2023 ATI Medical Surgical Final Exam Test Bank With Answers-634 Solved Questions

ATI MEDICAL SURGICAL FINAL EXAM TEST BANK 2023 GRADED
A CORRECT QUESTIONS AND ANSWERS
1. What is normal range for troponin I? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels?
Answer: Less than 0.03, three hours, 7 to 10 days
2. What is normal range for myoglobin? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels?
Answer: Less than 90 mcg/L, two hours, 24 hours
3. While an echocardiogram is being performed what side should the patient lie on?
Answer: Left side and remain still
4. What are indications for an echocardiogram
Answer: • Cardiomyopathy
• Heart failure
• Angina
• Myocardial infarction
5. What are indications for stress test
Answer: • Dysrhythmias
• HF
• Angin
• aMI
6. What are two medications that are prescribed for pharmacological stress test
Answer: • Dobutamine
• Adenosine
7. What do you instruct the patient to do 2 to 4 hours before a stress test
Answer: Avoid tobacco, alcohol and caffeine

8. Hemodynamic monitoring involves special indwelling catheters that provide information
about blood volume and perfusion, fluid status and how well the heart is pumping. Arterial
lines are placed in the radial (most common), brachial or femoral artery. What should you
Monitor for?
Answer: Monitor circulation in the limb with the arterial line. Such as capillary refill,
temperature, color. Arterial lines are not used for IV fluid administration.
9. The pulmonary artery (PA) catheter is inserted into a large vein (internal jugular, femoral,
subclavian, brachial) and threaded through the right atria and ventricles into a branch of the
pulmonary artery. PA catheters have multiple lumens, ports and components that allow for
various hemodynamic measurements, blood sampling and
Answer: Infusion of IV fluids
10. What is the expected reference range for CVP (Central venous pressure)
Answer: 1 to 8 MM HG
11. What is the expected reference range for pulmonary artery systolic (PAS)
Answer: 15 to 26
12. What is the expected range for pulmonary artery diastolic (PAD)
Answer: 5 to 15
13. What is expected range for pulmonary artery wedge pressure (PAWP)?
Answer: 4 to 12
14. What is the expected range for cardiac output
Answer: 4 to 7 L/minute
15. What is expected range for mixed venous oxygen saturation
Answer: 60% to 80%
16. When should a nurse anticipate lower hemodynamic values?
Answer: In older patients especially if dehydration is a complication

17. What position should the patient be in with hemodynamic monitoring
Answer: Supine or Trendelenburg
18. What are post procedure nursing interventions for hemodynamic monitoring
Answer: • Obtain chest x-ray to confirm catheter placement
• Continually monitor vitals
• Compare NIBP to arterial blood pressure
• Observe and document waveforms. Report changes in waveforms to the provider
• Document catheter placement each shift and as needed
• Place the patient in supine position prior to recording hemodynamic values ( HOB can be
elevated 15° to 30°)
19. What are nursing actions preprocedure before an angiography
Answer: • Patient is NPO for at least eight hours before
• Assess for iodine/shellfish allergy
• Assess renal function
• Teach the client that the affected leg must remain straight after the procedure
• The other normal stuff like ensure informed consent blah blah
20. What are post procedure nursing interventions for an angiography
Answer: 1. Assess vitals every 15 minutes for One hour, every 30 minutes for one hour,
every hour for four hours and then every four hours
• Assess the site for bleeding and hematoma with every vital sign check
• Maintain bed rest for 4 to 6 hours after the procedure
• Monitor urine output and administer IV fluids for hydration (contrast media acts as an
osmotic diuretic)
21. How long do patients receive anticoagulation therapy that have stent placement
Answer: 6 to 8 weeks
22. What is cardiac tamponade
Answer: Fluid accumulation in the pericardial sac
23. What are manifestations of cardiac tamponade

Answer: • hypotension
• JVD
• Muffled heart
• sounds Paradoxical
• pulse
24. What are nursing actions for cardiac tamponade
Answer: • Notify the provider immediately
• Administer IV fluids to combat hypotension as prescribed
• Obtain a chest x-ray or echocardiogram to confirm diagnosis
• Prepare the client for pericardiocentesis
25. What is retroperitoneal bleeding
Answer: Bleeding into the abdominal cavity behind the peritoneum can occur due to femoral
artery puncture (after an angiography)
26. What are nursing actions for retroperitoneal bleeding
Answer: • Assess for flank pain and hypotension
• Notify the provider immediately
• Administer IV fluids and blood products as prescribed
27. What are central catheter's appropriate for
Answer: Any fluids due to rapid hemodilution in the superior vena cava
28. What should you do if there's an occlusion in the access device that impedes flow
Answer: • Flush the line at least every 12 hours to maintain patency (3 mL for peripheral &
10 mL for central lines)
• Administer urokinase to lyse obstructions per facility protocol
• Flush implanted port after every use and at least once a month while implanted
29. What are nursing actions for a catheter thrombosis/emboli
Answer: • Flush the line per facility protocol
• Do not force fluid if resistance is encountered
• Use a 10 mL or larger syringe to avoid excessive pressure

30. What is treatment for infiltration and extravasation
Answer: • Remove using direct pressure with gauze sponge until bleeding stops
• Apply cool compress
• Elevation is optional
• Avoid starting a new IV site in the same extremity
31. What are nursing interventions to prevent an air embolism in a vascular access device
Answer: • Leave central lines clamped when not in use
• Have the patient hold breath while the tubing is changed
• If the patient has sudden SOB, place in Trendelenburg on left side, give oxygen and notify
the provider
32. What are nursing interventions to prevent accidental dislodgment of a catheter
Answer: • Cover the extremity site with stretch netting
• Wrap a washcloth folded into thirds around the arm before applying a needed restraint
• When removing the dressing, pull from distal to proximal
33. Hemodynamic pressure lines should be calibrated to read atmospheric pressure as blank.
Answer: Zero. Zero transducer to room air
34. What kind of medication would you use for vasodilation secondary to sepsis
Answer: Dopamine (vasopressors)
35. What are medications/electrical management for bradycardia
Answer: • Atropine and isoproterenol (antiarrhythmic and bronchodilator
• Pacemaker
36. What are medications/electrical management for a fib, SVT or VT with pulse
Answer: • Amiodarone, adenosine, verapamil (CCB)
• Synchronized cardioversion
37. What are medications/electrical management for VT without a pulse or ventricular
fibrillation

Answer: • Amiodarone, lidocaine and epinephrine
• Defibrillation
38. What is cardioversion
Answer: Delivery of a direct countershock to the heart synchronized to the QRS complex
39. What is defibrillation
Answer: Delivery of an unsynchronized, direct countershock to the heart. Stops all electrical
activity of the heart, allowing the SA node to take over and reestablish a perfusing rhythm
40. What is held 48 hours prior to elective cardioversion
Answer: Digoxin
41. What is indicative of an MI
Answer: Chest pain and ST segment depression or elevation
42. What is an arthrectomy
Answer: Used to break up and remove plaques within cardiac vessels
43. What is a stent
Answer: Placement of a mesh wire device to hold an artery open and prevent restenosis
44. What is a percutaneous transluminal coronary angioplasty
Answer: Involves inflating a balloon to dilate the arterial lumen and the adhering plaque,
therefore widening the arterial lumen
45. What are preprocedure nursing actions for a PCI (besides allergies, informed consent,
blah blah)
Answer: • NPO at least eight hours if possible
• Assess renal function prior to introduction of contrast dye
• Administer antiplatelet medications as prescribed
46. What are two medications that are administered during the intraprocedure for PCI
Answer: Midazolam (Versed) and fentanyl

47. What is post procedure nursing actions after a PCI
Answer: • Assess vitals every 15 minutes for one hour, every 30 minutes for one hour, every
hour for four hours and then every four hours.
• Assess the groin site at the same intervals for bleeding and hematoma formation
• Assess for signs of thrombosis
• Maintain bed rest in a supine position with the leg straight for 4 to 6 hours ( or prescribed
time)
• Monitor urine output
48. How long does a client with a stent replacement receive anticoagulation therapy
Answer: 6 to 8 weeks after
49. Perforation of an artery by the catheter may cause blank
Answer: Cardiac tamponade
50. What are clinical manifestations of anaphylaxis
Answer: • chills
• Fever
• Rash
• Wheezing
• Tachycardia
• Bradycardia
51. What are two medications that might be prescribed in the event of anaphylaxis
Answer: Diphenhydramine or epinephrine
52. A coronary artery bypass graft is most effective when a patient has sufficient ventricular
function such as an EF greater then
Answer: 40% to 50%
53. What are pre-procedure medications for a CABG
Answer: • Anxiolytics: lorazepam and diazepam
• Prophylactic antibiotics

• Anticholinergic such as scopolamine
54. What are some important preprocedure teachings for a patient that is going to undergo a
CABG
Answer: • Endotracheal tube and mechanical ventilator for airway management for several
hours following the surgery
• Inability to talk while endotracheal tube is in place
• Sternal incision and possible leg incision
• 1 to 2 mediastinal chest tubes
• Indwelling urinary catheter
• Pacemaker wires
• Hemodynamic monitoring devices
55. What are two medications that are discontinued before a CABG
Answer: • Diuretics 2 to 3 days before surgery
• Aspirin and other anticoagulants one week before surgery
56. What are medications that are often continued for CABG
Answer: • Potassium supplements Antidysrhythmic' s
• Antihypertensives
• Insulin
57. Post procedure: what should you do with the patient within two hours following
extubation
Answer: Dangle and turn the client from side to side as tolerated
58. What should you do within 24 hours after CABG
Answer: Assist the patient to a chair. Ambulate the patient 25 to 100 feet by first
postoperative day
59. How often should you assess neurological status after CABG
Answer: Every 30 to 60 minutes until the client awakens from anesthesia, then every 2 to 4
hours or per facility policy

60. Monitor chest tube patency and drainage. Measure drainage at least once an hour. Volume
exceeding blank could be a sign of possible hemorrhage and should be reported to the
surgeon
Answer: 150 mL/hour
61. What kind of manifestations of pain might an older female patient show instead of chest
pain
Answer: Dyspnea, indigestion
62. What is a heart healthy diet
Answer: Low-fat, low cholesterol, high-fiber, low-salt
63. What should the patient's activity level be after a CABG
Answer: After a CABG (Coronary Artery Bypass Grafting), the patient should gradually
increase activity, starting with light walking and progressing to more strenuous activities as
advised by the healthcare provider, typically within 6-8 weeks.

64. What can hypothermia cause
Answer: Vasoconstriction, metabolic acidosis and hypertension
65. What are indications of cardiac tamponade after a CABG
Answer: • Sudden decrease of chest tube drainage following heavy drainage
• JVD with clear lung sounds
• Equal PAWP & CVP values.
66. Treatment of cardiac tamponade after a CABG involves
Answer: • Volume expansion
• Emergency sternotomy (Pericardiocentesis is avoided because blood may have clotted)
67. What is maximum potassium administration rate IV
Answer: 10 to 20 mEq/hour
68. How long should a patient remain NPO before a peripheral bypass graft

Answer: Eight hours
69. What are two client education points for a peripheral bypass graft
Answer: • Advise the patient not to cross legs
• Explain that pedal pulses will be checked frequently
70. What are post procedure nursing interventions for a peripheral bypass graft
Answer: • Assess vitals every 15 minutes for one hour and then every hour after the first hour
• Administer anticoagulant therapy/antiplatelet therapy
• Maintain bed rest for 18 to 24 hours. The leg should be kept straight during this time
71. What are teaching points for foot inspection and care
Answer: Teaching points for foot inspection and care include checking for cuts, blisters,
redness, swelling, and signs of infection daily, keeping feet clean and dry, wearing proper
footwear, and avoiding walking barefoot.
72. The graft may occlude due to reduced blood flow and clot formation. This occurs
primarily in the first
Answer: 24 hours post operative
73. What kind of procedure is used for graft occlusion
Answer: Thrombectomy or thrombolytic therapy
74. What procedure is used for compartment syndrome
Answer: Fasciotomy
75. What are physical assessment findings for peripheral artery disease
Answer: • Bruit over femoral and aortic artery's
• Decreased capillary refill of toes
• Decreased or non-palpable pulses
• Loss hair on lower calf, ankle and foot
• Dry, scaly, mottled skin
• Thick toenails
• Cold/cyanotic extremity

• Pallor of extremity with elevation
• Dependent Rubor
• Muscle atrophy
• Ulcers and possible gangrene
76. What are nursing actions for arteriography
Answer: • Observe for bleeding and hemorrhage
• Palpate pedal pulses to identify possible occlusions
77. How does a plethysmography diagnose PAD
Answer: A decrease in pulse pressure of the lower extremity indicates a possible blockage in
the leg
78. A Doppler probe is used to take various blood pressure measurements for comparison. In
the absence of peripheral arterial disease, pressures in the lower extremities are
Answer: Higher than those in the upper extremities
79. What is nursing care for a patient with PAD
Answer: 1. Encourage collateral circulation
• Avoid crossing legs
• Avoid restrictive garments
• Elevate the leg to reduce swelling, but not to elevate them about the level of the heart
• Provide a warm environment
• Avoid exposure to cold
• Avoid stress, caffeine and nicotine and anything that causes vasoconstriction
80. What are medications for PAD
Answer: • Antiplatelet medications • aspirin, Plavix, trental
• Statins • can relieve manifestations associated with PAD such as intermittent claudication
81. What are two surgical procedures for PAD
Answer: • Percutaneous transluminal angioplasty
• Laser assisted angioplasty

82. What are nursing interventions for these two procedures
Answer: • Observe for bleeding/vitals
• Keep client on bed rest with limb straight for 6 to 8 hours before ambulation
• Antiplatelet therapy for 1 to 3 months
83. What is arterial revascularization surgery used for
Answer: Patients who have severe claudication and/or limb pain at rest, or patients who are
at risk for losing a limb due to poor arterial circulation
84. What are nursing actions for arterial revascularization surgery
Answer: 1. Maintain adequate circulation in the repaired artery. The location of the pedal or
dorsalis pulse should be marked and its strength compared with the contralateral leg on a
scheduled basis using a Doppler
• Assess color, temperature, sensation and capillary refill compared with the contralateral
extremity on a scheduled basis
• Monitor BP!!!!
• No bending of the hip and knee
85. One complication of graft is compartment syndrome what are manifestations of it
Answer: • Tingling
• Numbness
• Worsening
• pain Edema
• Pain on passive
• movement Unequal pulses (prepare patient for Fasciotomy)
86. What are risk factors for peripheral venous disease
Answer: • Venus thromboembolism associated with Virchow triad
• Hip surgery, total knee replacement, open prostate surgery
• Heart failure
• Immobility
• Pregnancy
• Oral contraceptives
• Family history

87. Patients with venous disease most often complain of limb pain that feels like
Answer: Aching pain and feeling of fullness or heaviness in the legs after standing
88. What are signs of DVT and thrombophlebitis
Answer: Signs of DVT (Deep Vein Thrombosis) include swelling, pain, redness, and warmth
in the affected leg, while thrombophlebitis presents with similar symptoms along with visible
veins that may feel hard or tender.
89. What are signs of Venous insufficiency
Answer: • Stasis dermatitis is a brown discoloration on the ankles that extends at the calf
relative to the level of insufficiency
• Edema
• Stasis ulcers ( typically found around ankles)
90. What are clinical manifestation of varicose veins
Answer: • Distended, superficial veins that are visible just below the skin and are torturous in
nature
• Patients often report muscle cramping and aches, pain after sitting and pruritus
91. What are laboratory tests for PVD
Answer: D dimer test measures fibrin degradation products present in the blood produced
from fibrinolysis. A positive test indicates that thrombus formation has possibly occurred
92. What are diagnostic procedures for DVT and thrombophlebitis
Answer: • Venus duplex ultrasonography
• Impedance plethysmography
• If the above test are negative for a DVT, but one is still suspected a venogram, which uses
contrast material or MRI may be needed for accurate diagnosis
93. For varicose veins Trendelenburg test is used. What are the nursing actions for this test
Answer: • Place the patient in the supine position with legs elevated
• When the patient sits up, the veins will fill from the proximal and if varicosities are present

94. What should you encourage the patient to do if they have DVT or thrombophlebitis
Answer: Encourage the patient to elevate the affected leg, avoid prolonged standing or
sitting, wear compression stockings, and follow prescribed treatments, such as anticoagulants
or pain management.
95. What should you teach the patient to do if they have venous insufficiency
Answer: Teach the patient to elevate their legs, wear compression stockings, avoid prolonged
standing or sitting, and perform regular leg exercises to improve circulation.
96. What are medications for DVT and thrombophlebitis
Answer: Anticoagulants
97. How long does it take for warfarin to take affect
Answer: 3 to 4 days
98. DVT and thrombophlebitis both can use thrombolytic therapy. What are the details of this
therapy?
Answer: Thrombolytic therapy for DVT and thrombophlebitis involves the administration of
medications like tissue plasminogen activator (tPA) to dissolve blood clots, typically in
severe cases where there is a high risk of complications, and is done under close medical
supervision due to potential bleeding risks.
99. For varicose veins, sclerotherapy may be performed. What are the details of this therapy?
Answer: Sclerotherapy for varicose veins involves injecting a sclerosing solution into the
affected veins, which causes them to collapse and fade over time, helping to improve the
appearance and alleviate symptoms of varicose veins.
100. What should the nurse monitor for postoperatively after varicose veins-vein stripping
Answer: Postoperatively after vein stripping, the nurse should monitor for signs of infection,
bleeding, swelling, pain, changes in skin color, and any signs of deep vein thrombosis (DVT).
101. What are two other surgical interventions that can be performed for varicose veins
Answer: • Endovenous laser treatment
• Application of radiofrequency energy

102. Venous stasis ulcers often form over the medial malleolus. Venous ulcers are chronic,
hard to heal and often recur. They can lead to amputation and/or death. What are nursing
interventions for venous ulcers
Answer:
103. What are patient teachings for patients that have venous ulcers (diet and DVT
prevention)
Answer: • Recommend a diet high in zinc, protein, iron and vitamins A & C
• Instruct patient on the use of compression stockings
104. A pulmonary embolism occurs when a thrombus is dislodged, becomes an embolus and
lodges into a pulmonary vessels. What are manifestations of a pulmonary embolism's
Answer: Sudden onset of dyspnea, pleuritic chest pain, restlessness and apprehension,
feelings of impending doom, cough and hemoptysis
105. What are clinical findings of a pulmonary embolism's
Answer: • Tachypnea
• Crackles
• plural friction
• rub Tachycardia
• S3 or S4 heart sounds
• Diaphoresis
• Low-grade fever
• Petechia over chest and
• axillae Decreased arterial O2
• sat
106. What should you do if you suspect that a patient has a pulmonary embolism
Answer: • Notify the health care provider immediately, reassure the client, and assist with
position of comfort with the head of the bed elevated.
• Prepare for oxygen therapy and ABGs while continuing to monitor and assess the patient for
other manifestations

107. When should Venus compression stockings be removed
Answer: Before going to bed. Legs should be elevated before the stockings are reapplied
108. What is secondary hypertension caused by
Answer: Certain disease states or medications
109. How does hypertrophia of the left ventricle develop
Answer: As the heart pumps against resistance caused by the hypertension
110. What is the maximum BMI a person should have in regards to health promotion and
disease prevention for hypertension
Answer: 30
111. What are risk factors for secondary hypertension
Answer: Risk factors for secondary hypertension include kidney disease, hormonal disorders
(e.g., hyperaldosteronism, pheochromocytoma), obstructive sleep apnea, certain medications
(e.g., oral contraceptives, steroids), and endocrine disorders (e.g., thyroid disease).
112. Blank, can occur with verapamil hydrochloride, so encourage intake of foods that are
high in fiber
Answer: Constipation
113. What kind of juice should not be taken with CCB medications
Answer: Grapefruit juice
114. What are two side effects of ARBs
Answer: Angioedema, hyperkalemia
115. Aldosterone receptor antagonists such as blank, block aldosterone action. They promote
the retention of potassium and excretion of sodium and water
Answer: Eplerenone
116. What are Side effects of aldosterone receptor antagonists
Answer: Hypertriglyceridemia, hyponatremia, hyperkalemia

117. What should you teach the patient that is taking aldosterone receptor antagonists
Answer: No grapefruit juice or St. John's wort. Do not take salt substitutes with potassium or
foods rich in potassium
118. What do central alpha antagonist such as clonidine do
Answer: Reduce peripheral vascular resistance and decrease blood pressure by inhibiting the
reuptake of norepinephrine
119. What are side effects of central alpha antagonist
Answer: Sedation, orthostatic hypotension, impotence
120. Alpha adrenergic antagonist, such as blank, reduce blood pressure by causing
vasodilation
Answer: Prazosin
121. When is prazosin given
Answer: Usually at Night and Monitor BP for two hours after initiation of treatment
122. What are dietary approaches to stop hypertension
Answer: • Diet high in fruits, vegetables, and low-fat dairy
• Avoid foods high in sodium and fat
• Consume foods rich in potassium, calcium and magnesium
123. What are clinical manifestations of a hypertensive crisis
Answer: • Severe headache
• Extremely high blood pressure-greater than 240/120
• Blurred vision, dizziness and disorientation
• Epistaxis
124. What are two medications that are given IV for a hypertensive crisis
Answer: • Nitroprusside
• Nicardipine

125. Before, during and after administration of IV antihypertensive what should you do
Answer: Monitor BP every 5 to 15 minutes and assess neurological status and monitor ECG
126. How long should a patient abstain from smoking before a pulmonary function test
Answer: 6 to 8 hours prior to testing
127. If a patient uses inhalers how long should they withhold use before a pulmonary
function test
Answer: Four to six hours prior to testing
128. What is PaO2
Answer: The partial pressure of oxygen
129. What is SaO2
Answer: Percentage of oxygen bound to hemoglobin as compared with the total amount that
can be possibly carried
130. What is normal bicarbonate according to ATI
Answer: 21 to 28
131. What are preprocedure nursing actions for an arterial puncture
Answer: Preprocedure nursing actions for an arterial puncture include assessing the patient's
medical history, obtaining informed consent, ensuring appropriate positioning, cleaning the
puncture site with antiseptic, and assessing distal pulses for baseline circulation.
132. What are intraprocedural nursing actions while performing an arterial puncture
Answer: Intraprocedural nursing actions during an arterial puncture include monitoring the
patient for signs of discomfort, maintaining sterile technique, assisting the provider with site
selection, ensuring proper needle placement, and observing for complications like bleeding or
hematoma.
133. What are postprocedural nursing actions while performing an arterial puncture
Answer: Postprocedural nursing actions after an arterial puncture include applying pressure
to the puncture site to prevent bleeding, monitoring for signs of hematoma or infection,

assessing distal pulses, and ensuring the patient remains stable while observing for any
complications such as hematoma or altered circulation.
134. What are two complications from an arterial puncture
Answer: Hematoma and air embolism
135. What should you do if the patient has a hematoma
Answer: • Observe the patient for changes in temperature, swelling, color, loss of pulse or
pain
• Notify the provider immediately if symptoms persist
• Apply pressure to the hematoma site
136. What should you do if a patient exhibits symptoms of an air embolism
Answer: • Place the patient on his left side in the Trendelenburg position
• Monitor the patient for a sudden onset of SOB, decrease in SaO2, chest pain, anxiety and air
hunger
• Notify the provider immediately if symptoms occur, administer oxygen and obtain ABGs
137. Why is a bronchoscopy performed
Answer: • Visualization of abnormalities such as tumors, inflammation and strictures
• Biopsy
• Removal of foreign bodies and secretions
• Treat post operative atelectasis
138. What is preprocedure nursing interventions for a bronchoscopy
Answer: Preprocedure nursing interventions for a bronchoscopy include obtaining informed
consent, assessing the patient's medical history and allergies, ensuring NPO status for several
hours, administering pre-procedure medications (e.g., sedatives or analgesics), and educating
the patient about the procedure and post-procedure care.
139. What are intraprocedural nursing interventions for a bronchoscopy
Answer: Intraprocedural nursing interventions for a bronchoscopy include monitoring the
patient’s vital signs and oxygen levels, assisting the healthcare team as needed, ensuring the
patient’s comfort and safety, and providing emotional support to reduce anxiety.

140. What are post procedure nursing interventions for a bronchoscopy
Answer: The patient is not discharged from the recovery room until adequate cough reflex
and respiratory effort are present
141. What are three complications that can occur from a bronchoscopy
Answer: Laryngospasm, pneumothorax, aspiration
142. What are nursing interventions for Laryngospasm spasm and what can decrease the
likelihood of laryngeal edema
Answer: • Monitor the patient for signs of respiratory distress
• Maintain a patent airway by repositioning the patient or inserting an oral/ nasopharyngeal
airway as appropriate
• Administer oxygen therapy to the patient as prescribed. Humidification can decrease the
likelihood of laryngeal edema
143. What are nursing interventions for a pneumothorax
Answer: Assess patient's breath sounds and O2 sat and obtain a follow-up chest x-ray
144. What are nursing interventions for aspiration
Answer: • Prevent aspiration and the patient by withholding oral fluids or food until the gag
reflex returns
• Perform suctioning as needed
145. What is a thoracentesis
Answer: Performed to obtain specimens for diagnostic evaluation, instill medication into the
plural space, and remove fluid or air from the plural space
146. What are preprocedure nursing interventions for a Thoracentesis
Answer: • Obtain preprocedure x-ray as prescribed
• Position the patient sitting upright with his arms and shoulders raised and supported on
pillows and/or on an overbed table and with his feet and legs well supported
• Instructed patient to remain absolutely still during the procedure and not to cough or talk
unless instructed by the primary care provider

147. What are intraprocedural nursing interventions for a thoracentesis
Answer: • Monitor the patient's vitals, skin color and O2 sat throughout the procedure
• Measure and record the amount of fluid removed from the patient's chest
(The amount of fluid removed is limited to one L at a time to prevent cardiovascular collapse)
• Label and send specimens to the Laboratory
148. What are post procedure nursing interventions for a thoracentesis
Answer: • Apply a dressing over the puncture site and assess dressing for bleeding/drainage
• Monitor vitals and respiratory status hourly for the first several hours after
• Encourage the patient to deep breathe to assist with lung expansion
• Obtain a chest x-ray (check resolution of effusions, rule out pneumothorax)
149. What are complications of a thoracentesis
Answer: Mediastinal shift, pneumothorax, bleeding, infection
150. What is a mediastinal shift
Answer: Shift of thoracic structures to one side of the body (Monitor VS, auscultate lungs for
a decrease in or absence of breath sounds)
151. What is a symptom of pneumothorax
Answer: Diminished breath sounds
152. What are indications of a pneumothorax
Answer: • Deviated trachea
• Pain on the affected side that worsens upon exhalation
• Affected side does not move in and out upon inhalation/exhalation
• Increased HR
• Rapid shallow respirations
• Nagging cough or feeling of air hunger
153. How long does it take for a patient to exhibit symptoms when exposed to healthcare
acquired pneumonia
Answer: 24 to 48 hours

154. What is rhinitis
Answer: Inflammation of the nasal mucosa
155. What is objective data for rhinitis
Answer: • Red, inflamed, swollen nasal mucosa
• Low-grade fever
156. What are nursing interventions for rhinitis
Answer: • Encourage rest, 8 to 10 hours a day and increase fluid intake to at least 2000
mL/day
• Encourage use of home humidifier or breathing steamy air
• Proper disposal of tissues and use of cough etiquette
157. What are medications for rhinitis
Answer: Medications for rhinitis include antihistamines (e.g., loratadine, cetirizine), nasal
corticosteroids (e.g., fluticasone, mometasone), decongestants (e.g., pseudoephedrine,
oxymetazoline), and leukotriene inhibitors (e.g., montelukast).
158. What are holistic or complementary therapies for rhinitis
Answer: Echinacea, large doses of vitamin C and zinc
159. What is sinusitis
Answer: Inflammation of the mucous membranes of one or more of the sinuses
160. What is sinusitis associated with
Answer: • Deviated nasal septum
• Occurs after rhinitis
• Nasal polyps
• Inhaled pollutants or cocaine
• Facial trauma
• Dental infections
• Loss of immune function

161. What are symptoms of sinusitis
Answer: • Nasal congestion
• Headache
• Facial pressure/pain (worse when head is tilted forwards)
• Cough
• Bloody/Purulent nasal drainage Tenderness to palpitation
• Low-grade fever
162. What are diagnostic tests for sinusitis
Answer: • CT scan or sinus x-rays
• Endoscopic sinus cavity lavage or surgery to relieve the obstruction and promote drainage
of secretions may be done as a diagnostic procedure.
163. What are nursing interventions for sinusitis and what should you discourage
Answer: • Encourage the use of steam, sinus irrigation, nasal spray
• Increase fluid and rest
• Discourage air travel, swimming and diving
164. What are medications for sinusitis
Answer: • phenylephrine: used to reduce swelling of the mucosa
• Patients should be encouraged to begin OTC decongestant at the first manifestation of
sinusitis
• Signs of rebound nasal congestion may occur if decongestions are used for more than 3 to 4
days
• Amoxicillin if there is bacteria
• NSAIDs, Tylenol, aspirin
165. What is patient education for sinusitis and what should the patient report
Answer: • Sinus irrigation and saline nasal spray's are an effective alternative to antibiotics
for relieving nasal congestion
• Contact the provider for manifestations of a severe headache, neck stiffness and high fever
(meningitis/encephalitis)
166. What are complications of sinusitis

Answer: Meningitis and encephalitis can occur if pathogens enter the bloodstream from the
sinus cavity
167. When are adults contagious when infected with the flu
Answer: 24 hours before manifestations develop and up to five days after
168. What are three extra symptoms of the avian flu compared to the flu
Answer: Severe diarrhea and cough, hypoxia
169. What is nursing care for hospitalized patients infected with influenza
Answer: Nursing care for hospitalized patients infected with influenza includes monitoring
vital signs, providing oxygen therapy if needed, administering antiviral medications (e.g.,
oseltamivir), ensuring adequate hydration and nutrition, managing fever and pain, and
implementing isolation precautions to prevent the spread of infection.
170. What are antivirals that may be prescribed for treatment and prevention of the flu
Answer: • Amantadine
• Rimantadine
• Ribavirin
171. What antivirals may be prescribed to shorten the flu
Answer: • Relenza
•Tamiflu
172. When should patients begin antiviral medications
Answer: 24 to 48 hours after the onset of manifestations
173. Vaccination for the flu is encourage for everyone over six months of age. However highrisk patients include
Answer: • History of pneumonia
• Chronic medical conditions
• Over the age of 65
• Pregnant women
• Health care Providers

174. What is a complication of the flu
Answer: Pneumonia
175. What is the most common manifestation of pneumonia in older adults
Answer: Confusion
176. How does the sputum look with pneumonia
Answer: Purulent, blood tinged or rust colored sputum
177. Elevated wbc's are normally elevated in pneumonia with the exception of
Answer: May not be present in older patients
178. What are diagnostic procedures for pneumonia
Answer: • Chest x-ray will show consolidation of lung tissue
• Pulse oximetry may show less than expected range
179. What are nursing interventions for pneumonia
Answer: • Position the patient in high Fowlers unless contraindicated
• Encourage coughing or suctioning
• Oxygen therapy/breathing treatments as prescribed
• Incentive spirometer
• Structure activity to include periods of rest
• Encourage fluid intake of 2 to 3 L/day
180. It is important to obtain a culture specimen before antibiotic therapy. What are two
common antibiotics given
Answer: Penicillins and cephalosporins
181. What are nursing considerations regarding medications for pneumonia
Answer: • Observe patients taking cephalosporins for frequent stools
• Monitor her kidney function, especially older adults who are taking penicillins and
cephalosporins

• Take medication with food. Some penicillins should be taken one hour before meals or two
hours after
182. Bronchodilators are given to reduce bronchospasms and reduce irritation. What is a
short acting Beta two agonist bronchodilator
Answer: Albuterol
183. Anti-cholinergic medications such as blank, block the parasympathetic nervous system,
allowing for increased bronchodilation and decreased pulmonary secretions
Answer: Ipratropium
184. Methylxanthines such as blank, require close monitoring of serum medication levels due
to narrow therapeutic range
Answer: Theophylline
185. What are adverse effects of Theophylline
Answer: Nausea, tachycardia, diarrhea
186. What should you watch for in patients taking albuterol
Answer: Tremors, tachycardia
187. Observe for dry mouth in patients taking ipratropium and monitor heart rate. Adverse
effects include
Answer: Headache, blurred vision and palpitations which may indicate toxicity
188. What should you encourage patients to do while taking ipratropium
Answer: Suck on hard candies to help moisten dry mouth
189. Anti-inflammatories such as glucocorticosteroids such as fluticasone and prednisones
are prescribed to reduce inflammation. Monitor for
Answer: Immunosuppression, fluid retention, hyperglycemia, hypokalemia and poor wound
healing, black/tarry stools
190. What are other nursing considerations for anti-inflammatories

Answer: Other nursing considerations for anti-inflammatories include assessing for
gastrointestinal side effects (e.g., ulcers, bleeding), monitoring kidney function, advising
patients to take with food to reduce stomach irritation, and educating about the potential for
increased bleeding risk, especially when combined with anticoagulants.
191. What are complications from pneumonia
Answer: Atelectasis, bacteremia, acute respiratory distress syndrome
192. What are manifestations of atelectasis
Answer: • Patient reports SOB and exhibits findings of hypoxemia
• Patient has diminished/absent breath sounds over the affected area
• Chest x-ray shows area of density
193. What are manifestations of acute respiratory distress syndrome (ARDS)
Answer: • Hypoxemia persists despite oxygen therapy
• Patients dyspnea worsens as bilateral pulmonary edema develops that is non-cardiac related
• Chest x-ray shows an area of density with a "ground glass "appearance
• Blood gas findings demonstrate hypercarbia even though pulse oximetry shows decreased
saturation
194. Patient with pulmonary tuberculosis is being discharged with a prescription for rifampin.
The nurse should plan to include which of the following in the patient's discharge teaching
plan
Answer: Urine and other secretions orange in color
195. A nurse is caring for a patient with COPD. What assessment finding should the nurse
report to the primary care provider regarding the color of sputum
Answer: Productive cough with green sputum
196. What kind of diet should a patient with COPD be on
Answer: High calorie and protein
197. What are some things that may trigger asthma attacks
Answer: • Changes in temperature and humidity

• Perfume
• Air pollutants
• Seasonal allergies
• Stress
• Medications (aspirin, NSAIDs, beta blockers, cholinergics)
• enzymes in laundry detergent
• Sinusitis with post nasal drip
• Viral respiratory tract infection
198. When a patient has asthma what temperature of water should be used to eliminate dust
mites in bed linens?
Answer: Hot water
199. What is something that should be encouraged as part of asthma therapy for a patient
Answer: Regular exercise because it promotes ventilation and perfusion
200. There are many risk factors for asthma, most of them are common sense. What are two
risk factors that you may not think of?
Answer: • GERD
• The older patient is more susceptible to infection and therefore they're at bigger risk for
complications
201. What are some physical assessment findings of asthma
Answer: • Dyspnea
• Anxiety or stress
• Coughing
• Wheezing
• Mucus production
• Use of accessory muscles
• Prolonged exhalation
• Poor O2 sat
• Barrel chest or increased chest diameter
202. What diagnostic test is most accurate for diagnosing asthma and its severity?

Answer: Pulmonary function test
203. What are some things that you can do as a nurse to maximize patient comfort in a patient
that has asthma
Answer: • Hi Fowler's
• Oxygen
• Monitor cardiac rate and rhythm for changes during an acute attack
• Initiate and maintain IV access
• Encourage prompt medical attention for infections and appropriate vaccinations
204. What are some things that a nurse should monitor when a patient is using Theophylline
Answer: Monitor the patient's serum levels for toxicity. Side effects will include tachycardia,
nausea and diarrhea
205. What are some things that a nurse should monitor the patient for when the patient is
using albuterol
Answer: Tremors and tachycardia
206. What is something that a nurse should monitor the patient for when the patient is using
Ipratropium
Answer: Dry mouth
207. If a patient was showing symptoms of ipratropium toxicity what would the symptoms
be?
Answer: Headache, blurred vision or palpitations
208. What kind of asthma attack is salmeterol used for
Answer: Is used to prevent an asthma attack and not at the onset of an attack
209. What are things that a nurse should watch for when a patient is taking corticosteroids,
leukotriene antagonist (singulair), mast cell stabilizer (Cromolyn), or monoclonal antibodies
(omalizumab)
Answer: • Decreased immune function
• Hyperglycemia

• Black, tarry stools
• Fluid retention/weight gain (common)
• Hypokalemia with corticosteroids such as prednisone
210. How should prednisone be taken?
Answer: With food
211. What is status asthmaticus
Answer: Life-threatening episode of airway obstruction that is unresponsive to common
treatment
212. What are symptoms of status asthmaticus
Answer: • Extreme wheezing
• Labored breathing
• Use of accessory muscles
• Distended neck veins
• Creates a risk for cardiac/respiratory arrest
213. What are nursing interventions for status asthmaticus
Answer: • Prepare for emergency intubation
• As prescribed, administer oxygen, bronchodilators, epinephrine and initiate systemic steroid
therapy
214. What is emphysema characterized by
Answer: Loss of lung elasticity and hyperinflation of lung tissue
215. What is a genetic risk for COPD
Answer: Alpha-1 antitrypsin deficiency
216. What are some physical assessment findings of COPD
Answer: • Barrel chest
• Hyperresonance on percussion
• Thin extremities and enlarged neck muscles
• Clubbing of fingers and toes

• Dependent edema secondary to right-sided heart failure (increase in pulmonary pressure)
217. Would hematocrit be low or high in a patient that has COPD?
Answer: High due to low oxygenation levels
218. Does COPD increase or decrease caloric demands
Answer: Increase because work of breathing has increased
219. Patients that have COPD may need blank of oxygen via nasal cannula or up to blank via
Venturi mask
Answer: 2 to 4 L/min, 40%
220. Patients who have chronically increased PaCO2 levels usually require blank of oxygen
via nasal cannula
Answer: 1 to 2 L/min
221. A positive expiratory pressure device assist patients to remove airway secretions. The
patient inhales deeply and exhales through the device. While exhaling, a ball moves causing
Answer: A vibration that results in loosening the clients secretions
222. How often should a patient with COPD do exercise conditioning (walking until dyspnea
occurs, resting and then walking again)
Answer: 20 minutes, 2 to 3 times weekly
223. How much fluids should a patient who has COPD drink
Answer: 2 to 3 L/day
224. Most of the medications for COPD are the same as asthma. With the exception of
Mucolytic's. What are two kinds of mucolytic's?
Answer: Mucomyst, dornase alpha
225. How long does it take for the risk of transmission to decrease regarding TB
Answer: 2 to 3 weeks after anti-tuberculin therapy

226. A patient will have a positive intradermal TB test within blank weeks of exposure to the
Answer: 2 to 10
227. How often should patients who live in high-risk areas be screened for tuberculosis
Answer: On a yearly basis
228. What are risk factors for TB
Answer: In addition, recent travel outside of the US, substance use and health care
occupation
229. What are symptoms of TB
Answer: • Persistent cough lasting longer than three weeks
• Purulent sputum, possibly blood streaked
• Fatigue and lethargy
• Weight loss and anorexia
• Night sweats
• Low-grade fever in the afternoon
230. When should the Mantoux test to be read
Answer: Within 48 to 72 hours
231. What is a positive Mantoux test?
Answer: • 10 mm or greater
• 5 mm is considered positive for immunocompromised patients
232. What kind of diet should a patient with TB be on?
Answer: Foods that are rich in protein, iron and vitamin C
233. How does isoniazid work
Answer: By preventing synthesis of mycolic acid in the cell wall
234. How should isoniazid be taken
Answer: On an empty stomach

235. What should you monitor for any patient that is taking isoniazid
Answer: Hepatotoxicity and neurotoxicity, such as tingling of the hands and feet (vitamin B6
is used to prevent neurotoxicity)
236. How does rifampin work
Answer: Inhibits DNA dependent RNA polymerase
237. activity
What are side effects of rifampin
Answer: • Hepatotoxicity (they should report yellowing of the skin, pain or swelling of
joints, loss of appetite or malaise)
• Orange color of urine and other secretions
• May interfere with oral contraceptives
238. What is a side effect of pyrazinamide
Answer: Hepatotoxicity
239. How should pyrazinamide be consumed?
Answer: Instruct the patient to drink a glass of water with each dose and increase fluids
during the day
240. How does ethambutol work
Answer: By inhibiting protein synthesis
241. What are two things that you need to obtain before administering ethambutol to a patient
Answer: • Baseline visual acuity
• Determine color discrimination ability
(this medication should not be given to children younger than 13 years of age)
242. What is the most important thing to teach a patient that is on ethambutol
Answer: To report vision changes immediately
243. What is streptomycin sulfate

Answer: Aminoglycoside antibiotic that potentiates the efficacy of macrophages during
phagocytosis
244. What kind of patients are put on streptomycin
Answer: Those who have multi drug-resistant TB because of this medications high level of
toxicity
245. What are two side effects of streptomycin
Answer: • Ototoxicity
• Renal function decline
246. How often are sputum samples needed during tuberculosis therapy
Answer: Every 2 to 4 weeks to monitor therapy
247. What is miliary TB
Answer: Where the infection invades the bloodstream and can lead to MODS
248. What are symptoms/complications of miliary TB
Answer: • Headaches
• Neck stiffness Drowsiness
• Pericarditis
249. What is the only condition that increases serum creatinine levels
Answer: Kidney disease
250. What is the purpose of a VCUG
Answer: To detect whether urine refluxes into ureters as an x-ray is taken while the patient is
voiding
251. What should you do as a nurse after a patient has a VCUG
Answer: • Monitor the patient for infection for the first 72 hours after
• Encourage increased fluid intake
• Monitor urine output

252. What are preprocedure nursing interventions for a patient that is going to have a kidney
biopsy
Answer: • Review coagulation studies
• NPO for 4 to 6 hours before
253. What are post procedure nursing interventions for a patient that has had a kidney biopsy
Answer: • Monitor vitals
• Assess dressings and urinary output (hematuria)
• Review HGB and HCT values
• Administer PRN pain medication
254. A cystography or cystourethrography are used to discover abnormalities of bladder wall
and/or a occlusions of ureter or urethra. What are pre-procedure nursing interventions for
these procedures?
Answer: • NPO after midnight
• Administer laxative/enema for bowel preparation the night before the procedure
255. What position should a patient be in for a cystography or Cystourethrography
Answer: Lithotomy position
256. What color urine may come out after a cystography or cystourethrography
Answer: Urine maybe pink tinged
257. What should you do if blood clots are present or urine output is decreased or absent after
a cystography or Cystourethrography
Answer: Irrigate urinary catheter with NS
258. What are a retrograde pyelogram, Cystogram, or urethrogram used for
Answer: To identify obstruction or structural disorders of the ureters and renal pelvis of the
kidneys by instilling contrast dye during a cystoscopy
259. What is a renography used for
Answer: To assess renal blood flow and estimate GFR after IV injection of radioactive
material to produce a scanned image of the kidneys

260. What should you assess frequently during and after A renography if captopril is given to
change blood flow to the kidneys
Answer: BP
261. What is an excretory urography used for
Answer: To detect obstruction, assess for a parenchymal mass, and assess size of the kidney.
IV contrast dye is used to enhance images
262. What are preprocedure nursing interventions for a patient that is having an excretory
urography
Answer: • Increased fluids the day before the procedure
• Bowel prep
• NPO after midnight
• Hold Metformin for 24 hours before procedure
263. What are post procedure nursing interventions for a patient that has had an excretory
urography
Answer: • Administer parenteral fluid or encourage oral fluids to flush dye
• Diuretics may be administered to increase dye secretion
• Follow up creatinine and bun serum levels before Metformin is resumed
264. A nurse is reviewing a patient's laboratory findings for urinalysis. The findings indicate
the urine is positive for leukoesterase and nitrates. Which of is an appropriate nursing action?
Answer: Obtain a clean catch urine specimen for culture and sensitivity because this
determines the antibiotic that will be most effective for treatment of the urinary tract infection
265. Why would a patient with a history of asthma be at risk for a complication when
undergoing excretory urography?
Answer: A patient who has a history of asthma has a higher risk of having an asthma attack
as an allergic response to the contrast dye used during the procedure
266. How do you estimate a patient's amount of fluid removed after dialysis
Answer: By comparing the patients preprocedure weight to the post procedure weight

267. How long should invasive procedures be avoided after dialysis
Answer: 4 to 6 hours due to the risk of bleeding related to an anticoagulant
268. How do you check an AV fistula or AV graft for patency
Answer: By checking for thrill or bruit
269. When should you contact the provider after dialysis
Answer: • If bleeding from the insertion site last longer than 30 minutes
• Absence of thrill/bruit
• Signs of infection
270. What kind of diet should a patient be on after dialysis
Answer: high folate, high protein diet
271. What is disequilibrium syndrome
Answer: Caused by too rapid of a decrease in BUN and circulating fluid volume. It may
result in cerebral edema and increased ICP
272. What are signs/symptoms of disequilibrium syndrome
Answer: • nausea
• Vomiting
• Change in
• LOC Seizures
• Agitation
273. Blank, is a risk factor for dialysis disequilibrium and hypotension due to rapid changes
in fluid and electrolyte status
Answer: Advanced age
274. What can a nurse do to decrease the risk of disequilibrium syndrome
Answer: • Use a slow dialysis exchange rate, especially for older adults and those being
treated with hemodialysis for the first time
• Administer anticonvulsants/barbiturates if needed

275. What is something that a nurse should do for a patient experiencing hypotension from
dialysis other than administer IV fluids
Answer: Lower the head of the patient's bed
276. What is peritoneal dialysis
Answer: Involves instillation of a hypertonic solution into the peritoneal cavity. The solution
dwells in the peritoneal cavity as ordered by the provider. Drain the solution that includes the
waste products. The peritoneum serves as the filtration membrane
277. What color should the dialysate solution be
Answer: Clear, light yellow is expected
278. How much should the outflow be compared to the inflow
Answer: Expected to equal or exceed amount of dialysate inflow (insufficient outflow could
mean infection)
279. If a fibrin clot has formed in the peritoneal dialysis catheter what should you do?
Answer: Carefully milk the catheter
280. What are two conditions caused by dialysis
Answer: Hyperglycemia and hyperlipidemia
281. Blank, is a common cause of poor inflow or outflow
Answer: Constipation
282. What position should a patient be in during CCPD and APD treatment
Answer: Supine with head slightly elevated
283. If medications are held before dialysis can they be administered after it is done
Answer: Yes, medications that can be partially dialysed during the treatment should be
withheld. After the treatment, the nurse should administer the medication.

284. Why should a patient that is experiencing shortness of breath not receive peritoneal
dialysis
Answer: Because they may not be able to tolerate excessive fluids being instilled into their
abdomen
285. What are patient indications of end-stage kidney disease necessitating kidney transplant
Answer: • Anuria
• Proteinuria
• Marked azotemia
• Severe electrolyte imbalance
• Fluid volume excess conditions (heart failure, pulmonary edema)
• Uremic lung
286. What are subjective signs/symptoms of end-stage kidney disease
Answer: • Anorexia
• Fatigue
• Paresthesia
• SOB
• Dry, itchy skin
• Metallic taste
• Muscle cramping
287. What are object of signs/symptoms of end-stage kidney disease
Answer: Decreased attention span, seizures, tremor, HF, Edema, dyspnea, hypertension,
distended jugular vein's, anemia, vomiting, pulmonary edema, cardiac dysrhythmias, pallor,
dry itchy skin, bruising, halitosis and diminished or dark colored urine
288. What is methylprednisone sodium succinate
Answer: An anti-inflammatory and immunosuppressant used to decrease the immune system
response of inflammation and rejection of donor kidney
289. What is another immunosuppressant medication used to prevent rejection of the donor
kidney
Answer: Cyclosporine

290. A patient has had a kidney transplant is usually dialyzed within blank of the surgery
Answer: 24 hours
291. What are some things you should assess/monitor the patient for after a kidney transplant
Answer: • Vital signs every 15 minutes initially and advance to every hour
• Report urine output less than 30 mL/HR
• Urine appearance and older should be checked hourly (initially pink and bloody)
• Daily weights
• Maintain continuous bladder irrigation as prescribed (to prevent clots from forming)
292. What diuretic is preferred when oliguria is present after a kidney transplant
Answer: Mannitol
293. What kind of diet should a patient be on after a kidney transplant
Answer: Low• fat, high-fiber, increased protein, low-sodium, avoid sugars or carbohydrates
294. When taking cyclosporine what are two things you need to do
Answer: • Magnesium supplements because it reduces magnesium levels
• Avoid grapefruit
295. What is hyper acute rejection
Answer: Rejection that occurs within 48 hours after surgery caused by an anti-body mediated
response that causes small blood clot to form in the transplanted kidney
296. What are symptoms of a hyper acute rejection
Answer: Fever, hypertension, pain at the transplant site
297. What is treatment for hyper acute rejection
Answer: Immediate removal of the donor kidney
298. What is acute rejection

Answer: Occurs one week to two years after surgery. An antibody mediated response causing
vasculitis in the donor kidney and cellular destruction starts with inflammation that causes
lysis of the donor kidney
299. What are symptoms of an acute rejection
Answer: • Oliguria
• Anuria
• Low-grade
• fever
• Hypertension
• Tenderness over the transplanted
• kidney Lethargy
• Azotemia
• Fluid
• retention
300. What is treatment for acute rejection
Answer: Involves increased doses of immunosuppressive medications
301. What is chronic rejection
Answer: Occurs gradually over months to years. Blood vessel injury from overgrowth of the
smooth muscles of the blood vessels causing fibrotic tissue to replace normal tissue resulting
in a nonfunctioning donor kidney.
302. What are symptoms of chronic rejection
Answer: • Gradual return of azotemia
• Fluid retention
• Electrolyte
• imbalance Fatigue
303. What is treatment for chronic rejection
Answer: Monitor kidney status, continue immunosuppressive therapy until dialysis is
required

304. What is acute tubular necrosis
Answer: Caused by a delay in transplanting the donor kidney after harvesting may result in
hypoxic injury of the donor kidney
305. What are symptoms/signs of renal artery stenosis
Answer: • Hypertension
• Bruit over artery anastomosis site
• Decreased kidney function
• Peripheral edema
306. What is the most common cause of first transplant year morbidity and mortality
Answer: Infection
307. What are the four phases of acute kidney injury
Answer: • Onset: begins with the onset of the event, ends when oliguria develops and lasts
for hours to days
• Oliguria: begins with the kidney insult, urine output is 100 to 400 mL/24 hour with or
without diuretics and lasts for 1 to 3 weeks
• Diuresis: begins when the kidneys start to recover, diuresis of a large amount of fluid occurs
and can last for 2 to 6 weeks
• Recovery: continues until kidney function is fully restored and can take up to 12 months
308. What is prerenal acute kidney injury
Answer: Occurs as a result of volume depletion and prolonged reduction of blood flow to the
kidneys which leads to ischemia of the nephrons
309. What is treatment for prerenal acute kidney injury
Answer: • Administer IV fluid if no fluid restrictions
• Administer calcium channel blocker to prevent the movement of calcium into the kidney
cells and to increase GFR
• Monitor I and O's
• Monitor for decreased cardiac output

310. Intrarenal acute kidney injury occurs as a result of direct damage to the kidney from lack
of oxygen (acute tubular necrosis). What are causes of intrarenal acute kidney injury
Answer: • Physical injury
• Hypoxic injury renal artery or vein stenosis or thrombosis
• Chemical injury acute nephrotoxins (antibiotics, NSAIDs, contrast dye, heavy metal, blood
transfusion reaction)
• Immunologic injury infection, vasculitis, acute glomerulonephritis
311. What are two complications of intrarenal acute kidney injury
Answer: Heart failure or pulmonary edema
312. What are signs/symptoms of acute intrarenal kidney injury
Answer: • ECG dysrhythmias (tall T waves)
• Flank pain N/V
• Lethargy
• Tremors
• Confusion
313. Post renal acute kidney injury occurs as a result of bilateral obstruction of structures
leaving the kidney. What are causes
Answer: • Stone, tumor, bladder atony
• Prostate hyperplasia, urethral stricture
• Spinal cord disease or injury
314. How do laboratory values look in post renal acute kidney injury
Answer: Gradually increases in serum creatinine, BUN, urine specific gravity
315. What is nutrition for post renal acute kidney injury
Answer: Restrict potassium, phosphate and magnesium during oliguric phase and increase
protein
316. What are the five stages of chronic kidney disease
Answer: • Stage one: minimal kidney damage with normal GFR (greater than 90 ML/min)
• Stage two: mild kidney damage with GFR 60 to 89 mL/min

• Stage III: GFR 30 to 59 mL/min
• Stage 4: GFR is 15 to 29 mL/min
• Stage five: GFR less than 15 mL/min
317. How much fluids are patients with chronic kidney disease encouraged to drink
Answer: At least 3 L of water daily
318. If a patient has diabetes or hypertension and chronic kidney disease what should you
encourage them to come in for regarding yearly tests
Answer: Yearly testing for albumin in the urine
319. What are some signs and symptoms of chronic kidney failure
Answer: • Fatigue
• Lethargy
• Involuntary movement of the legs
• Depression
• Intractable hiccups
320. How do you serum electrolytes look in chronic kidney disease
Answer: Decreased sodium and calcium; increased potassium, phosphorus and magnesium
321. Why is hemoglobin and hematocrit decreased in chronic kidney disease
Answer: From anemia secondary to the loss of erythropoietin
322. What are complications of CKD
Answer: • Electrolyte imbalance
• Dysrhythmias
• Fluid overload
• Hypertension
• Metabolic acidosis
• Secondary infection
• Uremia
323. What kind of diet should a patient be on that has chronic kidney disease

Answer: High in carbohydrates and moderate in fat
324. What medications are considered nephrotoxic
Answer: • Aminoglycosides
• Amphotericin b
• NSAIDs
• Ace
• inhibitors
• Arbs
• Contrast dye
325. If a patient is on digoxin when should you administer it
Answer: After receiving dialysis
326. Why is aluminum hydroxide given to patients with chronic kidney disease
Answer: Taken with meals to bind phosphate in food and stop phosphate absorption (take
two hours before or after digoxin)
327. What kind of diuretic should be avoided in patients that have end stage kidney disease
Answer: Loop diuretics
328. What kind of Antacids should a patient with kidney disease avoid
Answer: Those containing magnesium
329. If a patient has a high creatinine level what should you assess for in the urine
Answer: Blood
330. Who is more at risk for urosepsis women or men
Answer: Aging women due to decreased estrogen which promotes atrophy of the urethral
opening towards the rectum
331. What are subjective signs/symptoms of a urinary tract infection
Answer: • Lower back/abdominal discomfort
• Urinary frequency/urgency

• Nausea
• Dysuria, cramping
• Urinary retention
• Perineal itching
• Hematuria
• Pyuria (greater than four wbc in urine sample)
332. What are objective signs/symptoms of a urinary tract infection
Answer: • Fever
• Vomiting
• Voiding in small amounts
• Nocturia
• Urethral discharge
• Cloudy/smelly urine
333. What are older adult clinical manifestations of a UTI
Answer: • Mental confusion
• Incontinence
• Loss of appetite
• Nocturia and dyslexia
• Signs of urosepsis
334. What are signs of urosepsis
Answer: • Hypotension
• Tachycardia
• Tachypnea
• Fever
335. If a patient has a urinary tract infection what are some things you'd expect to find in the
urine
Answer: Bacteria, sediment, WBCs, RBCs, positive leukocyte esterase and nitrates
336. If a patient has a urinary tract infection what are some things you can encourage the
patient to do to relieve symptoms

Answer: • Promote fluid intake up to 3 L a day 2.
• Encourage urination every 3 to 4 hours instead of waiting until the bladder is completely
full
• Recommend warm sitz Bath 2 to 3 times a day to promote comfort
337. What are two medications that are prescribed less frequently for UTIs because the
medicine is less effective and tolerated
Answer: Penicillins and cephalosporins
338. If a sulfonamide is prescribed for a patient with a UTI what should you ask the patient
about?
Answer: Allergy to sulfa
339. What is a bladder analgesic that is used to treat UTIs
Answer: Phenozopyridine (take with food)
340. When a patient has a UTI they are encouraged to drink cranberry juice because a
compound in cranberries may stop certain bacteria from adhering to the mucosa of the
urinary tract. Patients who have blank should avoid cranberry juice, which irritates the
bladder
Answer: Chronic cystitis
341. What are risk factors for pyelonephritis
Answer: • Men over 65 who have prostatitis and hypertrophy of the prostate
• Chronic urinary stone disorders
• Spinal cord injury
• Pregnancy
• Bladder tumors
• Urine pH increases
• Chronic illnesses (DM, HTN)
342. Chills, nausea, malaise, fatigue, burning/urgency/frequency with urination are all
subjective signs and symptoms of pyelonephritis. What are two more less obvious
symptoms?

Answer: Colicky type abdominal pain and costovertebral tenderness
343. What are objective signs/symptoms of pyelonephritis
Answer: • Fever Tachycardia
• Tachypnea
• Hypertension
• Flank/back pain
• Vomiting
• Nocturia
• Asymptomatic bacteremia
• Inability to concentrate urine or conserve sodium
344. What are 4 lab values that will be increased with pyelonephritis nephritis
Answer: C-reactive protein, ESR, Creatinine and BUN
345. What are complications of chronic pyelonephritis
Answer: • Septic shock
• Chronic kidney disease
• Hypertension
346. Although penicillin antibiotics are rarely used to treat urinary tract infections with
kidney infections this type of penicillin may be used
Answer: Ampicillin
347. Does a diet high in calcium increase the risk for kidney Stones. Since the majority of
stones are composed of calcium phosphate or calcium oxalate
Answer: No not unless there is a pre-existing metabolic disorder or renal tubular defect
348. Who is more at risk for urolithiasis? Males or females
Answer: There is an increased incidence of urolithiasis in males
349. What are four things that contribute to an environment favorable for stone formation
Answer: Urinary stasis, urinary retention, immobilization and dehydration

350. What is something that you might see in a urinalysis of a patient that has a kidney stone
Answer: Crystals
351. What does KUB stand for
Answer: X-ray of kidney, ureters and bladder
352. What are things that a nurse should assess/monitor for any patient that has kidney stones
Answer: • Pain
• I and O's
• Urinary pH
• Strain all urine
• Encourage ambulation to promote passage of the stone
353. According to ATI what should respiration rate be
Answer: 12 to 20 breaths per minute
354. What are medications given for kidney stones
Answer: Opioids, nSAIDs, oxybutynin chloride
355. What are side effects of oxybutynin chloride
Answer: • Increased intraocular pressure (Contraindicated if there's a history of glaucoma)
• Dizziness
• Dry mouth
• Tachycardia
• Urinary retention
356. Antibiotics such as gentamicin and cephalexin are used to treat UTIs. Administer the
medication with food to decrease G.I. distress. What else should you monitor for
Answer: Nephrotoxicity and ototoxicity. Also inform the patient that urine may have a foul
odor related to the antibiotic.
357. What are two things that are common after a patient has had extracorporeal shockwave
lithotripsy
Answer: Bruising at the site where the waves are applied and hematuria

358. If a patient keeps having calcium phosphate stones what kind of diet should they be on
Answer: Limit intake of food high in animal protein, limit sodium, reduce calcium
359. What are medications that are given for calcium phosphate stones
Answer: • Thiazide diuretics,
• Orthophosphates,
• Sodium cellulose phosphate
360. If a patient has calcium oxalate stones what should their diet be
Answer: Avoid: spinach, black tea, rhubarb, cocoa, beats, pecans, peanuts, okra, chocolate,
wheat germ, lime peel, Swiss chard and limit sodium intake
361. What are medications for uric acid stones
Answer: Allopurinol, potassium or sodium citrate or sodium bicarbonate
362. What is hydronephrosis
Answer: When a stone has blocked a portion of the urinary tract causing the urine to back up
into the kidneys causing distention of the kidney
363. Which ethnicities is diabetes more prevalent in
Answer: African-American, American Indians and Hispanics
364. What are risk factors for diabetes
Answer: • Obesity
• Hypertension
• Inactivity
• Hyperlipidemia
• Cigarette smoking
• Genetic history
• Elevated CRP
• Ethnic group
• Women who have delivered infants weighing more than 9 pounds
• BMI greater than 24

365. What are two things that the patient can add to their diet to decrease the risk of
developing diabetes
Answer: Omega-3 fatty acids and fiber
366. What are clinical manifestations of diabetes
Answer: • Hyperglycemia (blood glucose level usually greater than 250)
• Polyuria
• Polydipsia
• Polyphagia
• Fruity breath
• Decreased
• LOC Headache
• N/V
• Seizures leading to coma
367. Diagnostic criteria for diabetes include 2 findings (on separate days) of one of the
following
Answer: • Manifestations of diabetes plus casual blood glucose concentration greater than
200
• Fasting blood glucose greater than 126
• Two hour glucose greater than 200 with an oral glucose tolerance test
368. How long is a patient instructed to not eat or drink (other than water) before a fasting
blood glucose test
Answer: Eight hours
369. How long should a patient fast for before an oral glucose tolerance test
Answer: 10 to 12 hours
370. What is normal hemoglobin A-1 C range
Answer: 4 to 6%
371. How often should the needle in a continuous infusion pump be changed

Answer: Every 2 to 3 days
372. Are insulin pens used if more than one insulin is given anytime
Answer: No
373. What kind of insulin is Humalog and NovoLog
Answer: Rapid acting, onset is 10 to 30 minutes
374. What kind of insulin is Humulin N and detemir insulin
Answer: Intermediate acting, administered for control between meals and at night
375. What kind of insulin is glargine
Answer: Long acting, administered once a day because it dissipates slowly over 24 hours
376. What are manifestations of hypoglycemia
Answer: • Mild shakiness
• Mental confusion
• Sweating
• Palpitations
• Headache
• Lack of coordination
• Blurred vision Seizures
• Coma
377. What are some preventative measures to avoid hypoglycemia
Answer: Avoid excess insulin, exercise and alcohol consumption on an empty stomach
378. Blood glucose increases approximately blank over 30 minutes following ingestion of
blank grams of absorbable carbohydrate
Answer: 40 mg/DL, 10
379. If a patient is unconscious or any able to swallow how can you administer glucagon to
them
Answer: By SQ or IM and repeat in 10 minutes is still unconscious

380. If the patient is in an acute care setting the nurse should administer blank if IV access is
available and consciousness should occur within 20 minutes
Answer: 50% dextrose
381. When a patient has a blood glucose level greater than 250 mg/DL they should restrict
Answer: Exercise
382. What are two things you should monitor for any patient taking Metformin
Answer: G.I. effects and lactic acidosis
383. When should Metformin be discontinued before anything with contrast dye
Answer: 48 hours
384. What kind of supplements should a patient be taking that is on Metformin
Answer: Vitamin B12 and folic acid
385. When should glipizide be taken
Answer: 30 minutes before meals
386. What medication can mask tachycardia typically seen during hypoglycemia
Answer: Beta blockers
387. Should diabetic patients use lotion between the toes after they wash their feet with mild
soap and water
Answer: No
388. When is the best time to perform nail care
Answer: After a shower or bath
389. What kind of socks should diabetic patients wear
Answer: Socks made of cotton or wool
390. How should a diabetic patient clean a cut on their foot

Answer: With warm water and mild soap, gently dry and apply a dry dressing
391. How often should a diabetic patient monitor their blood glucose when they're sick
Answer: Every 3 to 4 hours
392. What is the recommended blood pressure of a patient with diabetes
Answer: Less than 130/80
393. How often should a diabetic patient get eye and foot exams
Answer: Every year
394. What is hyperglycemic hyperosmolar State
Answer: An acute, life-threatening condition characterized by profound hyperglycemia
(above 600) osmolarity that leads to dehydration and an absence of ketosis
395. What are risk factors for HHS
Answer: • Older adult who has residual insulin secretion
• Older adult who has an adequate fluid intake
• Older adults who have decreased kidney function and are unable to excrete excess of
glucose into the urine
• MI, cerebral vascular injury or sepsis
• Infection/stress
• Glucocorticoids, diuretics, Dilantin, propranolol, CCB
396. What are clinical manifestations of HHS
Answer: • Blurred vision
• Headache
• Weakness
• Polyuria
• Polydipsia
• Orthostatic hypotension
• Change in LOC Seizures/myoclonic jerking
• Reversible paralysis

397. How does serum osmolarity look in HHS
Answer: Greater than 320 mOsm/L
398. How does your pH look in DKA
Answer: Less than 7.3
399. What is the pH look like in HHS
Answer: Greater than 7.4
400. What kind of fluids should be administered to patients with DKA or HHS
Answer: Isotonic fluid's such as normal NS followed with a hypotonic fluid (IV bolus of
insulin)
401. What should you do when serum glucose levels approach 250 mg/DL
Answer: Add glucose to IV fluids to minimize the risk of cerebral Edema associated with
drastic changes in serum osmolarity and prevent hypoglycemia
402. What else should you monitor a patient for when they are in a diabetic crisis
Answer: Hyperkalemia and then hypokalemia as potassium follows insulin into the cells
403. How often should an older adult patient monitor blood glucose when they are sick
Answer: Every 1 to 4 hours
404. If a patient who has diabetes would like to consume alcohol what should you tell them
Answer: Consume carbohydrates while drinking alcohol will help prevent hypoglycemia
405. What is PTU
Answer: Medication given to suppress the thyroid hormone and will allow for weight gain
406. When assessing a patient diagnosed with diabetes insipidus, the nurse should expect
which of the following laboratory findings
Answer: Increased hematocrit due to dehydration

407. A nurse is monitoring a patient's status 24 hours after a total thyroidectomy. What kind
of breath sound would you immediately report to the provider
Answer: Laryngeal stridor
408. How should the patient take their medication if they are on thyroid hormone
replacement therapy
Answer: On an empty stomach to promote proper absorption
409. Why is an arthroscopy performed
Answer: To visualize the internal structures of a joint, most commonly the knee or shoulder
joints
410. When can an arthroscopy not be performed
Answer: If there is an infection or if the patient is unable to bend the joint at least 40°
411. How often should you assess the patient's neurovascular status and dressing after an
arthroscopy
Answer: Every hour or per hospital protocol
412. How often should a patient ice and elevate extremity after an arthroscopy
Answer: Ice and elevation should be applied for 24 hours
413. Bone scans are done when a patient entire skeletal system is to be evaluated. A
radionucleotide test involves radioactive material injected blank before scanning
Answer: 2 to 3 hours
414. Blank and blank scans are more sensitive to detecting bone problems than a bone scan.
When is in radionucleotide injected before the scans
Answer: Gallium, Thallium, 4 to 6 hours
415. During a bone scan does the patient need to be sedated
Answer: Only if they are unable to lie still for 30 to 60 minutes

416. Following the procedure does the patient need to take any special radioactive
precautions
Answer: No but the patient should be encouraged to drink plenty of fluids to increased
excretion of radioisotope
417. What kind of scan is done to estimate the density of a patient's bone mass, usually in the
hip or spine, and the presence/extent of osteoporosis
Answer: DXA (dual x-ray absorptiometry)
418. Is contrast material used with a DXA scan
Answer: No
419. At what age might a baseline DXA scan be performed
Answer: 40
420. Why would an electromyography (EMG) and nerve conduction studies be performed
Answer: To determine the presence and cause of muscle weakness
421. How is an EMG performed
Answer: Thin needles are placed in the muscle under study and attach it to an electrode,
which is attached to oscilloscope. Electrical activity is recorded during a muscle contraction
422. How is a nerve conduction study performed
Answer: Flat electrodes are taped on the skin. Low electrical currents are sent through the
electrodes and muscle response to the stimulus is reported
423. What are two medications that must be avoided before receiving an EMG or nerve
conduction study
Answer: Anticoagulants or muscle relaxants
424. What are two things that the patient should report to the provider after receiving an
EMG or nerve conduction study
Answer: Swelling or tenderness

425. What kind of pain medication can be used for patients after an arthroscopy
Answer: Opioid
426. How long does a DXA scan last for
Answer: Several hours. The radionucleotide substance is injected and must be absorbed by
the bone prior to the procedure. The patient must wait several hours after the injection before
the scan can be completed
427. During an EMG what should you ask the patient to do for an easier insertion of the
needle into the muscle
Answer: To flex their muscles
428. What is an arthroplasty
Answer: The surgical removal of a diseased joint due to osteoarthritis, osteonecrosis,
rheumatoid arthritis, trauma or congenital anomalies and replacing it with prosthetics or
artificial components made of Metal and/or plastic
429. What are contraindications to an arthroplasty
Answer: • Recent or active infection
• Arterial impairment to the affected extremity
• The patient's inability to follow the post surgery regimen
• A comorbid condition such as uncontrolled diabetes or hypertension, osteoporosis,
progressive inflammatory condition, unstable cardiac/respiratory conditions
430. What should a patient do to prepare for arthroplasty the night before the surgery
Answer: • Scrub the surgical site with a prescribed anti-septic soap
• Wear clean clothes and sleep on clean linens
431. What should a patient do in the morning to prepare for an arthroplasty
Answer: • Scrub at the surgical site with a prescribed anti-septic soap
• Take antihypertensive medications as well as other medications that the surgeon allows with
a sip of water

432. Prosthetic components may or may not be cemented in place. Components that do not
use cement allow the bone to grow into
Answer: The prosthesis to stabilize it
433. If the components are not cemented when should weight-bearing occur
Answer: Weight bearing is delayed several weeks until the femoral shaft has grown into the
prosthesis
434. A CPM machine may be prescribed after surgery to promote motion in the knee and
Answer: Prevent scar tissue formation
435. When is a CPM turned off
Answer: During meals
436. What position of the patient should you avoid after an arthroplasty
Answer: Positions of flexion of the knee are limited to avoid flexion contractures. Avoid
knee gatch and pillows placed behind the knee
437. How should you position small blankets or pillows to keep heels off the bed in efforts to
avoid pressure ulcers
Answer: Slightly above the ankle area
438. After an arthroplasty opioids as well as a continuous peripheral nerve block may be
initiated for a patient. What should you monitor the patient for in regards to a continuous
peripheral nerve block
Answer: Monitor the patient for systemic effects of local anesthetic, such as hypotension,
bradycardia, restlessness or seizure
439. Ice or cold therapy may be applied to reduce post operative swelling. Monitor the
patients neurovascular status of the surgical extremity every blank
Answer: 2 to 4 hours (movement, sensation, color, pulse, capillary refill and compare with
the contralateral extremity)

440. After a patient has had a hip arthroplasty what kind of range of motion exercise should
you encourage
Answer: Plantar flexion, dorsiflexion, and circumduction to prevent clot formation
441. Early ambulation after a hip arthroplasty is important. How should you transfer the
patient out of bed
Answer: From the unaffected side into a chair or wheelchair
442. What should you apply to the surgical site following ambulation
Answer: Ice
443. What is patient positioning after a hip arthroplasty
Answer: Place the patient supine with the head slightly elevated and the affected leg in a
neutral position. Place a pillow or abduction device between the legs when turning to the
unaffected side. The patient should not be turned to the operative side, which could cause hip
dislocation
444. What are four do's after an arthroplasty
Answer: • Use elevated seating/raised toilet seat
• Use straight chairs with arms
• Use an abduction pillow, or a pillow, if prescribed between the patients legs while in bed
• Externally rotate a patient's toes
445. What are four don'ts after an arthroplasty
Answer: • Avoid flexion of hip greater than 90°
• Avoid low chairs
• Do not cross a patients legs
• Do not internally rotate a patient's toes
446. After a knee arthroplasty when can a patient kneel and deep knee bend
Answer: Unfortunately those are limited indefinitely
447. How often should a patient clean their incision after a total hip arthroplasty
Answer: Daily with soap and water

448. Upper extremity amputation's are usually the result of a traumatic injury however lower
extremity amputation's are usually the result of
Answer: Peripheral vascular disease as a result of arteriosclerosis
449. What are signs of inadequate peripheral circulation
Answer: • Edema
• Reduced cap Refill time
• Necrosis
• Lack of hair distribution
450. What is the ankle brachial index
Answer: Measures difference between ankle and brachial systolic pressures
451. What is a closed amputation
Answer: The most common technique used. Skin flap is sutured over end of residual limb,
closing site
452. What is open amputation
Answer: This technique is used when an active infection is present. Skin flap is not sutured
over end of residual limb allowing for drainage of infection. Skin flap is closed at a later date
453. When your palpating the residual limb for warmth what might heat indicate
Answer: Infection
454. What do patients often describe the pain associated with phantom pain as
Answer: Deep and burning, cramping, shooting or aching
455. What are two classes of medications that some patients may feel relief from phantom
pain
Answer: Anti-spasmodic's and antidepressants
456. Other than medications what are four alternative treatments for phantom limb pain
Answer: Massage, heat, biofeedback or relaxation therapy

457. What should you teach a patient to do to reduce phantom limb pain and prepare the limb
for a prosthesis
Answer: To push the residual limb down toward the bed while supported on a soft pillow
458. How should you position that affected extremity to promote blood flow/oxygenation
Answer: Dependent position
459. What are three things that you can do to assist in shrinking the residual limb for a
prosthesis fitting
Answer: • Wrapping the stump, using elastic bandages to prevent restriction of blood flow
and decrease edema (figure 8)
• Use a stump shrinker suck
• Use an air splint inflated to protect and shape the residual limb
460. What are four things that a nurse could do to prevent the patient from developing flexion
contractures after an amputation
Answer: • Range of motion exercises and proper positioning immediately after surgery
• Avoid elevating the stump on a pillow after the first 24 hours following surgery
• Have the patient lie prone for 20 to 30 minutes several times a day
• Discourage prolonged sitting in a chair
461. At what age does the remodeling of bone stop occurring at equal rates (osteoblastic
versus osteoclastic activity)
Answer: 30
462. What is the grading scale for open fractures
Answer: • Grade 1: minimal skin damage
• Grade 2: damage includes skin and muscle contusion but without extensive soft tissue
injury
• Grade 3: damage is excessive to skin, muscles, nerves and blood vessels
463. What is a comminuted fracture
Answer: Has multiple fracture lines splitting the bone into multiple pieces

464. What is the most common fracture found in children
Answer: Greenstick: Fracture occurring on one side but does not extend completely through
the bone
465. What are the three biggest risk factors for osteoporosis
Answer: • Excessive exercising/weight loss from dieting and malnutrition
• Women who do not use estrogen replacement therapy after menopause
• Patients on long-term corticosteroid therapy
466. What are five physical assessment findings of a fracture
Answer: Crepitus, deformity, muscle spasms, edema, ecchymosis
467. What position should a limb be in after a fracture
Answer: Elevated above the heart and apply ice
468. How often should neurovascular checks be performed when a patient has a fracture
Answer: Every hour for the first 24 hours and then every 1 to 4 hours after
469. What is a closed reduction
Answer: When a pulling force (traction) is applied manually to realign the displaced
fractured bone fragments
470. What is an open reduction/internal fixation
Answer: When a surgical incision is made and the bone is manually aligned and kept in place
with plates and screws
471. What is more effective than splints or immobilizers because they cannot be removed by
the patient
Answer: Casts
472. What is a spica cast
Answer: A portion of the trunk and one or two extremities

473. How should you handle a plaster cast until it is dry? It can take up to 24 to 72 hours to
dry
Answer: With the palms, not fingertips
474. Look at skin traction, bucks traction and balanced suspension skeletal traction
Answer: • Skin Traction: Uses adhesive or non-adhesive devices to apply a pulling force to
the skin for immobilization and muscle spasm relief.
• Bucks Traction: A form of skin traction that applies a pulling force to the leg, typically for
hip fractures or muscle spasms.
• Balanced Suspension Skeletal Traction: Involves using pins or wires inserted into bones and
balanced weights to stabilize fractures, commonly for femur fractures.
475. How often should you insure that pulley ropes are free of knots, fraying, loosening and
improper positioning
Answer: Every 8 to 12 hours
476. What are two things you can do to treat muscle spasms if it is prescribed
Answer: Heat, massage
477. What is a normal standard pin care protocol (if the patient has pins in place)
Answer: • Pin care is provided usually once a shift, 1 to 2 times a day
• Chlorhexidine is usually used and only one cotton tipped swabs per a pin to avoid cross•
contamination
478. What is external fixation
Answer: Involves fracture immobilization using percutaneous pins and wires that are
attached to a rigid external frame
479. What are advantages to external fixation
Answer: • Immediate fracture stabilization
• Minimal blood loss occurring in comparison with internal fixation
• Allows for early mobilization and ambulation
• Permitting wound care with open fractures

480. What is a disadvantage to external fixation
Answer: Risk of pin site infection leading to osteomyelitis
481. What is open reduction and internal fixation
Answer: Refers to visualization of a fracture through an incision in the skin and internal
fixation with plates, screws, pins, rods and prosthetics as needed
482. How often should you inspect bony prominences with an open reduction and internal
fixation
Answer: Every shift and ensure heels are off the bed at all times
483. What are the six p's associated with compartment syndrome
Answer: Pain, paralysis, paresthesia, pallor, pulselessness and poikilothermia
484. Who is at greatest risk for developing a fat embolism
Answer: Adults between the age of 70 and 80
485. Fat embolism's usually occur within blank hours following a long bone fracture or with
total joint arthroplasty
Answer: 48
486. What are clinical manifestations of a fat embolism
Answer: • Dyspnea
• Chest pain
• Decreased O2 sat
• Decreased LOC
• Respiratory distress
• Tachycardia
• Tachypnea
• Fever
• Cutaneous petechiae (late sign)
487. What is treatment for a fat embolism
Answer: • Maintain the patient on bedrest

• Oxygen for respiratory compromise
• Corticosteroids for cerebral edema
• Vasopressors and fluid replacement for shock
• Pain and anti-anxiety medications as needed
488. What is the most common complication following trauma, surgery or disability related
to immobility
Answer: DVT
489. What are ways to prevent DVT
Answer: • Encourage early ambulation
• Apply antiembolism stockings
• Administer anticoagulants
• Encourage intake of fluids to prevent hemoconcentration
• Instruct the patient to rotate feet at the ankles and perform other lower extremity exercises
as permitted by the particular immobilization device
490. What is treatment for osteomyelitis
Answer: • Long course of IV and oral antibiotic therapy (3 months)
• Surgical debridement
• Hyperbaric oxygen treatment
• Surgically implanted antibiotic beads
• Amputation
491. If a wound from osteomyelitis is left open to heal, standard precautions are adequate and
blank technique can be used during dressing changes
Answer: Clean
492. What is avascular necrosis
Answer: Bloodflow is disrupted to the fracture site and the resulting ischemia leads to
tissue/bone necrosis
493. Who is at greater risk for developing avascular necrosis
Answer: Patients receiving long-term corticosteroid therapy

494. A nurse is completing an assessment of a patient who had an external fixation device
applied two hours ago for a fracture of the left tibia and fibula. What are four things that the
nurse might find that would indicate compartment syndrome?
Answer: • Intense pain when the left foot is passively moved
• Hard, swollen muscle in the left leg
• Burning and tingling of the distal left foot
• Minimal pain relief following a second dose of opioid medication
495. A nurse in the emergency department is planning care for a patient who has a right hip
fracture. What kind of immobilization device should the nurse anticipate in the plan of care?
Answer: Bucks traction because it is a temporary immobilization device applied to diminish
muscle spasms and immobilize the affected extremity until surgery is performed
496. The posterior pituitary gland secretes the hormone blank which causes the kidneys to
reabsorb water
Answer: ADH (vasopressin)
497. A deficiency of ADH causes
Answer: Diabetes insipidus, which is characterized by the excretion of a large quantity of
diluted urine
498. Excessive secretion of ADH causes
Answer: Syndrome of inappropriate antidiuretic hormone. In SIADH, the kidneys retain
water, urine becomes concentrated, urinary output decreases and extracellular fluid volume is
increased
499. What is the water deprivation test
Answer: Measures the kidneys ability to concentrate urine in light of an increased plasma
osmolality and a low plasma vasopressin level.
500. The water deprivation test is performed for patients who have a diagnosis of diabetes
insipidus. It should only be conducted if the patient's baseline serum sodium level is blank
and The osmolality of the urine is below blank

Answer: Within the expected range, 300
501. What is a positive result for diabetes insipidus with the water deprivation test
Answer: The kidneys are unable to concentrate urine despite increased plasma osmolality
502. What are preprocedure nursing actions for the water deprivation test
Answer: • No smoking/caffeine or alcohol prior to test
• Withhold fluids for 8 to 12 hours
• Obtain IV access
503. What position is the patient in during the test
Answer: Recumbent position for 30 minutes however The patient may sit or stand during
voiding.
504. What is a complication of the water deprivation test
Answer: Dehydration
505. What is Cushing's disease (Hypercortisolism)
Answer: Hyper functioning of the adrenal cortex and an excessive production of cortisol
506. What is Addison's disease
Answer: Hypo functioning of the adrenal cortex and a consequent lack of adequate amounts
of serum cortisol
507. What is a diagnostic test they can use to determine if a patient has Cushing's disease
Answer: Dexamethasone suppression test
508. What is a positive result for Cushing's disease after doing the dexamethasone test
Answer: There is no decrease in the production of ACTH and cortisol
509. Disorders of the adrenal medulla may cause
Answer: Hypersecretion of catecholamines (pheochromocytoma)

510. The vanillylmandelic acid test is used to diagnose pheochromocytoma. How does this
test work
Answer: VMA testing is a 24 hour urine collection for VMA, a breakdown product of
catecholamines
511. What is the expected range for VMA in a 24-hour period
Answer: 2 to 7 mg
512. What is a positive result for the VMA test that indicates pheochromocytoma
Answer: Elevated levels
513. What kind of food and medications may be restricted 2 to 3 days before the test
Answer: Caffeine, vanilla, bananas, chocolate, aspirin and Antihypertensive medications
514. A clonidine suppression test is where the patients plasma catecholamine levels are taken
prior to and three hours after administration of clonidine. What is a positive result for
pheochromocytoma
Answer: The clonidine has no effect and no decrease in blood pressure
515. What is normal reference range for fasting blood glucose
Answer: Less than 110 mg/dL
516. How long does the patient need to abstain from food or fluids other than water before a
fasting blood glucose test
Answer: Eight hours
517. What is a normal reference range for the oral glucose tolerance test
Answer: Less than 140
518. How long does a patient need to fast before the oral glucose tolerance test
Answer: 10 to 12 hours
519. How often are blood samples taken during the oral glucose tolerance test
Answer: Every 30 minutes for two hours

520. What is normal range for HBA1C, what level indicates pre-diabetes and what level
indicates diabetes
Answer: • Normal: 5% or less
• Pre-diabetes: 5.7% to 6.4%
• Diabetes: 6.5% or higher
521. What is normal range for T3
Answer: 70 to 205
522. What is normal range for T4
Answer: 4 to 12 mcg/dL
523. What are risk factors for diabetes insipidus
Answer: • Head injury/tumor/ infection (meningitis, encephalitis)
• Lithium
524. What are signs/symptoms of diabetes insipidus
Answer: • Polyuria
• Polydipsia
• Nocturia
• Fatigue
• And other symptoms of dehydration
525. How is the urine chemistry in diabetes insipidus (PH, sodium, potassium, specific
gravity, osmolality)
Answer: Everything is decreased, think dilute
526. How is the serum chemistry in diabetes insipidus
Answer: Think concentrated everything is increased
527. What would a radioimmunoassay show you
Answer: Decreased ADH

528. What kind of drink would a patient with diabetes insipidus went to avoid
Answer: Anything with caffeine
529. What should be done daily with the patient that has diabetes insipidus
Answer: Daily weight
530. What is an anticonvulsant that stimulates the release of ADH
Answer: Tegretol
531. What are three side effects of Tegretol
Answer: Dizziness, drowsiness, thrombocytopenia
532. What are symptoms of thrombocytopenia
Answer: Sore throat, fever, bleeding
533. Should Tegretol be taken with or without food
Answer: With food
534. Who should vasopressin be given cautiously to
Answer: Patients who have coronary artery disease because it can cause vasoconstriction
535. What are four teaching points to a patient that has diabetes insipidus
Answer: • Weigh daily
• Eat a diet high in fiber
• Wear a medical alert wristband
• Monitor fluid intake
536. What are risk factors for syndrome of inappropriate antidiuretic hormone
Answer: • Malignant tumors
• Increased intrathoracic pressure (PPV)
• Meningitis
• Cardiovascular accident
• Medications
• Trauma

• Pain
• Stress
• Diuretics due to increased sodium losses
537. Early manifestations of SIADH include
Answer: • Headache
• Anorexia Muscle cramps
• Weakness
• Weight gain
538. As a serum sodium level decreases in SIADH, the patient begins to experience
personality changes, hostility, sluggish deep tendon reflexes and
Answer: Nausea, vomiting, diarrhea and oliguria
539. Later manifestations of SIADH include
Answer: • Confusion
• Lethargy
• Cheyne-stokes respirations
• Seizures
• Coma
• Death
540. What are manifestations of fluid volume excess
Answer: • Tachycardia
• Possible hypertension
• Crackles in the lungs
• Distended neck
• veins Taut skin
541. What is urine chemistry in SIADH
Answer: Think concentrated
542. What is blood chemistry in SIADH
Answer: Think dilute

543. What should oral fluids be restricted to any patient that has SIADH
Answer: 500 to 1000 mL/day
544. What is Demeclocycline
Answer: Tetracycline derivative. Used for SIADH
545. With patients taking demeclocycline monitor for indications of a yeast infection in the
mouth. What can you do to decrease the likelihood of this happening?
Answer: Have the patient rinse their toothbrush with a diluted bleach solution and increase
consumption of yogurt
546. How does lithium work in SIADH
Answer: Blocks the renal response to ADH
547. What are signs of lithium toxicity
Answer: Nausea, diarrhea, tremors ataxia
548. Should lithium be taken with or without food
Answer: With food
549. During treatment for SIADH if a patient is receiving hypertonic saline or loop diuretics
how often should their serum sodium level be monitored
Answer: Every 2 to 4 hours
550. What do the hormones T3 and T4 do
Answer: They affect all body systems by regulating overall body metabolism, energy
production, fluid and electrolyte balance and controlling tissue use of fats, proteins and
carbohydrates
551. What is the most common cause of hyperthyroidism
Answer: Graves disease. Autoimmune antibodies result in hypersecretion of thyroid
hormones

552. What are two other causes of hyperthyroidism
Answer: Toxic nodular goiter: caused by overproduction of thyroid hormone due to the
presence of thyroid nodules Exogenous hyperthyroidism: caused by excessive dosage of
thyroid hormone
553. What are some clinical manifestations of hyperthyroidism other than ones you would
already think of such as insomnia, tachycardia, irritability and so on
Answer: • Menstrual irregularities (Amenorrhea/decreased menstrual flow)
• Libido is initially increased and then followed by a decrease
• Exophthalmos (Graves disease only)
• Vision changes
• Bruit over the thyroid gland
554. If someone was given the thyrotropin-releasing hormone stimulation test, what would be
a positive result for hyperthyroidism
Answer: Failure of expected rise in TSH
555. In the radioiodine uptake and thyroid scan test, iodine is administered orally 24 hours
prior to the test, and then it is measured. What is a positive result?
Answer: An elevated uptake
556. One week prior to the radioiodine uptake test what should patients avoid regarding food
Answer: Anything that contains iodine
557. Thionamides such as blank and blank are used to inhibit the production of thyroid
hormone
Answer: Methimazole, propylthiouracil
558. What are side effects of thionamides
Answer: • Hypothyroidism
• Leukopenia
• Thrombocytopeni
• aHepatotoxicity

559. What is the medication that can be administered one hour after anti-thyroid medication
and is only used for short term
Answer: Iodine solutions (mixed with juice, use a straw and take the food)
560. How does radioactive iodine therapy work
Answer: It is taken up by the thyroid and destroys some of the hormone producing cells
561. How long after radioactive iodine therapy does a patient need to stay away from infants
and small children and avoid becoming pregnant
Answer: 2 to 4 days and avoid becoming pregnant for six months following therapy
562. What are four other precautions that a patient needs to take after radioactive iodine
therapy
Answer: • Do not use the same toilet as others for two weeks and flush the toilet three times
after use
• Take a laxative for 2 to 3 days after treatment
• Wear clothing that is washable and wash clothes separate from others
• Do not share a toothbrush and use disposable food service items such as paper plates
563. What should a patient receive 10 to 14 days before a thyroidectomy to reduce gland size
and prevent excess bleeding
Answer: Iodine
564. After a thyroidectomy what position should the patient be in
Answer: Hi Fowler's and avoid neck extension.
565. After thyroidectomy how do you check for laryngeal nerve damage
Answer: By asking the patient to speak as soon as they awake from the anesthesia and every
two hours there after
566. If the parathyroid gland gets damaged during a thyroidectomy what will the patient be
needing
Answer: Calcium supplements

567. What is usually given after a thyroidectomy to reduce postoperative edema
Answer: Prednisone
568. How much drainage should you expect in the first 24 hours after a thyroidectomy
Answer: 50 mL (after the first 24 hours there should only be scant drainage)
569. Thyroid storm/crisis results from a sudden surge of large amounts of thyroid hormones
into the blood stream, causing an even greater increase in body metabolism. Precipitating
factors include
Answer: • Infection
• Trauma
• Emotional stress Diabetic ketoacidosis
• Digitalis toxicity
• Thyroidectomy
570. What are clinical manifestations of a thyroid storm/crisis
Answer: • Hyperthermia
• Hypertension
• Delirium
• Vomiting
• Abdominal pain
• Hyperglycemia
• Tachydysrhythmias
• Dyspnea
571. If a patient is having a thyroid storm you can administer propylthiouracil to prevent
further release of thyroid hormones. You can then administer iodine one hour after. Why not
give it before
Answer: Because if it is given before it can exacerbate manifestations in susceptible clients
572. What are two things to look for as an indicator of hypocalcemia
Answer: Chvosteks and trousseau sign

573. A nurse in a providers office is reviewing the health record of a patient who is being
evaluated for graves disease. What is an expected laboratory finding for this patient?
Answer: Decrease in TSH because the pituitary gland decreases the production of TSH when
thyroid hormone levels are elevated
574. What are risk factors for hypothyroidism
Answer: • Women between the ages of 30 to 60
• Lithium and amiodarone
• In adequate intake of iodine
575. What are some early findings of hypothyroidism
Answer: • Fatigue/lethargy
• Intolerance to cold Constipatio
• n Weight gain Pale skin
• Thin, brittle nails
• Depression
• Thinning hair
• Joint and/or muscle pain
576. What are late manifestations of hypothyroidism
Answer: • Bradycardia
• Hypotension
• Dysrhythmias
• Slow thought process/speech
• Hypoventilation Thickening of the skin
• Dry flaky skin
• Swelling in face, hands and feet
• Decrease acuity of taste and smell
• Horse, raspy speech
• Abnormal menstrual periods
577. What kind of diet should a patient with hypothyroidism be on
Answer: Low• calorie, high bulk diet and encourage activity to prevent constipation and
promote weight loss

578. What is the medication of choice for thyroid hormone replacement therapy
Answer: Synthroid
579. What are three medications that Synthroid increases the effects of
Answer: • Coumadin
• Insulin (need for it) Digoxin
580. What type of medications decrease the absorption of Synthroid
Answer: PPI's and H2 antagonist
581. When should Synthroid be taken
Answer: 1 to 2 hours before breakfast
582. What is a severe complication of hypothyroidism
Answer: Myxedema
583. A nurse any providers office is reviewing the laboratory findings of a patient who's being
evaluated for primary hypothyroidism. What is expected a laboratory finding for this patient?
Answer: Hematocrit 34% which indicates anemia, which is an expected result for patient
who has hypothyroidism
584. What kind of laxative can a patient not take when they are on Synthroid
Answer: Fiber laxatives because it interferes with absorption
585. What are causes of Cushing's syndrome
Answer: • Organ transplant
• Chemotherapy
• Autoimmune diseases (rheumatoid arthritis)
• Asthma
• Long-term use of glucocorticoids
586. What are some signs/symptoms of Cushing's disease
Answer: • Weakness/fatigue

• Back/joint pain
• Decreased immune system
• Bruising/petechiae
• Hypertension
• Tachycardia Gastric ulcers
• Weight gain
• Hypervolemia
• Hirsutism
587. What are expected findings in laboratory test associated with Cushing's disease
Answer: • ATCH: increased
• Cortisol: increased
• Serum K/Ca: decrease
• Serum glucose: I
• Serum sodium: I
• Lymphocytes: D
588. What is Addison's disease
Answer: An adrenocortical insufficiency. The production of mineralocorticoids and
glucocorticoids is diminished resulting in decreased aldosterone and cortisol
589. What are some risk factors for Addison's disease
Answer: • Autoimmune dysfunction
• TB
• Cancer
• Adrenalectomy
• Sepsis Trauma Steroid withdrawal
590. What are some clinical manifestations of Addison's disease
Answer: • Weight loss
• Craving for salt
• Hyperpigmentation Severe hypotension
• Dehydration
• Hyponatremia

• Hyperkalemia
• Hypoglycemia
• Hypercalcemia
591. What would laboratory values be in a patient that has Addison's disease
Answer: • Bun/creatinine: I
• Serum glucose: D
• Serum cortisol: D
• Hydrocortisone, prednisone and cortisone are all glucocorticoids used for Addison's disease.
592. How should this medication be taken?
Answer: With food
593. What is a potential adverse side effects of the mineralocorticoid fludrocortisone
Answer: Hypertension and dosage may need to be increased during periods of stress or
illness (One the patient to expect mild peripheral Edema)
594. What is addisonian crisis
Answer: An acute adrenal insufficiency occurs when there is an acute drop in
adrenocorticoids due to sudden discontinuation of glucocorticoid medications or when
induced by severe trauma, infection or stress
595. What is treatment for addisonian crisis
Answer: • Administer insulin to move potassium into the cell
• Administer calcium and kayexalate to counteract the effects of hyperkalemia
• Establish an IV line and initiate a rapid infusion of NS
• Loop or thiazide diuretics are used to manage hyperkalemia
• Administer hydrocortisone as replacement therapy
596. In the presence of primary adrenal insufficiency, plasma cortisol levels blank in response
to the administration of ACTH
Answer: Do not rise
597. What is the best possible score for the Glasgow coma scale

Answer: 15
598. What do the other possible scores for the Glasgow coma scale indicate
Answer: • Less than eight: associated with severe head injury and coma
• 9 to 12: indicate a moderate head injury
• Greater than 13: reflect minor head injury
599. What are the three things that the Glasgow coma scale uses to determine the score
Answer: Eye-opening, verbal and motor response
600. What is the positioning for a lumbar puncture
Answer: Either the cannonball position or have the patient stretch over and over bed table if
sitting is preferred
601. What kind of meningitis is common among patients who have AIDS
Answer: Fungal
602. What is the haemophilus influenza type B vaccine
Answer: A vaccine for infants against bacterial meningitis
603. What is pneumococcal polysaccharide vaccine
Answer: For adults 65 years and older who have not been previously vaccinated nor have
history of the disease (for adults or immunocompromise, have a chronic disease, who smoke
cigarettes or live in a long-term care facility)
604. What is the meningococcal vaccine
Answer: For adolescence to receive prior to living in a residential setting in college and for
those in the military
605. What are risk factors for viral meningitis? Also there's no vaccine against viral
Answer: Mumps, measles, herpes and west Nile virus
606. What are some subjective signs of meningitis
Answer: • Excruciating, constant headache

• Nuchal rigidity
• Photophobia
607. What are some objective physical assessment findings of meningitis
Answer: • Fever and chills
• N/V
• Altered LOC
• Positive Kernig's sign
• Positive Brudzinski's sign
• Hyperactive deep tendon reflexes
• Tachycardia Seizures
• Red macular rash
• Restlessness/irritability
608. What is the most definitive diagnostic procedure for meningitis
Answer: CSF analysis
609. What results from the CSF analysis and lab values would be indicative of meningitis
Answer: • Appearance of CSF: cloudy (bacterial) or clear (viral)
• Elevated WBC
• Elevated protein
• Decreased glucose (bacterial)
• Elevated CSF pressure
610. What kind of precautions is a patient with meningitis placed on
Answer: Isolation/droplet precautions, which requires a private room
611. What position should a patient with meningitis be in, in bed
Answer: Head of bed elevated 30°
612. What is a myoclonic seizure
Answer: A brief jerking or stiffening of the extremities which may be symmetrical or
asymmetrical

613. What is an atonic seizure
Answer: Characterized by a few seconds in which muscle tone is lost. The seizure is
followed by a period of confusion
614. What is one anti-elliptic drug
Answer: Phenytoin (decreases effectiveness of oral contraceptives)
615. What is a medication that should not be given with phenytoin
Answer: Warfarin
616. What is a vagal nerve stimulator
Answer: A device implanted into the left chest wall and connected to an electrode placed on
the left vagus nerve
617. How does a vagal nerve stimulator work
Answer: It is programmed to administer intermittent stimulation of the brain via stimulation
of the vagal nerve, at a rate specific to the patients needs
618. In addition to routine stimulation, the patient may initiate vagal nerve stimulation by
holding a blank over the implantable device, at the onset of seizure activity. This either aborts
the seizure or lessons it's severity
Answer: Magnet
619. What is status epilepticus characterized by
Answer: A prolonged seizure activity occurring over a 30 minute time frame
620. Parkinson's disease is a progressively debilitating disease that grossly affects motor
function. It is characterized by four primary symptoms which are
Answer: Tremor, muscle rigidity, Bradykinesia and postural instability (dopamine is
decreased)
621. How's your patience Parkinson's eat their food
Answer: • Provide smaller, more frequent meals
• Add commercial thickener to thicken food

• Patients should be weighed at least weekly
622. Medications such as blank, are converted to dopamine in the brain, increasing dopamine
levels in the basal ganglia
Answer: Levodopa
623. Dopaminergics May be combined with blank, to decrease peripheral metabolism of
levodopa requiring a smaller dose to make the same amount available to the brain. Side
effects are subsequently less
Answer: Carbidopa
624. What is stereotactic pallidotomy
Answer: Destruction of a small portion of the brain within the Globus pallidus through the
use of brain imaging and electrical stimulation
625. Any patient that receives deep brain stimulation should be monitored for what
afterwards
Answer: Infection, brain hemorrhage, neurological impairment or stroke like symptoms
626. What are two complications of Parkinson's disease
Answer: Aspiration pneumonia and altered cognition such as dementia
627. What is normal range for cholesterol, HDL, LDL
Answer: Less than 200, above 40, less than 130
628. What is the desired INR range for people taking warfarin
Answer: 2.0-3.0
629. What is an indicator of cardiac tamponade
Answer: Blood pressure is 10 MM HG or higher on expiration then on inspiration
630. Patients scheduled for a coronary artery bypass graft should not take anticoagulants for
at least blank prior to the surgery to prevent excessive bleeding
Answer: A week

631. A patient is admitted with a diagnosis of Bradydysrhythmia. What assessment finding
requires immediate intervention?
Answer: The patient reports weakness and fatigue
632. Following insertion of a permanent pacemaker, a patient states they cannot get rid of
these hiccups. Why is this potentially a problem?
Answer: Hiccups may indicate that the pacemaker is stimulating the chest wall or diaphragm.
This could indicate a complication such as lead wire perforation
633. What is the normal range for creatine kinase? When are elevated levels first detectable
after myocardial injury and what is expected duration of the elevated levels?
Answer: 30 to 170 units/L, 4 to 6 hours, 3 days
634. What is the normal range for troponin T? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels?
Answer: Less than 0.2 ng/L, 3 to 5 hours, 14 to 21 days