HR Final
40. Dexa score that reflects osteoporosis?
-2.5
47. Math question=
0.3
24. SLE with rash and alopecia wont leave house nursing diagnosis?
Social isolation
27. Pantoprazole for burns effectiveness
Stool occult blood
45. Patient with ARDS on PEEP, which indicates it need to be decreased?
Subcutaneous emphysema
23. Radical mastectomy left breast priority to report?
Unequal arm circumference
12. The patient brought to the emergency department after a car accident is diagnosed with a femur fracture what nursing intervention should the nurse implement at this time to decrease risk of a fat embolus? a. Administer enoxaparin (lovaox) b. Apply sequential compression boots c. Provide range of motion exercises d. Immobilize the fracture preoperatively
ANS: D
13. A patient with aids has been tested for cytomegalovirus with positive titers, what severe complications should the nurse be alert for with cytomegalovirus? a. Fatigue b. Hearing impairment c. Diarrhea d. Blindness
ANS: D
16. A client has discussed therapy for his HIV positive status what does the nurse understand is the goal of antiretroviral therapy a. Eliminate the risk of AIDS b. Avoid the social stigma of wasting syndrome c. Reverse the HIV + status to a negative status d. Bring the viral load to a virtually undetectable level
ANS: D
3. A patient who has burns on the arms, legs, and chest from a house fire has become agitated and restless 8 hours after being admitted to the hospital which action should the nurse take first? a. Stay at the bedside and reassure the patient b. Administer ordered morphine sulfate IV c. Assess orientation and level of consciousness d. Use pulse oximetry to check oxygen saturation
ANS: D
4. Which patient is at greatest risk for ARDS a. The 24 year old with asthma who has not taken any of her asthma medications in 2 weeks b. The 62 year old with COPD who is experiencing an exacerbation c. The 78 year old with chronic congestive heart failure d. The 22 year old who received 10 units of blood after a motor vehicle accident
ANS: D
5. The nurse would recognize which assessment finding as suggestive of sepsis a. Sudden diuresis unrelated to drug therapy b. Urticaria c. Respiratory rate of seven breaths per minute d. Hyperglycemia in the absence of diabetes
ANS: D
22. Osteoarthritis symptoms SATA A.Notify HCP for red/swollen joints B. Maintain weight (bmi was 30.1) C. Keep Physical therapy appts D. Non pharmalogical treatments E. Running
A.Notify hop for red/swollen joints C. Keep Physical therapy appts D. Non pharmalogical treatments
25. 400-80 tabs give 2000-400 tabs
5 tabs
38. ALL pt has dry cough with diminished sounds:
ANC
55. The health care provider orders the following interventions for a 67-kg patient who has septic shock with a BP of 70/42 mm Hg and oxygen saturation of 90% on room air. In which order will the nurse implement the actions?(Put a comma and a space between each answer choice [A, B, C, D, E].) a. Obtain blood and urine cultures. b. Give vancomycin (Vancocin) 1 g IV. c. Start norepinephrine (Levophed) 0.5 mcg/min. d. Infuse normal saline 2000 mL over 30 minutes. e. Titrate oxygen administration to keep 02 saturation >95%.
ANS: E, D, C, A, B
31. Who to assess first on shift? A. BiPap patient who is obtunded B. Pt on heparin with ptt 64
A. BiPap patient who is obtunded
43. Patient with PE and HF which interventions? A. Diuretics B. Chest Tube C. Oxygen D. Hypotonic fluids E. Intotropes
A. Diuretics C. Oxygen E. Intotropes
37. Pt with angioedema, list of interventions you select appropriate or not appropriate A. Epinephrine B. Have intubation equipment available C. Dyphenhydramine D. High fowlers E. Packed RBC'5
A. Epinephrine B. Have intubation equipment available C. Dyphenhydramine
30. MVA with 36% burns has weak thready pedal pulses- priority? A. Prepare for emergency intubation B. Doppler to verify pulses
A. Prepare for emergency intubation
32. Sickle Cell symptoms SATA A. Priaprism B. Swollen joints C. Jaundice D. Fatigue E. Loss of taste F. Epistaxis
A. Priaprism B. Swollen joints C. Jaundice D. Fatigue
36.AIDS pt comes in for appointment, select all that you would monitor? A. Weight history B. BMI C. WBC D. Iron level/ ferritin or something E. Albumin level
A. Weight history B. BMI C. WBC E. Albumin level
10. A patient with blunt trauma to the abdomen has received 3L of normal saline what is the most appropriate intervention in response to the following ABG PH 7.21, PACO2 45 MM hg, PAO2 76 MM HG HCO3 15 MEQ/L a. Infuse a unit of packed red blood cells b. Infuse a bolus of normal saline at 40 ml/kg/hr c. Infuse normal saline at a keep vein open rate d. Administer total parateral nutrition (TPN)
ANS: A
2. Prone positioning is being used for a patient with acute respiratory distress syndrome (ARDS) which information obtained by the nurse indicates that the positioning is effective a. The patients PAO2 is 89mmhg and the SAO2 is 91% b. Endotracheal suctioning results in clear mucous return c. Sputum and blood cultures show no growth after 48 hours d. The skin on the patients back is intact without redness
ANS: A
7. A patient with a diagnosis of septic shock has a lactic acid level of 7mmol/L and fluid resuscitation has been initiated which of the following indicates that fluid resuscitation received by the patient is adequate? a. MAP of 70 mm Hg b. Central venous pressure (CVP) of 3 mm hg c. Scvo2 of 60% d. Urine output of 0.3 ml/kg/hr
ANS: A
9. A 26 year old patient receives the first dose of oxacillin IVPB and suddenly becomes restless on further assessment the RN notes urticaria and wheezes what medication do you expect the physician to order? a. Epinephrine IM b. Dopamine IVBP c. Vasopressin IV d. Dobutamine IVPB
ANS: A
58. A patient with a right retinal detachment had a pneumatic retinopexy procedure. Which information will be included in the discharge teaching plan? a. The purpose of maintaining the head in a prescribed position b. The use of eye patches to reduce movement of the operative eye c. The need to wear dark glasses to protect the eyes from bright light d. The procedure for dressing changes when the eye dressing is saturated
ANS: A Following pneumatic retinopexy, the patient will need to position the head so the air bubble remains in contact with the retinal tear. The dark lenses and bilateral eye patches are not required after this procedure. Saturation of any eye dressings would not be expected following this procedure.
17. Which finding is the best indicator that the fluid resuscitation for a 90 kg patient with hypovolemic shock has been effective? a. Hemoglobin is within normal limits b. Urine output is 65ml over the past hour c. Central venous pressure (CVP) is normal d. Mean arterial pressure (MAP) is 772 mm HG
ANS: B
18. The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer which information about the patient alerts the nurse to discuss a possible change in cancer therapy with the health care provider a. Frequent loose stools b. Increased carcinoembryonic antigen c. Nausea and vomiting d. Elevated WBC
ANS: B
19. After a patient who has septic shock receives 2 L of normal saline intravenously. The central venous pressure is 10 mmhg and the blood pressure is 82/40 mm hg what medication should the nurse anticipate? a. Nitroglycerine b. Norepinephrine c. Sodium nitroprusside d. Methylprednisolone
ANS: B
8. Eight hours after thermal burn covering 50% of a patients total body surface area the nurse assesses the patient the patient weighs 92 kg (202.4) pounds. Which information would be a priority to communicate to the health care provider a. Blood pressure of 95/48 per arterial line b. Urine output of 40 ml/hr for the past 2 hours c. Serous exudate is leaking from the burns d. Heart monitor shows sinus tachycardia of 108
ANS: B
54. After receiving 2 L of normal saline, the central venous pressure for a patient who has septic shock is 10 mm Hg, but the blood pressure is still 82/40 mm Hg. The nurse will anticipate an order for a. nitroglycerine (Tridil). b. norepinephrine (Levophed). c. sodium nitroprusside (Nipride). d. methylprednisolone (Solu-Medrol).
b. norepinephrine (Levophed).
14. Nurse palpates enlarged cervical lymph nodes on a patient diagnosed with HIV infection which action would be appropriate for the nurse to take? a. Instruct the patient to apply ice to the neck b. Tell the patient secondary infection is present c. Explain to the patient that this is an expected finding d. Request that an antibiotic is prescribed for this patient
ANS: C
15. The nurse teaching the patient newly diagnosed with systemic lupus erythematous about the condition which statement by the patient indicates teaching was effective a. My medications will ultimately correct my problem b. I do not need to make any changes to my diet c. I should avoid prolonged sun exposure d. My energy level will gradually increase over time
ANS: C
6. Esomeprazole is prescribed for a patient who incurred excessive burn injuries 5 days ago which nursing assessment would best evaluate the effectiveness of this drug? a. Bowel sounds b. Stool frequency c. Stool occult blood d. Abdominal distention
ANS: C
51. A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which action would be important for the nurse to take after the procedure? a. Elevate the head of the bed to 45 degrees. b. Apply a sterile 2-inch gauze dressing to the site. c. Use a half-inch sterile gauze to pack the wound. d. Have the patient lie on the left side for 1 hour.
ANS: D To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60 minutes. After a bone marrow biopsy, the wound is small and will not be packed with gauze. A pressure dressing is used to cover the aspiration site. There is no indication to elevate the patient's head.
1. A patient arrives at the emergency department after experiencing burns while in an enclosed warehouse. Which assessment findings below demonstrate the patient may experience an inhalation injury select all that apply a. Carbonaceous sputum b. Hoarse voice c. Bright red lips d. Tachycardia e. Hair singed on the head and nose
ANS: a,b,c,d,e
39. Which do you anticipate giving to a patient starting immunotherapy for ovarian cancer?
Acetaminophen
50.A patient who has cancer is about to begin chemotherapy. The patient asks the nurse why two chemotherapeutic agents are being used instead of just one. Which response by the nurse is correct? A. "The drugs may be given in less toxic doses if two drugs are used B. "Two agents used together can have synergistic effects." C. "Use of two drugs will increase tumoricidal activity in the GO phase of the cell." D. "Using two agents will shorten the length of time chemotherapy is needed"
B. "Two agents used together can have synergistic effects."
48. Signs and symptoms of retinal detachment include: A. double vision and partial or complete loss of peripheral vision. B. flashing lights, specks, or floaters in the field of vision. C. paralysis of upward gaze and greater than 50% loss of central vision. D. immediate pain and total loss of vision following blunt eye trauma.
B. flashing lights, specks, or floaters in the field of vision.
74. A patient with aids has been tested for cytomegalovirus with positive titers. What severe complications should the nurse be alert for with cytomegalovirus?
Blindness
77. A client has discussed therapy for his HIV positive antiretroviral therapy. What does the nurse understand the goal is to?
Bring the viral load to a virtuallv undetectable level
21. Symptom of retinal detachment A. Loss of central vision B. Room foggy C. Can't see up close D. Dots/floaters
D. Dots/floaters
34. Notify HCP before giving Norepinephrine
CVP 3
20. Cardiogenic shock intervention priority A. Position supine B. Check temp q2 hrs C. Check breath sounds frequently D. Monitor skin for itching/ flushing
Check breath sounds frequency
11. What labs values are indicative of glucose 6 phosphate dehydrogenase deficiency?
Normal range 5.5-20.5 units/ gram of hemoglobin Out of PowerPoint- spleen removes Heinz bodies causes hemolysis, reticulocytes, increase jaundice
33. Place in order of priority:
Oxygen Fluids Norepinephrine Cultures Vancomycin
26. Mechanical vent/ MODS symptom A. Decreased BUN B. Increased Gi motility C. Increased albumin D. Decreased respiratory compliance
D. Decreased respiratory compliance??
41. GOUT priority to report? A. Increased uric acid in urine B. CRP level (normal) C. Uric Acid of 7 (normal) D. Pain 8/10
D. Pain 8/10
42. Early cardiogenic shock which drug do you anticipate giving?
Dobutamine
72. Which action would be appropriate for the nurse to take?
Explain to the patient that this is an expected finding
35. Pt taking warfarin undergoes emergency surgery, post op nurse notices oozing and abdominal bruises
Give vitamin k
70. The nurse is teaching the patient newly diagnosed with systemic lupus erythematous about the caution. Which statement by the patient indicates teaching was effective?
I should avoid prolonged sun exposure
75. The patient brought to the emergency department after a car accident is diagnosed with a femur fracture. What nursing intervention should the nurse implement at this time to decrease risk of a fat embolus?
Immobilize the fracture preoperatively
29. Vincristine =
Non skid socks
44. Symptoms of rheumatoid arthritis?
Pain in joints, restricted movement, stiffness, weakness
76. Which finding is the best indicator that the fluid resuscitation for a 90-kg patient with hypovolemic shock has been effective?
Urine output is 65 ml over the past hour
60. A patient arrives at the emergency department after experiencing burns while in an enclosed warehouse. Which assessment findings below demonstrate the patient may have experienced an inhalation injury? Select all that apply a. Carbonaceous sputum b. Hoarse voice c. Bright red lips d. Tachycardia e. Hair singed on the head and nose
a. Carbonaceous sputum b. Hoarse voice d. Tachycardia e. Hair singed on the head and nose
59. A nurse is caring for a patient who is orally intubated and receiving mechanical ventilation. To decrease the risk for ventilator-associated pneumonia, which action will the nurse include in the plan of care? a. Elevate head of bed to 30 to 45 degrees. b. Suction the endotracheal tube every 2 to 4 hours. c. Limit the use of positive end-expiratory pressure. d. Give enteral feedings at no more than 10 mL/hr.
a. Elevate head of bed to 30 to 45 degrees.
68. A 26 year old patient receives the first dose of oxacillin IVPB and suddenly becomes restless. On further assessment the RN notes urticaria and wheezes. What medication do you expect the physician to order? a. Epinephrine IM b. Dopamine IVPB c. Vasopressin IV d. Dobutamine IVPB
a. Epinephrine IM
69. A patient with blunt trauma to the abdomen has received 3 L of normal saline. What is the most appropriate intervention in response to the following ABG: pH 7.21, PaCO2 45 mmHg, PaO2 76 mmHg, HCO3 15 mEq/L? a. Infuse a unit of packed red blood cells b. Infuse a bolus of normal saline at 40 ml/kg/hr c. Infuse normal saline at a keep vein open rate d. Administer total parenteral nutrition (TPN)
a. Infuse a unit of packed red blood cells
66. A patient with a diagnosis of septic shock has a lactic acid level of 7 mmol/L and fluid resuscitation has been initiated. Which of the following indicates that the fluid resuscitation received by the patient is adequate? a. MAP of 70 mm Hg b. Central venous pressure (CVP) of 3 mm Hg c. ScvO2 of 60% d. Urine output of 0.3 ml/kg/hr
a. MAP of 70 mm Hg
61. Prone positioning is being used for a patient with acute respiratory distress syndrome (ARDS). Which information obtained by the nurse indicates that the positioning is effective? a. The patient's PaO2 is 89 mm Hg, and the SaO2 is 91%. b. Endotracheal suctioning results in clear mucous return c. Sputum and blood cultures show no growth after 48 hours d. The skin on the patient's back is intact without redness
a. The patient's PaO2 is 89 mm Hg, and the SaO2 is 91%.
53. Which assessment in a client that has just returned from having a modified radical neck dissection with skin flap would require a nurse to take immediate action? a. The skin flap appears white. b. The client's voice is hoarse. c. The absence of bowel sounds. d. Sutures are visible on the client's face.
a. The skin flap appears white.
52. The nurse is reviewing the medications of a client who is being admitted to the oncology unit. The client is taking vincristine for metastatic cancer. Which of the following interventions should be added to the plan of care? a. Administer antidiarrheal daily. b. Provide nonskid socks to the client. c. Provide a 1200ml fluid restricted diet. d. Assess peripheral pulses every 2 hours.
b. Provide nonskid socks to the client.
49. A patient is admitted to the emergency department with an open stab wound to the left chest. What is the first action that the nurse should take? a. Position the patient so that the left chest is dependent. b. Tape a nonporous dressing on three sides over the chest wound c. Cover the sucking chest wound firmly with an occlusive dressing d. Keep the head of the patient's bed at no more than 30 degrees elevation
b. Tape a nonporous dressing on three sides over the chest wound
67. Eight hours after thermal burn covering 50% of a patient's total body surface area the nurse assesses the patient. The patient weighs 92 kg (202.4 lbs). Which information would be a priority to communicate to the health care provider? a. Blood pressure is 95/48 per arterial line b. Urine output of 40 ml/hr for the past 2 hours c. Serous exudate is leaking from the burns d. Heart monitor shows sinus tachycardia of 108
b. Urine output of 40 ml/hr for the past 2 hours
56. The health care providers progress note for a patient states that the complete blood count (CBC) shows a shift to the left. Which assessment finding will the nurse expect? a. Cool extremities b. Pallor and weakness c. Elevated temperature d. Low oxygen saturation
c. Elevated temperature
65. Esomeprazole is prescribed for a patient who incurred extensive burn injuries 5 days ago. Which nursing assessment would best evaluate the effectiveness of the drug? a. Bowel sounds b. Stool frequency c. Stool occult blood d. Abdominal distention
c. Stool occult blood
64. The nurse would recognize which assessment finding as suggestive of sepsis? a. Sudden diuresis unrelated to drug therapy b. Urticaria c. Respiratory rate of seven breaths per minute d. Hyperglycemia in the absence of diabetes
d. Hyperglycemia in the absence of diabetes
63. Which patient is at greatest risk for ARDS? a. The 24 year old with asthma who has not taken any of her asthma medications for 2 weeks b. The 62 year old with COPD who is experiencing an exacerbation c. The 78 year old with chronic congestive heart failure and pulmonary edema d. The 22 year old who received 10 units of blood after a motor vehicle accident
d. The 22 year old who received 10 units of blood after a motor vehicle accident
62. A patient who has burns on the arms, legs, and chest from a house fire has become agitated and restless 8 hours after being admitted to the hospital. Which action should the nurse take first? a. Stay at the bedside and reassure the patient b. Administer the ordered morphine sulfate IV c. Assess orientation and level of consciousness d. Use pulse oximetry to check oxygen saturation
d. Use pulse oximetry to check oxygen saturation
57. A 25-year-old female patient with systemic lupus erythematosUs (SLE) who has a facial rash and alopecia tells the nurse, I never leave my house because I hate the way I look. An appropriate nursing diagnosis for the patient is a. activity intolerance related to fatigue and inactivity. b. impaired social interaction related to lack of social skills. c. impaired skin integrity related to itching and skin sloughing. d. social isolation related to embarrassment about the effects of SLE.
d. social isolation related to embarrassment about the effects of SLE.
46. ABG's question=
give RBC's
28. What are the 6 P's?
pain, poikilothermia, pallor, pulselessness, paresthesia, paralysis
