NURS 241- Exam 3 Practice Questions
and Correct Answers
What is treatment for burn pt. With metabolic acidosis?
Respiratory acidosis? ✅metabolic- correct fluids; in some cases, give bicarbonate
Respiratory- O2- high flow, non rebreather- we DO NOT use bicarb to correct
respiratory
________ acidosis can occur with inhalation burns and the extreme version of ARDS
Is it more or less life threatening than MA? ✅respiratory acidosis- primarily occurs with
inhalation burns
More life threatening than MA
Cellular hypoxia also causes a loss of _______, which worsens acidosis
_______ acidosis can also occur with sepsis, a common complication of burns due to
the lactic acidosis occurring
Are adults or children more susceptible to MA? ✅bicarbonate
Metabolic acidosis
Children are more susceptible to MA
T/F both, metabolic and respiratory acidosis can occur with burns
_______ acidosis in burns results from too much acid and not enough base
What stage of burns does metabolic acidosis most likely occur?
What can also cause MA? ✅TRUE
TRUE
Most likely occurs during the emergent stage, when fluid shifts occur causing
hyperkalemia and hypovolemia
Can also be caused by cellular hypoxia- part of cellular hypoxia is due to hypovolemia,
also kidney and liver damage- kidney damage causes hyperchloremic acidosis, or low
bicarb acidosis
What is cohb used for? ✅used to detect carbon monoxide poisoning. The test
measures a combo of carbon monoxide and Hg. High= BAD; this would be a test to
evaluate inhalation burns or any fire smoke. Tx= high concentrations of O2
What two labs do we want to draw from firefighters? ✅anion gap
Cohb
Both are high=BAD, low= GOOD
With burns, anion gap will ______, also with metabolic acidosis
What can anion gap show? ✅increase with burns= BAD
,Anion gap can help show causes of metabolic acidosis. When bicarb dec. Anion gap
inc. With kidney causes, higher anion gap is expected. You have a dec. Anion gap with
hypoproteinemia
What are the normal ABG values...
Ph=?
Pco2=?
CO2=?
HCO3=?
Sao2=?
Anion Gap=?
Cohb=? ✅ph= 7.35-7.45
Pco2= 35-45
CO2= 20-30
HCO3= 22-28
Sao2= 95-100
Anion Gap= 12-16
Cohb= <3% for non smoker; <12% for smoker
Who published a manual on how healthcare workers should interview human trafficking
victims? ✅The World Health Organization
Nirtofurazone (furacin)
Description?
Advantages vs disadvantages?
Nursing considerations? ✅topical agent
Description- cream, ointment or foam; wide-spectrum antibiotic; used to tx burns that
are infected
Advantages vs disadvantages- painless and does not cause breakdown of the skin; can
cause renal problems; messy to apply
Nursing considerations- monitor BUN and Cr- assess for allergic rxn
What are some examples of vulnerable populations? ✅elder abuse, domestic/intimate
violence- males and females, human trafficking, child abuse, incarcerated clients,
homeless, transgendered, religious persecution
What are associated concepts with domestic violence? ✅anxiety, depression, stress,
mood/affect, coping, pain (physical and mental)
1 in ____ women experience intimate partner violence
1 in ____ men experience intimate partner violence
What types of abuse can it be?
1 in ______ women and 1 in ______ men say they have been stalked
Women between ____-_____ are the most likely victims of abuse
Only ____% of domestic violence victims get help ✅1 in 4 women
1 in 9 men
,Can include sexual, physical, emotional, financial
1 in 7 women and 1 in 18 men say they have been stalked- can include cyber stalking
Women between 18-24 are the most likely victims of abuse
34% get help
What are some mental symptoms of domestic violence?
Somatic symptoms?
Physical symptoms?
Which s/s are the most difficult to assess? ✅mental- PTSD, anxiety, depression, fear,
hopelessness, withdrawal (socially and mentally)
Somatic- IBS, pain, aches, skin changes (secondary and displaced s/s anxiety related
and to stress
Physical- bruising, injury, burns, scars, broken bones, perineal injury
Mental= most difficult to assess
What are the effects of intimate violence on work and life? ✅loss of relationships, jobs,
loss contact with children, friends, family, lack of acute healthcare (denied care by
abuser after abuse), lack of ongoing healthcare- denied routine healthcare to not have
victim enter healthcare
Finances and transportation controlled to restrict movement and freedom
What are some barriers for the nurse in domestic violence situations? ✅lack of time in
interactions, fear of saying the wrong thing, fear of offending someone who isnt the
victim by asking them, sense of not being able to make a difference in the situation, not
sure what to look for, afraid of being wrong, afraid of making situation worse
What are some barriers for the patient in domestic violence situations? ✅afraid of
being judged, afraid of making the situation worse, a sense of not being able to have an
impact or make a difference in the situation, feeling powerless, feeling shame,
deserving of blame, dependency on money, living space, attention
What do you look for as the nurse in domestic violence situations? ✅no labs to screen
for intimate violence, but may do UTI and STD screenings
Can occur in homosexual relationships as well
Men also abused
Fear of partner is a red flag
S/s can be physical (broken bones, healing injuries, scars) or emotional (shaming,
intimidation, controlling)
There can also be NO obvious s/s
Abuse can also be economical (withholding $$,etc)
Inappropriate clothing to hide physical s/s (scars to hide bruises, sleeves in summer,
etc)
S/s of controlling behavior (partner making healthcare decisions, etc)
, What do you say as a nurse in domestic violence situations? ✅are you having any
problems with your partner?
Have you been kicked, hit, punched, slapped or otherwise hurt in last 6 mos?
Are you afraid? Have you felt safe at home/work?
How is your stress level?
I've started asking all of my patients about relationship violence. I can help if thats going
on with you
How are things at home?
Do you feel you are in danger?
What experiences with violence have you had in your life?
Have you been touched in a way that makes you uncomfortable?
Has anyone forced you to have sex?
What happens when you and your partner disagree?
Do you have a safe place to go in an emergency?
What diagnostics are assessed for domestic violence? ✅assess s/s
Possible CT or MRI to assess injury
Screen for depression, PTSD, anxiety
Document injury with camera, narrative note (make it detailed)
Sexual assault may use a SANE nurse (sexual assault nurse examiner)- RN trained in
sexual assault
Rape kit may be used if rape is suspected
What are the extreme versions of domestic violence? ✅critical moments- rape, pt
being seen in hc as a direct result of a violent incident
Worst case scenario- suicide,homicide, doing NOTHING- we must do something as an
RN
Human trafficking has occurred if a person was induced to perform labor or a
commercial sex act through ______, _______ or ______
Any person under the age of ____ who performs a commercial sex act is considered a
victim of human trafficking regardless whether force, fraud or coercion was present
T/F $$ never reaches the victim-- theyre being held hostage ✅force, fraud or coercion
18 yrs
TRUE
What is the most common form of human trafficking?
Victims of the are predominantly ________ and ______
What is the second most common form? ✅sexual exploitation
Women and girls
Second= forced labor- less frequently detected and reported than sexual exploitation
