Medsurge 2 Final

1. Cause of Hyperkalemia ? Renal failure, Acidosis, elevated Potassium sparing diuretic, Tissue injury, muscle cramping, numbness and tingling and palpitation, abdominal pain 2. Question: Which of the following is an early electrocardiogram (EKG) finding in a patient with hyperkalemia? A. Presence of U waves B. Widened QRS complex C. Peaked T waves D. Sinus bradycardia Correct Answer: C. Peaked T waves 3. Question: What EKG change is commonly associated with hypokalemia? A. Peaked T waves B. U waves C. Prolonged PR interval D. Flattened P waves Correct Answer: B. U waves 4. Question: Which of the following EKG findings is most likely in a patient with hypocalcemia? A. Shortened QT interval B. Prolonged PR interval C. Prolonged QT and ST intervals D. Peaked T waves Correct Answer: C. Prolonged QT and ST intervals 5. Question: Hypercalcemia affects cardiac repolarization in which of the following ways in the EKG? A. Prolongs the PR interval B. Shortens the ST segment C. Causes U waves D. Causes prolonged QT intervals Correct Answer: B. Shortens the ST segment 6. Question: In the emergency triage system, what does a “Red” tag indicate? A. Non-urgent condition B. Deceased or expectant C. Immediate life-threatening condition D. Minor injuries only Correct Answer: C. Immediate life-threatening condition 7. Question: Which of the following best describe no Insulin deficiency causing fat breakdown and ketone accumulation leading to acidosis Type 1. A. DKA (Young) B. HHNS (Old people) C. Somogyi effect D. Dawn phenomenon Correct Answer: A 8. Question: A patient with type 2 diabetes presents with severe dehydration because of no osmotic diuresis. Which condition is most likely? A. DKA B. HHNS (Old people) C. Somogyi effect D. Dawn phenomenon Correct Answer: B. HHNS 9. Question: What best explains the Somogyi phenomenon? A. Morning hyperglycemia due to hormonal surge B. Nighttime hypoglycemia followed by rebound hyperglycemia 2 or 3am C. Poorly controlled type 2 diabetes D. Excessive glucose intake Correct Answer: B. Nighttime hypoglycemia followed by rebound hyperglycemia 10. Question: What causes the Dawn phenomenon in diabetic patients? A. Insulin overdose B. Hyperglycemia early morning 6-7 am due to release hormone C. Excessive bedtime snacks D. Nocturnal hypoglycemia Correct Answer : B 11. Question: A diabetic patient presents with fatty lumps at insulin injection sites that causing by repetead insulin injection What is the nurse’s most appropriate assessment? A. Lip hypertrophy B. Lipoatrophy C. Lipodystrophy D. Lipemia Correct Answer: C. Lipodystrophy 12. Question: What is the advantage of mixing regular insulin with NPH insulin? A. Faster onset of action B. Delayed glucose absorption C. Combination of (Regular) short- and intermediate-acting (NPH) insulin effects D. Reduced risk of hypoglycemia Correct Answer: C. Combination of (Regular) short- and intermediate-acting (NPH) insulin effects 13. Question (Select all that apply): Which of the following are causes of hyperkalemia? Renal failure Acidosis Potassium-sparing diuretics Tissue injury 14. Question (Select all that apply): Which conditions can lead to metabolic acidosis? Renal failure Diabetic ketoacidosis Diarrhea Antifreeze ingestion, Methanol or Toxins 15. Question: SIADH condition is characterized by water retention and dilutional due to excessive ADH which electrolyte imbalance? A. Diabetes insipidus B. Hyperaldosteronism C. Hyponatremia D. Addison’s disease Correct Answer: C 16. Question: A patient has polyuria and dilute urine due to ADH deficiency Diabetes Insipidus. What condition is most likely and electrolyte imbalance? A. Nephrotic syndrome B. Hyponatremia C. SIADH D. Hypoparathyroidism Correct Answer: B 17. Question: Which of the following is a characteristic finding in Grave’s disease? A. Weight gain B. Heat intolerance (Hyperthyroidism) C. Bradycardia D. Cold intolerance Correct Answer: B 18. Question: What is the purpose of a radioactive iodine uptake (RAIU) test? A. Evaluate glucose metabolism B. Diagnose adrenal insufficiency C. . Assess thyroid function by measuring the uptake of radioactive iodine, evaluation thyroid disorder D. Measure insulin sensitivity Correct Answer: C 19. Question: Which condition is characterized by autoimmune destruction of the thyroid, leading to hypothyroidism? A. Grave’s disease B. Hashimoto’s thyroiditis C. Addison’s disease D. Cushing’s syndrome Correct Answer: B 20. What is the primary action of insulin? A. Promotes gluconeogenesis B. Facilitates glucose uptake into cells C. Inhibits fat storage D. Stimulates glucagon secretion Correct Answer: B 21. Question: What is the primary mechanism of action of metformin? A. Stimulates insulin secretion from the pancreas B. Enhances glucose absorption in the intestines C. Decreases hepatic glucose production and improves insulin sensitivity D. Promotes glucagon release Correct Answer: C 22. Question: Which of the following can precipitate thyrotoxicosis in a patient with underlying thyroid disorder? A. Beta-blocker therapy B. Low iodine intake C. Surgery or stress D. Calcium supplementation Correct Answer: C. Surgery or stress 23. Question: Which of the following are classic signs of hypocalcemia? A. Positive Chvostek’s and Trousseau’s signs B. Bradycardia and bounding pulse C. Laryngospasm, and prolonged QT/ST D. Muscle weakness and fatigue Correct Answer: A and C 24. Question: Hypoparathyroidism results in: A. Hypercalcemia B. Hypocalcemia, tetany, muscle spasm, or irritability C. Hyperkalemia and edema D. Hyponatremia with confusion Correct Answer: B 25. A patient with hyperparathyroidism is at risk for: A. Muscle spasms and twitching B. Seizures due to low calcium C. Muscle weakness and fatigue due to hypercalcemia D. Water retention and edema Correct Answer: C 26. Question: Which of the following symptoms are associated with pheochromocytoma? A. Low blood pressure, cold intolerance B. Elevated Catecholamines (epinephrine, norepinephrine) C. Bradycardia, constipation, dry skin D. Edema, oliguria, chest pain Correct Answer: B 27. Question: What is the test to differentiate Cushing’s disease from Cushing’s syndrome? A. Presence of ketones B. Adrenal cortex atrophy C. Dexamethasone suppression test D. Hyperkalemia in Cushing’s syndrome Correct Answer: C 28. Question: What hormone is excessively secreted in Conn’s disease? A. Cortisol B. Elevated Aldosterone C. ADH D. Insulin Correct Answer: B 29. What does the HbA1c test measure? A. Immediate blood glucose levels B. Blood glucose levels after eating C. Measure blood Glucose levels over the past 3 months D. Renal glucose reabsorption capacity Correct Answer: C 30. Question: What is the primary use of the oral glucose tolerance test (OGTT)? A. Diagnose type 1 diabetes B. Screen for kidney damage C. Monitor blood glucose daily D. Diagnose gestational diabetes in pregnancy 2nd semester Correct Answer: D. Diagnose gestational diabetes in pregnancy 2nd semester 31. Question: What is considered a normal fasting blood glucose level? A. 60–80 mg/dL B. 70–99 mg/dL C. 100–125 mg/dL D. 126–140 mg/dL Correct Answer: B. 70–99 mg/dL 32. Question: During pregnancy, how do insulin requirements change in the later trimesters? A. Decrease due to placental hormone effects B. Remain stable C. Increase due to insulin resistance D. Fluctuate depending on fetal growth Correct Answer: C. Increase due to insulin resistance 33. Question: Which of the following insulins has no peak action? A. NPH (Humulin N, Novolin N) B. Regular (Humulin R,Novolin R) C. Lispro (Humalog) D. Glargine Correct Answer: D. Glargine 34. Question (Select all that apply): Which of the following are causes of pre-renal failure perfusion to kidney? Anaphylaxis Diabetes Hypovolemia heart failure/MI hypertension 35. Question (Select all that apply): Which of the following can cause intra-renal failure Acute Tubular Necrosis? Medication Aminoglycosids Glomerulonephritis Toxins Lupus Trauma PKD 36. Question: Which of the following is a common cause of post-renal failure (Obstruction)? A. Hypotension B. Dehydration C. Kidney stones, BPH D. Nephrotoxic drugs Correct Answer: C 37. Question: Nephrogenic diabetes insipidus is characterized by: A. Lack of ADH secretion B. Excessive ADH secretion C. Renal resistance to ADH or Kidney are unresponsive to antidiuretic hormone (ADH) D. Increased glucose excretion Correct Answer: C 38. Which of the following is true regarding neurogenic diabetes insipidus? A. The kidneys are unresponsive to ADH B. The hypothalamus or pituitary gland fails to produce or release ADH C. It is caused by overhydration D. It leads to water retention Correct Answer: B 39. Question: Which is a common complication of nephrotic syndrome? A. Pulmonary edema B. Hypertension C. Hypotension D. Hyperkalemia Correct Answer: C. Hypotension 40. Question: Acute glomerulonephritis (AGN) often follows which type of infection? A. Viral hepatitis B. Staphylococcal skin C. Streptococcal Infection D. Urinary tract infection Correct Answer: C 41. Question (SATA) Which of the following are common signs and symptoms of benign prostatic hyperplasia (BPH)? Urinary Frequency Urinary retention Weak or dribbling of urine Nocturia 42. Question: In prioritizing care, which principle should the nurse apply first? Airway, Breathing, Circulation (ABC) 43. Which of the following is the initial treatment for diabetic ketoacidosis (DKA)? A. Subcutaneous insulin and electrolyte replacement B. Begin IV fluids resuscitation and ad administer regular insulin IV C. Oral glucose and hydration D. Long-acting insulin and rest Correct Answer: B 44. Question: A patient reports chest pain. What is the nurse’s priority action? A. Administer antacid B. Assess for myocardial infarction (Report to the physician) C. Check blood glucose D. Notify the pharmacy Correct Answer: B 45. Question: Which of the following is a hallmark sign of acute respiratory distress syndrome (ARDS)? A. Bradycardia and hypotension B. Productive cough and fever C. Glass-like infiltrates and refractory hypoxemia, pulmonary edema D. Decreased lung compliance with wheezing Correct Answer: C 46. Question: Which diuretic is commonly used to treat pulmonary edema? A. Spironolactone B. Hydrochlorothiazide C. Furosemide (Lasix) D. Mannitol Correct Answer: C 47. Question: What medication is used to treat MRSA, and what adverse effect should the nurse monitor for? A. Penicillin – anaphylaxis B. Vancomycin – Watch for red man syndrome C. Ciprofloxacin – tendon rupture D. Tetracycline – tooth discoloration Correct Answer: B 48. Question: Which of the following best describes status asthmaticus? A. A mild asthma episode that resolves quickly B. A single asthma attack within 1 hour C. Severe prolonged asthma unresponsive to usual treatment D. A wheezing episode due to cold air Correct Answer: C 49. Question: A nurse caring for a trauma patient suspects a fat embolism (Fracture). What is the priority action? A. Administer aspirin B. Start IV fluids C. Report immediately to the physician D. Place the patient in Trendelenburg position Correct Answer: C 50. Question: Which of the following are hallmark signs of compartment syndrome? A. Numbness, tingling, warm skin B. Pain, pallor, paresthesia, and cool-clammy skin C. Edema, redness, and increased temperature D. Weakness and bounding pulses Correct Answer: B. Pain, pallor, paresthesia, and cool-clammy skin 51. Question: What is electrolyte imbalance for Addison’s disease? A. Overproduction of cortisol B. Excessive aldosterone secretion C. Hyperkalemia due to Insufficient aldosterone D. Increased renal excretion of sodium Correct Answer: C 52. Question: Which of the following can cause hypermagnesemia? A. Excessive dairy intake B. Excessive magnesium intake or renal failure C. Liver failure D. Diuretic overuse Correct Answer: B. Excessive magnesium intake or renal failure 53. Question: What is the antidote for hypermagnesemia? A. Sodium bicarbonate B. Potassium chloride C. Calcium gluconate D. Insulin with glucose Correct Answer: C. Calcium gluconate 54. Question: Autonomic dysreflexia most commonly occurs in patients with spinal cord injuries at which level? A. Below L1 B. C2–C4 C. T6 or above D. T12–L1 Correct Answer: C 55. Question: Which of the following may precipitate autonomic dysreflexia? Full bowel Full bladder Tight clothing Wrinkled linen Pressure ulcer 56. Question: Which class of medication is typically used in cardiogenic shock? A. Antihypertensives B. Antipyretics C. Inotropes D. Diuretics Correct Answer: C 57. Question: What is the treatment for hypoglycemia in a conscious patient? A. IV D50 B. Subcutaneous insulin C. 15 grams of fast-acting carbohydrates D. IM glucagon Correct Answer: C. 15 grams of fast-acting carbohydrates 58. Question: What is the appropriate treatment for an unconscious patient experiencing hypoglycemia? A. Subcutaneous insulin B. Oral glucose C. IV D50 (Dextrose 50%) D. Glucophage Correct Answer: C 59. Which of the following best describes the mechanism of anaphylaxis? A. Increased cortisol levels B. Sudden bradycardia C. Massive vasodilation and increased permeability leading to shock D. Decreased respiratory rate and alkalosis Correct Answer: C 60. Question: Which combination of symptoms is most suggestive of multiple organ dysfunction syndrome (MODS)? A. Tachycardia, fever, polyuria B. Jaundice, oliguria, confusion, coma, acidosis, stupor C. Hypotension, tachypnea, clear mental status D. Bradycardia, nausea, anxiety Correct Answer: B 61. Question: Which electrolyte imbalance is most critical to monitor due to its impact on cardiac function? A. Sodium B. Calcium C. Potassium D. Chloride Correct Answer: C. Potassium 62. Question: Which condition is a potential clinical manifestation of hypomagnesemia? A. Atrial fibrillation B. Torsades de Pointes C. Bradycardia D. Hypertension Correct Answer: B. Torsades de Pointes 63. Question: Which medication is used to treat Torsades de Pointes? A. Atropine B. Calcium gluconate C. Magnesium sulfate D. Lidocaine Correct Answer: C. Magnesium sulfate 64. Question: Which of the following is a serious adverse effect of oxycodone that requires monitoring? A. Hypertension B. Respiratory depression C. Polyuria D. Seizures Correct Answer: B. Respiratory depression 65. Question: A spinal cord injury at C3–C4 affects which body system most critically? A. Gastrointestinal function B. Urinary control C. Respiratory function D. Endocrine regulation Correct Answer: C. Respiratory function 66. Question: What is the priority treatment for a patient diagnosed with bacterial meningitis? A. Diuretics B. Corticosteroids C. Antipyretics D. Antibiotics Correct Answer: D. Antibiotics 67. Question: What is the nurse’s first priority during an active seizure? A. Administer antiseizure medication B. Apply physical restraints C. Protect the airway D. Check blood glucose Correct Answer: C. Protect the airway 68. Question: Which of the following is part of the seizure protocol? A. Leave the patient alone B. Apply restraints C. Ensure safety and call for help rapid respond D. Insert a tongue blade Correct Answer: C 69. Question: Which laboratory finding is expected in a patient with cystitis? A. Low RBC count B. Elevated WBC C. Hypokalemia D. Low specific gravity Correct Answer: B 70. Question: An 20 year college student present to ED experiencing respiratory Alkolosis with Anxiety, palpitation heart, what is the priority? Recommend patient breathing with Paper bag 71. Question: A patient experiences Dehiscence Vs evisceration of an abdominal wound. What is the nurse’s priority action? A. Apply dry sterile gauze B. Cover with sterile saline-soaked gauze and keep the patient calm C. Apply pressure to the wound D. Remove exposed organs Correct Answer: B ? 72 Non-Maleficence Choose something “Do no harm” 73. What does the ethical principle of autonomy involve? Respecting the patient’s right to make decisions 74. Question: Which of the following symptoms is characteristic of carbon monoxide poisoning? A. Blue lips and fatigue B. Cherry-red skin and headache C. Cold extremities and confusion D. Hypotension and cyanosis Correct Answer: B. Cherry-red skin and headache 75. Patient taking Test treadmill for stress test : Chest pain 76. Immediate intervention : Ventricular fibrillation 77. Patient when to ED which patient is prioritize : Heart rate 110 78. Delirium trument ? Risk for injury