NR 570 EXAM i i
PREPLATEST
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Common Diagnosis i
i&Management in
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i Acute Care Practicum
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ANSWERED
2023/2024
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,1. What iare ithe ithree imain itypes iof ishock iand ihow iare ithey idifferentiated? i(3 ipoints)
- Hypovolemic ishock: icaused iby ia iloss iof iblood ior ifluid ivolume, iresulting iin ilow iblood ipressure
iandiinadequate itissue iperfusion.
- Cardiogenic ishock: icaused iby ia ifailure iof ithe iheart ito ipump ieffectively, iresulting iin ilow
icardiacioutput iand iinadequate itissue iperfusion.
- Distributive ishock: icaused iby ia iwidespread idilation iof iblood ivessels, iresulting iin ilow
ivasculariresistance iand iinadequate itissue iperfusion.
2. What iare ithe isigns iand isymptoms iof isepsis iand iwhat iis ithe iinitial imanagement? i(4 ipoints)
- Sepsis iis ia ilife-threatening icondition ithat ioccurs iwhen ithe ibody's iresponse ito ian iinfection
icausesisystemic iinflammation iand iorgan idysfunction. iThe isigns iand isymptoms iof isepsis iinclude
ifever, itachycardia, itachypnea, ihypotension, ialtered imental istatus, ioliguria, iand iincreased
ilactate ilevels.
- The iinitial imanagement iof isepsis iinvolves irapid iidentification iand itreatment iof ithe isource iof
iinfection, iadministration iof ibroad-spectrum iantibiotics, ifluid iresuscitation, ivasopressors iif
ineeded,iand imonitoring iof ivital isigns iand iorgan ifunction.
3. What iare ithe iindications iand icontraindications ifor iendotracheal iintubation iand iwhat iare ithe
istepsiinvolved? i(5 ipoints)
- Endotracheal iintubation iis ia iprocedure ithat iinvolves iinserting ia itube ithrough ithe imouth ior inose
iintoithe itrachea ito iestablish ia isecure iairway. iThe iindications ifor iendotracheal iintubation iinclude
irespiratory ifailure, iairway iobstruction, iprotection iof ithe iairway ifrom iaspiration, ifacilitation iof
imechanical iventilation, iand iadministration iof icertain imedications.
- The icontraindications ifor iendotracheal iintubation iinclude isevere ifacial itrauma, icervical ispine
iinjury,icoagulopathy, iupper iairway iinfection ior iinflammation, iand ilack iof iequipment ior iexpertise.
- The isteps iinvolved iin iendotracheal iintubation iare:
- Prepare ithe iequipment iand ipatient
- Preoxygenate ithe ipatient iwith i100% ioxygen
- Administer isedation iand ineuromuscular iblockade iif iindicated
- Position ithe ipatient's ihead iin ithe isniffing iposition
,- Visualize ithe ivocal icords iwith ia ilaryngoscope
, - Pass ithe itube ithrough ithe ivocal icords iand iconfirm iplacement iwith icapnography iand iauscultation
- Secure ithe itube iand iprovide iventilation
- Check ifor icomplications isuch ias ihypoxia, ihypotension, iarrhythmias, ipneumothorax, ior
iesophagealiintubation
4. What iare ithe icommon icauses iand icomplications iof iacute ikidney iinjury i(AKI) iand ihow iis iit
idiagnosediand iclassified? i(4 ipoints)
- AKI iis ia isudden idecline iin ikidney ifunction ithat ileads ito ian iaccumulation iof iwaste iproducts
iandielectrolytes iin ithe iblood. iThe icommon icauses iof iAKI iare idivided iinto ithree icategories:
- Prerenal: idue ito idecreased iblood iflow ito ithe ikidneys, isuch ias ifrom idehydration, ihypovolemia,
iheartifailure, ior isepsis
- Intrinsic: idue ito idamage ito ithe ikidney itissue, isuch ias ifrom iischemia,
inephrotoxins,iglomerulonephritis, ior iacute itubular inecrosis
- Postrenal: idue ito iobstruction iof iurine iflow ifrom ithe ikidneys, isuch ias ifrom irenal istones,
ibenigniprostatic ihyperplasia, ior itumors
- The icomplications iof iAKI iinclude imetabolic iacidosis, ihyperkalemia, ihyponatremia, iuremia,
ivolumeioverload, ipulmonary iedema, ianemia, icoagulopathy, iand iincreased irisk iof iinfection.
- AKI iis idiagnosed iby imeasuring iserum icreatinine iand iurine ioutput. iAKI iis iclassified iaccording ito
itheiKDIGO icriteria ias ifollows:
- Stage i1: iincrease iin iserum icreatinine iby i≥0.3 img/dL iwithin i48 ihours ior iby i≥1.5 itimes ibaseline
iwithini7 idays ior iurine ioutput i<0.5 imL/kg/h ifor i6 ihours
- Stage i2: iincrease iin iserum icreatinine iby i≥2 itimes ibaseline iwithin i7 idays ior iurine ioutput
i<0.5imL/kg/h ifor i12 ihours
- Stage i3: iincrease iin iserum icreatinine iby i≥3 itimes ibaseline iwithin i7 idays ior iby i≥4 img/dL ior
iinitiationiof irenal ireplacement itherapy ior iurine ioutput i<0.3 imL/kg/h ifor i24 ihours ior ianuria ifor i12
ihours
Which imedication ibelow iis icontraindicated iin ian iasthma ipatient ibecause iit imay iincrease irisk
iofisudden ideath iif iused ialone? i(Long-acting ibronchodilator)
A ilong-acting ibronchodilator ican ibe iused ito itreat iasthma iwhen iit iis iused iin icombination iwith ian
iinhaledisteroid. iOtherwise, iusing ia ilong-acting ibronchodilator ilike isalmeterol iis icontraindicated.
iThere iis ian iincreased irisk iof isudden ideath iwith iasthma iexacerbations iwhen ithis iclass iis iused isolo
ito itreat iasthma.iThe iother ichoices ican ibe iused ito itreat iasthma. iChoices ivary idepending ion ithe
ipatient.
A i75-year-old ifemale iwith iemphysema iwho ihas ibeen itreated iwith iinhaled isteroids ifor imany
iyearsishould: i(should ibe iscreened ifor iosteoporosis)
Older ifemales iare iat ihigher irisk ithan iothers ifor iosteoporosis. iThis ifemale ipatient, iwho ihas iused
