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PNR 408 TEST #1 LEWIS CH 19, 27, 30, 33, 69, 70 Questions With Complete Solutions
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PNR 408 TEST #1 LEWIS CH 19, 27, 30, 33, 69, 70 Questions With Complete Solutions
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PNR 408 TEST #1 LEWIS CH 19, 27, 30, 33, 69, 70Questions With Complete Solutions
A 26-year-old man arrives via paramedics to ED with multiple
gunshot wounds to the abdomen. He is unresponsive, BP 58/30,
HR 146. Three units type O packed RBC given for profuse
blood loss before surgery. Surgery successful in removing
bullets and repairing blood vessels but surgeon estimated he lost
at least 3 L of blood before surgery and 1 L more during
surgery.
1.What complications will you anticipate with this amount of
blood loss? Correct Answers Hypovolemic shock and fluid vol
deficit
A 30 year old female patient has deep partial thickness burns on
the front and back of the right and left leg, front of right arm,
and anterior trunk. The patient weighs 63 kg. Use the Parkland
Burn Formula: What is the flow rate during the FIRST 8 hours
(mL/hr) based on the total you calculated?
A. 921 mL/hr
B. 938 mL/hr
C. 158 mL/hr
D. 789 mL/hr Correct Answers A
F/B R&L legs = 18% + 18% = 36%
F R arm = 4.5%
Ant trunk = 18%
Total = 58.5%
,Total Amount of LR = 4 mL x BSA % x pt's weight in kg
Therefore: LR = 4 x 58.5 x 63 = 14,742mL
So ½ needs to be given in first 8 hours, 14742/2 =
7,371mL/8hours = 921.375mL /hr
A 42-year-old woman has been diagnosed with a flail chest as a
result of her head-on collision with another vehicle this morning.
What is the present condition of the woman's chest?
A.The vacuum that normally exists in her pleural space has been
compromised.
B.The woman's liver has been punctured by her fractured ribs,
resulting in intraperitoneal bleeding.
C.Air has escaped from the lung and entered the pleural space.
D.Several of the woman's ribs have been fractured at multiple
sites and free-floating rib segments are present. Correct
Answers D
A 58 year old female patient has superficial partial-thickness
burns to the anterior head and neck, front and back of the left
arm, front of the right arm, posterior trunk, front and back of the
right leg, and back of the left leg. Using the Rule of Nines,
calculate the total body surface area percentage that is burned?
A. 63%
B. 81%
C. 72%
D. 54% Correct Answers A
Ant. head/neck = 4.5%
,Front/back L arm = 4.5+4.5 = 9%
Front R arm = 4.5%
Post. trunk = 18%
Front/back R leg = 9+9 = 18%
Back R leg = 9%
Total = 63%
A 65 year old male patient has experienced full-thickness
electrical burns on the legs and arms. As the nurse you know
this patient is at risk for the following: Select all that apply:
A. Acute kidney injury
B. Dysrhythmia
C. Iceberg effect
D. Hypernatremia
E. Bone fractures
F. Fluid volume overload Correct Answers A, B, C, E
A client has the following arterial blood gas results: pH, 7.52;
paCO2, 30 mmHg; HCO3 level, 24 mmol/L. These results
indicate the presence of which acid-base disturbance?:
a) metabolic acidosis
b) metabolic alkalosis
c) respiratory acidosis
d) respiratory alkalosis Correct Answers D
pH - HIGH = alkaline
PaCO2 - LOW = RESP alkaline
HCO3 - normal range
, A client is taking hydrochlorothiazide for treatment of
hypertension. What symptoms should the nurse teach the client
to report?
A.Anxiety and muscle twitching
B.Abdominal cramping and diarrhea
C.Fatigue and muscle weakness
D.Confusion and personality changes Correct Answers C -
HYPOKALEMIA
A - hypocalcemia
B - hypERkalemia
D - hypomagnesemia
A client who has required prolonged mechanical ventilation has
the following arterial blood gas results: pH 7.48, PO2 85 mm
Hg, PCO2 32 mm Hg, and HCO3- 25 mmol/L. How would the
nurse interpret these results?
A.Metabolic acidosis
B.Metabolic alkalosis
C.Respiratory acidosis
D.Respiratory alkalosis Correct Answers D
pH is HIGH = alkaline
PCO2 is altered = RESP
When PCO2 is low, pH will be higher (alkaline), and when
PCO2 is high, pH will be low (acidic)
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