1
Q
What are the clinical manifestations associated with acute viral infection and seroconversion? SATA
A. swollen lymph nodes
B. rapid viral load increase
C. low-grade fever
D. drop in blood pressure
E. generalized aches and pains
A
A, B, C, E
2
Q
The patient has Koposi’s sarcoma on the left shoulder area. What is the earliest stage of HIV infection they are experiencing?
A. Acute viral infection
B. Asymptomatic chronic infection
C. Symptomatic chronic infection
D. AIDS
A
C
3
Q
The nurse is working in the immediate triage area of a mass causality situation using the Simple Triage And Rapid Treatment (START) triage model. Which interventions would the nurse perform? Select all that apply.
A. Obtain a BP
B. Hold direct pressure to control bleeding
C. Assess pupillary response
D. Open the airway for someone not breathing
E. Obtain name and medical allergies
A
B and D
4
Q
Which type of continuous renal replacement therapy (CRRT) would not require a pump?
A. Slow continuous ultrafiltration
B. Continuous arteriovenous hemofiltration
C. Continuous venovenous hemofiltration
A
B
5
Q
If a patient has a salicylate level of 50 mg/dL, which clinical manifestation would the nurse anticipate?
A. hyperthermia
B. Rhabdomyolysis
C. Pulmonary edema
D. Hallucinations
A
D
6
Q
What are the four primary risk factors for HIV?
A
- Shared needles
- Sexual relations with infected person
- Infant born or breast-fed by infected mother
- Transport or transfusion from infected person
7
Q
If a patients CD4 level is below 200 what does that mean?
A
HIV has progressed to AIDS
8
Q
How many stages are there of CKD?
A
5
9
Q
What determines the stage of CKD a patient is in?
A
GFR
10
Q
What is considered a normal GFR?
A
Over 90 mL/min
11
Q
How many times a day does the body cycle it’s total amount of blood?
A
20-25
12
Q
If your BUN is high and your GFR and creatinine are normal what does that mean?
A
Dehydration
13
Q
What would GFR be for a patient in stage 4 of CKD?
A
29-15 mL/min
14
Q
What would the GRF be for a patient in end stage renal disease? (Stage 5)
A
Below 15
15
Q
What two things would a patient in Stage 5 need?
A
Dialysis and a kidney transplant if they are eligible
16
Q
What are the two biggest causes of CKD?
A
Uncontrolled type 2 diabetes and uncontrolled hypertension
17
Q
Remember: The kidneys are the princesses of the body. Putting thick sugary (hyperglycemia) blood through them is like pouring cement into a washing machine. There is no way it can clean and filter.
A
From Simple Nursing YouTube video on CKD
18
Q
What are three more causes of CKD besides uncontrolled Type 2 diabetes and hypertension?
A
Polycystic kidney disease, infection called polynephritis, acute renal failure that progresses.
19
Q
What lab would you look at to tell you about the overall kidney function?
A
creatinine
20
Q
What is the normal range of creatinine according to FA Davis?
A
0.5-1.2 according to FA Davis
21
Q
What is the normal range of BUN according to FA Davis?
A
22
Q
What does a creatinine clearance test measure?
A
How much creatinine waste is being cleared from the body through urination (how well the GFR is working)
23
Q
What types of specimens are needed for the creatinine clearance test?
A
Urine and blood
24
Q
When doing a 24 hour creatinine clearance test, what is important?
A. Discard first urine sample in the 24 hour time
B. Keep urine as close to 98.6 degrees as possible
C. Keep urine on ice
D. Catch urine mid-stream
A
A and C
25
What are the three priority key signs to monitor to see if a patient is in hypertensive crisis? (report to provider immediatly)
1. headache
2. nausea and vomiting
3. Change in mental status
26
What are the three priority signs to monitor for fluid volume overload?
1. crackles in the lungs
2. JVD
3. bounding pulses
27
Which is the priority problem in a patient with CKD? Fluid volume overload or hypertensive crisis.
hypertensive crisis
28
What hormone is released to tell bone marrow to create RBCs?
erythropoietin
29
What does urea develop into when it is not filtered from the body and is in excess in the blood?
uremic frost
30
What acide/base issue typically happens in patients with CKD?
metabolic acidosis
31
Uremic frost leads to pruritus. What is the biggest concern with pruritis?
infection
32
Would electrolyte values be high or low with CKD?
High - because the kidneys aren't filtering out
33
What is the normal value of hemoglobin?
14 to 17.3 g/dL for adult males and 11.7 to 15.5 g/dL for adult females
34
What is the normal value for hematocrit?
42% to 52% for adult males and 36% to 48% for adult females
35
Normal values of sodium according to FA Davis?
135-145 mEq/L
36
Normal values of potassium according to FA Davis?
3.5–5.3 mEq/L
37
Normal value of chloride according to FA Davis?
97–107 mEq/L
38
Normal value of magnesium according to FA Davis?
1.6–2.2 mg/dL
39
What are the clinical manifestations of hypernatremia?
Disorientation, hallucinations, agitation, restlessness, neuromuscular irritability, confusion, seizures, lethargy, tachycardia, dry mucous membranes, skin flushed, agitation, thirst
40
What are the clinical manifestations of hyperkalemia?
Generalized weakness, muscle cramps, paresthesia to weakness, ECG changes (abnormal rhythms, widened QRS complex), bradycardia, sinus arrest, heart blocks, or ventricular dysrhythmias
41
The heart is a muscle, so when Potassium is elevated (above 5.0) what happens to the heart?
It is weakened and cramping - bradycardia
42
What three EKG changes are seen with hyperkalemia?
peaked T waves (6-7 mEq/L), ST elevation (7-8 mEq/L), wide QRS complexes (over 8)
43
What is the priority electrolyte to treat if multiple are not within normal limits?
Potassium
44
For a patient with CKD and an extremely high potassium, dysrhythmias what is the priority treatment?
IV Calcium gluconate (GLUE down the heart muscles)
45
For a patient with CKD and high potassium (no dysrhythmias) what is the priority treatment?
IV D50 and regular insulin (insulin lowers blood sugar so it is paired with the Dextrose 50%)
46
These two pharmacological interventions work to lower potassium but take longer than IV calcium gluconate or D50 and insulin.
Kayexalate (polystyrene sulfonate) and dialysis
47
Patient with chronic kidney disease missed 3 dialysis sessions. Potassium level 8.1, wide QRS complexes, heart rate of 58 and lethargy. Which order should the nurse implement first?
A. IV 50% dextrose and regular insulin
B. sodium polyesterene
C. hemodialysis
D. IV calcium gluconate
D
48
End stage renal disease... potassium 7.2, BUN 35, creatinine 3.8, urine output of 300ml in 24 hours. Which order is priority?
A. IV 50% dextrose and regular insulin
B. sodium polyesterene
C. hemodialysis
D. dialysis
A
49
What should be checked daily at the same time each day in patients with CKD?
Daily weights (how we can monitor for fluid overload and hypertensive crisis)
50
What meds should patients with CKD avoid?
NSAIDS, antacids, CT contrast dye, antibiotics that end in 'mycin' -vancomycin and gentamicin
51
What three things are we restricting for the diet of a patient with CKD?
water, sodium and potassium
52
What two things are we going to give low amounts of in the diet of a CKD patient?
phosphorus and protein
53
If you are trying to avoid high sodium in a diet which things would you avoid? (SATA)
A. canned and processed foods
B. apples
C. processed meats
D. sweet potatoes
A and C
54
What is the best choice to give a patient on a low potassium diet?
apples!
55
Kidney filtration stops when GFR drops below _____
40
56
What acid/base balance should a client with CKD be monitored for?
metabolic acidosis
57
What should the nurse do with a client who comes in with white phosphorus poisoning?
Do not flush with water, brush away
58
A nurse in the emergency department receives four patients. Which patient should be seen FIRST?
A. A patient with a sprained ankle and pain level 8/10
B. A patient with chest pain and diaphoresis
C. A patient with a fever of 101.5°F and sore throat
D. A patient with a laceration requiring sutures
B - Chest pain with diaphoresis is a classic sign of possible myocardial infarction. This is life-threatening and requires immediate intervention (ABCs + circulation priority).
59
A patient arrives with stridor and difficulty breathing. What is the nurse’s PRIORITY action?
A. Obtain vital signs
B. Apply oxygen
C. Prepare for intubation
D. Notify the provider
C - Stridor = upper airway obstruction → airway is at risk. Immediate preparation for intubation is priority before full obstruction occurs.
60
A trauma patient arrives after a motor vehicle accident. What is the FIRST assessment?
A. Neurological status
B. Airway patency
C. Circulation
D. Pain level
B
61
A patient is experiencing an anaphylactic reaction. Which medication should the nurse administer FIRST?
A. Diphenhydramine
B. Epinephrine
C. Prednisone
D. Albuterol
B
62
A patient is found unresponsive with no pulse. What is the nurse’s FIRST action?
A. Call the provider
B. Start CPR
C. Apply oxygen
D. Check blood pressure
B - Follow BLS guidelines: start high-quality CPR immediately when no pulse is present.
63
During a mass casualty incident, which patient should be tagged RED (immediate)?
A. Walking wounded with minor cuts
B. Unconscious with no respirations even after airway repositioning
C. Respirations 34/min with delayed capillary refill
D. Stable fracture with controlled bleeding
C - START triage
RR > 30 = RED
Delayed cap refill = poor perfusion → RED
Walking wounded = GREEN
No respirations after repositioning = BLACK (expectant)
64
Which patients would be classified as GREEN (minor)? (Select all that apply)
A. Patient walking with minor abrasions
B. Patient with sprained ankle
C. Patient with respiratory rate of 10
D. Patient able to follow commands with small laceration
E. Patient with uncontrolled bleeding
A, B, D
65
What is the nurse’s PRIMARY goal during a mass casualty incident?
A. Provide detailed care to each patient
B. Save the greatest number of lives
C. Treat patients on a first-come basis
D. Focus on the most critical patient only
B
66
A patient is breathing, has a weak pulse, and is unable to follow commands. What triage category?
A. GREEN
B. YELLOW
C. RED
D. BLACK
C
67
Which findings indicate a YELLOW (delayed) classification? (Select all that apply)
A. Stable abdominal wound
B. Open fracture without severe bleeding
C. Respiratory rate 32/min
D. Capillary refill < 2 seconds
E. Alert and oriented
A, B, D, E
68
A patient exposed to a chemical spill arrives at the ED. What is the FIRST action?
A. Start IV fluids
B. Remove contaminated clothing
C. Administer antidote
D. Obtain vital signs
B
69
A patient is not breathing. After repositioning the airway, they begin breathing at 20/min. What is their triage category?
A. GREEN
B. YELLOW
C. RED
D. BLACK
C
70
Which role is responsible for overall management during a disaster?
A. Triage nurse
B. Charge nurse
C. Primary nurse
D. Incident commander
D
71
A patient with Chronic Kidney Disease has a potassium level of 6.2 mEq/L. What is the nurse’s PRIORITY action?
A. Administer a diuretic
B. Place the patient on a cardiac monitor
C. Restrict fluids
D. Encourage oral potassium intake
B
72
Which findings are expected in CKD? (Select all that apply)
A. Hyperkalemia
B. Metabolic acidosis
C. Increased hemoglobin
D. Edema
E. Hypocalcemia
A, B, D, E
73
Which symptoms are consistent with active TB? (Select all that apply)
A. Night sweats
B. Hemoptysis
C. Weight gain
D. Chronic cough
E. Fever
Answer: A, B, D, E
A, B, D, E
74
A patient with HIV has a CD4 count of 150. What is the nurse’s priority concern?
A. Risk for hypertension
B. Risk for opportunistic infections
C. Risk for dehydration
D. Risk for bleeding
B
75
Which foods should a nurse instruct a patient with CKD to avoid? SATA
A. High potassium and high sodium foods
B. High protein foods
C. High calcium foods
D. High fiber foods
A and B
76
Large protein molecules blocking kidney filtration is referred to as:
A. Pyelonephritis
B. Nephrotic syndrome
C. Rhabdomyolysis
D. Glomerulonephritis
C
77
A patient receiving dialysis reports severe pruritus. What complication should the nurse be concerned about?
A. Dehydration
B. Infection
C. Hyperglycemia
D. Hypertension
B
78
Which symptoms may indicate radiation exposure?
A. Nausea and vomiting
B. Bloody diarrhea
C. Hair loss
D. Severe hypertension
B
79
Which hormone released by the kidneys stimulates red blood cell production?
A. Renin
B. Aldosterone
C. Erythropoietin
D. Antidiuretic hormone
C
80
The ED nurse is caring for a client diagnosed with multiple rib fractures. Which data should the nurse include in the assessment?
A. Level of orientation to time and place
B. Current use and last dose of meds
C. Symmetrical movement of the chest
D. Time of last meal the client ate
C
81
The nurse is caring for a client in the ED diagnosed with abdominal trauma. Peritoneal lavage was performed. Which intervention should the nurse include in the plan of care?
A. Assess for the presence of blood, bile or feces
B. Palpate the client for bilateral femoral pulses
C. Perform Leopold's maneuver every 8 hours
D. Withhold the client's oral intake
A
82
The ED nurse is caring for a near-drowning victim. Which expected outcome should the nurse include in the plan of care for this client?
A. Maintain the client's cardiac function
B. Promote a continued decrease in lung surfactant
C. Warm rapidly to minimize the effects of hypothermia
D. Keep the oxygen saturation level above 93%
D
83
With burns, what type of fluids would be administered?
isotonic - LR and NS
84
The nurse is caring for a client with full thickness burns covering 20% of their body. What is the priority of care after ensuring a patent airway?
IV fluids
85
If the front and back of a person's head and neck were burned, what percentage of the body is burned?
9% (4.5% for the front and 4.5% for the back)
86
If a client had burns on the front and back of the left arm, front and back of the left arm and perineum were burned, what percentage of the body is burned?
28% (4.5% for front of arm, 4.5% for back of arm, 9% for front of leg, 9% for back of leg, 1% for perineum)
87
Client has full thickness burns to all posterior body surfaces. Using the rule of nines, calculate the % of total body surface area affected.
Head
Back
Right and Left Arm
Right and Left Leg
49.5% (4.5% back of head, 18% back, 9% back of both arms, 18% back of both legs)
88
What is the parkland formula?
4mL x kg of body weight x TBSA
89
The client weighs 100kg with 19% TBSA (total body surface area) affected. Calculate the LR fluid resuscitation needed in the first 24 hours.
4mL x 100 x 19 = 7,600 mL
90
How much of the fluid calculated with the Parkland formula is given within the first 8 hours?
3,800 mL (first have is given within first 8 hours and second half is given across the following 16 hours)
91
What is the first priority for a patient with high CKD, high potassium and dysrhythmias?
Calcium gluconate
92
A patient misses their hemodialysis sessions multiple days in a row. What are they at biggest risk for?
Increased electrolyte levels because the body is not able to remove them from the bloodstream
93
How does insulin help with high potassium levels?
It pushes potassium out of the bloodstream and into the cell
94
How do we assess fluid status in a patient that gets dialysis?
Assess weight before and after
95
How do you assess the fistula?
Feel a thrill and hear a bit
96
If there is no thrill or bruit, what is the suspected issue?
blood clot
97
A nurse is educating a client prescribed buspirone for generalized anxiety disorder. Which statement indicates correct understanding?
A. “I will take this medication only when I feel anxious.”
B. “This medication works immediately to relieve anxiety.”
C. “I should take this medication consistently as prescribed.”
D. “I can drink alcohol while taking this medication.”
C - Buspirone must be taken consistently; it does not work immediately and is not PRN
98
Which side effects should the nurse include when teaching a client about buspirone?
Select all that apply:
A. Dizziness
B. Headache
C. Sedation
D. Nervousness
E. Severe respiratory depression
A, B, D
99
A client taking olanzapine should be monitored for which adverse effect?
A. Hypoglycemia
B. Weight loss
C. Metabolic syndrome
D. Bradycardia
C - Olanzapine can cause weight gain, hyperglycemia, and dyslipidemia (metabolic syndrome).
100
Which client taking olanzapine should the nurse see first?
A. Client with mild dry mouth
B. Client reporting weight gain
C. Client with blood glucose of 320 mg/dL
D. Client with mild drowsiness
C - Severe hyperglycemia is a priority due to risk for complications like DKA.
101
Which client condition is a contraindication for propranolol?
A. Hypertension
B. Migraine headaches
C. Asthma
D. Anxiety
C - Propranolol is a nonselective beta-blocker and can cause bronchoconstriction.
102
Before administering propranolol, which assessments are essential?
Select all that apply:
A. Blood pressure
B. Heart rate
C. Respiratory rate
D. Blood glucose
E. Oxygen saturation
A, B
Rationale: Hold if HR < 60 or low BP.
103
Which statement by a client taking propranolol requires further teaching?
A. “I will check my pulse before taking this medication.”
B. “I may feel dizzy when standing up quickly.”
C. “I can stop this medication suddenly if I feel better.”
D. “This medication may help with my anxiety symptoms.”
C - Abrupt discontinuation can cause rebound hypertension and tachycardia.
104
The nurse understands prazosin is often prescribed for which condition?
A. Panic attacks
B. PTSD-related nightmares
C. Bipolar disorder
D. OCD
B - Prazosin is commonly used off-label for PTSD nightmares.
105
Which adverse effects should the nurse monitor for in a client taking prazosin?
Select all that apply:
A. Orthostatic hypotension
B. First-dose syncope
C. Hypertension
D. Dizziness
E. Bradycardia
A, B, D - Prazosin can cause significant hypotension, especially after the first dose
106
A nurse is reviewing medication orders. Which medication requires the most immediate follow-up?
A. Buspirone prescribed PRN for anxiety
B. Olanzapine prescribed at bedtime
C. Propranolol prescribed for migraine prevention
D. Prazosin prescribed for PTSD nightmares
A - Buspirone is not effective PRN—this order is inappropriate.
107
What are the 4 cardinal signs of PTSD?
CHAR - Change in mood or cognition, hyperawareness, avoidance behavior and reliving the event
108
What are two reasons we use olanzapine to treat anorexia?
1. Stimulates appetite/weight gain 2. Treats cognitive distortion/delusions/allows them to accept the weight gain
109
This personality disorder requires that you keep your promises to the patient?
Borderline personality disorder
110
Hyponatremia, proteinuria, amenorrhea and hypoglycemia are symptoms of this disorder?
Anorexia nervosa
111
Name 5 risk factors for developing PTSD-
1. What is happening to you or loved ones
2. Where you feel safe (home, work)
3. using drugs and alcohol to cope
4. Experiences outside usual human experiences
5. Lack of societal support
6. Repeat exposure
7. Not getting help
8. Previous mental health diagnosis
112
These three electrolyte imbalances are associated with referring syndrome...
hypokalemia, hypomagnesemia, hypophosphatemia
113
What can happen if a patient starts eating too quickly when being treated for anorexia nervous?
Referring syndrome
114
This med takes weeks to be effective for social anxiety.
Buspirone
115
This medication is used to treat the somatic symptoms of anxiety disorder
propanolol
116
Common defense mechanism commonly associated with borderline personality disorder
splitting
117
What is the main electrolyte imbalance seen in patients with bulimia?
hypokalemia - due to purging
118
119
Why do patients with chronic kidney disease have fluid overload?
Their kidneys aren’t functioning properly so they have an overload due to decreased urine output
120
With kidney disease do the following electrolytes become increased or decreased:
Potassium
Sodium
Calcium
Phosphorus
Potassium- increased bc impaired excretion
Sodium - decreased
Calcium - decreased
Phosphorus - decreaseed
121
Why does calcium becomes increased decreased in CKD?
There is a decreased GI absorption of calcium due to the kidneys inability to activate vitamin D
122
Why do CKD patients experience anemia?
They have impaired erythropoietin production
123
A nurse is reviewing labs for a client with chronic kidney disease (CKD). Which finding is expected?
A. Decreased potassium
B. Increased phosphorus
C. Increased calcium
D. Decreased BUN
B - CKD → ↓ phosphorus clearance → hyperphosphatemia
124
Which electrolyte imbalance is most concerning in CKD due to risk of cardiac dysrhythmias?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
B
125
A patient with CKD develops metabolic acidosis. What is the primary cause?
A. Increased bicarbonate production
B. Excess sodium retention
C. Increased calcium loss
D. Decreased acid excretion
D - Kidneys can’t excrete acids → acid buildup
126
Which finding differentiates chronic kidney disease (CKD) from acute kidney injury (AKI)?
A. Sudden onset of oliguria
B. Elevated creatinine
C. Gradual loss of kidney function over time
D. Decreased urine output
C
127
A CKD patient has low calcium levels. What is the underlying cause? (Select all that apply)
A. Decreased vitamin D activation
B. Increased phosphorus levels
C. Increased GI calcium absorption
D. Secondary hyperparathyroidism
A, B, D
128
Which lab value is the BEST indicator of renal function in CKD?
A. BUN
B. Sodium
C. Creatinine
D. Hemoglobin
C
129
A patient with CKD is anemic. What is the cause?
A. Blood loss from dialysis
B. Increased RBC destruction
C. Decreased erythropoietin production
D. Iron overload
C
130
Which statement best describes BUN levels in CKD?
A. BUN decreases due to kidney damage
B. BUN increases due to impaired clearance
C. BUN remains normal
D. BUN only rises in AKI
B
4th Semester Nursing
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