NUR 2392 / NUR2392: Multidimensional Care II / MDC 2 Exam 2 (2021/2022) Rasmussen College
1. A patiennt is brought into the ED with respiratory
... [Show More] depression. They have a history of COPD. What acid base imbalance is most likely?: Respiratory acidosis. The patient likely has a build up of CO2
2. The nurse is evaluating the lab work of a patient who has uncontrolled metabolic acidosis. Which lab result would result from this condition?: serum potassium 5.7 mEq- serum potassium increases during acidosis to act as a buffer in the acidic conditions.
3. The nurse is reviewing the standing orders for a patient who was admitted for evaluation of chest pain. The patient has a history of chronic obstructive pulmonary disease (COPD) and his laboratory results and assessment re- veal that he has mild respiratory acidosis. The nurse would question which order?: Oxygen therapy 4 mL/ min. Oxygen therapy is often needed for respiratory acidosis, however, COPD patient have a hard tie offloading CO2 and giving too much oxygen to these patients can cause a decrease in respiratory drive.
4. A client has acute alcohol intoxication. Which acid base imbalance are they at risk for?: metabolic acidosis
5. a client comes into the ED with respiratory acidosis. What type if medica- tion is the nurse likely to administer?: bronchodilators
6. A client has a fever and is hyperventilatiing. pH is 7.51, PaCO2 is 28 mmHg, and HCO3 is 24 mEq. Identify the imbalance.: Respiratory alkolosis. -PaCO2 (respiratory) is basic, and pH is basic.
7. A nurse is caring for a client who has metabolic alkolosis. As the client compensates for this imbalance which mechanism should the nurse expect to see the clients body use?: Hypoventilation.- helps clients body compensate during metabolic alkolosis.
8. A nurse is inserting a NG tube for eternal feedings. Which action should the nurse take to verify the tube placement?: Verify the tube placement with radiography.
9. Which patient statement alerts the nurse to perform a GI history and focused assessment?: "I take Ibprofen 3x daily for arthritis." - large amounts of NSAIDs can cause peptic ulcers or GI bleeds.
10. After abdominal surgery, what sould the nurse ask the patient to deter- mine whether peristalic movement is returning?: "Passing gas is evidence of peristalic movement"
11. When administering a new GI medication to an older patient, the nurse anticipates what?: Close monitoring is needed because toxic levels may develop.
12. What are the two most common causes of ulcers/ peptic ulcer disease?-
: NSAID use and H. Pylori
13. Which diagnostic results support the diagnosis of peptic ulcer disease? SATA: Low hemaglobin
Low hematocrit
positive for H. Pylori bacteria
(Low hematocrit and hemaglobin indicate bleeding)
14. An EGD confirms PUD. The patient complains of midline epigastric ten- derness and indigestion (dyspepsia). The patient is prescribed triple therapy, what does the nurse expect this to include?: PPI and two antibiotics. The antibiotics treat the H. Pylori, and PPI reduce acid flow to the ulcers to promote healing.
15. Which patient statement would cause the nurse to suspect that she may have ZollingerEllison syndrome (ZES)?: "The stomach pain hurts, but the foul-smelling diarrhea is worse."
16. . Zollinger-Ellison syndrome: hypersecretion of gastric acid that produces peptic ulcers as a result of pancreatic tumors.
17. Zollinger-Ellison syndrome symptoms: -Peptic ulcers (not responding to tx)
-Dyspepsia
-GERD
-Diarrhea (foul smellin)
-stomach pain
18. As the patient prepares for discharge, the nurse provides education about behaviors that reduce symptoms and aggravate peptic ulcers. Which teaching does the nurse provide?: -sit upright 30-60 min after meal
-extreme vomitting should be reported to physician
-H. Pylori is a concern in patients with peptic ulcers
-the goal of inititial treatment is to manage symptoms and prevent furthur compi- cations.
19. Which statement by a patient with PUD requres furthur teaching?: "My doctor said to take ibprofen for my aches and pains"
(NSAIDs are a no no for PUD, cause irritation)
20. A 68-year-old patient with a history of arthritis and hypertension is admit- ted reporting progressive epigastric cramping, dyspepsia, nausea, and dark, sticky stools for 3 days. Which order will the nurse question?: Naproxen 500 mg twice daily (naprosyn)- [Show Less]