NR324 FINAL EXAM/NR-324 ADULT HEALTH 1 FINAL EXAM
LATEST TEST BANK 2023-2024 ACTUAL EXAM 200
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES |AGRADE
Which diagnostic tool is most helpful in measuring heart function in
heart failure patients? – ANSWER- Echocardiogram (ECHO)
What electrolyte is most likely deficient in a patient with Torsades de
Point? – ANSWER- Magnesium
A client had a heart stent after having an MI, what med MUST they be
on to prevent occlusion of the stent? – ANSWER- Anticoagulant (Plavix,
Brilinta, etc.)
A patients heart can’t contract forcefully enough to expel blood out of
the heart, what type of heart failure is this? – ANSWER- Systolic
Which condition causes cor pulmonale (right sided heart failure)? –
ANSWER- Pulmonary hypertension
Which medication is used to treatment dysrhythmias, but can caused a
dangerous prolonged QT interval? – ANSWER- Amiodarone
Which dysrhythmia is defined by a heart rate > 150 bpm & is treated
with adenosine? – ANSWER- Supraventricular tachycardia
What medication treats symptomatic bradycardia? – ANSWERAtropine
Which medication can help treat all dysrhythmias except for sinus brady
& sinus tach? – ANSWER- Amiodarone
A client is experiencing ventricular fibrillation, what is the treatment? –
ANSWER- Defibrillation
Which dysrhythmia always requires defibrillation? – ANSWERVentricular fibrillation
When a patient is having premature ventricular contractions (PVCs)
what do we assess first? – ANSWER- SPO2
Which electrolyte imbalance can cause Torsades de Point? – ANSWERMagnesium
Which rhythm requires an anticoagulant to prevent emboli? – ANSWERAtrial fibrillation
Which rhythm involves abnormal P waves? – ANSWER- Atrial
fibrillation
A client has a pulse and is experiencing ventricular tachycardia, what is
the treatment? – ANSWER- Cardioversion
A client with afib has taken medications & has gotten a cardioversion
without success. What is the next treatment option – ANSWERAblation
Abnormalities in which measurement can cause Torsades de Point? –
ANSWER- QT interval
Which medication is given IV push in cardiac arrest? – ANSWEREpinephrine
Which rhythm does not require defibrillation? – ANSWER- Pulseless
electrical activity (PEA)
Which rhythm could be caused by stimulation of the vagal nerve? –
ANSWER- Sinus bradycardia
What labs are used to assess pancreatic function? – ANSWER- Amylase
Lipase
What labs are used to assess liver function? – ANSWER- AST/ALT
Bilirubin
Albumin
NR324 EXAM 2/NR-324 ADULT HEALTH 1 EXAM 2 LATEST VERSION
2023-2024 ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES |AGRADE
What is BMP – ANSWER- ( B-type natriuretic peptide) will be
increased in there is heart failure
What are the cholesterol level – ANSWER- Total cholesterol <200 LDL- (bad) <130 HDL-( happy ) >40
What are the nursing responsibility for cardiac cath – ANSWER- check
site, lay flat, log roll, check pulses, Bed rest for 2 hours
How much sodium should a cardio patient get in 24 hours – ANSWER2300 grams
What are the cardiac biomarkers ( troponin) – ANSWER- Troponin T
(cTnT)
Troponin I (cTnI)
Rises within 4-6 hours, peaks 10-24 hours, detected for up to 10-14 days
What are the cardiac biomarkers ( creatine kinase ( CK) – ANSWERThree isoenzymes
CK-MB cardiac specific
Rises in 3-6 hours, peaks in 12-24 hours, returns to baseline within 12-
48 hours
Cardiac catheterization – ANSWER- Right-sided to measure pressures
Left-sided to evaluate coronary arteries
How do the Baroreceptors Factors Influencing BP – ANSWERSensitive to stretching
Send impulses to sympathetic vasomotor center
Blood pressure (BP) – ANSWER- the force exerted by the blood against
the walls of the blood vessel, is primarily a function of cardiac output
(CO) and systemic vascular resistance.
What is the Systolic BP – ANSWER- the force exerted by the blood
against the walls of the blood vessel
What is the Diastolic BP – ANSWER- pressure in the arterial system
during ventricular filling
What is a normal BP – ANSWER- <120 /<80
What is prehypertension – ANSWER- 120/139/80-89
What is hypertension stage 1 – ANSWER- 140-149/90-99
What is hypertension stage 2 – ANSWER- >160/>100
What are the sign and symptoms of Hypertension – ANSWER- “Silent
killer”, Often asymptomatic
S/S reflect effects on target organs/tissues
Fatigue , Activity intolerance, Dizziness, Palpitations, Angina
Dyspnea
What kind of studies are done for hypertension – ANSWER- Urinalysis,
BUN and serum creatinine, Creatinine clearance
Serum electrolytes, glucose, Serum lipid profile, Uric acid levels, ECG,
Echocardiogram
What does MAP mean – ANSWER- it is the average pressure in the
arterial system
if the mean < 60mm HG for adequate tissue prefusion
Primary (essential or idiopathic) hypertension – ANSWER- elevated BP
without an identified cause, and it accounts for 90% to 95% of all cases
of hypertension.
Secondary hypertension – ANSWER- elevated BP with a specific cause
that often can be identified and corrected. relates to a underlying cause
NR324 EXAM 1/NR-324 ADULT HEALTH 1 EXAM 1 LATEST 2 VERSIONS A AND
B 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS|AGRADE
- What are possible causes of hypervolemia? known as “fluid overload” and occurs when the body retains
more
water than it needs. - What are the clinical manifestations of hypervolemia? Crackles, edema, Increased pulses, Jugular vein
distention,
weight gain - What are remarks that a patient might say if they are experiencing fluid volume overload?
- What are the vital signs changes you’ll see with hypervolemia? Increased or slowed HR, increased blood
pressure, Edema - What are specific nursing assessments to assess for hypervolemia? Mental status, crackles, SOB, Cough,
frothy
sputum - What is the treatment for these patients? Reduce fluid intake, reduce sodium intake,
o What are the different types of diuretics? Loop diuretics, thiazide diuretics, potassiumsparing
diuretics
o How would you educate your patient with each type? Thiazide – Instruct patient to
monitor weight weekly and report significant changes. Use sunscreen to prevent
photosensitivity reactions. Advise patient to consult health care professional before
taking OTC medication concurrently with this therapy. Instruct patient to notify health
care professional of medicationregimen before treatment or surgery, Advise patient to
contact health care professional immediately if muscle weakness, cramps, nausea,
dizziness, or numbness or tingling of
extremities occurs. - What are possible causes of hypovolemia? Diarrhea and vomiting are common causes of body fluid loss.
Fluid
can also be lost as a result of large burns, excessive perspiration, or diuretics. - What are the clinical manifestations of hypovolemia? Headache, fatigue, dizziness, nausea, cold clammy
skin,
rapid heartbeat, rapid sallow breathing, weak pulse, confusion, little or no output - What are remarks that a patient might say if they are experiencing dehydration?
- What are the vital signs changes you’ll see with hypervolemia? High temperature, increased heart rate,
decreased blood pressure, and faster breathing , - What are specific nursing assessments to assess for hypovolemia? including thirst, weight loss, dry
mucousmembranes, sunken-appearing eyes, decreased skin turgor, increased capillary refill time,
hypotension and
postural hypotension, tachycardia, weak and thready peripheral pulses, flat neck veins - What is the treatment for these patients? Replacement of fluids
- What are way’s to measure fluid volume status? In and outs
- Which measurement is the best way to measure total body fluid gains/loss? Daily weight
- What are lab value ranges, action in the body, clinical manifestation and treatments of the following:
Sodium 135-145 mEq/L
seizuresPotassium 3.5-
5mEq/L Magnesium 1.5-2.5
mEq/L Phosphorus 2.4-
4.4mg/dL Calcium 8.6-10.2
mEq/L
3
3
3
- Know how to interpret ABG results and evaluate priority ABG’s (aka terrible ABGs, which ABG result
you would
assess first)
PH:7.35-
7.45
CO2:45-35
HCO3:22-
26
Partial comp- all three values> OUT OF RANGE
Fully comp- pH is NORMAL; CO2 & HCO3 are OUT
OF RANGEUncomp- pH & CO2 are OUT OF
RANGE; HCO3 are NORMAL - Evaluate pH
- Analyze PaCO2
- Analyze HCO3–
- Determine if CO2 or HCO3– matches the alteration
- Decide if the body is attempting to compensate
- What type of clinical manifestations and treatments would you expect with each:
o Metabolic acidosis-Carbonic acid deficit caused by Hypoxemia from acute pulmonary
disordersHyperventilation.
- Increased CO2 excretion by lungs
- Kussmaul respirations (deep and rapid)
- Kidneys excrete acid
o Metabolic alkalosis-Base bicarbonate excess caused by Prolonged vomiting or gastric suction - Gain of HCO –
▪ Compensatory mechanisms - Renal excretion of HCO –
- Decreased respiratory rate to increase plasma CO2 (limited)
o Respiratory acidosis- Carbonic acid excess caused by - Hypoventilation
- Respiratory failure
▪ Compensation - Kidneys conserve HCO –
and secrete H
+
into urine
o Respiratory alkalosis- Carbonic acid deficit caused by Hypoxemia from acute pulmonary disorders
▪ Hyperventilation
- Describe each of the IV fluids (ECF/ICF changes), names of IV fluids in each category (ex. LR, 0.9
NS, 0.45 NS,etc.), when they are used and nursing assessment associated with each:
o Hypotonic- H2O into cells swell.
▪ Solutions:
- D5W
- 0.45% NaCL
o normal daily losses
▪ due to potential cellular swelling, monitor patients for changes in mentation that may
indicatecerebral edema.
o Hypertonic- H2O out of cell shrinks