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

Which action must be avoided on the arm with a haemodialysis fistula?

1. AMoving the arm in a normal way
2. BFeeling gently over the fistula for the thrill
3. CWashing it with soap and water
4. DBlood pressure cuffs or blood samples

What is the postictal phase?

1. AThe stiffening phase at the start of a tonic-clonic seizure
2. BThe period of drowsiness and confusion after a seizure
3. CThe warning sensation just before a seizure starts
4. DA seizure that lasts more than five minutes

Which gland produces cortisol?

1. AThe adrenal medulla
2. BThe adrenal cortex
3. CThe thyroid gland
4. DThe posterior pituitary

A patient taking dapagliflozin (an SGLT2 inhibitor) is vomiting, with blood ketones of 4.5 mmol/L but a glucose of only 11 mmol/L. What should be suspected?

1. AHyperosmolar hyperglycaemic state
2. BEuglycaemic diabetic ketoacidosis
3. CA normal side effect needing no action
4. DHypoglycaemia caused by the vomiting

How is cerebral perfusion pressure (CPP) calculated?

1. AMean arterial pressure divided by heart rate
2. BDiastolic pressure minus central venous pressure
3. CMean arterial pressure minus intracranial pressure
4. DSystolic arterial pressure plus intracranial pressure

Why is IV calcium gluconate given in severe hyperkalaemia?

1. AIt moves potassium into the cells
2. BIt removes potassium through the kidneys
3. CIt protects the heart from arrhythmias
4. DIt binds potassium in the gut

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

A patient with a new arm fistula says their hand on that side is cold, pale and painful, especially during dialysis. What is the concern?

1. AAn allergic reaction to the dressing on the arm
2. BNormal healing that needs no action
3. CSteal syndrome, which needs urgent review
4. DFluid overload in the arm