exam 3

cliche

-a stereotyped, trite, or pat answer -suggest that there is no cause for anxiety or concern, or they offer false assurance. ("Don't worry. You will be just fine in another day or two." "Your doctor knows best." "Everybody is afraid of surgery. Why should you be any different?" "You teenagers are all alike. You aren't cooperative because you deny authority.")

d (The use of the clarifying question or comment allows the nurse to gain an understanding of a patient's comment. When used properly, this technique can avert possible misconceptions that could lead to an inappropriate nursing diagnosis.)

A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and dehydration. During the admission interview, the nurse should implement which communication techniques to elicit the most information from the parents? a) The use of reflective questions b) The use of closed questions c) The use of assertive questions d) The use of clarifying questions

leading

A ___________ question suggests what response the speaker wishes to hear. (Nurse: You aren't going to smoke that cigarette, are you? Nurse: You have been well cared for by your nurses, haven't you?)

flow meter

A client has been put on oxygen therapy because of low oxygen saturation levels in the blood. What should the nurse use to regulate the amount of oxygen delivered to the client?

d

A client has edema of the feet and ankles, along with crackles in the lower lobes and a frothy, productive cough. The client is suffering from: a) pulmonary embolism. b) myocardial infarction. c) lung cancer. d) congestive heart failure.

c (It is inappropriate to rely on the client's family members or friends for this service.)

A client is diagnosed with diabetes. The client's adult child offers to serve as an interpreter, because the client does not speak the dominant language. Which is the best action for the nurse to take? a) Allow the client's child to interpret. b) Involve a friend who speaks both the dominant and the client's languages. c) Contact a professional interpreter. d) Ask a fellow nurse who knows some words in the client's language to help.

biofeedback

A client with chronic pain uses a machine to monitor his physiologic responses to pain. The unit transforms the data into a visual display and through seeing the pain responses, the client is taught to regulate his physiologic response and control pain through relaxation, imagery, or breathing exercises. This technique for pain control is known as __________________.

diabetic neuropathy

A common complication of long-term diabetes mellitus. Metabolic and vascular changes result in damage to peripheral and autonomic nerves. Sensory loss can result when peripheral nerves are involved and eventually lead to injury progressing to infection and gangrene. Symptoms include sensations of numbness, prickling, or tingling (paresthesias).

half life

A drug's _______ ________ is the amount of time it takes for 50% of the serum concentration of a drug to be eliminated from the body. -prolonged by liver & kidney disease, aging, absence of food, and slow metabolic rate.

therapeutic range

A drug's ____________ ____________ is the concentration of drug in the blood serum that produces the desired effect without causing toxicity.

b (When the prescriber writes a PRN order ("as needed") for medication, the patient receives medication when it is requested or required. With a single or one-time order, the directive is carried out only once, at a time specified by the prescriber. A stat order is a single order carried out immediately. A standing order (or routine order) is carried out as specified until it is canceled by another order.)

A health care provider orders a pain medication for a postoperative patient that is a PRN order. When would the nurse administer this medication? a) A single dose during the postoperative period b) Doses administered as needed for pain relief c) One dose administered immediately d) Doses routinely administered as a standing order

a (Holism is a theory and philosophy that focuses on connections and interactions between parts of the whole. Complementary therapy can be used to complement traditional medical interventions. Integrative care often incorporates sharing the responsibility in coordinating the best possible treatment plan for a client, including the client's choices for care and the provider's expertise. Homeopathy is based on the belief of supporting the body while the symptoms are allowed to "run their course.")

A home care nurse delivers care that incorporates a philosophy that focuses on connections and interactions between parts of the whole. Which term best describes this philosophy? a) holism b) complementary therapy c) integrative care d) homeopathy

b (It is unsafe to administer narcotics or adjuvant drugs without the approval of the clinician responsible for the epidural injection. Suppositories, abdominal palpation, and feeding are not contraindicated when the client has an epidural in place.)

A hospital client's pain is being treated with epidural analgesia. Which nursing action would pose a threat to the client's safety? a) Feeding the client food and fluids while in a semi-Fowler's (partially upright) position b) Administering an oral dose of morphine to treat the client's breakthrough pain c) Administering a glycerin suppository to treat the client's constipation d) Palpating the client's abdomen during a head-to-toe assessment

d (Many cartridges are overfilled, and some of the medication needs to be discarded. Always check the volume needed to provide the correct dose with the volume in the syringe. Giving the excess medication in the cartridge may result in adverse effects for the patient. For this dose, it is not necessary to call the pharmacy or refuse to give the medication, provided the order is written correctly. Wasting narcotics typically requires a second RN to witness the waste and verify the amount of narcotic discarded.)

A medication order reads: "Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain." The prefilled cartridge is available with a label reading "Hydromorphone 2 mg/1 mL." The cartridge contains 1.2 mL of hydromorphone. What should the nurse do? a) Give all the medication in the cartridge because it expanded when it was mixed and this is what the pharmacy sent. b) Call the pharmacy and request the proper dose. c) Refuse to give the medication and document refusal in the EHR. d) Dispose of 0.2 mL before administering the drug; verify the waste with another nurse.

c (The abbreviation BID refers to twice-a-day administration; "po" (by mouth) refers to administration by the oral route.)

A medication order reads: "K-Dur, 20 mEq po BID." When and how does the nurse correctly give this drug? a) Daily at bedtime by subcutaneous route b) Every other day by mouth c) Twice a day by the oral route d) Once a week by transdermal patch

c (If a patient vomits immediately after swallowing an oral pill, the nurse should assess the vomit for the pill or fragments of it. The nurse should then notify the primary care provider to see if another dosage should be administered.)

A nurse administers a dose of an oral medication for hypertension to a patient who immediately vomits after swallowing the pill. What would be the appropriate initial action of the nurse in this situation? A) Re-administer the medication and notify the primary care provider. B) Re-administer the pill in a liquid form if possible. C) Assess the vomit, looking for the pill. D) Notify the primary care provider.

c (a manual resuscitation bag (Ambu bag) may be used to deliver oxygen until the client is resuscitated or can be intubated with an endotracheal tube.)

A nurse assessing a client's respiratory effort notes that the client's breaths are shallow and 8 per minute. Shortly after, the client's respirations cease. Which form of oxygen delivery should the nurse use for this client? a. Oxygen mask b. Nasal cannula c. Ambu bag d. Oxygen tent

a, b, c, f (Chiropractors may combine the use of spinal adjustments and other manual therapies with several other treatments and approaches including heat and ice, electrical stimulation, relaxation techniques, rehabilitative and general exercise, counseling about weight and diet, and using dietary supplements. Chiropractors do not prescribe medication or perform invasive procedures.)

A nurse cares for patients in a chiropractic office. What patient education might this nurse perform? Select all that apply. a) Applying heat or ice to an extremity b) Explaining the use of electrical stimulation c) Teaching a patient relaxation techniques d) Teaching a patient about a prescription e) Explaining an invasive procedure to a patient f) Teaching about dietary supplements

a (The termination phase occurs when the conclusion of the initial agreement is acknowledged. Discharge planning coordinates with the termination phase of a helping relationship. The nurse should determine the progress made in achieving the goals related to the patient's care.)

A nurse caring for a patient who is hospitalized following a double mastectomy is preparing a discharge plan for the patient. Which action should be the focus of this termination phase of the helping relationship? a) Determining the progress made in achieving established goals b) Clarifying when the patient should take medications c) Reporting the progress made in teaching to the staff d) Including all family members in the teaching session

c (The nurse's first responsibility is the patient—careful observation is necessary to assess for any effect of the medication error. The other nursing actions are pertinent, but only after checking the patient's welfare.)

A nurse discovers that a medication error occurred. What should be the nurse's first response? a) Record the error on the medication sheet. b) Notify the physician regarding course of action. c) Check the patient's condition to note any possible effect of the error. d) Complete an incident report, explaining how the mistake was made.

d (The nurse should identify himself, be sure the patient knows what will be happening, and the time period he will be with his patient.)

A nurse enters a patient's room and examines the patient's IV fluids and cardiac monitor. The patient states, "Well, I haven't seen you before. Who are you?" What is the nurse's BEST response? a) "I'm just the IV therapist checking your IV." b) "I've been transferred to this division and will be caring for you." c) "I'm sorry, my name is John Smith and I am your nurse." d) "My name is John Smith, I am your nurse and I'll be caring for you until 11 PM."

d (The use of touch conveys acceptance, and the implementation of an open-ended question allows the patient time to verbalize freely.)

A nurse enters the room of a patient with cancer. The patient is crying and states, "I feel so alone." Which response by the nurse is the most therapeutic action? a) The nurse stands at the patient's bedside and states, "I understand how you feel. My mother said the same thing when she was ill." b) The nurse places a hand on the patient's arm and states, "You feel so alone." c) The nurse stands in the patient's room and asks, "Why do you feel so alone? Your wife has been here every day." d) The nurse holds the patient's hand and asks, "What makes you feel so alone?"

b (Effective communication by the sender involves the implementation of nonthreatening information by showing respect to the receiver. The nurse should identify the subject of the meeting and be sure it occurs at a mutually agreed upon time.)

A nurse in the rehabilitation division states to the head nurse: "I need the day off and you didn't give it to me!" The head nurse replies, "Well, I wasn't aware you needed the day off, and it isn't possible since staffing is so inadequate." Instead of this exchange, what communication by the nurse would have been more effective? a) "I placed a request to have 8th of August off, but I'm working and I have a doctor's appointment." b) "I would like to discuss my schedule with you. I requested the 8th of August off for a doctor's appointment. Could I make an appointment?" c) "I will need to call in on the 8th of August because I have a doctor's appointment." d) "Since you didn't give me the 8th of August off, will I need to find someone to work for me?"

b, c, f

A nurse instructor is teaching a class of student nurses about the nature of pain. Which statements accurately describe this phenomenon? Select all that apply. a) Pain is whatever the health care provider treating the pain says it is b) Pain exists whenever the person experiencing it says it exists c) Pain is an emotional and sensory reaction to tissue damage d) Pain is a simple, universal, and easy-to-describe phenomenon e) Pain that occurs without a known cause is psychological in nature f) Pain is classified by duration, location, source, transmission, and etiology

a (The nurse should ask the patient to state his name and birthdate based on facility policy. A sign over the patient's bed may not always be current. The roommate is an unsafe source of information. The patient may not hear his name but may reply in the affirmative anyway (e.g., a person with a hearing deficit).)

A nurse is administering a pain medication to a patient. In addition to checking his identification bracelet, the nurse correctly verifies the patient's identity by performing which action? a) Asking the patient his name and birthdate b) Reading the patient's name on the sign over the bed c) Asking the patient's roommate to verify his name d) Asking, "Are you Mr. Brown?"

c (When giving heparin subcutaneously, the nurse should not aspirate or massage, so as not to cause trauma or bleeding in the tissues.)

A nurse is administering heparin subcutaneously to a patient. What is the correct technique for this procedure? a) Aspirate before giving and gently massage after the injection. b) Do not aspirate; massage the site for 1 minute. c) Do not aspirate before or massage after the injection. d) Massage the site of the injection; aspiration is not necessary but will do no harm.

a (If the patient is receiving tube feedings, the nurse should review information about the drugs to be administered. Absorption of some drugs, such as phenytoin, is affected by tube-feeding formulas. The nurse should discontinue a continuous tube feeding and leave the tube clamped for the required period of time before and after the medication has been given, according to the reference and facility protocol.)

A nurse is administering phenytoin via a gastric tube to a patient who is receiving tube feedings. What would be an appropriate action of the nurse in this situation? A) Discontinue the tube feeding and leave the tube clamped for required period of time before and after medication administration. B) Notify the primary care provider that medication cannot be given to the patient at this time via the gastric tube. C) Remove the tube in place and replace it with another tube prior to administering the medication. D) Flush the tube with 60 mL of water prior to administering the medication.

b (Sedation level is more indicative of respiratory depression because a drop in level usually precedes it. A sedation level of 4 calls for immediate action because the patient has minimal or no response to stimuli. A respiratory level of 10 with normal depth of breathing is usually not a cause for alarm. Mild confusion may be evident with the initial dose and then disappear; additional observation is necessary. Constipation should be reported to the health care provider, but is not the priority in this situation.)

A nurse is assessing a patient receiving a continuous opioid infusion. For which related condition would the nurse immediately notify the primary care provider? a) A respiratory rate of 10/min with normal depth b) A sedation level of 4 c) Mild confusion d) Reported constipation

b (Pneumonia, which causes the lungs to swell and stiffen, can lead to atelectasis. Stiffer lungs tend to collapse, and their alveoli also collapse. Consequently, the amount of space available for gas exchange in the lungs decreases. Croup, asthma, and alcohol use do not lead to atelectasis.)

A nurse is assigned to care for a client admitted to the health care facility with the diagnosis of atelectasis. When interviewing the client, the nurse would anticipate a history of: a) croup b) pneumonia c) alcohol use d) asthma

c (Chest physiotherapy may help loosen and mobilize secretions, increasing mucus clearance. This is especially helpful for patients with large amounts of secretions or an ineffective cough, such as patients with cystic fibrosis. Chest physiotherapy has limited evidence for its effectiveness and is not recommended for use in numerous patient populations, including children with pneumonia, adults with COPD, and postoperative adults)

A nurse is assisting a respiratory therapist with chest physiotherapy for patients with ineffective cough. For which patient might this therapy be recommended? a) A postoperative adult b) An adult with COPD c) A teenager with cystic fibrosis d) A child with pneumonia

b (A side effect of morphine is respiratory depression. In this situation, the nurse should first stop the PCA pump and then notify the physician. Naloxone is used to reverse the sedative effects of opioids, but this is not the first step.)

A nurse is caring for a client who is receiving morphine via a patient controlled analgesia (PCA) pump. When assessing the client, she notes that his respiratory rate is 4. What should the nurse do first? a) Notify the physician. b) Stop the PCA pump. c) Administer naloxone. d) Increase the primary IV rate.

b (Pulse oximetry is used to obtain baseline information about the patient's oxygen saturation level and is also performed for patients with asthma. Diffusion capacity estimates the patient's ability to absorb alveolar gases and determines if a gas exchange problem exists. Maximal respiratory pressures help evaluate neuromuscular causes of respiratory dysfunction. Both tests are usually performed by a respiratory therapist. The physician or other advanced practice professional can perform a thoracentesis at the bedside with the nurse assisting, or in the radiology department.)

A nurse is caring for a patient who has been hospitalized for an acute asthma exacerbation. Which testing method might the nurse use to measure the patient's oxygen saturation? a) Thoracentesis b) Pulse oximetry c) Diffusion capacity d) Maximal respiratory pressure

a (Adding guided imagery (CHA) to the administration of pain medications (allopathy) is an example of integrative care. A person who uses integrative care uses some combination of allopathic medicine and CHA.)

A nurse is caring for a patient who has crippling rheumatoid arthritis. Which nursing intervention best represents the use of integrative care? a) The nurse administers naproxen and uses guided imagery to take the patient's mind off the pain. b) The nurse prepares the patient's health care provider-approved herbal tea and uses meditation to relax the patient prior to bed. c) The nurse administers naproxen and performs prescribed range-of-motion exercises. d) The nurse arranges for acupuncture for the patient and designs a menu high in omega-3 fatty acids.

a (If a problem exists in ventilation, respiration, or perfusion, hypoxia may occur. Hypoxia is a condition in which an inadequate amount of oxygen is available to cells. The most common symptoms of hypoxia are dyspnea (difficulty breathing), an elevated blood pressure with a small pulse pressure, increased respiratory and pulse rates, pallor, and cyanosis.)

A nurse is caring for a patient with COPD. What would be an expected finding upon assessment of this patient? a. Dyspnea b. Hypotension c. Decreased respiratory rate d. Decreased pulse rate

c (The nurse should encourage the patient to breathe through the nose with the mouth closed. The nurse should assure that the oxygen is flowing out of the prongs prior to inserting them into the patient's nostrils. The nurse should adjust the fit of the cannula so it is snug but not tight against the skin. The nurse should adjust the flow rate as ordered.)

A nurse is caring for a patient with chronic lung disease who is receiving oxygen through a nasal cannula. What nursing action is performed correctly? a) The nurse assures that the oxygen is flowing into the prongs. b) The nurse adjusts the fit of the cannula so it fits snug and tight against the skin. c) The nurse encourages the patient to breathe through the nose with the mouth closed. d) The nurse adjusts the flow rate to 6 L/min or more.

d (Imagery involves using all five senses to imagine an event or body process unfolding according to a plan. A patient can be encouraged to "go to a favorite place." With the other modalities, the patient is more passive.)

A nurse is caring for a postoperative patient who is experiencing pain. Which CHA might the nurse use to ensure active participation by the patient to achieve effective pre- or postoperative pain control? a) Acupuncture b) TT c) Botanical supplements d) Guided imagery

b (The nurse would base the size of the suctioning catheter on the size of the endotracheal tube. The external diameter of the suction catheter should not exceed half of the internal diameter of the endotracheal tube. Larger catheters can contribute to trauma and hypoxemia.)

A nurse is choosing a catheter to use to suction a patient's endotracheal tube via an open system. On which variable would the nurse base the size of the chosen catheter? a) The age of the patient b) The size of the endotracheal tube c) The type of secretions to be suctioned d) The height and weight of the patient

b (The client should be the only one to administer medication via the PCA pump. Using the pump prior to getting out of bed and/or ambulating will help decrease the pain. Distraction is an effective nonpharmacologic means of dealing with pain. Constipation is a common side effect from many pain medications. Increasing fluid intake is one way of attempting to prevent it.)

A nurse is evaluating the effectiveness of the preoperative education regarding pain control. Which statement by the client would indicate a need for further education? a) "I will push my PCA button before I get up to go to the bathroom." b) "I will have my wife push the PCA button when I'm asleep." c) "I will bring my favorite music to listen to after my surgery." d) "I will make sure to drink plenty of water so I don't get constipated from the pain medication."

c (A meter-dose inhaler has a canister that contains medication under pressure. It is much more commonly used than the turbo-inhaler, which is a propeller-driven device that spins and suspends a finely powdered medication.)

A nurse is explaining to a client the correct method of using a metered-dose inhaler when self-administering a prescribed dose of medication. What is a feature of a metered-dose inhaler? a) It is a battery-operated device that spins. b) It suspends finely powdered medication. c) It is a canister that contains pressurized medication. d) It has propellers that get activated during inhalation.

c (Meditators should have an open attitude by letting distractions come and go naturally without judging them. They should also maintain a specific, comfortable posture lying down, sitting, standing, walking, etc.; focus attention on a mantra, object, or breathing; and not suppress distracting or wandering thoughts; instead they should gently bring attention back to focus.)

A nurse is guiding a patient in the practice of meditation. Which teaching point is most useful in helping the patient to achieve a state of calmness, physical relaxation, and psychological balance? a) Teach the patient to always lie down in a comfortable position during meditation. b) Teach the patient to focus on multiple problems that the patient feels demand attention. c) Teach the patient to let distractions come and go naturally without judging them. d) Teach the patient to suppress distracting or wandering thoughts to maintain focus.

a, d, e (Chronic pain is pain that may be limited, intermittent, or persistent but that lasts beyond the normal healing period.)

A nurse is monitoring patients in a hospital setting for acute and chronic pain. Which patients would most likely receive analgesics for chronic pain from the nurse? Select all that apply. a) A patient is receiving chemotherapy for bladder cancer b) An adolescent is admitted to the hospital for an appendectomy c) A patient is experiencing a ruptured aneurysm d) A patient who has fibromyalgia requests pain medication e) A patient has back pain related to an accident that occurred last year f) A patient is experiencing pain from second-degree burns

a, b, d, f (The patient's expectations of the medication may affect the response to the medication, for example, when a placebo is given and a patient has a therapeutic effect. The patient's environment may also influence the patient's response to medications, for example, sensory deprivation and overload may affect drug responses. Circadian rhythms and cycles may also influence drug action. The liver is the primary organ for drug breakdown, thus pathologic conditions that involve the liver may slow metabolism and alter the dosage of the drug needed to reach a therapeutic level. The presence of food in the stomach can delay the absorption of orally administered medications. Alternately, some medications should be given with food to prevent gastric irritation, and the nurse should consider this when establishing a patient's medication schedule. Other medications may have enhanced absorption if taken with certain foods.)

A nurse is preparing medications for patients in the ICU. The nurse is aware that there are patient variables that may affect the absorption of these medications. Which statements accurately describe these variables? Select all that apply. a) Patients in certain ethnic groups obtain therapeutic responses at lower doses or higher doses than those usually prescribed. b) Some people experience the same response with a placebo as with the active drug used in studies. c) People with liver disease metabolize drugs more quickly than people with normal liver functioning. d) A patient who receives a pain medication in a noisy environment may not receive full benefit from the medication's effects. e) Oral medications should not be given with food as the food may delay the absorption of the medications. f) Circadian rhythms and cycles may influence drug action.

c (Many nurses are expanding their clinical practice by incorporating CHA. Although CHA may seem totally safe, some therapies have led to harmful and, at times, lethal outcomes. Many patients use these types of therapies as outpatients and want to continue their use as inpatients. Although the use of most complementary and alternative therapies predates modern medicine, it was not until recently that nursing and medical schools began to teach about their use.)

A nurse is providing a lecture on CHAs (Complementary Health Approaches) to a group of patients in a rehabilitation facility. Which teaching point should the nurse include? a) CHAs are safe interventions used to supplement traditional care. b) Many patients use CHA as outpatients but do not wish to continue as inpatients. c) Many nurses are expanding their clinical practice by incorporating CHA to meet the demands of patients. d) Most complementary and alternative therapies are relatively new and their efficacy has not been established.

b (The patient's question allows the nurse to clarify information that is new to the patient or that requires further explanation.)

A nurse is providing instruction to a patient regarding the procedure to change a colostomy bag. During the teaching session, the patient asks, "What type of foods should I avoid to prevent gas?" The patient's question allows for what type of communication on the nurse's part? a) A closed-ended answer b) Information clarification c) The nurse to give advice d) Assertive behavior

c (The tube depth should be maintained at the same level unless otherwise ordered by the health care provider. If the depth changes, the nurse should remove the tape, adjust the tube to ordered depth, and reapply the tape.)

A nurse is securing a patient's endotracheal tube with tape and observes that the tube depth changed during the retaping. Which action would be appropriate related to this incident? a) Instruct the assistant to notify the primary care provider. b) Assess the patient's vital signs. c) Remove the tape, adjust the depth to ordered depth and reapply the tape. d) No action is required as depth will adjust automatically.

a (When a patient vomits upon suctioning of an oropharyngeal airway, the nurse should remove the catheter; it has probably entered the esophagus inadvertently. If the patient needs to be suctioned again, the nurse should change the catheter, because it is probably contaminated. The nurse should also turn the patient to the side and elevate the head of the bed to prevent aspiration.)

A nurse is suctioning an oropharyngeal airway for a patient who vomits when it is inserted. Which priority nursing action should be performed by the nurse related to this occurrence? a) Remove the catheter. b)Notify the primary care provider. c) Check that the airway is the appropriate size for the patient. d)Place the patient on his or her back.

d (When nosebleed (epistaxis) is noted with continued suctioning, the nurse should notify the health care provider and anticipate the need for a nasal trumpet. The nasal trumpet will protect the nasal mucosa from further trauma related to suctioning.)

A nurse is suctioning the nasopharyngeal airway of a patient to maintain a patent airway. For which condition would the nurse anticipate the need for a nasal trumpet? a) The patient vomits during suctioning. b) The secretions appear to be stomach contents. c) The catheter touches an unsterile surface. d) A nosebleed is noted with continued suctioning.

d, e, f (Common mistakes that patients make when using MDIs include failing to shake the canister, holding the inhaler upside down, inhaling through the nose rather than the mouth, inhaling too rapidly, stopping the inhalation when the cold propellant is felt in the throat, failing to hold their breath after inhalation, and inhaling two sprays with one breath.)

A nurse is teaching a patient how to use a meter-dosed inhaler for her asthma. Which comments from the patient assure the nurse that the teaching has been effective? Select all that apply. a) "I will be careful not to shake up the canister before using it." b) "I will hold the canister upside down when using it." c) "I will inhale the medication through my nose." d) "I will continue to inhale when the cold propellant is in my throat." e) "I will only inhale one spray with one breath." f) "I will activate the device while continuing to inhale."

a, c, e (The correct procedure for using a meter-dosed inhaler is: Shake the inhaler well and remove the mouthpiece cover; breathe normally through the spacer; depress the canister releasing one puff into the spacer and inhale slowly and deeply; after inhaling, hold breath for 5 to 10 seconds, or as long as possible, and then exhale slowly through pursed lips; wait 1 to 5 minutes as prescribed before administering the next puff; and gargle and rinse with tap water after using the MDI.)

A nurse is teaching a patient how to use a meter-dosed inhaler to control asthma. What are appropriate guidelines for this procedure? Select all that apply. a) Shake the inhaler well and remove the mouthpiece covers from the MDI and spacer. b) Take shallow breaths when breathing through the spacer. c) Depress the canister releasing one puff into the spacer and inhale slowly and deeply. d) After inhaling, exhale quickly through pursed lips. e) Wait 1 to 5 minutes as prescribed before administering the next puff. f) Gargle and rinse with salt water after using the MDI.

a (Energy healing is focused on pain that lingers after an injury heals, as well as pain complicated by trauma, anxiety, or depression.)

A nurse manager who works in a hospital setting is researching the use of energy healing to use as an integrative care practice. Which patient would be the best candidate for this type of CHA? a) A patient who is anxious about residual pain from cervical spinal surgery b) A patient who is experiencing abdominal discomfort c) A patient who has chronic pain from diabetes d) A patient who has frequent cluster headaches

a, b, e (With CHA, mind, body, and spirit are integrated and together influence health and illness, and illness is a manifestation of imbalance or disharmony. Allopathic beliefs include: The main causes of illness are considered to be pathogens (bacteria or viruses) or biochemical imbalances, curing seeks to destroy the invading organism or repair the affected part, and emphasis is on disease and high technology. Drugs, surgery, and radiation are among the key tools for dealing with medical problems. According to allopathic beliefs, health is the absence of disease.)

A nurse mentor is teaching a new nurse about the underlying beliefs of CHAs versus allopathic therapies. Which statements by the new nurse indicate that teaching was effective? Select all that apply. a) "CHA proponents believe the mind, body, and spirit are integrated and together influence health and illness." b) "CHA proponents believe that health is a balance of body systems: mental, social, and spiritual, as well as physical." c) "Allopathy proponents believe that the main cause of illness is an imbalance or disharmony in the body systems." d) "Curing according to CHA proponents seeks to destroy the invading organism or repair the affected part." e) "The emphasis is on disease for allopathic proponents and drugs, surgery, and radiation are key tools for curing." f) "According to CHA proponents, health is the absence of disease."

a

A nurse notices a patient is walking to the bathroom with a stooped gait, facial grimacing, and gasping sounds. Based on these nonverbal clues, for which condition would the nurse assess? a) Pain b) Anxiety c) Depression d) Fluid volume deficit

d (Once medications have been prepared the nurse must either stay with the medications or lock them in an area such as the medication cart. The medications should never be left unattended or placed back in their containers. Another nurse cannot administer medications that have been prepared by the first nurse.)

A nurse preparing medication for a client is called away to an emergency. What should the nurse do? a) Have another nurse guard the preparations. b) Put the medications back in the containers. c) Have another nurse finish preparing and administering the medications. d) Lock the medications in a cart and finish them upon return.

d (When a chest tube becomes separated from the drainage device, the nurse should submerge the end in water, creating a water seal, but allowing air to escape, until a new drainage unit can be attached. This is done instead of clamping to prevent another pneumothorax. Then the nurse should assess vital signs and notify the health care provider.)

A nurse providing care of a patient's chest drainage system observes that the chest tube has become separated from the drainage device. What would be the first action that should be taken by the nurse in this situation? a) Notify the health care provider. b) Apply an occlusive dressing on the site. c) Assess the patient for signs of respiratory distress. d) Put on gloves and insert the chest tube in a bottle of sterile saline.

c (Endorphins are powerful pain-blocking chemicals that have prolonged analgesic effects and produce euphoria. It is thought that endorphins are released through pain relief measures, such as relaxation techniques. Prostaglandins, substance P, and serotonin are neurotransmitters or substances that either excite or inhibit target nerve cells.)

A nurse uses a whirlpool to relax a patient following intense physical therapy to restore movement in the patient's legs. What is a potent pain-blocking neuromodulator, released through relaxation techniques? a) Prostaglandins b) Substance P c) Endorphins d) Serotonin

d (A range of 95% to 100% is considered normal oxygen saturation. As such, there is no need to change the client's position, encourage deep-breathing exercises and coughing, or to review the client's medication history.)

A nurse using a pulse oximeter to measure a client's SpO2 obtains a reading of 95%. What is the nurse's most appropriate action? a) Encourage the client to do deep-breathing exercises. b) Raise the head of the client's bed slightly, if tolerated. c) Review the medications that the client has taken in the past 90 minutes. d) Document this expected assessment finding.

d (Therapeutic Touch (TT) involves "unruffling," or clearing, congested areas of energy in the body and redirecting this energy. After assessing a client's "energy field," the nurse uses therapeutic touch to promote comfort, relaxation, healing, and a sense of well-being.)

A nurse who "unblocks" and "clears" congested areas of energy in a client's body to promote comfort is applying the phenomenon known as: a) "Unruffling" touch b) Interpersonal touch c) Tactile manipulation d) Therapeutic Touch (TT)

c (The nurse should use the Z-track technique for intramuscular injections to prevent leakage of medication into the needle track, thus minimizing discomfort. The nurse should select a needle of the smallest gauge that is appropriate for the site and solution to be injected, and select the correct needle length. The nurse should also inject the medication into relaxed muscles since there is more pressure and discomfort if medication is injected into contracted muscles. The nurse should apply gentle pressure after injection, unless this technique is contraindicated.)

A nurse who gives subcutaneous and intramuscular injections to patients in a hospital setting attempts to reduce discomfort for the patients receiving the injections. Which technique is recommended? a) The nurse selects a needle of the largest gauge that is appropriate for the site and solution to be injected. b) The nurse injects the medication into contracted muscles to reduce pressure and discomfort at the site. c) The nurse uses the Z-track technique for intramuscular injections to prevent leakage of medication into the needle track. d) The nurse applies vigorous pressure in a circular motion after the injection to distribute the medication to the intended site.

a, d, f (Absorption is the process by which a drug is transferred from its site of entry into the body to the bloodstream. Metabolism, or biotransformation, is the change of a drug from its original form to a new form. The liver is the primary site for drug metabolism. The gastrointestinal tract, as well as sweat, salivary, and mammary glands, are routes of drug excretion.)

A nurse who is administering medications to patients in an acute care setting studies the pharmacokinetics of the drugs being administered. Which statements accurately describe these mechanisms of action? Select all that apply. A) Distribution occurs after a drug has been absorbed into the bloodstream and is made available to body fluids and tissues. B) Metabolism is the process by which a drug is transferred from its site of entry into the body to the bloodstream. C) Absorption is the change of a drug from its original form to a new form, usually occurring in the liver. D) During first-pass effect, drugs move from the intestinal lumen to the liver by way of the portal vein instead of going into the system's circulation. E) The gastrointestinal tract, as well as sweat, salivary, and mammary glands, are routes of drug absorption. F) Excretion is the process of removing a drug, or its metabolites (products of metabolism), from the body.

b (Commonly used essential oils in a health care setting are ginger or peppermint for nausea and lavender or chamomile for insomnia.)

A nurse working in a long-term care facility incorporates aromatherapy into her practice. For which patient would this nurse use the herb ginger? a) A patient who has insomnia b) A patient who has nausea c) A patient who has dementia d) A patient who has migraine headaches

b, d, e (When caring for patients with COPD, it is important to create an environment that is likely to reduce anxiety and ensure that they eat a high-protein/high-calorie diet. People with dyspnea and orthopnea are most comfortable in a high-Fowler's position because accessory muscles can easily be used to promote respiration. Patients with COPD should pace physical activities and schedule frequent rest periods to conserve energy. Meals should be eaten 1 to 2 hours after breathing treatments and exercises, and drinking 2 to 3 quarts (1.9 to 2.9 L) of clear fluids daily is recommended.)

A nurse working in a long-term care facility is providing teaching to patients with altered oxygenation due to conditions such as asthma and COPD. Which measures would the nurse recommend? Select all that apply. a) Refrain from exercise. b) Reduce anxiety. c) Eat meals 1 to 2 hours prior to breathing treatments. d) Eat a high-protein/high-calorie diet. e) Maintain a high-Fowler's position when possible. d) Drink 2 to 3 pints of clear fluids daily.

b, d, e, f (Naturopathic medicine is not only a system of medicine, but also a way of life, with emphasis on patient responsibility, patient education, health maintenance, and disease prevention. Its principles include minimizing harmful side effects and avoiding suppression of symptoms, educating patients and encouraging them to take responsibility for their own health, treating the whole person, preventing illness, believing in the healing power of nature, and treating the cause of a disease or condition rather than its symptoms.)

A nurse works for a health care provider who practices the naturopathic system of medicine. What is the focus of nursing actions based on this type of medical practice? Select all that apply. a) Treating the symptoms of the disease b) Providing patient education c) Focusing on treating individual body systems d) Making appropriate interventions to prevent illness e) Believing in the healing power of nature f) Encouraging patients to take responsibility for their own health

c (By engaging in self-talk, or intrapersonal communication, the nursing student can plan her day and enhance her clinical performance to decrease fear and anxiety.)

A nursing student is nervous and concerned about working at a clinical facility. Which action would BEST decrease anxiety and ensure success in the student's provision of patient care? a) Determining the established goals of the institution b) Ensuring that verbal and nonverbal communication is congruent c) Engaging in self-talk to plan the day and decrease fear d) Speaking with fellow colleagues about how they feel

b (The nurse should ask permission to assist the patient with a bath. This allows for consent to assist the patient with care that invades the patient's private zones.)

A nursing student is preparing to administer morning care to a patient. What is the MOST important question that the nursing student should ask the patient about personal hygiene? a) "Would you prefer a bath or a shower?" b) "May I help you with a bed bath now or later this morning?" c) "I will be giving you your bath. Do you use soap or shower gel?" d) "I prefer a shower in the evening. When would you like your bath?"

d (Many pain medications are ordered on a PRN (as needed) basis. Therefore, nurses must be diligent to assess patients for pain and administer medications as needed. A patient should not be afraid to request these medications and should not wait until the pain is unbearable. Few people become addicted to the medications if used for a short period of time. Pain following surgery can be controlled and should not be considered a natural part of the experience that will lessen in time.)

A patient is postoperative following an emergency cesarean section birth. The patient asks the nurse about the use of pain medications following surgery. What would be a correct response by the nurse? a) "It's not a good idea to ask for pain medication regularly as it can be addictive." b) "It is better to wait until the pain is severe before asking for pain medication." c) "It's natural to have to put up with pain after surgery and it will lessen in intensity in a few days." d) "Your doctor has prescribed pain medications for you, which you should request when you have pain."

b (The patient's pain would be categorized as visceral pain, which is poorly localized and can originate in body organs in the abdomen. Cutaneous pain (superficial pain) usually involves the skin or subcutaneous tissue. A paper cut that produces sharp pain with a burning sensation is an example of cutaneous pain. Deep somatic pain is diffuse or scattered and originates in tendons, ligaments, bones, blood vessels, and nerves. Strong pressure on a bone or damage to tissue that occurs with a sprain causes deep somatic pain.)

A patient reports abdominal pain that is difficult to localize. The nurse documents this as which type of pain? a) Cutaneous b) Visceral c) Superficial d) Somatic

b (Regular or short-acting insulin (unmodified insulin) should never be contaminated with NPH or any insulin modified with added protein. Placing air in the NPH vial first without allowing the needle to contact the solution ensures that the regular insulin will not be contaminated.)

A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What is the correct sequence when mixing insulins? a) Inject air into the regular insulin vial and withdraw 10 units; then, using the same syringe, inject air into the NPH vial and withdraw 40 units of NPH insulin. b) Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin. c) Inject air into the regular insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the NPH insulin vial and withdraw 40 units; then, withdraw 10 units of regular insulin. d) Inject air into the NPH insulin vial and withdraw 40 units; then, using the same syringe, inject air into the regular insulin vial and withdraw 10 units of regular insulin.

d (Referred pain is perceived in an area distant from its point of origin, whereas transient pain is brief and passes quickly. Superficial pain originates in the skin or subcutaneous tissue. Phantom pain may occur in a person who has had a body part amputated, either surgically or traumatically.)

A patient who is having a myocardial infarction reports pain that is situated in the neck. The nurse documents this as what type of pain? a) Transient pain b) Superficial pain c) Phantom pain d) Referred pain

d (For a patient who is too fatigued to complete daily hygiene on his or her own, the nurse should group personal care activities into smaller steps and allow rest periods between the activities. The nurse should assist with bathing and hygiene tasks as needed and only when the patient has difficulty. The nurse should encourage the patient to voice feelings and concerns about self-care deficits, and teach the patient to coordinate diaphragmatic breathing with the activity.)

A patient with COPD is unable to perform personal hygiene without becoming exhausted. What nursing intervention would be appropriate for this patient? A) Assist with bathing and hygiene tasks even if the patient feels capable of performing them alone. B) Teach the patient not to talk about the procedure, just to perform it at the best of his or her ability. C) Teach the patient to take short shallow breaths when performing hygiene measures. D) Group personal care activities into smaller steps, allowing rest periods between activities.

intramuscular

A person in shock has poor peripheral circulation. Which route would promote fast absorption? Intramuscular or Intravenous?

integrative

A person who uses _______________ care uses some combination of allopathic medicine and complementary therapy approach.

d (Too much of an opioid drug given by way of an epidural catheter or a displaced catheter may result in the occurrence of respiratory depression. Pruritus, urinary retention, and vomiting may occur but are not life threatening.)

A pregnant woman is receiving an epidural analgesic prior to delivery. The nurse provides vigilant monitoring of this patient to prevent the occurrence of what side effect? a) Pruritus b) Urinary retention c) Vomiting d) Respiratory depression

a (The nurse must maintain confidentiality when providing care. The statement "New mothers need support" is a general statement that all new parents need help. The statement is not judgmental of the family's roles.)

A public health nurse is leaving the home of a young mother who has a special needs baby. The neighbor states, "How is she doing, since the baby's father is no help?" What is the nurse's BEST response to the neighbor? a) "New mothers need support." b) "The lack of a father is difficult." c) "How are you today?" d) "It is a very sad situation."

electrocardiogram

A recording of the electrical activity of the heart

bronchodilators

A substance that dilates the bronchi in the lungs decreasing resistance in the respiratory airways -allows air to get into lungs -works on nervous system -can be used as rescue inhaler

oxygen tent

An ___________ _________ is commonly used with children who need a cool and highly humidified airflow. It is also more effective for children because they often do not like to keep oxygen administration devices in place.

analgesic

An ____________ is a pharmaceutical agent that relieves pain. -They function to reduce the person's perception of pain and to alter the person's responses to discomfort. -There are three general classes of drugs used for pain relief: opioid, non-opioid, adjuvant

endotracheal

An ________________ tube is a polyvinyl chloride airway that is inserted through the nose or mouth into the trachea, using a laryngoscope as a guide. It is used to administer oxygen by mechanical ventilator, to suction secretions easily, or to bypass upper airway obstructions

a

An occupational therapist conducts daily relaxation exercises with clients who are receiving treatment on the psychiatric unit of a hospital. Stimulation of which of the following components of the nervous system will result in relaxation for the clients? a) Parasympathetic nervous system b) Autonomic nervous system c) Central nervous system d) Sympathetic nervous system

a

An older adult client is visibly pale with a respiratory rate of 30 breaths per minute. Upon questioning, the client states to the nurse, "I can't seem to catch my breath." The nurse has responded by repositioning the client and measuring the client's oxygen saturation using pulse oximetry, yielding a reading of 90%. The nurse should interpret this oxygen saturation reading in light of the client's: a) hemoglobin level b) age c) blood pH d) sodium and potassium level

concentrator

An oxygen _________________ removes nitrogen from the room air and concentrates the oxygen left in the air. -needs a power source such as an electrical outlet, battery pack, or car charger, but never runs out (of oxygen) and does not need to be refilled. -used instead of cylinders -portable and cost effective

b (Kripalu, or "gentle yoga," focuses on relaxation and coming into balance. Ashtanga focuses on synchronizing breath with a fast-paced series of postures. The nurse should not discourage the use of yoga in patients who are healthy enough to participate. Yoga is not contraindicated in patients with controlled high blood pressure.)

At a follow-up visit, a patient recovering from a myocardial infarction tells the nurse: "I feel like my life is out of control ever since I had the heart attack. I would like to sign up for yoga, but I don't think I'm strong enough to hold poses for long." What would be the nurse's best response? a) "Right now you should concentrate on relaxing and taking your blood pressure medicine regularly, instead of worrying about doing yoga." b) "There is a slower-paced yoga called Kripalu that focuses on coming into balance and relaxation that you could look into." c) "Ashtanga yoga is a gentle paced yoga that would help with your breathing and blood pressure." d) "Yoga is contraindicated for patients who have had a heart attack."

sender, message, channel, reciever

Berlo's SMCR Model of Communication stands for...

physiotherapy

Chest ___________________ may help loosen and mobilize secretions, increasing mucus clearance. -This is especially helpful for patients with large amounts of secretions or an ineffective cough. -Includes percussion, vibration, and postural drainage and is generally performed by respiratory therapists and physical therapists, or nurses with specialized skills, in acute care environments for select patients

c, d, e

During an interaction with a patient diagnosed with epilepsy, a nurse notes that the patient is silent after communicating the nursing care plan. What would be appropriate nurse responses in this situation? Select all that apply. a) Fill the silence with lighter conversation directed at the patient. b) Use the time to perform the care that is needed uninterrupted. c) Discuss the silence with the patient to ascertain its meaning. d) Allow the patient time to think and explore inner thoughts. e) Determine if the patient's culture requires pauses between conversation. f) Arrange for a counselor to help the patient cope with emotional issues.

d (The charge nurse should direct the patient care technician to determine the patient's safety. Then the nurse should address any concerns regarding the patient care technician's communication techniques privately. The nurse should direct the patient care technician on aspects of therapeutic communication.)

During rounds, a charge nurse hears the patient care technician yelling loudly to a patient regarding a transfer from the bed to chair. Upon entering the room, what is the nurse's BEST response? a) "You need to speak to the patient quietly so you don't disturb the other patients." b) "Let me help you with your transfer technique." c) "When you are finished, be sure to apologize for your rough demeanor." d) "When your patient is safe and comfortable, meet me at the desk."

neuromodulators

Endorphins and enkephalins are opioid ______________________, they regulate sensations of pain.

intramuscular

Excessive exercise draws blood away from the stomach & intestines to the muscles. Which route would promote absorption for someone who has just heavily exercised? Oral or Intramuscular?

face, legs, activity, cry, consolability

FLACC scale stands for:

carbon dioxide

Hyperventilation can lead to a lowered level of arterial ___________________

b (Whereas physicians and other health care providers prescribe and pharmacists dispense therapeutic agents, it is the nurse's legal domain to administer medications in a safe and timely manner.)

If the dosage is inappropriate for a client, who is responsible? a) Physician b) Nurse c) Pharmacist d) Medical Technician

sender

In Berlo's Model of Communication, The __________ or source (encoder) of the message is a person or group who initiates or begins the communication process.

receiver

In Berlo's Model of Communication, The _____________ (decoder) must translate and interpret the message sent and received.

message

In Berlo's Model of Communication, The ______________ is the actual communication product from the source. It might be a speech, interview, conversation, chart, gesture, memorandum, or nursing note.

channel

In Berlo's Model of Communication, the ____________ of communication is the medium the sender has selected to send the message. This might target any of the receiver's senses.

active, passive

Inspiration, the ____________- phase, involves movement of muscles and the thorax to bring air into the lungs. Expiration, the _____________ phase, is the movement of air out of the lungs.

d (The Z-track method is suggested for older adults who have decreased muscle mass. While some agents, such as iron, are best given via the Z-track method due to the irritation and discoloration associated with this agent, none of the other clients demonstrate specific characteristics that suggest the need for Z-tracking.)

It is particularly important for the nurse to use The Z track technique when administering intramuscular (IM) medication to which client? a) A 30-year-old client diagnosed with Tourette syndrome prescribed haloperidol b) A 40-year-old client diagnosed with breast cancer prescribed fulvestrant c) A 50-year-old client idemonstrating delerium tremors prescibed lorazepam d) A 70-year-old demonstrating muscle wasting prescribed chlorpromazine

compliance

Lung ________________ refers to the ease with which the lungs can be inflated.

b (The nurse is responsible for any medications given and must inform the doctor of the patient's allergy to the drug. The nurse should not give the medication and might speak with the supervisor only if uncomfortable with the health care provider's answer when notified. The nurse is legally unable to order a replacement medication, as is the pharmacist.)

Ms. Hall has an order for hydromorphone, 2 mg, intravenously, q 4 hours PRN pain. The nurse notes that according to Ms. Hall's chart, she is allergic to hydromorphone. The order for medication was signed by Dr. Long. What would be the correct procedure for the nurse to follow in this situation? a) Administer the medication; the doctor is responsible for medication administration. b) Call Dr. Long and ask that the medication be changed. c) Ask the supervisor to administer the medication. d) Ask the pharmacist to provide a medication to take the place of hydromorphone.

diffuse

Pain covers a large area. Usually, the patient is unable to point to a specific area without moving the hand over a large surface, such as the entire abdomen.

dull

Pain is not as intense or acute as sharp pain, possibly more annoying than painful. It is usually more diffuse than sharp pain.

sharp

Pain is sticking in nature and that is intense.

shifting

Pain moves from one area to another, such as from the lower abdomen to the area over the stomach.

transmission

Pain sensations from the site of an injury or inflammation are conducted along pathways to the spinal cord and then on to higher centers. This is called ________________________.

pursed lip

Patients who experience dyspnea and feelings of panic can often reduce these symptoms by using ___________ _______ breathing. -creates a smaller opening for air movement, effectively slowing and prolonging expiration.

pain threshold

The ______ _____________ is the "minimum intensity of a stimulus that is perceived as painful"

simple

The ________ face mask is connected to oxygen tubing, a humidifier, and a flow meter, just like the nasal cannula. -has vents on its sides that allow room air to leak in the vents also allow exhaled carbon dioxide to escape. -Often used when an increased delivery of oxygen is needed for short periods (e.g., less than 12 hours). -eating and talking are difficult, a tight seal is required, and there is the potential for skin breakdown. -low flow

wong baker

The _________ - ___________ scale is used for adults and children >3, and compares pain to a series of faces (broad smile to fearful grimace)

trough level

The _________ __________ is the point when the drug is at its lowest concentration, indicating the rate of elimination. -typically drawn 30 minutes before the next dose is scheduled to be administered.

peak level

The _________ __________, or highest plasma concentration, of the drug should be measured when absorption is complete. -typically drawn 1 hour after a drug has been administered

partial rebreather

The __________ ______________ mask is similar to a simple face mask, but is equipped with a reservoir bag for the collection of the first part of the patient's exhaled air. (The remaining exhaled air exits through vents.) -The air in the reservoir is mixed with 100% oxygen for the next inhalation. -eating and talking are difficult, a tight seal is required, and there is the potential for skin breakdown. -conserves oxygen -low flow

lower

The __________ airway, known as the tracheobronchial tree, includes the trachea, main stem bronchi, segmental bronchi, and terminal bronchioles. Its major functions are conduction of air, mucociliary clearance, and production of pulmonary surfactant.

helpful

The ___________ relationship is characterized by an unequal sharing of information. (The patient shares information related to personal health problems, whereas the nurse shares information in terms of a professional role.) -built on the patient's needs -It is purposeful and time limited

upper

The ______________ airway is composed of the nose, pharynx, larynx, and epiglottis. Its main function is to warm, filter, and humidify inspired air.

nonrebreather

The _______________ mask delivers the highest concentration of oxygen via a mask to a spontaneously breathing patient. -It is similar to the partial rebreather mask except that two one-way valves prevent the patient from rebreathing exhaled air. -eating and talking are difficult, a tight seal is required, and there is the potential for skin breakdown. -low flow

retraction

The accessory muscles of the abdomen, neck, and back are used to maintain respiratory movements at times when breathing is difficult. These muscles are used to facilitate breathing; the movement is called ___________________.

transduction

The activation of pain receptors is referred to as _____________________. It involves conversion of painful stimuli into electrical impulses that travel from the periphery to the spinal cord at the dorsal horn.

transduction. transmission. perception. modulation

The four specific physiologic processes involved in nociception (the ability to feel painful stimuli) include _____________, ______________, _______________, and _______________,

c, d, f (The nurse should use the recommended procedure for checking tube placement prior to administering medications. The nurse should also give each medication separately and flush with water between each drug and adjust the amount of water used if fluids are restricted. Enteric-coated medications should not be crushed, the tube should be flushed with 15 to 30 mL of water, and the head of the bed should be elevated to prevent reflux.)

The nurse is administering a medication to a patient via an enteral feeding tube. Which are accurate guidelines related to this procedure? Select all that apply. a) Crush the enteric-coated pill for mixing in a liquid. b) Flush open the tube with 60 mL of very warm water. c) Use the recommended procedure for checking tube placement in the stomach or intestine. d) Give each medication separately and flush with water between each drug. e) Lower the head of the bed to prevent reflux. f) Adjust the amount of water used if patient's fluid intake is restricted.

a (The CRIES Pain Scale is a tool intended for use with neonates and infants from 0 to 6 months. The COMFORT Scale, used to assess pain and distress in critically ill pediatric patients, relies on six behavioral and two physiologic factors that determine the level of analgesia needed to adequately relieve pain in these children. The FLACC Scale (F—Faces, L—Legs, A—Activity, C—Cry, C—Consolability) was designed for infants and children from age 2 months to 7 years who are unable to validate the presence or severity of pain. The FACES Scale is used for children who can compare their pain to the faces depicted on the scale.)

The nurse is assessing the pain of a neonate who is admitted to the NICU with a heart defect. Which pain assessment scale would be the best tool to use with this patient? a) CRIES scale b) COMFORT scale c) FLACC scale d) FACES scale

a (The infant's normal respiratory rate is 20 to 40 breaths per minute. The normal range for a child age 1 to 5 years is 20 to 32 breaths per minute. For a child 6 to 12 years of age the normal respiratory rate is 18 to 26 breaths per minute. The normal respiratory rate for an adult 65 years and older is 16 to 24 breaths per minute.)

The nurse is assessing the vital signs of clients in a community health care facility. Which client respiratory results should the nurse report to the health care provider? a) An infant with a respiratory rate of 16 bpm b) A 4-year-old with a respiratory rate of 32 bpm c) A 12-year-old with a respiratory rate of 20 bpm d) A 70-year-old with a respiratory rate of 18 bpm

distilled water

The nurse is caring for a client who has been prescribed humidified oxygen at 6 L/minute. Which type of liquid will the nurse gather to set up the humidifier?

b

The nurse is certified in providing Therapeutic Touch and is preparing to initiate this for a client. What activity should the nurse perform first? a) Calling to rebalance the soul b) Requesting the client's permission to touch the body c) Embracing the client for energy d) Moving the hands 2 to 6 in (5 to 16 cm) away from the client's skin surface

a (A 15-degree angle is correct, as this allows the drug to be injected between the layers of the skin. A 45-degree angle is incorrect, as this will allow the drug to be injected beneath the skin but above the muscle. A 90-degree angle is incorrect, as this will allow the drug to be injected in the muscle. A 120-degree angle is incorrect, as this will be more suitable for intravenous injections.)

The nurse is preparing to administer a tuberculin test. At which angle is the nurse expected to instill the drug? a) 15-degree angle b) 45-degree angle c) 90-degree angle d) 120-degree angle

b (Isotonic fluids are used to increase blood pressure secondary to hypovolemia.)

The nurse is working the night shift in the ER when an ambulance arrives carrying a man s/p motor vehicle accident (MVA). His initial BP is 100/56 and the nurse notes that he is bleeding heavily from a laceration on the forehead. Fifteen minutes later, the nurse reassesses the client and finds that his BP is 95/58. What IV fluid would the nurse expect to be ordered? a) 0.45% NS b) 0.9% NS c) 3% NS d) D5 ¼ NS

d (Naloxone is an opioid antagonist—meaning that it binds to opioid receptors and can reverse and block the effects of other opioids.)

The nurse preparing to admit a client receiving epidural opioids should make sure that which of the following medications is readily available on the unit? a) furosemide b) lisinopril c) digoxin d) naloxone

phantom

The pain that often occurs with an amputated leg where receptors and nerves are clearly absent, is a real experience for the patient. This type of pain is called _____________ pain.

modulation

The process by which the sensation of pain is inhibited or modified is referred to as __________________.

sensitization

The prolonged effect of pain stimuli acting on the central nervous system (CNS) can lead to _____________________, meaning that the threshold for activation of pain is lowered. -At that point, even harmless stimuli can trigger pain; pain signals are faster and feel more intense.

medulla

The respiratory center is located in the ______________ in the brainstem, immediately above the spinal cord.

sputum

The respiratory secretion expelled by coughing or clearing the throat is called _______________.

b (Ginkgo biloba affects platelet function and thus should not be used concurrently with warfarin or aspirin. The remaining questions are correct and important during the assessment, but assessing for concurrent warfarin or aspirin use is essential due to the increased risk of bleeding concern.)

The spouse of a client diagnosed with early memory loss asks about the use of ginkgo biloba as a dietary supplement. Which nursing assessment is essential prior to responding? a) Does the client have loss of recent memory or remote memory? b) Is the client taking warfarin or aspirin? c) Has the client ever had a myocardial infarction? d) What other dietary supplements does the client use?

a, b, f (Protecting or guarding a painful area, moaning and crying, and moving away from painful stimuli are behavioral responses. Examples of a physiologic or involuntary response would be increased blood pressure or dilation of the pupils. Affective responses, such as anger, withdrawal, and depression, are psychological in nature.)

The three types of responses to pain are physiologic, behavioral, and affective. Which are examples of behavioral responses to pain? Select all that apply. a) A patient cradles a wrist that was injured in a car accident b) A child is moaning and crying due to a stomachache c) A patient's pulse is increased following a myocardial infarction d) A patient in pain strikes out at a nurse who attempts to provide a bath e) A patient who has chronic cancer pain is depressed and withdrawn f) A child pulls away from a nurse trying to give an injection

clarifying

The use of the __________ question or comment allows the nurse to gain an understanding of a patient's comment. When used properly, this technique can prevent possible misconceptions that could lead to an inappropriate nursing diagnosis.

creatine kinase, troponin

These biomarkers are used to monitor cardiac injury and myocardial infarction. Measuring the levels of these enzymes can help determine the extent and timing of the damage.

a (The cylinder must always be checked before use to ensure that enough oxygen is available for the patient. It is unsafe to use a cylinder that reads 500 psi or less because not enough oxygen remains for a patient transfer. A cylinder that is not secured properly may result in injury to the patient. Oxygen flow is discontinued by turning the valve clockwise until it is tight.)

What action does the nurse perform to follow safe technique when using a portable oxygen cylinder? a) Checking the amount of oxygen in the cylinder before using it b) Using a cylinder for a patient transfer that indicates available oxygen is 500 psi c) Placing the oxygen cylinder on the stretcher next to the patient d) Discontinuing oxygen flow by turning the cylinder key counterclockwise until tight

onset, precipitative or palliative, quality, radiation, severity, timing

What does OPQRST stand for?

b

What kind of analgesic would a patient most likely be given for severe following surgery? a) non opioid b) opioid c) adjuvant

a

What term is defined as "those practices that do not form part of the dominant system for managing health and disease"? a) alternative medicine b) complementary health c) homeopathic medicine d) holistic health care

b (Health care personnel are only now becoming aware of pain relief as a priority for children in pain. The evidence supports the fact that children do indeed feel pain and reliable assessment tools are available specifically for use with children. Opioid analgesics may be safely used with children as long as they are carefully monitored.)

When assessing pain in a child, the nurse needs to be aware of what considerations? a) Immature neurologic development results in reduced sensation of pain b) Inadequate or inconsistent relief of pain is widespread c) Reliable assessment tools are currently unavailable d) Narcotic analgesic use should be avoided

c (Nonpharmacologic and nonopioid pharmacologic therapies are the preferred choices for chronic pain that is not related to active cancer, palliative care, or end-of-life care. If progression to opioids becomes necessary, the lowest effective dose of an immediate-release opioid should be initiated first.)

When developing the care plan for a patient with chronic pain, the nurse plans interventions based on the knowledge that chronic pain not related to cancer or palliative/end-of-life care is most effectively relieved through which method? a) Using the highest effective dose of an opioid on a PRN (as needed) basis b) Using nonopioid drugs conservatively c) Using consistent nonpharmacologic and nonopioid pharmacologic therapies d) Administering a continuous intravenous infusion on a regular basis

d (The adult chest contour is slightly convex, with no sternal depression. The skin of the thorax should be warm and dry, and the anteroposterior diameter of the chest should be less than the transverse diameter. The contour of the intercostal spaces should be flat or depressed.)

When inspecting a client's chest to assess respiratory status, the nurse should be aware of which normal finding? a) The contour of the intercostal spaces should be rounded. b) The skin at the thorax should be cool and moist. c) The anteroposterior diameter should be greater than the transverse diameter. d) The chest should be slightly convex with no sternal depression.

intractable

When pain is resistant to therapy and persists despite a variety of interventions, it is referred to as __________________.

a (Normal cardiac output averages from 3.5 L/minute to 8.0 L/minute. With decreased cardiac output, there is a reduction in the amount of circulating blood that is available to deliver oxygen to the tissues. The body compensates by increasing respiratory rate to increase oxygen delivery to the tissues. The client with decreased cardiac output would gain weight, have decreased urine output, and display mental confusion.)

When reviewing data collection on a client with a cardiac output of 2.5 L/minute, the nurse inspects the client for which symptom? a) rapid respirations b) weight loss c) increased urine output d) mental alertness

a (The patient's immediate problem is the pain that is unrelieved because the patient refuses to take pain medication for an unknown reason. The other nursing diagnoses are plausible, but not a priority in this situation.)

When the nurse assists a patient recovering from abdominal surgery to walk, the nurse observes that the patient grimaces, moves stiffly, and becomes pale. The nurse is aware that the patient has consistently refused pain medication. What would be a priority nursing diagnosis for this patient? a) Acute Pain related to fear of taking prescribed postoperative medications b) Impaired Physical Mobility related to surgical procedure c) Anxiety related to outcome of surgery d) Risk for Infection related to surgical incision

d (Pulmonary function testing is used to measure lung size and airway patency. Chest x-rays are used to detect pathologic lung changes. Bronchoscopy allows the visualization of the airways directly. Skin tests are used to detect allergies.)

Which diagnostic procedure measures lung size and airway patency, producing graphic representations of lung volumes and flows? a) Chest x-ray b) Bronchoscopy c) Skin tests d) Pulmonary function tests

b

Which guideline is recommended for determining suction catheter depth when suctioning an endotracheal tube? a) Combine the length of the endotracheal tube and any adapter being used, and add an additional 2 cm. b) Using a suction catheter with centimeter increments on it, insert the suction catheter into the endotracheal tube until the centimeter markings on both the endotracheal tube and catheter align, and insert the suction catheter no further than an additional 1 cm. c) Using a spare endotracheal tube of the same size as being used for the client, insert the suction catheter halfway to the end of the tube and note the length of catheter used to reach this point. d) For a closed system, combine the length of the endotracheal or tracheostomy tube and any adapter being used, and add an additional 3 cm.

a (Endorphins and enkephalins are opioid neuromodulators. Endorphins are powerful pain blocking chemicals with prolonged analgesic effects. Enkephalins are considered less potent. There are no neuromodulators called efferent or afferent.)

Which of the following is considered to be the most potent neuromodulators? a) endorphins b) enkephalins c) efferent d) afferent

a

Which parenteral route of administration has the longest absorption time? a) Intradermal b) Intravenous c) Subcutaneous d) Intramuscular

d (The Native American/Canadian Indigenous view disease as a disharmony with Mother Earth, a result of negative thinking, or violation of a taboo. Chinese medicine proposes that health is the outcome of balancing yin and yang.)

Which would be the least consistent with the Native American/Canadian Indigenous view of disease? a) Disharmony with Mother Earth b) A result of negative thinking c) Violation of a taboo d) Balance of yin and yang

acidic

________ (pH) medications absorb best in the stomach.

IV

________ (route) drugs have the fastest absorption rate.

basic

_________ (pH) medications absorb best in the intestine.

oral

_________ (route) drugs have the longest absorption rate.

closed

__________ questions are used to gather specific information from a patient and to allow the nurse and patient to focus on a particular area. -often a barrier to effective communication -often a yes or no question

peak expiratory flow rate

___________ __________ ________ ____________ refers to the point of highest flow during forced expiration. -patient forcibly exhales into the peak flow meter, this is repeated 3x and highest number is recorded

Acute

___________ pain is generally rapid in onset and varies in intensity from mild to severe. -It is protective in nature. -After its underlying cause is resolved, acute pain disappears. -Example: pricked finger, sore throat, or surgery.

cough suppressants

_____________ ______________ are recommended in patients with a dry, nonproductive cough. It is not usually recommended for a productive cough unless used during sleep because retaining secretions could lead to pulmonary infection.

incentive spirometry

_____________ ______________ provides visual reinforcement for deep breathing by the patient. An incentive spirometer assists the patient to breathe slowly and deeply and to sustain maximal inspiration. The gauge on the spirometer allows the patient to measure one's own progress, providing immediate positive reinforcement.

sympathetic

_____________ nerves stimulate the SA and AV nodes to increase HR and the force of contraction.

mucolytic

______________ agents liquefy or loosen thick secretions

Sequencing

______________ is used to place events in a chronologic order or to investigate a possible cause-and-effect relationship between events. (Patient: I don't feel like myself anymore since I've been taking my blood pressure medicine. I'm tired and don't have any energy. Nurse: Your tiredness began after you started taking your medicine?)

Chronic

______________ pain is pain that lasts beyond the normal healing period. -may have remissions and exacerbations -Some providers are transitioning to use of the word persistent to describe this type of pain.

Nonopioid

_______________ analgesics, such as acetaminophen and NSAIDs, are usually the drugs of choice for both acute and persistent moderate chronic pain. -The simplest dosage schedules and least invasive pain management modalities should be used first.

Adjuvant

_______________ drugs are typically used for other purposes, but are also used to enhance the effect of opioids by providing additional pain relief. -They may also reduce side effects from prescribed opioids or lessen anxiety about the pain experience. -antidepressants, anticonvulsants, corticosteroids, and biophosphonates.

capnography

_______________ is a method to monitor ventilation and, indirectly, blood flow through the lungs. Exhaled air passes through a sensor that measures the amount of carbon dioxide (CO2) exhaled with each breath.

Substance P

________________ _____ sensitizes receptors on nerves to feel pain and also increases the rate of firing of nerves.

Pharmodynamics

________________ is the process by which drugs act on target cells resulting in alterations in cellular reactions and functions. (what the drug does to the body)

spirometry

________________ measures the volume of air in liters exhaled or inhaled by a patient over time. -The patient inhales deeply and exhales forcefully

perception

________________ of pain is the sensory process resulting in the patient's awareness of pain.

Cutaneous

________________ pain (superficial pain) usually involves the skin or subcutaneous tissue -A paper cut that produces sharp pain with a burning sensation is an example

Opioids

________________, formerly called narcotic analgesics, are generally considered the major class of analgesics used in the management of moderate to severe pain because of their effectiveness. -morphine, codeine, oxycodone, hydromorphone, methadone

parasympathetic

_________________ nerves (vagus) stimulate the SA and AV nodes to decrease HR.

metabolism

_________________ or biotransformation, is the change of an active drug from its original form to an inactivated or new form. -this mainly takes place in the liver, but also occurs in the kidneys, blood plasma, intestinal mucosa, and lungs.

somatic

_________________ pain is diffuse or scattered and originates in tendons, ligaments, bones, blood vessels, and nerves. -Strong pressure on a bone or damage to tissue that occurs with a sprain causes this

nociceptive

_________________ pain is initiated by nociceptors that are activated by injury to the peripheral tissue and is representative of the normal pain process

Visceral

_________________ pain, or splanchnic pain, is poorly localized and originates in body organs in the thorax, cranium, and abdomen. -one of the most common types of pain produced by disease, and occurs as organs stretch abnormally and become distended, ischemic, or inflamed

Proprioceptors

__________________ in the muscles and joints respond to body movements, such as exercise, and cause an increase in ventilation.

thoracocentesis

__________________ is the procedure of puncturing the chest wall and aspirating pleural fluid. -may be performed to obtain a specimen for diagnostic purposes or to remove fluid that has accumulated in the pleural cavity and is causing respiratory difficulty and discomfort

Absorption

__________________ is the process by which a drug is transferred from its site of entry into the body to the bloodstream. -influenced by route of administration, lipid solubility, pH, blood flow, drug dose, and conditions at administration site

physiologic

__________________ responses to pain are involuntary and include: -increased BP, P, and R -pupil dilation -muscle tension -pallor -increased glucose

affective

__________________ responses to pain are psychological and include: -withdrawal -anxiety -depression -fear -anger -anorexia -hopelessness

behavioral

__________________ responses to pain are voluntary and include: -moving away from painful stimuli -grimacing -moaning -crying

Bradykinin

__________________, a powerful vasodilator that increases capillary permeability and constricts smooth muscle, plays an important role in the chemistry of pain at the site of an injury even before the pain message gets to the brain. -It also triggers the release of histamine and, in combination with it, produces the redness, swelling, and pain typically observed when an inflammation is present.

excretion

___________________ is the process of removing a drug, or its metabolites (products of metabolism), from the body. -this mainly occurs in the kidneys.

distribution

___________________ is the transportation of a drug in body fluids to the various tissues and organs of the body -influenced by local blood flow to target area, membrane permeability, and protein binding capacity of drug.

Expectorants

____________________ are drugs that facilitate the removal of respiratory tract secretions by reducing the viscosity of the secretions.

chemoreceptors

______________________ in the aortic arch and carotid bodies are sensitive to the same arterial blood gas (ABG) levels and blood pressure and can activate the medulla.

Pharmokinetics

_______________________ is the effect the body has on a drug once the drug enters the body. It is the movement of drug molecules in the body in relation to the drug's absorption, distribution, metabolism, and excretion.

Prostaglandins

________________________ are important hormone-like substances that send additional pain stimuli to the CN

oropharyngeal airway

a curved device inserted through the patient's mouth into the pharynx to help maintain an open airway

surfactant

a detergent-like phospholipid, reduces the surface tension between the moist membranes of the alveoli, preventing their collapse.

chemical

a drug's _______ name is the precise description and composition of the drug -example: acetylsalicylic acid

trade

a drug's ___________ name is selected by the pharmaceutical company that sells the drug -protected by trademark -also called "brand name" or "proprietary name" -example: bayer

generic

a drug's ___________ name is the name assigned by the manufacturer that first develops the drug. -identifies active ingredient -this is the "official name" and is universally accepted. -example: aspirin

nasopharyngeal airway

a flexible breathing tube inserted through the patient's nostril into the pharynx to help maintain an open airway

first pass effect

a phenomenon in which drugs given orally are carried directly to the liver after absorption, where they may be largely inactivated by liver enzymes before they can enter the general circulation -oral drugs frequently are given in higher doses than drugs given by other routes because of this early breakdown

ayurveda

a science of life that delineates the diet, medicines, and behaviors that are beneficial or harmful for life and considers that balance among people, the environment, and the larger cosmos is integral to human health -Central to this type of medicine is an understanding of the client's basic constitution, or dosha.

naturopathy

a system of alternative medicine with a belief that health is a dynamic state. It emphasizes client responsibility, client education, health maintenance, and disease prevention. -focus on treating cause of disease, not treating symptoms -herbal supplements can interfere with prescribed medication.

traditional Chinese medicine

a system of ancient Chinese medicinal treatments including acupuncture, diet, herbal therapy, meditation, physical exercise, and massage to prevent, diagnose, and treat disease -vital energy circulates through pathways called meridians

nasal cannula

also called nasal prongs, is the most commonly used oxygen delivery device. -The cannula is a disposable plastic device with two protruding prongs that are inserted into the nostrils. -The cannula is connected to an oxygen source with a flow meter and, many times, a humidifier. -does not impede eating or speaking and is used easily in the home -can be dislodged easily and low-flow rates can cause dryness of the nasal mucosa. -can be high or low flow

idiosyncratic (paradoxical)

an __________________ effect of a drug is any unusual or peculiar response to a drug that may manifest itself by overresponse, underresponse, or even the opposite of the expected response. -example: child may become agitated or excited instead of drowsy after taking Benadryl.

therapeutic touch

an alternative therapy that involves using one's hands to consciously direct an energy exchange from the practitioner to the patient to facilitate healing or pain relief

tracheostomy

an artificial opening made into the trachea, usually at the level of the second or third cartilaginous ring. -can be temporary or permanent -inserted for a variety of reasons (replace endotracheal tube, provide a method for mechanical ventilation of the patient, to bypass an upper airway obstruction, or to remove tracheobronchial secretions.) -may result in the inability to speak, depending on the type of tube in use.

PAINAD Scale (Pain Assessment in Advanced Dementia)

assessment tool for pain; assesses 5 common behaviors: breathing, vocalization, facial expression, body language, and consolability. A score of 4 or above indicates a need for pain management. -used for patients with advanced dementia

shamanism

belief that illness originates in the spirit world and usually involves a loss of power; treatment consists of first, restoring the individual's power, and second, treating symptoms

diaphragmatic breathing

breathing with the use of the diaphragm to achieve maximum inhalation and slow respiratory rate. -he patient places one hand on the stomach and the other on the middle of the chest. The patient breathes in slowly through the nose, letting the abdomen protrude as far as it will go, then breathes out through pursed lips while contracting the abdominal muscles, with one hand pressing inward and upward on the abdomen. -helpful for COPD

integrative health

combination of complementary health and conventional health approaches in a coordinated way

interpersonal communication

communication that occurs between two or more people with a goal to exchange messages

oxygen

considerations for __________ therapy: -avoid excessive static electricity -no smoking within 10 feet of source

rhonchi

continuous low pitched, rattling lung sounds that often resemble snoring -heard in patients with chronic obstructive pulmonary disease (COPD), pneumonia, or cystic fibrosis

wheezes

continuous musical sounds, produced as air passes through airways constricted by swelling, narrowing, secretions, or tumors. -heard in patients with asthma, tumors, or a buildup of secretions.

tolerance

drug _____________ occurs when the body becomes accustomed to the effects of a drug and larger doses are needed to produce the desired effect.

antagonistic

drug interaction in which combined drugs alter the overall sum effect or negate each other; results in an effect less than that of each drug alone

syngergistic

drug interaction results in greater effects when taken together (one drug potentiates the other)

crackles

fine, intermittent crackling sounds made as air moves through fluid in the airways or alveoli and opening of deflated small airways and alveoli. -occur due to inflammation or congestion and are associated with pneumonia, heart failure, bronchitis, and COPD -also called rales

respiration

gas exchange between the atmospheric air in the alveoli and blood in the capillaries

parenteral

intramuscular, intradermal, intraveneous, and subcutaneous injections are all examples of the ______________ route of administration. -the smaller the needle the larger the gauge (example: 25 gauge) -the larger the needle the smaller the gauge (example: 18 gauge)

increases

lipid solubility _________ the ability for a drug to be absorbed because cell membranes contain lipids.

ventrogluteal, deltoid, vastus lateralis

list 3 intramuscular injection sites.

bronchial

loud, high-pitched sounds heard primarily over the trachea and larynx

vesicular

low-pitched, soft sounds heard over peripheral lung fields

bronchovesicular

medium-pitched blowing sounds heard over the major bronchi

b

most communication is... a) verbal b) nonverbal

medication, dose, route, time, patient, documentation

name 6 rights of medication administration

pulse oximetry

noninvasive technique that measures the arterial oxyhemoglobin saturation (SpO2) of arterial blood. -reported result is a ratio, expressed as a percentage, between the actual oxygen content of the hemoglobin and the potential maximum oxygen-carrying capacity of the hemoglobin -SaO2 can be measured by ABG, not this technique

heart failure

occurs when the heart is unable to pump a sufficient blood supply, resulting in inadequate perfusion and oxygenation of tissues.

homeopathy

practice of medicine based on the belief of supporting the body while the symptoms are allowed to "run their course" to stimulate and strengthen the immune system and promote healing -"like cures like"

acupuncture

procedure consisting of placing very thin, short, sterile needles at particular acupoints, believed to be centers of nerve and vascular tissue, along a meridian to either increase or decrease the flow of chi along the meridian, restoring the balance of yin and yang, and thereby contributing to healing -part of traditional Chinese medicine

chiropractic medicine

profession that focuses on the relationship between the body's structure—mainly the spine—and its functioning; its practitioners primarily perform adjustments (manipulations) to the spine or other parts of the body with the goal of correcting alignment problems, alleviating pain, improving function, and supporting the body's natural ability to heal itself

echocardiogram

record of the heart using sound

intrapersonal communication

self-talk, communication within a person.

topical

skin applications, vaginal administration, rectal administration, instillation, and irrigation are all examples of the ___________ route of administration.

corticosteroids

substance that lowers swelling in the breathing passages and lungs. -not a rescue inhaler, takes longer to work -works on inflammatory cells in airway

analgesic ladder

the World Health Organization devised a three-step ______________ _________________ that recommends the appropriate progression of drugs and dosages that should be used to manage chronic pain effectively.

toxic concentration

the _________ __________ or threshold, is the serum level at which toxic effects occur.

cumulative

the ___________ effect is when repeated administration of drug results in a more pronounced effect than the first administration because the drug has not cleared the body yet.

venturi

the ___________ mask delivers the most precise concentrations of oxygen. -eating and talking are difficult, a tight seal is required, and there is the potential for skin breakdown. -high flow

Minimal Effective Concentration (MEC)

the lowest plasma concentration of a drug that will produce a therapeutic effect

pulmonary ventilation

the movement of air into and out of the lungs

perfusion

the process by which oxygenated capillary blood passes through body tissue

carbon dioxide, hydrogen ions

the respiratory center (medulla and pons) is stimulated by an increase in what two things?

allopathic medicine

the term generally used to describe "traditional" medical care (biomedicine), dominant for about 100 years, which spearheaded remarkable advances in biotechnology, surgical interventions, pharmaceutical approaches, and diagnostic tools

arterial blood gas

this test examines arterial blood to determine the pressure exerted by oxygen and carbon dioxide in the blood and blood pH. -measures the adequacy of oxygenation, ventilation, and perfusion.

true

true or false: Confirmation that a client has learned a skill requires more than the client verbalizing understanding, passing a written test, nodding, or assisting with cleanup.

0-10 numeric scale

use this pain scale for adults and children (>9 years old) in all patient care settings who are able to use numbers to rate the intensity of their pain

FLACC scale

use this pain scale for infants and children (2 months-7 years) who are unable to validate the presence of or quantify the severity of pain

guided imagery

using all five senses to imagine an event or body process unfolding according to a plan, focusing on evoking pleasant images to replace negative or stressful feelings and to promote relaxation

6

when providing supplementary oxygen to a client through a nasal cannula, the volume should not exceed ________L/min. If more oxygen than this is needed, a mask should be used.