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King Saud University Riyadh Community College Applied Medical Science, NURSING Final Practicum Exam, Nur 300 Name: I D Number: Date: 5 / 1 / 1429 Grade: / 40 Q 1 – ( 10 Marks ) Mr. P is a 78-year-old male with severe chronic obstructive pulmonary disease (COPD) and arthritis who lives alone. He is dependent on home oxygen. Other medication include diuretics, no steroidal anti-inflammatory drugs (NSAIDs), bronchodilators, and respiratory medications. He states that he wants to avoid future hospitalizations for his disease, does not want to be intubated. Mr. P is currently hospitalized For seven days, Mr. P has been on oral antibiotics for acute bronchitis, but his overall condition is stable. Today he is lethargic, unable to stand and having difficulty swallowing his medications. Based on above case: a- analyze the above data into subjective and objective data ( 2 marks ) b- formulate the most three prior nursing diagnosis for Mr. P ( 3 marks ) c- what is your goal and objectives for the first prior nursing diagnosis ( 3 marks ) d- what is the most important nursing teaching regarding non-steroidal anti inflammatory therapy ( 2 marks ) ----------------------------------------------------------------------------------------Q 2 – ( 10 marks ) Ahmed, age 55yrs; 6years history of type 2 diabetes mellitus, presents to the medical clinic this morning for recheck of BP, last visit was one week ago; BP last week was 152/94 mm Hg. He reports that he has been feeling well; his diabetes has been under good control. He checks his sugar every morning and every evening and his blood sugar range from 140-160 1) Based on Ahmed initial BP elevation, which of the following activities would you do first? a. b. c. d. contact the physician to obtain medical orders teach the patient about the disease process and management assess Ahmed's BP and perform a through nursing assessment schedule next follow up visit His BP was 158/94 mm Hg, patient's smokes 2 packs per day with no epistaxis, fatigue, or nocturia, Ahmed has occasional headache which is relieved by acetaminophen 2) All of the following topics are important for Ahmed to assess in more details except? a. smoking b. history of nose bleeds and nocturia c. headache and dizziness d. Fatigue and GI problems Ahmed started to be investigated a lot of diagnostic tests have been sent: 3) which of the following are important test(s) for Mr. Ahmed: a. b. c. d. chemistry panel, CBC, urine analysis electrocardiogram (ECG) Chest X-ray All of the above 4) Normal hemoglobin for male adult is: a. b. c. d. 14-16 g/dl 10-12 g/dl 18-20 g/dl 11-13 g/dl 5) Which of the following assessments are the most important for Mr. Ahmed to rule out his hypertension? a. b. c. d. a coarse lung sound oxygen saturation of 96% blood glucose of 143 mg/dl BP 152/92 mm Hg After confirmation of hypertension diagnosis, physician explained to Ahmed how to make life style modification including: increase activity level, weight loss, and reducing salt in diet. Also physician prescribed diuretic for his hypertension 6) As nurse you are developing a care plan for Ahmed, which of the following nursing diagnosis are not related to Mr. Ahmed case? a. b. c. d. risk for fluid volume deficit fluid volume excess knowledge deficit risk for non compliance related to medication side effects 7) all of the following are instruction topics the nurse should teach for the patient except: a. b. c. d. disease process and stress reduction low sodium diet and smoking cessation decrease physical activity weight reduction On clinic visit one month later for recheck of hypertension: BP was 154/88, weight loss of 2Kg, blood sugar has been tested and result was 180 mg/dl. 8) The normal blood sugar level is: a. b. c. d. 80-120 mg/dl 50-70 mg/dl 140-150 mg/dl 50 mg/dl 9) What does a nurse need to know about capillary glucose testing? a. capillary testing is unreliable b. if site is swabbed with alcohol before puncture, glucose test will show more reliable result c. to obtain a specimen hold patients hand down and allow a large drop to form before applying to the strip d. increase reliability by using the same finger for repeated punctures 10) Based on clinical manifestation of diabetes (polyurea, polyphagia, polydepsia), which nursing diagnosis takes priority at this time? a. b. c. d. alteration in nutrition: more than body requirements pain knowledge deficit fluid volume deficit Q 3The order: 2 liters of D5W are to infuse at 30 drops / min. The drop factor is 15. How many minutes will this take? (2 Marks) A patient is prescribed 50mg of sodium valproate orally. 200mg/5mL is available. How many milliliters should be administered? (2 Marks) A patient is prescribed 1L dextrose 5% to be infused intravenously over 8 hours using a giving set which delivers 10 drops/ml. calculate the rate in drops/minute. (2 Marks) Paracetamol suspension 120mg/5mL is prescribed for a 5 year old child at a dose of 15mg/kg. The child weighs 18kg. What volume should be administered? (2 Marks) ----------------------------------------------------------------------------------------Q 4- Describe your experience as a nursing student in the surgical unit GOOD LUCK