Last AH

A young boy has come to the cast clinic for the scheduled removal of his arm cast. In preparation, what teaching point should the nurse provide to the boy?

"Do not be surprised if your arm looks thinner than it normally does"

the nurse is conducting patient teaching about cholesterol levels in the body. When discussing the patients elevated low-density lipoprotein (LDL) and lowered HDL levels, the patine shows understanding when she states what?

"incresed LDL levels and decreased HDL levels increase my risk for coronary artery disease"

the nurse is caring for a patent with Paget's disease is analyzing the patients lab values. which of the following values is most often

A high serum alkaline phosphate level and normal serum calcium level

During a mumps outbreak at a local school, a teacher is exposed, She has been previously immunized for mumps. What type of immunity does she possess?

Active acquired immunity

Asthma requires life ling management by patients and clinicians to achieve the goals of therapy. the signs and symptoms of this disease are primarily related to what pathophysiological process?

Acute inflammation of the patients's hyperresponsive airway to triggers (allergens)

With an increased amount of insulin in the body (hyperinsulinemia), what electrolyte imbalance would one anticipate?

Hypophosphatemia

which of the following immunoglobulins is responsible for allergic reactions and eradicating parasitic infections?

IgE

The nurse is caring for a 69 year old patient with a history of OA who has just been admitted to the medical unit. The patient asks the nurse what the difference is between OA and RA. What is the best response by the nurse?

OA is considered noninflammatory joint disease and RA is characterized by inflamed swollen joints

In which cardiac rhythm abnormality would you expect to see an early p wave?

PAC

The nurse is assessing the musculoskeletal system and the patient states "my legs feel very tingling and become numb for prolonged periods of time" The nurse is aware the this subjective data is referred to as what?

Paresthesia

An individual's exposure to an airborne pathogen has prompted an immune response that includes both cellular and humoral components. Which of the following activities is most closely associated with the humoral response?

Plasma cells producing antibodies that are specific to the pathogen

Your elderly patient had been managing her BP through diet and exercise for the past 20 years. As she gets older, her blood pressure has increased over the last few years. What will be the initial therapy to start this patient on die to its effectiveness as well as promoting born integrity?

Thiazude Diuretics

You notice a premature QRS complex after every Third heart beat. You realize the patient is in what cardiac rhythm and can be caused by what risk factor?

Trigeminy; caffeine intake

What test us used to monitor the effectiveness of treating HIV with HAART?

Viral load

The nurse asks the patient to repeat saying the number "99" several times as the lungs are being auscultated. The nurse is assessing:

bronchophony

The nurse is conducting a scheduled assessment of a female patient who has been admitted to the unit following surgical repay of her fractured humerus. Which of the following assessment findings should prompt the nurse to contact the patient's care provider?

capillary refill is 3-4 seconds bilaterally

A patient is experiencing pain in his right calf when he exercises, which subsides after resting for a few minutes. The nurse recognizes that this description is most consistent with what condition?

ischemia caused by a partial blockage of an artery that supplies the right leg

A nurse is planning the care for a patient who has fibromyalgia and is aware of the damaging effect that the disease has had on the patient's quality and quantity of sleep. When discussing strategies to manage this problem with the patient, the nurse should recommend:

setting consistent times for going to bed and getting up in the morning

You are called to your patients room by a family member who voices concern about the patient's status. On assessment you fin the patient tachypenic, lethargic, weak and exhibiting a diminished cognitive ability. What electrolyte imbalance would you suspect based on these clinical manifestations?

sodium level of 124 mEq/L

A 46 year old man has been diagnosed with systolic heart failure and has begun treatment. You ask the RN what this indicates. What is her expected response related to this diagnosis?

the contractility and ejection fraction of the heart are reduced

A patient with severe nausea/vomiting and diarrhea suddenly develops a rapid weak pulse and the nurse finds it is difficult to obtain a blood pressure. Which of the following IV floods does the nurse anticipate the physician will order STAT?

0.9% sodium chloride

During shift assessment, the nurse is auscultation the aortic valve. Where would be the best place for the nurse to place her stethoscope?

2nd ICS RSB

Pressure in the left ventricle must exceed pressure in the _________ before the left ventricle can eject blood.

Aorta

Which of the following is a non shockable rhythm?

Asystole

While osculating your patient's lung sounds after his nap, you temporarily hear a high-pitched, discontinuous, crackles sound heard predominately on end inspiration. How will you document this finding?

Atelectatic Crackles

which of the following components of the heart's conduction is found in the inferior portion of the right atrium and control the number of impulses that reach the ventricles in order to prevent extremely rapid heart rates?

Atrial-ventricular (AV) node

A nurse on a medical unit is caring for a patient who has experienced a recent exacerbation of HIV. The nurse is being vigilant in assessments and preventative measures a related to the common complications of HIB infection. What assessment addresses the most common fungal opportunistic infection related to HIV?

Auscultating the patient's lungs and monitoring their oxygen saturation

Which of the following lung sounds are expected during auscultation between the scapula posteriorly and between the 1st and 2nd ICS anteriorly?

Bronchovesicular

the nurse working on the respiratory intensive care unit is aware that several respiratory conditions can affect the compliance of lung tissue. Which condition leads to an increase in lung compliance?

Emphysema

A female patient with a diagnosis of AIDS has experienced a recent acceleration int he progression of her disease. The nurse is documenting the patient's memory lapses and increasing slow, uncoordinated movements. The nurse is justified in suspecting that this patient may be exhibiting the signs and symptoms of what complication of AIDS?

HIV encephalopathy

Your patient has been diagnosed with diabetes insipid us. What would you anticipate to find when reviewing lab results?

High serum osmolality and low urine osmolality

Your 32 year old patient fell off her bike into the grass and arrived at the ER due to severe right arm pain. An X-ray was done and the patient was found to have a fractured humerus. Due to the low impact fall, what electrolyte imbalance do you suspect AND what medication can be the cause of this imbalance?

Hypercalcemia; corticosterioids

A patient has been admitted to your unity for cellular dehydration. The nurse knows that which of the following is a potential etiology and expects to find which type of IV fluid order?

Hyperglycemia; 0.45% NSS

The nurse is checking deep tendon reflexes and notes that her patient's reflexes are hyperactive. What laboratory finding would indicate this?

Hypomagnesemia

Which of the following immunoglobulins is the first antibody to be produced by the developing fetus?

IgM

An ER nurse has provided care for may patient who have primarily and secondary diagnosis of immune dysfunction. Which of the following patients likely has the highest risk of a disruption to normal immune functioning?

a man who has recently completed chemotherapy for his bladder cancer

A nurse on a medical unit is providing care for a patient who has been admitted because of simultaneous development of several complications of AIDS. For the past several days, the patient has been experiencing six to eight watery bowel movements each day. The nurse should consequently assess the patient's:

electrolyte levels

A 66 year old man who originally sought care because of increasing pain in his great toe has subsequently been diagnosed with gout. In addition to pharm interventions, ?

high fluid intake and low protein intake

which of the following pressures is located on the arterioles side of the capillary and is responsible for pushing fluid out?

hydrostatic

Which of the following is a common endocrine disorder that is likely to cause respiratory acidosis?

hypothyroidism

Matabolic alkalosis results in a(n):

increased oxygen affinity to hemoglobin

your patients asthma is not well controlled and is requiring long-term management. Which drug class is used for decreasing the amount of histamine released and which class is it important to reach the patient to rinse their mouth after use to prevent thrush?

mast cell stabilizers; corticosteriods

You are reviewing the patient's ABG results and notice your patien's base excess is -2.8 mEq/L. What does this value indicate and what electrolyte changes will also be observed?

metabolic acidosis; increased calcium level and decreased phosphate level

A 48 year old patient has had multiple sclerosis for 15 years and she is receiving interferon injections. What is the purpose of these injections?

modify the immune response by suppressing antibody production and cellular immunity

Mitral stenosis can be described as a valvular heart disease that causes restriction of blood:

moving into the left ventricle, increasing after load and is associated with an opening snap after s2

A patient presented to the ER with a fracture of the nose that has resulted in a skin tear and involvement of the mucous membranes of the nasal passages. The ER nurse is aware that his description likely indicates which type of fracture?

open

Which of the following actions related to cue care is appropriate?

outline, date and time any drainage notes on the cast

Your patient is suspected of being in an uncompensated metabolic alkalosis based on her signs and symptoms. What ABG values would validate our suspicions?

pH of 7.48; PaCO2 of 36 and HCO3 of 30 mEq/L

the nurse is admitting a 24 year old female patient who had gastric bypass 4 years ago. the patient complains of altered vision and hearing, numbness in her hands and feet, tachycardia, dyspnea, and beefy sore tongue. Which type of anemia would you suspect this patient has developed and which diagnostic test should be performed?

pernicious anemia, shilling's test

While palming care for a heart patient, which principle should the nurse recall? Right ventricular afterload is affected by:

pulmonary vascular resistance

A hospital patient's most recent blood work reveals a calcium level of 12.2 mg/dL. In response to this level if calcium, what physiological response is most likely to occur?

secretion fo calcitonin hormone

A water-seal system for chest drainage had been inserted into a patient who suffered chest trauma and had been diagnosed with a pleural effusion. At the beginning of night shift, the nurse has entered the patient's room to assess the system and the patient's condition. Which of the following assessment findings suggest that the system is operating correctly and the patient is maintaining oxygenation and has clear kung sounds bilaterally?

the level in the water seal chamber remains constant during breathing

Which statement is true regarding acid-base compensation?

the lungs are quicker in promoting compensation than the kidneys

Which of the following statements best describes atrial fibrillation?

the rhythm is irregularly irregular; atrial rate is > ventricular rate and due to the high rate of thrombi, the patient must be on a daily anticoagulant

The nurse is talking witht he patient about her hypertension and her antihypertensive drug therapy The patient has a history of diabetes mellitus type II but otherwise is in good health. When assessing the response to an antihypertensive drug regime, what blood pressure would be the goal of her treatment?

130/80 mmHg or less

A nurse who oversees care in a long term care facility is aware that a high percentage of residents have osteoporosis. The residents who do not have the disease must be assessed and monitored closely for this health problem. Which of the following older adults most clearly exemplifies the risk factors for osteoporosis?

A caucasian woman who has low body mass index

A NP who works with many older patients integrates screening for osteoporosis into health promotion activities. What screening tool is most clinically useful when screening for osteoporosis?

Dual energy x ray absorptometry

Which class of the following meds is most likely to cause respiratory alkalosis?

Epinephrine

Your patient has a history of hypertension and was taking thiazide diuretics. Her blood pressure remains elevated; therefore, the health care provider decides to add an ACE Inhibitor to her treatment plan. How does this medication help reduce BP?

Prevents Angiotension II from being formed and reduces aldosterone

A nurse is observing a patient's respiratory pattern and notices rapid, deep breathing due to anxiety of his upcoming final exams. The nurse anticipates that if this patten continues for a prolonged period of time, the pH will:

Rise

the school nurse is caring for a 10 year old girl who is having an asthma attack on the playground during recess. What is the preferred treatment to alleviate the patient's current airflow obstruction?

Short Acting Beta Agonists

You are evaluating a 6 second rhythm strip. You nots that all the complexes are present and they look normal. There is a p wave before every QRS and the rhythm is regular. You determine the rate to be 52 BPM. The patient has complained that he feels tired all the time and cannot tolerate too much activity What rhythm is the patine exhibiting and how would this be treated>

Sinus bradycardia; intravenous atropine

a 65 year old man is transported to the Er for chest pain. An EKG reveals a prolonged QRS interval. What is the nurse monitoring when he is observing the QRS complex?

Ventricular depolarization

The nurse is aware of the importance of synchronization of the atrial and ventricular events in the maintenance of normal cardiac function. What are the psychologic characteristics of the nodal and purkinje cells that provide this synchronization?

automaticity, excitability, conductivity

The nurse is providing health education for a male patient who is preparing to be discharged home following recovery from a total hip replacement surgery. When reviewing the guidelines for safe mobility and positioning to prevent injury, the nurse should teach the patient to:

avoid crossing his legs for the next several months

A patient had been admitted with endocarditis. The patient asks the nurse how the health care provider knows what medicines to order to kill the bacteria. The nurse is aware that the most appropriate treatment is bases on the results of what diagnostic test?

blood cultures

The nurse notices an irregular breathing pattern evidenced by an increase in rate, along with both deep and shallow depth of breathing that alternates with varying periods of apnea. The nurse would be documenting accurately id she refers to this pattern as:

Biot's

Which of the following electrolytes follows sodium and helps to form cerebrospinal fluid?

Chloride

Your patient has been diagnosed with iron deficiency anemia. What would you expect from her lab results?

Decreased ferritin, increased transferring

The nurse is admitting a patient who is experiencing increased signs and symptoms of dilated cardiomyopathy (DCM). WHat changes in the heart characterize DCM?

Dilated ventricles without hypertrophy of the ventricles

A 58 Year old woman was diagnosed with OA by her primary car provider several months ago. She claims that she is achieving acceptable control of her symptoms by taking acetaminophen several times per day. The nurse should perform further assessment to ensure that the patient is doing which of the following?

Drinking sufficient amounts (2L per day) of fluid

Your patient was admitted for a recent femoral fracture and has rung his call light. The nurse enters the room and finds the patient in distress and complaining of chest pain. The nurse immediately assesses him and finds that he is tachycardic, tachypneic, has bilateral crackles throughout lung fields, and subconjunctival petechiae has been observed. Bases on this knowledge, the nurse knows that patient may be experiencing what complication?

Fat embolism

A patient presented o the ED with shortness of breath and has been informed that her chest X-ray is suggestive of a pleural effusion. The physical outlined the proposed course of treatment. The patient asks you to explain exactly what a pleural effusion is and if there are any complication. What response would be most accurate?

Fluid has built up between your lungs and the lining that surounds your lungs and needs to be treated before it causes compressive atelectasis.

A nurse is receiving change-of-shift report about an older adult patient who has a diagnosis of chronic obstructive pulmonary disease (COPD). The nurse's colleague reports that he has applied oxygen at 6L/min by nasal cannula in an effort to bring the patients oxygen saturation levels >95%. How should the nurse best interpret this collegues's action?

Giving oxygen at a high rate has the potential to interfere with the patient's hypoxic drive

Radiographs were ordered for a 10 year old boy who had his right upper arm injured. the radiographs show that the humerus appears to be fractured on one side and slightly bent on the other side. what type of fracture is this an example of?

Greenstick

The significance of the atrial kick is that it affects the contraction of the:

Left atria which increases the blood volume into the ventricle

The nurse is performing the initial assessment of a patient who has been diagnosed with systemic lupus erythematosus (SLE). What skin manifestation would the nurse expect to find on this patient?

Malar Rash

A patient has recently been diagnosed in the early stages of RA. What medication classification would the nurse expect to be ordered for this patient?

NSAIDs

A nurse caring for a patient with bacterial pneumonia. Blood gas results indicate a ph of 7.30; PaCO2 of 48 mmHg, and HCO3 of 32 mEq/L. The nurse has determined that the patient is experiencing ______________ and expects which abnormal lab value to be notes in this condition as the body is attempting to compensate?

Respiratory Acidosis with Partial Compensation; Hyperkalemia

You receive a patient in the ED who is experiencing sudden onset of severe chest pain. Blood work has been drawn and the patient had an electrocardiogram done. Which of the following cardiac biomarkers is considered the most accurate in detecting myocardial infarction?

Troponin I

The nurse is providing discharge teaching to a patient diagnosed with heart failure. What should the nurse teach this patient to do to monitor fluid balance?

Weigh self on a daily basis at the same time

A female patient tells the nurse that she has pain and numbness in her thumb, first and second finger of her right hand. The nurse discovers that the paint is employed as an auto mechanic an that the pain is increased while working. This may indicate that the patient could possible have what?

carpal tunnel syndrome

A patient's history, physical exam and pulmonary function testing have led to the diagnosed of chronic bronchitis. The nurse who is providing care for this patient will understand that the effect of the disease is primarily attributable to _________ and knows the earliest sign of this disorder is ____________.

chronic mucous hypersecretion; productive cough

A patients history, physical exam and pulmonary function testing have led to the diagnosis of chronic bronchitis. The nurse who is providing care for this patient will understand the effect of the disease is primarily attributable to _________ and knows the earliest sign of this disorder is ______________.

chronic mucous hypersecretion; productive cough

When the nurse taps on the patients facial new ve the cheek begins to twitch, the nurse understands the patient is exhibiting what positive sign and know this is indicative of which electrolyte imbalance?

chvostek's sign; hypocalcemia

The first heart sound is the result of ___________ and signifies the ___________.

closure of the AV valves; beginning of systole

A 40 year old male who has recently been diagnosed with hypertension is discussing risk factors with the nurse. The nurse tale about lifestyle changes with the patient and advises that he avoid tobacco use. What is the rationale behind this advice? Smoking:

increases platelets to adhere leading to thrombus formation

A 62 year old male patient has been prescribed allopurinol for the treatment of gout. When providing health education to this patient about his new medication, the nurse should know that this drug achieves a therapeutic effect by:

interrupting the breakdown of purines

A man with a history of poorly controlled diabetes has developed osteomyelitis adjacent to a chronic diabetic ulcer on his great toe. The patient has been informed that medical treatment for osteomyelitis requires a longer course of antibiotics than most other infections because of what reason?

involves the active infection of born tissue which is largely avascular

A 13 year old african american boy comes to the ER complaining of fatigue and a rapid heartbeat. In conversation with the father, is becomes apparent to you that the boy has grown 2 inches in the previous 5 months. What is the first problem the health care team identifies?

iron-deficiency

Following a chest X-ray, a patient had been diagnosed with pleural effusion. The care team has concluded that the quantity of fluid in the patients intrapleural space necessitates a thoracentesis. What patient education should the nurse provide in anticipation of this procedure?

it is very important that you remain still while the physical is performing the procedure

Following an extensive diagnostic workup, a 40 year old woman's complaints of fatigue and muscle pain have been attributed to systemic lupus erythematosus (SLE). When performing health education with this patient, what should the nurse emphasize?

its important to limit your exposure to sunlight and use good sunscreen

You are observing a fractured area to see if it is aligning correctly. You notice it has healed in an incorrect anatomic position. You document this as:

malunion

An older adult man had been diagnosed with a femoral head fracture after falling outside his home and his health care provider has chosen open reduction with intern fixation (ORIF). How should the nurse best explain this procedure to the patient? "The surgeon will:

use pins and rods to keep your bones in place until they heal"

While auscultating the patients apical pulse, you note an extra sound immediately following the s2. You not this sound is referred to as a(n) ______________ gallop and is caused by what pathophysiologic effect?

ventricular gallop; resistance to ventricular filling at beginning diastole