FINAL EXAM PNR 309 - CAD, PAD, MI, Stroke, TIA,
Diabetes, Visual and Auditory Disorders, Neurological
disorders Questions With Complete Solutions
A 40-year-old male client called the clinic requesting to speak to
the charge nurse. When the nurse gets to the phone and speaks
with the client, he tells her that he has spiked a temperature of
100º F or 37.7º C, has generalized weakness, and a red painful
rash appeared on the right upper side of his abdomen and wants
to know what he should do. What is the nurse's best response for
this client's complaints?
a. "Please come to the clinic. It sounds like you have shingles
and need to be treated."
b. "Please go to the emergency department. You will need to be
hospitalized for shingles."
c. "Take some acetaminophen or ibuprofen for pain and lay
down for a few hours."
d. "Call your health care provider (HCP) and tell them exactly
what you just told me." Correct Answers a. "Please come to the
clinic. It sounds like you have shingles and need to be treated."
Rationale:
Clients with shingles who exhibit early symptoms may have a
low grade temperature, generalized weakness, a red painful rash
that follows a nerve's pathway. Other symptoms may include a
burning, tingling, pins and needles sensation over the nerve
pathway. The client may have red or pink blotchy patches and
rash within a linear distribution. The client could experience
fatigue and itching as well. Some clients experience severe pain
after the lesions disappear and this is a complication of shingles
,called postherpetic neuralgia. The best response of the nurse
should be to advise the client to come to the clinic because it
sounds like he has shingles and needs treatment.
- what the client described does not sound like an emergency,
therefore going to the emergency department is unnecessary.
- although taking acetaminophen or ibuprofen may help with the
pain and fever, the symptoms will continue to persist.
- the client called the clinic for advice and needs help. The client
should be advised to come to the clinic because it sounds like he
has shingles and needs treatment.
A 50-year-old woman weighs 95 kg and has a history of tobacco
use, high blood pressure, high sodium intake, and sedentary
lifestyle. When an individualized care plan is developed for this
client, which of the following risk factors related to PAD would
the nurse determine need to be modified?
a. Salt intake
b. Sedentary lifestyle
c. Tobacco use
d. Excess weight Correct Answers c. Tobacco use
A client admitted with closed-angle glaucoma is prescribed
mannitol. After administration of the first dose of mannitol, the
client develops peripheral edema. Which of these statements are
correct regarding mannitol and the development of peripheral
edema?
,a. Mannitol is an osmotic diuretic that drains fluid out of the cell
into the vascular spaces which can cause the body to go into
fluid volume overload.
b. Mannitol is a loop diuretic that works in the loop of Henle to
decrease extra fluid by reducing urine output, therefore the body
absorbs the excess fluid.
c. Mannitol is a potassium-sparing diuretic that increases the
sodium level and reduces the potassium level, thus fluid
overload occurs.
d. Mannitol is a thiazide diuretic that increases sodium in the
blood causing fluid to accumulate in the peripheries. Correct
Answers a. Mannitol is an osmotic diuretic that drains fluid out
of the cell into the vascular spaces which can cause the body to
go into fluid volume overload.
Rationale:
Mannitol is an osmotic diuretic that drains fluid out of the cell
into the vascular spaces which can cause the body to go into
fluid volume overload. Mannitol decreases intracranial pressure
and intraocular pressure. It is only administered intravenously.
The client should be monitored for adverse effects such as
peripheral edema 30-60 minutes after administration. The client
should also be monitored for pulmonary edema and congestive
heart failure symptoms. Other side effects of mannitol may
include nausea, vomiting, excessive thirst and urination, dry
mouth, and headache.
A client diagnosed with Meniere's disease stated that she has
had sudden attacks more often over the past year. The client
asked the nurse if experiencing more attacks with hearing loss
progressively getting worse during attacks indicates that she will
, eventually have permanent hearing loss. What is the nurse's best
response?
a. "With Meniere's disease, hearing loss comes and goes, but
would never be permanent."
b. "With Meniere's disease, hearing loss comes and goes during
attacks, but results in permanent hearing loss."
c. "With Meniere's disease, hearing loss usually occurs during
attacks, but during remission hearing is repaired."
d. "With Meniere's disease, hearing loss is minimal during
attacks but does not result in permanent hearing loss." Correct
Answers b. "With Meniere's disease, hearing loss comes and
goes during attacks, but results in permanent hearing loss."
Rationale:
Meniere's disease is caused by a collection of major fluid within
the ear typically affecting only one side. Meniere's disease
affects the ear labyrinth membranes causing permanent hearing
loss with flare-ups of vertigo and ringing of the ears.
A client experiencing transient ischemic attacks is scheduled for
a carotid endarterectomy. What does the nurse explain to the
client about the purpose of this procedure?
a. To decrease cerebral edema
b. To reduce the brain damage that occurs during a stroke in
evolution
c. To prevent a stroke by removing atherosclerotic plaques
blocking cerebral blood flow
d. To provide a circulatory bypass around thrombotic plaques
obstructing cranial circulation Correct Answers c. To prevent a
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