtle manner. A. chlamydia B. syphilis C. gonorrhea D. HPV - CORRECT ANSWER B. syphilis Chlamydia and Gonorrhea are more common in those under 25 but syphilis is more common in: A. age 50+ B. age 30- C. age 16- D. age 25+ and transgender women - CORRECT ANSWER D. age 25+ and transgender women A male patient presents with dysuria, urethral discharge (clear/cloudy), meatus inflammation and proctitis. What are these symptoms of?

A. chlamydia B. syphilis C. gonorrhea D. HPV - CORRECT ANSWER A. chlamydia A patient presents with vaginal discharge, intermenstrual bleeding, anorectal discomfort and cervicitis. What are these symptoms of? A. chlamydia B. syphilis C. gonorrhea D. HPV - CORRECT ANSWER C. gonorrhea A patient presents with genital ulcers, skin rash, fever, and vision changes. What are these symptoms of? A. chlamydia B. syphilis C. gonorrhea D. HPV - CORRECT ANSWER B. syphilis Which patient is most likely to be diagnosed with benign prostatic hyperplasia? A. 45 y/o man with low potassium, frequent urination, and history of cancer B. 50 y/o man with frequent kidney stones, nocturia, and pain when urinating C. 75 y/o man experiencing nocturia, weak urine stream and obesity D. 60 y/o man experiencing polyuria and a hard lumpy prostate upon digital exam - CORRECT ANSWER C. 75 y/o man experiencing nocturia, weak urine stream, and obesity What is the key symptom of BPH? A. weak force of urine stream B. nocturia

C. bladder infection D. frequent urination - CORRECT ANSWER A. weak force of urine stream True/False BPH symptoms are rapid in onset. - CORRECT ANSWER False. Symptoms are gradual True/False There is no direct relationship with the size of the prostate and the severity of the symptoms. - CORRECT ANSWER True. There is no direct relationship with the size of the prostate and the severity of the symptoms. How does sildenafil (Viagra) work? A. It increases blood pressure to allow for rapid blood supply to the penis. B. It stimulates the production of testosterone. C. It alters hormones to increase sex drive. D. It promotes relaxation and vasodilation to the vessels that supply blood to erectile tissue - CORRECT ANSWER D. It promotes relaxation and vasodilation to the vessels that supply blood to erectile tissue. Sildenafil (viagra) patient teaching should include: A.take 30-60 minutes before sex B. it can work for 4-6 hours C. it should not be taken with hypertension medications because it can further decrease BP D. all of the above - CORRECT ANSWER D. all of the above Side effects of viagra include: A. headache and flushing B. stuffiness and hypotension C. upset stomach and indigestion D. all of the above - CORRECT ANSWER D. all of the above

True/False Viagra and other ED medications are not recommended for a patient who is taking nitrates, alpha blockers or other HTN medications because these medications together can cause sudden hypotension. - CORRECT ANSWER True When teaching a patient who has had a transurethral resection of the prostate (TURP), is on bladder irrigation, and is going home with a foley catheter, which of the following is not correct? A. the catheter may remain in place for 3-5 days B. there is potential for infection and bleeding after TURP C. patient can resume regular activity right away D. watermelon color urine with little-minimal clots is desired - CORRECT ANSWER C. Patients are only permitted light activity immediately postoperatively Patient teaching for bladder irrigation should include (select all that apply) A. Teach how to clean urethral meatus 1x/day B. Eat a diet high in dairy and simple carbs C. Increase fluid intake, at least 2L/day D. Practice kegel exercises E. Report bladder spasms or fever - CORRECT ANSWER A, C, D, E Instead of a diet high in dairy and simple carbs eat a high fiber diet and use laxatives. What is active surveillance? A. monitoring PSA once a month B. exploratory surgery C. digital exam D. watchful waiting - CORRECT ANSWER D. watchful waiting Who is more likely to get prostate cancer? (select all that apply) A. cyclists

B. someone who sits at a desk all day for work C. someone who smokes and drinks alcohol D. someone with a 1st degree relative who has had prostate cancer E. African Americans and Jamaicans - CORRECT ANSWER D, E Athletes such as bicyclists may have an elevated PSA but this does not increase their risk of prostate cancer. Prostate cancer is more common in men as they age. The median age is

67. Should we be concerned with a patient who is only 40 but has a brother with prostate cancer and an elevated PSA? - CORRECT ANSWER yes Prostate exams are recommended starting at the age 50 or 40-50 with a family history of the cancer. If a 55 year old man has a PSA of 3.0 what should be done? A. further evaluation B. complete a risk assessment (family history, race, results of previous biopsy, DRE) C. recommend follow up with HCP every other year D. no further action is needed - CORRECT ANSWER B Complete a thorough risk assessment 4.0 ng/mL or greater needs further eval 2.5-4.0 ng/mL complete a risk assessment (family history, race, results of previous biopsy, DRE) <2.5 ng/mL follow up with HCP every other year Risk factors for prostate cancer include all except: A. IBD B. diet high in red meat and high fat dairy C. diet low in fruit and vegetables D. obesity - CORRECT ANSWER A. IBD is not a risk factor for prostate cancer. Additionally, eat foods with lycopene (tomatoes), selenium and antioxidants to prevent prostate cancer. Treatment for prostate cancer can include: (select all that apply) A. brachytherapy

B. cryotherapy C. chemotherapy D. radical prostatectomy - CORRECT ANSWER A, B, C, D Symptoms of prostate cancer and BPH are similar except: A. urinary frequency B. dribbling C. dysuria, hesitancy D. pain in lumbosacral area that radiates down to hips - CORRECT ANSWER D Hematuria and pain in lumbosacral area that radiates down to hips is unique to prostate cancer True/False GERD is regurgitation of gastric contents into the esophagus due to immaturity of the lower esophageal sphincter. - CORRECT ANSWER True Symptoms of GERD in infants include: (select all that apply) A. milk drips out of the nose B. eating large amounts every 4 hours C. diarrhea D. irritability after eating - CORRECT ANSWER A, D milk drips out of the nose and irritability after eating Also, poor feeding, large amounts of emesis, slow or no weight gain Patient education for parents of infant with GERD should include all except: A. risk for aspiration and pneumonia B. keep the baby sitting up for 15-30 min after eating C. place the infant in the car seat after eating to keep them sitting up D. feed smaller portions slower with frequent burping - CORRECT ANSWER C. Do not place infant in car seat after eating. Also, teach parents infant CPR. Sudden arching of the head, neck, and upper trunk during feeding due to reflux are characteristics of:

A. reflux B. Sandifer's Syndrome C. pyloric stenosis D. GERD - CORRECT ANSWER B. Sandifer's Syndrome Forceful PROJECTILE VOMITING due to narrowing of pyloric sphincter between stomach and duodenum is a characteristic of: A. reflux B. Sandifer's Syndrome C. pyloric stenosis D. GERD - CORRECT ANSWER C. pyloric stenosis Symptoms of pyloric stenosis include: (Select all that apply) A. small palpable mass in epigastrum that feels like an olive B. occurs more in boys 4: C. pain is in LRQ but without peristaltic waves D. surgery is required to correct it - CORRECT ANSWER A, B, D Babies with pyloric stenosis are always hungry, irritable, poor weight gain and feedings must start small and slowly increase Nursing interventions for pediatric patients with pyloric stenosis include: A. Prepare baby for surgery, NPO, D5 IV fluids, post op monitoring, half- strength formula B. Prepare baby for surgery, NPO, NS IV fluids, infant massage C. Prepare baby for surgery, NPO, D5 IV fluids, post op monitoring, only water for 24 hours post op D. Prepare baby for surgery, NPO, NS IV fluids, NG tube formula feedings for 48 hours post op - CORRECT ANSWER A Prepare baby for surgery, NPO, D5 IV fluids, post op monitoring, half- strength formula Discharge teaching to parents whose baby has surgery to correct pyloric stenosis is effective if patient's mother says: A. surgery always corrects it B. this is more common in girls than boys

C. feed the baby 4-6 ounces per feeding D. I will report continuation of persistent vomitiing - CORRECT ANSWER D. I will report continuation of persistent vomiting A severe condition where part of the intestine slides into the adjacent part of the intestine and it blocks fluid or food from passing through. It also cuts off the blood supply to the part of the intestine that's affected, which can lead to perforation, infection, and bowel tissue death. A. Hirschsprung's disease B. Intussusception C. Obstructive bowel disease D. Celiac disease - CORRECT ANSWER B. intussusception Symptoms of intussusception include: (select all that apply) A. pain comes in 15-20 minute intervals B. vomiting, distention, and tachycardia C. currant jelly stool and D. vomiting, bloating and bradycardia - CORRECT ANSWER A, B, C True/False Intussusception is a serious condition but not emergent as long as it's corrected. - CORRECT ANSWER False Intussusception is an EMERGENCY and the most common intestinal obstruction in children younger than 3 yrs old. True/False In appendicitis, pain is located in the RLQ (McBurney's point). - CORRECT ANSWER True When pressing on LLQ if pain is felt in RLQ when released this is common "rebound pain" indicating appendicitis. A patient experiencing RLQ pain for several days is diagnosed with appendicitis. Suddenly the pain stops and the patient feels much better. What does this likely mean? A. appendix has ruptured and this is an emergency

B. appendix has begun to correct its inflammation C. this is not actually appendicitis D. this is not actually appendicitis and instead its Grave's disease - CORRECT ANSWER A Appendix has ruptured and this is an emergency Appendicitis is often associated with: A. Pain after internal rotation of flexed thigh B. Pain on passive extension of right hip C. Pain in right lower quadrant when jumping and landing on the heels D. all of the above - CORRECT ANSWER D. all of the above Pain after internal rotation of flexed thigh Pain on passive extension of right hip Pain in right lower quadrant when jumping and landing on the heels The adrenal glands sit on top of the kidneys and produce: A. TRH B. TSH C. T3 and T D. ACTH E. cortisol - CORRECT ANSWER E. cortisol The hypothalamus produces: A. TRH B. TSH C. T3 and T D. ACTH E. cortisol - CORRECT ANSWER A. TRH The thyroid gland produces: A. TRH B. TSH C. T3 and T D. ACTH E. cortisol - CORRECT ANSWER C. T3 and T

The anterior pituitary gland produces: A. TRH B. TSH C. T3 and T D. ACTH E. cortisol - CORRECT ANSWER B, D ACTH, TSH Which is considered the master gland? A. pituitary gland B. thyroid gland C. adrenal glands D. hypothalamus - CORRECT ANSWER A. pituitary gland If T3 and T4 high, then TSH is : A. high B. low C. equal - CORRECT ANSWER B. low They have an inverse relationship. With elevated circulating levels of thyroid hormones (T3 and T4), the hypothalamus decreases the secretion of TRH, and the anterior pituitary gland decreases secretion of TSH. Kelly is exhibiting neuromuscular irritability, tetany (tingling noted around the mouth and in her feet), dry skin and fingernails, more prone to cavities (you suspect weak tooth enamel). Her blood work is normal, except that hypocalcemia is noted. She is treated with supplemental calcium and Vitamin D. The disorder is: A. hyperthyroidism B. hypothyroidism C. hyperparathyroidism D. hypoparathyroidism - CORRECT ANSWER D. hypoparathyroidism

Duane, age 28, is hospitalized for this eighth kidney stone this year. He is also complaining of having to urinate large amounts frequently, bone tenderness and muscle weakness. His blood work is unremarkable, except for hypercalcemia. It is recommended that he have surgery to remove his parathyroid glands. The disorder is: A. hyperthyroidism B. hypothyroidism C. hyperparathyroidism D. hypoparathyroidism - CORRECT ANSWER C. hyperparathyroidism Autumn, age 30, has had noticeable weight gain resulting in purple striae (stretch marks) along the abdomen. She has increased deposits of adipose tissue in the face (moon face), the shoulders (buffalo hump), neck and trunk. She states that when she cuts herself, it takes "forever" to heal. She complains of an irregular heartbeat as well. A physical examination indicates hypertension (high blood pressure). Her blood work reveals hypernatremia, hypokalemia, and hyperglycemia. A urine test reveals glucosuria. Surgery is recommended to remove the involved glands. A. hyperthyroidism B. cushing's disease C. hypothyroidism D. addison's disease E. diabetes insipidus - CORRECT ANSWER B. Cushing's disease Jerome, age 17, is complaining of frequent urination, fatigue, dry mouth, dizziness, polydipsia (extreme thirst), and a craving for cold water. He is hospitalized to record his intake and output to obtain lab values. In a 24-hour period, he voided 7 liters of dilute urine and drank 8.5 liters of fluid. His blood pressure was an average of 72/36. Treatment involves discovering the cause, possibly a tumor in the pituitary gland. The disorder is: A. hyperthyroidism B. cushing's disease C. hypothyroidism D. addison's disease

E. diabetes insipidus - CORRECT ANSWER E. diabetes isipidus Rebecca, age 33, states she has lost a lot of weight in the past 6 months. She claims this is surprising due to her voracious appetite. She complains of her heart racing in her chest, difficulty concentrating, and nervousness. She claims that she can no longer tolerate heat, even though she grew up in New Zealand. Her eyes are protruding, a condition called exophthalmos. Examination reveals an enlarged thyroid gland. Treatment would include anti-thyroid drugs and possibly surgery to remove part of the thyroid gland. The disorder is: A. hyperthyroidism B. cushing's disease C. hypothyroidism D. addison's disease E. diabetes insipidus - CORRECT ANSWER A. hyperthyroidism True/False Normal value of T4 is 0.4-4.02 - CORRECT ANSWER True hypothyroidism is associated with: (select all that apply) A. hyponatremia B. hypokalemia C. hyperkalemia D. hypohloremia - CORRECT ANSWER A, B, D hyponatremia, hypokalemia, and hypohloremia are all associated with hypothyroidism A goiter is related to: (select all that apply) A. excess iodine levels B. iodine deficiency C. enlarged thyroid D. swelling caused by lack of sodium - CORRECT ANSWER B, C A goiter is an enlarged thyroid due to low iodine levels. Which electrolyte is most important in the endocrine system?

A. sodium B. chloride C. calcium D. magnesium - CORRECT ANSWER C. When blood calcium levels are low, your parathyroid glands secrete PTH. to help your bones release calcium into the blood. Low production of PTH causes: A. hypocalcemia and hyperphosphatemia B. hyponatremia and hypocalcemia C. hypercalcemia and hypernatremia D. hypokalemia and hypernatremia - CORRECT ANSWER A Low PTH causes hypocalcemia and hyperphosphatemia If PSH is above normal: A. hyperparathyroidism B. hyperthyroidism C. hypoparathyroidism D. hypothyroidism - CORRECT ANSWER D. hypothyroidism What kind of feedback loop is found in the endocrine system? A. negative B. positive - CORRECT ANSWER A negative What are the nursing priorities for a patient who has had a thyroidectomy? (select all that apply) A. ABCs, especially airway B. assess for tetany and monitor vitals C. have patient get up slowly D. emotional support and promote rest E. trach tray at bedside - CORRECT ANSWER A, B, D, E

Also monitor weight, fluid balance, protect eyes if bulging, encourage balance of physical activity and energy conserving activities and monitor for thyroid storm. Spasms and decreased calcium in parathyroid glands is: A. hyperparathyroidism B. precursor to thyroid cancer C. tetany - CORRECT ANSWER C. tetany When gently tapping over the cheek, 2 cm in front of the ear you see a twitch in the cheek, this is: A. Trousseau sign B. Chovstek sign C. goiter D. hyperthyroidism - CORRECT ANSWER B Chvostek sign When the hand and wrist turn in after the sphygmomanometer cuff is inflated above the systolic blood pressure within 3 minutes. A. Trousseau sign B. Chovstek sign C. goiter D. hyperthyroidism - CORRECT ANSWER A. Trousseau sign Thyroid storm is: (select all that apply) A. extreme case of hyperthyroidism B. life-threatening C. bradycardia, dyspnea and hypercalcemia D. chronic, hoarse voice, tetany - CORRECT ANSWER A, B A patient presents with, headache, salt cravings, alopecia, abdominal and low back pain, anxiety, dark pigmented skin and mucous membranes, weight loss, vomiting and diarrhea. These are all symptoms of: A. Addison's disease

B. Cushing's sydrome C. SIADH D. Diabetes Insipidus - CORRECT ANSWER A. Addison's disease Nursing assessment for Addison's disease should include: A. Assess cortisol, potassium, sodium B. Monitor lab values, vitals, prevent falls C. chloride, gluose, BUN D. Monitor EKG E. all of the above - CORRECT ANSWER E all of the above Steroid medication will need to be adjusted during times of stress/surgery/sepsis; diet high in protein, carbs, sodium; don't abruptly stop taking steroids; medication is not a cure and hormone replacement is lifelong are all patient teaching for: A. Addison's disease B. Cushing's syndrome C. SIADH D. Diabetes Insipidus - CORRECT ANSWER A. Addison's disease High BP, high glucose, infections, weight gain, increased abdominal weight, and brittle bones are all symptoms of: A. Addison's disease B. Cushing's disease C. SIADH D. Diabetes Insipidus - CORRECT ANSWER B. Cushing's disease Patient teaching for Cushing's disease should include: A. Don't stop steroids abruptly, taper off gradually B. Drug therapy to inhibit adrenal function C. Monitor glucose levels and prevent falls D. Avoid extreme temperatures and stress

E. all of the above - CORRECT ANSWER E all of the above What is a mastectomy? A. tumor removal in breast cancer B. chemo treatment for breast cancer C. surgical removal of breast tissue D. removal of lymph nodes - CORRECT ANSWER C surgical removal of breast tissue What is the first line treatment for endometriosis? A. hysterectomy B. hysterectomy and oophorectomy C. gonaotropin-releasing hormone (GnRH) agonists D. oral contraceptives - CORRECT ANSWER D Oral contraceptives When uterine endometrial glands exist and grow outside the uterine cavity or endometrium, often resulting in pain this is: A. cervical displagia B. endometriosis C. uterine cancer D. polycystic ovarian syndrome - CORRECT ANSWER B Endometriosis True/False A patient with endometriosis should keep a menstrual calendar. - CORRECT ANSWER True While understanding that endometriosis is often acyclic, patients can chart symptoms in relation to their menstrual cycles to determine whether a pattern exists. A patient who has had a hysterectomy needs discharge education that includes: A. do not put anything in the vagina for 6 weeks

B. estrogen therapy may be needed if you have reached the age of menopause or your ovaries were also removed C. seek immediate medical care if fever, abdominal pain, chest pain, shortness of breath, passes out, pain swelling or redness of your legs, heavy vaginal bleeding with or without clots D. Women who have had a total hysterectomy for benign cause and with no history of cervical intraepithelial neoplasia in the preceding 20 years should not have any further Pap smears. E. all of the above - CORRECT ANSWER E all of the above Most common sexually transmitted virus that may cause cervical cancer. A. Chlamydia B. HPV C. Gonorrhea D. Syphilis - CORRECT ANSWER B. HPV Prevention of cervical cancer from HPV should include: (select all that apply) A. routine screening (pap smear) B. oral contraceptives C. HPV vaccine D. pregnancy - CORRECT ANSWER A, C 12 months of no vaginal bleeding, or amenorrhea in women typically in their 50s is A. ovarian cancer B. endometriosis C. perimenopause D. menopause - CORRECT ANSWER D menopause Symptoms of menopause include which of the following? (Select all that apply.)

A. Osteoporosis B. Increased uterine bleeding C. Vaginal atrophy D. Hot flashes E. Abdominal pain - CORRECT ANSWER A, C, D The time during which your body makes the natural transition to menopause, marking the end of the reproductive years. It is also called the menopausal transition and starts typically in the 40s, can start as early as the mid-30s. - CORRECT ANSWER perimenopause Symptoms of perimenopause include: A. Irregular periods B. Mood changes C. Decreasing fertility D. Changes in sexual functioning E. all of the above - CORRECT ANSWER E all of the above How are hormones are used for someone who's going through menopause or has had TAHBSO? A. to relieve symptoms of menopause B. to treat conditions like bone loss C. to replace declining estrogen and progesterone levels. D. can only be used if patient has had a hysterectomy - CORRECT ANSWER A, B, C When there are abnormal, or precancerous, cells in and around a woman's cervix. - CORRECT ANSWER cervical displasia (HPV is the primary cause) How is cervical displasia diagnosed? A. pap smear B. after hysterectomy C. biopsy D. when estrogen levels falls below 20 - CORRECT ANSWER A, C pap smear and biopsy

(people usually don't have symptoms so screening is very important) If the Pap smear reveals dysplasia or atypical cells with the presence of HPV, the patient is referred for A. colonoscopy B. cervical biopsy C. both a and b D. none of the above - CORRECT ANSWER C both a and b True/False Guillain-Barré syndrome (GBS), another disorder of the PNS, is an acute inflammatory demyelinating polyneuropathy (simultaneous neuropathy of peripheral nerves). It often occurs after an infection and leads to a rapidly progressing flaccid paralysis. - CORRECT ANSWER True GBS Acute Stage: starts with the onset of clinical manifestations of peripheral nerve demyelination (destruction of myelin sheath), edema, and inflammation and lasts approximately 4 weeks. Plateau Stage is what happens in recovery stage of GBS? A. onset of clinical manifestations of peripheral nerve demyelination (destruction of myelin sheath) and lasts about 4 weeks. B. when demyelination ceases and lasts from a few days to weeks C. remyelination and axonal regeneration begin, and there is a gradual improvement in the patient's signs and symptoms. - CORRECT ANSWER C. Remyelination and axonal regeneration begin, and there is a gradual improvement in the patient's signs and symptoms. Respiratory status is monitored in terms of breath sounds and forced vital capacity. Because ventilation is compromised by the loss of motor innervation to the skeletal muscles of respiration, these patients are at risk for respiratory compromise. A. Parkinsons disease B. Alzheimers disease

C. ALS

D. GBS - CORRECT ANSWER D

GBS

Nursing actions for GBS include: A. keep a trach tray at bedside B. assess the ABCs C. monitor for new numbness, tingling, pain D. prevent falls E. all of the above - CORRECT ANSWER E all of the above In GBS patients, we expect to see: (select all that apply) A. respiratory or GI infections B. bilateral and symmetric disturbances in lung function C. weakness and numbness in legs that moves upward toward respiratory muscles D. use of seizure medication - CORRECT ANSWER A, B, C Symptoms of Parkinson's disease include: A. tremors of head and knees B. slow shuffling gate C. stiff and rigid trunk D. upright posture E. hypomimia (facial masking that makes it difficult to make facial expressions) - CORRECT ANSWER A, B, C, E The 4 cardinal signs of Parkinson's disease are: A. tremor, bradykinesia, rigor and postural instability B. tremor, slow speech, tachycardia, drooling C. slow speech, rigor, memory loss, muscle weakness - CORRECT ANSWER A tremor, bradykinesia, rigor and postural instability are the cardinal signs of parkinson's

Eye response, verbal response and motor responses are scored on a scale from 3-15 to determine level of consciousness. - CORRECT ANSWER Glasgow coma score A GCS score of 8 or less indicates: A. no deficits B. coma C. severe neurological issue D. minor neurological issue - CORRECT ANSWER C severe neurological issue What would be the highest nursing priority for a patient who's had a brain attack or a stroke with neurological deficits? A. delerium B. aspiration C. bronchospasm D. palpitations - CORRECT ANSWER B aspiration always remember ABCs A rapidly progressing, fatal CNS (brain and spinal cord) disease that affects voluntary muscle control. It is the most common adult-onset motor neuron disease. - CORRECT ANSWER Lou Gherig's disease (ALS) Symptoms of ALS include: A. muscle cramps or stiffness B. muscle weakness on one part of the body first C. tremors D. slurred speech and difficulty swallowing (dysphagia) - CORRECT ANSWER A, B, D True/False To be diagnosed with ALS, patients will have upper or lower motor neuron damage that cannot be attributed to other causes. - CORRECT ANSWER False They must have BOTH upper and lower

Which of the following CNS chronic degenerate progressive diseases is characterized by small patches of demyelination in the brain and spinal cord? A. ALS B. Alheimers C. Parkinsons D. MS - CORRECT ANSWER D MS (degenerative, chronic neurological disorder in which the nerves of the CNS (brain and spinal cord) Forgetfulness that progresses with time, short-term memory decline, cognitive impairment, inability to handle personal finances, inability to self- manage medications and motor and verbal skill decline. - CORRECT ANSWER Alzheimers disease How do you know if Alzheimers disease is progressing and getting worse? A. changes in personality B. inability to perform multiple or complex tasks C. anger or hostility D. increased appetite due to forgetting to eat - CORRECT ANSWER A, B Poor feeding, sucking or muscle tone, irritability, vomiting, apnea, increase or decrease in temperature, seizures and full or bulging fontanel are all symptoms of - CORRECT ANSWER Meningitis True/False Viral meningitis is life threatening - CORRECT ANSWER False Bacterial is life-threatening Priorities of care after a diagnosis of bacterial meningitis in peds patient are: (select all that apply) A. isolation B. negative pressure ventilation C. administer antibiotics D. daily weights with I&O monitoring E. NPO - CORRECT ANSWER A, C, D

What are the priorities for a child who is actively seizing? (select all that apply) A. aspiration prevention B. protect head and airway C. suction and O2 ready at bedside D. lay patient on his back - CORRECT ANSWER A, B, C Also, padding on beds, administer meds if appropriate How do you prepare a patient for lumbar puncture? - CORRECT ANSWER lateral side lying, knees to chest, sitting up and bent over Nursing considerations for lumbar pucture include all except: A. HOB at 65-90 degress B. measure head circumference C. decrease environmental stimuli d. monitor anterior fontanel - CORRECT ANSWER A. HOB should be at 30-45 degrees What is the therapy for children with cerebral palsy since there is no cure? A. physical therapy B. educational therapy C. occupational and speech therapy D. all of the above - CORRECT ANSWER E all of the above Signs of cerebral palsy in infants include all except: A. poor head control and hypotonia B. moving only one side of the body C. extreme irritability and feeding difficulties D. GERD - CORRECT ANSWER D GERD is not a symptom of CP If a toddler presents with fever, lethargy, difficulty to arouse and grumpy all day we should always suspect:

A. Group B strep B. Meningits C. RSV D. Whooping cough - CORRECT ANSWER B meningitis Assessment for a toddler with fever, lethargy, irritability and difficulty to arouse should always include: A. lumbar puncture B. lumbar puncture and blood cultures C. blood cultures D. lumbar puncture and abuse - CORRECT ANSWER B. lumbar puncture and blood cultures

• An elevated white blood count (>1,000/mm3)
• Elevated protein count (greater than 50 mg/dL)
• Low glucose level (<40% of serum glucose)
• The CSF will also be cloudy in appearance. - CORRECT ANSWER Bacterial meningitis
• The white blood count is variable, is normal to elevated (>50 mg/dL)
• The glucose count is low (<40% of serum glucose) - CORRECT ANSWER fungal meningitis
• The white blood count is low (<100/mm3)
• The protein count is normal to elevated (>50 mg/dL)
• The glucose level is normal to high (>60% of serum glucose)
• The CSF is clear. - CORRECT ANSWER viral meningitis An umbrella term for two similar chronic diseases of the GI tract: Crohn's disease and ulcerative colitis. - CORRECT ANSWER Inflammatory bowel disease (These conditions may develop when the body's immune system attacks parts of the digestive tract. A clue to the presence of inflammatory bowel disease is the presence of blood in the stool.) If a patient has chronic diarrhea we worry about all except: A. IBS and dehydration

B. Chrohn disease and ulcerative colitis C. hyperkalemia and hypernatremia D. Malabsorption syndromes in which food cannot be digested and absorbed, and chronic infections. - CORRECT ANSWER C hyperkalemia and hypernatremia What kind of precautions do you place a patient with C. Diff on? A. contact B. airborne C. droplet D. contact-isolation - CORRECT ANSWER D Contact-isolation Hand washing with soap and water instead of sanitizer, vancomycin, and IV fluids are all typical with patients who have: A. Hepatitis C B. Liver cirrhosis C. C. diff D. pancreatitits - CORRECT ANSWER C. c-diff What causes the ascites to happen in patients with advanced liver cirrhosis? A. Liver tissue no longer filters and functions B. Blockage of the vessels in the liver causes portal hypertension causes blood to backs up C. Esophageal varices develop D. Serum albumin is decreased E. all of the above - CORRECT ANSWER E all of the above What is the most common cause of cirrhosis? A. alcohol abuse B. Hepatitis C C. cholecystitis D. overuse of NSAIDS - CORRECT ANSWER B