COMPLEX ADULT HEALTH

COMPLEX ADULT HEALTH

FINAL EXAM

MODULE 1

QNS & ANS

2023/2024

• What is the most common cause of acute kidney injury (AKI) in hospitalized patients?
• Prerenal AKI due to hypovolemia or hypotension
• Intrinsic AKI due to glomerulonephritis or tubular necrosis
• Postrenal AKI due to urinary obstruction or nephrolithiasis
• Chronic kidney disease due to diabetes or hypertension

Answer: A

• What are the signs and symptoms of pulmonary embolism (PE)?
• Chest pain, dyspnea, tachycardia, and hypoxia
• Cough, hemoptysis, fever, and leukocytosis
• Wheezes, stridor, cyanosis, and hypercapnia
• Pleural effusion, dysphonia, hoarseness, and Horner's syndrome

Answer: A

• What are the risk factors for developing pressure ulcers in bedridden patients?
• Age, immobility, malnutrition, and moisture
• Smoking, obesity, diabetes, and infection
• Anemia, hypotension, edema, and venous stasis
• Allergy, friction, shear, and trauma

Answer: A

• What are the criteria for diagnosing sepsis according to the Sepsis-3 definition?
• Systemic inflammatory response syndrome (SIRS) plus confirmed or suspected infection
• SIRS plus organ dysfunction or hypoperfusion
• Life-threatening organ dysfunction caused by a dysregulated host response to infection
• Infection plus lactate > 2 mmol/L or hypotension requiring vasopressors

Answer: C

• What are the common causes of upper gastrointestinal bleeding (UGIB)?
• Peptic ulcer disease, gastritis, esophageal varices, and Mallory-Weiss tear
• Diverticulosis, angiodysplasia, ischemic colitis, and colon cancer

• Crohn's disease, ulcerative colitis, appendicitis, and Meckel's diverticulum
• Cholecystitis, pancreatitis, hepatitis, and cirrhosis

Answer: A

• What are the indications for mechanical ventilation in patients with acute respiratory failure?
• PaO2 < 60 mmHg or PaCO2 > 50 mmHg on room air
• Respiratory rate > 30 breaths/min or tidal volume < 5 mL/kg
• pH < 7.35 or bicarbonate < 22 mEq/L on arterial blood gas
• Any of the above

Answer: D

• What are the complications of diabetes mellitus that affect the eyes, kidneys, nerves, and feet?
• Diabetic retinopathy, nephropathy, neuropathy, and foot ulcers
• Diabetic cataract, glaucoma, macular edema, and blindness
• Diabetic ketoacidosis, hyperosmolar hyperglycemic state, hypoglycemia, and coma
• Diabetic dyslipidemia, hypertension, coronary artery disease, and stroke

Answer: A

• What are the types of stroke and how are they diagnosed?
• Ischemic stroke due to thrombosis or embolism; diagnosed by computed tomography (CT) scan or

magnetic resonance imaging (MRI)

• Hemorrhagic stroke due to intracerebral or subarachnoid hemorrhage; diagnosed by lumbar puncture or

angiography

• Transient ischemic attack due to temporary occlusion or spasm; diagnosed by electroencephalography

(EEG) or Doppler ultrasound

• All of the above

Answer: D

• What are the stages of Alzheimer's disease and how are they assessed?
• Mild cognitive impairment (MCI), mild dementia, moderate dementia, and severe dementia; assessed by

Mini-Mental State Examination (MMSE)

• Preclinical Alzheimer's disease (AD), prodromal AD, mild AD dementia,

moderate AD dementia,

and severe AD dementia; assessed by Clinical Dementia Rating (CDR)

• Early-onset AD,

late-onset AD, familial AD, and sporadic AD; assessed by genetic testing or biomarkers

• None of the above

Answer: B

• What is the difference between acute and chronic pain? How would you assess and manage each type of

pain in a patient?

• Acute pain is a sudden and intense sensation that usually indicates tissue damage or injury. Chronic pain is

a persistent and often debilitating sensation that lasts longer than six months and may not have a clear cause.To assess pain, you would use a valid and reliable pain scale, such as the numeric rating scale (NRS) or the Wong-Baker FACES scale, and ask the patient about the location, intensity, quality, duration, frequency, and aggravating or relieving factors of their pain. To manage pain, you would use a multimodal approach that includes pharmacological and non-pharmacological interventions, such as analgesics, anti-inflammatory drugs, opioids, nerve blocks, ice, heat, massage, relaxation, distraction, etc.

• What are some common causes and complications of chronic obstructive pulmonary disease (COPD)?

How would you educate a patient with COPD about self-care and prevention of exacerbations?

• COPD is a group of lung diseases that cause airflow limitation and chronic inflammation. Some common

causes are smoking, air pollution, occupational exposure, genetic factors, and respiratory infections. Some common complications are hypoxemia, hypercapnia, pulmonary hypertension, cor pulmonale, respiratory failure, and frequent exacerbations. To educate a patient with COPD, you would explain the nature and progression of the disease, the importance of smoking cessation, the proper use of inhalers and oxygen therapy, the signs and symptoms of exacerbations and when to seek medical help, the benefits of pulmonary rehabilitation and exercise, the need for vaccinations and infection prevention, and the strategies for coping with anxiety and depression.

• What are some risk factors and warning signs of stroke? How would you perform a neurological

assessment on a patient with suspected stroke?

• Stroke is a sudden interruption of blood flow to the brain that causes neurological damage. Some risk

factors are hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, smoking, obesity, physical inactivity, age, gender, race, family history, and previous stroke or transient ischemic attack (TIA). Some warning signs are sudden onset of weakness or numbness on one side of the body or face, difficulty speaking or understanding speech, confusion or altered mental status, vision loss or double vision in one or both eyes, severe headache with no known cause, dizziness or loss of balance or coordination. To perform a neurological assessment on a patient with suspected stroke, you would use a standardized tool such as the Cincinnati Prehospital Stroke Scale (CPSS) or the National Institutes of Health Stroke Scale (NIHSS), which evaluate facial droop, arm drift, speech,