A patient in hyperosolar hyperglycemic state (HHS) is being admitted with dehydration and a
t t t t t t t t t t t t t
serum glucose level of 836 mg/dL. Which of the following additional laboratory findings should
t t t t t t t t t t t t t t
the nurse anticipate?
t t t t
A. decreased BUN, decreased creatinine, and elevated serum osmolality
t t t t t t t t t
B. decreased BUN, decreased creatinine and decreased serum osmolality
t t t t t t t t t
C. decreased BUN, elevated creatinine and decreased serum osmolality
t t t t t t t t t
D. elevated BUN, elevated creatinine and elevated serum osmolality - ANSWER: ➡ D. elevated
t t t t t t t t t t tt t t
BUN, elevated creatinine and elevated serum osmolality
t t t t t t t
Serum osmolality > 320 mOsm/kg distinguishes HHS from DKA
t t t t t t t t
On the fifth day post-admission, a patient with Q waves in V1, V2, and V3 develops hypotension,
t t t t t t t t t t t t t t t t
tachycardia, and a pan-systolic murmur that is loudest at the lower left sternal border. This
t t t t t t t t t t t t t t t
patient most likely developed
t t t t t
A. idiopathic hypertrophic cardiomyopathy
t t t t
B. inferior wall infarction
t t t t
C. cardiac tamponade
t t
D. a ruptured inter-ventricular septum - ANSWER: ➡ D. a ruptured inter-ventricular septum
t t t t t t tt t t t t t
(septal wall MI)
t t t
A patient with a history of chronic pain, asthma, diabetes, and heavy alcohol intake is now
t t t t t t t t t t t t t t t
experiencing cognitive impairment from medications. Assessment: awake but confused, BP
t t t t t t t t t t
155/82, HR 84, RR 16 and SpO2 95% on RA. This patient is at high risk for
t t t t t t t t t t t t t t t t t t
,A. Intubation
t t
B. needing long-term psychiatric care
t t t t
C. attempting suicide
t t t
D. over-sedation by staff - ANSWER: ➡ C. attempting suicide (chronic medical illness, heavy
t t t t t tt t t t t t t t
alcohol intake, and chronic pain)
t t t t t
Which of the following 12-lead ECG changes should be expected in a patient with acute coronary
t t t t t t t t t t t t t t t
syndrome involving the inferior wall?
t t t t t t
A. ST segment elevation and deeply inverted T waves in leads V4-V6, I and aVL
t t t t t t t t t t t t t t t
B. ST segment elevation in leads II, III, and all precordial leads
t t t t t t t t t t t t
C. ST segment elevation and deeply inverted T waves in leads II, III, aVF
t t t t t t t t t t t t t t
D. ST segment depression and T wave elevation in leads II, III, aVL - ANSWER: ➡ C. ST segment
t t t t t t t t t t t t t t tt t t t
elevation and deeply inverted T waves in leads II, III, aVF
t t t t t t t t t t t
The major effect of acute lung injury (ALI) on the lung tissue is
t t t t t t t t t t t t t
A. decreased capillary permeability
t t t t
B. increased function residual capacity (FRC)
t t t t t t
C. decreased compliance
t t t
D. decreased alveolar surface tension - ANSWER: ➡ C. decreased compliance (related to the
t t t t t t tt t t t t t t
alteration of lung endothelium and vascular tissue. Results in stiffness and fluid filled non-
t t t t t t t t t t t t t t
aerated airways) t
A patient with mitral regurgitation suddenly develops atrial fibrillation with a rate of 156. BP is
t t t t t t t t t t t t t t t
118/74. The nurse should anticipate medication orders for
t t t t t t t t t
A. beta-blockers and vasopressors
t t t t
B. warfarin (Coumadin) and alpha-agonists
t t t t
C. beta-agonists and calcium-channel blockers
t t t t t
,D. cardiac glycosides and calcium channel blockers - ANSWER: ➡ D. cardiac glycosides
t t t t t t t t tt t t t
(digoxin) and calcium channel blockers
t t t t t
Which of the following pulmonary artery catheter findings would be anticipated in a patient
t t t t t t t t t t t t t
with chronic emphysema?
t t t t
A. increased CVP
t t
B. decreased CI
t t t
C. increased SV
t t
D. decreased PAOP - ANSWER: ➡ A. increased CVP (emphysema can cause cor pulmonale
t t t t tt t t t t t t t t
secondary to increased pressure)
t t t t
A patient is admitted complaining of chest pain and nausea. The ECG monitor reveals secondary
t t t t t t t t t t t t t t
AV block, Type II. These findings are probably a result of occlusion of which of the following
t t t t t t t t t t t t t t t t t
coronary arteries?
t t t
A. left anterior descending
t t t t
B. left circumflex
t t
C. posterior descending
t t t
D. right - ANSWER: ➡ A. left anterior descending (LAD supplies blood to the septum)
t t t tt t t t t t t t t t t
A patient has heart failure secondary to ischemic cardiomyopathy and end-stage coronary
t t t t t t t t t t t
artery disease. Which of the following agents would be most beneficial
t t t t t t t t t t t t
A. digoxin and diltiazem
t t t t
B. carvedilol and lisinopril
t t t t
C. veramapril and spironolactone
t t t t
D. flecainide and hydralazine - ANSWER: ➡ B. carvedilol and lisinopril (decreases after-load
t t t t t tt t t t t t t
and minimizes remodeling that is associated with HF)
t t t t t t t t
, When providing care to a patient with status epilepticus, the nurse should recognize that
t t t t t t t t t t t t t
usually
t t
A. it is a state of continuous seizures lasting more than two minutes
t t t t t t t t t t t t
B. the patient comes out of the post ictal state between seizures
t t t t t t t t t t t t
C. it results from abrupt discontinuation of anti-seizure meds
t t t t t t t t t
D. the cause of death is due to cerebral hemorrhage - ANSWER: ➡ C. it results from abrupt
t t t t t t t t t t t tt t t t t t
discontinuation of anti-seizure meds
t t t t
A patient with a history of angina is admitted to the units after surgical repair of an AAA. The
t t t t t t t t t t t t t t t t t t
patient is receiving a sodium nitroprusside (Nipride) gtt for severe postop hypertension.
t t t t t t t t t t t t
Twelve hours later, the pattient complains of back pain.
t t t t t t t t t t
BP 80/60 t t
HR 120 t t
UO 20 mL/hr t t t
+1 left and right dorsalis pedis pulse
t t t t t t t
A. Admin of NS 200 ml/hr and prepare for doppler studies
t t t t t t t t t t t
B. spiral chest CT and emergent pericardiocentesis
t t t t t t t
C. procedural sedation and IABP insertion
t t t t t t
D. discontinuation of Nipride and prepare for surgery - ANSWER: ➡ D. discontinuation of
t t t t t t t t t tt t t t
Nipride and prepare for surgery (because the patient is hypotensive-DUH! w/ s/s of postop
t t t t t t t t t t t t t t
bleeding and hypovolemic shock)
t t t t
A patient with head trauma is experiencing increased ICP. The ideal level at which to maintain
t t t t t t t t t t t t t t t
arterial pCO2
t t t
A. below 20 t t t
B. between 35 and 45
t t t t t
C. between 25 and 30
t t t t t
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Fordenken. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.