N112 M2 Canvas quiz questions

A patient with chronic heart failure is treated with hydrochlorothiazide (hctz), dogoxin, and lisinopril. To prevent the risk of digitalis toxicity with these drugs, it is most important that the nurse monitor the patient's ________________. a. Heart rate b. blood pressure c. potassium levels d. gastrointestinal function

"Hypokalemia is one of the most common causes of digitalis toxicity because low serum potassium levels enhance ectopic pacemaker activity. When a patient is receiving potassium loosing diuretics, such as htcz and furosemide, it is essential to monitor the patient's serum potassium levels to prevent digitalis toxicity."

The Nurse is reviewing labs of a patient admitted with a history of hypertension. Which of following labs are significant for complications of hypertension? a. Blood urea nitrogen (BUN) of 48mg/dL and creatinine of 4.3 mg/dL b. Serum K of 3.4 mEq/L c. Fasting blood glucose of 163 mg/dL d. Serum Lactic acid of 3.2 mg/dL

a. Blood urea nitrogen (BUN) of 48mg/dL and creatinine of 4.3 mg/dL "Elevated BUN and creatinine may indicate destruction of glomeruli and tubules of the kidney resulting from hypertension."

Identify the correct stage of general anesthesia: a. Induction : stage I b. Emergence : Stage II c. Maintenance: Stage III d. Deepening: Stage IV

a. Induction : stage I

A patient with a respiratory infection is described as having a "shift to the left." Which of the following is then also true? a. Lots of immature neutrophils are in the blood. b. The complement cascade is malfunctioning. c. The infecting organism is "colonized." d. Signs of infection were not present until weeks after the infection actually began

a. Lots of immature neutrophils are in the blood.

The outcome of improper intraoperative surgical positioning is: a. Nerve damage b. Hypothermia c. Hemorrhage d. Increased joint flexibility

a. Nerve damage

The patient with primary hypertension is likely to report: a. No symptoms b. cardiac palpitations c. dyspnea on exertion d. dizziness and vertigo

a. No symptoms "Hypertension is often asymptomatic, especially if it is mild or moderate, and has been called the "silent killer." The absence of symptoms often leads to non compliance with medical treatment and a lack of concern about the disease in patients. With severe hypertension, symptons usually occur and may include a morning occipital headache, fatigatility, dizziness, palpitations, angina and dyspnea."

The patient has a total WBC of 18,000 cells/ml. There are 50% mature polymorphonuclear cells, many band cells and 15% lymphocytes. Your analysis is: a. The patient likely has a new bacterial infection b. The patient likely has a chronic viral infection c. The patient likely has an allergy d. The findings are normal

a. The patient likely has a new bacterial infection

The urine you are emptying from the urinal is cloudy. What is the significance? a. The patient may have a urinary tract infection. b. The patient may be fluid overloaded. c. The patient may be on a high protein, low carbohydrate diet. d. The specimen is probably fresh.

a. The patient may have a urinary tract infection.

Working on a medical-surgical unit one evening, you get a call that you are to admit a patient from the emergency room with a diagnosis of "neutropenia". What is the most important thing you can do when admitting this patient to your unit? a. Wash your hands. b. Get 2 or more large bore IVs started. c. Get pain medicine orders from the MD. d. Get hypoallergenic sheets on the bed.

a. Wash your hands.

A physical assessment finding that the nurse would expect to be present in the patient with acute left sided heart failure is: a. crackles in lungs and tachycardia b. hepatosplenomegaly and tachypnea c. peripheral edema and cool, diaphoretic skin d. jugular distention and distant heart tones

a. crackles in lungs and tachycardia "clinical manifestations of acute left sided heart failure are those of pulmonary edema, with crackles and tachycardia; frothy, blood tinged sputum; severe dyspnea; tachypnea; and orthopnea. Severe tachycardia and cool, clammy skin are present as a result of stimulation of the sympathetic nervous system from hypoxemia. Systemic edema reflected by jugular vein distension, peripheral edema, and hepatosplenomegaly are characteristic of right sided heart failure. Distant heart tones occur in patients with barrel chest from chronic bronchitis"

The patient has "Alteration in skin integrity (cellulitis) related to infection." A good expected outcome for this problem would be: a. no redness, warmth, swelling, patient denies pain. b. temperature greater than 37 degrees celsius, normal blood mast cell level. c. elevate affected area at all times. d. administer antimicrobials as ordered.

a. no redness, warmth, swelling, patient denies pain.

A patient who has just return to the PACU from the OR after a cholecystectomy is difficult to arouse, has loud snoring respirations, and a decreasing oxygen saturation. The appropriate intervention for the nurse would be: a. To increase the amount of oxygen the patient is receiving from 2 liters to 4 liters via nasal cannula b. Insertion of an oral pharyngeal airway c. Reposition the patient's head using a head tilt and chin lift technique for a minute. d. No intervention necessary, snoring respirations are expected after general anesthesia

b. Insertion of an oral pharyngeal airway

The patient is scheduled for a mediastinoscopy. This means: a. An opening will be created into the mediastinum. b. The area around the heart will be viewed through a camera on a scope. c. The surgical area will be heard, visualized and smelled thru use of noninvasive technology. d. The surgery will be conducted using a midline incision.

b. The area around the heart will be viewed through a camera on a scope.

The patient with VTE is receiving therapy with heparin and asks the nurse whether the drug will dissolve the clot in her leg. The best response by the nurse is: a. This drug will break up and dissolve the clot so that circulation in the vein can be restored b. The purpose of the heparin is to prevent growth of the clot or formation of new clots where the circulation is slowed c. Heparin won't dissolve the clot, but it will inhibit the inflammation around the clot and delay the development of new clots d. The heparin will dilate the vein, preventing turbulence of blood flow around the clot that may cause it to break off and travel to the lungs

b. The purpose of the heparin is to prevent growth of the clot or formation of new clots where the circulation is slowed "Anticoagulant therapy with heparin or warfarin does not dissolve clots but prevents propagation of the clot, development of new thrombi, and embolization; lysis of the clot occurs through the action of the body's intrinsic fibrinolytic system or by the administration of fibrinolytic agents."

Most organ damage that occurs from hypertension is related to: a. increased fluid pressure exerted against organ tissue b. artherosclerotic changes in vessels that supply the organs c. erosion and thinning of blood vessels from constant pressure d. increased hydrostatic pressure causing leakage of plasma into organ interstitial spaces

b. artherosclerotic changes in vessels that supply the organs "Elevated BP causes the entire inner lining of arterioles to become thickened from hyperplasia of connective tissues in the intima and affects coronary ciruclation, cerebral circulation, peripheral vessels, and renal and retinal blood vessels. The narrowed vessels lead to ischemia and, ultimately, to damage of these organs."

The most important measure in the treatment of venous stasis ulcers is: a. elevation of the limb b. extrinsic compression c. application of moist dressings d. application of topical antibiotics

b. extrinsic compression "Although leg elevation, moist dressings and topical antibiotics are useful in treatment of venous stasis ulcers, the most important factor appears to be extrinsic compression to minimize venous stasis, venous hypertension, and edema. Extrinsic compression methods include compression gradient stockings, elastic bandages and Unna's boot."

The pathophysiologic mechanism that results in the pulmonary edema of left sided heart failure is: a. increased right ventricular preload b. increased pulmonary hydrostatic pressure c. impaired alveolar oxygen and carbon dioxide exchange d. increased lymphatic flow of pulmonary extravascular fluid

b. increased pulmonary hydrostatic pressure "In left sided heart failure, blood backs up into the pulmonary veins and capillaries. This increased hydrostatic pressure in the vessels causes fluid to move out of the vessels and into the pulmonary interstitial space. When increased lymphatic flow cannot remove enough fluid from the interstitial space, fluid moves into the alveoli resulting in pulmonary edema and impaired alveolar oxygen and carbon dioxide exchange. Initially, the right side of the heart is not involved."

Lymph nodes are where: a. IgA is secreted. b. normal flora has a protective function. c. B lymphocytes proliferate. d. red blood cells are made.

c. B lymphocytes proliferate.

Removal of the spleen after a traumatic abdominal injury puts the patient at risk for: a. Cancer b. Allergies c. Bacterial bloodstream infections d. Granulomatous reaction

c. Bacterial bloodstream infections

The patient is a 82 year old who fractured her hip. She is scheduled for surgery. Pre-op labs include: WBC 10k, Hct 37, INR 3, Na 134, K 4.2. Your clinical reaction to these labs is: a. In good enough shape for surgery. b. Will have trouble with O2 delivery. May need pre-op transfusion. c. Could have clotting trouble intra- and post-op. d. Sodium is a little low but not too bad, should correct as K is replaced.

c. Could have clotting trouble intra- and post-op.

The patient's care plan states the following nursing diagnosis: Infection related to incision contamination as evidenced by redness, swelling, and increased skin temperature at incision margins. Given this nursing diagnosis, which one of the following is the best expected outcome? a. Further infection will be prevented by vigilant handwashing and the use of aseptic technique. b. Infection will not spread to surrounding tissues c. No evidence of redness, swelling. Return of skin temperature to normal d. Incision dry and intact

c. No evidence of redness, swelling. Return of skin temperature to normal

After the client has undergone surgery with a spinal anesthetic, a post operative spinal headache occurs. Which intervention is the appropriate one for the nurse to implement? a. Decrease client hydration b. Raise the head of the bed 45 degrees c. Prepare the client for a blood patch procedure d. Restrict all caffeine products

c. Prepare the client for a blood patch procedure

Informed consent does NOT need to include: a. description and purpose of the proposed procedure b. alternative treatments or procedures available c. date, time and location of the proposed surgical procedure d. right to refuse treatment or withdraw consent

c. date, time and location of the proposed surgical procedure

Which is not a common assessment finding of a client who is experiencing symptoms of a pulmonary embolism? a. anxiety b. decreased oxygen saturation c. decrease in respiratory rate d. cough

c. decrease in respiratory rate

All of the following are associated with the inpatient surgical experience EXCEPT: a. loss of control b. unfamiliar environment c. more social support d. risk of nosocomial infection

c. more social support

The benefits of outpatient surgery to the patient include all of the following except: a. more control. b. convalescence at home. c. prolonged exposure to nosocomial infection d. lessened exposure time to the hospital environment.

c. prolonged exposure to nosocomial infection

Patient teaching regarding dietary sources of potassium is indicated for the hypertension patient taking ____________ because this medication can cause hyperkalemia. a. Enalapril (Vasotec) b. labetalol (Normodyne) c. spironolactone (Aldactone) d. hydrochlorothiazide (HydroDiuril)

c. spironolactone (Aldactone) "Spironolactone may cause hyperkalemia by inhibiting the action of aldosterone and retaining potassium."

Your patient is to receive mycostatin to swish around in the mouth and then to swallow. Which nursing diagnosis would you most likely have on the care plan? a. Impaired skin integrity (oral mucosa) related to latex allergy b. Pain: (oral mucosa) related to inflammation of mucosa c. Oral mucous membrane, (altered) related to malnutrition d. Infection (fungal overgrowth) related to use of broad spectrum antibioitcs

d. Infection (fungal overgrowth) related to use of broad spectrum antibioitcs

A nurse uses the complete blood count (CBC) with differential to assess the patient's oxygenation and baseline immune status. All of the following are components of the CBC with differential except: a. red blood cell count b. hematocrit c. white blood cell count d. bleeding time

d. bleeding time

To help prevent embolization of the thrombus in a patient with a VTE, the nurse teaches the patient to: a. dangle the feet over the edge of the bed q 2 - 3 hours b. ambulate for short periods three to four times a day c. keep the affected leg elevated above the level of the heart d. maintain bed rest until edema is relieved and anticoagulation is established

d. maintain bed rest until edema is relieved and anticoagulation is established "Prevention of emboli formation can be achieved by bedrest and limiting movement of the involved extremity until the clot is stable, inflammation has receded, and anticoagulation is achieved. Elevating the affected limb will promote venous return, but it does not prevent embolization, and dangling the legs promotes venous stasis and further clot formation."