NURS 6550 FINAL EXAM / NURS6550 FINAL EXAM (3 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 300 Q & A)

NURS 6550 FINAL EXAM / NURS6550 FINAL EXAM (3 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 300 Q & A)

Walden University NURS 6550 Final Exam / Walden University NURS6550 Final Exam

QUESTION 1

1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter was inserted intraoperatively and remains in place. His urine output has declined markedly despite continued IV fluid infusion. Today his morning labs reveal a BUN of 19 mg/dL and a creatinine of 2 mg/dL. A leading differential includes:

 

A.

Foley lodged in the urethra causing post-renal   failure

 

B.

Decreased renal perfusion causing prerenal   failure

 

C.

Age-related decreased eGFR causing prerenal   failure

 

D.

Post-surgical rhabdomyolysis causing intrarenal   failure

QUESTION 2

1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is weak, diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb black female who is awake, alert, and oriented, anxious, with moist skin and racing pulse. Her blood pressure is 140/100 mm Hg. Temperature and respiratory rate are within normal limits. The patient admits to having a “thyroid condition” but she never followed up on it when she was advised to see an endocrinologist. The AGACNP anticipates a diagnosis of:

 

A.

Hashimoto’s thyroiditis

 

B.

Cushing’s syndrome

 

C.

Grave’s disease

 

D.

Addison’s disease

QUESTION 3

1. Systemic lupus erythematosis (SLE) is a multiorgansystem autoimmune disorder that can prevent with a wide variety of manifestations. Which clinical triad should prompt an evaluation for SLE?

 

A.

Fever, normal white count, elevated sedimentation   rate

 

B.

Hyperkalemia, hyponatremia, low blood pressure

 

C.

Leukocytosis, hyperglycemia, hypokalemia

 

D.

Joint pain, rash, fever

QUESTION 4

1. A patient presents with profound vertigo of acute onset yesterday. She can barely turn her head without becoming very vertiginous; she is nauseous and just doesn’t want to move. This morning when she tried to get out of bed she felt like she was pushed back down. The vertigo is reproducible with cervical rotation. The patient denies any hearing loss or tinnitus, she has no fever or other symptoms. The AGACNP knows that the most helpful intervention will probably be:

 

A.

Meclizine

 

B.

Diazepam

 

C.

Bed rest

 

D.

Epley’s maneuvers

QUESTION 5

1. Mrs. Mireya is an 85-year-old female who is admitted for evaluation of acute mental status change from the long term care facility. She is normally ambulatory and participates in lots of facility activities. Today a nursing assistant found her in her room, appearing confused and disconnected from her environment. When she tried to get up she fell down. Her vital signs are stable excepting a blood pressure of 90/60 mm Hg. The AGACNP knows that the most likely cause of her symptoms is:

 

A.

Osteoarthritis

 

B.

Drug or alcohol toxicity

 

C.

Hypotension

 

D.

Urosepsis

QUESTION 6

1. A patient with SIADH would be expected to demonstrate which pattern of laboratory abnormalities?

 

A.

Serum Na+ 119 mEq/L, serum osmolality 240 mEq/L,   urine Na+ of 28 mEq/L, urine osmolality of 900 mOsm/kg

 

B.

Serum Na+ 152 mEq/L, serum osmolality 315 mEq/L,   urine Na+ of 5 mEq/L, urine osmolality of 300 mOsm/kg

 

C.

Serum Na+ 121 mEq/L, serum osmolality 290 mEq/L,   urine Na+ of 7 mEq/L, urine osmolality of 850 mOsm/kg

 

D.

Serum Na+ 158 mEq/L, serum osmolality 251 mEq/L,   urine Na+ of 20 mEq/L, urine osmolality of 420 mOsm/kg

QUESTION 7

1. Sean is a 29-year-old male who presents to the emergency department for evaluation and treatment of foreign body in the eye. Ophthalmic anesthesia is achieved and removal is attempted unsuccessfully with a moist cotton tipped swab. A wet fluorescein stain is applied to the lower eyelid, and a corneal abrasion ruled out but the AGACNP notes a positive Seidel sign. This indicates:

 

A.

Penetration of the cornea with resultant aqueous   leak

 

B.

A rust ring remnant due to metal foreign body

 

C.

An elevated intraocular pressure

 

D.

Paradoxical pupil dilation in response to light

QUESTION 8

1. Mrs. Lowen is an 82-year-old female who comes to the emergency department for evaluation of a fever of 102.9° F. She complains of a headache in the right side of her temple and some right-sided jaw pain. A urinalysis, chest radiograph, complete blood count (CBC) and 12-lead ECG are all non-contributory. A comprehensive metabolic panel is significant only for a slightly elevated BUN and creatinine. The AGACNP appreciates distinct right temple tenderness to percussion. Which laboratory test is necessary to support the suspected diagnosis?

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