CEN Practice Exam 2 Study online at A nurse is caring for a tra-cheostomy patient who begins to cough and has increased se-cretions. The patients SpO2 has dropped to 89. What is the most likely cause of this acute change? The tracheostomy tube is dis-plac

CEN Practice Exam 2 Study online at https://quizlet.com/_exd9xd1.1. A nurse is caring for a tra-cheostomy patient who begins to cough and has increased se-cretions. The patient's SpO2 has dropped to 89%. What is the most likely cause of this acute change? The tracheostomy tube is dis-placed. The patient is experiencing a pul-monary embolism. The patient has developed tra-cheitis. The inner cannula of the tra-cheostomy is obstructed.(D) The inner cannula of the tracheostomy is obstruct-ed.Increased seretions and coughing in a tracheostomy patient, along with a drop in oxygen saturation, are often signs that the inner cannula of the tracheostomy tube is obstructed.dmi1raS1ETNgEiacrgxcrtex rEar ilgNtEPricrfxicExicic9roxygenation and ventilation.2.2. Which of the following clinical features highly suggests a duode-nal ulcer? Nocturnal pain. Hematemesis. Vomiting. Hematochezia.(A) Nocturnal pain.Duodenal ulcers typically present with nocturnal pain that rouses the patient from sleep.Unlike gastric ulcers, duodenal ulcers are relieved by food, although pain can return about three hours after eating. Hematemesis and vomiting are general symp-toms that are seen in both ulcers. Other symptoms of a duodenal ulcer are epigastric pain, dyspepsia, and nausea. Hematochezia, or bright red blood in stools, is not a typical symptom of duodenalulcers.3.1 / 81 1 / 4

CEN Practice Exam 2 Study online at https://quizlet.com/_exd9xd3. A 49-year-old male presents to the ER with complaints of severe epigastric pain of 12 hours dura-tion. He said he has GERD and has )eeqd_qd9i.dheTinoli_qdm_ d?Aedyears. On examinationhe is noticed to have gynecomastia. Which of the follow-ing drugs is most likely the cause of gynecomastia? Omeprazole. Cimetidine. Aluminum hydroxide. Magnesium hydroxide.,(B) Cimetidine.Cimetidine is an H2 receptor blocker used in reducing 1EafxgmrmP2eTxgi iEPsr5Pcegafx1Eixri1rxr1i ereKegEra'riE1rtac9OEeTfrN1er NerEariE1rxcEix TeceT9igreKegEs4.4. You are giving IV amphotericin B to a patient being managed for systemic histoplasmosis. An hour after commencing the infusionthe patient complains of chills and rigors. Which of the following responses is most appropriate? CWiEgmrxf2maEeTigicrBrEar7Ngacxuates Administer IV prednisolone and continue with the infu-sion. Stop the infusion. Administer IV acetaminophen and premedicate for con-sequent doses.,(D) Administer IV acetaminophen and premedicate for consequent doses.Ymitt1rxc rTi9aT1rxTer1i ereKegE1ra'rxf2maEeTigicrBsrThese symptoms typically subside with subsequent dos-2 / 81 2 / 4

CEN Practice Exam 2 Study online at https://quizlet.com/_exd9xdes. Premedication with a steroid or an antipyretic re- Nge1rEmerTi1zra'rEme1er1i ereKegE1s5.5. Which of the following sub-strates is not expected to be pre-sent on dipstick urinalysis in a 45-year-old female with diabetic ketoacidosis? Glucose. Ketones. Protein. Bilirubin.(D) Bilirubin.Bilirubin is not expected to be present on urinalysis. Protein may be increased in patients with a suspected urinary tract infection (which, in such cases, may be a trigger for the glycemic event). Nitrates and red blood cells may also be increased.6.6. Which is the following interven-tions is prioritized in managing a patient with diabetic ketoacido-sis? IV insulin. IV normal saline. IV potassium. IV antibiotics.(B) IV normal saline.Acute volume resuscitation is the priority goal in patients with diabetic ketoacidosis. These patients are severe-ly dehydrated, with an estimated 10 percent de@cit in blood volume.Thereire, fessitation must include volume repletion with at least 3 Lof normal IV saline in the @rst @ve hours of presentation. Thereafter, other measures can be taken, like potassium repletion, insulin, and treatment of un-derlying infections.7.7. A patient being managed for al-coholic ketoacidosis does not pre-sent with which of the following?(B) Hyperglycemia.Patients with alcoholic ketoacidosis do not typically pre-sent with hyperglycemia. Those with hyperglycemia may 3 / 81 3 / 4

CEN Practice Exam 2 Study online at https://quizlet.com/_exd9xd Ketonemia. Hyperglycemia. Hypokalemia. Metabolic acidosis.have undiagnosed diabetes mellitus. Biochemical ab-normalities in alcoholic ketoacidosis include ketonemia, metabolic acidosis, hypokalemia, hypophosphatemia, and hypomagnesemia.8.8. Which of the following is not a clinical feature of pheochromocy-toma? Hypertension. Postural hypotension. Palpitations. Diarrhea.(D) Diarrhea.Diarrhea is not a clinical feature of pheochromocytoma. Pheochromocytoma is characterized by an excess secre-tion of adrenergic hormones in the adrenal medulla. These hormones stimulate receptors that mediate the sympathetic nervous system. Therefore, clinical features of pheochromocytoma are a result of the sympathetic drive. These features include constipation, palpitations, paroxysmal hypertension, postural hypotension, tachyp-nea, angina, anxiety, headaches, nausea, vomiting, epi-gastric pain, and paresthesia.9.9. You are managing a patient with pheochromocytoma. Which of the following interventions is most appropriate to reduce the risk of paroxysmal hypertension? Place the patient in the semi-Fowler's position. Avoid abdominal palpation. Elevate the foot of the bed.(B) Avoid abdominal palpation.Paroxysmal hypertension can be triggered by palpating the tumor, which releases catecholamines. Abdominal palpations should be avoided or kept to a minimum to reduce this risk.4 / 81

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