WorksheetsMedical & Surgical Nursing: Exam 4 Study Guide
Total questions: 58
Worksheet time: 29mins
What is the Parkland formula for fluid resuscitation in burn patients?
4 mL x kg x %TBSA (total body surface area) burned; give half in first 8 hours, the rest over next 16 hours.
2 mL x kg x %TBSA burned; give all fluids in first 24 hours.
6 mL x kg x %TBSA burned; give half in first 12 hours, the rest over next 12 hours.
4 mL x kg x %TBSA burned; give all fluids in first 8 hours.
List two signs of inhalation injury in burn patients.
Singed nasal hair, soot in mouth/nose, hoarseness, stridor, wheezing, carbonaceous sputum.
Blistering of the palms and soles, pale skin, bradycardia, hypotension.
Swelling of the lower limbs, cyanosis of the fingers, dry cough, chest pain.
Loss of consciousness, dilated pupils, excessive sweating, muscle cramps.
What is the priority intervention for a patient with suspected inhalation injury?
Early intubation.
Administering pain medication.
Starting IV fluids.
Applying a cooling blanket.
What is the most common cause of death in burn patients?
Infection/sepsis.
Renal failure.
Hypovolemic shock.
Pulmonary embolism.
What is the first priority in the management of a burn patient?
Airway management.
Pain control.
Fluid resuscitation.
Wound cleaning.
Which type of diabetes is associated with absolute insulin deficiency?
Type 1 Diabetes.
Type 2 Diabetes.
Gestational Diabetes.
MODY (Maturity Onset Diabetes of the Young)
Which type of diabetes is associated with insulin resistance?
Type 2 Diabetes.
Type 1 Diabetes.
Gestational Diabetes.
Juvenile Diabetes.
What is the classic triad of symptoms for diabetes mellitus?
Polyuria, polydipsia, polyphagia.
Weight loss, fever, night sweats.
Headache, nausea, vomiting.
Chest pain, shortness of breath, palpitations.
What is the treatment for diabetic ketoacidosis (DKA)?
IV fluids, insulin, potassium replacement.
Oral antibiotics and bed rest.
High-protein diet and exercise only.
Antihypertensive drugs and statins.
What is the main difference between DKA and HHS (Hyperosmolar Hyperglycemic State)?
DKA has ketosis and acidosis; HHS does not.
DKA occurs only in type 2 diabetes; HHS only in type 1.
HHS is associated with severe hypoglycemia; DKA is not.
DKA presents with high blood pressure; HHS presents with low blood pressure.
What is the most common cause of DKA?
Infection.
Trauma.
Excessive exercise.
Overhydration.
What is the most common cause of HHS?
Infection or illness in Type 2 diabetics.
Excessive exercise in Type 1 diabetics.
Overuse of insulin in non-diabetics.
High carbohydrate intake in healthy individuals.
What is the treatment for hypoglycemia?
15g of fast-acting carbohydrate, recheck glucose, repeat if needed, follow with complex carb/protein.
Administer insulin immediately and restrict all carbohydrates.
Encourage high-fat foods and avoid glucose monitoring.
Provide only water and monitor for improvement.
What is the most common cause of SIADH?
Small cell lung cancer.
Renal cell carcinoma.
Thyroid adenoma.
Pancreatic adenocarcinoma.
What is the main symptom of SIADH?
Hyponatremia (low sodium).
Hypernatremia (high sodium).
Polyuria (excessive urination).
Hyperkalemia (high potassium).
What is the treatment for SIADH?
Fluid restriction, salt tablets, hypertonic saline if severe.
Increase fluid intake and avoid salt.
Administer diuretics and restrict potassium.
High protein diet and regular exercise.
What is the main symptom of Diabetes Insipidus (DI)?
Polyuria (large amounts of dilute urine).
Weight gain.
Bradycardia (slow heart rate).
Jaundice (yellowing of the skin).
What is the treatment for central DI?
Desmopressin (DDAVP).
Insulin.
Beta-blockers.
Antibiotics.
What is the main difference between SIADH and DI?
SIADH: too much ADH, water retention, hyponatremia. DI: too little ADH, water loss, hypernatremia.
SIADH: too little ADH, water loss, hypernatremia. DI: too much ADH, water retention, hyponatremia.
SIADH: increased aldosterone, water retention, hypernatremia. DI: decreased aldosterone, water loss, hyponatremia.
SIADH: decreased cortisol, water retention, hyponatremia. DI: increased cortisol, water loss, hypernatremia.
What is the most common cause of Cushing's syndrome?
Long-term steroid use.
Pituitary adenoma.
Adrenal carcinoma.
Ectopic ACTH production.
What is the main symptom of Addison's disease?
Hyperpigmentation, hypotension, hyponatremia, hyperkalemia.
Weight gain, hypertension, hypernatremia, hypokalemia.
Polyuria, polydipsia, hyperglycemia, hypertension.
Jaundice, bradycardia, hypercalcemia, hypoglycemia.
What is the treatment for Addisonian crisis?
IV hydrocortisone, fluids, correct electrolytes.
Oral antibiotics and bed rest.
Insulin and glucose infusion.
Antihistamines and bronchodilators.
What is the most common cause of hyperthyroidism?
Graves' disease.
Hashimoto's thyroiditis.
Toxic multinodular goiter.
Subacute thyroiditis.
What is the most common cause of hypothyroidism?
Hashimoto's thyroiditis.
Graves' disease.
Thyroid cancer.
Iodine excess.
What is the treatment for myxedema coma?
IV levothyroxine, supportive care.
Oral metformin, fluid restriction.
Subcutaneous insulin, high-protein diet.
Oral prednisone, bed rest.
What is the treatment for thyroid storm?
Beta blockers, PTU/methimazole, iodine, steroids, supportive care.
Insulin, fluids, antibiotics, oxygen therapy.
ACE inhibitors, calcium channel blockers, diuretics, statins.
Antivirals, interferon, ribavirin, supportive care.
Which of the following is not a characteristic of living things?
Growth
Reproduction
Movement
Decay
Which of the following is a non-living thing?
Dog
Cat
Stone
Tree
Which of the following is a living thing?
Car
Book
Man
Chair
Which of the following is not a plant?
Mango tree
Rose plant
Cow
Grass
Which of the following is not an animal?
Lion
Tiger
Sunflower
Elephant
Which of the following is not a natural thing?
River
Mountain
Table
Sun
Which of the following is a man-made thing?
Tree
Chair
Dog
Fish
Which of the following is not a man-made thing?
Car
Book
Table
River
Which of the following is not a source of water?
Well
Pond
Mountain
Tap
Which of the following is not a source of light?
Sun
Moon
Star
Chair
Which of the following is not a source of food?
Plant
Animal
Stone
Tree
Which of the following is not a source of air?
Plant
Tree
Car
Grass
Which of the following is not a source of energy?
Sun
Water
Air
Stone
Which of the following is not a source of heat?
Sun
Fire
Ice
Heater
Which of the following is not a source of sound?
Bell
Drum
Table
Whistle
Which of the following is not a source of electricity?
Battery
Generator
Bulb
Solar cell
Which of the following is not a source of fuel?
Petrol
Diesel
Kerosene
Water
Which of the following is not a source of fibre?
Cotton
Jute
Wool
Plastic
Which of the following is not a source of paper?
Bamboo
Wood
Grass
Iron
Which of the following is not a source of rubber?
Rubber tree
Bamboo
Dandelion
Guayule
A 68-year-old man with a history of hypertension and hyperlipidemia presents to the emergency department with chest pain radiating to his left arm. He is diaphoretic and nauseated. His ECG shows ST-segment elevations in leads II, III, and aVF. What is the most likely diagnosis?
Angina pectoris
Pericarditis
Pulmonary embolism
Inferior wall myocardial infarction
A 55-year-old woman is evaluated for progressive dyspnea on exertion and orthopnea. Physical examination reveals an S3 gallop, bibasilar crackles, and 2+ pitting edema. What is the most likely diagnosis?
Acute renal failure
Heart failure
Liver cirrhosis
COPD
The normal ejection fraction (EF) in adults is ____%.
55-70
35-50
70-85
40-55
Which test is the most sensitive for detecting early diabetic nephropathy?
Serum creatinine
Urinalysis for protein
Urine microalbumin
Renal ultrasound
A patient is admitted to the hospital for acute pancreatitis. Which of the following is the most common cause of acute pancreatitis in the United States?
Alcohol abuse
Gallstones
Hypertriglyceridemia
Medications
A 70-year-old man has had fever and productive cough for 3 days. His chest X-ray shows a right lower lobe infiltrate. What is the most likely diagnosis?
Asthma
Bronchitis
Pneumonia
Pulmonary embolism
The most common cause of community-acquired pneumonia is _____
Streptococcus pneumoniae
Staphylococcus aureus
Klebsiella pneumoniae
Pseudomonas aeruginosa
A 60-year-old woman presents with sudden onset of severe headache, nausea, and vomiting. She has a stiff neck and photophobia. What is the most likely diagnosis?
Migraine
Subarachnoid hemorrhage
Tension headache
Temporal arteritis
A 45-year-old man is brought to the emergency department after a motor vehicle accident. He is hypotensive, tachycardic, and has cool, clammy skin. What is the most likely type of shock?
Cardiogenic shock
Hypovolemic shock
Neurogenic shock
Septic shock
If you suspect sepsis in a patient, what should you do?
Start broad-spectrum antibiotics and initiate sepsis protocol
Wait for blood culture results before starting treatment
Monitor the patient without intervention
Refer the patient to outpatient care
The best initial test for suspected pulmonary embolism in a hemodynamically stable patient is _____
CT pulmonary angiography
Chest X-ray
D-dimer assay
Ventilation-perfusion (V/Q) scan
The most commonly seen electrolyte abnormality in adrenal insufficiency is:
Hyponatremia
Hyperkalemia
Hypernatremia
Hypokalemia
