TEST I. Part I.

1. A client was admitted due to blunt trauma to the chest. On x-ray, multiple rib fractures were seen and the client complains of pain on breathing. Which of the following acid-base imbalances should the nurse anticipate the client may experience?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic acidosis

2. Which of the following statements by the client indicates that the discharge teaching for respiratory alkalosis is understood?
A. "I will not take so many antacids anymore."
B. "I will take a stress management class."
C. "I will not take my Lasix without taking my potassium supplement."
D. "I will tell the doctor the next time i have diarrhea for so long."

3. Your unit is admitting a client with metabolic alkalosis due to overdosing of bicarbonate-containing antacid. Which of the following should the nurse implement? Select all that apply.
A. Restrict the use of potassium-containing IV fluids
B. Administer the diuretic acetazolamide
C. Pad the side rails and put the bed at the lowest level
D. Administer sodium-potassium exchange resin enema

4. A non-compliant client with diabetes type I was rushed in the hospital for sudden loss of consciousness. Upon assessment the capillary blood sugar of the client was high at 560mg/dL, noted with ketone bodies in both her blood and urine. Which of the following assessment parameters would indicate to the nurse that client is having diabetic ketoacidosis?
A. Elevated blood pressure
B. Warm, dry skin
C. Deep, rapid respirations
D. Fever

5. A client's blood gas results are pH 7.36, PaCO2 50, HCO3 28. What do these results indicate to the nurse?
A. Respiratory acidosis, compensated
B. Metabolic acidosis, compensated
C. Metabolic acidosis, uncompensated
D. Respiratory acidosis, uncompensated

6. You are caring an unconscious patient who has been bed-bound for a long time. An ABG was done the result are as follow: pH 7.34 PaCO2 52 HCO3 23. Which of the following should the nurse implement to help correct the acid-base imbalance? Select all that apply.
A. Administer oxygen at 3-5 liters via non-rebreather face mask
B. Administer acetylcysteine
C. Humidify the client's room using a hospital-approved room humidifier
D. Restrict the client's intake of water to 1.5 liters a day
E. Turn the client every 2 hours and tap his back every 4 hours

7. You are caring for a client who is on enteral feeding via NGT. You are about to administer his 10am scheduled feeding. Having in mind that the client is prone to metabolic alkalosis due to enteral feeding, which of the following should the nurse do prior to the administration of the feed?
A. Administer 30ml of NSS prior to feeding
B. Reintroduce to the aspirated residual
C. Administer acidifying agents such as citric acid or tartaric acid supplement
D. Administer H2- receptor antagonist as prescribed

1. You have been providing care for Mrs. Stern, who is terminally ill at home. You prepare her meals and she enjoys custard and scrambled egg. During the past two days, while feeding her, you notice that she often coughs after having sips of water or juice. What would be the action required in this case and why?
2. Mrs. Stern has dementia. She refuses to eat her lunch and when you try to encourage her, she shouts and pushes the plate away. What could you do to get her to eat her lunch?
3. Mrs. Stern is now receiving nourishment via a G-tube. How should you position Mrs. Stern and why?
4. Mrs. Stern today, yells “I am wet again” and starts crying you are about to leave. She tells you that she is always wet. You notice for the second time today that the site where the gastrostomy tube has fluid that again has soaked through her clothes. She tells you her skin is burning. You ask Mrs. Stern if you can look and you immediately notice a very red area surrounding the tube insertion point.  
5. What do you do?
6. What do you think is happening?
7. Can this be harmful to Mrs. Stern’s skin if left like this?
8. At a retirement home in the community, you are assigned to aid a client at feeding time. In the dining room, while assisting the person with his meal, you observe that the person beside him is not eating his breakfast, lunch and supper. What is your responsibility, and what steps would you take?
9. You have a client who is receiving nutrition through their intravenous therapy. While assisting the client to put on a new hospital gown after his partial bath, you notice the site where the intravenous is inserted in the client’s arm is swollen, red and is leaking fluid. What do you do in this situation? Is this normal?

Now that you have spent the last 7 weeks looking at community health from a fairly wide lens, think about your own community. Considering what you learned about the multidimensional nature of health and the major determinants of health, and in a in a post of a minimum 125 words, identify the greatest threat to the health of your community(St.Petersburg, Fl). Include in your answer how the issues impact you personally or may play a role in your future career. In other words, what is the biggest takeaway from this course?

DIRECTIONS: Calculate the following using the subject below (Show the computation).

1. Dbw (Tannhauser's Method)
2. Basal Metabolic Rate
3. Physical Activity
4. Specific Dynamic Action (Sda) Of Food
5. Total Energy Requirement
6. Nutrient Allocation in Calories and Grams
7. Diet Prescription

1. 32 year old male, 5'8" tall, medium built performing moderate activity.
2. 28 year old female, 5'2" tall, medium built performing light activity.

As people grow older, bones and joints get weaker, with arthritis being one of the common diseases of the elderly. List three types of arthritis, describe them and provide at least THREE differences between them (Hint: cause, clinical features, diagnosis, and treatment). Choose one of them and discuss its prevention and management strategy. Reminder: Show critical thinking. Support your opinions with scientific evidence (in initial response and response to your classmates). Provide citations for the information you discuss.

1. Write an essay which outlines the structure and profile of the aged care sector. Your essay should cover:

• The residential aged care sector
• The home and community support sector
• Current best practice service delivery models

Relevant agencies and referral networks for support services

Scenario:

You have just arrived at the scene of a volatile situation at ABC Day Care in Sentinel City. A situation involving a gun is occurring at the daycare center. Other than that little information regarding the situation inside the daycare is known.

Report:

1) Describe the potential short and long-term impact on the children and their parents.

2) Describe potential short and long term impact the emergency responders and community at large.

3) Discuss the risks and benefits of using social media to communicate about the situation.

4) Create a communication message for use on social media describing the situation which is directed to the parents of the children at the daycare center OR to the community at large (Student's choice).

6) Identify two issues that should be addressed during the recovery phase for one of the following groups: the children, their parents, the community at large, OR the emergency responders. Provide an evidence-based rationale for each issue identified.

please explain the difference between antibody, antigen and immunity.

1. Discuss and compare the caste and class systems of social stratification.
2. Why is social stratification still prevalent in the world today? How does it impact the medical field?
3. With global stratification, terms such as first, second, and third world are often used when referring to countries. How did global stratification occur, and do you think it works Why? Why not? What leads to global inequality?

A nurse is caring for a 68-year-old male patient who is reporting SOB. He has a history of HTN, DM, emphysema, and was a heavy smoker for 25 years.

21. List at least three assessment findings the nurse should expect to assess in this client while performing INSPECTION.

22. What method of breathing can the nurse suggest the patient use in order to promote carbon dioxide expiration? Explain the process of how to perform this method.

23. When performing a respiratory assessment on a patient, the nurse notices the AP to transverse diameter is 1:1, which indicates:

1. Kyphosis
2. A normal finding in an adult
3. An expected finding in patient with certain forms of COPD
4. Scoliosis

24. Explain in detail the pathophysiology behind why the ratio would change to 1:1.

25. 11. The patient using accessory muscles to breathe indicates hypoxia. And early sign of hypoxia is __________ and a late sign of hypoxia is __________. List 3 other assessment findings the nurse would observe in a patient with hypoxia.

Contrast the dietary needs of special populations. A variety of ANY 3 special populations. The populations cannot be related. They must be 3 separate populations. For example, Females, Elderly, and Autistic populations and contrast. You may pick any 3 populations, not just the ones I put for example.

Complete drugs cards

Generic /brand name

Category class

expected Pharmacological Action

Complications

Contraindications/Precautions

Interactions

Medication Administration

Evaluation of Medication Effectiveness

Therapeutic Use

Nursing Interventions

Client Education

1. Sinemet

2. Amantadine

3. Rocephin

Complete drugs cards

Generic /brand name

Category class

expected Pharmacological Action

Complications

Contraindications/Precautions

Interactions

Medication Administration

Evaluation of Medication Effectiveness

Therapeutic Use

Nursing Interventions

Client Education

1. Sinemet

2. Amantadine

3. Rocephin