Final Examination Flashcards by Austinne Joya Espejo

CASE # 1: This is a case report of Patient X, a 53-year-old patient who developed acute myopericarditis with systolic dysfunction confirmed on cardiac magnetic resonance imaging a week after onset of fever and dry cough due to COVID-19. The patient was treated with inotropic support, antiviral drugs, corticosteroids, and chloroquine, with progressive stabilization of the clinical course. (NOTE: the following questions are all related to Case # 1)

Virus infection has been widely described as one of the most common causes of myocarditis. However, less is known about the cardiac involvement as a complication of COVID-19. What is the causative agent of this disease?

A. Middle East Respiratory Syndrome CoronaVirus (MERS-CoV)
B. Severe Acute Respiratory Syndrome CoronaVirus 1 (SARS-CoV-1)
C. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2)
D. CoViD-19

C. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2)

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What diagnostic procedure is done to Pt X to confirm the diagnosis of Acute Myopericarditis?

A. Laboratory Studies
B. Cardiac CT-Scan
C. MRI
D. Chest X-Ray
E. none of these

C. MRI

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The COVID-19 patient was treated with inotropic drugs. Which of the following drugs are examples of Inotropic agents?

A. ivermectin
B. remdesivir
C. dopamine
D. lidocaine
E. dobutamine
F. nicardepine
G. dexamethasone

C. dopamine

E. dobutamine

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Patient X has IVF of PNSS 1 L x 60 cc/hr in his left hand with SD of D5W 500 ml + 2 ampules of Dopamine x 4 mcg/kg/min. If the patient weighs 65 kg, what is the rate of the dopamine drip?

A. 20 cc/hr
B. 16 mgtts/min
C. 18 mgtts/min
D. 20 gtts/ml
E. 10 mgtts/min
F. 15 gtts/min

A. 20 cc/hr

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If the available set is macroset (20 gtts/ml), what is the regulation of the patient’s IVF: PNSS 1 L x 60 cc/hr?

20 gtts/min

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If the IVF was initiated at 7 am, and the dopamine drip at 8 am; what is the total IVF intake of the patient from 6-2 shift?

540
540 cc
540 ml

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COVID-19 patients also receive antiviral medications. Patient X is receiving this drug and the order reads: “Remdesivir 200mg IV as loading dose, then 100 mg IV for 9 days”. If you are using 10 ml as diluent, how many ml should be given as initial dose?

Stock dose: 100mg/vial

20 ml

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The doctor’s order is Dexamethasone 6 mg IV OD x 10 days. How many ml are you going to give?

1.5 ml

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Patient X also received Chloroquine. CQ is an aminoquinolone used for many years for the prophylaxis and therapy of which of the following conditions?

A. Leprosy
B. Dengue
C. Malaria
D. Stroke
E. Diabetes

C. Malaria

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Current data shows that the drug below does not reduce deaths among hospitalized COVID-19 patients nor help people with moderate disease. But this was used to patient X despite the controversy. The order reads: “100 mg PO x 14 days”. What is the route of the said drug?

by mouth

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The wife of Pt X already received CoVid vaccine. She already completed the dose of Sinovac Vaccine. How is it administered?

A. Oral
B. Sublingual
C. Subcutaneous
D. Intramuscular
E. Intravenous

D. Intramuscular

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The World Health Organization (WHO) has approved China’s Sinovac CoVid Vaccine for emergency use. The DOH Philippines also procured vaccines under EUA. What does EUA stand for?

Emergency Use Authorization

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The recommendation for Sinovac-CoronaVac vaccine is:

A. 2 doses, 0.5 ml, given subcutaneously, 2-4 weeks interval
B. 2 doses, 1 ml, given intramuscularly, interval of 2-4 weeks between the 1st and 2nd dose
C. 2 doses, 0.5 ml, given intramuscularly, interval of 2-4 weeks between the 1st and 2nd dose
D. 1 dose only, o.5 ml, given IM, 2-4 weeks interval

C. 2 doses, 0.5 ml, given intramuscularly, interval of 2-4 weeks between the 1st and 2nd dose

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Clinical trials show COVID vaccine protection is optimal from about two weeks after your second dose. Sinovac Vaccine is derived from inactivated coronavirus and once it is injected, it may produce what type of immunity?

A. Natural Active Immunity
B. Artificial Active Immunity
C. Natural Passive Immunity
D. Artificial Passive Immunity

B. Artificial Active Immunity

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TRUE or FALSE: Because the coronaviruses in CoronaVac are dead, they can be injected into the arm without causing Covid-19.

True

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CASE # 2: Nurse Poh Sia is a Nursing Supervisor at St. George Medical Foundation. Nurse Poh is also a member of a Research Team in their department. Nurse Poh attended a webinar about Research and the Resource Speaker asked different questions to all the participants. Some of the questions are as follows:

What are 4 types of quantitative research design? SELECT all correct answers:

A. Descriptive design research 
B. Correlational design research 
C. Experimental design research
D. Quasi-experimental design research
E. Exploratory research

A. Descriptive design research
B. Correlational design research
C. Experimental design research
D. Quasi-experimental design research

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This research design is more in-depth research, that answered the question of what and how?

A. Exploratory research
B. Descriptive research
C. Evaluation research
D. Explanatory research

B. Descriptive research

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It is a systematic approach that a researcher uses to conduct a scientific study; it is the overall synchronization of identified components and data resulting in a plausible outcome?

A. Research design
B. Research title
C. Research process
D. Research output

A. Research design

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TRUE or FALSE: The dependent variable is the variable being tested and measured in an experiment, and is ‘dependent’ on the independent variable.

TRUE

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CORRECT OR INCORRECT: The independent variable is the variable the experimenter manipulates or changes, and is assumed to have a direct effect on the dependent variable.

CORRECT

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The independent variable is the condition that you change in an experiment. This variable is called the:

A. Responding variable
B. Controlled variable
C. Effect
D. None of these

B. Controlled variable

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The dependent variable is the condition that you measure in an experiment. This is sometimes called:

A. Responding variable
B. Controlled variable
C. The Cause
D. None of these

A. Responding variable

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In a study to determine whether how long a student sleeps affects test scores. Which of the following is the Independent Variable?

A. the length of time spent sleeping
B. the test score
C. how long the student study
D. the result of the exam

A. the length of time spent sleeping

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In a study to determine whether how long a student sleeps affects test scores. Which of the following is the Dependent Variable?

A. the length of time spent sleeping
B. the result of the grade
C. how long the student study
D. the test score

D. the test score

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Which of the following phrases would be found in a report of a qualitative study? A. “The hypothesis of this study is?” B. “Perceived pain was measured using the Abbott pain scale?” C. “The control group received no instruction?” D. “Subjects were asked to relate their perceptions of pain?”

D. “Subjects were asked to relate their perceptions of pain?” Data collected were perceptions of pain, not numeric data. Other options are found in a report of a quantitative study.

Which one of the following statements about hypotheses is most accurate? A. Hypotheses represent the main idea to be studied and are the foundations of research studies. B. Hypotheses help frame a test of the validity of a theory. C. Hypotheses provide the means to test nursing theory. D. A hypothesis can also be called a problem statement.

B. Hypotheses help frame a test of the validity of a theory.

A nurse wants to study the effectiveness of meditation on people with anxiety disorder. Which variable would be most relevant to explore in the literature on this topic? A. Use of meditation during childbirth B. Meditation techniques found to be effective C. Pain management for people with anxiety disorders D. Outcomes of meditation when used by elderly populations

B. Meditation techniques found to be effective

Which type of research allows researchers to be neutral observers? A. Qualitative research B. Ethnographic research C. Quantitative research D. Case studies

C. Quantitative research

It is a document submitted in support of candidature for an academic degree or professional qualification presenting the author's research and findings? ``` A. Case Study B. Case Presentation C. Transcript of Record D. Thesis E. Special Order ```

D. Thesis

It is a detailed review of existing literature related to the topic of a thesis or dissertation? ``` A. Introduction B. Review of Related Literature C. Research Methodology D. Research Findings E. Conclusion ```

B. Review of Related Literature

What is Chapter 4 in your research study? A. Literature Review B. Presentation, Analysis, and Interpretation of Data C. Research Methodology D. Summary of Findings, Conclusion, and E. Recommendations

B. Presentation, Analysis, and Interpretation of Data

Which one is not part of Chapter 1? ``` A. Statement of the Problem B. Significance of the Study C. Scope and Delimitation of the Study D. Definition of Terms E. Research Design F. Background of the Study G. Conceptual Framework H. Assumptions and Hypothesis ```

E. Research Design

CASE # 3: Nurse Lham Nia Uhl is also an Attorney by profession. She was invited for a webinar by Nursing Students at PCHS. She talked about Legal and Ethical Considerations and asked several questions to the student nurses. If you are attending the said webinar, can you also answer the questions correctly? Below are the interesting and informative questions: When the nurse described the client as “that nasty old man in 354,” the nurse is exhibiting which ethical dilemma? A. Gender bias and ageism B. HIPAA violation C. Beneficence D. Code of ethics violation

A. Gender bias and ageism

The distribution of nurses to areas of “most need” in the time of a nursing shortage is an example of: A. Utilitarianism theory B. Deontological theory C. Justice D. Beneficence

C. Justice

When a client is confused, left alone with the side rails down, and the bed in a high position, the client falls and breaks a hip. What law has been broken? A. Assault B. Battery C. Negligence D. Civil tort

C. Negligence

When signing a form as a witness, your signature shows that the client: A. Is fully informed and is aware of all consequences. B. Was awake and fully alert and not medicated with narcotics. C. Was free to sign without pressure D. Has signed that form and the witness saw it being done

D. Has signed that form and the witness saw it being done

A client who had a “Do Not Resuscitate” order passed away. After verifying there is no pulse or respirations, the nurse should next: A. Have family members say goodbye to the deceased. B. Call the transplant team to retrieve vital organs. C. Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately. D. Call the funeral director to come and get the body.

C. Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately.

The nurse puts a restraint jacket on a client without the client’s permission and without the physicians order. The nurse may be guilty of: A. Assault B. Battery C. Invasion of privacy D. Neglect

B. Battery

The nurse practice acts are an example of: A. Statutory law B. Common law C. Civil law D. Criminal law

A. Statutory law

The scope of Nursing Practice, the established educational requirements for nurses, and the distinction between nursing and medical practice is defined by: A. Statutory law B. Common law C. Civil law D. Nurse practice acts

D. Nurse practice acts

The client’s right to refuse treatment is an example of: A. Statutory law B. Common law C. Civil laws D. Nurse practice acts

B. Common law

Even though the nurse may obtain the client’s signature on a form, obtaining informed consent is the responsibility of the: ``` A. Client B. School Physician C. Student nurse D. Nurse Supervisor E. Chief Nurse F. Doctor ```

F. Doctor

The nurse is obligated to follow a physician’s order unless: A. The order is a verbal order B. The physician’s order is illegible C. The order has not been transcribed D. The order is an error, violates hospital policy, or would be detrimental to the client.

D. The order is an error, violates hospital policy, or would be detrimental to the client.

It is a dereliction of professional duty or a failure to exercise an ordinary degree of professional skill or learning by one rendering professional services which results in injury, loss, or damage? ``` A. Abandonement B. Malpractice C. Negligence D. Battery E. Assault ```

B. Malpractice

The following are examples of Medical Negligence: (SELECT all correct answers) A. Failure to diagnose or misdiagnosis. B. Misreading or ignoring laboratory results. C. Unnecessary surgery. D. Putting unnecessary arm restraints E. Surgical errors or wrong site surgery. F. Improper medication or dosage.

A. Failure to diagnose or misdiagnosis. B. Misreading or ignoring laboratory results. C. Unnecessary surgery. E. Surgical errors or wrong site surgery. F. Improper medication or dosage.

Performing an invasive procedure without a patient's consent is an intentional tort called: ``` A. battery B. assault C. invasion of privacy D. defamation E. fraud ```

A. battery

CASE # 4: Nurse Eve Ree Ting is now a very successful RN who had the chance to work in different hospitals locally and internationally. She successfully passed local and international examinations. She sent me some of the questions and these are as following; Colostomy is a surgical opening anywhere along the entire length of the large intestine directly onto the abdominal surface to drain fecal materials. Which of the following type of colostomy is created if the entire descending colon is removed? ``` A. Descending Colostomy B. Cecostomy C. Sigmoid Colostomy D. Transverse Colostomy E. Ascending Colostomy ```

D. Transverse Colostomy

The following are types of bowel diversion ostomies that drain fecal materials. SELECT all that apply: ``` A. Ileostomy B. Cecostomy C. Ureterostomy D. Sigmoid Colostomy E. Gastrostomy F. Descending Colostomy G. Tracheostomy ```

A. Ileostomy B. Cecostomy D. Sigmoid Colostomy F. Descending Colostomy

When administering ear drops for infants and children younger than 3 years, have the patient lie on the opposite side of the ear being medicated, then gently pull the top of the ear downward and backward. The technique used for adult patient is: A. occlude the ear canal, then administer the right amount of drug B. pull the top of the ear downward and backward. C. press the tragus of the ear to prevent leaking of drugs D. pull the earlobe upward and backward E. pull the ear auricle (pinna) upward and backward to straighten the canal.

E. pull the ear auricle (pinna) upward and backward to straighten the canal.

The nurse is aware of the "11 Rights in drug administration". Which of the following Rights is being followed if the equation-D/SxQ is used? ``` A. Right patient B. Right formula C. Right dose D. Right drug E. Right documentation F. Right time ```

C. Right dose

Paracetamol 250 mg is ordered q6 hrs for Pt X, 17 y/o at Room 105. Available are 500mg tablets of Paracetamol (Biogesic). How many tablets will he receive each day? A. 2 tablets B. 4 tablets C. 8 tablets D. 10 tablets

A. 2 tablets

What are the two sinuses that are congested if the patient is treated with nasal medication in a Parkinson’s position? ``` A. Ethmoidal & sphenoidal B. Ethmoidal and maxillary C. Frontal & ethmoidal D. Frontal & sphenoidal E. Maxillary and Frontal ```

E. Maxillary and Frontal

TRUE OR FALSE: In drug computation formula, the Q in D/S x Q is the same with desired dose?

FALSE

Which of the following blood vessels carry oxygenated blood? A. Pulmonary veins B. Pulmonary artery C. Coronary artery D. Aorta

A. Pulmonary veins C. Coronary artery D. Aorta

It is a symmetrical, bilateral, peripheral polyneuritis characterized by ascending paralysis that can occur at any age affecting women and men equally; this disorder was first described by the French physician Jean Landry in 1859? ``` A. Parkinson's Disease B. Alzheimer's Disease C. Guillain-Barre Syndrome D. Myasthenia Gravis E. Multiple Sclerosis ```

C. Guillain-Barre Syndrome

It is a degenerative disorder of the central nervous system that leads to shaking, stiffness, and difficulty with walking, balance, and coordination? ``` A. Multiple Sclerosis B. Myasthenia Gravis C. Guillain-Barre Syndrome D. Parkinson's Disease E. Alzheimer's Disease ```

D. Parkinson's Disease

A patient with Parkinson's Disease has slow movements that affects their swallowing, facial expressions, and ability to coordinate movements. As the nurse you will document the patient has: ``` A. bradypnea B. akinesia C. "freeze up" tremors D. pill-rolling E. bradykinesia ```

E. bradykinesia

CORRECT OR INCORRECT: Cholinergic crisis is caused by overmedication with the cholinergic (anticholinesterase) drugs.

CORRECT

Which patient below is MOST at risk for developing a myasthenic crisis? A. A patient with myasthenia gravis who is not receiving sufficient amounts of their anticholinesterase medication. B. A patient with myasthenia gravis who reports not taking the medication Pyridostigmine for 2 weeks C. A patient with myasthenia gravis who is experiencing a respiratory infection and recently had left hip surgery. D. A patient with myasthenia gravis who reports taking too much of their anticholinesterase medication

B. A patient with myasthenia gravis who reports not taking the medication Pyridostigmine for 2 weeks

The nurse is assessing the client diagnosed with bacterial meningitis. Which clinical manifestations would support the diagnosis of bacterial meningitis? A. Positive Babinski's sign and peripheral paresthesia. B. Negative Chvostek's sign and facial tingling. C. Kernig's sign and nuchal rigidity. D. Negative Trousseau's sign and nystagmus.

C. Kernig's sign and nuchal rigidity.

Which of the following are the most common bacterial organisms that can cause inflammation of the meninges? SELECT ALL correct answers. ``` A. C. tetani B. menigococcus C. pneumococcus D. poliovirus E. H. influenzae F. streptococcus ```

B. menigococcus C. pneumococcus F. streptococcus

The Glasgow Coma Scale (GCS), designed in 1974, is a tool that has the ability to communicate the level of consciousness of patients with acute or traumatic brain injury. The Glasgow Coma Scale analyzes patients on three different criteria namely: (SELECT ALL correct answers) ``` A. Pain Response B. Motor Response C. Sensory Response D. Verbal Response E. Eye Opening Response ```

B. Motor Response D. Verbal Response E. Eye Opening Response

Each criteria of GCS is on a different scale with a total possible score of ___ and the lowest possible score is ___.

15 and 3

If when you approach the patient they are awake and looking at you, how would you record this on the Glasgow Coma Scale? ``` A. Spontaneous eye opening B. Orientated C. Obeying commands D. Conscious and coherent E. Responsive and Alert ```

A. Spontaneous eye opening

A 45 year old man called Juan is admitted to the Emergency Department on Tuesday 1 June 2021 after being assaulted. When you ask the patient to tell you his name, where he is and what the date is, he answers, Juan, Hospital, January. How would you record this finding? A. Oriented B. Confused C. Conscious and Coherent D. Alert and Active

B. Confused

A type of radiation therapy where the radioactive material is administered systematically, such as by injection or orally? A. UNSEALED-SOURCE RADIATION THERAPY B. TELETHERAPY C. COBALT RADIATION THERAPY D. SEALED-SOURCE RADIATION THERAPY

A. UNSEALED-SOURCE RADIATION THERAPY

Hepatitis B Vaccine is used to prevent which of the following cancer? ``` A. Hepatitis B B. Liver Cirrhosis C. Pancreatic Cancer D. Liver Cancer E. Gallbladder cancer ```

D. Liver Cancer

The nurse is instructing a client how to perform a testicular self-examination (TSE). The nurse should explain that which is the best time to perform this exam? A. After a shower or bath B. While standing to void C. After having a bowel movement D. While lying in bed before arising

A. After a shower or bath

It is a biomarker for the diagnosis and screening of prostate cancer and it was the first cancer biomarker approved by the FDA? A. Prostate-Specific Antigen (PSA) B. Alpha Feto-Protein (AFP) C. Carcino-Embryonic Antigen (CEA) D. BRCA1

A. Prostate-Specific Antigen (PSA)

A nurse is caring for a client who just had a liver biopsy due a history of liver cirrhosis. Which of the following is a priority nursing intervention for this patient? A. position the client on a right side B. assess for ascites C. monitor for coagulation studies D. change the dressing over the biopsy site

A. position the client on a right side

You're preparing to help the neurologist with conducting a Tensilon test. Which antidote will you have on hand in case of an emergency? A. Atropine Sulfate B. Protamine Sulfate C. Naloxone HCl D. Leucovorin Calcium

A. Atropine Sulfate

Which meal option would be the most appropriate for a patient with myasthenia gravis? A. clam chowder with mashed potatoes B. roasted potatoes and cubed steak C. hamburger with baked fried D. fresh veggies with sliced cheese cubes

A. clam chowder with mashed potatoes

It is the surgical removal of the thymus gland (thought to be involved in the production of acetylcholine receptor antibodies)? A. Thymustectomy B. Thyroidectomy C. Thymus Glandectomy D. Thymectomy

D. Thymectomy

The order reads: "Pyridostigmine Bromide (Mestinon) 60 mg/tab, 1 tab q 8 hours". How many tablets will be given in 1 day? ``` A. 3 bottles B. 60 mg /tab C. 1 tablet D. 2 tabs E. 150 dragees F. 3 tablets ```

F. 3 tablets

This sign describes a transient sensation of an electric shock extending down the spine and/or extremities upon flexion of the neck, often a sequela of neurologic disease. This is due to an increased sensitivity of demyelinated axons to the stretched or pressure on the spinal cord induced by neck flexion: ``` A. Kernig sign B. Brudzinski sign C. Uhthoff's phenomenon D. Lhermitte's sign E. Chvostek sign ```

D. Lhermitte's sign

T if TRUE or F if FALSE: Patient with Multiple Sclerosis has visual disturbances like blurring of vision, scotomas (blind spots), diplopia; with impaired sensation to touch, pain, temperature or position change; including paresthesia; and in MRI study, it shows areas of demyelinization?

What are the three layers of the meninges covering the brain and spinal cord? SELECT correct answers ``` A. dura mater B. gray matter C. epidural area D. subdural space E. pia mater F. white matter G. arachnoid mater H. subarachnoid space ```

A. dura mater E. pia mater G. arachnoid mater

The nurse caring for the client diagnosed with Guillain-Barré syndrome writes the client problem "impaired physical mobility." Which long-term goal should be written for this problem? A. The client will have no skin irritation. B. The client will have no muscle atrophy. C. The client will perform range-of-motion exercises. D. The client will turn every two (2) hours while awake.

B. The client will have no muscle atrophy.

Each of the three components of the Glasgow Coma Scale have a number of steps. Which of these are the correct combinations? ``` A. Eyes 5, Verbal 4, Motor 6 B. Eyes 4, Verbal 5, Motor 5 C. Eyes 4, Verbal 5, Motor 6 D. Verbal 4, Eyes 5, Motor 6 E. Motor 6, Eyes 5, Verbal 4 ```

C. Eyes 4, Verbal 5, Motor 6

DRE is done to men whose prostate gland may be enlarged due to the following conditions. SELECT three (3) possible answers: ``` A. Benign Prostatic Hypertrophy B. Hemorrhoids C. Anal Fissure D. Prostatitis E. Cervical cancer F. Prostate Cancer ```

A. Benign Prostatic Hypertrophy D. Prostatitis F. Prostate Cancer

Which of the following assessment techniques are used in BSE? ``` A. Inspection B. Inspection & Palpation C. Inspection, Palpation, Percussion and Auscultation D. Palpation and Percussion E. Palpation only ```

B. Inspection & Palpation

A nurse teaches a client who is at risk for colon cancer. Which dietary recommendation should the nurse teach this client? A. Eat low-fiber and low-residual foods. B. White rice and bread are easier to digest. C. Add vegetables such as broccoli and cauliflower to your new diet. D. Foods high in animal fat help to protect the intestinal mucosa.

C. Add vegetables such as broccoli and cauliflower to your new diet.

ABG Result: pH- 7.37; pCO2- 49mmHg; HCO3- 29mmol/L; pO2- 88mmHg; SaO2- 97% A. normal ABG Result B. Respiratory Acidosis, fully compensated with adequate oxygenation C. Respiratory Acidosis, partially compensated with Adequate Oxygenation D. Metabolic Alkalosis fully compensated with adequate oxygenation E. Metabolic Acidosis uncompensated but with Adequate Oxygenation F. Respiratory acidosis, uncompensated, with mild hypoxemia

B. Respiratory Acidosis, fully compensated with adequate oxygenation

A patient has an aminophylline IV drip ordered for acute asthma to run at 30ml/hr. No IV infusion controller is available right now. How many mgtts per minute will be required if microdrip tubing is used? ``` A. 30 cc/hr B. 20 mgtts/min C. 15 mgtts/min D. 30 mgtts/min E. 10 mgtts/min ```

D. 30 mgtts/min