PN review
Which nursing task would be appropriate for the LPN/VN to complete? 1) Obtain a wound culture 2) Administer regular IV insulin to a pt w DKA 3)Update plan of care on patient 4) Initiate client teaching on ostomy care
1) Obtain a wound culture
Which nursing intervention should receive priority after a client has returned from having had eye surgery? 1) keeping patient bed in 35 degrees 2) administer pain medication around the clock 3) alternate between applying heat and cold compress 4) instruct on importance of turn, cough and deep breathing
1) keeping patient bed in 35 degrees
What does the LPN know about the administration of Prenisolone?
1) treats Addison's 2) given 2x a day. Client willl take 2/3 of dose in the morning and 1/3 dose in the aftnernoon. 3) fludrocortisone = aldosterone 4) daily weights and BP must be monitored 5) do not quite taking abruptly ******addisonian crisis = severe hypotension and vascular collapse
Low fiber Avoid cold foods, hot foods, smoking
Dietary considerations for UC and Crohn's disease?
decreased protein decreased sodium increased carbs
Dietary needs for pt with glomerulonephritis?
iodine and shellfish allergies *******palpitations are normal
what must the LPN ask the patient who is going for a cardiac catheterization?
Which task would be appropriate for the nurse to assign to an unlicensed assistive personnel (UAP)? 1. Totaling I & O records on five clients at the end of the shift. 2. Assessing VS on a client who was admitted 30 minutes ago. 3. Administering nasogastric (NG) tube feeding. 4. Changing an abdominal surgical dressing on a client that is 3 days post op.
1. Totaling I & O records on five clients at the end of the shift.
1. C1ient states "I will need to check my BUN and creatinine levels for an increase indicating nephrotoxity 2. Ototoxicity may occur
What statements indicate that the client understands patient teaching regarding mycin drugs?
Which comment by the client indicates understanding of possible complications of long term hypertension? 1. "I would like to have my serum creatinine checked at this visit." 2. "My blurred vision is part of getting older." 3. "I have leg pain caused by excessive exercise." 4. "Adding salt to my food is permissible."
1. "I would like to have my serum creatinine checked at this visit." R : Hypertension is one of the leading causes of end stage renal disease. The client understands that renal function is reflected by serum creatinine levels. This request demonstrates understanding of the disease and possible complications.
What discharge instructions should the nurse reinforce to the client post abdominal hysterectomy? 1. Ambulate at least 3-4 times per day. 2. Notify the primary healthcare provider of a yellow discharge from the surgical wound. 3. Swimming is allowed if staples were used to close the skin. 4. Press a pillow over incision when coughing to ease discomfort. 5. Apply moist heat to surgical site the first couple of days for pain relief.
1. Ambulate at least 3-4 times per day. 2. Notify the primary healthcare provider of a yellow discharge from the surgical wound. 4. Press a pillow over incision when coughing to ease discomfort.
Sit with client at meals and observe for 1 hour after eating allow 30 min for meals take focus away from the food self-esteem building is important
What treatments are common for patients with bulimia nervosa?
The nurse determines that a client does not have an advance directive. The daughter is designated to make healthcare decisions in the event that the client becomes incapacitated or unable to make informed decisions. Which nursing actions are appropriate for this client? 1. Document the client's statement in the client's own words. 2. Provide information on advance directives to the client. 3. Provide personnel for assistance with completing an advance directive. 4. Encourage client to complete advance directive as soon as possible. 5. Determine if the client's daughter agrees with the client's decision.
1. Document the client's statement in the client's own words. 2. Provide information on advance directives to the client. 3. Provide personnel for assistance with completing an advance directive.
A home care nurse is visiting a client who delivered her first baby one week ago. What behavior by the client would indicate to the nurse that maternal-infant bonding is occurring? 1. Holds baby face to face 2. Talks about the baby's features 3. Touches baby frequently 4. Talks to baby 5. Allows baby to cry vigorously for 15 minutes
1. Holds baby face to face 2. Talks about the baby's features 3. Touches baby frequently 4. Talks to baby
What potential contributing factors for stress urinary incontinence should a nurse collect data for in an elderly female client? 1. Lack of estrogen 2. Rising abdominal pressure 3. Multiparous vaginal births 4. Spinal cord injury 5. Dementia
1. Lack of estrogen 2. Rising abdominal pressure 3. Multiparous vaginal births
A nurse who has never had varicella has been exposed to a client diagnosed with herpes zoster. What actions should the nurse take? 1. Notify the infection control nurse. 2. Continue to care for client as varicella and herpes zoster are not related. 3. Go to the lab to have a Tzanck smear performed. 4. Obtain herpes zoster vaccine for protection from this exposure. 5. Receive the varicella-zoster immune globulin within 96 hours of exposure.
1. Notify the infection control nurse. 5. Receive the varicella-zoster immune globulin within 96 hours of exposure.
The nurse, caring for a client diagnosed with Alzheimer's disease (AD), notices the client becoming agitated. What nursing intervention would be appropriate for the nurse to initiate? 1. Provide a snack for the client. 2. Tell the client to stop the unwanted behavior. 3. Take client for a walk. 4. Ask the client to sweep the floor. 5. Inform the client that restraints will be used if behavior continues. 6. Turn on the client's favorite music.
1. Provide a snack for the client. 3. Take client for a walk. 4. Ask the client to sweep the floor. 6. Turn on the client's favorite music.
A primipara at 36 weeks gestation is seen in the OB/GYN clinic. Which sign/symptom should the nurse immediately report to the primary healthcare provider? 1. Puffy hands and face 2. Reports indigestion 3. Pedal edema 4. Backache 5. Severe headaches rated 9/10
1. Puffy hands and face 5. Severe headaches rated 9/10
The nurse is caring for a client taking a selective serotonin reuptake inhibitor (SSRI). The client tells the nurse "I am sweating more than ever!" What is the nurse's best response? 1. This is a common side effect of antidepressant medications. 2. Excessive sweating can have many causes. 3. You should report this side effect to your primary healthcare provider. 4. This symptom should go away within a few days.
1. This is a common side effect of antidepressant medications.
What should the nurse document after a client has died? 1. Time of death 2. Who pronounced the death 3. Disposition of personal articles 4. Destination of body 5. Primary healthcare provider's prescriptions 6. Time body left facility
1. Time of death 2. Who pronounced the death 3. Disposition of personal articles 4. Destination of body 6. Time body left facility
What does the LPN expect to administer pre-procedure prior to ECT treatment?
succinylcholine (Anectine) - relax muscles NPO atropine *****have patient void post-procedure place patient in left lateral position
The nurse is preparing to administer iron dextran IM. Which injection site would be best for administration? 1. Ventrogluteal 2. Vastus lateralis 3. Rectus Femoris 4. Deltoid
1. Ventrogluteal
Which interventions are appropriate for the nurse to identify for a client admitted to the psychiatric unit for management of anorexia nervosa? 1. Weigh daily at the same time each day. 2. Allow only 20 minutes of exercise daily. 3. Allow the client to bargain for privileges as long as the client eats. 4. Stay with the client during the established time for meals. 5. Maintain visual observation for 1 hour following meals.
1. Weigh daily at the same time each day. 4. Stay with the client during the established time for meals. 5. Maintain visual observation for 1 hour following meals.
What nursing interventions should the nurse implement for a client with Addison's disease? 1. Administer potassium supplements as prescribed. 2. Assist the client to select foods high in sodium. 3. Administer Fludrocortisone as prescribed. 4. Monitor intake and output. 5. Record daily weight.
2. Assist the client to select foods high in sodium. 3. Administer Fludrocortisone as prescribed. 4. Monitor intake and output. 5. Record daily weight.
sore throat flank pain increased BP facial edema dec urinary output
what are signs and symptoms of glomerulonephritis?
The nurse is caring for a client with decreased cardiac output secondary to heart failure with fluid volume overload. Which signs/symptoms are an indication to the nurse that treatment has not been effective? 1. Diuresis 2. Dyspnea on exertion 3. Persistent cough 4. Warm, dry skin 5. Heart rate irregular at 118/min 6. Alert and oriented
2. Dyspnea on exertion 3. Persistent cough 5. Heart rate irregular at 118/min
A LPN/VN is caring for a client who reports a pain level of 8 on a numeric scale of 1-10. The LPN/VN reports the client's pain level to the RN and administers pain medication as prescribed. Which actions should a nurse take to advocate for this client? 1. Notify the primary healthcare provider. 2. Ensure that bed side rails are raised and locked. 3. Administer naloxone within 30 minutes. 4. Advise the client to call for assistance before getting out of bed. 5. Monitor the client's pain level after administering medication.
2. Ensure that bed side rails are raised and locked. 4. Advise the client to call for assistance before getting out of bed. 5. Monitor the client's pain level after administering medication.
Which electrolyte imbalance would be the nurse's priority concern in the burn client? 1. Hypernatremia 2. Hyperkalemia 3. Hypoalbuminemia 4. Hypermagnesemia
2. Hyperkalemia When the cells lyse, they release potassium, and then the serum potassium goes up. And if the kidneys stop functioning, we are in real trouble.
What symptoms would the nurse anticipate in a client with a calcium level of 3.2 mg/dL (0.80 mmol/L)? You answered this question Incorrectly 1. Slowed deep tendon reflexes 2. Muscle rigidity and cramping 3. Hypoactive bowel sounds 4. Positive Chvostek's sign 5. Seizures 6. Laryngospasms
2. Muscle rigidity and cramping 4. Positive Chvostek's sign 5. Seizures 6. Laryngospasms Normal serum calcium is 8.7 - 10.3 mg/dL (2.18 - 2.58 mmol/L). The client with a calcium level of 3.2 mg/dL (0.80 mmol/L) is hypocalcemic. With hypocalcemia, the muscle tone is rigid and tight. Therefore, the client may report muscle cramping. A hallmark sign of hypocalcemia is a positive Chvostek's sign, which is a twitching of facial muscles following tapping in the area of the cheekbone that is indicative of hyperirritability. The client may be at risk of having seizures due to the neuromuscular irritability. Prolonged contraction of the respiratory and laryngeal muscles causes laryngospasm and stridor and may result in cyanosis.
A client is diagnosed with seizures. Which nursing interventions should the nurse implement? 1. Have an unlicensed assistive personnel stay with the client. 2. Pad the side rails with blankets. 3. Place the bed in low position. 4. Keep a padded tongue blade at the bedside. 5. Instruct client to call for help to ambulate.
2. Pad the side rails with blankets. 3. Place the bed in low position. 5. Instruct client to call for help to ambulate.
A client is hospitalized for chronic renal failure. The nurse will need to notify the primary healthcare provider concerning which findings? 1. Sodium 135 mEq/L (135 mmol/L) 2. Potassium 5.8 mEq/L (5.8 mmol/L) 3. BP 100/70 4. No weight loss 5. Calcium 8.0 mg/dL (2 mmol/L)
2. Potassium 5.8 mEq/L (5.8 mmol/L) 5. Calcium 8.0 mg/dL (2 mmol/L)
When reinforcing teaching, what symptom would the nurse include as being the most common initial visual change associated with glaucoma? 1. Central vision is lost. 2. Progressive tunnel vision occurs. 3. Sudden flashes of light in the eyes. 4. Eye floaters begin to be noticed.
2. Progressive tunnel vision occurs.
A client, who is having difficulty falling asleep, asks the nurse for a sleeping aid. What is the first action the nurse should provide to the client? 1. Assist client to take a cool bath. 2. Provide a back massage. 3. Administer prescribed triazolam. 4. Give client a crossword puzzle to work.
2. Provide a back massage.
A nurse is caring for a Mexican-American client post stroke. While in the client's room, a curandero visits at the request of client. What is the best action of the nurse? 1. Leave, and return once the curandero has left. 2. Reinforce client care with the client and curandero. 3. Ask the curandero to leave so that the client can be observed. 4. Explain to the client that the curandero is not a reliable healthcare option.
2. Reinforce client care with the client and curandero.
The nurse is reinforcing teaching to a client who has been prescribed fluticasone/salmeterol. What points are important for the client to understand? 1. Swallow the capsule when having an acute asthma episode. 2. Rinse mouth after medication administration to decrease infection. 3. Take this medication every day, even on days when breathing fine. 4. Administer by inhalation device twice daily. 5. Carry a rescue inhaler, such as albuterol, when leaving home.
2. Rinse mouth after medication administration to decrease infection. 3. Take this medication every day, even on days when breathing fine. 4. Administer by inhalation device twice daily. 5. Carry a rescue inhaler, such as albuterol, when leaving home.
Which assignments would be most appropriate for the LPN/VN to accept from the RN? You answered this question Incorrectly 1. Six year old with new onset diabetes. 2. Ten year old with pneumonia admitted two days ago. 3. Three month old admitted with severe dehydration. 4. Four year old admitted for developmental studies. 5. Twelve year old with post op wound infection taking oral antibiotics.
2. Ten year old with pneumonia admitted two days ago. 4. Four year old admitted for developmental studies. 5. Twelve year old with post op wound infection taking oral antibiotics.
What should the nurse include when reinforcing teaching to a female client prescribed doxycycline for the treatment of acne? 1. Take this medication with food to maximize absorption. 2. Use a non-hormone method of birth control while taking this medication. 3. Wear protective clothing when outside. 4. Drink plenty of fluids while taking this medication. 5. Iron and calcium supplements can be taken with this medication.
2. Use a non-hormone method of birth control while taking this medication. 3. Wear protective clothing when outside. 4. Drink plenty of fluids while taking this medication.
Nurse is monitoring the lab values of a client on a long term steroid therpay. Which values would the nurse expect to be altered in the urine? 1. protein 2. glucose 3. ketones 4 RBC 5 uric acid
2. glucose 3. ketones
The nurse is caring for a client who has taken an acetaminophen overdose. Which symptom is the client most likely to exhibit? 1) pink, frothy sputum 2) Sudden onset of chest pain 3) Jaundiced conjunctiva 4) diaphoresis and fever
3) Jaundiced conjunctiva
What expected finding would the LPN observe in a client recently diagnosed with DM I? 1) hypoglycemia 2) DKA 3) weight loss 4) dehydration
3) weight loss
The nurse is caring for a client taking spironolactone. Which needed dietary change should the nurse reinforce to the client? 1. Eat extra helpings of bananas. 2. Increase intake of water. 3. Avoid salt substitutes. 4. Increase intake of green leafy vegetables.
3. Avoid salt substitutes. Spironolactone is a potassium sparing diuretic. Salt substitutes have potassium instead of sodium and should be avoided.
A busy LPN instructs an unlicensed assistive personnel (UAP) to obtain daily weights on a client. The LPN provides initial direction for the task, monitors that the task is successfully completed, reviews the results of the daily weight, and reports the results to the RN. Which action has the LPN taken? 1. Failed to supervise the actions of the UAP. 2. Improperly assigned a client care task. 3. Appropriately assigned a client care task. 4. Supervised the performance of a client care task. 5. Functioned outside of the LPN scope of practice.
3. Appropriately assigned a client care task. 4. Supervised the performance of a client care task.
A client with a history of congestive heart failure has an implantable cardioverter defibrillator (ICD) surgically implanted. What teaching points should the nurse reinforce with the client prior to discharge? 1. Avoid hot baths and showers. 2. Increase intake of leafy green vegetable products. 3. Avoid magnets directly over the site. 4. Notify primary healthcare provider whenever a shock is delivered by the ICD. 5. Driving is not recommended for 1 year after placement of an ICD.
3. Avoid magnets directly over the site. 4. Notify primary healthcare provider whenever a shock is delivered by the ICD.
What important principle should the nurse reinforce with the client performing intermittent self-catheterization? You answered this question Incorrectly 1. Inserted in an emergency department. 2. Used to treat urinary catheter infections. 3. Is a clean procedure. 4. Requires use of sterile gloves.
3. Is a clean procedure.
The nurse prepares a sterile field for a procedure. Fifteen minutes later, the nurse is informed that there will be a 20 minute delay before the primary healthcare provider will arrive. What action should the nurse take? 1. Cover the sterile field with a sterile drape 2. Close and tape the doors so that no one may enter. 3. Monitor the sterile field while awaiting the primary healthcare provider. 4. Take down the sterile field.
3. Monitor the sterile field while awaiting the primary healthcare provider.
A licensed practical nurse (LPN) is utilizing the nursing process to care for assigned clients. Which nursing actions should the LPN relate to the implementation step of the nursing process? 1. Collecting client data for a nursing history. 2. Reporting client response to a new medication. 3. Procuring equipment for a planned medical procedure. 4. Assigning client care activities to unlicensed assistive personnel. 5. Delivering skilled nursing care according to an established health care plan.
3. Procuring equipment for a planned medical procedure. 4. Assigning client care activities to unlicensed assistive personnel. 5. Delivering skilled nursing care according to an established health care plan.
Which task would be appropriate for the LPN/VN to accept from the Labor, Delivery, Recovery, Postpartum (LDRP) charge nurse? 1. Administer IV pain medication to a client three days postopertive cesarean section. 2. Draw a trough vancomycin level on a client 3 days postpartum with bilateral mastitis. 3. Reinforce how to perform perineal care to a primipara who is four hours postpartum. 4. Draw admission labs on a client admitted in final stages of labor.
3. Reinforce how to perform perineal care to a primipara who is four hours postpartum.
Which task would be most appropriate for the nurse to assign to an unlicensed assistive personnel (UAP)? 1. Obtain a sterile urine specimen from an indwelling catheter. 2. Insert an in-and-out catheter on a postpartum client. 3. Take vital signs on a client 12 hours postpartum. 4. Remove an indwelling catheter on a postpartum client. 5. Perform perineal care on a client with an episiotomy.
3. Take vital signs on a client 12 hours postpartum. 5. Perform perineal care on a client with an episiotomy.
After shift report, which client should the nurse see first? You answered this question Incorrectly 1. Eight year old that is in skeletal traction. 2. Six year old who is 5 hours postop appendectomy. 3. Unattended two year old admitted for a sleep study. 4. Four year old cerebral palsy child with a urinary tract infection (UTI).
3. Unattended two year old admitted for a sleep study.
A client diagnosed with arachnophobia is prescribed alprazolam 0.5 mg orally three times daily. The nurse knows that reinforcement of teaching about this medication is successful when the client makes what statement? 1) Alprazolam will take up to two weeks to start working 2) ALprazolam will not cause drowsiness so I will not have to worry about driving 3) This medication cannot be taken with food 4) I will not stop taking this medication abruptly
4) I will not stop taking this medication abruptly
The primary healthcare provider prescribes glycopyrrolate 0.2 mg IM thirty minutes prior to electroconvulsive therapy (ECT). What should be the nurse's response when the client asks why this drug is being given? 1. "The action of the medication is complex." 2. "This drug will prevent you from having a seizure." 3. "This medication will relax your muscles so that you do not break a bone." 4. "Glycopyrrolate will decrease stomach secretions."
4. "Glycopyrrolate will decrease stomach secretions." Glycopyrrolate is an anticholinergic. Glycopyrrolate blocks the activity of acetylcholine which reduces secretions in the mouth, throat, airway, and stomach. It is used prior to procedures to decrease the risk of aspiration
The client states, "I really do not want to have surgery. I have told my children this, but they still want me to go through with the surgery. I do not know what to do." What is the best response for the nurse as client advocate? 1. "Your children are concerned about you. The surgery is the best thing for your health." 2. "You have some genuine concerns about the surgery, and you feel as if your children are not addressing your concerns. You and your family will need to resolve this before you go to surgery." 3. "I can contact your primary healthcare provider so that you can discuss your concerns regarding surgery." 4. "You have some genuine concerns about the surgery, and you feel as if your children are not addressing your concerns. Tell me more about your concerns."
4. "You have some genuine concerns about the surgery, and you feel as if your children are not addressing your concerns. Tell me more about your concerns."
Which nursing intervention should the nurse include when caring for a client with Alzheimer's disease being admitted to a long term care facility? 1. Offer multiple environmental stimuli at the same time to provide distraction. 2. Encourage the client to participate in activities such as board games. 3. Restrain the client in a chair to prevent falls when sundowning occurs. 4. Involve the client in supervised walking as a routine.
4. Involve the client in supervised walking as a routine A regular routine and physical activity help clients with Alzheimer's disease maintain abilities for a longer period of time. Physical activities promote strength, agility, and balance. The client's walking should be supervised for client safety issues.
Which is a risk factor for developing breast cancer in women? 1. Menopause before the age of 50 2. Drinking one glass of wine daily 3. Multiparity 4. Menarche at age 10
4. Menarche at age 10 Early menarche, before age 12, is a known risk factor for breast cancer. The increased risk of breast cancer linked to a younger age at the first period is likely due, at least in part, to the amount of estrogen a woman is exposed to in her life. A higher lifetime exposure to estrogen is linked to an increase in breast cancer risk. The earlier a woman starts having periods, the longer her breast tissue is exposed to estrogens released during the menstrual cycle, and the greater her lifetime exposure to estrogen.
A client has an intestinal obstruction and a NG tube to low suction. Blood gases are ph 7.54, pCO2 40, HCO3 35. The client is weak, shaky, and reports tingling of the fingers. The nurse knows that this client is most likely in which acid base imbalance? 1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis
4. Metabolic alkalosis Metabolic alkalosis happens when there is a loss of acid or a gain in bicarbonate. Metabolic alkalosis occurs from gastric losses via vomiting, NG tubes to suction, or lavage, and potent diuretics. Signs and symptoms include n/v, sensorium changes, tremors, and convulsions. pH > 7.45, pCO2 normal between 35-45, HCO3 > 26.
Which foods should the nurse encourage a client to avoid when prescribed a diet limiting purine rich foods? You answered this question Incorrectly 1. Peanut butter 2. Potatoes 3. Apples 4. Venison 5. Scallops
4. Venison 5. Scallops
3. Apply ice packs to affected area every shift.
A client with a history of eczema has been admitted with cellulitis of the left forearm. Which admission order should the nurse question immediately? 1. Start IV of normal saline at 100 mL per hour. 2. Keep left arm elevated on pillow at all times. 3. Apply ice packs to affected area every shift. 4. Ibuprophen 800 mg po every 6 hours prn pain.
1. Monitor blood sugar around 0200
A client with type II diabetes reports normal blood glucose levels at bedtime and high blood glucose levels in the morning for the past week. What information would the nurse reinforce with the client? 1. Monitor blood sugar around 0200 2. Decrease bedtime snacking. 3. Decrease intermediate acting insulin. 4. Increase intermediate acting insulin.
FLUID REPLACEMENT = 24 hr loss + 500 cc
How is fluid replacement determined for glomerulonephritis?
Extreme fatigue N/V and diarrhea hypotension confusion vitiligo
Addison's disease signs and symptoms
1. Provide mouth care prior to feeding. 2. Flex head forward for eating. 4. Use crushed ice as a stimulant for swallowing. 5. Offer thickened liquids to drink.
After determining that a client diagnosed with a stroke has adequate swallowing ability, the nurse implements care to safely provide oral feedings to the client. What interventions should the nurse include in this client's care? 1. Provide mouth care prior to feeding. 2. Flex head forward for eating. 3. Have dietary puree foods. 4. Use crushed ice as a stimulant for swallowing. 5. Offer thickened liquids to drink. 6. Position client in semi fowler's position after feeding.
In what order, after initially washing hands, should the nurse change a dressing on an infected abdominal surgical wound that has a Penrose drain and a large amount of purulent drainage? Place in priority order from first to last.
Apply clean gloves. Remove soiled dressings. Discard soiled dressings and clean gloves in red bag. Don sterile gloves. Clean surgical wound with moistened sterile 4x4's. Clean around Penrose drain using a circular pattern inside to outside. Place dry, sterile 4x4's over surgical wound and Penrose drain. Apply abdominal dressing pad.
What is the priority after an escharotomy?
Check the circulation ***escharotomy relieves the pressure and restores circulation
1) mafenide acetate 2) silver nitrate 3) povidine-iodine (Betadine)
Common drugs associated with burns
pinpoint pupils respiratory depression coma
Common signs of opiate intoxication?
1) bleeding is a major post-procedure complication 2) report pain ASAP 3) keep extremity straight for 4 - 6 hrs
Name a few nursing considerations for post-procedure cardiac catheterization.
1) magnesium carbonate 2) pantoprazole 3) famotidine
Drugs given to prevent a stress ulcer Curling ulcer (antacids, H2 antagonist, proton pump inhibitor)
4. The client with pancreatitis. 4. Correct: Standard precautions are observed with all clients admitted to the hospital, without the need for additional safeguards. The client with pancreatitis is not contagious and does not present any unique concerns other than the need for gloves and hand washing. 1. Incorrect: Chicken pox, also known as varicella zoster, requires airborne precautions. The virus can be spread through contact with the droplets, either touching or inhaling the droplet, while providing care for this client. 2. Incorrect: Measles, also called rubeola, is spread through droplet contact with the contaminated individual, including inhalation of the droplets. Airborne precautions are necessary when caring for a client diagnosed with rubeola. 3. Incorrect: Impetigo is a severe skin infection characterized by itchy, red, fluid-filled blisters caused by either staphylococcus or streptococcus bacteria. This skin infection is highly contagious, and requires contact precautions to protect staff and visitors.
Four clients are admitted to the medical-surgical unit. The nurse is aware that what client will need standard precautions only? 1. The client with chicken pox. 2. The client with rubeola. 3. The client with impetigo. 4. The client with pancreatitis.
Gastric ulcers - malnourished; pain is usually half hr to 1 hr after meals; food doesn't help, but vomiting does; vomit blood Duodenal ulcers - well-nourished, night time is common and also occurs 2-3 hrs after meals; food helps; blood in stool
Gastric vs duodenal ulcers
a) discontinue any iodine containing medication 1 wk prior to the thyroid scan and must wait 6 wks to restart medications. b) thyroid scan c) ultrasound/MRI/CT
How is the diagnosis of hyperthyroidism made? a) discontinue any iodine containing medication 1 wk prior to the thyroid scan and must wait 6 wks to restart medications. b) thyroid scan c) ultrasound/MRI/CT d) PET e) palpation
pain with eating ascites abdominal mass rigid board-like abdomen cullen's sign (bruising around umbilicus) Gray Turner's sign (bruising around flank) N/V jaundice hypotension
what are some signs and symptoms of pancreatitis?
What drug might be ordered to flush the kidneys on a burn patient?
Mannitol ******if output < 30mL/hr worry about kidney failure. after 48 hr pt will begin to diurese bc fluid goes back to the vascular space.
Amiodarone (Antiarrhythmic)
what drug controls rhythm of the heart?
Hemaglobin M 14 - 18 F 12 - 16 Hematocrit M 42 - 52 F 37 -47
Normal lab values for hematocrit and hemoglobin
diuretics (furosemide) nitrates (nitroglycerine)
what drugs cause vasodilation / diuresis to reduce preload?
alcohol
what is the nunmber one cause of acute adn chronic pancreatitis?
Insulin profiles - what are the onset, peak and duration for types of insulin?
RA 15m, 1 - 3 HR, 3 - 5 HR REG 30 M, 2- 4HR, 6- 8 HR NPH 1 1/2HR, 4 - 12HR, 16 - 24HR LA 2 - 4 HR, N/A, 24HR *****REG = standard insulin given IV RA can also be given IV
v - Fib
Serious rhythm associated with burns
not enough steroids hyperkalemia hypoglycemia shock
The LPN suspects these problems associated with adrenal cortex problems.......
3. Auscultate the lungs every 2 hours.
The nurse is caring for a burn client 48 hours after the burn occurred. What would be the nurse's priority action? 1. Measure the abdominal girth. 2. Administer pain medication. 3. Auscultate the lungs every 2 hours. 4. Inspect the burn for infection.
2. Vomiting 3. Tinnitus 4. Diaphoresis 5. Dehydration
The nurse is collecting data on a child who is admitted with salicylate overdose. What findings would indicate salicylate toxicity? 1. Hypoventilation 2. Vomiting 3. Tinnitus 4. Diaphoresis 5. Dehydration 6. Hypothermia
3 The three-point gait is appropriate for this patient because in a three-point gait, the patient bears all of the weight on the unaffected foot. In a two-point gait, partial weight is placed on each foot. In a four-point gait, weight is placed on both the legs. In a swing-through gait, weight is placed on the supported legs, which have weight-supporting braces.
The nurse is observing crutch walking of a client with a fractured lower leg with a non weight bearing cast. Which crutch gait would be most appropriate for the nurse to reinforce teaching? 1. Swing through 2. Two point 3. Three point 4. Four point alternating
1. Abdominal cramping 2. Lethargy 3. Salivation 5. Lacrimation 6. Miosis
The nurse suspects a client admitted with myasthenia gravis is going into a cholinergic crisis. Which signs and symptoms would validate the nurse's suspicions? 1. Abdominal cramping 2. Lethargy 3. Salivation 4. Hypertension 5. Lacrimation 6. Miosis
4. "We need to prepare high calorie, high fat meals."
The parents of a child hospitalized with cystic fibrosis have been given discharge instructions. The nurse knows that teaching has been successful when the parents make what statement? 1. "Our child will need to have a gluten free diet." 2. "The enzymes should be given at bedtime daily." 3. "Salt needs to be decreased in our child's diet." 4. "We need to prepare high calorie, high fat meals."
dangle arteries elevate veins
Treatment for circulation issues (arteries/veins)
2. Keep a sterile tracheostomy at the bedside. 3. Monitor for heart rate above 120/min.
What actions would the nurse expect to see in the care plan of a client admitted with Guillain-Barre syndrome? 1. Monitor for descending paralysis. 2. Keep a sterile tracheostomy at the bedside. 3. Monitor for heart rate above 120/min. 4. Maintain in side-lying, supine position. 5. Active range of motion (ROM) every 2 hours while awake.
1) must be evaluated in-person by PHC within 1 hr of restraint 2) orders must be renewed Q4hrs for adults, Q2hrs for ages 9 - 17, Q 1hr < 9 yrs 3) check client face to face every 15 min
What are JACO standards for restraints?
1) slurred speech 2) decreased GI motility 5) weight gain
What are common findings for hypothyroidism? 1) slurred speech 2) decreased GI motility 3)spasticity 4) rhinorrhea 5) weight gain
1) increased BP 2) increased HR 3) palpitations 4) diaphoretic 5) headache ******tends to be familial ******avoid palpating the abdomen
What are common signs/symptoms of pheochromocytoma?
1) sit up 1 hr after eating 2) small frequent meals 3) elevate HOB 4) surgery 5) teach lifestyle changes and healthy diet
What are common treatments for hiatal hernia?
1) take on an empty stomach 2) people with hypothyroidism tend to have CAD 3) must take forever 4) start slowly and increase gradually
What are considerations for Levothyroxine?
CT colonoscopy ******clear liquid diet for 12 - 24 hrs pre-procedure *******NPO 6 - 8 HRS pre-procedure ******AVOID NSAIDS ****Laxatives or enemas until clear *****sodium polystyrene sulfonate (Go-Litely) *****ICY cold colon prep ****Sedated for procedure POST-OP: WATCH FOR PERFORATION
What are diagnostics for UC and Chrohn's disease?
fiber protein
What are dietary needs for a pt undergoing peritoneal dialysis?
Weigh weekly talk face-to-face monitor food and fluid intake
What are nursing considerations for alzheimer's patients?
1) looks at the esophagus and stomach with dye 2) NPO PAST MIDNIGHT 3) no smoking, chewing gum, or mints. remove the nicotine patch, too ****smoking increases stomach motility and stomach secretions, which increase the chance of aspiration
What are nursing considerations for an UPPER GI?
1) change your mood 2) alter defense mechanism 3) breakdown proteins and fats 4) inhibits insulin
What are some actions of glucocorticoids?
amputations cataracts gait problems neurological deficits also, client may be placed on a spine board w a c-collar
What are some complications of burn victims
Hyperkalemia retain phospohorus decreased calcium.....pulled from bones (osteoporosis likely)
What are some fluid and electrolyte problems of nephrotic syndrome patients?
1) semi-recumbent with meals 2) lie down after meals 3) no drink with meals 4) meals should be small and frequent 5) avoid foods high in carbs and electrolytes
What are some treatments for dumping syndrome?
ALT = 10 - 30 U/L AST = 8 - 40 U/L
What are the normal lab values for liver enzymes?
CXR and baseline VS sitting up ove r the bedide table Can't sit up? lie on unaffeced side w HOB @ 45 degrees
What are the pre-procedure considerations for a thoracentesis?
CXR and baseline VS sitting up, propped over the bedside table Can't sit up? lie on unaffected side w HOB @ 45 degrees
What are the pre-procedure considerations for a thoracentesis?
carbohydrates 45% fats 30 - 40% protein 15 - 20%
What are the typical diets of type 1 and type 2 diabetics?
odansetron increase fluids maybe surgery strain urine ESWL (extracorporeal shock wave lithotripsy
What are treatments for renal stones?
NO BP NO NEEDLE STICKS NO CONSTRICTION
What care for alternate vascular access for an extremity must be observed?
lower sodium increase protein
What diet is recommended for nephrotic syndrome pt?
1) tight rigid muscles 2) sedated patient
What does the LPN expect in a patient who has hyperparathyroidism? ) tight rigid muscles 2) sedated patient 3) not enough PTH 4) low serum calcium
Beta blockers (propanolol, metoprolol, atenolol) Calcium channel blockers ( diltiazem, verapamil, amlodipine) Digoxin
What drugs affect rate control of the heart?
1) nitroglycerin 2) beta blockers 3) calcium channel blockers 4) acetylsalicylic acid (Aspirin)
What drugs are used to treat chronic stable angina?
1) anti-thyroids (methimazole) 2) iodine compounds ( potassiumn iodine) ****drink with straw, milk or juice) 3) beta-blockers *****decrease anxiety 4) radioactive iodine (1 dose)
What drugs are used to treat hyperthyroidism?
Inotropes (dopamine, dobutamine, milrinone
What drugs improve heart contractility?
1) ACE 2) ARB 3) DIGOXIN - normal 0.5 - 2ng/ml 4) diuretics (morning administration)
What drugs will the LPN administer for HF client?
HOLD lisinopril, nitroglycerin, water soluble vitamins, ampicillin
What drugs would the LPN expect to hold for the cleint going to hemodialysis?
1) short term use of anxiolytics 2) re-channel through exercise 3) relaxation techniques 4) remain calm
What interventions would the LPN expect when treating a patient with GENERALIZED ANXIETY DISORDER?
Intermittent claudication (progresses to pain at rest)
What is a sign of chronic arterial insufficiency?
protenuria anasarca - total body edema hyperlipidemia hypoalbuminemia
What is common for nephrotic syndrome?
Strep infections Kidneys and heart may be damaged
What is the main cause of glomerulonephritis?
1) weigh them in their underwear 2) monitor exercise routine 3) teach healthy diet and exercise routine 4) allow patient's input for healthy food 6) monitor for suicidal thoughts
What treatments can the LPN expect for a patient with anorexia nervosa? 1) weigh them in their underwear 2) monitor exercise routine 3) teach healthy diet and exercise routine 4) allow patient's input for healthy food 5) vitamins and proteins to supplement their diet 6) monitor for suicidal thoughts
Teach ways to stop anxiety. Teach that symptoms should peak with 10 min and last no longer than 20 - 30 min.
What will the LPN teach regarding anxiety?
1. White grape juice 2. Gelatin 4. Lemon Popsicle 5. Fat free Broth 6. Tea with honey
Which food items, if chosen by a new unlicensed assistive personnel (UAP), would indicate to the nurse that the UAP understands a clear liquid diet? 1. White grape juice 2. Gelatin 3. Vanilla pudding 4. Lemon Popsicle 5. Fat free Broth 6. Tea with honey
1. Dysuria 3. Nocturia 4. Polyuria 5. Lower back pain
Which signs and symptoms if noted in a male client would lead the nurse to suspect prostate cancer? 1. Dysuria 2. Proteinuria 3. Nocturia 4. Polyuria 5. Lower back pain 6. Pyuria
2. Breathlessness while talking.
Which symptom identified in a client diagnosed with Guillain-Barre Syndrome would indicate that the nurse needs to notify the primary healthcare provider? 1. Vital lung capacity of 900 mL. 2. Breathlessness while talking. 3. Heart rate of 98 beats per minute. 4. Respiratory rate of 24 breaths per minute.
1) decreased insulin production 2) TPN 3) steroids
Why must the LPN provide insulin for the pt with pancreatitis?
watch for bleeding gums, hematuria, and black stools use an electric razor, a soft toothbrush and NO IMs
bleeding precautions
aPTT : 30 - 40 sec PT - 11.0 - 12.5 SEC therapeutic INR - 2 - 3
clotting studies normal lab values
what drugs cause vasodilation / diuresis to reduce preload?
diuretics (furosemide) nitrates (nitroglycerine)
