NUSC 1165 FINAL EXAM NEWEST 2024- 2025 ACTUAL EXAM QUESTIONS AND DETAILED CORRECT ANSWERS, Exams of Nutrition

Download NUSC 1165 FINAL EXAM NEWEST 2024- 2025 ACTUAL EXAM QUESTIONS AND DETAILED CORRECT ANSWERS and more Exams Nutrition in PDF only on Docsity! NUR251 CDU FINAL EXAM PRACTICE TEST ACTUAL EXAM NEWEST QUESTIONS AND DETAILED CORRECT ANSWERS WITH RATIONALES | 2024- 2025 What is the most likely treatment plan for reoccurring endometrial cancer? Correct Answer Progesterone therapy. Endometrial cancer is the most common invasive gynaecological cancer in Australia. Surgery is the treatment of choice for primary diagnosis of endometrial cancer. Approximately 1/3 of women respond well to progesterone therapy with chemotherapy the least effective. Whilst inserting an indwelling catheter you observe blisters on a female patient's labia majora. On further assessment she states the blisters are new onset and painful. What is the most likely cause of these symptoms? Correct Answer First episode of genital herpes. Red papules appear 2-10 days after exposure to the herpes virus with the first outbreak or first episode lasting up to 12 days. The clear fluid in the papules contains virus particles and is highly infectious. Whilst inserting an indwelling catheter you observe cauliflower shaped lesions on the shaft of a male patient's penis. What is the most likely condition causing this? Correct Answer Genital warts. Genital warts (condyloma acuminate) are caused by the human papillomavirus (HPV) which is chronic, incurable and largely asymptomatic. During a nursing assessment a female patients stated an abnormal watery vaginal discharge with an offensive 'fishy' odour. What is the most likely cause of these symptoms? Correct Answer Bacterial vaginosis. Non-specific vaginitis is the most common cause of vaginal infections in women of reproductive age and is easily treated with oral or intravaginal antibacterial agents. You are providing discharge education to a female patient diagnosed with the STI chlamydia. Which of the following statements would not be included? Correct Answer Now you have had it once you cant can't get it again. Chlamydia is asymptomatic in most women until the uterus and fallopian tubes have been invaded and delay in treatment can result in devastating long term complications with fertility. Regular screening is recommended for people who are young, sexually active and do not use condoms. Sexual health assessment is essential to the prevention and control of STIs. When conducting an assessment remember to include the 5Ps - partners, prevention of pregnancy, protection from STIs, current practice and past history. Good, professional, non-judgemental communication is key in sexual health assessment. Which sexually transmitted virus causes cervical cancer? Correct Answer Human papillomavirus. Almost all cervical cancer is caused by the human papillomavirus (HPV). Current screening using pap smears is recommended for all sexually active females every 2 years. The Gardasil vaccine has been included to the National Vaccination Program which will see changes to screening in the future. What is NOT a function of the kidneys? Correct Answer Hormone production including insulin. Excretion: the removal of wastes from body fluids. Elimination: the elimination of wastes from the body. Homeostatic: regulation of the volume and solute concentration of plasma in the blood. Which of the following is a normal result from a urinary sample? Correct Answer Light - straw to amber - yellow coloured urine. When assessing a patient, ask about changes in urinary habits, frequency, pain and smell. Also ask about recent food intake or changes to diet as some food can cause distinct odours in urine. Remember medications can also affect the appearance of urine (e.g. Vitamin B can produce bright yellow urine) The patient you are provide nursing care to, complains of severe pain to bilateral flank region. What could this indicate? Correct Answer Acute kidney pain. When assessing a patient always explore the location, duration and intensity of their pain. Kidney pain is experienced in the back region, costovertebral angel and may spread to the umbilicus. If pain is associated with pyuria and infective process is indicated. The patient you are providing nursing care to state urinary symptoms during assessment. What further investigation will you conduct? Correct Answer Urinalysis. A routine urinalysis (dipstick) from a clean catch urine sample will provide a quick snapshot of any abnormalities. If sample results are abnormal, it should be sent off for MSU test to determine causative agent. The glomerular filtration rate (GFR) of >90mL/min/1.73m2 indicated normal kidney function? Correct Answer True. Glomerular filtration rate is the passive, nonselective process where hydrostatic pressure forces fluid and solutes from the blood into the glomerular capsule. Remember to keep in mind age related renal changes which can be as low as 60mL/min/1.73m2 for this cohort. On inserting a urinary catheter a patient voids 450mls. What is this urine output considered to be? Correct Answer Normal. In healthy adults the bladder holds about 300-500mls of urine. However, it can hold more than twice that amount if necessary. Normal hourly output should be above 30mls/hr. Results from a routine urinalysis show +3 ketones in the urine. What could this indicate? Correct Answer Diabetes mellitus. Presence of ketones in the urine is called ketonuria. When the body is unable to get enough glucose for energy it will use body fats. Ketones are the result of body breaking down these fats to use for energy. Normal ketones should be negative. A patient with an indwelling catheter is demonstrating signs of bacteriuria. Which of the following would be the recommended treatment plan? Correct Answer Remove the catheter and begin antibiotic therapy. A person with acute kidney injury (AKI) is prescribed frusemide. Why is this medication helpful? Correct Answer It will reduce oedema. Frusemide is a loop diuretic. In AKI the kidneys are unable to excrete adequate urine to maintain a normal extracellular fluid balance. Oedema results from fluid retention and heart failure can develop. A person who is recovering from acute renal injury is being discharged. Which of the following should the nurse include in the discharge instructions? Correct Answer Avoid alcohol. During recovery nephrons remain vulnerable to damage by nephrotoxins. Alcohol increases the nephrotoxicity of some materials so it is discouraged. The most common cause of kidney damage is: Correct Answer Blunt trauma. Injury ranges from small contusion to haematomas to fragmentation or shattering of the kidney that causes significant blood loss and urine extravasation. Tearing of renal vessels may cause rapid haemorrhage and death. A person diagnosed with only 45% of the normal glomerular filtration rate is experiencing which of the following: Correct Answer Renal insufficiency. Renal insufficiency is the broad term describing any condition in which kidneys are unable to remove accumulated metabolites from the blood, leading to altered fluid, electrolytes and acid-base balance. A patient undergoing haemodialysis must have their vascular access site assessed for pulsation or vibration and an audible bruit? Correct Answer True. Infection & thrombus formation are the most common problems affecting the access site in haemodialysis. Always alert staff to the extremity with the vascular access so it is not used for any procedures, this can damage vessels and lead to failure of the arteriovenous fistula Stage 4 kidney disease is also known as end stage kidney disease? Correct Answer False. Stage 5 is also known as end stage kidney disease is the terminal phase of CKD, kidney replacement therapy is needed to sustain life. The postoperative instruction is to ambulate the patient gradually. You are aware the patient is feeling weak from inadequate fluid pre and intra operatively. How can you implement these instructions? Correct Answer Assist the person to move into different positions in stages. The person with fluid volume deficit is at risk of injury because of dizziness and loss of balance resulting from decreased cerebral perfusion secondary to hypovolaemia. Teach ways to reduce orthostatic hypotension - go slowly. A person is prescribed 40mEq potassium replacement. How should this be administered? Correct Answer Mixed in the prescribed intravenous fluid. Potassium should always be diluted and administered using an electronic infusion device. It should be given no quicker than 10-20mEq/hour. Rapid administration of potassium can lead to hyperkalaemia and cardiac arrest. A man has been admitted with elevated serum sodium levels after being stranded in bushland for 5 days with no fresh water. Which of the following is he most at risk of developing? Correct Answer Cerebral bleeding. Rapid water replacement or rapid changes in serum sodium or osmolality can cause fluid shift within the brain, increasing the risk of bleeding and/or cerebral oedema. In severe, acute cases of hypernatraemia, the osmotic shift of water from cells leads to shrinkage of the brain with tearing of the meningeal vessels resulting in intracranial haemorrhage. A patient has been admitted with acute renal failure. Which electrolyte will be most affected? Correct Answer Potassium. Impaired renal excretion of potassium is the primary cause of hyperkalaemia. Kidneys control the balance of Radical orchidectomy is used in all forms and stages of testicular cancer. Nursing care is complex and the must be inclusive of patient reactions to diagnosis, change to body image and sexual/reproductive issues. What patient education is needed to manage the symptoms of prostatitis? Correct Answer Void frequently; Maintain regular bowel movements; Increase fluid intake to approx. 3L daily. Prostatitis refers to different types of inflammatory disorders of the prostate gland. Education focusses on symptom management. Urinary incontinence is not a normal part of aging. What is the most common cause urinary problem in men? Correct Answer Benign prostatic hyperplasia. Benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate gland and is a common disorder of the ageing male. Nursing care focuses on correcting or minimising the urinary obstruction and preventing or treating complications. A TURP can be performed to treat benign prostatic hyperplasia (BPH), what does TURP stand for? Correct Answer Transurethral resection of the prostate. A transurethral resection of the prostate is the most common surgical procedure used to treat BPH. The obstructing prostate tissue is removed using a wire loop resectopscope and electrocautery inserted through the urethra. Early stage prostate cancer is often asymptomatic? Correct Answer True. Symptoms which may occur are due to metastasis of bone and can affect the genitourinary, musculoskeletal and neurological systems. You are providing nursing care to a 55 year old female patient who voices concerns about constant anxiety, inability to sleep, headaches and just not feeling like herself. What is the most likely cause of these symptoms? Correct Answer Menopause. Nursing care for women experiencing menopausal symptoms focuses on symptomatic relief and education. Menopause is the permanent cessation of menses and is a normal physiological process. A female complains about increasing premenstrual symptoms over the past few years and thinks something must be wrong. What is the most likely cause? Correct Answer Normal pattern of premenstrual syndrome (PMS). Premenstrual syndrome (PMS) is a complex group of symptoms from mood swings to breast tenderness, fatigue, irritability, food cravings and depression. Usually limited to 2-14 days and self-resolving. The nurse is assisting a female patient with ways to reduce the severity of her monthly menstrual discomforts associated with PMS. What healthy lifestyle choices may provide symptom relief? Correct Answer Limited alcohol intake; Regular exercise; Relaxation techniques. Teaching complementary therapies and coping mechanism is helpful. Techniques for relaxation and stress management include deep abdominal breathing, medication and muscle relaxation. Alcohol and unhealthy diets should be avoided as it exacerbates the symptoms of PMS. What factors most likely contribute to a uterine prolapse into the vaginal canal? Correct Answer Multiple pregnancies. When the uterus is displaced within the pelvic cavity, it can be mild to completely prolapsed (outside the vagina) it is commonly due to weakened pelvic musculature usually attributable to stretching of the supporting ligaments and muscles during pregnancy. Which of the following is not a term for dysfunctional uterine bleeding? Correct Answer Dyspareunia. Dysfunctional uterine bleeding is any abnormal volume, duration or time of bleeding. Factors including stress, Specific gravity measures the concentration of urine. When someone is dehydrated, the kidneys conserve water resulting in the increased specific gravity and osmolality of urine. A patient states they are experiencing several days of watery diarrhoea and abdominal/muscle cramping. What condition are they most at risk of? Correct Answer Hyponatraemia. These signs are very early indicators of decreasing sodium levels. As they continue to decrease the brain and nervous system are affected by cellular oedema. When sodium levels drop dangerously low convulsions or coma are likely. You perform an ECG with has peaked T waves and widened QRS complexes. What is the most likely cause? Correct Answer Hyperkalaemia. Hyperkalaemia alters the cell membrane, increasing the concentration of potassium outside the cell. Cardiac depolarisation is decreased as a result. All ECGs needs to be reviewed by a medical officer to initiate the appropriate treatment. You are providing nursing care to a patient with a history of sodium retention. During assessment you identify skipping heart beats and leg tremors. What is the most likely cause? Correct Answer Using salt alternative. Salt substitutes usually contain potassium. These are symptoms of hyperkalaemia. Take the opportunity to discuss the importance of hydrating using adequate fluids to maintain renal function and eliminate potassium from the body. A patient is having a blood transfusion. You note their temperature has risen from 36.3oC to 37.5oC and they feel flushed. What is not a correct nursing intervention? Correct Answer Administer 1g paracetamol. Adverse reactions to blood transfusions can be mild to life threatening. Baseline vital signs prior to transfusion are a critical step. Continue to check and monitor your patient's vital signs whilst you wait for the doctor to attend. DOCUMENT as soon as possible. You have received blood products from the blood bank for a transfusion. How long can you keep it out of the fridge for? Correct Answer Must be used within 4 hours. Due to increased risk of bacterial growth in the products when out of refrigeration, all transfusion should be completed within 4 hours. Unrefrigerated bloods not used within 4 hours must be returned to the blood bank. The mechanism of hypertonic solutions in equalising the fluid concentration is: Correct Answer Osmosis. The higher osmotic pressure draws water out of the cells into the ECF therefore it initially expands the ECF. Hypertonic solutions are useful in the treatment of hypovolaemia and hyponatraemia. The fluid replacement of choice for a patient with fluid volume deficit is: Correct Answer Hartmann's. Isotonic solutions such as Hartmann's and 0.9% normal saline expand only in the ECF which is ideal replacement for patients with fluid volume deficit. Ensure you commence a fluid balance chart and monitor hourly urine output. You are reviewing a person's blood pH level. Which body system helps regulate blood pH? Correct Answer Renal. The renal system is responsible for the long term regulation of acid base balance in the body via excreting or retaining acid in the form of hydrogen ions. An elderly post-operative patient is demonstrating lethargy, confusion and respiratory rate of 8bpm. Which of the following acid-base disorders is most likely the cause? Correct Answer Metabolic alkalosis. Treatment for metabolic alkalosis includes restoring normal fluid volume and administering potassium chloride and sodium chloride solution. Due to the patient's depressed respiratory effort, the risk of hypoxaemia is high. products. It also cushions them to help prevent injury in the event of trauma. Cerebrospinal fluid is also referred to as CSF is a clear, colourless liquid consisting of 99% water and protein, sodium, chloride, potassium bicarbonate and glucose the remaining 1%. What activity best assesses the function of cranial nerve XI (spinal accessory)? Correct Answer Shrug shoulders and turn head against resistance. Look for equal strength when shrugging both shoulders and note symmetry of the shoulders. When a nurse asks a patient to walk heel to toe, on toes and then on heels, what function is being assessed? Correct Answer Cerebellar. Ataxia is a lack of coordination and clumsiness of movement i.e. staggering or unbalances gait. The inability to walk on toes and heels may indicate disease of the upper motor neurons. Dorsiflexion of the big toe and fanning of other toes is called: Correct Answer Babinski's sign. The reflex determines adequacy of the higher central nervous system. It is obtained by stimulating the outside of the sole of the foot, causing extension movement of the toes. A Babinski reflex is an abnormal sign indicating a problem in the brain or spinal cord. The patient you are caring for has lower motor neuron injuries. What type of reflexes would you expect to find during assessment? Correct Answer Decreased. Reflexes will still be present but decreased. You should make special consideration when conducting a neurological assessment on an elderly patient? Correct Answer True. Absolutely! Many parts of the nervous system are affected by ageing. For example diminished strength, slower reflexes, change in gait/ambulation, hearing and vision deficits. What should a nurse evaluate when assessing a person's cognitive function? Correct Answer Orientation to time, place, person and recall of recent/past events. Disorientation occurs with conditions affecting the right cerebral hemisphere. Level of consciousness is simply a measure of alertness. Always assess and monitor patients using the Glasgow Coma Scale (GCS) and their orientation to the environment. How would you describe the level of consciousness for a patient only responding to painful stimuli? Correct Answer Stupor. Stupor is the lack of critical cognitive function; the sufferer is almost entirely unresponsive. The word stupor is Latin meaning insensible. The unconscious patient is at risk of: Correct Answer Impaired skin integrity due to perspiration, incontinence and pressure areas. Contractures develop due to immobility. Decrease in nutritional status also increases the risk of factors. The most accurate sign that a person is developing intracranial pressure is a decreasing pulse pressure and tachycardia. Correct Answer False. The most accurate sign is decreasing level of consciousness. This results from the deficit in oxygen, the patient becomes confused, irritable and agitated from hypoxia. Deterioration leads to coma and complete unresponsiveness The rigid cranial cavity contains brain, CSF and blood. For equilibrium these elements must increase and decrease to maintain a constant state. This is known as: Correct Answer Monroe Kellie hypothesis. The brain houses essentially 3 non compressible elements, the brain 80%, blood 12%, and cerebrospinal fluid 8%. Having a seizure means you have epilepsy? Correct Answer False Epilepsy is a chronic disorder characterized by recurring seizures. A seizure, as a single event, of an abnormal discharge in the brain resulting in an abrupt and temporary altered state of cerebral function is not a diagnosis of epilepsy. The patient you are caring for has a tonic-clonic seizure. What is your priority nursing care during seizure activity? Correct Answer Protect the person from injury. Your number 1 priority is patient safety. Put the person in the recovery position on their side, bed rail up to prevent falls risk and move anything away that could cause harm. What is the period immediately after a seizure called? Correct Answer Post ictal. During the post ictal phase the patient will feel exhausted and may be confused and disorientated. Often the patient is amnesic to the event and everyone recovers from this period at different rates. Anti-epileptic medications cure the seizure disorder? Correct Answer False. Anti epileptic medications help in the management of its manifestations. They work by raising the threshold or limiting the spread of abnormal activity within the brain. The risk of direct damage to brain tissue from contusion and bone fragments is increased in which type of fracture? Correct Answer Depressed fracture. This fracture requires surgical intervention usually within 24 hours to remove bone fragments to prevent ischemia or infection to brain tissue. Which of the following is not a focal brain injury? Correct Answer Concussion. Diffuse brain injury affects the whole brain and is caused by twisting/shaking motion. Concussion means 'violent shaking'. Focal brain injuries refer to specific, grossly observable brain lesions confined to one area of the brain. A patient with a traumatic brain injury (TBI) complains of feeling unwell with increasing headaches and vomiting. What is your priority of care? Correct Answer Notify the doctor immediately. These manifestations may be early indicators of increased intracranial pressure which need immediately medical assessment and intervention. Do a set of observations including neurological observations and continue to vigilantly monitor until medical team attends. An unconscious patient is posturing with their arms and legs adducted and arms hyper-pronated. What type of posture is this? Correct Answer Decerebrate. Decerebrate posturing is abnormal. Often the legs are extended straight out and the feet are plantar flexed. It usually indicated severed damage has been done to the brain. You are changing the sheets of a patient and notice blood tinged fluid on the pillow slip, it appears to have a halo around it. What is this? Correct Answer Cerebrospinal fluid. This is suggestive of CSF leakage. It can further be tested against a dextrostix to see if it reacts to glucose, this confirms CSF. What is the most common cause of secondary brain injuries? Correct Answer Ischemia. Secondary injury is the progression of the initial injury (primary injury results from initial impact). Ischemia is the most common cause of secondary brain injury which then leads to cerebral hypoxia. A patient has become unresponsive with a left side facial droop; early diagnosis is a cerebrovascular accident (CVA). What is the priority nursing care? Correct Answer Assess and maintain the airway and breathing. A stroke may impair patients' ability to swallow. Weakness or lack of coordination with the tongue and deficit in Other manifestations include changes in bowel and or bladder function and changes in sexual function. Pain is often the initial symptoms. Initial care for a patient with a suspected spinal injury is: Correct Answer Immobilising of the neck immediately. It is crucial to immobilise your patient as soon as possible avoiding flexing, extending or rotating the neck. Transfer patient from stretcher to bed using a log roll, pat slide and qualified staff. During the assessment of a person with hyperthyroidism the nurse notices smooth, fine hair and warm, dry skin. What are these findings indicate of? Correct Answer Nothing as these are normal findings of hyperthyroidism. It is common for hair to become fine and hair loss to the scalp, eyebrows, armpits and pubic area. Other symptoms may include increase in appetite and decrease in weight. The nurse is preparing a person for a thyroidectomy. Which of the following instructions should the nurse include pre-operatively? Correct Answer Instruct about how to support the neck with the hands while coughing. Teach the patient to place their hands behind the neck to provide support for the suture line. The person needs to be positioned in the semi-fowlers position during and after recovery with neck and head supported by pillows. A post-operative thyroidectomy person wants to know why her eyes have not returned to normal. What nursing problem would address this? Correct Answer Disturbed body image. Establish a therapeutic relationship and encourage verbalisation of feelings about self-image in relation to condition. Generally treatment does not reverse changes in the eyes therefore it is important to facilitate open sharing of feelings and perceptions. What assessment findings would be consistent for a patient with hyperparathyroidism? Correct Answer Muscle weakness Muscle weakness and atrophy is a result of hypercalcaemia. Elevated calcium levels after neural and muscular activity. See p544 3rd edition of the set textbook for manifestations per body system. What are the 3 types of hyperparathyroidism? Correct Answer Primary, secondary, tertiary. Refer to page 544 3rd edition of your set text for more information A 35 year old female is on oral contraceptives and commencing steroid therapy. Which of the following should you include in patient education? Correct Answer Consider alternative contraception. Corticosteroids may impair the effectiveness of oral contraception. Refer the patient to their GP or sexual health/family planning clinic to identify a more suitable contraception whilst receiving steroid therapy. A person with hyperthyroidism has commenced Carbimazole (thioamide medication). What are your nursing responsibilities on administration? Correct Answer Monitor for life threatening agranulocytosis. Life threatening agranulocytosis is evidence by reduced neutrophil count, fever, pruritus rash, periorbital oedema, anorexia, vomiting, loss of taste and menstrual irregularities. Exophthalmos is forward displacement of the eye? Correct Answer False. Exophthalmos is forward protrusion of the eyeball resulting from an accumulation of inflammation by products in the retro orbital tissues. Proptosis is the forward displacement of the eye. Both are seen in Grave's disease. What is Addison's disease? Correct Answer Insufficient cortisol secretion from the adrenal gland. Addison's disease is a rare endocrine, or hormonal disorder that affects about 1 in 100,000 people. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes A patient with diabetes talks of a back problem and numb feet. What does this indicate? Correct Answer Polyneuropathy. Systems of distal parasthesisas (subjective feeling of change in sensation such as numbness/tingling), pain described as aching, burning and feelings of cold feet are common. It is a disorder of peripheral and autonomic system resulting from diabetes. What must be accessed to determine if a patient has peripheral vascular disease associated with diabetes? Correct Answer Intermittent claudication of the lower legs. People with diabetes are at significant risk of lower limb gangrene. Peripheral vascular disease may cause intermittent claudication, absent pulses, delayed venous filling on elevation and even gangrene. Patient education about skin care and injuries to feet is vital. A patient is experiencing slurred speech, blurred vision, shakiness, rapid pulse and hypotension. What are these signs and symptoms indicative of? Correct Answer Hypoglycaemia. The patient is displaying manifestations caused by responses of the autonomic nervous system (shaky, rapid pulse, hypotensive) and also impaired cerebral function. Refer to p586 3rd of set text for treatment of hypoglycaemia. Coronary artery disease is the most common cause of death in people diagnoses with diabetes? Correct Answer True. Coronary artery disease is a major risk factor in the development of myocardial infarction in people with diabetes, especially middle to older aged adults with type 2 DM. Health promotion is an important element of nursing care. Why is a patient with diabetes at risk of injury from multiple factors? Correct Answer Neuropathies alter sensation, gait and muscle control; Retinopathy causes visual defects; Changes in blood glucose levels can cause altered levels in consciousness. The impaired mobility, sensory deficits and neurological effects of complications of diabetes increases risks of accidents, burns, falls and trauma.