Download NR 507 Final Exam Study Guide ( With Possible Questions A-Z )(NEW, 2024 ) : Chamberlain and more Exams Nursing in PDF only on Docsity!
NR 507 Final Study Guide
& Possible Questions A-Z
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1. Acid base imbalance While checking arterial blood gas results, a nurse finds respiratory acidosis. What does the nurse suspect is occurring in the patient? reduced tidal volumes A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2 ) levels. Which of the following does the nurse suspect is the most likely cause? Hyperventilation The nurse is assessing a client with suspected respiratory acidosis. Which assessment items are priority for the nurse to collect? Rate and depth of respirations, Skin color and temperature, Appearance of the optic nerve o The nurse is administering sodium bicarbonate to the client with respiratory acidosis. The nurse understands that which is the primary goal of treatment for this client? Removing excess acids in blood
The student nurse is assisting in the care for a client with acute respiratory acidosis. The nurse explains to the student nurse that the client's blood pH initially falls in the development of acute respiratory acidosis because of which process? Hypoventilation
2. ACTH The nurse is preparing a client for testing to determine if the client has Cushing syndrome. What tests are included in the screening process 24-hour urine secretion of cortisol Dexamethasone suppression test Plasma levels of ACTH A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing? Increased levels of ACTH A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client? Cortisol replacement therapy
The client has been taking an oral cortisol preparation for 2 years to manage an autoimmune disease. What effects does the nurse expect this therapy to have on this client's circulating levels of ACTH and aldosterone? Decreased ACTH, decreased aldosterone A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with elevated levels of: Adrenocorticotropic hormone (ACTH)
3. Acute epiglottitis A caregiver calls the pediatrician's office and reports to the nurse that her 4-year-old, who was fine the previous day, complained of a sore throat early in the morning and now has a temperature of 102.6° F (39.2° C). The caregiver has tried to get the child to nap but the child gets panicky, immediately sits back up, and leans forward with her mouth open and tongue out when the caregiver encourages her to lie down. The nurse suspects the child has which of the following conditions? Epiglottitis The caregivers of a child report that their child had a cold and complained of a sore throat. When interviewed further they report that the child has a high fever, is very anxious, and is breathing by sitting up and leaning forward with the mouth open and the tongue out. The nurse recognizes these symptoms as those seen with which of the following disorders? Epiglottitis
The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder is for the child to: be at risk for respiratory distress. A 5-year-old child is brought to the clinic by his father because the child developed a high fever over the past 2 to 3 hours. The nurse suspects epiglottitis based on which signs and symptoms?
**- Difficulty speaking• Drooling• Sitting with neck extended• Frightened appearance
- AIDS** A 36-year-old man enters the hospital in an extremely debilitated condition. He has purple-brown skin lesions (a symptom of Kaposi's sarcoma) and a persistent cough. A physical examination reveals swollen lymph nodes, and laboratory tests find a very low lymphocyte count. Information taken during the personal history reveals that he has multiple sex partners with whom he frequently engages in unprotected sex. What is likely to be the man's problem and what is his prognosis? He is probably suffering from AIDS. His outlook is poor once the disease has progressed to this advanced stage. There is no cure, and drug therapy has had limited short-term success. Why does nursing care of a patient with acquired immune deficiency syndrome (AIDS) include monitoring of T lymphocyte counts? A decrease in the number of T cells would make the patient more susceptible to infection and unusual cancers.
The nurse is describing the movement of blood into and out of the capillary beds of the lungs to the body organs and tissues. What term should the nurse use to describe this process? Perfusion A pulmonologist is discussing the base of the lungs with staff. Which information should be included? At the base of the lungs: Arterial perfusion pressure exceeds alveolar gas pressure When the pulmonologist discusses the condition in which a series of alveoli in the left lower lo be receive adequate ventilation but do not have adequate perfusion, which statement indicates the nurse understands this condition? When this occurs in a patient it is called: Alveolar dead space Which of the following conditions should the nurse monitor for in a patient with hypoventilation? hypercapnia A nurse is describing the pathophysiology of emphysema. Which information should the nurse include? Emphysema results in: the destruction of alveolar septa and air trapping.
6. Alzheimer’s disease A patient is admitted to the unit in the middle stages of Alzheimer's disease. How would the nurse expect to find the patient's state of mind? Unable to perform simple tasks
When teaching the children of a patient who is being evaluated for Alzheimer's disease (AD) about the disorder, the nurse explains that a diagnosis of AD can be made only when other causes of dementia have been ruled out. The patient has been diagnosed with the mild cognitive impairment stage of Alzheimer's disease. What nursing interventions should the nurse expect to use with this patient? Use a calendar and family pictures as memory aids. A patient with Alzheimer's disease (AD) dementia has manifestations of depression. The nurse knows that treatment of the patient with antidepressants will most likely do what? Improve cognitive function The wife of a patient who is manifesting deterioration in memory asks the nurse whether her husband has AD. The nurse explains that a diagnosis of AD is usually made when what happens? All other possible causes of dementia have been eliminated
- Angiotensin-renin system The nurse recognizes that the action of angiotensin II is what? Vasoconstriction The nurse understands that aldosterone secretion is increased when the patient has what? Hyperkalemia With what does the nurse correlate the release of renin? Decreased renal perfusion What are the 2 most common causes that activate the RAAS system? Low cardiac output or low renal perfusion
IgE In teaching a patient with SLE about the disorder, the nurse knows that the pathophysiology of SLE includes the production of a variety of autoantibodies directed against components of the cell nucleus A patient is diagnosed with a hypersensitivity reaction mediated by immunoglobulin E (IgE) antibodies. For which type of hypersensitivity reaction should the nurse plan care for this patient? Type 12
- Autosomal dominant diseases A nurse is assessing a patient with an autosomal-dominant inherited condition. When discussing the risk of transmission to the patient's offspring, which of the following would the nurse include? Each child has a 50% risk of inheriting the gene. A client has an autosomal-dominant disorder. His wife is unaffected. When explaining the risk for inheritance of the disorder in their offspring, which statement by the nurse would be most appropriate? There is a 50% chance that each of your children will have the condition The daughter of a patient with Huntington disease has requested that she be tested for the disease even though she has no symptoms at this time. What type of test does the nurse anticipate the physician will order? Presymptomatic testing Which of the following risk factors have been linked to ovarian cancers? Select all that apply.
Gene mutations BRCA-1 and BRCA-2, Nulliparity A late acting dominant disorder is: Huntington's chorea Huntignton's chorea is characterised by Disordered muscle movement and mental disorientation Dancing gait and bizarre grimacing are characteristics of: Huntignton's disease The RN is reading the chart of a new pt. at the genetic clinic. The chart notes that the pt., her brother, and her mother all have inherited a particular condition. The RN plans care for a condition with which of the following type of inheritance pattern? autosomal dominant
- Bartholin glands A woman visits her primary care provider with a complaint of pain and swelling in the vagina area. The pain is present when she sits and walks intercourse is painful. The nurse prepares the patient for an examination. The nurse and health care provider suspect that the patient may have an inflammation or infection of the? Bartholin glands A patient has been diagnosed with a Bartholin gland cyst. The nurse expects the patient may experience which symptoms if this becomes infected? Pain, tenderness, and dyspareunia The female external genitalia are made up of several components. What is in the vestibule of the female external genitalia? Bartholin glands
A nurse is conducting a session on education about cancers of the reproductive tract and is explaining the importance of visiting a health care professional if certain unusual symptoms appear. Which should the nurse include in her list of symptoms that merit a visit to a health care professional for further evaluation Irregular vaginal bleeding, persistent low backache not related to standing, and elevated or discolored vulvar lesions are some of the symptoms that should be immediately brought to the notice of the primary health care provider The postmenopausal woman who has bleeding and spotting and cannot tolerate a endometrial biopsy in the office would expect to have which of the following tests done to rule out endometrial cancer? transvaginal ultrasound The nursing student correctly identifies which of the following to be the treatment of choice for endometrial cancer? hysterectomy and salpingo-oophorectomy The nursing student correctly identifies which of the following age group to be when ovarian cancer occurs more frequently? 55-75 years of age Treatment for Stage IA (Microinvasive Carcinoma) is? Ia1: Vaginal hysterectomy. Cervical conizationif the patient desires to maintain her fertility. An aide asks the nurse what is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion. How should the nurse respond? Cancer
The nurse working with oncology clients understands that interacting factors affect cancer development. Which factors does this include? Genetic predisposition, Exposure to carcinogens, Immune function A nurse is providing community education on the seven warning signs of cancer. Which signs are included a sore that does not heal, indigestion or trouble swallowing, obvious changes in a mole. changes in bowel or bladder habbits, unusual bleeding or discharge, thickening of lump in breast or elsewhere, nagging cough or hoarseness The nursing instructor explains the difference between normal cells and benign tumor cells. What information does the instructor provide about these cells? Growing in the wrong place or time is typical of benign tumors. The nursing student learning about cancer development remembers characteristics of normal cells. Which characteristics does this include? Nonmigratory, Specific morphology, Differentiated function The student nurse caring for clients who have cancer understands that the general consequences of cancer include which client problems? reduced immunity and blood-producing functions, altered GI structure and function, decreased respiratory function, motor and sensory deficits
- Cervical dysplasia The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which of the following information is important for the nurse to include?
A thick mucus plug forms that protects the fetus from infection.
- Chicken pox An older adult client tells the nurse that her granddaughter has chickenpox. The client is afraid to visit because she is afraid of getting shingles from her granddaughter. What is the nurse's best response? "If you already had chickenpox, you can safely visit your granddaughter." The nurse counsels the parent of a 12 year old diagnosed with chickenpox about when the child can return to school. The nurse determines that teaching is effective if the parent makes which statement? My child can return to school when the lesions are crusted A parent calls the clinic to report that the child has been exposed to varicella zoster (chicken pox). The nurse should tell the parent that the incubation period for chickenpox is which length of time? 2-3 weeks
- Chronic inflammatory joint disease In assessing the joints of a patient with rheumatoid arthritis, the nurse understands that the joints are damaged by bony ankylosis following inflammation of the joints invasion of pannus into the joint causing a loss of cartilage Assessment data in the patient with osteoarthritis commonly include joint pain that worsens with use
The nurse is working with a 73-year-old patient with osteoarthritis (OA). In assessing the patient's understanding of this disorder, the nurse concludes teaching has been effective when the patient describes the condition as which of the following Degeneration of articular cartilage in synovial joints A 60-year-old woman has pain on motion in her fingers and asks the nurse whether this is just a result of aging. The best response by the nurse includes the information that changes in the cartilage and bones of joints may cause symptoms of pain and loss of function in some people as they age The basic pathophysiologic process of rheumatoid arthritis (RA) is an immune response that activates complement and produces inflammation of joints and other organ systems During the physical assessment of the patient with moderate RA, the nurse would expect to find spindle-shaped fingers After teaching a patient with RA about the prescribed therapeutic regimen, the nurse determines that further instruction is needed when the patient says, I should perform most of my daily chores in the morning when my energy level is highest A 70-year old patient is being evaluated for symptoms of RA. The nurse recognizes that a major problem in the management of RA in the older adult is that drug interactions and toxicity are more likely to occur with multidrug therapy
- Clonal selection When a nurse uses the term clonal diversity, what is the nurse describing?
The nurse is assessing a patient's pain perception. What should the nurse use to make this assessment? PQRST guide A patient is being treated for chronic pain. What should the nurse keep in mind when assessing this patient's level of pain? The pain rating may be inconsistent with the underlying pathology. A patient is seen talking and laughing in the clinic's waiting room yet complains of excruciating pain. What should the nurse realize this patient is demonstrating? inconsistent behavioral response to pain
- Congenital heart defects The comment made by a parent of a 1-month-old that would alert the nurse about the presence of a congenital heart defect is: "He tires out during feedings." The nurse explains that which congenital cardiac defect(s) cause(s) increased pulmonary blood flow? Atrial septal defects (ASDs), Patent ductus arteriosus, Ventricular septal defects (VSDs) A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal that the lumen of the duct between the aorta and pulmonary artery remains open. This defect is known as patent ductus arteriosus or PDA. Congenital heart defects (CHDs) are classified by which of the following? Defects with increased pulmonary blood flow, Defects with decreased pulmonary blood flow., Mixed defects, Obstructive defects.
Hypoxic spells in the infant with a congenital heart defect (CHD) can cause which of the following? Polycythemia, Blood clots, Cerebrovascular accident, Developmental delays, Brain damage. A 6-month-old who has episodes of cyanosis after crying could have the congenital heart defect (CHD) of decreased pulmonary blood flow called tetalology of fallot or TOF While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding? Polycythemia. In which congenital heart defect (CHD) would the nurse need to take upper and lower extremity BPs? Coarctation of the aorta (COA).
- Congenital intrinsic factor deficiency A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart? Pernicious anemia A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in intrinsic factor is the most likely cause.
- Congenital murmurs While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:
