AH II Theory Blackboard Quizzes PDF

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AH II THEORY BLACKBOARD QUIZZES ACID BASE QUIZ Question 1

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1 out of 1 points

Describe 3 different nursing actions that could increase oxygenation in a client with pneumonia and an acid base imbalance. Selected Answer:

Correct Answer:

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1. Administer high flow oxygen therapy prn by face mask or at 5 to 6 L/min to improve oxygen exchange. 2. Administer bronchodilators such as albuterol to open the airways 3. Reposition the patient frequently to prevent the pooling of respiratory secretions and to allow for better airway clearance. position with head of bed elevated, oxygen , encourage cough and deep breathing, medication administration-be specific as to which meds

Question 2 1 out of 1 points

Arterial blood gas levels are obtained for the client. If the client’s results are pH 7.48, CO2 42 mm Hg, and HCO3 32 mEq/L, the client is exhibiting which one of the following acid-base imbalances? Selected Answer:

Answers:

Metabolic alkalosis Metabolic acidosis Respiratory acidosis Respiratory alkalosis

Metabolic alkalosis

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Question 3 0.7 out of 1 points

Analyze the following arterial blood gases (ABGs): pH 7.31, PaCO2 48mmHg, HCO3 26meq/L, PaO2 55mmHg. Interpret the ABGs and discuss what is the most serious complication that you anticipate?

Selected The client is experiencing respiratory acidosis. The most serious complication

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Answer:

of this would be a dangerously low respiratory rate or hypoventilation. The client will also not be breathing out enough CO2 and will be hypercapnic, which is what makes the pH low/acidic.

Correct Answer:

[None]

Question 4 1 out of 1 points

The nurse is aware that the compensating mechanism that is most likely to occur in the presence of respiratory acidosis is: Selected Answer:

Answers:

Retention of HCO3 by the kidneys to increase the pH level Hyperventilation to decrease the CO2 levels Hypoventilation to increase the CO2 levels

Retention of HCO3 by the kidneys to increase the pH level Excretion of HCO3 by the kidneys to decrease the pH level

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Question 5 1 out of 1 points

In a client with diabetic ketoacidosis, which of the following arterial blood gas results demonstrates the greatest impairment in oxygenation? Selected Answer:

pH 7.14, PaCO2 47 mm Hg, HCO3 19 mEq/L, PaO2 40 mm Hg

Answers:

pH 7.14, PaCO2 47 mm Hg, HCO3 19 mEq/L, PaO2 40 mm Hg pH 7.22, PaCO2 55mm Hg, HCO3 29 mEq/L, PaO2 80 mm H pH 7.36, PaCO2 45mm Hg, HCO3 22 mEq/L, PaO2 75 mm Hg pH 7.46, PaCO2 45mm Hg, HCO3 29 mEq/L, PaO2 72 mm Hg

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Question 6 1 out of 1 points

Of all of the following clients, the nurse recognizes that the individual who is most at risk for an acid base imbalance is:

Selected Answer:

Answers:

A thirty year female with uncontrolled diabetes type I A 27 year old female smoker An 80 year old male with a recent hip fracture

A thirty year female with uncontrolled diabetes type I A 52 year old male with stage I heart failure

Question 7

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0 out of 1 points

A client with COPD and a new diagnosis of pneumonia is admitted to the hospital. Arterial blood gas levels are drawn. The nurse anticipates which of the following arterial blood gas results? Selected Answer:

Answers:

pH 7.53, PaCO2 35 mm Hg, HCO3 24 mEq/L pH 7.34, PaCO2 37 mm Hg, HCO3 19 mEq/L

pH 7.22, PaCO2 54 mm Hg, HCO3 20 mEq/L pH 7.53, PaCO2 35 mm Hg, HCO3 24 mEq/L pH 7.53, PaCO2 35 mm Hg, HCO3 24 mEq/L

Question 8

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0.7 out of 1 points

Based on the following vital signs results, describe what may be happening to the client. BP 148/81 HR 118 Respiratory Rate 26 PaO2 60mm Hg

SaO2 90% Selected Answer: Correct Answer:

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Hyperventilation (tachypnea) due to fright or anxiety?

the client has elevated BP, HR, RR, and decreased sao2 and paO2 . The client may be in pain or anxious and needs supplemental oxygen to increase the PaO2.

Question 9 1 out of 1 points

A homeless client is brought into the emergency department with indications of extremely poor nutrition. Arterial blood gas levels are assessed, and the nurse anticipates that this client will demonstrate which of the following results? Selected Answer:

pH 7.3, PaCO2 38 mm Hg, HCO3 19 mEq/L

Answers:

pH 7.3, PaCO2 38 mm Hg, HCO3 19 mEq/L pH 7.5, PaCO2 34 mm Hg, HCO3 20 mEq/L pH 7.35, PaCO2 35 mm Hg, HCO3 24 mEq/L pH 7.52, PaCO2 48 mm Hg, HCO3 28 mEq/L

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ACUTE CORONARY SYNDROME QUIZ Question 1 1 out of 1 points

A client is experiencing unstable angina unrelieved by 1 nitroglycerin sublingual tablet. The nurse implements which of the following orders next? Selected Answer:

Aspirin 325mg PO

Answers:

Aspirin 325mg PO Captopril 10mg PO Surgical consent form Blood draw for lab tests: CBC, lipid panel

Question 2

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1 out of 1 points

For a client experiencing a STEMI, what are 2 serious complications that the nurse will monitor for (give the rationale for each)? Selected Because the myocardial tissue damaged by the MI, cardiac nerve impulses Answer: might be impacted and the client could experience dysrhythmias. The patient

would also have decreased cardiac output which could lead to heart failure because the hearts pumping action would be implaired. Correct Answer:

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decreased cardiac output, dysrhythmias

Question 3 1 out of 1 points

The nurse is caring for a client post MI. The nurse conduct client teaching and knows that the client has understood the teaching when the clientstates: Selected Answers: Answers:

“I will begin exercising with moderate intensity.” “I do not need to immediately consider smoking cessation.” “Nitroglycerin and a beta blocker will prevent another MI.” “I will begin exercising with moderate intensity.” “I will stop taking my anti-depressants until I have fully recovered.”

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Question 4 1 out of 1 points

The nurse is caring for a client post CABG. Which of the following may be delegated to the unlicensed assistive personnel (UAP)? (select all that apply) Selected Answers:

Vital signs Shower and linen change

Answers:

Vital signs Assessment of the sternal incision site Shower and linen change Incentive spirometer teaching Monitor pedal pulses and dependent edema

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Question 5

1 out of 1 points

A client has just had a stent placed in the circumflex artery. The nurse’s post operative care includes which of the following? (select all that apply) Selected Answers:

Frequent vital signs monitoring Assessment of the catheter insertion site for bruising, hematoma Monitoring the neurovascular status of the extremity used for catheter insertion

Answers:

Frequent vital signs monitoring Assessment of the catheter insertion site for bruising, hematoma Monitoring the neurovascular status of the extremity used for catheter insertion Administration of thrombolytic therapy Active and passive ROM exercises

Question 6

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1 out of 1 points

You are caring for a client that has signs of a possible STEMI. What are your 3 priority actions and include your rationale. Selected Answer: Correct Answer:

Priority nursing interventions would be to obtain a 12 lead ECG, applying O2 via nasal cannula to keep their oxygen level above 92%, and administering sub lingual NTG and/or morphine. 12L ecg, troponin , nitroglycerin, oxygen, asa, morphine

Question 7

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1 out of 1 points

A 54 year old female client admitted to the med surg unit with fatigue, shortness of breath, and nausea has the following lab results. Which lab result is the priority for the nurse to report, give your rationale. glucose 133 mg/dl, WBC 6500, creatinine 1.1 mg.dl, potassium 3.8 meq/L, troponin I 9ng/ml Selected Answer: Correct Answer:

The troponin of 9ng/ml is the most concerning because it it elevated. Increased troponin is an indicator on an MI. The patient will need immediate attention depending on when the MI started. troponin due to possible AMI and need for emergent treatment

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Question 8 1 out of 1 points

A client is experiencing symptoms consistent with acute coronary syndrome. The nurse assesses the client’s pain location. What are possible areas of referred angina pain? (select all that apply) Selected Answers:

Jaw Should er Arms

Answers:

Jaw Should er Arms Legs Head

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Question 9 1 out of 1 points

A female client is admitted to the hospital with shortness of breath, diaphoresis, nausea, and tachycardia. Which of the following diagnostic procedures would the nurse expect to be ordered to confirm the presence of myocardial infarction (MI)? (select all that apply) Selected Answers:

12 lead ECG Stress test Cardiac catheterization

Answers:

12 lead ECG Echocardiogram Chest xray Stress test Cardiac catheterization

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Question 10 1 out of 1 points

The nurse is conducting discharge planning for a client with unstable angina. Which of the following members of the interdisciplinary team will the nurse include in the discharge planning process? Selected Answer:

Answers:

Dietician for low saturated fat, low cholesterol diet teaching Respiratory therapist for home oxygen therapy

Dietician for low saturated fat, low cholesterol diet teaching Occupational therapy to assist client with ADLs Pharmacist for Coumadin teaching

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Question 11 1 out of 1 points

A client presents with neck pain, dyspnea, and vomiting. The nurse starts an IV and draws labs. Which of the following lab results would the nurse report to the provider immediately? Selected Answer:

Troponin I = 2.0 ng/ml

Answers:

Troponin I = 2.0 ng/ml Troponin I = 0.1ng/ml CK-MB = 0.3 creatinine kinase = 20U/L

HEART FAILURE QUIZ 

Question 1 1 out of 1 points

A patient with left-sided heart failure has oxygen at 4 L/min per nasal cannula, furosemide (Lasix) 40 mg PO daily, spironolactone (Aldactone) 25 mg PO daily, and enalapril (Vasotec) 5 mg PO twice daily. Which of the following actions is most important

for the nurse to carry out? Selected Answer: Answers:

Auscultate lung sounds Assess skin turgor

Auscultate lung sounds Measure intake and output Draw a blood sample for arterial blood gases

Question 2

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1 out of 1 points

A patient with a history of chronic heart failure is hospitalized with severe dyspnea and a dry, hacking cough. She has pitting edema in both ankles, and her vital signs are blood pressure 170/100 mm Hg, pulse 92 beats/min, and respirations 28 breaths/min. The nurse recognizes that the patient’s symptoms indicate... Selected Answer:

Answers:

impaired emptying of both the right and left ventricles, with low forward blood flow. that venous return to the heart is impaired, causing a decrease in cardiac output.

impaired emptying of both the right and left ventricles, with low forward blood flow. the right side of the heart is failing to pump enough blood to the lungs to provide systemic oxygenation. the myocardium is not receiving enough blood supply through the coronary arteries to meet its oxygen demand.

Question 3

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1 out of 1 points

You are caring for a client that has left sided heart failure and is experiencing fluid overload. Which of the following lab values is of greatest concern to the nurse-(give your rationale)? Na 142 meq/L K 4.1 meq/L Creatinine 3.9 mg/dl BNP 78

Selecte Creatinine level of 3.9 is of greatest concern because creatinine is the most d accurate indicator of renal function. A high creatinine value means that the Answer: kidneys are severely impaired and are not able to function or excrete waste.

This could cause renal failure in heart failure patients because there is decreased cardiac output and perfusion to the kidneys. This is a major reason why the patient is experiencing fluid volume overload. Correct Answer:

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creatinine may indicate compromised renal perfusion

Question 4 0.5 out of 1 points

A nurse is caring for a patient with stage 3 heart failure. The patient is becoming increasingly short of breath, tired, and confused. Which of the following is the patient at risk for? (select all that apply) Selected Answers:

respiratory acidosis ventricular arrhythmias electrolyte imbalances

Answers:

respiratory acidosis cardiogenic shock ventricular arrhythmias electrolyte imbalances endocarditis

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Question 5 1 out of 1 points

You are caring for a client with heart failure that had a previous ejection fraction of 45% and now has an ejection fraction of 38%. What is the significance of the change in the client's ejection fraction? Selecte The ejection fraction (EF) is the amount of blood pumped by the left ventricle d with each heartbeat. In patients with heart failure, it is an indicator of systolic Answer: heart failure and can tell us the degree of a patients heart failure. The reduced

EF is significant because it means the patients heart failure is progressing and could also lead to fatal ventricular dysrrhythmias.

Correct Answer:

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worsening heart failure, so less cardiac output and perfusion

Question 6 1 out of 1 points

You are caring for a client with heart failure that has had an increase in weight of 10 pounds in the last 9 days. You receive the following information about the client's diet: (Discuss specific teaching that you would do to address the client's diet related to heart failure) Enjoys frozen vegetables, favorite beverage is iced tea-drinks at least 4 large cups daily, eats a ham and cheese sandwich everyday for lunch with baked potato chips, often makes soup for dinner. Selecte Sodium should be restricted in the diet of a patient with HF. One of the main d issues with heart failure is fluid overload and because water follows Answer: sodium, sodium needs to be restricted in the diet. Patients should only

consume a maximum of 2 grams of sodium in a day and should also avoid using salt to prepare or flavor foods. Foods that are high in sodium include cheese, canned soups, deli meats, chicken, eggs, potatos, fozen meals and other savory snacks. Patients should also limit the consumption of milk products to 2 cups/day and eat small frequent meals instead of fewer larger meals. In addition, patients should also be taught to weight themselves daily at the same time each day, preferably in the morning, using the same scale and wearing similar clothes. Correct [None] Answer:

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Question 7 1 out of 1 points

A patient with chronic heart failure who is taking digoxin (Lanoxin) 0.25 mg PO daily with furosemide (Lasix) 60 mg PO daily develops nausea and vomiting. The home care nurse should... Selected Answer:

notify the health care provider.

Answers:

notify the health care provider. perform a dipstick urine test for protein. instruct the patient to increase intake of highpotassium foods. ask the patient to weigh each morning and call the nurse in 3 days.

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GI QUIZ Question 1 1 out of 1 points

The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment findings would most likely indicate perforation of the ulcer? Selected Answer:

Answers:

A rigid, board-like abdomen Bradycardia Numbness in the legs Nausea and vomiting

A rigid, board-like abdomen

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Question 2 1 out of 1 points

The nurse is caring for a male client postoperatively following creation of a colostomy. Which nursing diagnosis should the nurse include in the plan of care? Selected Answer: Answers:

Body image, disturbed Sexual dysfunction

Body image, disturbed Fear related to poor prognosis Nutrition: more than body requirements, imbalanced

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Question 3 1 out of 1 points

A male client with a peptic ulcer is scheduled for a vagotomy and the client asks the nurse about the purpose of this procedure. Which response by the nurse best describes the purpose of a vagotomy? Selected Answer:

Answers:

Reduces the stimulus to acid secretions Halts stress reactions Heals the gastric mucosa

Reduces the stimulus to acid secretions

Decreases food absorption in the stomach

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Question 4 1 out of 1 points

A nurse is assigned to a 41-year-old client who has a diagnosis of acute pancreatitis. The nurse reviews the laboratory results and expects to see which of the following results? (select all that apply) Selected Answers:

Elevated amylase Elevated lipase

Answers:

Elevated amylase Elevated hemoglobin Decreased BUN Elevated lipase

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Question 5 1 out of 1 points

A male client who is recovering from surgery has been advanced from a clear liquid diet to a full liquid diet. The client is looking forward to the diet change because he has been "bored" with the clear liquid diet. The nurse would offer which full liquid item to the client? Selected Answer:

Answers:

Custar d Tea Gelati n

Custar d Popsic le

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Question 6 1 out of 1 points

A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the

following? Selected Answer:

Answers:

Metabolic alkalosis with hypokalemia Metabolic acidosis with hyperkalemia Metabolic acidosis with hypokalemia Metabolic alkalosis with hyperkalemia

Metabolic alkalosis with hypokalemia

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Question 7 1 out of 1 points

The nurse is monitoring a female client for the early signs and symptoms of dumping syndrome. Which of the following indicate this occurrence? Selected Answer:

Sweating and pallor

Answers:

Sweating and pallor Bradycardia and indigestion Double vision and chest pain Abdominal cramping and pain

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Question 8 1 out of 1 points

Which of the following terms best describes the pain associated with appendicitis? Selected Answer: Answers:

Steady Aching Fleeting Intermitt ent

Steady

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Question 9 1 out of 1 points

The nurse is caring for a female client following a Billroth II procedure. Which postoperative order should the nurse question and verify? Selected Answer:

Answers:

Frequent coughing and deep breathing exercises Leg exercises Early ambulation Placement of a nasogastric tube

Frequent coughing and deep breathing exercises

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Question 10 1 out of 1 points

The nurse is providing discharge instructions to a male client f...