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NUR 436 Final Exam Questions with Latest Update
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NUR 436 Final Exam Questions with Latest Update
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NUR 436 Final Exam Questions withLatest Update
What is the Parkland formula used for? - Answer-To calculate the fluid replacement in a
burn injury patient
Parkland formula - Answer-Volume of Lactated Ringers solution = 4 mL x total body
surface area of burn (%) x body weight (kg); first half over 8 hours, second half over 16
hours
What symptoms may indicate an adverse reaction to blood products? - Answer-Nausea
or vomiting, burning along infusion line, facial swelling, abdominal cramping, significant
back pain, chills, diarrhea, chest pain, headache, dry and flushed skin, hematuria, temp
increase, pallor, laryngeal/pharyngeal edema, hypertension, tachycardia, severe
apprehension, tachypnea, shock, difficulty breathing, severe bilateral pulmonary edema,
bleeding/oozing from IV site/wound
What are the immediate nursing actions if a patient displays signs of an adverse blood
transfusion reaction? - Answer-1. Stop transfusion immediately
2. Remove blood product tubing, connect 0.9% NS tubing to patient's IV site, and begin
0.9% NS infusion
3. Do NOT leave patient alone
4. Continue monitoring patient's assessment and VS
5.Notify blood bank - they will tell you what labs to draw from patient and paperwork to
bring to blood blank
6. Administer any meds ordered by provider for adverse transfusion reaction
7. Discuss with HCP how frequently they want VS following reaction
8. Chart VS, reactions symptoms, and interventions
Diagnostic criteria for sepsis - Answer-Altered mental status, fever, tachycardia,
hyperglycemia, hypothermia, hypotension, significant edema, tachypnea, elevated
prolactin level, hyperlactatemia, arterial hypoxemia, acute oliguria, increase in serum
creatinine, thrombocytopenia
DKA priority assessment - Answer-1. Physical assessment with focused neuro and LOC
2. IV access and draw labs: CMP, CBC, VBG, blood glucose, hemoglobin A1C
3. Urine sample for analysis and ketones
4. Assess degree of dehydration
5. Baseline EKG
How is pediatric pain assessed? - Answer-FLACC scale, FACES scale, numeric pain
scale
, Signs of IV site infiltration - Answer-Swelling, compartment syndrome, tight skin, cool to
touch, numbness, burning/pain, impaired blood circulation
Signs of IV site infection - Answer-Red, warm, pain, swelling, discharge
Clinical manifestations of septic shock - Answer-Tachycardia, change in temperature,
myocardial dysfunction, hyperventilation, crackles, hypoxemia, decreased urine output,
change in mental status, decreased platelets, increased lactate, increased BG, positive
blood cultures
Hour-1 Bundle: initial resuscitation for sepsis and septic shock - Answer-1. Measure
lactate level, remeasure lactate if initial lactate is elevated (> 2 mmol/L)
2. Obtain blood cultures before administering antibiotics
3. Administer broad-spectrum antibiotics
4. Begin rapid admin of 30 mL/kg crystalloid for hypotension or lactate > 4 mmol/L
5.Apply vasopressors if hypotensive during or after fluid resuscitation to maintain a MAP
> 65 mmHg
What are examples of crystalloids? - Answer-Lactated Ringer's, Normal Saline, D5W
Why is a neuro exam important in a patient in DKA? - Answer-Cerebral edema can
occur caused by osmolarity shift during rehydration and glucose management
Supraventricular tachycardia (SVT) - Answer-HR 150-220, regular rhythm, P waves and
PR intervals usually hidden by T waves
Treatment for SVT - Answer-Vagal maneuvers, adenosine, cardioversion
Atrial fibrillation - Answer-Rapid, random, ineffective contractions of the atrium; atrial
rate of 350-600 bpm; no P waves, normal QRS
Treatment for atrial fibrillation - Answer-Anticoagulants, antidyshrythmic meds,
cardioversion
Atrial flutter - Answer-Atrial rate of 200-350 bpm characterized by P waves and R waves
Treatment for atrial flutter - Answer-Anticoagulants, antidyshrythmic meds,
cardioversion
Ventricular fibrillation - Answer-The rapid, irregular, and useless contractions of the
ventricles; no P waves or QRS complex, rate 0 and rhythm is irregular
Treatment for ventricular fibrillation - Answer-CPR and defibrillation
Ventricular tachycardia - Answer-A very rapid heartbeat that begins within the
ventricles, HR 100-250 bpm
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