Practice Test 2
Increased tendency of the tissues to hold water in the extra-cellular space is called as
- Cutaneous edema
- Peripheral edema
- Pitting edema
Correct Answer: C. Myxedema
In myxedema, edema occurs because of an increased tendency of the tissues to hold water in the extra-cellular space; there is also an increase in hydrophilic carbohydrate-rich molecules embedded in the tissue matrix. All other above-mentioned edemas are not related toincreased tendency of the tissues to hold water in the extra-cellular space.
A nurse cares for an elderly patient with hypertensive crisis. Which pharmaceutical intervention is considered as the most fast acting one in the treatment of hypertensive crisis?
Correct Answer: A. Sodiumnitroprusside
Immediate treatment for hypertensive crisis is with intravenous sodium nitroprusside. This drug is considered as a fast acting drug. The other above-mentioned drugs are anti-hypertensives. If sodium nitroprusside is unavailable some other drugs are also used, but it will take several minutes for the other drugs to have onset of action. After initial treatment, with sodium nitroprusside the blood pressure is reduced to normal, slowly.
A nurse cares for a 55-year-old male patient with severe respiratory failure. The patient is managed with endotracheal intubation and mechanical ventilation. Which of the following parameters would the patient possibly have?
- PaO2 less than 50 mmHg
- PaO2 less than 80 mmHg
- PaO2 less than 70 mmHg
- PaO2 less than 60 mmHg
- PaO2 less than 90 mmHg
Correct Answer: A. PaO2 less than 50 mmHg
When thePaO2 is less than 50 mmHg, endotracheal intubation and mechanical ventilation is used in case of respiratory failure, then the situation is considered as a severe condition. The other above-mentioned oxygen concentrations are usually managed with oxygen administration. Drugs like respiratory stimulants are used in case of overdose of sedative drugs.
A patient who was on anti-psychotics for a period of 10 years developed cogwheel rigidity, bradykinesia, tremors, and postural instability. What would a hospice nurse infer from the symptoms?
- The patient is likely to have pseudoparkinsonism.
- The patient is likely to have psychosis.
- The patient is likely to have tardive dyskinesia.
- The patient is likely to have acute dystonic reactions.
- The patient is likely to have encephalitis.
Correct Answer: A. The patient is likely to have pseudoparkinsonism
Drug-induced parkinsonism includes the symptoms of cogwheel rigidity, bradykinesia, tremors, and postural instability. It is also known as pseudoparkinsonism. The above-featured symptoms in the patient are typically seen in pseudoparkinsonism. The other above-mentioned options are present in extrapyramidal symptoms along with pseudoparkinsonism.
The triage nurse is working in an emergency department. Which patient must be assessed first?
- Massive uncontrolled bleeding
- Multiple fractures
- Renal calculi
- Chronic headache
- Acute psychosis
Correct Answer: A. Massive uncontrolled bleeding
Massive uncontrolled bleeding is life threatening and it is given the first priority and continuous assessment in triage nursing. Multiple fractures, renal calculi and acute psychosis are the second priority as the condition is considered as urgent in triage nursing. It needs assessment once in half an hour. Chronic headache is considered non-urgent; it needs assessment once in every 2 hours.
A nurse educates a patient with Vincent’s angina that the treatment of the condition will include all of the following except
- Chlorhexidine mouth rinses, twice daily
- Application of topical antibiotics
- Consumption of high-protein diet
- Frequent need for debridement
- Consumption of high-fiber diet
Correct Answer: E. Consumption of high-fiber diet
A patient with Vincent’s angina needs chlorhexidine mouth washes two times a day. Since Vincent’s angina is a bacterial infection, treatment also includes application of topical antibiotics and frequent debridement. The patient must take soft nutritious diet, which must be rich in protein. The patient must avoid high-fiber diet.
Which of the following nursing interventions must be included in the management of Crohn’s disease?
- Restriction of fluids
- Providing fiber-rich diet
- Providing cold foods
- Encouraging vigorous activity
- Administering anti-diarrheal agents as prescribed
Correct Answer: E. Administering anti-diarrheal agents as prescribed
InCrohn’s disease, the inflammation must be reduced and inappropriate immune response must be suppressed. Anti-diarrheal agents are provided to reduce peristalsis and to rest the inflamed bowel. Fiber is restricted and fluids are encouraged orally; if this is not possible, fluids are given parenterally. Cold foods are avoided to prevent peristalsis. Moderate activity is advised to the patient.
A nurse cares for a 23-year-old female patient who reports to have a severe headache in the mornings. She has recently gained 22 pounds of weight. Fundoscopy reveals optic disc swelling and hemorrhage is seen around the disc. Which of the following would the patient be likely to suffer from?
- Intracranial hypotension
- Cerebral venous thrombosis
- Idiopathic intracranial hypertension
- Obstructive Hydrocephalus
- Normal-pressure hydrocephalus
Correct Answer: C. Idiopathic intracranial hypertension
Females with recent history of weight gain and high body mass index are most commonly affected with idiopathic intracranial hypertension. Headache is a typical sign of the disease. Papilledema seen in fundoscopy is also a typical clinical feature seen in patients affected with idiopathic intracranial hypertension.
Which of the following pre-operative instructions must be given by a nurse to the patient who is going to undergo permanent illeostomy?
- The patient will have one normal bowel movement in a day
- Liquid stool will drain constantly in the bag attached to the stoma
- The patient will be taught how to drain liquid stool at regular intervals with a catheter
- The patient will be taught how to irrigate the bowel through the stoma
- The patient will have 2 normal bowel movements in a day
Correct Answer: B. Liquidstool will drain constantly in the bag attached to the stoma
After surgery, the patient will have fecal drainage from the stoma which would be liquid in consistency and it would drain constantly in an illeostomy bag. The patient must know that he would not be able to have normal bowel movement with formed stool. Drainage of liquid stool with the help of catheter is possible only in continent illeostomy. Illeostomy stoma must not be irrigated.
A 39-year-old woman was admitted with the complaints of coughing of pink frothy sputum, difficulty in breathing, anxiety and pale skin. She is unable to lie down flat due to breathlessness. On auscultation, end-inspiratory crackles were heard by the nurse. Which of the following would the patient be likely to suffer from?
- Pulmonary edema
- Pulmonary hypertension
- Pulmonary embolism
Correct Answer: A. Pulmonary edema
The pulmonary edema symptoms are breathing difficulty with coughing of blood, diaphoresis and pallor. Orthopnea is common in pulmonary edema. On auscultation, inspiratory crackles are heard at the end of deep breaths with the presence of a third heart sound. In pulmonary hypertension, there is usually non-productive cough and rare hemoptysis. Inpulmonary embolism, there is loud pulmonary component of the second heart sound, on auscultation. In ARDS, there is usually no symptom of cough .In sepsis, the above-mentioned symptoms are not found in the patient.
Which of the following is not junctional arrhythmia?
- Supraventricular tachycardia
- AV nodal reentrant tachycardia
- Accelerated idioventricular rhythm
- Junctional rhythm
- Junctional tachycardia
Correct Answer: C. Accelerated idioventricular rhythm
Accelerated idioventricular rhythm is a condition where depolarization rate of normally suppressed focus is higher or above that of the "higher order" focuses. Junctional arrhythmias include supraventricular tachycardia, which is a rapid heart rhythm starting at or above the AV node. AV nodal reentrant tachycardia originates from a part within the heart or above the bundle of His. Junctional rhythm occurs with an abnormal heart rhythm resulting from impulses, arising from locus of a tissue in the area of AV node. Junctional tachycardia is a form of SV tachycardia, with the involvement of AV node. Accelerated idioventricular rhythm is a ventricular arrhythmia. This most commonly occurs in the setting of a sinus bradycardia.
A nurse is performing an assessment in a 40-year-old male patient who underwent colostomy 24 hours ago. Which of the following data would the nurse report immediately to the surgeon?
- Stoma appearing red in color
- Stoma appearing slightly edematous
- Stoma appearing dusky blue in color
- Slight oozing from stoma on touch
- Slight redness around the stoma
Correct Answer: C. Stoma appearing dusky blue in color
The nurse must report when the stoma appears dusky blue in color, because this may indicate ischemia. Redness in and around the stoma, slight edema in stoma and mild oozing from stoma on touch are commonly seen in immediate post-operative condition, so the nurse need not report on it.
A 65-year-old woman is posted for intravenous pyelogram. Which of the following findings would the nurse assess and record?
- Frequent burning micturition
- History of allergies
- History of hematuria
- Presence of sugar in urine
- Presence of acetone in urine
Correct Answer: B. History of allergies
IVP involves injection of contrast medium containing iodine; some patients develop serious allergic reactions like utricaria, itching, and respiratory distress to this contrast medium. So, the nurse must obtain history of allergies in the patient before scheduling the patient for an IVP. The other above-mentioned options are not needed for IVP.
A 45-year-old woman develops syncope after vigorous exercise. What type of syncope is usually triggered by exercise?
- Vasovagal syncope
- Carotid sinus hypersensitivity
- Cardiac syncope
- Carotid sinus syndrome
- Orthostatic syncope
Correct Answer: A. Vasovagal syncope
Vasovagal syncope is also known as reflex syncope or neurocardiogenic syncope; it is the most common syncope. It occurs when heart rate and blood pressure malfunctions occur in response to a trigger such as pain or fear, coughing, sneezing or laughing, exercise, and prolonged standing. Most people affected with this type of syncope will have warning signs and symptoms before fainting. Warning signs and symptoms include severe dizziness, nausea and sweating. Reflex syncope is usually harmless. The other above-mentioned syncopes are not triggered by exercise.
Which of the following parameters indicates the presence of hypercalcemic crisis?
- 9-10.5 mg/dL
- 10-12.0 mg/dL
- 11-12 mg/dL
- 12-13 mg/dL
- 14-16 mg/dL
Correct Answer: E. 14-16 mg/dL
Hypercalcemiccrisis a medical emergency with the blood calcium level above or approximately equal to 14 mg/dL. The patients with hypercalcemiccrisis are known to have symptoms of oliguria or anuria and even coma. The condition is usually treated by lowering calcium levels with extensive hydration. Calcitonin and bisphosphonates will lower the calcium levels, within one or two days.