ATI: Medical Surgical

Which age group is at highest risk of getting hepatitis A? - Children - Older adults - Pregnant women - Middle aged men

Children

primary intention

Closing the wound mechanically, leaving well-approximated edges. Minimal scaring. Surigcal incision is an example wound.

AUscultating loud, bubbly sounds on inspiration would be documented as what

Coarse crackles

What does vasopressin do for a client with esophageal varices?

Constricts the splanchnic bed and decreases portal pressure. Constricts distal esophageal and proximal gastric veins- reduces inflow into the portal system.

Which should be applied to systemic lupus lesions: - Topical corticosteroid creams - Antibiotic creams

Corticosteroid creams

Kussmaul respirations

Deep, rapid breathing; usually the result of an accumulation of certain acids when insulin is not available in the body.

thyroid storm sx

Diarrhea, abd pain, n/v, restless, confusion, seizures, tachycardia, HTN

Which of the following is an adverse effect of LASIX surgery? - Intraocular hemorrhage - Dry eyes

Dry eyes Intraocular hemorrhage is an adverse effect of cataract surgery

Which of the following DOES NOT exacerbate systemic lupus erythematosus? - Exercise - Pregnancy - Infections

Exercise

Which of the following is a manifestation of systemic scleroderma? - Finger contractures - Alopecia

Finger contractures

Ig_____ is elevated in blood borne and tissue infections

G

Esomeprazole is a PPI used to treat what GI disease?

GERD

Ig____ would be elevated from allergies, anaphylaxis, and asthma

IgE

What happens to heart rate in fluid volume overload?

Increases

Hepatitis B is given to what two age groups

Infants and children- especially infants born to hepatitis B surface antigen negative mothers. Infants receive one, second dose between 1 - 4 months of age

Oliguria is a manifestation of what failure

Kidney failure

Second degree frostbite

Large, fluid-filled blisters

Orthopnea is which sided heart fialure

Left

Which side of the brain is responsible for language

Left side - expect speech difficulties if they have a stroke there

What dietary restrictions does a client with addisons disease require?

Low potassium, high sodium carbs and proteins

Ig____ would be elevated with a bacterial or viral infection

M

What would the nurse call this- Flat, variably shaped, discolored, small, change in color of skin.

Macules

Ulceration, bleeding, or exudation of an excised mole associated with basal cell carcinoma indicates what status of the disease?

Malignancy

A client who had a percutaneous transluminal coronary angioplasty with stent should have what done during the postprocedure plan of care? - check for peak lab markers of myocardial damage - Monitor for bleeding

Monitor for bleeding.

Does ALS affect the sensory nervous system?

NO. its a progressive neurodegenerative disease that affects motor nerve cells in the brain and spinal cord.

naproxen

NSAID

Is a PPD used to Dx active TB

No

Would you give a PPI like omeprazol for a pt with esophageal varices

No, its only for duodenal and gastric ulcers

Should you place abstract pictures on the wall of a client with stage II alzheimers disease?

No, these clients can be fearful of pictures of people or objects.

Should a client scheduled for a total knee arthroplasty avoid taking NSAIDs after surgery?

No, they can use NSAIDS.

A client who has alzheimers stage II should be reoriented to reality frequently?

No, this causes agitation.

Is alopecia associated with systemic scleroderma?

No.

Is chemo effective for melanoma?

No. It is for squamous cell.

In an EGD, is the client under general anesthesia?

No. Moderately sedated.

Is covering lupus lesions necessary?

No. The lesions are typically dry and scaly, not open and draining. The client should apply moisturizer to them after bathing them in warm water.

Autonomic Dysreflexia

Occurs in T6 or above spinal injuries. Triggered by full bladder or distended rectum. Manifestations: Severe, throbbing HA... Flushing of face and neck, bradycardia, HTN

Omeprazole is what kind of medication

PPI- tx duodenal and gastric ulcers

What would the nurse call this- Small, solid, elevated lesion with distinct boarders.

Papules

aura seizure

Period of altered sensation before the onset of a seizure - Often aware of strange smells, auditory, motor activity, or sights prior to seizure

Which of the following are manifestatiosn of aplastic anemia? - Plethoric appearance - Petechiae and ecchymosis

Petechiae and ecchymosis Aplastic anemia includes reduction of RBCs, white blood cells, and platelets.

Which of the following should be done first in the event of a seizure- - Protect the client's head - Turn the client on his side

Protect the client's head. The first risk of the client hitting their head as they fall.

What three cell types are reduced in aplastic anemia?

RBCs, WBCs, and platelets

Coarse, loud, low-pitched sounds during inspiration or expiration would be documented as what?

Rhonchi

First degree frostbite

Skin of the affected area is reddened and looks waxy

Which would be done for melanoma w/o metatasis: - SUrgical excision - External radiation therapy

Surgical excision

What would the nurse call this- Circumscribed, elevated lesion or blister containing serous fluid. Arise with herpes, poison ivy, chickenpox

Vesicles

What vitamin in addition to protein promotes wound healing

Vitamin C

What would the nurse call this- Transient, elevated, irregularly shaped lesions caused by localized edema.

Wheals

A high0pitched musical squeak on inspiration or expiration would be documented as what in auscultating breath sounds

Wheezes

Should rifampin be taken with or without food?

Without food

Will rifampin turn the skin orange

Yes

is melanoma resistant to radiation therapy?

Yes

Should choices be limited in a client with stage II alzheimers disease?

Yes, this will reduce confusion and frustration.

Raynaud's disease

a peripheral arterial occlusive disease in which intermittent attacks are triggered by cold or stress

graves disease

an autoimmune disorder that is caused by hyperthyroidism and is characterized by goiter and/or exophthalmos

Crushing's Syndrome

caused by prolonged exposure to high levels of cortisol

In a LP of a bacterial meningitis pt, glucose would be increased or decreased?

decreased

What happens to hr in autonomic dysreflexia

decreases

What does aspirin do to probenecid (A gout rx)

decreases the effectiveness of the rx

acromegaly

enlargement of the extremities caused by excessive secretion of growth hormone after puberty

EGD

esophagogastroduodenoscopy

What happens to BP in autonomic dysreflexia

extreme HTN

presbyopia

farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age.

dependent position

feet lower than the rest of the body. causes venous pooling...redness, warmth, distended veins

Loud, dry, rubbing or grating sounds over the lower antewrior chest surface during inspiration or expiration would be documented as what on auscultation

friction rub

Somogyi effect

hypoglycemia followed by rebound hyperglycemia

In a LP of a bacterial meningitis pt, protein would be increased or decreased?

increased

systemic scleroderma

inflammation, fibrosis, and sclerosis of the skin and vital organs.

What happens to CP when a client with pericarditis sits up or leans forward

it decreases

pruritus

itching

Decreased capillary refill is which sided heart failure?

left

Dyspnea is which sided heart failure

left

Kaposi's sarcoma

malignant tumor of the blood vessels associated with AIDS

Cheyne-Stokes respiration

pattern of breathing characterized by a gradual increase of depth and sometimes rate to a maximum level, followed by a decrease, resulting in apnea

____uria is part of diabetes insipidus

polyuria

Dependend edema is which sided heart failure

right

herpes zoster

shingles

heterograft

skin transplant taken from a species other than the patient's. I.e. a pigs

Third degree frostbite

small blisters and skin does not blanch

Famotidine is used to treat what kind of ulcer

stress ulcers

SIADH

syndrome of inappropriate antidiuretic hormone. a condition in which the body makes too much antidiuretic hormone (ADH). This hormone helps the kidneys control the amount of water your body loses through the urine. SIADH causes the body to retain too much water. HYPONATREMIA, will not be dehydrated or polyuric

The mantoux test is used to determine if there is an infection of mycobacterium ______

tuberculosis

silver sulfadiazine

used as a topical cream on burns Monitor for decreased WBCs (Leukopenia)

In a LP of a bacterial meningitis pt, would there be a presence of WBCs?

yes

What is the purpose of an EGD

*a type of endoscopy that looks at the mucosal lining of the esophagus, stomach, and duodenum -ALL patients with cirrhosis should have an upper EGD to screen for varices

Which of the following is a manifestation of unstable angina: - physical exertion does not precipitate CP - CP lasts >15min

- CP lasts >15min Unstable angina- CP with exertion.

A nurse is assessing a client who has pericarditis. Which of the following manifestations should the nurse expect? - chest pain that increases when sitting upright - Dyspnea with hiccups

- Dyspnea with hiccups Pericarditis sx- dyspnea, hiccups, nonproductive cough. CP would decrease when the client sits up or leans forward.

Which of the following can a client do to relieve itching in a fiberglass cast? - Hair dryer on a cool setting to blow air into the cast - Cotton swab to rub the affected skin

- Hair dryer on a cool setting to blow air into the cast Do not place any foreign objects under the cast. This is to prevent injury to the skin

Which of the following best indicates an understanding of hydrotherapy? - I will be on a special shower table - The water temperature will be very cool to ease my pain

- I will be on a special shower table The nurse would use warm water during hydrotherapy to retain adequate body temperature. Hydrotherapy tables allow for examination and debridement of the wounds.

Which of the following is an adverse effect of cataract surgery? - Intraocular hemorrhage - Dry eyes

- Intraocular hemorrhage Dry eyes is an adverse effect of LASIX

Which of the following labratory findings should the nurse evaluate the client for when taking silver sulfadiazine cream for her burn wounds? - Leukopenia - Elevated BUN

- Leukopenia Transient leukopenia is an adverse effect of silver sulfadiazine. Impaired kidney function (BUN) is an adverse effect of gentamicin.

A nurse is caring for a client who has hemophilia. The client reports pain and swelling in a joint following an injury. Which of the following acitons should the nurse take? - Obtain blood samples to test platelet function - Prepare for the replacement of the missing clotting factor

- Prepare for replacement of the missing clotting factor

Which lab value should the RN monitor 4hr after their client receives fresh frozen plasma? - Hct - Prothrombin time

- Prothrombin time FPP is rich in clotting factors. Hct is monitored when the client is receiving packed RBCs

A nurse is transfusing a unit of B+ fresh frozen plasma to a client whose blood type is 0-. Which of the following actions should the nurse take? - Continue to monitor for manifestations of a transfusion reaction - Remove the unit of plasma immediately and start an IV infusion of normal saline solution

- Remove the unit of plasma immediately and start an IV infusion of normal saline solution Incompatible blood can result in a hemolytic transfusion reaction.

Which of the following actions should the RN take for a client with cardiac tamponade? - auscultate blood pressure for pulsus paradoxus - Check for pulse deficit

- auscultate blood pressure for pulsus paradoxus Systolic blood pressure will be 10mm Hg higher on expiration than on inspiration. There will be no pulse deficit in cardiac tamponade

Ig_____ would be elevated with autoimmune diseases and chronic infections

A

What drug is the first line for herpes zoster? -= Amoxicillin - Imfiximab - Acyclovir

Acyclovir Amoxicillin is ABX, Infiximab is for crohn's disease, Axyclovir is a viral drug (-vir)

fourth degree frostbite

Affected area is frozen. No blisters. Muscles and bones are affected.

Which of the following lab values will be within expected range after pancreatitis tx begins 72hours? - Amylase - Alsolase - Lipase

Amylase.

Which of the following is a manifestation of early hepatitis A? - Jaundice - Anorexia

Anorexia Jaundice is a late manifestation.