Med-surg: neuro, endocrine & renal worksheet with answers

Which serum sodium result shows hyponatraemia in an adult?

1. A142 mmol/L
2. B138 mmol/L
3. C129 mmol/L
4. D147 mmol/L

What is a common complication after a lumbar puncture?

1. ALoss of hearing in one ear
2. BPermanent paralysis of both legs from nerve damage
3. CA rapid rise in blood glucose
4. DA headache that is worse when sitting or standing

What is diabetic gastroparesis?

1. ASlow emptying of the stomach due to nerve damage
2. BInflammation of the pancreas from high glucose
3. CA blockage of the small bowel by scar tissue
4. DA stomach ulcer caused by long-term metformin use

Why may a person with long-standing diabetes have a heart attack without typical chest pain?

1. ANerve damage can blunt the pain signals
2. BInsulin acts as a strong painkiller
3. CPeople with diabetes do not have heart attacks
4. DHigh glucose protects the heart from pain

Which picture fits Brown-Séquard syndrome?

1. AWeakness of both arms with normal strength in the legs
2. BParalysis of both legs, with normal sensation everywhere in the body
3. CWeakness on the same side and loss of pain on the opposite side
4. DLoss of all feeling but normal movement on both sides

A patient receives phenytoin through a nasogastric tube along with continuous enteral feed. Which issue should the nurse know about?

1. APhenytoin makes the feed curdle, so the two must never be used in one patient
2. BPhenytoin must be crushed and mixed into the feed bag
3. CThe feed increases phenytoin levels and causes toxicity within hours
4. DThe feed can reduce phenytoin absorption, so the feed is often paused around the dose

An older man was found on the floor after lying there for many hours. His urine is dark brown, and his creatine kinase is very high. What is the main kidney risk and the key treatment?

1. AA urinary infection, treated with oral antibiotics only
2. BHypothermia, treated with a fluid restriction
3. CA kidney stone, treated with strong pain relief
4. DAKI from rhabdomyolysis, treated with generous IV fluids

A patient with untreated end-stage kidney disease has chest pain that is worse lying flat and better sitting forward. A rub is heard over the heart. What is most likely?

1. AIndigestion from phosphate binders
2. BA stable angina attack, which needs only a nitrate spray and rest
3. CA rib fracture from coughing
4. DUraemic pericarditis, which usually needs urgent dialysis