Mr. Balzkeriwitz is in your medical unit waiting to go for surgery to have his left
foot amputated. He is 65 years old, is a "brittle" diabetic and is a very active man in
his community. He will return to your unit because of his Diabetes.
Questions 1 - 2 refer to this case study.
1. What key nursing diagnoses preoperatively would the nurse include for this
client:
A. Pain related to surgery.
B. Altered body image.
C. Cardiac output drop.
D. All of the above.
2. Clients who have experienced an amputation of a limb experience phantom pain.
This can be described in the following way:
A. Burning, throbbing, itching sensation in the existing limb.
B. It is in the client's mind as they remember their limb.
C. It is a temporary discomfort and does not require intervention.
D. It happens only immediately after surgery. - ANSWER C. Cardiac output drop.
C. It is a temporary discomfort and does not require intervention.
Case Study #2
An older gentleman is admitted to the hospital in complete collapse. His blood pH
is 7.6 Medical history reveals that this client is a chronic alcoholic.
Questions 3 - 4 refer to this case study.
,3. What diagnosis would you give this gentleman?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
4. Clients with chronic alcohol dependency may have which of the following
electrolyte and acid-base balancers?
A. Decreased in potassium.
B. Did you sign the student handbook?
C. Increased potassium.
D. Decreased calcium. - ANSWER C. Respiratory acidosis
C. Increased potassium.
Case Study # 3
Mrs. Duncan is a 36-year-old woman who burned her hand in steam in a cooking
accident. She has been told by her physician that her hand will take less than 3
weeks to heal.
Questions 5 - 7 refer to this case study.
5. What depth of burn does Mrs. Duncan likely have
A. Full-thickness fourth-degree
B. Superficial partial-thickness
C. Deep full thickness
D. Deep partial-thickness
6. Mrs. Duncan's burn area is a possible site for because of the injury depth.
A. Pain
,B. Scarring
C. Hyperpigmentation
D. All of the above
7. Because Mrs. Duncan's burn covers only a small area of the body surface, it will
probably not lead to the same serious complication of extensive burns, which is:
A. Pain
B. Scarring
C. Hyperthermia
D. Hypovolemia - ANSWER B. Superficial partial-thickness
C. Hyperpigmentation
C. Hyperthermia
Case Study # 4
Judy is a 62-year-old smoker. Her physician has diagnosed her with emphysema
which has caused her to hyperventilate. She is tired and sedentary.
Questions 8 - 9 refer to this case study.
8. Besides having difficulty breathing, what other condition is Judy likely to
experience?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
9. What breathing techniques would the PN advise Judy to help resolve this
condition?
A. Shallow breathing.
B. Deep breathing.
, C. Rapid breathing.
D. Breath holding exercise. - ANSWER D. Respiratory alkalosis
D. Breath holding exercise.
Case Study #5
45-year-old Burt Wohl is a real estate agent. As an active member of several
community organizations and because of his business contacts, Mr. Wohl entertains
frequently. He loves rich foods and admits that he drinks and smokes a
considerable amount every day. Other than occasional jogging, Mr. Wohl does
little exercise. He is 175 cm tall and weighs 95.3 kg. Mr. Wohl's father has a
history of coronary artery disease. - ANSWER Following a luncheon meeting, Mr.
Wohl suddenly feels a sharp pain in the epigastric region. A colleague offers to take
him to the emergency department of the nearest hospital. A diagnosis of acute
myocardial infarction is made by the physician, and the treatment plan includes:
· 12 lead electrocardiogram STAT and for 3 days
· Morphine Sulfate, 2-4 mg. I.V. Q 5 min prn
· Oxygen by nasal cannula 4 L/min
· Blood work: Creatine Kinase Isoenzymes (CK isoenzymes) and LDH daily for 3
days
· IV Dextrose 5% in water (D5W), 500 ml TKVO. Questions 10 - 15 refer to this
case study.nic alcohol dependency
(See Q&A with the next flash cards)
10. In addition to pain, which of the following would be signs of decreasing cardiac
output?
A. Fatigue and shortness of breath.
B. Rapid and bounding pulses.
C. Restlessness and depressed respirations.
D. Flushed face and depressed respirations. - ANSWER B. Rapid and bounding
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