Nội dung text RECALLS 4 - NP4 - SC
D. Potassium monitoring is less important Situation: Justine Lloyd, a 12-year-old boy, presents to the clinic with cola-colored urine, periorbital edema, and hypertension three weeks after recovering from a streptococcal throat infection. 36. Based on the clinical presentation, what is the probable diagnosis? A. Acute interstitial nephritis B. Acute pyelonephritis C. Acute nephritic syndrome D. Chronic glomerulonephritis 37. Which of the following laboratory findings is most consistent with this diagnosis? A. Elevated serum creatinine and BUN, with normal urine protein B. Normal serum creatinine and BUN, with microscopic hematuria C. Elevated serum creatinine and BUN, with significant proteinuria and hematuria D. Normal serum creatinine and BUN, with significant glycosuria 38. The boy's mother asks about the long-term prognosis. What is the nurse's best response? A. "Most children with this condition make a full recovery." B. "This condition always progresses to end-stage renal disease." C. "There is a high risk of developing chronic kidney disease later in life." D. "The only treatment is dialysis." 39. Which of the following nursing interventions is priority in managing this patient's edema? A. Restricting fluid intake B. Monitoring intake and output (I&O) C. Encouraging high-sodium diet D. Administering diuretics without physician order 40. Which dietary adjustment is typically recommended in this type of treatment plan? A. High-protein diet B. High-sodium diet C. Protein restriction D. Unlimited fluid intake Situation: Mrs. Santiago, a 70-year-old patient with a history of heart failure is admitted to the hospital with oliguria, elevated BUN and creatinine, and a serum potassium level of 6.2 mEq/L. 41. Which condition best fits the patient's clinical presentation? A. Chronic kidney disease B. Acute kidney injury (AKI) C. Urinary tract infection D. Benign prostatic hyperplasia 42. What underlying cause is contributing to the development of AKI in this patient? A. Obstruction of the urinary tract B. Nephrotoxic medication C. Prerenal azotemia D. Acute tubular necrosis 43. Which of the following is a priority nursing intervention for this patient? A. Administering a loop diuretic B. Restricting fluids C. Monitoring for signs of hyperkalemia D. Encouraging increased physical activity 44. Which of the following medications would the nurse anticipate administering to address Mrs. Santiago's persistent hyperkalemia? A. Calcium gluconate B. Sodium bicarbonate C. Furosemide D. Mannitol 45. The patient progresses to the diuretic phase of AKI. What is the nurse's priority concern during this phase? A. Fluid overload B. Hyperkalemia C. Metabolic acidosis D. Hypovolemia Situation: A patient with end-stage renal disease (ESRD) is scheduled to begin hemodialysis (HD). The vascular access team is evaluating the patient's suitability for different types of vascular access. 46. What is the preferred method of permanent vascular access for hemodialysis? A. Central venous catheter B. Arteriovenous graft (AVG) C. Arteriovenous fistula (AVF) D. Peripherally inserted central catheter (PICC) 47. Why is a maturation period of at least 3 months required for an AVF before it can be used for dialysis? A. To allow the graft material to fully integrate with the vessels. B. To allow the venous segment to dilate sufficiently to accommodate needles. C. To allow the patient to adjust to the presence of the fistula. D. To allow the body to produce sufficient clotting factors. 48. Under what circumstances is an arteriovenous graft (AVG) typically created instead of an AVF? A. When the patient is allergic to the materials used in AVF creation. B. When the patient's native vessels are unsuitable for AVF creation. C. When the patient prefers a less invasive procedure. D. When the patient requires only temporary dialysis access. 49. What is a common complication associated with arteriovenous grafts? A. Spontaneous closure B. Thrombosis C. Aneurysm formation D. Hypertension 50. What physical examination findings should the nurse regularly assess in a patient with an AVF? A. Presence of a bruit and thrill B. Presence of a palpable pulse C. Presence of edema in the extremity D. Presence of skin discoloration Situation: A 25-year-old male presents to the clinic with complaints of penile pain and swelling. He reports difficulty retracting his foreskin and a persistent, painful erection unrelated to sexual activity. 51. The patient's inability to retract his foreskin is consistent with which condition? A. Paraphimosis B. Priapism C. Phimosis D. Balanitis 52. The persistent, painful erection the patient is experiencing is which type of priapism? A. Nonischemic priapism B. Stuttering priapism C. Ischemic priapism D. Psychogenic priapism 53. Which laboratory test is most helpful in differentiating between ischemic and non-ischemic priapism? A. Complete blood count B. Blood urea nitrogen and creatinine C. Blood gas analysis D. Penile blood gas analysis 54. Initial treatment for ischemic priapism typically involves which of the following? A. Manual reduction B. Circumcision C. Aspiration of the corpora cavernosa D. Application of ice packs 55. A patient with phimosis secondary to inflammation is likely to be treated with: A. Surgical circumcision B. Topical steroid cream C. Antibiotic therapy 3 | Page
D. Manual reduction Stages in the Development of Pressure Injuries 56. What is the defining characteristic of a Stage 1 pressure injury? A. Partial-thickness skin loss B. Full-thickness skin loss C. Non-blanchable erythema of intact skin D. Exposed bone or muscle 57. Which stage involves partial-thickness skin loss with exposed dermis? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4 58. In which stage does adipose tissue become visible? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4 59. Which stage involves exposed fascia, muscle, tendon, or bone? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4 60. What term describes a pressure injury where the stage cannot be determined due to slough or eschar? A. Deep tissue injury B. Unstageable pressure injury C. Suspected deep tissue injury D. Partial-thickness skin loss Management of Patients with Dermatologic Disorders 61. A 6-year-old child presents with multiple, itchy, honey-yellow crusts on the face and hands, which started as small blisters. What is the most likely diagnosis? A. Cellulitis B. Bullous impetigo C. Nonbullous impetigo D. Ecthyma 62. Which of the following is the most appropriate initial treatment for this child? A. Oral corticosteroids B. Topical mupirocin ointment C. Systemic antibiotics D. Oral antiviral medication 63. Which of the following is a serious complication of streptococcal impetigo? A. Cellulitis B. Acute glomerulonephritis C. Permanent scarring D. Ecthyma 64. A nurse is providing education to a family about impetigo prevention. Which of the following strategies is essential to prevent its spread? A. Restricting fluid intake B. Avoiding contact with infected individuals C. Administering prophylactic antibiotics D. Encouraging high-protein diets 65. What is the typical prognosis for most children with impetigo? A. Complete recovery within 24 hours B. Full recovery without scarring C. High risk of chronic kidney disease D. Recurrence in 50% of cases 66. What condition is suggested by intense itching, particularly at night, and a rash with thin, wavy lines on their wrists and between their fingers? A. Cellulitis B. Bullous impetigo C. Scabies D. Ecthyma 67. What is a classic sign of scabies that may also indicate a secondary infection? A. Red, pruritic eruptions B. Tinnitus C. Hearing difficulties D. Isolation 68. What is the first-line treatment for scabies? A. Oral ivermectin B. Topical permethrin C. Topical lindane D. Oral clindamycin 69. Following treatment with permethrin cream, when should the family expect to see improvement in their symptoms? A. Within 24 hours B. Within 2-3 days C. Within 1-2 weeks D. Within 4-6 weeks 70. A nurse is educating a patient about scabies prevention. Which of the following is the most effective strategy? A. Avoiding contact with infected individuals B. Restricting fluid intake C. Administering prophylactic antibiotics D. Encouraging high-protein diets Hearing Loss 71. Which of the following age groups has the highest rate of adults experiencing disabling hearing loss? A. 45 to 54 years B. 55 to 64 years C. 65 to 74 years D. Over 75 years 72. What is the primary nursing intervention when communicating with this patient? A. Speak loudly and slowly. B. Speak directly into the patient's ear. C. Face the patient and speak clearly at a normal pace. D. Write down all important information. 73. Which type of hearing loss is characterized by a dysfunction in sound transmission due to an external or middle ear disorder? A. Sensorineural hearing loss B. Conductive hearing loss C. Mixed hearing loss D. Functional hearing loss 74. Which type of hearing loss is characterized by a dysfunction in sound transmission due to an internal ear disorder? A. Sensorineural hearing loss B. Conductive hearing loss C. Mixed hearing loss D. Functional hearing loss 75. What is the recommended action for individuals experiencing hearing loss? A. Wait for symptoms to improve B. Seek medical attention or wear a hearing aid C. Avoid communication with others D. Increase volume on all devices Conditions of the Middle Ear 76. A patient presents with acute ear pain, fever, and a bulging, opaque tympanic membrane. What is the most likely diagnosis? A. Otitis Externa B. Otitis Media with Effusion C. Acute Otitis Media D. Chronic Suppurative Otitis Media 77. What is the first-line treatment for Acute Otitis Media in children under two years old? A. Watchful Waiting B. High-dose Amoxicillin C. Topical Analgesics D. Myringotomy 78. Which of the following is not a risk factor for Acute Otitis Media? A. Younger Age B. Chronic Upper Respiratory Infections C. Breastfeeding D. Chronic Exposure to Secondhand Cigarette Smoke 79. What is a serious complication of Acute Otitis Media? A. Temporary Hearing Loss B. Tympanic Membrane Perforation 4 | Page