Med-Surg 2 Final Part 1

A 20-year-old college student who has not been immunized against hepatitis B virus (HBV) comes to the clinic and reports that he has been exposed to hepatitis B. The nurse anticipates that the health care provider will likely recommend which treatment? A. A prescription for a broad-spectrum antibiotic B. A prescription for an antiviral agent C. The first of the three immunizations for HBV D. An injection of hepatitis B immune globulin (HBIG)

An injection of hepatitis B immune globulin (HBIG) *HBIG will give immediate passive immunity. Immunization for HBV takes too long for immediate coverage. Oral medications are of little value at this stage

The nurse is caring for a patient who has been experiencing severe diarrhea and can now resume solid foods. The nurse educates the patient about appropriate food choices. Which food choice indicates that the nurse's teaching has been successful? A. Whole-grain rice B. Wheat toast C. Applesauce D. Grapes

Applesauce *When a patient has severe diarrhea and is allowed to resume solid foods, the foods should be slowly introduced in order to help thicken the stool. Foods such as applesauce, pretzels, bananas, white rice, white toast, and yogurt are beneficial

A tonometer reading reflects the amount of pressure exerted by which component of the eye? A. Sclera B. Aqueous humor C. Vitreous humor D. Cornea

Aqueous humor *The tonometer reads the pressure exerted by the aqueous humor in the anterior chamber. The sclera is the part of the eyeball that is opaque white and covers the posterior portion of the eyeball. The vitrerous hymor is the substance found in the posterior chamber of the eye between the lens and the retina. The cornea is a transparent structure in the eye that allows light to hit the lens. It is involved in the bending of light rays

The nurse is caring for a patient who is complaining of postoperative gas pain. What intervention should the nurse implement? A. Assist the patient with ambulation B. Apply a cold compress on the abdomen C. Offer a cup of coffee or tea D. Offer chilled vegetable juice

Assist the patient with ambulation *Ambulation is the most effective method for helping a patient expel gas. Hot or cold beverages and cold compresses will increase gas

The nurse is educating a patient who has gastroesophageal reflux disease (GERD) about dietary modification. Which information is most important for the nurse to include in the teaching plan? A. Avoid highly seasoned or spiced foods B. Drink ginger ale or lemon lime soda rather than cola C. Use a straw to drink all fluids D. Eating three meals spaced evenly apart

Avoid highly seasoned or spiced foods *Avoiding highly seasoned or spicy food should be incorporated into diet changes for the patient with GERD. The avoidance of carbonated beverages with meals and the use of a straw do not reduce the impact of GERD. The frequency of dietary intake does not influence GERD

The nurse is collecting data from a patient who complains of having urinary frequency. When reviewing the patient's health history, the nurse would be prompted to inquire about the patient's intake of: a. red meat. b. caffeine. c. over-the-counter cold remedies. d. tomato juice.

B - caffeine

The patient confides that sneezing makes her "wet her pants." The nurse recognizes that this is a cardinal sign of ______ incontinence. a. urge b. stress c. functional d. overflow

B - stress

The nurse is caring for a patient with an inner ear disorder and is aware that the patient is at risk for which of the following? A. Aspiration B. Falls C. Incontinence D. Impaired gas exchange

Falls *Inner ear disorders can cause problems with balance, Dizziness, vertigo, and ataxia can greatly interfere with an individual's ability to work or to perform usual activities of daily living.

Which causative agent is the primary cause of Barrett esophagus? A. Gastroesophageal reflux disease (GERD) B. Eating hot, spicy foods C. Anorexia nervosa D. Esophageal polyps

Gastroesophageal reflux disease (GERD) *A major cause of Barrett esophagus is esophageal reflux

The patient has been diagnosed with primary stage syphilis. The nurse would anticipate the patient to display which symptom? A. Sore throat B. Hard sore on mucous membrane of genitalia C. Patchy loss of hair from the scalp D. Skin rash on arms and back

Hard sore on mucous membrane of genitalia Syphilis has three stages. During the primary stage (after a 3-week incubation period), a chancre (hard, painless sore) appears on the mucous membrane of the mouth or genitals, often unnoticed in women. Sore throat, rash, and hair loss are not symptoms of primary stage syphilis.

While ambulating, a patient with Meniere disease complains of dizziness and vertigo. An immediate nursing action would be to A. Provide oxygen B. Have the patient sit down C. Administer nausea medication D. Notify the health care provider

Have the patient sit down *Although option 3 might also be relevant, safety concerns decree that having the patient sit down to prevent a fall or injury takes priority. The patient may only be dizzy, not nauseated. (1) Meniere disease does not result from oxygen deprivation. (3) Nausea medication may be necessary but will not help immediately. (4) The health care provider does not need to be notified of an expected symptom of the diagnosis.

The nurse is caring for a patient with hepatitis. The nurse explains that jaundice occurs in conjunction with hepatitis based on which underlying pathophysiology? A. Liver ischemia in hepatitis causes jaundice B. Increased bile production by the enlarged Kupffer cells causes jaundice C. The hepatitis virus destroys red blood cells and causes jaundice D. Hepatitis causes liver congestion that obstructs bile flow

Hepatitis causes liver congestion that obstructs bile flow *Congestion from the inflammation obstructs the bile from entering the duodenum and keeps it in the circulating volume

You emphasize safety precautions to an 80 year old female patient with Meniere disease. An appropriate nursing approach would be to A. Use the patient's first name when addressing her B. Include family members in instructions C. Address decision making with the patient D. Set a specific schedule for providing instructions

Include family members in instructions *Including family members when giving safety instructions will help reinforce needed interventions and help keep the patient safe from falls. (1) Using the patient's name will not increase safety. (3) Decision making is not the focus. (4) There is no need to schedule instructions for a specific time.

The nurse is caring for a patient admitted with suspected acute viral hepatitis. Which laboratory value would best support this diagnosis? A. Decreased aspartate aminotransferase (AST) B. Decreased alanine aminotransferase (ALT) C. Decreased gamma-glutamyl transpeptidase (GGT) D. Increase prothrombin time

Increase prothrombin time *During the acute phase of hepatitis, the patient will likely display prolonged prothrombin times. Levels of aspartate aminotransferase (AST), alanine aminotransferase, and GGT will be elevated

The nurse is caring for a patient diagnosed with acute pancreatitis who complains of significant pain. Which nursing action holds the highest priority for this patient? A. Instruct the patient to sit and lean forward B. Monitor intake and output C. Monitor laboratory values and note changes D. Check blood glucose values frequently

Instruct the patient to sit and lean forward *Pancreatitis causes abdominal pain that is usually acute, steady, and localized to the epigastrium or left upper quadrant. As it progresses, it spreads and radiates to the back and flank. Sitting and leaning forward may ease the pain. The severity of the pain may slowly decrease after 24 hr. Eating makes the pain worse. While monitoring intake and output and lab values are important actions, none of these actions actively address the patient's pain

The nurse is reviewing the plan of care for a patient following a tympanoplasty. Which intervention should the nurse implement in the immediate postoperative period? A. Keep the patient flat in bed B. Encourage deep breathing and coughing C. Reposition the patient quickly to reduce nausea and vomiting D. Position the patient's head with the affected ear touching the mattress

Keep the patient flat in bed *Postoperative care involves keeping the patient quiet and flat in bed for at least 12 h. Coughing and sneezing should be avoided, or if unavoidable, should be accomplished with the mouth opern to decrease pressure in the ear. Position changes should be accomplished slowly. The head is turned so that the affected ear is uppermost

The nurse is educating a patient with acne rosacea that has facial erythema andtelangiectases. Which information should the nurse include in the teaching plan? a. Drink 4 ounces of wine daily to promote vasodilation .b. Wash your face at least three times daily. c. Avoid direct sunlight. d. Apply tea bags to the affected areas.

c. Avoid direct sunlight.

The nurse is educating a patient with acne rosacea that has facial erythema andtelangiectases. Which information should the nurse include in the teaching plan? a. Drink 4 ounces of wine daily to promote vasodilation. b. Wash your face at least three times daily. c. Avoid direct sunlight. d. Apply tea bags to the affected areas.

c. Avoid direct sunlight.

A patient has come to the clinic after having been notified of exposure to gonorrhea. He states this his exposure occurred 11 days ago. If he is infected, signs and symptoms that would be expected are A. headache, rash, stiff neck, irritability, and joint pain and stiffness B. urinary frequency, and burning with purulent discharge from the urethra C. nausea, diarrhea, fever, and urinary frequency and urgency D. burning sensation of the penis and swollen lymph nodes in the groin

urinary frequency, and burning with purulent discharge from the urethra

A patient has reported to the clinic with concerns about contracting hepatitis A from her boyfriend. What response by the nurse is most appropriate? A. "If you are having unprotected sexual intercourse with your partner, there is a relatively high risk for hepatitis A. "B. "Hepatitis A is not transmitted as a result of close contact with an infected individual." C. "Hepatitis A transmission is associated with contact with infected body fluids." D. "Hepatitis A is relatively uncommon in our country and seen more in underdeveloped countries."

"Hepatitis A is not transmitted as a result of close contact with an infected individual." *Hepatitis A and hepatitis E viruses are transmitted primarily by the fecal-oral route. They are responsible for the epidemic forms of viral hepatitis. Hepatitis A virus can be transmitted by food handlers to customer or by mollusk shellfish from contaminated waters. Hepatitis B is transmitted via infected blood and body fluid. Hepatitis E virus infection is primarily seen in less developed countries

An office assistant tells the nurse his job requires him to work at his computer for 7 to 8 h each day. Which statement indicates that the nurse's teaching about preventing eyestrain has been successful? A. "I will wear protective googles while working." B. "I will eat more carrots and cooked spinach." C. "I will close my eyes every few hours." D. "I will instill artificial tears each hour while working."

"I will close my eyes every few hours."* To prevent eyestrain, the patient should rest the eye muscles periodically when working at the computer or performing any activity that demands intensive vusual effort. Resting the eye muscles every several hours helps prevent eye fatigue. Protective googles do not help prevent eyestrain. Nutrients such as lutein and zeaxanthin are found in carrots and cooked spinach and are good for the eyes but do not reduce eyestrain. Overuse of artificial tears is not recommended, and proper usuage works to combat dry eyes

What should the nurse tell a patient experiencing hearing loss, they should inquire about a hearing aid? A. "You can wait until your hearing is nearly gone before worrying about it." B. "The earlier your brain is able to adapt to the hearing aid, the easier it will be to use." C. "You might want to get one before you get too old." D. "They don't work very well so I wouldn't spend too much money on it."

"The earlier your brain is able to adapt to the hearing aid, the easier it will be to use." *The sooner a person with a hearing loss obtains and learns to use a hearing aid, the greater the hearing improvement. The brain is better able to integrate thhe hearing aid transmissions when hearing has not been impaired for a very long time.

The nurse is interviewing a patient who is seeking assistance at the urology clinic for erectile dysfunction. Which statement is the best way to open the interview? D. "What experiences have you had with erectile dysfunction?"

*Asking open-ended questions will help the patient respond with information that can be used in a plan of care

You are caring for an adolescent who has been diagnosed with gonorrhea. When the patient refuses to notify recent sexual partners, what is your appropriate response? A. "Do you not feel responsible for infecting other people? "B. "You do not have to notify anyone that you don't wish to contact. "C. "I am still accountable to report this disease through required channels." D. "It is considered a felony offense if you do not disclose names of your sexual partners."

. "I am still accountable to report this disease through required channels." *Gonorrhea is one of the STIs that is required to be reported to the health department. The health department will follow up to determine others that may have been exposed. (1) Scolding an adolescent is not the most effective communication technique and will not usually obtain the desired outcome. (2) You cannot make the adolescent contact partners, but information should be given regarding the role of the health department. (4) It is not a criminal offense to withhold the names of sexual partners.

A patient returns 1 weeks after receiving hearing aids and states, "I guess I may as well return these; I just cannot get used to them." What is an appropriate nursing response? (select all that apply) B. "You have not been able to hear well for a long time. Adjusting to the way you hear the sound through a hearing aid may take quite a bit of t ime, but it will be worth it!" C. "To adjust to the hearing aids, you must wear them most of the time. Are you able to keep them in most of the time, or so you spend most of your time without them?"

1. "You have not been able to hear well for a long time. Adjusting to the way you hear the sound through a hearing aid may take quite a bit of t ime, but it will be worth it!" 2. "To adjust to the hearing aids, you must wear them most of the time. Are you able to keep them in most of the time, or so you spend most of your time without them?"* It can take several months to realize the full benefit of hearing aids. The more a patient goes without them, the longer it will take to adjust. The patient should be encouraged to keep trying. (1) It is too early to test other aids. Test one hearing aid for several months. (4) People adjust to hearing aids differently.

You are assessing a patient for syphilis. which will you document as classic signs and symptoms of syphilis? (select all that apply) A. An open ulcer on the genitals B. A red rash on the palms of the hands C. A cough and fever D. A red rash on the soles of the feet E. Abdominal pain accompanied by vomiting

1. An open ulcer on the genitals 2. A red rash on the palms of the hands 3. A red rash on the soles of the feet *An open lesion on the genitals, a red rash on the palms, and a red rash on the soles of the feet are characteristic signs of a syphilis infection. (3, 5) Cough and fever and abdominal pain with vomiting are not associated with syphilis.

The nurse working in a fertility clinic is aware that reproductive health can be disrupted by a variety of disorders, such as (select all that apply) A. Infertility B. Spontaneous abortion C. Premature labor D. Infection E. Abnormal tissue growth

1. Infertility 2. Spontaneous abortion 3. Premature labor 4. Infection 5. Abnormal tissue growth *including cancerous and noncancerous tumors

When teaching the elderly patient about care of his hearing aid, you would include which action(s) (select all that apply) A. Keep the battery in the hearing in the hearing aid B. Clean the ear mold regularly with alcohol C. Never put the hearing aid in water D. Open the battery cover when the hearing aid is not in the ear

1. Keep the battery in the hearing aid 2. Clean the ear mold regularly with alcohol 3. Never put the hearing aid in water 4. Open the battery cover when the hearing aid is not in the ear

The nurse is caring for a 70-year-old patient who was diagnosed with gastroenteritis after returning from a camping trip to Mexico. Which manifestation(s) is/are consistent with this diagnosis? (select all that apply)A. Positive stool culture for Giardia or Shigella B. Abdominal cramping C. Fat in the stool D. Mucus in stool E. Blood in stool

1. Positive stool culture for Giardia or Shigella 2. Abdominal cramping 3. Mucus in stool 4. Blood in stool *Manifestations associated with gastroenteritis include a positive stool culture for Giardia or Shigella, abdominal cramping, and presence of mucus or blood in the stool. Fat in the stool is not symptomatic of gastroenteritis

A 57-year-old man is admitted with a diagnosis of cirrhosis. The nurse is aware that he will most likely require which intervention(s)? (Select all that apply.) A. Vegetable-based proteins B. Bleeding precautions C. Diuretics D. Increased fluids E. Lactulose administration

1. Vegetable-based proteins2 . Bleeding precautions 3. Diuretics 4. Lactulose administration *Because the liver produces clotting factors and is now dysfunctional, risk for bleeding exists. The liver cannot metabolize proteins, especially albumin, properly. This leads to edema and ascites and requires diuretics, preferably potassium wasting. Ammonia buildup is likely; lactulose binds with this toxic metabolic by-product and allows for its excretion through the GI tract. Patients with liver disorders are at high risk for fluid volume excess.

An adult male patient enters the emergency department with full and partial thickness burns on the entire right leg, front of the right arm, and one half of the front torso. The nurse, using the rule of nines, assesses the burn as ________%.

31.5

Using the Parkland formula, the fluid needed for a person weighing 140 pounds with a25% burn would be _____ mL.::::::: 4ml x ??kg x Burn% =

6360

Which patient is exhibiting manifestations consistent with the primary stage of syphilis? A. A female patient with copious vaginal discharge B. A male patient with a generalized skin rash C. A female patient with a painless nodule on her vagina D. A male patient with a gumma

A female patient with a painless nodule on her vagina *Syphilis has three stages. The chancre, or painless, hear nodule, is visible in the primary stage of syphilis and disappears withing a few weeks. The secondary stage occurs approximately 6 weeks later; symptoms may include a generalized skinrash. In tertiary syphilis, spirochetes access to all body tissues and a gumma (a soft encapsulated tumor) may appear on any organ

How long after exposure does the incubation period for gonorrhea last? A. 2 to 6 days B. 1 week C. 2 weeks D. 4 weeks

A. 2 to 6 days

After a medicated bath, the patient is assisted from the tub and lotion is applied: a. Immediately after drying the patient. b. In a thick layer to warm skin. c. When the patient is returned to bed.d. By the patient to preserve modesty.

ANS: A- Immediately after drying the patient. Medication is applied in a thin layer as soon as the patient has completed a bath.

The nurse reminds the CNAs that the main chemical that damages skin of the immobilized patient is: a. Urine b. Medications c. Skin lotions d. Laundry soap

ANS: A- Urine Urine and feces are the most common chemical irritants that cause skin breakdown.

The action of the CNA that the nurse observes that would be harmful to a patient's skin is: a. Lifting the patient on the draw sheet to the stretcher. b. Pulling the draw sheet out from under the patient. c. Rolling the patient to the side to change the draw sheet. d. Using the gait belt to lift the patient from the bed to a wheelchair.

ANS: B- Pulling the draw sheet out from under the patient .Pulling linens out from under a patient instead of rolling or lifting the patient causes a shearing type of skin tear. Use of a lift sheet, rolling the patient from side to side, and the use of the gait belt are recommended.

The action of the CNA that the nurse observes that would be harmful to a patient's skin is: a. Lifting the patient on the draw sheet to the stretcher. b. Pulling the draw sheet out from under the patient. c. Rolling the patient to the side to change the draw sheet. d. Using the gait belt to lift the patient from the bed to a wheelchair.

ANS: B- Pulling the draw sheet out from under the patient. Pulling linens out from under a patient instead of rolling or lifting the patient causes a shearing type of skin tear. Use of a lift sheet, rolling the patient from side to side, and the use of the gait belt are recommended.

The nurse best describes a "shave biopsy" of a skin lesion as: a. Removal of the central core of the lesion. b. Excising the entire lesion with a 1/4-inch border around it. c. Removal of the top of the lesion that stands above the skin line. d. Excising the lesion down to the dermis.

ANS: C- Removal of the top of the lesion that stands above the skin line The shave biopsy removes the top level of the lesion, which stands above the skin line. Removal of a core from the center of the lesion is referred to as a punch biopsy. Excision of the entire lesion is an excisional biopsy.

When applying lotion to the skin, the nurse should: a. Avoid shaking lotion as this causes bubble formation. b. Apply lotion heavily as the water from lotion evaporates. c. Wash off residue before applying fresh lotion. d. "Dab" on lotion to reduce skin irritation.

ANS: C- Wash off residue before applying fresh lotion. The residue from previous applications should be removed before applying fresh lotion.

An 80-year-old resident prefers to lie in bed on her left side. The nurse will take extra care in assessing the left ______ for evidence of skin breakdown. a. Buttock b. Heel c. Trochanter d. Ribs

ANS: C-Trochanter The areas that are prone to break down in the immobile patient are over bony prominences.

The nurse is aware that the gradual graying of an older adult's hair is related to: A. Reduced hair follicles. B. Less sebaceous gland activity. C. Loss of collagen fibers in dermis. D. Decreased melanocytes at hair follicle.

ANS: D- Decreased melanocytes at hair follicle. Reduction in melanocytes at the hair follicle is the cause of graying hair. A reduction in the number of hair follicles will result in thinning hair. Reduced sebaceous gland activity and collagen will result in drying.

The student nurse is preparing to document a suspicious area over a bony prominence. Which description would be most appropriate? a. Reddened area on left hip b. Reddened, nonblanching area approximately 1 cm 1 cm c. Suspicious area over left trochanterd. D. Nonblanching area over left trochanter 0.8 cm 1.2 cm

ANS: D- Nonblanching area over left trochanter 0.8 cm 1.2 cm The area should be described as to location, appearance, and exact measurement.

During the immediate postoperative period following tympanoplasty, what is the priority action by the LPN/LVN? A. Keep the patient on bed rest for the first 24 h. B. Provide cold compresses to be placed on the operative side. C. Position the patient on the operative side. D. Be sure the patient avoids coughing and sneezing.

Be sure the patient avoids coughing and sneezing. *Immediately after tympanoplasty, it is important to avoid coughing and sneezing. The patient will be expected to remain quiet and flat in bed for 4 h postoperatively. The head is turned so that the affected ear is uppermost. Cold compresses are not used in the postoperative period.

The nurse is educating a patient about testicular self-examination. Which information is most important for the nurse to include? A. Report any lumps larger than a pea to the health care provider B. Perform weekly self-examinations on the same day of the week C. Perform self-examinations after bathing when scrotal skin is relaxed D. Pinch skin for at least 5 seconds

C. Perform self-examinations after bathing when scrotal skin is relaxed

The nurse is caring for a patient who presents to the emergency department with severe nausea and vomiting with stomach pain that radiates to his right scapula. The patient has a temperature of 101.2 F. The nurse anticipates that this patient will undergo workup for which problem?A. Cholecystitis B. Hepatitis C. Pancreatitis D. Gastroenteritis

Cholecystitis *Nausea and vomiting, fever, and leukocytosis occur with cholecystitis. Pain may be referred to the right clavicle, scapula, or shoulder. Hepatitis causes liver dysfunction, including jaundice. Pancreatitis causes abdominal pain that is usually acute, but this can vary among individuals. The pain is steady and is localized to the epigastrium or left upper quadrant. Gastroenteritis causes nausea, vomiting, and diarrhea

The nurse is aware that men with honorrhea are more likely to seek medical attention because their symptoms are more visible than those of wome. Which clinical manifestations is most consistent with symptoms of gonorrhea in men? A. Copious, purulent penile discharge B. Hematuria when initiating the stream of urine C. Penile ulcers with a foul odor D. Scale scrotal lesions

Copious, purulent penile discharge *Signs and symptoms of gonorrhea in men include penal discharge and scrotal pain. Gonorrhea should not cause hematuria when urinating, penile ulcers with a foul odor, or scaly scrotal lesions.

A female patient comes to the emergency department with severe abdominal pain, a temperature of 101 F, and a foul smelling, purulent vaginal discharge. The nurse recognizes that these findings are consistent with which infection? A. Pelvic inflammatory disease (PID) B. Gonorrhea C. Syphilis D. Vaginosis

Pelvic inflammatory disease (PID) *Fever, abdominal pain, and purulent discharge are cardinal indicators of PID. Gonorrhea most often presents in females with vaginal discharge and burning with urination. The initial state of syphilis presents with chancre (hard, painless sore) on the mucuous membrane of the mouth or genitals. Vaginosis most often presents with symptoms including a grayish-white discharge that has a fishy odor

Which type of drug is most effective in the treatment of erectile dysfunction (ED)?

Phosphodiesterase inhibitors

The nurse is caring for a patient with syphilis. Which manifestation indicates that the syphilis has progressed to the secondary stage? A. Foul-smelling penile discharge B. Positive serology C. Purulent skin rash D. Scrotal swelling

Positive serology *A positive serology will appear in the secondary stage of syphilis. Penile discharge is not associated with the secondary stage of syphilis. A generalized skin rash, not purulent, may be seen in the secondary stage of syphilis. Scrotal swelling is not assocated with syphilis

The nurse caring for a patient with acute pancreatitis assesses a bluish tinge around the patient's umbilicus. The nurse recognizes that this finding likely results from which underlying problem? A. Increased amylase B. Retroperitoneal hemorrhage C. Inflammatory response to a pseudocyst D. Ascites

Retroperitoneal hemorrhage *A bluish tinge around the umbilicus or in the flank area indicates a retroperitoneal hemorrhage. Increased amylase levels, inflammatory response to a pseudocyst, and ascites do not result in a bluish tinge around the belly button

The nurse explains that a hernioplasty is a surgery that involves which process? A. Reducing the hernia by manual pressure B. Sewing synthetic mesh over the abdominal wall defect to reduce the hernia C. Applying an individualized truss for the reduction of the hernia D. Reducing the hernia and suturing the defect in the abdominal wall

Sewing synthetic mesh over the abdominal wall defect to reduce the hernia *Hernioplasty is a surgical intervention in which the hernia is reduced and a synthetic mesh is sewn over the defect in the wall to prevent reoccurrence

In caring for a patient with hepatitis B, a nurse would employ which precautions? A. Standard Precautions B. Strict isolation C. Contact Precautions D. Surgical asepsis

Standard Precautions *Standard Precautions are needed to care for a patient with hepatitis B. Isolation and contact precautions are not indicated for this diagnosis unless this patient is experiencing active bleeding. Surgical asepsis is not required

Which type of hernia can lead to necrosis? A. Strangulated hernia B. Indirect hernia C. Direct hernia D. Irreducible hernia

Strangulated hernia *The incarcerated hernia may become strangulated, which cuts off the blood supply and can lead to necrosis of the trapped bowel loop. Hernias are classified as reducible, which means the protruding organ can be returned to its roper place by pressing on the organ, and irreducible, which means that the protruding part of the organ is tightly wedged outside the cavity and cannot be pushed back through the opening. Another name for irreducible hernia is incarcerated hernia. An indirect hernia protrudes through the inguinal ring. A direct hernia protrudes through the posterior inguinal wall

A health care provider has ordered a Venereal Disease Research Laboratory (VDRL) test for a patient. Which condition do you recognize the provider is screening for? A. HIV B. HPV C. Syphilis D. Gonorrhea

Syphilis *A VDRL test measures antibodies to syphilis. (1, 2, 4) A VDRL does not test for these infections.

In counseling a man with erectile dysfunction about a prescription for sildenafil (Viagra), when should the nurse suggest a different treatment? A. The patient is over 50 years of age B. The patient takes nitroglycerin for angina C. The patient is more than 50 pounds overweight D. The patient is a long-term diabetic

The patient takes nitroglycerin for angina *Viagra is contraindicated if the patient is also taking nitrates because the combination can cause significant hypotension. Age, weight, and diabetes are not contraindications for the use of Viagra

During examination of the fundus of the eye, the nurse assesses a choked disc. Which statement accurately explains the significant of this finding?

There is increased intracranial pressure (ICP)

During examination of the fundus of the eye, the nurse assesses a choked disc. Which statement accurately explains the significant of this finding?

There is increased intracranial pressure (ICP).

The nurse is caring for a burn patient. Which action best prevents contractures? a. Assist the patient with ambulation as soon as fluid shifts stabilize. b. Medicate the patient approximately 30 minutes prior to dressing changes. c. Ensure adequate hydration. d. Ensure adequate nutritional intake.

a. Assist the patient with ambulation as soon as fluid shifts stabilize.

Which type of medication would be used to dilate the pupils before an eye examination? a. Osmotics b. Adrenergic agent c. Beta-adrenergic agent d. Corticosteroid

b. Adrenergic agent Adrenergic agents are sympathomimetic. They cause pupil dilation, increased outflow of aqueous humor, vasoconstriction, relaxation of ciliary muscle, and a decrease in the formation of aqueous humor. Adrenergic agents are used to lower intraocular pressure (IOP) in open-angle glaucoma, relieve congestion and hyperemia, and produce mydriasis for ocular examinations. Osmotics are given to reduce IOP. Beta adrenergics are given for the treatment of asthma. Corticosteroids are given for acute allergic reactions in the eye.

The nurse is preparing a patient for an ophthalmic examination. Which action occurs when the nurse instills eyedrops to produce mydriasis? a. Drying of tears in the eyes b. Extreme dilation of the pupil c. Opening of the canal of Schlemm d. Paralysis of the ciliary muscle

b. Extreme dilation of the pupil Dilating the eye before eye examinations allows for better visualization of the interior of the globe. Anticholinergic drugs may produce drying of tears in the eye as an adverse effect of use. Obstruction of the canal of Schlemm results in glaucoma. Paralysis of the ciliary muscle is cycloplegia.

The nurse is caring for a patient taking long-term estrogen replacement for osteoporosis prevention. The nurse recommends that the patient undergo which type of examination annually?

bone density study

The nurse is providing fluid resuscitation for a burn victim according to the Parklandformula. The nurse determines that the patient requires 8000 mL in a 24-hour time period. The burnoccurred at noon, and the present time is 1400. How many milliliters of fluid should infuse by2000? a. 2000 mL b. 3000 mL c. 4000 mL d. 7000 mL

c. 4000 mL

Which interventions are appropriate for a burn patient newly admitted to theemergency department? (select all that apply.) a. Cover burns with sterile saline-saturated towels. b. Carefully remove clothing adhered to burned areas. c. Carefully avoid disturbing blisters. d. Remove jewelry from injured limbs .e. Determine the causative agent of the burn.

c. Carefully avoid disturbing blisters. d. Remove jewelry from injured limbs .e. Determine the causative agent of the burn.

The nurse has completed the assessment on a newly admitted patient. Which finding(s) is/are risk factor(s) in the development of cataracts?

cigarette smoking long term steroid use

The nurse is caring for a patient with a history of a chronic incarcerated hernia. The patient suddenly complains of abdominal pain and vomits dark material with a fecal odor. The nurse recognizes these signs as indications of which complication? A. complete intestinal obstruction B. rupture C. gastroenteritis D. duodenal ulcer

complete intestinal obstruction *The symptoms of intestinal obstruction vary according to the location of the obstruction. Fecal odor or material in the emesis suggest a complete intestinal obstruction. In this case, the incarcerated hernia has blocked the flow of bowel content. If there is a defect his protrusion is called a hernia or a rupture. Gastroenteritis is inflammation of the stomach and intestines. A duodenal ulcer occurs in the small intestine (the duodenum)

Which component in the eye refracts light rays to be directed to the lens?

cornea

Which symptom is consistent with an inhalation burn? a. Full-thickness burns to chest b. Hypotension c. Agitation d. Persistent coughing

d. Persistent coughing

Accommodation is accomplished through the interaction of the ciliary bodies and the

lens