Med-Surg Mod 1 - ______
Morphine 2 mg IV q 4 hrs prn has been ordered. You have 1 ml ampule containing 15 mg. How much do you give?
0.1 ml Step 1) 2mg / 15mg = 0.1ml
30,000 units of PCN have been ordered. You have 1,000,000 units in 10 mls. How much do you give?
0.3ml Step 1) 10ml / 1,000,000 Units = 0.0001 Step 2) 0.0001 x 30,000 Units = 0.3 ml
According to Maslow's hierarchy of human needs, which of the following is the highest level of need(s)?
Self Actualization
According to Maslow's hierarchy of human needs, which of the following is the highest level of need(s)?
Self-actualization
20 mg of Pepcid has been ordered. You have 40 mg tabs. How much do you give?
0.5 Tab
Dilantin 30 mg PO TID has been ordered. You have Dilantin 60 mg tabs. How much do you give?
0.5 Tab Step 1) 30mg / 60mg Tab = 0.5 Tab
0.374 gms of Ceclor PO have been ordered. You have 100 mls vial concentrated to 187 mg/5 mls. How much do you give?
10mls 1) 0.374gms Ordered 2) 100ml vial concentrated to 187 mg/5mls Step 1) 0.374gms = 374mg Step 2) 187mg/5ml = 37.4 mg Step 3) 374mg / 37.4mg = 10 mls
50 units Heparin SQ has been ordered. You have Heparin 10 units per 2.5 mls. How much do you give?
12.5ml Step 1) 50 units / 10 units = 5 Step 2) 5 x 2.5ml = 12.5ml
Tylenol 60 mg/kg/24 hours is ordered for your child who weighs 32 pounds. How many mg would you give if this was divided into 6 equal doses for the day?
145.5 mg
Indocin 3 mg/kg/day has been ordered. The capsules are labeled 0.05 gms. The client's weight is 50 kg. How many mg do you give?
150mg Step 1) 50kg x 3mg = 150mg
Robitussin 1 T and 1 t has been ordered. How many ml(s) total is this?
19.7 mls Step 1) 1 T = 14.8ml Step 2) 1 t = 4.92ml Step 3) 14.8ml + 4.92ml = 19.7ml **Online practice rounds up to 20mls**
ASA 60 mg/kg/24 hours has been ordered for a child who weighs 70 lbs. Divide it in six equal doses. How much will they be given in 24 hours?
1904.8 mgs Step 1) 70lbs / 2.205 = 31.75kgs Step2) 31.75kgs x 60 mgs = 1904.8mg/24 hrs
Lopressor 1.4 mg/kg has been ordered. You have Lopressor 50 mg tabs. Weight 72 kg. How much do you give?
2 Tabs Step 1) 72kg x 1.4mg = 100.8 mgs Step 2) 100.8mgs / 50mg Tabs = 2 Tabs
Heparin 2500 units has been ordered. You have Heparin 500 units/0.5 ml. How much do you give?
2.5ml Step 1) 2500 units / 500units = 5 Step 2) 5 x 0.5ml = 2.5ml
ASA 60 mg/kg/24 hours has been ordered for a child who weighs 70 lbs. Divide it in six equal doses. How much is in one dose?
217.5mgs Step 1) 70lbs / 2.205 = 31.75kgs Step 2) 31.75kgs x 60mgs = 1904.8 mg/24 hours Step 3) 1904.8mg/24hr / 6 doses = 317.5mg ***The online tutorial we do states 318.2mgs --- I'm not sure how they got this?****
A nurse is planning a smoking-cessation program for a client and incorporates stages from the Transtheoretical Model of Change in the program. For the client to be successful, the client follows the stages in this order from steps 1 to 5: 1: Works to prevent relapse of smoking 2 : Thinks about smoking cessation 3: Resists relapsing into smoking 4: Takes steps to stop smoking 5: Makes a plan to cease smoking
2: Thinks about smoking cessation 5: Makes a plan to cease smoking 4: Takes steps to stop smoking 1: Works to prevent relapse of smoking 3: Resists relapsing into smoking
Indocin 3 mg/kg/day has been ordered. The capsules are labeled 0.05 gms. The client's weight is 50 kg. How many capsules do you give?
3 Capsules Step 1) 50kg x 3mg = 150mg Step 2) 150mg / 1000 = .15gms Step 3) .15gms / .05gms = 3 Capsules
Aspirin gr 6 tab is ordered. You have this drug in gr 2 tabs. How many tabs will you give to the patient?
3 Tabs
Demerol 75 mg has been ordered. Each ampule is 20 mg/mls. How much do you give?
3.8ml Step 1) 75mg / 20mg/ml = 3.8ml
2 tablespoons and 1 teaspoon of cough syrup has been ordered. How many ml(s) is this?
34.5ml Step 1) 14.8ml = 1 tblsp Step 2) 4.92ml = 1 tsp Step 3) 14.8ml x 2 = 29.6ml Step 4) 4.92ml x 1 = 4.92ml Step 5) 29.6ml + 4.92ml = 34.52 ml ***Our practice rounded this up to 35mls***
Scopolamine 0.2 mg is ordered and you have this drug available in 1/200 per 1.5 mls. How much do you give?
3mls
0.4 gms Cyclosporin PO have been ordered. You have 100 mg tabs of Cyclosporin. How much do you give?
4 tabs Step 1) 0.4 gms = 400mg Tabs Step 2) 400mg tabs / 100mgs = 4 Tabs
20 mEq of KCl to be added to IV bag has been ordered. You have KCl in a 30 mls vial with a concentration of 5 mEq/mls. How many ml(s) will you add to each IV bag?
4ml Step 1) 20mEq / 5mEq per ml = 4ml
Chloral hydrate 20 mg/kg PO has been ordered. The child weighs 60 lbs. How much do you give?
544.5 mgs Step 1) 60lbs / 2.205 = 27.22kg Step 2) 20mg x 27.22kg = 544.4 mg ***The online tutorial we do states 545.5mgs --- I'm not sure how they got this? *****
KCl 10 mEq has been ordered. You have KCl 5 mEq per 2.5 ounces. How much do you give?
5oz Step 1) 2.5 ounces / 10 mEq = 5ounces
The central figure in health care services is the:
Patient
Tylenol 60 mg/kg/24 hours is ordered for your child who weighs 32 pounds. How many mg will you give in the entire 24 hours?
872.7mgs
Based on Maslow's hierarchy of needs, when prioritizing a patient's plan of care, what would be the nurse's first priority? A) Administer Pain Medication B) Ambulate Patient C) Allow family to see newly admitted patient
A - Administer Pain Medication -Pain relief addresses the patients basic physiologic need.
Which is an example of a direct measurement technique used to evaluate the teaching-learning process? A) Behavioral observation B) Patient satisfaction surveys C) Attitude surveys D) Instruments that evaluate specific health status variables
A - Behavioral Observation **Direct measurement techniques include behavioral observation, checklists, and anecdotal notes to document the behavior. Client satisfaction surveys, attitude surveys, and oral questioning, and instruments that evaluate specific health status variables, are indirect measurements.
Which factor refers to a client's experiential readiness to learn? A) Educational history and life experience B) Emotional Readiness C) Acceptance of an illness D) Physical Readiness
A - Educational history and life experience **Experiential readiness refers to past experiences that influence a client's ability to learn.
Which of the following is a nursing diagnosis related to health education? A) Ineffective health maintenance B) Altered Nutrition, less than body requirements
A - Ineffective Health maintenance **Diagnoses related to health education may include ineffective health maintenance, health-seeking behaviors, deficient knowledge, and readiness for enhanced knowledge.
Sims Position
Patient is laying on side, top knee is bent. -Used for rectal exams, enemas.
According to the American Nurses Association (1995), the advanced practice registered nurse is distinguished from other registered nurses according to scope of practice. Select the activity that would distinguish the advanced practice nurse from other RNs. A) Prescribes medications B) Reports abnormal test results C) Develops nursing care plans D) Interprets health care provider orders
A - Prescribes medications
Knee Chest Position
A prone position in which the individual rests on the knees and upper part of the chest, assumed for gynecologic or rectal examination. -Bed is Flat (0 degrees)
Trendelenburg Position
Patient is supine, Feet are elevated 15 degrees above head
Dorsal Recumbent Position
Patient lies on their back with their knees bent up in an outward position while their feet are planted flat on the ground, a bed, table or resting platform allowing the pelvic area to be easily examined and observed.
A nurse who works in a large long-term care facility is committed to providing sound, evidence-based nursing care. Which of the following sources provides the legal framework for the nurse's role? A) The Nurse Practice Act in the state where the nurse practices B) Legal precedents in the local jurisdiction C) Parameters described by the National League for Nursing (NLN) D) The norms and accepted practices of the nursing profession
A) The Nurse Practice Act in the state where the nurse practices
Hyper-
Above / Elevated
Which statement made by the client indicates understanding of the Centers for Disease Control and Prevention and U.S. Preventive Services Task Force recommendation for prostate screening frequency? A) "I will schedule my prostate exam every 5 years after I am 50." B) "I will see you next year for my prostate exam." C) "I will schedule my PSA levels every 5 years after I am 50."
B - I will see you next year for my prostate exam **Prostate examinations should be done yearly. PSA levels are assessed every 2 years after age 50. Colonoscopy examinations are every 5 years.
Hypo-
Below
A client is experiencing social isolation. Using Maslow's hierarchy of needs, identify the level that would correspond to this need? A) Self-Actualization B) Esteem & Self-Respect C) Belongingness & Affection D) Safety & Security E) Physiologic Needs
C - Belongingness & Affection
The nurse is providing care for a patient in the hospital scheduled for discharge in the morning. The patient will require further services after discharge since recovery is not complete. What can the nurse do to ensure quality care delivery for this patient? A) Inform a family member that they will need to stay with the patient after discharge. B) Contact the social worker in order to check on patient after discharge. C) Contact the case manager for coordination of care prior to discharge of the patient.
C - Contact the case manager for coordination of care prior to discharge of the patient
Which is a primary task of nursing research?
Contributing to the scientific base of nursing practice
A nurse on a medical-surgical unit has asked to represent her unit on the hospital's Continuous Quality Improvement (CQI) committee. In researching CQI programs, the nurse should understand that they have what characteristic? A) CQI programs justify health care costs. B) CQI programs identify incidents rather than processes. C) CQI programs establish accountability on the part of health care professionals. D) CQI programs focus on the process used to provide care.
D - CQI programs focus on the process used to provide care *Unlike QA, which focuses on individual incidents or errors and minimal expectations, CQI focuses on the processes used to provide care, with the aim of improving quality by assessing and improving those processes that most affect patient care outcomes and patient satisfaction. The other options are incorrect because CQI programs do not focus on the accountability of the health care professionals, they do not identify incidents rather than processes, and they do not justify health care costs.
Which of the following would NOT be categorized as a mid-level practitioner? A) Nurse Practitioner B) CRNA C) Nurse Midwife D) Nursing Assistant
D - Nursing assistants
The nurse is assisting with the development of a program to administer flu shots to a group of senior citizens. What type of prevention does this program reflect? A) Tertiary prevention B) Prevalence C) Secondary prevention D) Primary prevention
D - Primary Prevention
Dys-
Difficult
-Pathy
Disease
-ectomy
Removal
-itis
Swelling / Inflammation
Trendelenburg Position
The patient is supine. The feet are elevated 15-30 degrees above the head.
A type of nursing that includes individualized care provided by the same nurse throughout the period of care is defined as
primary nursing
The World Health Organization defines health as:
"a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity."
0.125 mg of Digoxin has been ordered. You have 0.25 mg/ml. How much do you give?
.05 ml
Your patient takes Zantac 150 mg BID. Zantac is available in 150 mg tabs. How many tabs will your patient take by the end of 4 days?
8 tabs Step 1) Bidaily means 2xday Step 2) 2tabs per day x 4 days = 8tabs
Which step of the nursing process determines whether the client understands the health teaching that is provided? A) Evaluation B) Implimentation C) Assessment D) Planning
A - Evaluation **Evaluation includes observing the client, asking questions, and then comparing the client's behavioral responses with the expected outcomes. Assessment includes determining the client's readiness regarding learning. Planning includes identification of teaching strategies and writing the teaching plan. Implementation is the step during which the teaching plan is put into action.
During a teaching session with a client with a new walker, the nurse provides frequent reinforcement to the client to get up from a chair that has arms by holding the top of the chair arm with one hand. Once standing and stable, the client can grasp either the other side of the walker or both sides of the walker. The nurse knows that this educational strategy is most effective with which type of disability? A) Input B) Output C) Perceptual D) Developmental
A - Input **Reinforcement is an appropriate educational strategy with clients experiencing input disabilities. It is important to allow ample time to learn and to provide reinforcement. Individuals with output disabilities benefit from review of information. Individuals with developmental disabilities benefit from repetition of simple explanations. Individuals with perceptual disabilities benefit from highlighting significant information for easy reference.
The nurse educator is planning a teaching session for nursing students related to the treatment and management of gestational diabetes. The nurse educator arranges for a dietitian, pharmacist, and physician assistant to participate in the lesson plan. Which professional nurse competency is the nurse educator demonstrating? A) Interdisciplinary teamwork B) Patient Centered Care C) Evidence Base Practice D) Quality Improvement Measures
A - Interdisciplinary teamwork
A nurse is preparing an in-service education program for a group of nurses involved in health education. When describing the connection between health teaching and health promotion, which information would the nurse most likely include? A) Health teaching goals are achieved before those for health promotion. B) Both are linked by the common goal of achieving high-level wellness.
B - Both are linked by the common goal of achieving high-level wellness **Health teaching and health promotion are linked by a common goal—to encourage people to achieve the highest level of wellness possible so that they can live healthy lives and avoid preventable illnesses. Health teaching goals are not necessarily achieved before those of health promotion. Clients are the primary managers of their health conditions. Nurses are in an ideal position to provide the kind of support that clients need to manage their conditions. Health promotion has become a cornerstone in health policy because of the need to control costs and reduce unnecessary sickness and death.
Select the nursing action that is least likely to motivate a person to learn. A) The creation of an atmosphere in which the patient is encouraged to express anxiety B) Emphasis on negative outcomes as a method to prevent learning incorrect practices
B - Emphasis on negative outcomes as a method to prevent learning incorrect practices
The nurse is providing a program at the local YMCA about stress-reduction techniques combined with a 1-mile walk around the indoor track once a week. What does this type of program address for the community? A) Early detection of illness B) Health promotion C) Illness prevention D) Health maintenance
B - Health Promotion
The National Center for Health Statistics uses data from healthcare agencies to issue quarterly and annual reports on performance related to goals for improving the health of the U.S. population. Which initiative is targeted with improving the health of all Americans? A) Agency for Healthcare Research & Quality B) Healthy People 2020 C) The Joint Commission D) Quality Indicators
B - Healthy People 2020
Tetra-
Four
Hemi-
Half
Semi-Fowler Position
Head of bed at a 30 degree angle
Uni-
One
-plegia
Paralysis
A Jewish patient, who adheres to the dietary laws of his faith, is in traction and confined to bed. He needs assistance with his evening meal of chicken, rice, beans, a roll, and a carton of milk. Choose the nursing approach that is most representative of promoting wellness. The nurse:
Prepares the environment and the over-bed table and inspects the contents of the dinner tray. The nurse asks the patient whether he would like to make any substitutions in the foods and fluids he has received.
The leadership of a private hospital have chosen to begin the process of accreditation in order to enhance the credibility and status of the hospital. The accreditation process and necessary performance improvements that the hospital will undertake will most likely occur under the auspices of what regulatory body?
The Joint Commission
The nurse informs the administrative assistant that a client is expected to come in for lab work. The administrative assistant inquires about why the nurse refers to the individual as a client. What is the best response by the nurse?
Using the term client implies that they are an active partner in nursing care.
A client comes to the clinic with the complaint that he has been ill for several weeks but does not have insurance and has delayed care. What does the nurse understand about the overall healthcare reform goals that will address issues such as this client?
The goal of healthcare reform is to provide affordable healthcare to more citizens.
Reverse Trendelenburg Position
The patient is supine on an incline with the head elevated 15-30 degrees above the feet. The Trendelenburg position is used in surgery, especially of the abdomen and genitourinary system.
Para- & Bi-
Two
-paresis
Weakness
A nursing student is preparing for a class presentation addressing the collaborative practice model. Which of the following would the student expect to include? A) Accountability that is primarily attributed to the patient B) Participation in decision making that is shared by all involved
B - Participation in decision making that is shared by all involved
Which of the following is an example of adherence to treatment? Select all that apply: A) Self-monitoring for signs and symptoms of illness B) Maintaining a healthy diet C) Taking prescribed medications D) Increasing daily activities E) Inability to comply with future appointments
A - Self-monitoring for signs and symptoms of illness B - Maintaining a healthy diet C - Taking prescribed medications D - Increasing daily activities
The nurse develops outcome criteria for a patient with chronic obstructive pulmonary disease. Which outcome criteria are appropriate for this patient? A) The patient will have the ability to climb a flight of stairs without experiencing difficulty in breathing. B) The patient will not experience an alteration in skin integrity. C) The patient will perform passive range-of-motion exercises once daily. D) The nurse will obtain a pulse oximetry reading twice a day.
A) The patient will have the ability to climb a flight of stairs without experiencing difficulty in breathing. **Outcomes of teaching strategies can be stated in terms of expected behaviors of patients, families, or both. Outcomes should be realistic and measurable, and the critical time periods for attaining them should be identified. The desired outcomes and the critical time periods serve as a basis for evaluating the effectiveness of the teaching strategies.
Anti-
Against
A 54-year-old client on a fixed income has had an electrocardiogram (ECG) as part of an annual physical examination. The physician notes an abnormal Q wave on an otherwise unremarkable ECG. What legislation supports the focus on chronic disease prevention, health promotion, and quality, affordable health care for everyone? A) A New Health System for the 21st Century Bill B) Patient Protection and Affordable Care Act C) Healthcare Research and Quality Improvement Bill D) Building a Safer Health System Act
B - Patient Protection & Affordable Care Act
An advanced practice registered nurse (APRN) specializing in adult-gerontology has accepted a new position in a different state. Which governing body does the APRN need to consult to verify prescriptive authority in the new state? A) The National Council of State Boards of Nursing (NCSBN) B) The new state's boards of nursing
B - The new state's boards of nursing
The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about: A) Bone Density B) Mammography C) Parenting Issues
C - Parenting Issues
A local college is having a career-day seminar for student nurses. Booths from various agencies and facilities have been set up. One of the students approaches the booth of a home care agency and asks the nurse there about what is required to become a home care nurse. Which of the following would the nurse incorporate into the response? A) Expert case management abilities B) Specialization in a specific area of practice C) Strong clinical decision-making skills D) Need for at least a master's degree in nursing
C - Strong clinical decision - making skills
Changes in population demographics over the next 40 years will significantly affect the delivery of health care services. Select the one change that will have the most impact on the practice of nursing. A) Hispanics will become the largest minority group in the United States, constituting about 29% of the population. B) The number of immigrants will double in size C) The number of adults over age 65 will double in size.
C - The number of adults over age 65 will double in size
The nurse is teaching a client with diabetes how to perform checks of blood glucose level. To optimize learning, it is best for the nurse to: A) Verbalize it to the patient B) Provide written instructions C) Have the client return demonstrate D) Just demonstrate it
C- Have the client return demonstration
Students are reviewing information about community health nursing. The students demonstrate understanding of the term "community-oriented nursing practice" by describing it as which of the following? A) Nursing care of clients with complex needs who are discharged from acute care institutions early in the recovery process B) Provision of primary care services, often with care being provided to underserved populations C) Nursing care directed to specific client groups with identified needs, usually related to illness D) Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups
D - Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups.
Which statement is true regarding population demographics? A) The birth rate is increasing. B) Life spans are decreasing. C) Homelessness is decreasing. D) The culturally diverse population is increasing.
D - The culturally diverse population is increasing. *The population has become more culturally diverse as increasing numbers of people from different national backgrounds enter the country. The number of homeless people has significantly increased. There has been a decrease in the birth rate, and life spans are longer.
A nurse on a postsurgical unit has performed health education on the correct technique for emptying a drain for a woman who will be discharged home with a drain in situ. The nurse has asked the patient to demonstrate the correct technique and will now provide feedback. Which of the following statements provides the most effective feedback for the patient? A) "You did a really good job of emptying your drain. You'll do great when you get home." B) "How did you feel about that?" C) "You should be proud of yourself; this certainly isn't a skill that comes naturally to anyone." D) "You kept the drain clean when you emptied it, and you restored the negative pressure effectively."
D - You kept the drain clean when you emptied it, and you restored the negative pressure effectively.
As part of a clinical post-conference discussion, an instructor is showing the students examples of clinical pathways used in the facility. When explaining these examples, the instructor identifies which of the following as being commonly used as a basis for developing these tools? Select all that apply. A) Nursing diagnosis B) Treatments C) Medications D) Diagnostic tests E) Diagnosis related groups F) Common health problems
E - Diagnosis related groups F - Common health problems *Clinical pathways have been developed for patients with certain diagnosis related groups, common health problems and for high-risk patients. They indicate key events such as diagnostic tests, treatments, activities, medications, consultataion, and education. Nursing diagnoses are typically not addressed.
Fowler Position
Head of bed is at a 45 degree angle. -Standard patient position
High Fowler Position
Head of bed is at a 90 degree angle. -Feeding and feeding precautions
A nurse who provides care in a postsurgical care unit of a hospital is aware that reimbursement to the hospital for Medicare patients is based on diagnosis-related groups (DRGs). How are DRGs used to determine reimbursement for Medicare patients?
Hospitals receive payment at a fixed rate for patients with diagnoses that fall into a specific DRG. **Based on DRGs, prospective payment sets the rates of reimbursement for hospital services for Medicare patients. Hospitals receive payment at a fixed rate for patients with diagnoses that fall into a specific DRG.
The word leadership has a connotation of a position that brings with it a title that suggests leading large groups of people. What has nursing identified leadership as?
Inherent to ALL nursing positions
Supine Position
Patient is flat on back in bed. (0 degree)
Side lying position
Patient is laying on side - pillow under head, pillow between knees.
Prone Position
Patient is laying on stomach, flat. 0 degrees.
An occupational nurse is working with patients at a construction site. According to Maslow's Hierarchy of Needs, what dimension of care should the nurse make the highest priority in working with these clients?
Physiologic **Maslow ranked human needs as follows: physiologic needs; safety and security; sense of belonging and affection; esteem and self-respect; and self-actualization, which includes self-fulfillment, desire to know and understand, and aesthetic needs. Such a hierarchy is a useful framework that can be applied to the various nursing models for assessment of a client's strengths, limitations, and need for nursing interventions.
Primary Nursing
Primary nursing refers to comprehensive, individualized care provided by the same nurse throughout the period of care.
Which of the following delineates actions that are legally permitted for a particular profession based on specific educational qualifications
Scope of practice
Scope of practice
Scope of practice is used to delineate actions that are legally permitted for a particular profession, based on specific educational qualifications