quiz
The patient is in the operating room for surgery. What perioperative phase is the patient in? A. Intra-operative B. Pre-operative C. Post-operative D. Registration
A
The nurse understands that acid-base balance in the body is regulated by several mechanisms, but the most rapid response is due to the:
. Carbonic acid-bicarbonate buffer system
The nurse is completing preoperative teaching for a patient, and it becomes apparent that the patient does not completely understand the surgery that will be performed. What is the priority action for the nurse? A. Notify the surgeon and note the finding in the patient's chart. B. Obtain informed consent from the client. C. Revise the teaching plan for the client. D. Teach the patient about the surgery to be performed.
A
While going through the pre-op checklist the nurse verifies whether the consent is signed. It is signed by the patient and provider but was not witnessed. What action would the nurse NOT need to do? A. Ask the patient what date they signed it B. Ask the patient if the signature is theirs C. Ask the patient if they understand the procedure D. Ask the patient is they signed it willingly
A
Two staff nurses applied for promotion to nurse manager. Initially, the nurse not promoted had feelings of loss but then became supportive of the new manager by helping make the transition smooth and encouraging others. Which term best describes the nurse's response?
Altruism
A patient is brought to the emergency department (ED) after a motorcycle accident. The patient has suffered a ruptured spleen and requires surgery to stop the hemorrhaging. Which type of surgery will the patient have? A. Elective surgery B. Emergent surgery C. Palliative surgery D. Radical surgery
B
The nurse is caring for a patient who will be undergoing surgery. Which information is most important post-operatively for the nurse to teach the patient at this time? A. Complications that may occur after surgery B. Importance of early ambulation after surgery C. NPO status prior to surgery D. What to expect in the operating and recovery room
B
The nurse is caring for a client who presents to the emergency department with complaints of nausea and vomiting. The arterial blood gas (ABG) results reveal the following: pH 7.36, PaCO2 36 mm Hg, HCO3- 24 mEq/L. What is the priority action by the nurse?
Continue assessing the patient.
A client says, "Before taking a test, I feel a heightened sense of awareness and restlessness." The nursing intervention most suitable for assisting the client is to:
Explain that the symptoms are the result of mild anxiety, and discuss the helpful aspects.
A nurse is assessing a client with a diagnosis of kidney failure for clinical indicators of metabolic acidosis. What should the nurse conclude is the reason metabolic acidosis develops with kidney failure?
Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate
A nurse plans health teaching for a patient diagnosed with generalized anxiety disorder (GAD) who takes lorazepam (Ativan). What information should be included? Select all that apply.
Use caution when operating machinery. Restrict intake of caffeine. Avoid using alcohol and other sedatives.
The nurse has just completed preoperative teaching with a female patient who will be having surgery the following day. Which statement by the patient indicates that additional teaching is needed? A. "I will remember to wear my glasses tomorrow instead of my contact lenses." B. "I will wear my lucky earrings tomorrow during the surgery." C. "I won't have to worry about putting my makeup on tomorrow morning." D. "When I brush my teeth tomorrow, I will be sure to spit out the water."
B
The patient will be undergoing palliative surgery to debulk an abdominal tumor. The patient's daughter asks why the surgery is considered to be palliative. What is the nurse's best response? A. "The surgery must be performed immediately to save your father's life." B. "The surgery will relieve the symptoms of the bowel obstruction but will not cure your father." C. "There are fewer risks with palliative surgery than with reconstructive or restorative surgery." D. "There is no guarantee of the outcome of the surgery."
B
client who is preparing for surgery has moderate anxiety and is unable to understand preoperative information. Which nursing intervention is appropriate?
Describe the procedure again in a calm manner, using simple language.
A 15-year-old adolescent who has type 1 diabetes mellitus is admitted to the pediatric intensive care unit in ketoacidosis with a blood glucose level of 170 mg/dL (9.4 mmol/L). The adolescent has a history of fluctuating blood glucose readings and difficulty adhering to the therapeutic regimen. A continuous insulin infusion is started. What adverse reaction to the infusion is most important for the nurse to monitor?
Hypokalemia
A nurse wishes to teach alternative coping strategies to a client experiencing severe anxiety. The priority action by the nurse is to:
Lower the pt anxiety level
A client arrives to the emergency department with the following arterial blood gas results: pH 7.24; PaCO2 29; PaO2 81; HCO3- 13 mEq/L. Which of the following best describes these results?
Partially compensated metabolic acidosis
A 48-year old female client has been admitted to the hospital with the following ABG results: pH 7.54; PaCO2 29 mm Hg; PaO2 86 mm Hg; HCO3- 24 mEq/L. Which of the following is the best interpretation of these results?
Respiratory alkalosis
A nurse administers the prescribed regular insulin to a client in diabetic ketoacidosis. In addition, an intravenous (IV) solution with potassium is prescribed even though the serum potassium level is within normal limits. What does the nurse recognize as the reason for potassium administration?
Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.
The nurse reviews the patient's laboratory results prior to surgery. Which finding will the nurse report immediately? A. Hematocrit: 42% B. Potassium: 4.1 mEq/L C. Prothrombin time (PT): 15.2 seconds D. Random blood glucose: 98 mg/dL
c
A client tells a nurse, "My new friend is the most perfect person one could imagine—kind, considerate, and good looking. I can't find a single flaw." This client is demonstrating:
idealization
A client arrives to the emergency room in metabolic acidosis. The nurse expects to see the following clinical manifestations of this state for this client. Select all that apply.
lethargy deep rapid respirations dizziness
A client who is lethargic and exhibits deep, rapid respirations has the following arterial blood gas (ABG) results: pH 7.32, PaO2 88 mm Hg, PaCO2 37 mm Hg, and HCO3 16 mEq/L. How should the nurse interpret these results?
metabolic acidocis
A patient's ABG results show that she has a pH of 7.56 and a PaCO2 of 48 mm Hg. Without any other information, how would you interpret the patient's status?
metabolic alkalosis
A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day, when asked about the project, the worker says, "I've been working on other things." When asked 4 hours later, the worker says, "Someone else was using the copier, so I couldn't finish it." The worker's behavior demonstrates:
passive aggression