Describe a scenario involving an individual with metastatic lung cancer. Include the physical, psychosocial, cultural, economic, educational, and environmental factors that influence the health status of the individual in the scenario.
Where is the individual on the health continuum, and why?
How might the MSN-prepared nurse support positive health outcomes through a holistic approach and expanded competency with advanced assessment, pathophysiology, and pharmacology?
Looking ahead, how will competency in advanced health assessment, pathophysiology, and pharmacology be especially useful to your practice?

Laura, a 20-year-old college student, went to the health department for oral contraceptives. Laura asks the nurse how to take the medication and wants to know the adverse effects of oral contraceptives.

• What should the nurse assess for prior to the physician prescribing oral contraceptives?
• How would the nurse respond to Laura’s questions?

One month later, she started on oral antibiotics for acute bronchitis. She has taken her antibiotics for one week and she now has a vaginal yeast infection. She continues to take oral contraceptives as scheduled.

• How did Laura develop a vaginal yeast infection?
• What medication might be prescribed for a vaginal yeast infection? Discuss the adverse effe

Scott, Britton, and McLemore (2019) discuss structural racism and the ethics of care related to black mothers.  Explain the concept of “mother blame” narratives and how they can affect nursing care. Explain the strategies to optimize health equity in birth outcomes. What is reproductive justice, and can the concept of ethical care for this population be applied to other vulnerable populations?

 

Which of the following conditions at the atrioventricular node will cause a decrease in heart rate? Increased calcium permeability. Increased norepinephrine levels

1. Decreased acetylcholine
2. Increased sodium permeability
3. Increased potassium permeability

 

Question 3

 

Which of the following is caused by acetylcholine?

 

1. Hyperpolarization of the sinoatrial node
2. Decreased permeability of the sinoatrial node to potassium ions
3. Increased heart rate
4. Increased permeability of the cardiac muscle to calcium ions
5. Depolarization of the atrioventricular node

 

Question 4

 

Which of the following is correct regarding sympathetic stimulation of the heart?

 

1. Releases norepinephrine at the sympathetic endings
2. Decreases excitability of the heart
3. Releases acetylcholine at the sympathetic endings
4. Decreases sinus nodal discharge rate
5. Decreases cardiac contractility

 

Question 5

 

Parasympathetic (vagal) nerve stimulation can cause ____________.

 

1. Increased transmission of impulses
2. Increased heart rate
3. Tachycardia
4. Decreased heart rate

 

 

 

Question 6

 

The ___________ functions as the pacemaker of the heart because of its faster discharge rate

 

1. Sinoatrial node
2. A-V bundle
3. Purkinje fibers
4. A-V node

 

Question 7

 

If the sinus node stops discharging, what is the expected heart rate (in beats per minute) if the ventricular Purkinje fibers take over as the cardiac pacemaker?

 

1. 40-60
2. 72-80
3. 15-40
4. 55-75

 

Question 8

 

When recording lead III on an electrocardiogram, where are the negative electrode(s) placed?

 

1. Right leg
2. Left arm and left leg
3. Left arm
4. Right arm and left leg

 

Question 9

 

From the AV bundle, the impulse goes into the ___________.

 

1. Purkinje fibers
2. Sinoatrial node
3. Internodal pathway
4. AV node

 

 

 

 

Question 10

 

The R-to-R distance in the ECG of a patient with tachycardia was measured to be 2.5 squares. The heart rate of the patient is calculated to be ____________.

 

1. 300
2. 120
3. 200
4. 400

 

Question 11

 

The Q-T interval represents _______________________

 

1. Ventricular relaxation
2. Ventricular contraction
3. Atrial flutter
4. Atrial contraction

 

Question 16

 

What is the delay between the sinoatrial node discharge and arrival of the action potential at the ventricular septum?

 

1. 0.09 seconds
2. 0.12 seconds
3. 0.16 seconds
4. 0.80 seconds

 

Question 18

 

The sympathetic nervous system/catecholamines, cause ____ in the resistance of the afferent arterioles and ______ in the resistance of the efferent arterioles resulting in ____ in the glomerular filtration rate during conditions such as severe hemorrhage

 

            Increase, increase, decreased

            Decrease, decrease, increase

            Decrease, increase, increase

Increase, increase, increase

Decrease, decrease, Decrease,

 

Question 19

 

In a successful ventricular defibrillation invention, ventricular muscles resume coordinated contractions after a strong high-voltage electrical current brings all the ventricular muscles into a state of simultaneous refractoriness and quiescence for a few seconds

 

1. True
2. False

 

Question 20

 

Shift of the pacemaker from the sinus node to another place in the heart would result in which one of the following conditions.?

 

1. Aortic stenosis
2. Increased ventricular mass
3. Cardiac arrhythmia
4. Interventricular septal defect

 

Question 22

 

When the P-R interval is above 0.25 s but below 0.45 s and there is an intermittent block of impulses through the A-V node, this condition is indicative of ___________.

 

1. Third-degree block
2. First-degree block
3. Premature contractions
4. Second-degree block

 

Question 23

 

A 50-year-old man has been having fainting “spells” for about 2 weeks. During the fainting episodes, his electrocardiogram shows a ventricular beat of 25 per minute and 100 P waves per minute. After about 30 seconds of fainting, a normal sinus rhythm reoccurs. Which is likely diagnosis

 

1. Third-degree atrioventricular block/ Stokes Adams Syndrome
2. Atrial flutter
3. Second-degree atrioventricular block

 

Question 24

 

A 70-year-old woman had an electrocardiogram taken at her local hospital, and the diagnosis was atrial fibrillation. Which of the following is likely in someone with atrial fibrillation?

 

1. The atrial “a” wave is normal
2. Ventricular fibrillation normally accompanies atrial fibrillation
3. The rate of ventricular contraction is regular and slow
4. The atria have a smaller volume than normal
5. The P waves of the electrocardiogram are missing

 

Question 25

 

Hypoxic conditions can result in ______.

 

1. Atrial flutter
2. Atrial fibrillation
3. Cardiac arrest
4. Ventricular fibrillation
5. First-degree atrioventricular block

 

Question 26

 

A 50-year-old man has a blood pressure of 140/85 mm Hg and weighs 200 lbs. He reports that he is not feeling well. His electrocardiogram has no P waves, and he has a heart rate of 42 beats/min. What is his condition?

 

1. Third-degree heart block
2. Second-degree heart block
3. Sinus bradycardia
4. Sinoatrial heart block
5. First-degree heart block

 

Question 27

 

At the end of ventricular isovolumic contraction in the cardiac cycle, which of the following occurs?

 

1. Aortic and pulmonary valves close
2. Atrioventricular valves open
3. Aortic valves and pulmonary valves open
4. Mitral valve open

 

Question 28

 

The most important structures that prevent the backflow of blood into the atria during ventricular contraction are the __________.

 

1. Chordae tendinae
2. Pulmonary valve
3. Sinoatrial discharge
4. Purkinje fibers

 

Question 29

 

The trigger for SR release of calcium is opening of the ryanodine receptor by ________ in the cardiac muscle and ______ in the skeletal muscle.

 

1. change in calcium levels, voltage change
2. voltage change, sodium influx
3. potassium influx, sodium influx

 

Question 30

 

The most important kidney functions include: (Select All that Apply)

 

1. Excretion of metabolic
2. Regulation of acid base balance
3. Exertion of drugs and toxins
4. Gluconeogenesis
5. Triglyceride digestion

 

Question 31

 

Creatinine is a waste product of _______ metabolism while uric acid is a waste product from _______ metabolism

 

1. Muscle, nucleic acid
2. Protein, urea
3. Protein, nucleic acid
4. Protein, carbohydrate
5. Muscle, protein

 

Question 32

 

Erythrocyte production by the kidney is by the hormone __________.

 

1. Thyroid
2. Renin
3. Aldosterone
4. Adrenaline
5. Erythropoietin

 

Question 33

 

Select the sequential pathway of the blood through the arteries of the kidney

 

1. Interlobar-Renal artery – segmental artery – arcuate arteries – interlobular/cortico-radiate artery
2. Renal artery – interlobar artery- arcuate arteries – segmental artery – interlobar artery
3. Renal artery – segmental artery – interlobar artery – accurate arteries – 
4. Renal artery – interlobar artery – segmental artery – accurate arteries – interlobular/cortico-radiate artery

 

Question 34

 

Describe the pathway of the formation and excretion of urine.

 

1. Papilla – ureter – bladder – urethra – renal pelvis – major calyx – minor calyx
2. Minor calyx – papilla – renal pelvis – major calyx – ureter – bladder – urethra
3. Renal pelvis – major calyx – minor calyx – papilla – ureter – bladder – urethra
4. Papilla – minor calyx – major calyx – renal pelvis – ureter – bladder – urethra

 

Question 35

 

70% of the nephrons in the kidney are juxtamedullary nephrons.

 

1. True
2. False

 

 

 

 

Question 36

 

The epithelial cells in the early portion of the distal tubules are the main site of action of ______ diuretics.

 

1. K+ sparing
2. Na+ channel inhibiting
3. Loop
4. Thiazide

 

Question 37

 

The drug of choice to treat excessive fluid retention in the lungs would be _____ diuretics.

 

1. Na+ channel inhibiting
2. K+ sparing
3. Thiazide
4. Loop

 

Question 38

 

Thrombosis or dehydration can lead to _____ failure.

 

1. Perirenal
2. Postrenal
3. Prerenal
4. Intrarenal

 

Question 39

 

______ failure can be caused by prostatic hypertrophy.

 

   Perirenal

        Prerenal

  Intrarenal

 

Question 40

 

____________ is slow, insidious process of kidney destruction. It may go unrecognized for years as nephrons are destroyed and renal mass is reduced.

1. Acute renal injury
2. Post renal kidney injury
3. Chronic renal failure
4. Renal insufficiency

 

 

Question 41

 

Acute renal failure in adults is generally identified by oliguria (urine output <___ML/day).

 

 

1. 200 ml/day
2. 100 ml/day
3. 400 ml/day
4. 300 ml/day

 

 

Question 42

 

When the kidneys have too few nephrons to excrete metabolic wastes and regulate fluid and electrolyte balance adequately, the client is said to have _____, the final stage of Chronic Renal Failure.

 

1. End-stage renal disease (ESRD)
2. Acute tubular necrosis
3. Dialysis
4. Renal insufficiency

 

 

Question 43

 

Which diagnostic test would be monitored to evaluate glomerular filtration rate and renal function?

 

 

1. Kidney biopsy
2. Serum creatinine and BUN levels
3. Urinalysis
4. Na+ level

 

 

Question 44

 

_____ Failure is caused by acute damage to renal tissue and nephrons or acute tubular necrosis: abrupt decline in tubular and glomerular function due to either prolonged ischemia and/or exposure to nephrotoxins.

 

 

1. Prerenal
2. Intrarenal
3. Perirenal

Question 45

 

Assuming steady-state conditions and that water and electrolyte intake remained constant, a 75% loss of nephrons due to chronic kidney disease would cause all of the following except:

 

 

1. A large increase in plasma sodium concentration
2. An increase in plasma creatinine to four times normal
3. An increase in average volume excreted per remaining nephron to four times normal
4. A significant increase in plasma phosphate concentration

 

 

Question 46

 

Autoregulation of glomerular filtration rate allows it to stay at a relatively constant level despite large fluctuation in arterial pressure.

 

 

1. True
2. False

 

 

Question 47

 

Hydrostatic pressure in the Bowman’s capsule can drastically increase by _________.

 

 

1. Kidney stones
2. Tubular necrosis
3. Urinary tract obstruction
4. Tubular obstruction

 

 

Question 48

 

Both primary and secondary aldosteronism can be treated with ______ diuretics. (Select all that apply.)

 

 

1. Thiazide
2. Loop
3. Mineralocorticoid receptor antagonists
4. Na+ channel inhibitors

 

 

Question 49

 

1. 40%
2. 5%
3. 30%
4. 50%
5. 20%

 

 

Question 50

 

Decreasing number of nephrons will cause ____ and _____ of surviving nephrons resulting in further deterioration of the existing nephrons.

 

 

1. Hypotrophy, vasoconstriction
2. Hypertrophy, vasodilation
3. Hypertrophy, vasoconstriction
4. Hypotrophy, vasodilation