Wayground logo

Free Printable Worksheets

Font size

S
M
L
XL
Worksheets

Pharm II Exam I

Total questions: 219

Worksheet time: 2hrs 29mins

Name
Class
Date
1.

Which of the following are used for sickle cell anemia?

a)

hydroxyurea

b)

hydrocychloroquine

c)

buprenophrine/naloxene

d)

aminocaprioc acid

e)

desmopression

2.

Which of the following are used for hemophilia?

a)

hydroxyurea

b)

hydrocychloroquine

c)

buprenophrine/naloxene

d)

aminocaprioc acid

e)

desmopression

3.

PT education for buprenophine/naloxene

a)

this decreases pain by working on your mood receptros

b)

this decreases pain by suppressing the CNS

c)

this will give you a euphoric experience

d)

this is teratogenic

e)

this will prevent your cells from sickling by inhibiting s-phase

4.

PT education for buprenophine/naloxene

a)

this decreases pain by working on your mood receptros

b)

this decreases pain by suppressing the CNS

c)

this will give you a euphoric experience

d)

this is teratogenic

e)

this will prevent your cells from sickling by inhibiting s-phase

5.

PT education for hydroxyurea

a)

this decreases pain by working on your mood receptros

b)

this decreases pain by suppressing the CNS

c)

this will give you a euphoric experience

d)

this is teratogenic

e)

this will prevent your cells from sickling by inhibiting s-phase

6.

CAR-T cells complications

a)

Hepatic complications

b)

monitor for anaphylaxis

c)

risk for cytokine release syndrome

d)

hypotension/fever

e)

GI distress

7.

Monoclonal antibodies

a)

Hepatic complications

b)

monitor for anaphylaxis

c)

risk for cytokine release syndrome

d)

hypotension/fever

e)

GI distress

8.

T/f. Tacrolimus would not be necessary following a stem cell transplant.

a)

true

b)

false

9.

filgrastim

a)

cancer patients must be cancer free

b)

boosts aldosterone

c)

builds up WBC

d)

monitor for bone pain

e)

synthetic keratin

10.

Palifermin

a)

synthetic keratin that increases epithelial tissues

b)

white tongue rule out thrush

c)

given to help prevent hair loss from chemo

d)

given to help reduce mucositosis/stomatitis to prevent ulcerations

e)

may cause photosensitivity

11.

Drugs that end in "-alidomine"

a)

multiple myeloma

b)

pheochromocytoma

c)

teratogenic

d)

bone marrow suppress->no angiogenesis

e)

reduces catecholamines

12.

what orders whould the nurse expect to see when her patient is taking "-alidomine"

a)

CBC

b)

Blood thinner medication

c)

gabapentin for nerve pain

d)

BMP

e)

24 hour urine

13.

which medications are used for allergies

a)

fosphenytoin/phenytoin

b)

certrizine

c)

beclomethasone/corticosteroid nasal spray

d)

phenylephrine/pseudophedrine

e)

montelukast

14.

which medication should you monitor elderly patients closely for neurologigical effect (beers list)?

a)

fosphenytoin/phenytoin

b)

certrizine

c)

beclomethasone/corticosteroid nasal spray

d)

phenylephrine/pseudophedrine

e)

montelukast

15.

which medication can make you feel jittery or cause rebound drip/congestion if taken nasally?

a)

fosphenytoin/phenytoin

b)

certrizine

c)

beclomethasone/corticosteroid nasal spray

d)

phenylephrine/pseudophedrine

e)

montelukast

16.

which medication can cause epitaxis

a)

fosphenytoin/phenytoin

b)

certrizine

c)

beclomethasone/corticosteroid nasal spray

d)

phenylephrine/pseudophedrine

e)

montelukast

17.

when providing patients education on diphenydramine what should be included

a)

it has more CNS antagonist effects than certrizine

b)

it has less CNS antagonist effects than certrizine

c)

it can cause a paradoxyl effect

d)

if taken frequently it can cause urine hesitation

e)

it blocks inflammation

18.

what drugs might be prescribed for a patient suffering from rheumatoid arthritis

a)

methotrexate

b)

mannitol

c)

sulfasalazine

d)

hydrocychloroquine

e)

colchicine

19.

what patient education should be provided for patients on methotrexate

a)

you need to use a micronfilter on IV

b)

takes weeks to months to build up

c)

it inhibits folate if you were to become pregnant your baby would be at risk for spinal/neuro complications

d)

it may cause fibrosis especially in liver and lungs

e)

you should update your vaccinations because you are at increased risk for infection

20.

what patient education should be provided for patients on methotrexate

a)

you need to use a micronfilter on IV

b)

takes weeks to months to build up

c)

it inhibits folate if you were to become pregnant your baby would be at risk for spinal/neuro complications

d)

it may cause fibrosis especially in liver and lungs

e)

you should update your vaccinations because you are at increased risk for infection

21.

sulfasalazine

a)

monitor for chest pain due to vasoconstriction

b)

aspirin family monitor for infections

c)

bone marrow suppression

d)

stops folate synthesis to preven DNA formation

e)

can also work for lupus patients

22.

hydrocychloroquine

a)

can cause retinal damage

b)

agranulocytosis

c)

anemia

d)

enzymes stop DNA synthesis

e)

thrombocytopenia

23.

T/F. Hydrocychloroquine is also effective for lupus

a)

true

b)

false

24.

what are medications used for gout

a)

sodium ziroconium

b)

aluminum carbonate

c)

allopurinol

d)

calchicine

e)

clonidine

25.

calchicine

a)

used for chronic gout

b)

used for acute gout

c)

may cause bone marrow suppression

d)

risk for rabdo

e)

risk for cushings triad

26.

-zomib

a)

stops protein synthesis

b)

bone marrow suppression

c)

weak

d)

neuropathy

e)

prophylactic blood thinners

27.

thyrotoxic crisis/storm

a)

lugol solution

b)

methimazole

c)

PTU

d)

liothyronine

e)

levothyroxine

28.

hyperthyroidism

a)

lugol solution

b)

methimazole

c)

PTU

d)

liothyronine

e)

levothyroxine

29.

hypothyroidism

a)

lugol solution

b)

methimazole

c)

PTU

d)

liothyronine

e)

levothyroxine

30.

can cause liver failure/agranulocytosis

a)

lugol solution

b)

methimazole

c)

PTU

d)

liothyronine

e)

levothyroxine

31.

teratogenic/wear gloves

a)

lugol solution

b)

methimazole

c)

PTU

d)

liothyronine

e)

levothyroxine

32.

Hypothyroid Crisis/Myxedema Coma

a)

lugol solution

b)

methimazole

c)

PTU

d)

liothyronine

e)

levothyroxine

33.

levothyroxine education

a)

take in AM on empty stomach or 2 hours after eating

b)

monitor for thyrotoxicosis

c)

take at night

d)

T3

e)

T4

34.

lliothyronin education

a)

take in AM on empty stomach or 2 hours after eating

b)

monitor for thyrotoxicosis

c)

take at night

d)

T3

e)

T4

35.

Hypoadrenal gland/addisons

a)

Potassium Cocktail

b)

Hydrocortisone/cortisone/predisone

c)

dexamethasone

d)

fludrortisone

e)

Mitotame

36.

Dexamethason/methylpredisone

a)

has both gluccocrticoids/mineralcorticoids

b)

only has gluccorticoids

c)

combine with filgrastim

d)

combine with fludrocortsione

e)

best for respiratory infections

37.

hydrocortisone/cortisone/predisone

a)

has both gluccocorticoids/mineralcorticoids

b)

take in the AM

c)

take with food or milk

d)

mineralcorticoid mostly some gluccocorticoid

e)

improves cravings for salt and water

38.

fludrocortisone

a)

has both gluccocorticoids/mineralcorticoids

b)

take in the AM

c)

take with food or milk

d)

mineralcorticoid mostly some gluccocorticoid

e)

improves cravings for salt and water

39.

Hyperkalemia Cocktail for Addsions

a)

insulin

b)

dextrose

c)

bicarb

d)

calcium

e)

sodium zirconium

40.

Hyper-Andrenal Function/Cushings

a)

clonidine

b)

mitotane

c)

mannitol

d)

ketocanazole

e)

steroids

41.

mitotane

a)

stops cortisol secretion in adrenal tissue

b)

stops cortisol secretion in anterior pituitary

c)

stops PTH from being released

42.

clonidine

a)

pheochromocytoma

b)

for hyper-andrenal crisus

c)

for hypo-adrenal crisis

d)

for myxedema come

43.

clonidine acts on

a)

catecholamines

b)

cortisol

c)

ADH

d)

aldosterone

44.

Hyper-paraythroid

a)

calcitonin

b)

alendronate

c)

aluminum carbonate

d)

calcium/vitamin D

45.

calcitonin

a)

hypercalcemia

b)

hypocalcemia

c)

hyperkalemia

d)

hypokalemia

46.

aldrenonate

a)

reduces osteoclast

b)

sit up RIGHT

c)

stops all PTH secretion

d)

only stops PTH secretion from bone

e)

monitor for esophagitis

47.

aluminium carbonate lowers

a)

phosphorus

b)

calcium

c)

potassium

d)

sodium

48.

hypo-secretion ADH/Diabietes insipidus

a)

desmopressin

b)

demeclocycline

c)

conivaptan

d)

diphenhydramine

49.

hyper-secretion ADH/SIADH

a)

desmopressin

b)

demeclocycline

c)

conivaptan

d)

diphenhydramine

50.

SIADH crisis

a)

desmopressin

b)

demeclocycline

c)

conivaptan

d)

diphenhydramine

51.

demeclocycline

a)

photosensitivity

b)

super-infections

c)

monitor hypovalemia

d)

pulmonary edema

52.

conivaptan considerations

a)

hypervalemia

b)

hypovalemia

c)

monitor weights

53.

ICP medications

a)

mannitol

b)

hypertonic solution

c)

hypotonic solution

d)

levetiracetam

e)

corticosteroids

54.

mannitol

a)

micronfilter

b)

diureses them

c)

stops folate production->teratogenic

d)

hypotension

e)

risk for pulmonary edema

55.

levetiracetam

a)

decrease ICP

b)

antiseizure

c)

muscle weakness

d)

reduces inflammation caused by leaky tumors

56.

corticosteroids

a)

decrease ICP

b)

antiseizure

c)

muscle weakness

d)

reduces inflammation caused by leaky tumors

57.

fosphenytoin/phenytoin

a)

delays growth and development

b)

purple glove syndrome

c)

gingival hyperplasia->horse gums

d)

causes sedation

e)

long-term CNS effects- nystagumus and diplopa

58.

phenobarbital

a)

delays growth and development

b)

purple glove syndrome

c)

gingival hyperplasia->horse gums

d)

causes sedation

e)

long-term CNS effects- nystagumus and diplopa

59.

Carbamazepine

a)

treats CN neuralggia and seizures

b)

bone marrow suppression

c)

increases ADH

d)

decreases ADH

e)

temporary CNS effects

60.

lamotrigine

a)

aseptic meningitis

b)

liver failure

c)

pancreatitis

d)

works on bicarbonate->risk for kidney stones and metabollic acidois

e)

monitor for pursed lips/ABG

61.

valproate/valporic acid

a)

aseptic meningitis

b)

liver failure

c)

pancreatitis test enzyme function

d)

works on bicarbonate->risk for kidney stones and metabollic acidois

e)

monitor for pursed lips/ABG

62.

topiramate

a)

aseptic meningitis

b)

liver failure

c)

pancreatitis test enzyme function

d)

works on bicarbonate->risk for kidney stones and metabollic acidois

e)

monitor for pursed lips/ABG

63.

what stops a seizure

a)

fosphenyton/phenytoin

b)

phenorbarbital

c)

benzos

d)

phenylephrine/psuedophedrine

e)

lamotrigine

64.

what meds would be used for seizure

a)

carbamazepine

b)

lamotrigine

c)

valproate/valmoric acid

d)

topiramate

e)

levetiracetam

65.

what meds would be used for headache/migraine

a)

suma

b)

ergotomine

c)

valproate/valmoric acid

d)

topiramate

e)

levetiracetam

66.

sumatriptan

a)

monitor for chest pain

b)

causes vasoconstiction

c)

causes vasodilation

d)

no constriction but peripheral effects monitor chest

e)

nausea/vomit

67.

ergotomine

a)

monitor for chest pain

b)

causes vasoconstiction

c)

causes vasodilation

d)

no constriction but peripheral effects monitor chest

e)

nausea/vomit

68.

pernicious anemia body can't absorb

a)

B9

b)

B12

c)

iron

69.

What can cause anemia

a)

autoimmune hemolysis

b)

chemo medications

c)

hyperspleenism

d)

heart failure

e)

liver disease

70.

thalessemia

a)

more common in black/mediterranean people

b)

  • Protein chain in RBC don’t form a RBC 

c)

body attacks red blood cells

d)

Genetic disorder

71.

t/f. crohns patients are more at risk for developing anemia because can't absorb B9/folic acid

a)

true

b)

false

72.

S/S of anemia

a)

  • Hypotension

b)

tingles and neuropathy

c)

Glossy tongue

d)

Respirations/heart rate increase

e)

  • Hypertension

73.

Anemia Testing

a)

  • BMP/CMP

b)

Ultrasound

c)

  • EPO Levels

d)

  • Bone marrow biopsy

e)

colonoscopy/edoscopy/occult

74.

  • priority interventions for anemia

a)

  • Safety for falls

b)

  • Supplement iron/B9/B12 

c)

Blood transfusion

d)

  • O2 therapy 

e)

IV fluids

75.

  • Parenteral Iron 

a)

  • Monitor for anaphylactic shock

b)

  • Assess BP ever 15 minutes 

c)

  • Has to be in clinic

d)

  • Take with OJ 

e)

  • Take with milk 

76.

  • B12

a)

  • IM injections 

b)

  • Metformin blocks absorption 

c)

  • Alcoholics need parenteral 

77.

  • B9

a)

  • IM injections 

b)

  • Metformin blocks absorption 

c)

  • Alcoholics need parenteral 

78.

what would be important patient education when someone who is anemic started b9/b12/iron therapy

a)

IM injections will make you feel better instantly

b)

it can take a few weeks to replenish stores

c)

these will need to be lifelong interventions

d)

you can stop when you feel your fatigue has gone away

e)

having a well-rounded diet can also help

79.

what could induce Sickle Cell Anemia 

a)

COPD/smoking

b)

Trauma

c)

  • High altitude 

d)

  • Lack of fluids

80.

  • Sickle Cell Assessment 

a)

Lower leg

b)

Neuropathy

c)

  • Jaundice

d)

  • Puiritis

e)

  • Blindness

81.

  • Sickle Cell Assessment 

a)

  • Dysrhythmia 

b)

Acute chest

c)

Cushings triad

d)

Stroke

e)

Priapism

82.

what would some orders a nurse might have on order for sickle cell

a)

  • 12 EKG normal 

b)

X-ray for infiltrations

c)

Hydroxyurea

d)

opiods

e)

Hydrolochloroquine

83.

if a patient is receiving a blood transfusion for symptomatic anemia the nurse should

a)

collect history the more infusions the higher chances of transfusion reaction

b)

must take vitals

stay 15 minutes

c)

make sure informed consent is get

d)

will give if HH is greater than 7

84.

Thrombocytopenia causes

a)

  • H. pylori

b)

  • Petechiae

c)

  • Obstructive sleep apnea 

d)

  • heparin/bloodthinners  

85.

Hemophilia A/B

a)

Don’t make factor 5 or 8

b)

Biggest problem is bleeding into tissue

c)

  • Ask how severe?

d)

  •  inherited 

e)

If overclotting, “donate” wont use/remove blood

86.

  • Polycythemia causes

a)

Chronically hypoxic

b)

heart failure

c)

  • high altitude

d)

Tumor on adrenal gland

87.

  • Leukemia 

a)

  • Anemia 

b)

  • Thrombocytopenia 

c)

  • Leukopenia

d)

Overproduction of leukocytes/prolonged leukocytosis

e)

  • Cancer of lymph tissue  

88.

T/F. Acute lymphoid leukemia (ALL) more common in children will more than likely be genetic

  • Chromosome 9 and 23 

a)

true

b)

false

89.

  • Clinical manifestations of leukemia

a)

bleeding

b)

  • Bone pain overproduction 

c)

  • Infection like symptoms  

d)

Swollen lymph nodes/enlarged spleen and liver

e)

Jaundice

90.

  • Diagnostic test for leukemia

a)

CBC with differential

b)

Clotting factors

c)

Bone marrow biopsy

d)

X-rays

e)

  • Viral testing 

    • Mono 

    • HIV

91.

Stem cell transplants

a)

Peripheral blood of umbilical cord harvests stem cells

b)

  • High dose of chemo to knock everything out-> healthy cells are infused into the patient's bloodstream 

c)

  • quick recovery

d)

  • Engraftment syndrome

e)

Graft versus host

92.

Nursing interventions for all leukemia/lymphoma or chemo patients

a)

  • Prophylactic therapy 

b)

  • Avoid antiplatelets/anticoagulants 

c)

  • neutropenic precautions if neutrophils less than 500

d)

  • Monitor Output 

    • .5 kg/HR

e)

  • Blood transfusion PRN

93.

Lymphoma

a)

  • Reed-Sternberg cells differentiate (RARE)

b)

  • Epstein bar/MONO

c)

  • Fever

d)

  • Nigh sweats

e)

Unplanned weight gain

94.

  • Stage 1 Lymphoma

a)

  • isolated to one spot above diaphragm

b)

multiple spots same side above diaphragm

c)

above below the diaphragm on same side

d)

  • multiple organ involvement 

95.

  • Stage 2 Lymphoma

a)

  • isolated to one spot above diaphragm

b)

multiple spots same side above diaphragm

c)

above below the diaphragm on same side

d)

  • multiple organ involvement 

96.

  • Stage 3 Lymphoma

a)

  • isolated to one spot above diaphragm

b)

multiple spots same side above diaphragm

c)

above below the diaphragm on same side

d)

  • multiple organ involvement 

97.

  • Stage 4 Lymphoma

a)

  • isolated to one spot above diaphragm

b)

multiple spots same side above diaphragm

c)

above below the diaphragm on same side

d)

  • multiple organ involvement 

98.

  • Assessment Lymphoma

a)

Ultrasound biopsy

b)

CT to see lymph involvement

c)

PET tag RBC cells to see O2 supply light

d)

Bone marrow biopsy

e)

  • CBC with differential 

99.

  • Multiple Myeloma cancer is the

a)

RBC

b)

WBC

c)

plasma

d)

platelets

100.

  • Multiple Myeloma 

  • Decreased

a)

  • RBC

b)

  • WBC

c)

  • Platelets

d)

Serum protein

101.

  • Multiple Myeloma 

  • increased

a)

  • RBC

b)

  • WBC

c)

  • Platelets

d)

Serum protein

102.

  • Multiple Myeloma 

a)

Extreme bone pain/fractures

b)

  • fatigue/anemia 

c)

  • Kidney dysfunction 

d)

  • swollen lymphs

103.

  • Assessment for multiple myeloma

a)

  • CT to see lymph involvement 

b)

PET

c)

  • Bone marrow biopsy 

d)

  • CBC with differential 

e)

  • Serum protein 

104.

  • Leukocytes in allergies

a)

  • Goal is to identify invaders and build memory cells but when in overdrive and produce too fast causes more damage and attack the wrong thing 

b)

  • 1st time won’t have an allergic reaction don’t antibodies yet

c)

IgE antibodies causes most reactions

d)

can have range of symptoms

105.

Hypersensitivity

Type 1

a)

food/environment

b)

  • transfusion reaction, someone elses antibodies 

c)

  • body over exaggerated immune over drive 

    • lupus/rheumatoid 

d)

  • delayed

    • Graft v host 

    • Hashimotos 

106.

Hypersensitivity

Type 2

a)

food/environment

b)

  • transfusion reaction, someone elses antibodies 

c)

  • body over exaggerated immune over drive 

    • lupus/rheumatoid 

d)

  • delayed

    • Graft v host 

    • Hashimotos 

107.

Hypersensitivity

Type 3

a)

food/environment

b)

  • transfusion reaction, someone elses antibodies 

c)

  • body over exaggerated immune over drive 

    • lupus/rheumatoid 

d)

  • delayed

    • Graft v host 

    • Hashimotos 

108.

  • Assessment Allergy

a)

CBC with differential

b)

  • IgE serums

c)

Penicillin allergy testing introduce penicillin intradermally

d)

Sputum culture

e)

allergy shots

109.

  • t.f. for patient education don’t have anti-histamine meds for a few days before allergy testing

a)

true

b)

false

110.

  • Moderate/Severe Allergies

a)

  • bronchospams->stridor upper airway closing EMERGENCY

b)

Resemic epi stronger than duoneb

c)

Edema of airway from inflammation

d)

Hypotension-> risk for shock 

e)

  • Cardiac arrest

111.

what can we do for allergies

a)

  • SPO2/BP STAT

b)

  • Monitor for accessory or distress 

c)

Will be tachycardic

d)

Will be bradycardic

e)

  • get a rapid response 

112.

  • Anaphylaxis Interventions

a)

  • 1:1000 or .3 mg IM 

b)

Different than code cart

c)

IV fluids to keep BP

d)

  • Intubate if needed 

e)

  • diphenhydramine IV

113.

  • Epi education 

a)

  • Remove blue safety cap 

b)

Multi-use

c)

  • One time use 

d)

  • Large muscle at 90 degree in thigh 

e)

  • Hold for 10 second and massage 10 seconds 

114.

  • Inflammation Lab for anything 

a)

Antinuclear antibody ANA

b)

  • C reative protein

c)

Erythrocyte sedimentation rate ESR

d)

  • CBC

e)

  • Rheumatoid factor lab 

115.

Antinuclear antibody ANA

a)

  • indicates inflammation in tissue 

b)

  • causes liver to make a glycoprotein 

c)

  • Normal blood sinks to the bottom this measures how fast they sink-> the more inflammation the faster they sink

d)

  • WBC differential 

116.

  • C reative protein

a)

  • indicates inflammation in tissue 

b)

  • causes liver to make a glycoprotein 

c)

  • Normal blood sinks to the bottom this measures how fast they sink-> the more inflammation the faster they sink

d)

  • WBC differential 

117.

  • Erythrocyte sedimentation rate ESR

a)

  • indicates inflammation in tissue 

b)

  • causes liver to make a glycoprotein 

c)

  • Normal blood sinks to the bottom this measures how fast they sink-> the more inflammation the faster they sink

d)

  • WBC differential 

118.

  • CBC

a)

  • indicates inflammation in tissue 

b)

  • causes liver to make a glycoprotein 

c)

  • Normal blood sinks to the bottom this measures how fast they sink-> the more inflammation the faster they sink

d)

  • WBC differential 

119.

Rheumatoid arthritis

a)

Breaks down collagen and bone damage can be permanent=pannus and cause deformities

b)

Joints may be red/hot

c)

  • Pneumonitis 

d)

Myocarditis

e)

Valvular incompetence

120.

Rheumatoid arthritis ASSESSMENTs

a)

  • Rheumatoid factor lab 

b)

  • Anti-DNA 

c)

  • BMP

d)

Bone scans to measure damage

e)

  • Uric acid levels

121.

  • Systemic Lupus Erythematosus 

a)

  • Butterfly rash 

b)

Raynauds: occludes vessels decreases perfusion

c)

  • Pneumonitis 

d)

Myocarditis

e)

Pericarditis

122.

  • Systemic Lupus Erythematosus 

a)

CNS/psychosis

b)

Strokes lack of perfusion

c)

  • Seizure inflammation in nerves cause misfires 

d)

  • Swollen lymph 

e)

  • Renal nephritis 

123.

Systemic Lupus Erythematosus Assessment

a)

  • ANA

b)

  • Anti-DNA 

c)

  • CBC

d)

  • BMP

e)

24 hour urine

124.

  • Gout 

a)

  • Synovial fluid aspiration

b)

  • Anti-DNA 

c)

  • urine/blood

d)

  • BMP

e)

24 hour urine

125.

Gout

a)

autoimmune

b)

Overtime cause joint issues/arthritis

c)

inflammatory disease

d)

Uric acid crystals that accumalate and cause massive inflammation

e)

  • Diet/ 

  • Impaired renal excretion 

126.

Gout Assessment 

a)

  • Pain/ 

  • Swelling

b)

  • Tenderness

  • Warmth 

c)

usually bilaterally

d)

usually one side

127.

ADH function

a)

don’t pee hold on to fluid

b)

  • Says to pee cause extra fluid in heart it’s not fluid volume issue it’s a pressure issue

c)

Kidney is looking for fluid vasocontricts to increase flow back to the kidney

128.

Renin-angiotensintensin

a)

don’t pee hold on to fluid

b)

  • Says to pee cause extra fluid in heart it’s not fluid volume issue it’s a pressure issue

c)

Kidney is looking for fluid vasocontricts to increase flow back to the kidney

129.

Atrial natriuretic peptide BNP

a)

don’t pee hold on to fluid

b)

  • Says to pee cause extra fluid in heart it’s not fluid volume issue it’s a pressure issue

c)

Kidney is looking for fluid vasocontricts to increase flow back to the kidney

130.

Diabetes

a)

don’t pee hold on to fluid

b)

  • Says to pee cause extra fluid in heart it’s not fluid volume issue it’s a pressure issue

c)

Kidney is looking for fluid vasocontricts to increase flow back to the kidney

d)

  • electrolytes and ions base

    • If anion gap closes indicates acid/base balance

131.

t/f. BMP only measures what's outside the cell

a)

true

b)

false

132.

  • OUTSIDE the cell 

a)

  • Sodium 

b)

  • Chloride

c)

  • Calcium 

d)

Bicarbonate

e)

  • Potassium

133.

  • INSIDE the cell 

a)

  • Magnesium

b)

  • Chloride

c)

  • Calcium 

d)

Phosphorus

e)

  • Potassium

134.

  • Interventions for electrolyte imbalances

a)

  • I/O’s 

b)

  • Bladder scan 

c)

  • Acid balance base 

d)

  • 24 hour urine for hormone secretion  

e)

  • BMP

135.

  • Isotonic 

a)

D5W dextrose

b)

Normal saline .9%:

c)

Lactated ringers:

d)

  • 0.45% 

e)

  • 3% 

136.

Hypertonic

a)

  • Common for brain pressure draws fluid out and shrinks cell, decreasing intracranial pressure

b)

Small amount given to shrink cells

c)

Should never be an standing order

d)

  • Monitor BMP for NA closely 

e)

  • Hypernatremia 

137.

Hypotonic

a)

  • Common for brain pressure draws fluid out and shrinks cell, decreasing intracranial pressure

b)

Small amount given to shrink cells

c)

Should never be an standing order

d)

  • Monitor BMP for NA closely 

e)

  • Hypernatremia 

138.

Hypoactive Thyroid

a)

HIGH TSH

b)

LOW TSH

c)

HIGH T3/T4

d)

LOW T3/T4

139.

Hyperactive Thyroid

a)

HIGH TSH

b)

LOW TSH

c)

HIGH T3/T4

d)

LOW T3/T4

140.

  • Thyroid Tests

a)

TSH

b)

  • Test T3 and T4 

c)

Radioactive iodine uptake test

d)

Thyroid antibodies

e)

Fine needle aspiration of the thyroid

141.

t/f. Hypothyroidism patients at risk for pneumonia/atelectasis because respirations are depleted do a chest x-ray

a)

true

b)

false

142.

  • Hyperthyroid S/S

a)

  • hot/warm 

b)

Skinny

c)

High heart rate/BP

d)

  • nervous/shaking 

e)

  • waxy skin

143.

Plummer disease

a)

  • Benign goiter that accumulates on thyroid still push/plug to release more T3/T4 

b)

  • If causing problem have surgically removed

c)

  • hyperthyroidism

d)

  • hypothyrdoism

e)

  • autoimmune

144.

  • Fine needle aspiration of thyroid

a)

  • Consent

b)

  • monitor for signs of bleeding

c)

  • Ask about blood thinner

d)

Monitor for bleeding into the airway

e)

NPO

145.

  • inteventions for hyperthyroid

a)

  • Telemetry 

b)

  • High cal diet

c)

  • eye drops

d)

  • calm environment

e)

  • warming blankets

146.

Thyrotoxic crisis/Thyroid storm

a)

  • Too much T3/T4 

b)

  • Too little T3/T4 

c)

  • Tachycardia/Tachypnea

d)

  • Hyperthermia 

e)

  • Cardiogenic shock 

147.

Iron PO

a)

take on empty stomach

b)

take with juice

c)

use straw

d)

monitor anaphylaxis

e)

must be done as patient not at home

148.

Iron IV

a)

take on empty stomach

b)

take with juice

c)

use straw

d)

monitor anaphylaxis

e)

must be done as patient not at home

149.

causes of hypothyroidism

a)

  • Thyroiditis 

b)

  • Tumors push/plug on anterior pituitary

c)

  • autoimmune 

d)

aging

e)

head/neck radiation

150.

  • Hypothyroidism 

    • S/S

a)

Chronically cold

b)

  • Constipated

c)

Hypoglycemia

d)

Hyperglycemia

e)

Elevate cholesterol can’t metabolize fats

151.

Hypothyroid Crisis/Myxedema Coma Emergency

a)

  • Hypothermia 

b)

Hypoventiliation

c)

  • Bradycardia

d)

Coma

e)

  • EKG changes 

152.

Thyroid Nodules

a)

  • pushing or plugging T3/T4 

b)

  • benign or malignant

c)

  • Enlarged thyroid 

d)

  • thyroid atrophy

e)

if causing a problem remove

153.

  • Thyroidectomy/parathyroidectomy  

a)

  • Consent needed

b)

  • Remove thyroid/Relocate parathyroid if cancer free

c)

  • Monitor for calcium levels 

d)

  • Blood type and screen 

e)

  • monitor airway for patency or bleeding

154.

Thyroidectomy/parathyroidectomy patient education

a)

  • Weight restriction on head and neck 

b)

Don’t bend over

c)

don't brush your teeth

d)

nose packing

e)

CBC/HH to monitor for bleeding

155.

Hyperparathyroidism

a)

MOANS GROANS STONES

b)

Hypocalcemia

c)

Hypercalcemia

d)

  • Sedative effects

e)

  • tight contracted

156.

Hypoparathyroidism

a)

MOANS GROANS STONES

b)

Hypocalcemia

c)

Hypercalcemia

d)

  • Sedative effects

e)

  • tight contracted

157.

Hyperparathyroidism Assessment

a)

BMP

b)

Double antibody test for PTH

c)

Ultrasound for tumor

d)

Needle biopsy

e)

X-ray

158.

Hyperparathyroidism Assessment

a)

fractures/deformities

b)

 renal calculi

c)

  • Arrhythmia 

d)

Pancreatitis CA+ deposits cause inflammation

e)

  • Bronchospasms->wheezing

159.

Hypoparathyroidism

a)

  • Dysrhythmia

  • EKG

b)

Tentany

c)

  • Bronchospasms->wheezing

d)

Muscle hypertonia- rigidity

e)

  • Risk for fractures

160.

Adrenal Glands

a)

T3

b)

T4

c)

aldosterone

d)

cortisol

e)

ADH

161.

posterior pituitary

a)

T3

b)

T4

c)

aldosterone

d)

cortisol

e)

ADH

162.

  • Cortisol/glucocorticoid

a)

Vasoconstriction keeps things from leaking

b)

  • Energy 

c)

Fluid/electrolyte balances

163.

  • aldosterone

a)

Vasoconstriction keeps things from leaking

b)

  • Energy 

c)

Fluid/electrolyte balances

164.

Addisons disease/Hypofunction of adrenal gland

a)

  • High Potassium 

  • Decrease NA/H2O

b)

  • Decrease Potassium 

  • increased NA/H2O

c)

  • dehydrated/weak/confused 

d)

Peak t-wave

e)

  • Anorexia/weightloss 

165.

  • Causes of hypo/hyperthyroidism

a)

trauma/tumor on anterior pituitary

b)

trauma/tumor

c)

  • Adrenal gland dysfunction 

d)

  • autoimmune

166.

  • Assessment of adrenal issues

a)

Serum cortisol/Serum osmolarity 

b)

BMP

c)

  • aldosterone/renin levels

d)

  • 24 hour urine 

e)

  • ACTH 

167.

Hyperparathyroidism

a)

  • ISOTONIC IV fluids pee it out 

b)

D5/ normal saline

168.

addisons

a)

  • ISOTONIC IV fluids pee it out 

b)

D5/ normal saline

169.

  • addisons intervention 

a)

monitor BP

b)

monitor for cardiac arrest

c)

Decreased vasoconstriction everything leaks out

d)

  • Telemetry 

e)

monitor cbc

170.

  • Cushing/Hyperfunction of adrenal gland

a)

  • Holding NA/H2O

  • Excreting potassium 

b)

  • Excreting NA/H2O

  • holding potassium 

c)

  • Long-term steroid use-most common 

    • Cancer 

    • Autoimmune 

d)

  • Suppressed immune system because of steroid usage

171.

  • Cushing/Hyperfunction of adrenal gland

a)

  • Hyperlipedema

b)

  • Hypertension

c)

  • CAD

d)

risk for breakdown/fragile skin

e)

Ulcers inhibits prostaglandin no protective mucosa

172.

  • Cushing/Hyperfunction of adrenal gland

a)

  • Loss of muscle mass

b)

  • Fat redistribution

c)

  • Stops calcium absorption risk for osteoporosis 

d)

  • Central obesity/buffalo hump 

e)

  • Moodswings 

  • Personality changes

173.

Cushing interventions

a)

insulin for hyperglycemia

b)

  • Balanced I/Os

c)

  • skin checks

d)

safety for fractures

e)

increase protein

174.

  • Hypophysectomy 

a)

Removes pituitary

b)

nose packing

c)

don't brush teeth

d)

don't bend forward

e)

  • removes adrenal gland(s)

175.

  • Adrenalectomy

a)

  • Just need 1 adrenal to live 

b)

  • Will need to supplement cortisol and aldosterone in the beginning until other catches up 

c)

will only need to supplement aldosterone ACTH will still make cortisol

176.

Pheochromocytoma

a)

  • Tumor on adrenal gland-> overproduces epinephrine and norepinephrine (catecholamine)  

b)

  • Tumor on thyroid-> overproduces epinephrine and norepinephrine (catecholamine)  

c)

  • Tumor on pituitart-> overproduces epinephrine and norepinephrine (catecholamine)  

d)

  • 24 hour urine 

e)

CT to find tumor

177.

Pheochromocytoma S/S

a)

  • Headache 

b)

  • Hyperhidrosis/sweaty 

c)

Hypertension

d)

  • Hypermetabolism 

e)

Hyperglycemia

178.

  • Diabetes insipidus

a)

NOTHING to do with blood sugar

b)

  • NOT ENOUGH ADH 

c)

  • TOO MUCH ADH 

d)

  • elevated serum osmolarity/

  • decreased urine serum

e)

decreased serum osmolarity/

  • elevated urine serum

179.

  • SIADH

a)

  • NOT ENOUGH ADH 

b)

  • TOO MUCH ADH 

c)

  • elevated serum osmolarity/

  • decreased urine serum

d)

decreased serum osmolarity/

  • elevated urine serum

180.

Diabetes Insipidus

a)

Water deprivation test

b)

BMP- could be elevated or not

c)

hypertonic solution

d)

24 hour urine test

e)

hypotonic solution

181.

SIADH causes

a)

  • Bronchogenic carcinoma can synthesize and store ADH in the lungs

b)

  • Pancreatic carcinoma can synthesize and store ADH 

c)

  • Meds

    • MDMA/ecstasy 

    • SSRIs

d)

  • Meds

  • lithium/alcohol 

182.

SIADH SS

a)

  • seizures

b)

  • Increase BP 

c)

  • Edema 

  • JVD

d)

Crackles respiratory

e)

diarrhea

183.

SIADH Interventions

a)

restrict fluids

b)

hypertonic solution

c)

diuresis

d)

monitor BP

e)

hypotonic solution

184.

 ICP

a)

  • Pressure has nowhere to go but down putting pressure on respiratory system and stops breathing 

b)

Swelling effects work their way down the brainstem with coordinating effects

c)

Order operation assessment

LOC

  • ADH changes

  • Eyes CN 3 and 4 

  • face/auditory CN 5 6 7 8

  • CN 9 10 11 12

d)

Order operation assessment

LOC

  • ADH changes

  • CN 9 10 11 12

  • Eyes CN 3 and 4 

  • face/auditory CN 5 6 7 8

185.

Monroe-kellie Hypothesis

a)

CSF shifts to spinal

Blood shifts

  • Tissue shifts 

b)

  • Tissue shifts 

  • Blood shifts

  • CSF shifts to spinal

c)

  • Blood shifts

  • Tissue shifts

  • CSF shifts to spinal

186.

  • ICP 

a)

  • Normal ICP 5-15

b)

straining can increase

c)

constriction and dilation controls

d)

constriction decreases

e)

dilation

decreases

187.

Cerebral Perfusion Pressure

a)

Metabolic needs for the brain

b)

  • keep between 70-100 CPP

c)

  • MAP (SBP+DBx2) - ICP 

d)

  • Need art line 

e)

  • keep 5-15

188.

Causes of ICP

a)

  • Lesions 

b)

  • Head injury 

c)

  • Inflammation/infections

d)

  • Lack of perfusion

e)

  • leaky tumor

189.

  • SS of ICP

a)

  • Vision changes 

b)

  • Papilledema- brain out of eyes

c)

Projectile vomiting

d)

  • Cushings triad 

e)

  • Uncle herniation- unilateral 

190.

Cushings triad

a)

  • widening of pulse pressure->systolic increases->trying to get up to the brain->body tries to slow things down to balance and turn bradycardiac-> changes in respirations Cheyne Cheyne-Stokes/apneic/ataxic 

b)

  • compressed of pulse pressure->systolic increases->trying to get up to the brain->body tries to slow things down to balance and turn bradycardiac-> changes in respirations Cheyne Cheyne-Stokes/apneic/ataxic 

191.

  • Interventions for ICP

a)

Posture/leave alone

b)

map-pressor/titrate drips

c)

get head CT

d)

lumbar puncture

e)

bone biopsy

192.

ICP Waveform 

a)

measures p1, p2, p3

b)

  • measures neuron firing

c)

measures ICP through CSF fluid

193.

Electroencephalogram (EEG) 

a)

measures p1, p2, p3

b)

  • measures neuron firing

c)

measures ICP through CSF fluid

194.

Ventriculostomy measures

a)

measures p1, p2, p3

b)

  • measures neuron firing

c)

measures ICP through CSF fluid

195.

Lumbar Puncture for ICP considerations

a)

CT first

b)

  • Assess for blood thinners

c)

  • A shift can cause a herniation

d)

risk for bleeding

196.

Decreased Cerebral Blood Flow

a)

  • Elevates ICP 

b)

  • Cells swell and die 

c)

  • Intra-abdominal/Intra-thoracic pressure forces air in:

    • Collapsed lung 

    • Ventilator 

    • Flexed position occludes flow 

d)

CO2 high

e)

  • decrease ICP 

197.

Interventions for cerebral perfusion issue due to ICP

a)

Life support

b)

Put O2/oxymask

c)

  • Sedative to reduce metabolic needs 

d)

  • Seizure precautions neurons overfire 

e)

  • Monitor I/Os-> ADH impacts

198.

  • Intracranial surgeries- when ICP won’t go down  

    • Craniotomy

a)

  • Skull cap off

b)

  • Remove the tumor or clot 

c)

  • EVD device catheter

d)

  • Aspirate clot or abcess

e)

Scope up nose

199.

  • Intracranial surgeries- when ICP won’t go down  

    • Buur holes

a)

  • Skull cap off

b)

  • Remove the tumor or clot 

c)

  • EVD device catheter

d)

  • Aspirate clot or abcess

e)

Scope up nose

200.

  • Intracranial surgeries- when ICP won’t go down  

    • Transsphenoidal 

a)

  • Skull cap off

b)

  • Remove the tumor or clot 

c)

  • EVD device catheter

d)

  • Aspirate clot or abcess

e)

Scope up nose

201.

T/f. Anyone with increase ICP or has had surgery on the brain will prophylactically be put on anti-seizure medications

a)

true

b)

false

202.

  • Seizure causes

a)

  • Tumors 

b)

Drugs and alcohol

c)

Electrolyte disturbance especially Na

d)

  • Cerebrovascular disease 

e)

CNS infection/High fever

203.

  • Assessment seizure and headaches

a)

  • MRI/CT 

b)

EEG

c)

  • Medications changes

d)

  • Seizure history 

204.

Deficit medication knowledge for seizure

a)

  • Special therapeutic range 

    • Monitor plasma drug levels 

b)

Changes/Withdrawal  need to happen under monitoring

c)

Risk for suicide/black box

d)

  • Teratogenic/competes with birth control 

e)

  • Dermatological effects 

    • SJS

    • Necrolysis 

205.

Migraines

a)

Dilation of coronary arteries

b)

  • temples

c)

Come and go 

206.

Tension

a)

Dilation of coronary arteries

b)

  • temples

c)

Come and go 

207.

Cluster

a)

Dilation of coronary arteries

b)

  • temples

c)

Come and go 

208.

Pharmacological interventions for migraine

a)

Antiemetics

b)

Botulinum toxin: botox

c)

  • Ketoralac: IV NSAID

d)

Diphenhydramine

e)

Dexamethasone

209.

Meningitis Aseptic

a)

anti-seizure/drug-induced

b)

Will probably start you on prophylactic antivirals/antibiotics

c)

  • bacterial/viral/fungal

210.

Meningitis

a)

Photophobia

b)

Fever: pressure on thalamus

c)

  • Change in mental status

d)

Neck mobility/Brudzinki sign chin to sternum

e)

Leg extension/kernig sign knee lift

211.

t/f. ICP symptoms will appear in meningitis

a)

true

b)

false

212.

  • Meningitis 

a)

Risk for ineffective tissue perfusion

b)

Risk for increased ICP

c)

Risk for bleeding

213.

Interventions for meningitis

a)

dark room

b)

Infection precaution

c)

Neurochecks

d)

Temp control risk for febrile seizure

e)

  • intubate

214.

  • brain abscess causes

a)

Intracranial surgery

b)

  • Head injury 

c)

  • Tongue piercing 

d)

  • Infections

    • Teeth/gums/tongue  

    • Sinus infection 

    • Lungs

    • Heart

e)

  • HSV

215.

  • Brain Abscess Assessment 

a)

Depends on location

b)

  • Fever

  • Headache

c)

  • CT

d)

  • CBC/

  • Blood culture 

e)

  • LOTS of antibiotics/

  • Dexamethasone for inflammation 

216.

t/f. can’t do chemo for brain tumors don’t cross blood blood-brain barrier 

a)

true

b)

false

217.

interventions for brain tumors

a)

Brachytherapy: beads go internally

b)

Reduces inflammation caused by leaky vessels

c)

  • Medications to reduce ICP 

    • Mannitol 

    • Hypertonic solution

d)

  • chemo

e)

  • positioning

218.

Trigeminal Neuralgia

a)

Carbamazepine

b)

sudden/firey pain

c)

  • Corticosteroids 

d)

  • Protect corneal injury 

e)

  • Avoid cold 

219.

  • Bells Palsy 

a)

Carbamazepine

b)

facial paralysis

c)

  • Corticosteroids 

d)

  • Protect corneal injury 

e)

  • Avoid cold