DOH Nursing Adult Health Nursing 2

Question 1

Which electrolyte imbalance is most commonly associated with prolonged nasogastric suction?

Accepted Answer

Hypokalemia and metabolic alkalosis

Answer

NG suction removes gastric acid (HCl) and fluids rich in potassium. Loss of hydrogen and chloride ions causes metabolic alkalosis. Continuous loss of gastric contents depletes potassium, causing hypokalemia.

Question 2

A patient post-thyroidectomy develops tetany and positive Chvostek's sign. Which electrolyte abnormality is most likely?

Accepted Answer

Hypocalcemia

Answer

The parathyroid glands lie adjacent to the thyroid and may be inadvertently removed or damaged during thyroidectomy. Loss of PTH causes hypocalcemia, manifesting as neuromuscular irritability, tetany, and positive Chvostek's/Trousseau's signs.

Question 3

Which finding should the nurse report immediately in a patient receiving heparin therapy?

Accepted Answer

Sudden back pain and decreased blood pressure

Answer

Sudden back pain with hypotension in a heparinized patient suggests retroperitoneal hemorrhage or aortic dissection/hemorrhage — a life-threatening complication. This requires immediate physician notification and possible reversal with protamine sulfate.

Question 4

A patient's troponin I level is elevated 6 hours after chest pain onset. What does this finding indicate?

Accepted Answer

Myocardial cell necrosis consistent with MI

Answer

Troponin I is a highly specific cardiac biomarker released when cardiomyocytes die. Elevation 6 hours post-chest pain onset confirms myocardial necrosis (MI). Troponin begins rising 3–4 hours after MI and peaks at 24–48 hours.

Question 5

Which nursing assessment is most important after administering morphine for post-operative pain?

Accepted Answer

Respiratory rate and oxygen saturation

Answer

Opioids like morphine cause respiratory depression as their primary serious adverse effect. Monitoring respiratory rate and SpO2 is critical to detect early respiratory compromise. Naloxone (reversal agent) must be immediately available.

DOH Nursing Practice Test

DOH Nursing Practice Test

DOH Nursing Adult Health Nursing 2