Physiological Integrity Practice Quiz 1

Answer: D – I V fluids to increase intravascular volume.

Explanation: Circulation and perfusion are addressed first so I V fluids will be started immediately. After blood cultures are obtained, broad-spectrum antibiotics should be administered without delay. Vasopressors are administered if the patient is not responding to the fluid challenge. Corticosteroids may be considered to address the inflammatory-induced vasodilation and capillary leakage.

Answer: D – Eat small meals throughout the day.

Explanation: The patient may not feel hungry due to chemotherapy-induced nausea, but should be encouraged to eat even if not hungry. Encouraging the patient to small meals frequently throughout the day can help avoid nutritional deficiencies and improve quality of life. Chemotherapy can cause changes in smell or taste; aversion to favorite foods can result.

Answer: A – Fecal impaction

Explanation: Fecal impaction can be serious. When constipation is not resolved, stool becomes hardened and unable to pass. Liquid stool may pass around the impaction. Patients may complain of feeling bloated; having the urge to push; nausea or vomiting; not wanting to eat. The impaction may need to be manually removed. Patient education should include increasing liquids and fiber, as well as regular physical activity.

Answer: B – Vision loss

Explanation: MS is an inflammatory demyelinating disease of the central nervous system. Demyelination will cause slowed conduction and eventually loss of function. Vision loss and eye pain (optic neuritis) are early symptoms of MS due to inflammation of the optic nerve. Dementia is uncommon and found only in severely affected patients. Clonus (rhythmic contractions when a muscle is stretched) is a sign of nerve damage which may be seen as MS progresses. Muscle atrophy is also a later sign of MS which is caus

Answer: D – Lack of insulin causes increased counter-regulatory hormones and ketone release

Explanation: DKA prevents glucose from entering the cells. The body releases an counter-regulatory hormones and undergoes lipolysis in an effort to increase glucose, resulting in hyperglycemia, ketogenesis, and acidosis.

Answer: B – Decreased breath sounds on the left side of the chest

Explanation: If the endotracheal tube is inserted too far, it often goes into the right main stem bronchus. Air will then be delivered to the right lung and not the left. A low pressure alarm indicates a disconnection or a leak in the circuit. A high pressure alarm can mean an obstruction, such as a kink in the tubing or a need for suctioning.

Answer: B – Sodium, potassium, and calcium

Explanation: Because abnormalities in sodium, potassium and calcium levels are likely to affect depolarization and repolarization of cardiac cells, it is most important for the healthcare provider to monitor these laboratory values. BUN and creatinine levels are always important to monitor when giving any drug, not only anti-dysrhythmia drugs. The PT and INR will be important for patients who are on warfarin (Coumadin).

Answer: A – Respiratory acidosis, compensated

Explanation: Chronic bronchitis diminishes airflow during expiration, trapping carbon dioxide (CO2) in the lungs. The increased CO2 lowers the arterial pH, causing respiratory acidosis. The kidneys compensate for the chronic acidosis by conserving bicarbonate. This keeps the pH in a low-normal range, resulting in compensated respiratory acidosis.

Answer: B – Hematocrit

Explanation: Prothrombin time, partial thromboplastin time, and platelet count are all included in coagulation studies. The hematocrit does not assess coagulation; it reports the percentage of red blood cells (RBCs) in the blood.

Answer: A – Potentiation

Explanation: Potentiation is a type of drug interaction. Potentiation occurs when two drugs are taken together, and the action of one drug increases the action of the other, causing the pharmacologic response to be greater for one of the drugs.