ccrn aacn practice questions and answers provided
A patient with a history of bronchogenic carcinoma is admitted with respiratory failure. the
patient is intubated and on mechanical ventilation. the patient develops lethargy,
headache, slight confusion and abdominal cramping urinary output is decreasing and
significant lab data includes
Serum Na+ 127
Serum osmolality 270
urine specific gravity elevated - Correct Answer Initiation of fluid restriction -
this pt has risk factors signs and symptoms of SIADH
fluid restriction slows glomerular filtration and blood flow enhances proximal reabsorption
of sodium and water increases aldosterone secretion and enhances distal tubule sodium
reabsorption. chemo may alleviate some of the water retention caused by some cancers
but non will completely inhibit ADH secretions. three percent saline administration in
severe case only
A pt is being admitted in HHS with dehydration and a serum glucose level of 836 mg/dl.
Which additional laboratory findings should the nurse anticipate? - Correct Answer >
elevated BUN > Elevated creatinine >elevated osmolality
HHNS - Hyperosmolar hyperglycemic nonketonic state
A 49 year old patient male recently admitted with an inferiors wall MI resulting from 100%
occlusion of the right coronary artery (RCA). The 12 lead ECG reveals ST elevation in
leads 11, 111, and aVf. you would expect to see reciprocal changes in which leads? -
Correct Answer 1 and aVL the RCA perfuses the inferior wall and the mirror image or
reciprocal changes would be seen in the the high lateral wall, which is reflected in leads 1
and avl on the 12 lead ECG. Lead v1 and v2 correlate with the septal area, lead v 3 and v4
correlate with the anterior area of the heart
a patient is admitted following a MVA , Lab data reveal elevated creatinine phosphokinase
and myoglobin. What should the nurse anticipate? - Correct Answer Rhabdomyolysis -
MVA is a risk factor for rhabdomyolysis and lab data consistent with condition
