The AGACNP is reviewing a chart of a head-injured patient. Which of the
following would alert the AGACNP for the possibility that the patient is over
hydrated, thereby increasing the risk for increased intracranial pressure?
A. BUN = 10
B. Shift output =
800 ml, shift
input = 825 ml
Unchanged
weight
, 2
C. Serum osmolality = 260
2. QUESTION/ ANSWER:
A patient who has been in the intensive care unit for 17 days develops
hyponatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is
intubated, and is receiving mechanical ventilation. The serum osmolality is
320 mOsm/L kg H2O. Clinical signs include tachycardia and hypotension.
The adult-gerontology acute care nurse practitioner's initial treatment is to:
A. reduce serum osmolality by infusing a
5% dextrose in 0.2% sodium chloride
solution
B. reduce serum sodium concentration by
infusing a 0.45% sodium chloride solution
C. replenish volume by infusing a 0.9% sodium chloride solution
D. replenish volume by infusing a 5% dextrose in water solution.
3. QUESTION/ ANSWER:
A 16-year-old male presents with fever and right lower quadrant
discomfort. He complains of nausea and has had one episode of vomiting,
but he denies any diarrhea. His vital signs are as follows: temperature
, 3
101.9°F, pulse 100 bpm, respirations 16 breaths per minute, and blood
pressure 110/70 mm Hg. A complete blood count reveals a WBC count of
19,100 cells/µL. The AGACNP expects that physical examination will reveal:
A. + Murphy’s sign
B. + Chvostek’s sign
C. + McBurney’s sign
D. + Kernig’s sign
4. QUESTION/ ANSWER:
Myasthenia gravis is best described as:
A. An imbalance of dopamine and
acetylcholine in the basal ganglia
Demyelination of peripheral
ascending nerves
, 4
B. Demyelination in the central nervous system
C. An autoimmune disorder characterized by decreased neuromuscular activation
5. QUESTION/ ANSWER:
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