Exam 1 DA & Practice Questions

Which findings would be consistent with a clinical diagnosis of acute appendicitis? Select all that apply. Elevated white blood cell count with a shift to the right Hypothermia Presentation of pain in the left lower quadrant correlated with McBurney's point Presence of Rovsing's sign eliciting referred pain in the right lower quadrant Nausea and vomiting

Presence of Rovsing's sign eliciting referred pain in the right lower quadrant Nausea and vomiting ????

The nurse is caring for a patient who has gastric cancer. He says "I'm so afraid to be in pain and to die and leave my family." How should the nurse respond? "This must be very frightening for you." "Tell me about your family." "Are you having pain now?" "We will give you medications for your pain."

"This must be very frightening for you."

Which white blood cell (WBC) count indicates that perforation may have occurred from appendicitis? 2,000/mm3 10,000/mm3 18,000/mm3 20,000/mm3

20,000/mm3

Who is at the highest risk of having appendicitis? A 16-year-old male A 14-year-old female A 32-year-old male A 42-year-old female

A 16-year-old male

Which order would the nurse question in the initial management of acute pericarditis? A. Aspirin B. Colchicine C. Prednisone D. NSAIDs

C. Prednisone ??????

Transcutaneous pacing should be considered for which of the following dysrhythmias? A. VF B. VT C. Symptomatic heart block D. AF

C. Symptomatic heart block

What do second-degree and third-degree heart blocks have in common? A. Wide QRS complexes B. Narrow QRS complexes C. Dropped QRS complexes D. No commonalities

D. No commonalities

Which herbal therapy would aid in the expulsion of flatulence in a client diagnosed with irritable bowel syndrome? Ginger St. John's Wort Garlic Echinacea

Ginger

What type of bacteria is a common cause of peptic ulcer disease? C. difficile H. pylori E. coli Streptococcus

H. pylori

Common cause of peptic ulcers H. PYLORI or C. DIFFICILE

H. pylori H. pylori is a bacterium that commonly causes peptic ulcers. It may be acquired by ingesting contaminated food and water. Family history has been reported as a predisposing factor.

A patient with oral cancer has dysphagia. Which complication is associated with this condition? Anxiety Imbalanced nutrition Ineffective airway clearance Impaired oral mucous membrane

Imbalanced nutrition

Which is a cause for diastolic dysfunction for a patient diagnosed with heart failure? Contraction difficulty Left ventricle hypertrophy Elevated demands on the heart Impaired venous return to the heart

Left ventricle hypertrophy

Which statements regarding Crohn's disease are accurate? Select all that apply. "A patient with Crohn's disease may pass five to six soft, loose, non-bloody stools per day." "Fistulas, fissures, and abscesses are common in Crohn's disease." "Tenesmus is common in Crohn's disease." "Strictures and obstructions are common in Crohn's disease." "A cobblestone appearance of the mucosa is rare in Crohn's disease."

"A patient with Crohn's disease may pass five to six soft, loose, non-bloody stools per day." "Fistulas, fissures, and abscesses are common in Crohn's disease." "Strictures and obstructions are common in Crohn's disease."

A nurse is teaching about orthostatic hypotension. Which statement indicates a need for further teaching? "A reduction of 20 mm Hg in the systolic blood pressure upon standing up indicates orthostatic hypotension." "It results in a feeling of dizziness when a patient suddenly moves to an upright position from the supine position." "An increase of 15 mm Hg in the diastolic blood pressure indicates orthostatic hypotension." "It is also known as postural hypotension."

"An increase of 15 mm Hg in the diastolic blood pressure indicates orthostatic hypotension."

The nurse is discussing dietary considerations with a patient diagnosed with peptic ulcer disease. Which responses made by the patient indicate the need for further discussion? "I must refrain from drinking coffee." "I should consume six small meals a day." "I must limit my alcohol consumption." "I must restrict my intake of fluids."

"I must restrict my intake of fluids."

The nurse is evaluating ECG strips of clients with suspected heart block. Which observations demonstrate that a heart block is present? Select all that apply. A second-degree AV block, type II is present because the PR is 0.24 seconds A first-degree AV block is present because there is no correlation between the P waves and QRS complexes A second-degree AV block, type I is present because the PR progressively lengthens until a beat is dropped A third-degree AV block is present because there are more P waves then QRS complexes The PR interval is 0.16 so there is no heart block

A second-degree AV block, type I is present because the PR progressively lengthens until a beat is dropped A third-degree AV block is present because there are more P waves then QRS complexes???

Signs or symptoms of symptomatic ventricular dysrhythmias include which of the following? (Select all that apply.) A. Hypotension B. Dizziness C. Fever D. Shortness of breath E. Hypertension

A. Hypotension B. Dizziness D. Shortness of breath

The nurse is caring for a client who has peptic ulcer disease. Which abnormal labs may be related to the condition? Select all that apply. Anemia Metabolic acidosis Elevated liver enzymes Elevated pancreatic enzymes H. pylori

Anemia H. pylori ???

The nurse is assessing a patient who is suspected to have left-sided heart failure. Which assessment provides specific information regarding the left-sided heart function? Auscultating lung sounds Monitoring for hepatomegaly Palpating for peripheral edema Assessing for jugular vein distension

Auscultating lung sounds

In preparing a patient for esophageal manometry, which content does the nurse include in preprocedure teaching? A. This test measures the acid content in your stomach. B. This test measures the pressure and action of the esophagus. C. This test allows a sample of the esophagus to be obtained. D. This test is used only in patients with diagnosed hiatal hernia.

B. This test measures the pressure and action of the esophagus.

The nurse caring for a client with a peptic ulcer shows these assessment changes. What complication should the nurse further assess for? Temp - Now: 98.9 F - 2 hr: 97.8 F Heart rate - Now: 110 - 2 hr: 89 Respirations - Now: 22 - 2 hr: 16 BloodPressure - Now: 95/65 - 2 hr: 110/76 SatsNow - Now: 93% - 2 hr: 95% Aspiration Perforation Penetration Bleeding

Bleeding ???

Which medication is prescribed to enhance contractility of the heart muscle in patients suffering from heart failure? Beta blockers Angiotensin receptor blockers (ARB) Cardiac glycosides Venous vasodilators

Cardiac glycosides

Which complementary therapy listed by the nursing student for treating irritable bowel syndrome (IBS) symptoms indicates a need for further training? Hypnosis Chinese herbs Acupuncture Cold packs

Cold packs

Which of the following is not an appropriate intervention for all atrial dysrhythmias? A. An ECG B. A pulse check C. Blood pressure D. Cardioversion

D. Cardioversion

What are common clinical findings associated with the presence of gastroesophageal reflux disease? Select all that apply. Dental caries Odynophagia Hoarseness throughout the day but worse in the evening Bronchitis Pelvic pain

Dental caries Odynophagia Bronchitis

Which potential complications can arise if appendicitis is not diagnosed and treated promptly? Select all that apply. Development of abscess Viral infection Deep vein thrombosis Peritonitis Gangrene

Development of abscess Peritonitis Gangrene ???

Which medications should the nurse anticipate for a client diagnosed with heart failure who requires positive inotropic therapy? Select all that apply. Digoxin Enalapril Furosemide Metoprolol Dopamine

Digoxin????

Which clinical manifestations should the nurse anticipate when providing care to a client who is diagnosed with left-sided heart failure? Select all that apply. Dyspnea Hepatomegaly Fatigue Ascites Crackles noted on lung auscultation

Dyspnea Fatigue Crackles noted on lung auscultation

Which symptom indicates the need for Nissen fundoplication surgery? Chest pain Regurgitation Belching Feeling of suffocation

Feeling of suffocation

A patient with peptic ulcer disease is being discharged on several new medications. When performing medication education, which medication should the nurse say helps block gastric secretions? Antacids H2-receptor antagonists Metoclopramide Sucralfate

H2-receptor antagonists

neric names include cimetidine, famotidine, and ranitidine H2RAS PPIS

H2RAs

Which is true regarding diverticulitis? This occurs frequently in the jejunum. This can be seen more frequently in vegetarians. This is more common in newborns. This occurs more in Western industrialized societies.

This occurs more in Western industrialized societies.

Which diagnostic test is usually used to confirm the diagnosis of infective endocarditis (IE)? Exercise stress test Coronary angiogram Lipid profiles Transesophageal echocardiogram (TEE)

Transesophageal echocardiogram (TEE)

A patient who has recently been diagnosed with irritable bowel syndrome asks for assistance in dietary selection. Which foods would the nurse recommend based on the patient's diagnosis? Wheat products Apple, pears, cherries Dairy items High-fiber foods

High-fiber foods

The nurse performs an assessment and sees this. What could cause this condition? Excessive oral hygiene Immune suppression Allergic reaction Excess milk intake

Immune Suppression Rationale: White coating of the tongue is usually called thrush and is also secondary to oral candidiasis. In addition, older adults are more prone to developing candidiasis because of their decreased immune function and other risk changes related to the aging process.

Which complications are associated with untreated peptic ulcer disease? Select all that apply. Inflammation Perforation Peritonitis Localized abcess Vomiting

Inflammation Perforation Peritonitis Localized abcess

What is the function of the appendix? Assists with fecal removal Assists with motility Its purpose is unknown Secretes digestive acid

Its purpose is unknown

The nurse is caring for a patient who suddenly develops dizziness and sweating. He has had similar symptoms in the past and has fainted. Which type of heart block should the nurse consider is causing these symptoms? First-degree atrioventricular block (AVB) Second-degree, type I, atrioventricular block (AVB), asymptomatic Second-degree, type I, atrioventricular block (AVB), symptomatic Third-degree complete heart block, asymptomatic

Second-degree, type I, atrioventricular block (AVB), symptomatic

Recommended dietary change SMALL FREQUENT MEALS or LARGE MEAL AT MID-DAY

Small frequent meals Clients who have peptic ulcer disease are encouraged to eat small frequent meals so that their gastric secretions have food to digest.

A patient tells the nurse, "I have labored breathing and chest pain while doing vigorous physical activities, but feel comfortable at rest." Which stage of heart failure does the patient fall under according to the New York Heart Association's classification of functional status? Stage A Stage B Stage C Stage D

Stage C

A nurse is preparing to perform Rovsing's sign to determine if the client has appendicitis. Which action is incorrect? The nurse performs hand hygiene prior to the assessment. The nurse places his or her hands on the right side of the abdomen. The nurse provides an explanation of his or her action prior to touching the client. The nurse asks the client if he or she has any questions prior to touching the client.

The nurse places his or her hands on the right side of the abdomen

Which change in rhythm requires immediate action by the nurse? Select all that apply. Ventricular tachycardia Ventricular fibrillation Atrial fibrillation Sinus bradycardia Complete heart block

V. fib & Complete Heart Block???

The nurse is performing discharge teaching with Andrew. Which statement by him requires additional teaching? "I will not drive after taking my pain medication." "If my wound opens up, I'll call the surgeon." "My antibiotics are used as needed." "I'll follow up with my surgeon in 7 days." Check Answer

"My antibiotics are used as needed." *** A client may have antibiotics prescribed, particularly if the appendix ruptured prior to surgery. The nurse should emphasize the importance of completing all antibiotics, even if having no symptoms. The other three statements are correct.

As the nurse caring for a patient on a cardiac monitor, you understand that which of the following steps are necessary to correctly identify the rhythm? (Select all that apply.) A. Determine the rate B. Determine the regularity C. Determine if there is a QRS for every P wave D. Determine if there is a P wave for every QRS E. Determine if there is a U wave for every QRS

A. Determine the rate B. Determine the regularity C. Determine if there is a QRS for every P wave D. Determine if there is a P wave for every QRS

Key patient teaching points for AF include which of the following? (Select all that apply.) A. Medications for HR control B. Bleeding precautions C. Signs and symptoms of AF with RVR D. Cardioversion E. Defibrillation

A. Medications for HR control B. Bleeding precautions (cuz anticoagulant meds) C. Signs and symptoms of AF with RVR D. Cardioversion

A nurse is caring for a patient who presents to the emergency department with abdominal trauma and requires advanced trauma life support (ATLS). Arrange the order in which the nurse should perform the task. Exposure Breathing Disability Airway Circulation

Airway Breathing Circulation Disability Exposure

The nurse is caring for a client newly diagnosed with atrial fibrillation with a ventricular response of 130 beats per minute. What medication should the nurse consider requesting when performing a Situation-Background-Assessment-Recommendation (SBAR) communication with the provider? Select all that apply. Anticoagulant Beta blocker Calcium channel blocker Digoxin Aspirin

Anticoagulant Beta blocker Calcium channel blocker Digoxin

The nurse hears a loud systolic murmur at the second intercostal space right sternal border. What valve problem is the patient likely experiencing? A. Aortic regurgitation B. Aortic stenosis C. Pulmonic regurgitation D. Pulmonic stenosis

B. Aortic stenosis

After a percutaneous coronary angioplasty, what assessment should most concern the nurse? A. Back discomfort B. Chest pain C. Capillary refill of less than 3 seconds D. Hypoactive bowel sounds

B. Chest pain

As the nurse, you know that the following can cause rhythm disorders: A. Exercise B. Electrolyte imbalances C. Myocardial hypertrophy D. Myocardial damage E. Eating red meat

B. Electrolyte imbalances C. Myocardial hypertrophy D. Myocardial damage

Which of the following dysrhythmias requires defibrillation? A. Atrial tachycardia B. Atrial fibrillation C. Ventricular tachycardia with a pulse D. Ventricular fibrillation

D. Ventricular fibrillation

The primary healthcare provider prescribes famotidine to a patient with gastroesophageal reflux disease. Which outcome can be expected? Neutralization of stomach acid Increased gastric emptying Decreased production of acid Blocking the production of acid

Decreased production of acid Rationale: Famotidine is an H2 Receptor Antagonist. Decreases acid production by blocking H2 receptor at initial stage of production.

The nurse finds the client unresponsive and without a pulse. The rhythm on the monitor is wide and bizarre. What is the priority action? Insert a pacemaker Intubate Apply oxygen Defibrillation

Defibrillation

Kaitlin has provided the nurse with a food diary to help identify possible food triggers for IBS. Which diet entry poses a concern? Select all that apply. Egg substitute omelet for breakfast Diet sodas at lunch time Bran cereal for breakfast English breakfast decaffeinated tea for breakfast Apple as an afternoon snack

Diet sodas at lunch time Apple as an afternoon snack Diet sodas and apples contain sorbitol or fructose, which can stimulate symptoms of IBS. The other items do not pose a concern.

Which nursing actions should a nurse perform when caring for a patient with peptic ulcer disease? Select all that apply. Include bedtime snacks for the patient. Document and notify the primary health-care provider about symptoms of dumping syndrome. Administer proton pump inhibitors (PPIs) after meals. Administer antacids 1 to 3 hours after meals. Prepare the patient for an upper endoscopy or surgery per order.

Document and notify the primary health-care provider about symptoms of dumping syndrome. Administer antacids 1 to 3 hours after meals. Prepare the patient for an upper endoscopy or surgery per order.

Kaitlin reports clinical symptoms that affect her enjoyment of meals. Which symptoms are associated with IBS? Eructation and dyspepsia Hiccups and indigestion Dizziness and feelings of satiety Urge to void

Eructation and dyspepsia Belching and heartburn are common clinical symptoms of IBS that can affect enjoyment of meals. Hiccups, dizziness, urge to void, and headache are not associated with IBS. Feelings of satiety and cramping are usually associated with abdominal bloating.

A patient reports a sore and burning sensation in the mouth and tongue. The nurse finds red, macular lesions that are velvety in appearance. The patient is a chronic alcoholic and smoker. Which condition does the patient most likely have? Stomatitis Xerostomia Leukoplakia Erythroplakia

Erythroplakia

Common pattern of peptic ulcers EXACERBATION AND REMISSION or CONTINUAL WITH LITTLE RELIEF

Exacerbations and Remissions Peptic ulcer pain occurs in intervals of weeks or months. During exacerbation, it occurs daily for a period of several weeks and then remits until the next recurrence.

A nurse is discussing postsurgery care techniques for a patient with a hernia. Which techniques are appropriate? Select all that apply. Inspect the incision for signs and symptoms of infection and report any concerns to the primary healthcare provider. Avoid heavy lifting for several weeks. Promote atelectasis and venous thromboembolism (VTE). Avoid deep breathing and early ambulation. Splint the surgical site with pillows while coughing.

Inspect the incision for signs and symptoms of infection and report any concerns to the primary healthcare provider. Avoid heavy lifting for several weeks. Splint the surgical site with pillows while coughing.

The nurse is providing a community event about heart disease. Which statements are true regarding stable angina? Select all that apply. It is associated with symptoms that are often alleviated with rest and/or medication. It is prolonged and may not be relieved with medication. It is chest pain or discomfort that is associated with physical activity. It is identified as the initial phase of acute coronary syndrome and can be a precursor to myocardial infarction. It is typically linked to fixed plaque formations.

It is associated with symptoms that are often alleviated with rest and/or medication. It is chest pain or discomfort that is associated with physical activity. It is typically linked to fixed plaque formations.

Which is true regarding the usefulness of the diagnostic test esophageal manometry? It is useful in evaluating esophagitis and monitoring Barrett's esophagitis. It is useful in monitoring gastric pH. It is useful in obtaining a sample of the esophagus for biopsy. It is useful in measuring esophageal motor activity.

It is useful in measuring esophageal motor activity.

Which is true regarding leukoplakia? It is a malignant lesion found commonly on the mandibular mucosa. It occurs mostly in newborns. It is more prevalent in women than men. It looks like nonremovable, slightly raised, sharply rounded white plaques.

It looks like nonremovable, slightly raised, sharply rounded white plaques.

The nurse is instructing a patient about his newly diagnosed Prinzmetal's angina? What information is correct? It normally occurs between midnight and 8 a.m. It is associated with physical activity. It is caused by fixed plaque formations. It is a variation of stable angina.

It normally occurs between midnight and 8 a.m. (form of unstable angina)

Which members of the interdisciplinary team would a nurse include in discharge planning for a client who has been diagnosed with irritable bowel syndrome? Select all that apply. Nutrition counseling Psychological therapy Support group Hospice Ostomy support group

Nutrition counseling Psychological therapy Support group

Which conditions may influence the development of gastroesophageal reflux disease? Select all that apply. Pernicious anemia Obesity Loss of esophageal motility Hiatal hernia Constipation

Obesity Loss of esophageal motility Hiatal hernia

Most common symptom of peptic ulcers PAIN or VOMITING

Pain The pain of peptic ulcers depends on the location and age of the patient. Older adults have fewer symptoms. Pain is reported as burning in the midline epigastric area related to eating patterns, which may radiate to the costal margins into the back.

Low-Sodium Diet REDUCES FLUID or NORMALIZES ELECTROLYTES

REDUCES FLUID Clients who are diagnosed with heart failure will need to be placed on a low-sodium diet to prevent fluid retention and exacerbation of HF. The nurse should teach the patient to avoid adding salt to food and avoid foods with hidden sodium, such as canned vegetables. The nurse should recommend that the patient consume fresh vegetables.

A patient with a history of gastroesophageal reflux disease is diagnosed with Barrett's esophagus. Which endoscopic treatment is appropriate for the condition? Laser ablation Photodynamic therapy Radiofrequency ablation Endoscopic mucosal resection

Radiofrequency ablation Used to treat dysplasia in Barrett's Esophagus. Balloon is passed into esophagus & aerated until balloon meets inner lining of esophagus. High energy is supplied to destroy the cells. - Endoscopic mucosal resection is used to remove precancerous lesions by removing esophageal lining.

Which assessment in the patient with appendicitis is most concerning? Development of a fever Elevated white blood cell (WBC) count Intense pain in the right lower quadrant Sudden pain resolution without medication or treatment

Sudden pain resolution without medication or treatment

As the nurse is getting a patient with peptic ulcer disease out of bed, he vomits, has severe epigastric pain, and states he is feeling dizzy. Which priority nursing actions should the nurse take? Select all that apply. Return the patient to bed. Assess the bowel sounds. Lower the head of the bed. Obtain a blood pressure reading. Call for help.

The nursing actions should the nurse take? Select all that apply. Return the patient to bed. Lower the head of the bed. Obtain a blood pressure reading. Call for help.

Chester, 78 years old, experiences an acute myocardial attack and collapses on the golf course. When the paramedics arrive, they see this rhythm on the monitor.Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

Ventricular Fibrillation Ventricular fibrillation (VF) is a life-threating dysrhythmia requiring immediate resuscitation with defibrillation. It is a wide and bizarre rhythm that does not provide a cardiac output as the ventricles fibrillate from rapid and chaotic firing. Common causes include hypovolemia, hypoxia, acidosis, potassium imbalance, hypoglycemia, hypothermia, toxins, cardiac tamponade, MI, PE.

Which statement regarding a colonoscopy indicates a need for further learning? "Biopsies can be taken and polyps can be removed during a colonoscopy." "A colonoscopy is the gold standard for colorectal cancer screening." "A colonoscopy involves taking x-ray images after performing a barium enema." "A colonoscopy is an invasive procedure."

"A colonoscopy involves taking x-ray images after performing a barium enema." (no barium involved. That would be just an x-ray)

Which statement regarding toxic megacolon indicates a need for further learning? "It occurs more commonly in ulcerative colitis and requires an emergency colectomy." "It is colonic dilatation greater than 5 cm." "It usually occurs during an acute exacerbation." "Bacterial infection does not play any role in toxic megacolon."

"Bacterial infection does not play any role in toxic megacolon."

Which statement by a nurse regarding oral cancer of the lips indicates a need for further learning? "Outcomes regarding carcinoma of the upper lip are less favorable." "Cancer of the oral cavity is primarily basal cell carcinoma." "Males are more prone to carcinoma of the lip than females." "The average age for carcinoma of the lips is 60 to 65."

"Cancer of the oral cavity is primarily basal cell carcinoma." Cancer of oral cavity is primarily SCC. Basal cell does more commonly affect the lip, but cancer of the oral cavity in general is not basal.

Which statement made by a nursing student regarding irritable bowel syndrome (IBS) indicates a need for further learning? "It is also known as spastic colon." "It is characterized by abdominal pain and altered bowel habits where the mucosal lining of the bowel remains unchanged." "It can be diagnosed by the Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders." "Diarrhea dominant irritable bowel syndrome (IBS-D) causes too much water to be absorbed in the small intestine."

"Diarrhea dominant irritable bowel syndrome (IBS-D) causes too much water to be absorbed in the small intestine."

A nurse is proving community education about peptic ulcer disease, its causes, treatment, and symptoms. Which statement by the nurse is incorrect? "The most common form of chronic gastritis is caused by Helicobacter pylori infection." "The incidence of H pylori infection increases in patients who are older than 60." "H pylori infection is more prevalent in industrialized countries than in developing countries." "Urea breath testing can be used to detect active infection with H pylori."

"H pylori infection is more prevalent in industrialized countries than in developing countries."

A nurse is instructing a patient about management of his coronary artery disease (CAD). Which information stated by the patient indicates a need for further discussion? "I should include exercise in my daily routine." "I should summon emergency personnel if my chest pain worsens after taking the first dose of nitroglycerin." "I can take more than three doses of nitroglycerin if spaced a minute apart." "I should decrease my consumption of alcohol."

"I can take more than three doses of nitroglycerin if spaced a minute apart."

The nurse is caring for a patient diagnosed with gastritis 6 months ago. The nurse evaluates the patient's compliance with suggested lifestyle modifications and medication compliance. Which comments from the patient require reeducation? "I enjoy citrus fruits for breakfast." "I've stopped eating snacks at bedtime." "I take the antacids 1 hour after meals." "I take the pantoprazole on an empty stomach."

"I enjoy citrus fruits for breakfast."

A nurse is teaching a patient with irritable bowel syndrome (IBS) about a precautionary measure that he or she needs to take in order to prevent further complications. Which statement made by the patient indicates the need for further training? "I should consume 10 grams of fiber each day." "I should drink 8 to 10 cups of liquid per day." "I should avoid drinking beverages that contain sorbitol or fructose." "I should sleep at least 7 to 8 hours each night."

"I should consume 10 grams of fiber each day." (pt should consume 30-40 g a day)

The nurse is teaching postsurgical care to a patient who has undergone a laparoscopic Nissen fundoplication surgery. Which statement indicates the need for further teaching? "I should drink water rapidly." "I should report severe bloating or unusual pain." "I will notify the primary healthcare provider if I have difficulty breathing." "I should continue my antireflux medication regimen unless advised by a healthcare practitioner."

"I should drink water rapidly."

The nurse provides a discharge care plan to a patient who is diagnosed with infective endocarditis. Which statement made by the patient indicates effective teaching? "I should use a hard-bristled toothbrush for good oral hygiene." "I should take any over-the-counter drug if there is any chest pain." "I should administer the antibiotics until my chest pain is relieved." "I should notify the healthcare provider about my history of infective endocarditis prior to any invasive procedure."

"I should notify the healthcare provider about my history of infective endocarditis prior to any invasive procedure."

A nurse is teaching a patient with stomatitis about the precautionary measures that can promote rapid healing. Which comments by the patient indicate a need for further teaching? Select all that apply. "I should use a hard-bristled toothbrush to clean the mouth." "I should apply water soluble lubricants for lips and mouth." "I should use lemon-glycerin swabs to clean the mouth." "I should remove dentures and other oral appliances if pain persists." "I should limit intake of protein-rich foods in the diet."

"I should use a hard-bristled toothbrush to clean the mouth." "I should use lemon-glycerin swabs to clean the mouth." "I should limit intake of protein-rich foods in the diet."

The nurse is making a plan of care for a patient with acute gastritis. Which step listed by the nurse needs correction? "Provide rest to the gastrointestinal tract with 6 to 12 hours of NPO status." "Introduce clear liquids such as caffeinated beverages." "Gradually introduce heavier liquids, such as cream soups, puddings, and milk." "Finally, introduce bland foods that are not highly spiced."

"Introduce clear liquids such as caffeinated beverages."

The primary health-care provider has prescribed sucralfate for a patient with gastritis. Which is the nurse's best response to the patient if he or she wants to know why this medication has been prescribed? "It helps in preventing pernicious anemia." "It helps in preventing mucosal damage by gastric acid." "It helps in decreasing gastric acidity by neutralizing the acid." "It helps in obstructing H+-K+-ATPase enzyme in the gastric parietal cells."

"It helps in preventing mucosal damage by gastric acid." (forms protective lining)

A patient is scheduled for surgery for a ruptured appendix and asks the nurse how large the incision will be. How should the nurse respond? "Most likely you will have an incision about an inch long." "The procedure is often done laparoscopically, so there will be several small incisions." "Since your appendix has ruptured a larger incision will be make to irrigate out your abdominal cavity." "Typically, they cut from the base of the sternum to the pubic bone."

"Since your appendix has ruptured a larger incision will be make to irrigate out your abdominal cavity."

A nurse performing a review of systems for a patient being admitted to the hospital notes that the patient has a history of irritable bowel syndrome (IBS). Which patient statement would require additional investigation? "I have tried acupuncture for relief of symptoms and it has worked well." "I have learned which foods may act as potential irritants and try to avoid them whenever possible." "Probiotics have provided some relief for my clinical symptoms." "Stool cultures identified that I have IBS."

"Stool cultures identified that I have IBS."

The nurse is providing nutrition education to Kaitlin, a 35-year-old female client who has a clinical diagnosis of irritable bowel syndrome.Which options should the nurse include with dietary teaching to help manage exacerbation of symptoms? Select all that apply. Maintain a minimum intake of caffeine to prevent caffeine withdrawal Include a consistent level of fiber in the diet (30 to 40 grams per day) to maintain stool bulk Limit intake of carbonated beverages to one can a day Increase daily fluid intake to 6 to 8 glasses of water Ingest gas-forming foods only every other day to prevent cumulative effects

1) Include a consistent level of fiber in the diet (30 to 40 grams per day) to maintain stool bulk 2) Increase daily fluid intake to 6 to 8 glasses of water Maintaining a consistent fiber intake and hydration level will help to provide stool frequency and stool bulk. Caffeine, gas-forming foods, and carbonated beverages are potential IBS triggers and should be avoided.

Which client is most likely to be at risk for developing gastroesophageal reflux disease? 38-year-old male who is a vegetarian 25-year-old pregnant woman 18-year-old female who likes to eat several small meals a day 44-year-old male who has no reported comorbidities

25-year-old pregnant woman

Which client should be classified, according to the American Heart Association and American College of Cardiology, as stage C? A client with risk factors but no left ventricular impairment A client with impaired left ventricular function A client with current symptoms of heart failure A client requiring inotropic support

A client with current symptoms of heart failure

The nurse is assessing the client's incision. Since the appendix was ruptured, what would the nurse expect to see? A larger incision Retention sutures in place Steri-strips over a small puncture wound Incision covered by an occlusive dressing

A larger incision *** If the appendix has ruptured or peritonitis is expected, the surgeon will make a larger incision. Retention sutures may be indicated in obese clients or for complex wounds for which surgical edges cannot be approximated. Puncture wounds are used after a laparoscopic procedure and surgical wounds are not covered with an occlusive dressing

The nurse understands that rhythms originating in the ventricle have which of the following characteristics? (Select all that apply.) A. Wide QRS complexes B. Narrow QRS complexes C. Only QRS complexes D. Only fast rates E. Only slow rates

A. Wide QRS complexes C. Only QRS complexes

Which assessment findings are consistent with identification of positive McBurney's point in a client with suspected appendicitis? Select all that apply. Abdominal tenderness Left lower quadrant pain Guarding in response to pain Right lower quadrant pain Hyperactive bowel sounds

Abdominal tenderness Guarding in response to pain Right lower quadrant pain

A patient underwent a surgical procedure for grade 3 hemorrhoids. Which interventions are appropriate for postoperative care? Select all that apply. Use narcotic analgesics when pain is severe. Apply local, moist heat immediately after surgery. Administer docusate sodium for softening the stool. Administer an analgesic before the first bowel movement. Encourage the patient to reduce the fluid intake while on bulk laxatives.

Administer docusate sodium for softening the stool. Administer an analgesic before the first bowel movement. (No narcotics bc may cause *constipation*. No heat immediately after bc can cause bleeding)

Which nursing action taken may lead to further complications in the patient with diverticulitis? Administering antibiotics Administering IV fluids Administering opiates Administering laxatives

Administering laxatives

Which nursing intervention performed by the nurse when caring for a patient with coronary artery disease helps in dilating the coronary arteries? Administering aspirin as ordered Administering nitroglycerin as ordered Administering calcium channel blockers as ordered Administering statin drugs as ordered

Administering nitroglycerin as ordered

The nurse is creating a plan of care for a patient with peptic ulcer disease. What is important to include? Select all that apply. Advise the patient to refrain from caffeine intake. Advise the patient to limit the use of aspirin. Advise the patient to limit bedtime snacks. Administer antacids 1 hour before meals. Administer proton pump inhibitors (PPIs) before breakfast.

Advise the patient to refrain from caffeine intake. Administer proton pump inhibitors (PPIs) before breakfast.

Which is most appropriate to advise a patient with reports of heartburn, belching, and a feeling of suffocation? Select all that apply. Advising the patient to avoid spicy foods Advising the patient to wear loose clothing Encouraging the patient to perform oral hygiene Advising the patient to maintain ideal body weight Advising the patient to lie on the left side after eating

Advising the patient to avoid spicy foods Advising the patient to wear loose clothing Advising the patient to maintain ideal body weight

John is a 57-year-old with a new onset of palpitations and an irregular pulse. He has a history of a heart murmur since experiencing endocarditis 5 years ago. Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

Atrial Fibrillation Atrial fibrillation (AF) is an irregular rhythm without P waves, caused when the SA node is no longer the primary pacemaker the atria fibrillate. Patients can become symptomatic with dizziness and a drop in the blood pressure because 30% of the cardiac output can be lost. Another risk of this rhythm is the formation of clots in the atria of the heart from pooling blood. Treatment includes anticoagulants, beta blockers, calcium channel blockers, and digoxin to control the heart rate. Cardioversion is sometimes considered.

The nurse is discharging a client who was newly diagnosed with a peptic ulcer. What should be included in the teaching? Select all that apply. Avoid NSAIDs. Increase fluid intake. Avoid caffeine at bedtime. Increase spicy foods. Avoid eating within two hours of bedtime.

Avoid NSAIDs. Avoid caffeine at bedtime. Avoid eating within two hours of bedtime ???

The nurse asks a client with gastric ulcers to describe his symptoms. Which symptoms should the nurse anticipate? Select all that apply. Burning pain aggravated by eating Midline epigastric pain Pain radiation to the right shoulder Worse pain when lying flat Exacerbation and remission of symptoms

Burning pain aggravated by eating Midline epigastric pain Pain radiation to the right shoulder Exacerbation and remission of symptoms ????

The nurse determines which patient is at greatest risk for developing IE? A. A 22-year-old student undergoing a dental procedure B. A 35-year-old man with a past medical history of IV drug use C. A 65-year-old male heart transplant patient on immunosuppressive therapy undergoing a colonoscopy D. A 70-year-old female with heart failure with an intravascular access device for home infusion

C. A 65-year-old male heart transplant patient on immunosuppressive therapy undergoing a colonoscopy

What assessment would the nurse identify as a hallmark finding of left-sided heart failure? A. Ascites B. Bradycardia C. Crackles D. Edema

C. Crackles

A client with irritable bowel syndrome is instructed to begin using a food diary. The client is unclear as to why a food diary is needed. What is the basis of the nurse's explanation? Flare-ups of the disease process are associated with increased caloric intake. Food selection should be based on following a low-sodium, low-fat diet. Excess fluid intake can lead to exacerbations of the disease. Certain foods can act as triggers and cause flare-ups of the disease.

Certain foods can act as triggers and cause flare-ups of the disease.

Which observation would indicate that the client's appendix had perforated? Changes in blood pressure and pulse Temperature 99.2°F 1+ pitting edema bilaterally lower legs Client experiences excessive thirst

Changes in blood pressure and pulse

Which foods should be avoided in a client who has already been diagnosed with gastroesophageal reflux disease? Select all that apply. Chocolate Beer Caffeinated coffee Peppermint gum Broth or consommé

Chocolate Beer Caffeinated coffee Peppermint gum

A patient is diagnosed with inflammatory bowel disease. While reviewing the patient's laboratory reports, the primary healthcare provider finds evidence of gallstones. Which manifestation does the nurse infer? Uveitis Cholangitis Cholelithiasis Nephrolithiasis

Cholelithiasis

Type of peptic ulcer ESOPHAGEAL or GASTRIC

Gastric Gastric ulcers are a type of peptic ulcer. They are chronic in nature and make up about 20% of the peptic ulcer cases. They affect the lesser curvature of the stomach, near the pylorus.

Which is true of ulcerative colitis? Select all that apply. Complications such as hemorrhage and nutritional deficiencies may occur. It occurs anywhere in the gastrointestinal tract from mouth to anus. Weight loss rarely occurs. Granuloma is common. Stools are frequent and watery with blood and mucus.

Complications such as hemorrhage and nutritional deficiencies may occur. Weight loss rarely occurs. Stools are frequent and watery with blood and mucus.

A patient reports abdominal pain, fever, and vomiting. The primary healthcare provider suspects appendicitis. Which diagnosis will confirm the condition? X-ray of abdomen Physical assessment White blood cell count Computed tomography (CT)

Computed tomography (CT)

The nurse is caring for a client with suspected appendicitis who has just arrived at the nursing unit. The nurse knows which test is most commonly used to diagnose appendicitis? Magnetic resonance imaging Computed tomography scan X-ray Ultrasound

Computed tomography scan ???

Pulmonary Edema BETA BLOCKER or DIURETIC

DIURETIC Pulmonary edema is often a medical emergency requiring the administration of a prescribed intravenous diuretic, such as furosemide, and the initiation of supplementary oxygen. Some clients may even require intubation and mechanical ventilation.

A patient is diagnosed with medication-induced nonsteroidal anti-inflammatory drug (NSAID) peptic ulcer disease. Which clinical finding is the nurse most likely to find in the patient? Decrease in pepsin secretion Increase in bicarbonate levels Decrease in mucus production Increase in gastric mucosal blood flow

Decrease in mucus production

Which drug classification should the nurse anticipate for a client diagnosed with heart failure to increase urine output? Diuretic Inotropic Angiotensin-converting-enzyme inhibitor Beta blocker

Diuretic

The nurse is caring for a patient with an elevated white blood cell count, fever, and rebound tenderness. What action is a priority? Do not allow the patient to eat or drink anything. Administer an antipyretic. Deliver pain medication as needed. Begin IV fluids.

Do not allow the patient to eat or drink anything.

Which is a cause for high-output failure for a patient diagnosed with heart failure? Relaxation difficulty Contraction difficulty Elevated demands on the heart Impaired venous return to the heart

Elevated demands on the heart

A nurse is caring for a patient with facial trauma. Which actions of the nurse are most beneficial in promoting wound healing? Select all that apply. Keeping wire cutters near the patient at all times Providing oral humidification Encouraging the patient to consume adequate nutrition Providing frequent mouth care by rinsing the mouth after meals Administering antibiotics to the patient

Encouraging the patient to consume adequate nutrition Providing frequent mouth care by rinsing the mouth after meals Administering antibiotics to the patient

Physiological change EROSIONS or GROWTHS

Erosions An ulcer occurs when there is an erosion of the mucosa with considerable depth and involvement of the submucosa.

Kaitlin tells the nurse she feels she is losing her friends because her dietary restrictions and symptoms are preventing her from socializing. What might the nurse suggest? Allow for cheat meals Find an online support group Find new friends Ignore restrictions when out with friends

Find an online support group Complications associated with IBS revolve around psychosocial concerns such as social isolation related to frequent diarrhea. Patients can be referred to support groups to develop strategies to manage changes in physical functioning caused by IBS, such as spasm, constipation and diarrhea.

A nurse is caring for a patient who has a sudden development of shortness of breath, pink frothy sputum, tachycardia, chest pain, and anxiety. Which is most likely to have occurred? Janeway lesions Pulsus paradoxus Osler's nodes Flash pulmonary edema

Flash pulmonary edema

The nurse is caring for a patient with a sigmoid colostomy. Which stool assessment is considered normal? Semi-liquid Formed Semi-liquid to semi-formed Liquid to semi-liquid

Formed

Which is the most common clinical manifestation of pericarditis? Epigastric discomfort Night sweats Friction rub Weight gain

Friction rub

Which ingredients should be avoided in food selection for a client who has irritable bowel syndrome? Select all that apply. Sodium Fructose Sorbitol Dextrose Lactose

Fructose Sorbitol Lactose

Which medication is most likely to be prescribed to treat pulmonary edema in a patient with heart failure? Digoxin Nesiritide Furosemide Nitroglycerin

Furosemide

Andrew is frightened to have surgery. He asks the nurse why surgery is needed, saying, "What's the worst thing that could happen if I just leave it alone?" What complications should the nurse include in the teaching discussion? Select all that apply. It will heal over time. Gangrene can occur and is life-threatening. Abscess can happen if the bacterial invasion is slow. The pain becomes excruciating. Rupture can occur in as little as 24 hours, which results in peritonitis.

Gangrene can occur and is life-threatening. Abscess can happen if the bacterial invasion is slow. Rupture can occur in as little as 24 hours, which results in peritonitis. *** Without treatment for appendicitis, bacterial invasion occurs and an abscess may develop. Gangrene can occur in as little as 24 to 36 hours and is life-threatening. Perforation can occur in as little as 24 hours, but the risk increases after 48 hours and can result in peritonitis, which can also be fatal.

A patient reports tarry stools and emesis with a "coffee grounds" appearance. They have a history of peptic ulcer disease. Which complication is the patient likely experiencing? Perforation Penetration Obstruction Gastrointestinal (GI) bleeding

Gastrointestinal (GI) bleeding

After receiving hand-off report, the nurse begins reflecting on the possible complications that can occur in the patient with peptic ulcer disease. Which considerations should the nurse make? Select all that apply. Ulcer crater penetrating through adjacent organs Gastrointestinal (GI) contents entering the peritoneum Edema, spasm, or contraction of scar tissue Abdominal distention and third spacing Abdomen tender when palpating

Gastrointestinal (GI) contents entering the peritoneum Abdominal distention and third spacing Abdomen tender when palpating

A patient who is diagnosed with inflammatory bowel disease (IBD) complains of bloating, tightness of stomach, and nausea. Which herb would be most beneficial to relieve the symptoms of the patient? Ginger Fennel Chamomile Peppermint

Ginger (Fennel & peppermint are anti-inflammatories . Chamomile & ginger are antispasmotics. Ginger helps with nausea)

Which describes a patient with internal hemorrhoids that prolapse upon defecation and must be reduced manually? Grade I Grade II Grade III Grade IV

Grade III **** • Grade I: The hemorrhoids do not prolapse. • Grade II: The hemorrhoids prolapse on defecation but reduce spontaneously. • Grade III: The hemorrhoids prolapse on defecation and must be reduced manually. • Grade IV: The hemorrhoids are prolapsed and cannot be reduced manually

Clinical indication - used to treat H. pylori in addition to GERD H2RAS PPIS

H2RAS

Quicker onset of action to provide relief H2RAS PPIS

H2RAS PPIs have a delayed onset of action compared to H2RAs, so patients may need additional therapy for immediate relief of symptoms.

Decrease acid production of parietal cells H2RAS PPIS

H2RAs H2RAs decrease acid production of parietal cells in the stomach lining by blocking histamine-2 at one of the first steps of acid production.

Acute Exacerbation of Heart Failure HYPERTENSION or HYPOTENSION

HYPOTENSION In severe HF exacerbations, the client has decreased cardiac output and often presents with hypotension, cool extremities, decreased or no urine output, and poor or decreasing mentation. Often, he or she will have both an S3 and S4 heart sound.

A nurse is talking about the symptoms of a patient diagnosed with irritable bowel syndrome (IBS). Which symptom listed indicates a need for further discussion? Sensation of incomplete evacuation More frequent stools at the onset of pain Visible abdominal distension Hard stools at the onset of pain

Hard stools at the onset of pain

Kaitlin asks about using alternative therapies to relieve clinical symptoms of IBS. Which suggestions should the nurse make? Select all that apply. Herbal tea Ginger Fennel Peppermint Garlic

Herbal Tea Ginger Fennel Peppermint Ginger, fennel, and peppermint can help to expel gas. Although herbal tea does not expel gas, it can be helpful for its antispasmodic properties.

As the nurse continues to monitor Kaitlin's progress, which laboratory findings might be observed? Select all that apply. Hypokalemia Hyperglycemia Elevated BUN Decreased creatinine Hypernatremia

Hypokalemia Elevated BUN Hypernatremia The patient is at risk of hypokalemia during bouts of diarrhea. Additionally, the serum sodium and BUN may be elevated secondary to dehydration. There should not be changes seen in the glucose or creatinine levels.

What are the most common causes of asystole? Select all that apply. Hypovolemia Hypoxia Acidosis Hypokalemia Heart attack

Hypovolemia Hypoxia Acidosis Hypokalemia

The nurse is admitting a client with mid-epigastric pain. Which medication is most concerning from the client's list of current medications? H2 blockers Antacids Ibuprofen Iron

Ibuprofen

The nurse notes anxiety in a patient with oral cancer. Which is the most likely cause of the client's anxiety? Surgery affecting the quality of speech Radiation therapy Painful swallowing or inability to swallow Impaired breathing

Impaired breathing

A patient with irritable bowel syndrome has been advised to increase dietary fiber. Which additional treatment measure should be included in the plan of care? Limiting exercise pattern training to once a week Increasing fluid intake Consuming carbonated beverages as part of one's daily fluid intake Trying to nap frequently throughout the day

Increasing fluid intake

The nurse observes a client go into pulseless ventricular tachycardia and become unresponsive. What should be the nurse's next action? Apply oxygen Position the client upright Initiate CPR Obtain a blood pressure

Initiate CPR???

A client has been diagnosed with acute appendicitis and is being prepped for surgery. Which provider's order should the nurse question? Initiate intravenous access. Maintain NPO status. Administer an enema. Withhold pain medication until the surgical consent is signed.

Initiate intravenous access. ???

Which is most appropriate to include when teaching a patient with a Helicobacter pylorus-induced gastric ulcer about the prevention of a reoccurrence? Tell the patient that he or she can resume smoking. Advise the patient to include spicy foods in the diet. Advise the patient to consume one or two large meals per day. Instruct the patient to maintain proper hygiene.

Instruct the patient to maintain proper hygiene.

Which assessment changes might the nurse observe in a client with peptic ulcer disease? Intermittent abdominal pain, fluctuating with food intake Nausea and vomiting Right lower quadrant pain with rebound tenderness Heartburn when lying flat in bed at night

Intermittent abdominal pain, fluctuating with food intake

Which is true regarding xerostomia? Select all that apply. It may be also termed as wet mouth as it increases the flow of saliva in the mouth. It occurs in patients receiving significant radiation exposure to the salivary glands during radiotherapy. It is a symptom of several diseases as well as a side effect of many different medications. It decreases the risk of contracting candidiasis and developing stomatitis. It may be caused by removal of the salivary glands, dehydration, and diabetes.

It occurs in patients receiving significant radiation exposure to the salivary glands during radiotherapy. It is a symptom of several diseases as well as a side effect of many different medications. It may be caused by removal of the salivary glands, dehydration, and diabetes.

The lower prevalence of gastroesophageal reflux disease in underdeveloped countries is attributed to which of the following factors? Select all that apply. Lifestyle Dietary habits Prevalence of Helicobacter pylori Reduced carbon emissions Smoking cessation

Lifestyle Dietary habits Prevalence of Helicobacter pylori

An older adult patient receiving treatment with bisphosphonates and calcium supplements for osteoporosis experienced epigastric pain and hematemesis. Which risk factor could be causing the problem? Increasing age Long-term use of bisphosphonates Complication of osteoporosis Reduced bone density

Long-term use of bisphosphonates

Kaitlin expresses concerns that she wants to lose weight. What recommendations should the nurse make to help her attain this goal without exacerbating her IBS? Limit caloric intake to 1,500 calories a day for 1 month Maintain a regular meal schedule Begin an all-liquid diet to stimulate weight loss Include processed frozen foods as meal replacements Check Answer

Maintain a regular meal schedule All clients with IBS should keep regular meal schedules in order to regulate bowel habits. An all-liquid diet and processed frozen foods are not nutritious options.

Which medication should the nurse anticipate for a client diagnosed with heart failure with pulmonary edema? Digoxin Enalapril Furosemide Metoprolol

Metoprolol

The nurse is caring for a patient experiencing a peptic ulcer in the image presented. What should be included in the plan of care? Select all that apply. Monitor stools for bleeding. Deliver nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control. Monitor gastric pH. Increase fiber intake. Encourage caffeine ingestion.

Monitor stools for bleeding. Monitor gastric pH.

Which interventions should a nurse implement for a patient after colorectal surgery? Select all that apply. Take vital signs of the patient every 48 hours. Monitor white blood cell count every day for the first few days. Check if the urine output is at least 10 mL/hour during the first 24 hours. Check if the stoma is reddish pink and moist. Ensure that the patient does not receive food and water per order.

Monitor white blood cell count every day for the first few days. Check if the stoma is reddish pink and moist. Ensure that the patient does not receive food and water per order.

In managing postoperative care for a client who had an appendectomy, which nursing action would be included? Positioning the client on the right side for comfort Maintaining complete bed rest for the first 24 hours postoperatively Monitoring for return of bowel sounds before advancing diet Medicating the client for pain relief around the clock

Monitoring for return of bowel sounds before advancing diet

When caring for a patient with peptic ulcer disease (PUD), he mentions that "something feels different, it's like I have a fullness or heaviness above my stomach after eat." What complication should the nurse consider is occurring? Penetration Perforation Obstruction Gastrointestinal (GI) bleeding

Obstruction

Andrew's appendectomy is performed, revealing that the appendix has ruptured. Based on this finding, what should the nurse include in the postoperative care? Providing nourishment by administering total parenteral nutrition (TPN) in the postoperative period Advancing diet as tolerated within 24 hours of surgery Monitoring nasogastric (NG) tube attached to low intermittent suction for drainage Maintaining complete bedrest with both side rails up to ensure safety

Monitoring nasogastric (NG) tube attached to low intermittent suction for drainage Since the appendix has ruptured, the client is at high risk for infection and aspiration of matter released into circulation in the abdominal area. An NG tube hooked up to low intermittent suction will be required in the immediate postoperative period. NPO status is typically maintained until bowel sounds return and the NG tube is withdrawn. TPN is not required as a postoperative nutrition management method as a quick recovery time is anticipated even with the complication of rupture.

The nurse is caring for a patient diagnosed with pericarditis. Which assessment finding may indicate the presence of cardiac tamponade? Muffled heart sounds Presence of peripheral edema Pulse rate of 55 beats per minute Wheezing sounds on auscultation

Muffled heart sounds

Medication that raises risk for peptic ulcers ACETAMINOPHEN or NSAIDS

NSAIDs By blocking the Cox-1 enzyme and disrupting the production of prostaglandins in the stomach, NSAIDs increase the risk of ulcers forming in the stomach.

A patient has a family history of gastric cancer and says his dad died from advanced disease. Which are common symptoms of this condition that the son should be monitoring? Select all that apply. Nausea and vomiting Heartburn Enlarged lymph nodes Weight gain Anemia

Nausea and vomiting Enlarged lymph nodes Anemia

A patient is admitted for the third time with bleeding gastritis, despite medication compliance. Realizing that surgery may be the next option, he asks the nurse about possible surgical procedures. Which should the nurse NOT share as possibilities? Vagotomy Nissen fundoplication Total gastrectomy Pyloroplasty

Nissen Fundoplication (treats hiatal hernia)

Which order would the nurse question in a client who is admitted for appendicitis? Having the client sign the consent form for an appendectomy Maintaining NPO status prior to surgery Obtaining medical consult for therapeutic management of inflammation Monitoring vital signs

Obtaining medical consult for therapeutic management of inflammation

A patient with stomatitis reports pain when swallowing. How should the nurse document this in the patient's medical report? Odynophagia Dysphasia Xerostomia Dysarthria

Odynophagia

According to the Rome IV criteria, which would confirm positive findings associated with irritable bowel syndrome? Select all that apply. Recurrent abdominal pain 1 day a month for the past 6 months Onset associated with change in frequency of stool No change in stool patterns with onset of clinical symptoms Pain relief with defecation Onset associated with change in appearance of stool

Onset associated with change in frequency of stool Pain relief with defecation Onset associated with change in appearance of stool *** The Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders is one of the most common diagnostic instruments. The patient must have had recurrent abdominal pain or discomfort at least 1 day per week in the last 3 months associated with two or more of the following: • Improvement with defecation • Onset associated with a change in frequency of stool • Onset associated with a change in form (appearance) of stool

Blocks acid secretion in the last step of production in the stomach H2RAS PPIS

PPIS

OTC medications include lansoprazole and omeprazole. H2RAS PPIS

PPIs

Longer duration of action H2RAS PPIS

PPIs PPIs have a delayed onset of action and a duration of action lasting up to 24 hours. H2RAs have an onset of action of 1 hour and a duration of about 12 hours. PPIs have a longer duration of action than H2RAs, so they are more effective for long-term management of clinical symptoms.

The patient comes to the emergency department with nausea, vomiting, and pain upon deep palpation at the location on the image. How should the nurse document this finding? Positive Rovsing's sign Pain at McBurney's point Rebound tenderness Normal findings

Pain at McBurney's point

A patient underwent a partial gastrectomy as a surgical intervention for gastric cancer. The primary health-care provider asks the nurse to monitor the patient for the occurrence of postsurgical problems. Which manifestations in the patient would the nurse consider indicative of onset of dumping syndrome? Select all that apply. Pallor Tachycardia Sweating Bradycardia Indigestion

Pallor Tachycardia Sweating

Which is true regarding infective endocarditis (IE)? Select all that apply. Patients with prosthetic heart valves are at high risk of developing IE. IV drug abusers tend to have left-sided or mitral valve endocarditis. Infective endocarditis (IE) is known for affecting any valves; however, the pulmonic valve is least commonly affected. Patients with an intravascular access device are at a higher risk of developing IE. Non-IV drug abusers tend to have right-sided or tricuspid valve endocarditis.

Patients with prosthetic heart valves are at high risk of developing IE. Infective endocarditis (IE) is known for affecting any valves; however, the pulmonic valve is least commonly affected. Patients with an intravascular access device are at a higher risk of developing IE.

Kaitlin tells the nurse "I know this sounds crazy, but my stomach feels better when I suck on a peppermint candy." How should the nurse reply? Peppermint has no impact on your intestinal functioning. Peppermint is an antispasmodic and has anti-inflammatory properties. Peppermint is a laxative, which increases motility. Peppermint has antinausea affect and can improve stomach irritation. Check Answer

Peppermint is an antispasmodic and has anti-inflammatory properties. Peppermint (Mentha piperita) and fennel (Foeniculum) are natural antispasmodics and have anti-inflammatory properties. They relax smooth muscle in the intestines and help expel gas.

The nurse is teaching about valvular diseases. Which statement indicates a need for further teaching? Prolapse is a condition of the valves. Regurgitation is from insufficient valves. Pericarditis is inflammation of the valves. Stenosis is stiffening of the valves.

Pericarditis is inflammation of the valves.

What potential complications can occur from untreated appendicitis? Select all that apply. Peritonitis Obstruction Abscess Gangrene Perforation

Peritonitis Obstruction Abscess Gangrene Perforation

Which clinical manifestations should a nurse look for in a patient with infective endocarditis (IE)? Select all that apply. Petechiae Exercise intolerance Weight gain Janeway lesions Osler's nodes

Petechiae Janeway lesions Osler's nodes X *Weight gain*???

The nurse is taking care of a client diagnosed with acute appendicitis who is awaiting surgical intervention. The client has been medicated for pain as ordered. What additional comfort measure should the nurse include in the plan of care to relieve the client's pain? Place a warm compress on the area that the client identifies as the source of pain. Position for comfort on the right side with pillow support. Maintain patient's position in high Fowler's to decrease pressure on the diaphragm. Place an ice pack to the right lower quadrant.

Place an ice pack to the right lower quadrant. ???

Andrew, a 20-year-old male college student, presents at the emergency room with recent onset acute abdominal pain in the right lower quadrant along with nausea, but no vomiting. He denies history of any comorbid conditions and does not take any prescription or over-the-counter medications. He is physically active and in overall good health apart from the symptoms he's experiencing. After the healthcare provider makes a clinical diagnosis of appendicitis, the nurse begins to prepare him for surgery.Andrew is experiencing pain of 4 on a 1 to 10 scale prior to the surgery. Which interventions should be used to alleviate pain? Select all that apply: Apply warm compress to the right lower quadrant Position the client with the knees flexed Apply ice pack to the right lower quadrant Administer opioid analgesic prior to having the client sign the surgical consent Maintain NPO status prior to surgery

Position the client with the knees flexed Apply ice pack to the right lower quadrant *** Ice can be applied to the right lower quadrant to impede blood flow, helping to decrease inflammation. Positioning the client with the knees flexed will help relieve pressure. Heat is not used as it will increase blood flow to the area and increase inflammation. Pain medication should not be given prior to signing a surgical consent. NPO status should be maintained, but is not considered a comfort measure.

Andrew continues to recover from surgery and hopes that the NG tube will be removed soon. What clinical finding supports the removal of the NG tube? Client has resumed ambulation with minimal assistance. Less pain medication has been administered during a 12-hour shift. Client is able to tolerate small sips of liquids without nausea or vomiting. Presence of bowel sounds.

Presence of bowel sounds. **** Removal of the NG tube coincides with the return of bowel sounds in the postoperative period, as this indicates that peristalsis is returning. The other clinical findings support clinical improvement, but are not used as a determining factor for removal of a NG tube.

What medications used in the treatment of gastroesophageal reflux disease work by increasing gastric emptying? Antacids Prokinetics Proton pump inhibitors Histamine receptor antagonists

Prokinetics

Which medication option would have a longer duration of action in treating the clinical condition of gastroesophageal reflux disease? Proton pump inhibitors Antacids Corticosteroids Opioid analgesics

Proton pump inhibitors

The nurse is concerned about the client's increasing number of premature ventricular contractions on the electrocardiogram. What could be a cause? Pulse oximetry of 91% Potassium of 3.6 mEq/L 3 cups of decaffeinated coffee Sodium of 145 mEq/L

Pulse oximetry of 91%

Which nursing action, when caring for a patient with abdominal trauma, may result in further complications? Administering IV fluids to the patient Removing objects emerging from the wound Promoting hemodynamic stability Obtaining samples for a complete blood count (CBC), serum electrolytes, and urinalysis

Removing objects emerging from the wound

*While diagnosing a patient with oral trauma, the nurse finds ineffective airway clearance. Which characteristic findings are likely observed? Select all that apply. Respiratory stridor Impaired ability to eat or drink Swelling in and around the mouth Increased vascularity of the face and mouth Difficulty in managing oral secretions

Respiratory stridor Swelling in and around the mouth

The nurse is admitting a client with peptic ulcer disease. During a dietary assessment the client lists these as his favorite types of foods. What is most concerning? Pasta with white sauce Fresh fish and green salad Rice with curry and spices Ham and potatoes

Rice with curry and spices

The nurse on a cardiac unit hears the monitor alarm and sees that a patient that she is not assigned to is in ventricular tachycardia. What should be the nurse's next action? Run to the room and assess the patient. Find the assigned nurse and let them know. Walk to the room and assess the patient. Silence the alarm and walk away.

Run to the room and assess the patient.

Gary is a 70-year-old experiencing acute chest pain. The nurse places the client on oxygen at 2L per nasal cannula and places him on the cardiac monitor, seeing this rhythm.Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type II Second Degree AV Block Type I Sinus Rhythm with PVCs

Second degree AV block type II Second degree AV block type II is also called a Mobitz II. It is when the SA node fires but not all of the electrical conduction progresses to the ventricles. It can be identified when each QRS has a P wave but there are several P waves without a QRS following them. It is considered more concerning than a Mobitz I and is potentially life-threatening because it can quickly progress to a complete heart block. The aggressiveness of the treatment is dependent of the patient's symptoms. Temporary pacing may be needed.

Which intervention is considered a conservative treatment for hemorrhoids? Bipolar, infrared, and laser coagulation Sclerotherapy Sitz bath Hemorrhoidectomy

Sitz bath

The nurse is caring for a client with a newly placed transvenous pacemaker. What findings are anticipated? Select all that apply. Large pads on the torso are intact Small incision in the left upper chest External pacemaker box A pacer spike for each P wave A pacer spike prior to each QRS complex

Small incision in the left upper chest External pacemaker box A pacer spike prior to each QRS complex???

The nurse is providing teaching to a client with irritable bowel syndrome. Along with teaching the client about proper nutrition, what other topics should the nurse address? Select all that apply. Smoking cessation Keeping daily activity low, exercising only as necessary Sleeping seven to eight hours each night Limiting alcohol intake Investigating alternative therapies

Smoking cessation Sleeping seven to eight hours each night Limiting alcohol intake Investigating alternative therapies

The nurse is caring for a client experiencing dark stools with a positive Hemoccult test. The client is being prepared for an esophageal gastroduodenoscopy to rule out peptic ulcers. The client is anxious and asks where peptic ulcers are located. What should the nurse include in the response? Select all that apply. Esophagus Stomach Duodenum Jejunum Colon

Stomach Duodenum

A patient is hospitalized to rule out peptic ulcer disease (PUD). He asks the nurse what types of noninvasive tests the provider will perform. Which test should the nurse say is most commonly performed? Upper-endoscopy test Liver function test Esophagogastroduodenoscopy (EGD) Stool antigen test

Stool antigen test

A nurse overhears another team member saying that atrial fibrillation begins in the atrioventricular (AV) node of the heart. What action should the nurse take? Stop the team member and correct their comment. Allow them to finish their comments as being correct. Share with another colleague what you overheard. Confirm the information as being accurate with an internet search.

Stop the team member and correct their comment.

A patient reports nausea, vomiting, and epigastric pain, and is diagnosed with acute gastritis. Which medications are appropriate for symptomatic relief of the patient? Select all that apply. Sucralfate Diclofenac Pantoprazole Vitamin B12 Magnesium sulfate

Sucralfate (forms protective lining in stomach) Pantoprazole (PPI) Magnesium sulfate (Antacid)

The patient with signs of appendicitis prefers not to take pain medication. What position may help to relieve the pain? Head of bed flat with legs extended Side lying with legs extended Supine with head of bed elevated 30° to 45° with knees flexed Prone with arms above the head

Supine with head of bed elevated 30° to 45° with knees flexed

Kaitlin asks the nurse about stress management to help control her symptoms. Which suggestions should the nurse make? Select all that apply. Take a daily walk Go to church every week Consider a group yoga class Find a massage therapist Take 15 minutes each day to meditate

Take a daily walk Consider a group yoga class Find a massage therapist Take 15 minutes each day to meditate Regular exercise, yoga, massage, or meditation may be effective ways of relieving stress and anxiety. Attending church meets religious needs but may not be appropriate to suggest to Kaitlin without further questions about her spiritual beliefs.

Which are true regarding the QRS wave? Select all that apply. The QRS wave is the first wave that is normally seen in patients. The QRS wave represents ventricular depolarization. Normal QRS waves are usually rounded in width. Wide QRS waves may indicate that there is a block in the ventricles. QRS waves can take on many different forms.

The QRS wave represents ventricular depolarization. Wide QRS waves may indicate that there is a block in the ventricles. QRS waves can take on many different forms.

Andrew verbally consents to surgery. Which statement about the consent is true? Andrew's parents must be contacted since he is younger than 21. The consent must be signed before narcotics are administered. A verbal consent is acceptable and the nurse can document that. The consent cannot be signed until the anesthesiologist sees Andrew.

The consent must be signed before narcotics are administered. *** The nurse must ensure that the surgical consent form is signed prior to the client receiving any sedatives or narcotics. Legal age for consents is 18 years, not 21. Verbal consents are not acceptable for surgery. Although the surgeon should speak with the client before the consent is signed, the anesthesiologist typically does not.

The nurse provides a cool mist to a patient with oral cancer. Which outcome indicates this is an effective nursing action? The patient does not have aspiration. The patient has adequate air exchange. The patient has decreased oral edema. The patient does not have xerostomia.

The patient does not have xerostomia.

The nurse is caring for a patient with a peptic ulcer. Which symptom would suggest that it is in the duodenum? The patient is dizzy, sweating, and has palpations. The patient has ulcer-like pain that cannot be relieved by antacids. The patient has burning epigastric pain, which can be relieved after taking antacids. The patient feels stomach fullness.

The patient has burning epigastric pain, which can be relieved after taking antacids.

Which is true of the action of proton pump inhibitors (PPIs) in treating gastroesophageal reflux disease? They block gastric acid production. They increase gastric pH. They increase gastric emptying. They are short-acting medications that decrease gastric acid production.

They block gastric acid production.

Which is true regarding umbilical hernias? Select all that apply. They can be congenital and appear in infancy. They may be caused by the intake of immunosuppressive medications. They are more frequently seen in women than in men. They are usually omentum or peritoneal fat that detains blood flow into the hernia. They form from a previous abdominal surgical incision.

They can be congenital and appear in infancy. They are more frequently seen in women than in men. They are usually omentum or peritoneal fat that detains blood flow into the hernia. (Not at previous ab incision - that's ventral)

In working with clients who have been diagnosed with gastroesophageal reflux disease, which statement is accurate related to the use of proton pump inhibitors as therapeutic treatment? It is also useful in the treatment of H. pylori. The client is encouraged to increase fluid intake while taking this therapy to prevent dehydration from occurring. It leads to resolution of clinical condition after two months of therapy. Tolerance is unlikely.

Tolerance is unlikely.

Preferred procedure for diagnosis UPPER GI ENDOSCOPY UPPER GI SERIES

Upper GI endoscopy Upper GI endoscopy is the preferred procedure for evaluation of peptic ulcer disease, as compared with a barium upper GI radiograph, because of its increased sensitivity and specificity.

A patient reports epigastric pain, blood in stools, and a loss of appetite. Which initial diagnostic test is the primary health-care provider most likely to order to determine if the client has Helicobacter pylori infection? Endoscopy Urea breath test Complete blood count Upper gastrointestinal (GI) x-ray

Urea breath test

Which diagnostic tests are used to detect an active infection with Helicobacter pylori? Select all that apply. Radiological test Urea breath test Barium x-ray test Serological test Fecal antigen test

Urea breath test Serological test Fecal antigen test

In hopes of promoting a prompt recovery, which of the following aspects will be included in care planning for this client? Select all that apply. Use of incentive spirometer Early ambulation as tolerated Discontinuation of antibiotic therapy upon client becoming afebrile Assistance with turning, coughing, and deep breathing techniques (TCDB) Limiting oral fluids

Use of incentive spirometer Early ambulation as tolerated Assistance with turning, coughing, and deep breathing techniques (TCDB) *** To promote a prompt recovery, the client should be encouraged to use incentive spirometry to facilitate lung expansion. Similarly, assisting the client with TCDB techniques will facilitate lung expansion and prevent occurrence of postoperative atelectasis. Early ambulation is encouraged to prevent the occurrence of venous thromboembolism (VTE), which can be a complication of bed rest and immobility in the postoperative period.

What are the theories on the etiologic mechanisms of irritable bowel syndrome (IBS)? Select all that apply. Visceral hypersensitivity Gastrointestinal motility Decrease in mast cells Bacterial overgrowth Food sensitivity

Visceral hypersensitivity Gastrointestinal motility Bacterial overgrowth Food sensitivity *** • Gastrointestinal motility • Visceral hypersensitivity • Intestinal inflammation • Postinfectious • Bacterial overgrowth • Food sensitivity • Carbohydrate malabsorption • Gluten sensitivity • Genetics • Psychosocial dysfunction

Which medication can help to decrease the gag reflex if administered to a patient with stomatitis? IV acyclovir Viscous lidocaine Nystatin Histamine receptor agonists

Viscous Lidocaine

In which way are external hemorrhoids diagnosed? Anoscopy Visual inspection Digital examination Sigmoidoscopy

Visual inspection

The nurse is providing care to a patient who has just completed the procedure in this image (Percutaneous Transluminal Coronary Angioplasty) . What postprocedure medication should the nurse anticipate will be prescribed? Warfarin Heparin Enoxaparin sodium Aspirin

Warfarin

A nurse is reviewing the risk factors that may increase the risk for developing esophageal cancer. Which risk factor listed indicates a need for further training? Nutritional deficiency Barrett's esophagus Weight loss Gastroesophageal reflux disease (GERD)

Weight loss

In which diagnostic study does the patient swallow a pill to capture the image of the gastrointestinal (GI) tract to assess for colorectal cancer? Lower GI series Wireless capsule endoscopy Virtual colonoscopy Sigmoidoscopy

Wireless capsule endoscopy

An RN is teaching a nursing student about the heart rates in patients with atrial fibrillation. Which statement made by the nursing student indicates the need for further teaching? "Atrial rates in patients with atrial fibrillation can range from 300 to 600 beats per minute." "A heart rate of 110 beats per minute is considered to be uncontrolled atrial fibrillation." "Heart rate of 95 beats per minute indicates atrial fibrillation with rapid ventricular response." "When the atrioventricular (AV) node maintains the heart rate at less than 100 beats per minute, the condition is referred to as controlled atrial fibrillation."

"Heart rate of 95 beats per minute indicates atrial fibrillation with rapid ventricular response." Rationale: *>100 bpm* indicates rapid ventricular response

The nurse is teaching about spironolactone as a treatment for patients with heart failure. Which dietary instruction indicates a need for further teaching? "Avoid alcohol intake." "Limit salt in your diet." "Decrease the intake of foods that are high in fat." "Increase the intake of potassium-containing foods."

"Increase the intake of potassium-containing foods."

Fatigue ALTERNATE REST/ACTIVITY or GIVE ANTIDEPRESSANT

ALTERNATE REST/ACTIVITY Fatigue is a common clinical manifestation associated with heart failure. The nurse should alternate rest and activity periods for this patient. An antidepressant may be prescribed for the depression that often accompanies a diagnosis of heart failure.

Which drug classification should the nurse anticipate for a client diagnosed with heart failure to reduce fluid volume and afterload? Diuretic Inotropic Angiotensin-converting-enzyme inhibitor Beta blocker

Angiotensin-converting-enzyme inhibitor

Which are the clinical manifestations of right-sided heart failure? Select all that apply. Ascites Dyspnea Hepatomegaly Generalized edema Weak pulses

Ascites Hepatomegaly Generalized edema

A nurse finds the patient is unresponsive with no pulse or blood pressure. Which dysrhythmia does the nurse anticipate? Normal sinus rhythm Asystole Second degree heart block, type I Premature ventricular contractions (PVCs), symptomatic

Asystole

Scott is a 91-year-old client in a long-term care facility. The nurse enters the room and finds that Scott does not have a pulse and activates EMS. The paramedics place the monitor and find this rhythm.Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

Asystole Asystole is a condition in which there is no electrical activity in the heart. Resuscitation should be immediate. Causes include hypovolemia, hypoxia, acidosis, and potassium imbalances.

The nurse recognizes which risk factors for the development of stomatitis? (Select all that apply.) A. High-fiber diet B. Radiation therapy C. Past history of skin cancer D. Poor dental hygiene E. Smoking

B. Radiation therapy D. Poor dental hygiene E. Smoking

Which symptoms should the nurse anticipate when providing care to a client who is diagnosed with left-sided heart failure? Select all that apply. Cyanosis Peripheral edema S3 and S4 heart sounds Jugular vein distention Weak peripheral pulses

Cyanosis S3 and S4 heart sounds Weak peripheral pulses

The nurse correlates which clinical manifestation to type I hiatal hernia? A. Heartburn B. GERD C. Chest pain D. Anorexia

D. Anorexia

For each of these rhythms, place the priority action in the correct order. Determine level of consciousness. Assess blood pressure. Defibrillate. Document.

Defibrillate. Determine level of consciousness. Assess blood pressure. Document.

Which clinical manifestations should the nurse anticipate when providing care to a client who is diagnosed with right-sided heart failure? Select all that apply. Weak pulses Dependent edema Delayed capillary refill Jugular vein distention Wheezes noted on lung auscultation

Dependent edema Jugular vein distention

The nurse looks at the electrocardiogram (ECG) monitor and sees this rhythm. What action should the nurse take first? Begin cardiopulmonary resuscitation (CPR). Assess for a pulse. Determine unresponsiveness. Silence the alarm.

Determine unresponsiveness.

Type of peptic ulcer DUODENAL or JEJUNAL

Duodenal Duodenal ulcers are a type of peptic ulcer. They are chronic in nature and make up about 80% of peptic ulcers, affecting the proximal part of the small intestine. They are characterized by remissions and exacerbations.

Tolerance to medication is likely to occur H2RAS PPIS

H2RAs With H2RAs therapy, medication tolerance is likely to occur. This is not seen with PPI therapy.

The patient asks the nurse what it means to be in "stage B" of heart failure? Which statement by the nurse is accurate? It signifies current or past symptoms of heart failure. It signifies refractory heart failure eligible for heart transplant, inotropic and/or mechanical support. It signifies hypertrophy and/or impaired function of the left ventricle with asymptomatic conditions. It signifies risk factors but no left ventricle impairment.

It signifies hypertrophy and/or impaired function of the left ventricle with asymptomatic conditions.

Cool Extremities RIGHT-SIDED HF or LEFT-SIDED HF

LEFT-SIDED HF A patient diagnosed with left-sided heart failure experiences weakened cardiac contractions. This results in a backflow of blood that negatively impacts peripheral circulation. Poor peripheral circulation manifests with cool skin and often poor skin color.

Which action taken by the nurse may cause aspiration in a patient with oral cancer? Providing elixir form of medications Instructing the patient to refrain from talking when eating Lowering the head of the bed Assessing the patient's ability to swallow

Lowering the head of the bed

Fluid Excess and Edema MONITOR I/O or RANGE OF MOTION

MONITOR I/O Generalized edema is a clinical manifestation of heart failure. The patient is prescribed a diuretic and the nurse should monitor intake and output to determine if the prescribed diuretic is working.

Hepatomegaly MONITOR LIVER or MONITOR KIDNEYS

MONITOR LIVER Hepatomegaly indicates an enlarged liver; therefore, the nurse should monitor the patient's liver enzymes. BUN and creatinine should be monitored for clients who are receiving large doses of diuretics.

Daily Weight MORNING or BEFORE VOIDING

MORNING Daily weight should be taken at home at same time each day, preferably morning after voiding. This is important to monitor for possible fluid retention and the need for intervention.

The nurse reviews the ECG strip of a client admitted with dizziness and syncope. Which findings are considered normal? Select all that apply. P wave has a positive deflection and with a rounded at the top in lead II. T wave is inverted in lead II. U wave is a positive deflection and rounded at the top in lead II. QRS is less than 0.10 seconds. There is a P wave immediately before each T wave.

P wave has a positive deflection and with a rounded at the top in lead II. QRS is less than 0.10 seconds.???

Interfere with the absorption of ketoconazole, ampicillin, iron, and digoxin. H2RAS PPIS

PPIs Can interfere with the absorption of ketoconazole, ampicillin, iron, and digoxin. The H2RA cimetidine can interact with warfarin, phenytoin, and theophylline with long-term use.

This patient is experiencing right-sided heart failure. Which symptom should the nurse anticipate? Peripheral edema Crackles in the lungs Dyspnea Orthopnea

Peripheral edema

Ascites RIGHT-SIDED HF or LEFT-SIDED HF

RIGHT-SIDED HF The weakened contraction of the right ventricle results in a backflow of blood into the right atrium and venous circulation, resulting in ascites.

Jason is an 18-year-old who comes to the emergency department because his heart is racing. He admits to drinking 4 energy drinks at a party and "it's never done this to me before."Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

Supraventricular tachycardia Supraventricular tachycardia (SVT) is a rapid rhythm from the ventricular with a narrow QRS complex and a rate > 100 beats per minute. The client can be symptomatic with a decreased cardiac output and low blood pressure. Treatment includes a variety of medications or cardioversion.

The nurse is reviewing the compensatory mechanisms of heart failure. Place the sequence of events in the correct order. Increase in venous return to the heart Sympathetic nervous system release of epinephrine and norepinephrine Brain natriuretic peptide release Release of the renin-angiotensin-aldosterone system

Sympathetic nervous system release of epinephrine and norepinephrine Release of the renin-angiotensin-aldosterone system Increase in venous return to the heart Brain natriuretic peptide release

Mary is a 68-year-old admitted with syncope. She has a history of hyperthyroidism that is poorly controlled.Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

Atrial Flutter Atrial flutter (AFL) is a dysrhythmia from atrial pacemaker cells that take over the primary SA node's function. There are no P waves, but rather "flutter waves" as the atrial rate can range from 250 to 350 beats per minute. Like atrial fibrillation, the treatments aim to control the ventricular rate by using medications. Chemical conversion or cardioversion are sometimes indicated.

While assessing the electrocardiogram (ECG) report of a patient, the nurse observes that there is an absence of P waves and the QRS complex is narrow with irregular RR intervals. Which dysrhythmia is the patient experiencing? Atrial fibrillation Sinus tachycardia Sinus bradycardia Junctional tachycardia

Atrial fibrillation

Which of these symptoms would the nurse expect to find in a client with gastroesophageal reflux disease? Select all that apply. Atypical chest pain Sleep issues Adult-onset asthma Elevated temperature Laryngitis

Atypical chest pain Sleep issues Adult-onset asthma Laryngitis

Marvin, 54 years old, is running a marathon when he suddenly becomes light headed and short of breath. He falls to his knees and is quickly attended to by the first-aid attendants. They check a pulse and find that his heart rate is 30 beats per minute and his blood pressure is 67/35 mm Hg. EMS is activated.Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

Complete Heart Block Complete heart block (CHB), also known as third-degree atrioventricular block, is a potentially life-threatening dysrhythmia that occurs when the atria and ventricles beat completely independently of each other. It can be recognized when the P waves are regular and the QRS complexes are regular, but they are not correlating with each other. Treatment of the symptoms is the priority and a pacemaker is often required to increase the ventricular heart rate and improve cardiac output.

Which clinical manifestations should a nurse look for in a patient with type II hiatal hernia? Select all that apply. Feeling full after eating Regurgitation Chest pain like angina Feeling of suffocation Belching

Feeling full after eating Chest pain like angina Feeling of suffocation

Kamal is 40 years old and anxious about an upcoming diagnostic test for cancer. His father was 40 when he died of cancer. He has a history of hypertension. Kamal puts on his call light and says it feels like his heart is skipping beats.Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

PVC Premature Ventricular Contractions (PVC) are abnormal beats that originate in the ventricles. On the monitor they are wide and bizarre in appearance and > 0.12 seconds. They can be described in many ways including by frequency (rare, occasional, frequent), direction (unifocal, multifocal), or by patterns (couplets, triplets, bigeminal, trigeminal). Three PVCs in a row or more is considered ventricular tachycardia. Some patients feel the irregular beats, but unless the beats are extensive or frequent, they are benign. Causes include hypoxia, electrolyte imbalance, hypertension, stimulant ingestion, and recreational drug use.

Jose is a 68-year-old with a history of a myocardial event 4 years ago. He comes to the clinic today for a routine exam. The nurse notes this rhythm on the ECG monitor.Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

Second degree AV block type I Second degree AV block type I is also called Mobitz I or Wenckebach. It is a slowing of conduction between the SA node and the AV node until a ventricular beat is "dropped." After the QRS is dropped the process starts over. It can be identified by measuring progressive, prolonging of the PR intervals. It is not considered life-threatening and is typically intermittent but on rare occasions can be continuous. Treatment is considered if the patient is symptomatic from the loss of cardiac output.

Which is true regarding H2 receptor antigen antagonists in treating gastroesophageal reflux disease? Select all that apply. Some patients may develop a tolerance. They have a delayed onset of action and a longer duration of action. They reduce acid production longer than antacids but are slower to take effect. They are more effective in suppressing gastric acid secretion than proton pump inhibitors. They decrease acid production of parietal cells in the stomach lining by blocking histamine 2 at one of the first steps of acid production.

Some patients may develop a tolerance. They reduce acid production longer than antacids but are slower to take effect. They decrease acid production of parietal cells in the stomach lining by blocking histamine 2 at one of the first steps of acid production

A patient is known to have risk factors for heart failure. Diagnostic testing reveals the absence of left ventricular involvement. In which stage of heart failure development, according to the American Heart Association (AHA), is the patient? Stage A Stage B Stage C Stage D

Stage A Rationale: According to the AHA, stage A signifies a patient with risk factors but with no left ventricle impairment.

Which are true regarding a third-degree atrioventricular (AV) or complete heart block? Select all that apply. The P waves will be equal to the QRS complexes. The atrial rate is between 60 and 100 bpm; ventricular rate is less than or equal to 40 bpm. The P waves should march throughout the rhythm strip at an irregular rate. The ventricles and atria do not have any communication. The permanent pacemaker may be inserted as per the order.

The atrial rate is between 60 and 100 bpm; ventricular rate is less than or equal to 40 bpm. The ventricles and atria do not have any communication. The permanent pacemaker may be inserted as per the order

A client with gastroesophageal reflux disease has a catheter and sensor that is placed in the nose and terminates in the distal esophagus. The client has also been asked to keep a diary of symptoms and activities. Which diagnostic test has been ordered for this client? Twenty-four-hour ambulatory esophageal pH monitoring Pulmonary function tests Endoscopy Telemetry monitoring

Twenty-four-hour ambulatory esophageal pH monitoring

Chongan is a 72-year-old experiencing vomiting and diarrhea for the last 3 days. His serum potassium is 2.9 mEq/dL. The nurse looks up and sees this rhythm on the monitor.Which dysrhythmia is the client experiencing? Atrial Fibrillation Atrial Flutter Supraventricular Tachycardia Sinus Rhythm with PVCs Ventricular Tachycardia Ventricular Fibrillation Asystole Complete Heart Block Second Degree AV Block Type I Second Degree AV Block Type II

Ventricular tachycardia Ventricular tachycardia (VT) is defined as 3 or more PVCs. When VT is significant and impacts the cardiac output, it can be life-threatening. Some patients can maintain a pulse and blood pressure for a limited time while other patients are pulseless. The priority is to rapidly assess the client to see how they are tolerating the rhythm. Treatment for "stable" VT includes IV antiarrhythmic medications such as amiodarone with electrolyte replacement. Cardioversion may be required. If the patient becomes pulseless from the VT, cardiopulmonary resuscitation with defibrillation is required.