Med Surge II Midterm

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What should the patient be encouraged to eat during the active phase of acute renal failure

A diet high in fats

What should the nurse caution a type one diabetic about exercise

You can decrease the need for insulin and me also result in hypoglycemia

nurse explains the diagnostic text that can scan chest and the abdomen in less than 30 seconds

spiral or helical CT scan

older adult with emphysema complains of a sharp pleuritic pain after a severe period of coughing. heart and respiratory rate is increased.auscultation reveals no breath sounds on left side

spontaneous pneumothorax

information should be obtained from the pt. before an iodine 131 test

status of possible pregnancy

what pt assessment indicates the most severe respiratory distress

substernal retraction SaO2 84%

when assessing the SaO2 with a pulse oximeter the nurse will place the oximeter on finger

that is normal temperature

inspiratiory capacity

the amount of air that can be inhaled in one breath from the resting expiratory level

prepares pt for the procedure of _ which will remove the fluid from around the lung to improve the respiration and obtain a specimen

throacentesis

Exercises to increase muscle tone of the pelvic floor are known as

Kegel

Which is a sign of acute angle closure glaucoma (AACG)?

Large fixed pupil

Progressive deafness caused by ankylosis of the stapes is the condition of

Ostoscleriosis

What is a common mistake that hinders communication when communicating with the hearing impaired?

Overaccentuating words

nurse recognizes _ the reading in arterial gas report indicates the amount of oxygen dissolved in the plasma

PaO2

nurse explains to the person with pneumonia in the left lung that being positioned in the "good lung down"

PaO2 rising in the good lung the dependent lung being better perfused decreased hypoxia

An intravenous pyelegram confirms the presence of a 4 mm renal calculus in the proximal left ureter of a newly admitted patient division orders include demoral 100 mg IM highest priority when planning of care for this patient would be

Pain related to irritation of a stone

What is the first indication of macular degeneration?

The loss of central vision

a pt. 69 has emphysema. on assessment nurse notes "barrel chest" what pathophysiology results from

an increased anteroposterior diameter cause by over inflation of the alveoli

The nurse clarifies that the difference between a photorefractive keratectomy (PRK) and a laser in-situ keratomileusis (LASIK) is that a LASIK:

removes some internal layers of the cornea

The nurse notes the amount and color of urine the patient with urolithiosis has voided while using standard for cautions what should be the nurses next action

strain the urine

pt with history of graves disease is admitted to the unit with shortness of breath. v/s: T 103, P 160, R24, BP 160/80

thyroid storm

The human insulin who is onset of action occurs with in _____minutes is lispro

15

nurse cautions the pt who is being instructed on self medication with insulin 25-30, 50, and 100 unit syringes. how is 100 unit syringe marked

2 unit increments

The nurse is aware that the patient has 20/40 vision. This means that the patient can see at 20 feet what the normal eye can see at _______ feet

40

When the newly blind male home health patient asks the nurse how he might get assistance, who might the nurse suggest he contact?

American Foundation for the Blind for a list of agencies

In diabetes insipidus a deficiency of which hormone causes clinical manifestations

ADH

What is a hormone from the posterior pituitary gland that influences the amount of water that is eliminated with the Urine

ADH

To which day should be patient with Cushing's syndrome adhere

Less sodium

What is the process when the lens of the eye changes its curvature to focus on the retina

Accommodation

When the home health patient is started on dialysis the home health nurse refers the patient to a community support group that assists with adjustments necessary to living with dialysis which group offers this service

American Association of kidney patients

Is a term for generalized exema

Anasarca

When the patient stares at the black dot on an Amsler grid, what should the nurse ask him to report?

Any distortion of the grid

A patient who had an enucleation of the right eye has been admitted PACU. What should the nurse include in the plan of care?

Apply a pressure dressing over the right eye socket

Impatient age 78 has been admitted to the hospital with dehydration and electrolyte in balance she's confused and incontinent of urine on admission which nursing intervention did the nurse include in developing a plan of care

Apply absorbent incontinence pads

What should the nurse advise the 20-year-old to do who has been put on cefaclor (Ceclor) for a resistant otitis media?

Avoid alcoholic beverages

What instructions should a nurse give to a diabetic patient to prevent injury to the feet

Avoid going barefoot and always wear shoes with soles

Which foods should the home health nurse consul hypokalemic patience to include in their diet

Bananas oranges cantaloupe

A cuteglomerulonephrin is commonly a result of a pre-existing infection of

Betahemo strep

What does the cataract treatment of phacoemulsification involve?

Breaking the cataract with ultrasound

Select all the conditions that may cause conductive hearing loss

Build up of cerulean Foreign bodies osteosclerosis of external auditory canal otitis media with effusion

What does diabetes retinopathy result from?

Capillaries in retina hemorrhage

What should the nurse comes out the young man with chronic prostatitsis to avoid

Cessation of intercourse

A patient who is receiving continuous bladder irrigation following a transurethral resection of the prostate complains of spasm like pain over his lower abdomen what should the initial intervention be by the nurse

Check the catheter and drain system for obstruction

As a nurse is shaving a patient who is today's post operative from a thyroidectomy the patient has a spasm of the facial muscles what should the nurse recognizes as

Chvostek sign

What is a significant risk factor for renal cancer

Cigarette smoking

What factors mostly nurse consider when assessing readiness to learn when teaching health promotion practices for the visually and hearing impaired

Cultural believes values habits

The nurse councils the 16-year-old boy playing his music at high-volume can result in which impairment in hearing related to

Damage of the fine hair cells in the organ of Corti

The patient has an stage renal disease and is it made it to the hospital with a blood urea nitrogen and level of 48 and excessive elevation of Brian could result from

Dehydration

What should the nurse do you want assisting a blind person to walk in and unfamiliar hospital environment

Describe the surroundings encourage the patient to ask for verbal cues place patient's hand on your shoulder or elbow

A patient has undergone test that indicate a deficiency of the parathyroid hormone secretion she should be informed of which potential complication

Laryngeal spasm

The purpose of the use of radioactive iodine in the treatment of hypothyroidism is to

Destroy some of the thyroid tissue

When the patient in the emergency room complains of seeing flashing lights and a curtain down over his right eye, the nurse recognizes this as a symptom of which condition?

Detached retina

Which complaint made by a 64-year-old patient during a health interview would alert the nurse to the possibility of cataracts?

Difficulty driving at night

A male patient age 71 has benign prosthetic hypertrophy he is recovering from a trans urethral prosthetic resection . the physician orders removal of the indwelling catheter two days after the procedure what made the patient experience after the catheter is removed

Dribbling of urine

term that describes a condition of normal thyroid function

Euthyroid

It is two days after a 42-year-old male patients urinary diversion surgery he continues to be critical of the hospital and the nursing care even though the staff has spent time explaining that cared to him what is the most likely explanation for his behavior

He is reacting to the loss of self-esteem and altered body image

Four hours after a stapedectomy the patient complains that hearing has not improved at all. What knowledge would the nurse use to shape a response?

Hearing will not return until edema subsides

Which of the following are causes of cataracts

Long-term use of corticosteroids congenital from exposure diabetes smoking

Chevostek and trousseau indicate

Low levels of calcium

The surgical incision into the air drum with either a knife or heating wire loop to relieve pressure in the middle ear is

Myringotomy

Is a prosthetic pain without evidence of infection or inflammation

Proatatodynia

The nurse is caring for a 75-year-old man who has developed diabetes insipidus falling ahead injury will include a plan Of care for

Protecting the patient from injury

In nephrotic syndrome the glomeruli are damaged by inflammation and allow small to pass through the urine

Proteins

The nurse reassured the patient recovering from acute glomerulonephritis that after all other signs and symptoms of the disease of side it is normal to have some residual

Proteinurea hemateria

To help a patient control incontinence what should the nurse recommended patient avoid

Spicy foods

The technique which involves an incision through the abdomen and the bladder is a

Suprapubic

Why would the nurse encourage a group of teenagers to protect their eyes with dark sunglasses by using a UV lamp

The lamp can cause cataracts

What should a patient who has had a cataract repair avoid?

The lifting of heavy objects

The patient tells the nurse that he is legally blind. How would this information impact the nurse's plan of care for this patient

The nurse would need to determine how this patient's visual impairment affects normal functioning.

The nurse explains that the negative feedback system controls formal release by communication between

The pit and other target organ

How would the nurse explain the purpose of photocoagulation to a diabetic patient with diabetic retinopathy?

The procedure will destroy new blood vessels, seal leaking vessels, and help prevent retinal edema

The patient with the nephrosis complains about the need for bedrest how would the nurse explained the benefit of bedrest

The recumbent position me in the indicate diuresis

What action should the nurse provide at the bedside when you post operative thyroidectomy patient

Trache tray

how should the newly diagnosed patient who has been prescribed isoniazid (INH) for the treatment of active TB

accept that therapy is long term

structures of the lung in which gas exchanged occurs

alveoli

leukotriene modifiers reduce the symptoms of asthma

by causing bronchodilation and anti-inflammation effects

27 year old pt with hypothyroidism is referred to the dietitian for dietary consultation.

calorie restricted meals

nurse should instruct pt who is hypocalcemic from hypoparathyroidism about a diet

canned fish with bones cucumbers tofu vit D supplement

what happens when there is a decrease in the oxygen level in the blood

chemo-receptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates

what instruction by the nurse is inappropriate for teaching the proper technique for collection of sputum specimen

collect specimens before meals

another term for hyperglycemic reaction

diabetic ketoacidosis

nursing caring for a pt who has a closed chest drainage system notes there is fluctuation (tidaling) in the water seal chamber.

document the tidaling

purpose of chest drainage

drains air blood and fluid from pleural space restores negative intrapleural pressure allow route for medication administration

nurse caring for pt who is receiving calcium gluconate for treatment of hypoparathyroid tetany. what assessment would indicate an adverse reaction

drop in blood pressure

pt on postoperative day 2 after undergoing a total hip replacement. pt complains of chest pain and is coughing up blood tinged sputum

elevate head of bed and administer oxygen

83 year old admitted with temperature of 102, chest pain, and fatigue. what is the infected fluid that the physician removes

empyema

The nurse will assess for _____________ when the older adult home health patient complains that the entire right side of his head hurts and he cannot chew without pain.

external otitis

how would the nurse examining a pt with pleurisy document a low pitched grating lung sound

friction rub

nurse explains the opening between the vocal cords

glottis

adrenal cortex secretes glucocorticoids. most important is cortisol

glucose metabolism providing extra reserve energy during stress

three major life threatening complications postoperatively of thyroidectomy

hemorrhaging tetany thyroid crisis

condition with a deficiency in growth hormone is

hypopituitary dwarfism

true about activities such as walking for the pt with emphysema

increase capacity to use oxygen

exacerbation

increase in the seriousness of a disease or disorder

s/s of hypoglycemia

irritability tremors diaphoresis

glyburide for pt age 57 when diet and exercise have not been able to control type 2 diabetes

it is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites

55 year old man comes to the health nurse at his place of work with epistaxis. reports having frequent nosebleeds that can usually control himself. whats the helpful assessment to do after

obtain blood pressure

stertorous

pertains to respiratory effort that is strenuous

master gland of the endocrine system

pituitary

appropriate nursing intervention for a patient age 40 who is diagnosed with active tuberculosis

place the pt in acid-fast bacillus (AFB) Isolation precaution

activity intolerance related to an imbalance between the oxygen supply & demand

plan care to provide optimum rest

independent nursing measure are effective in aiding pt to expectorate

positioning orthopneic position suctioning assisting to cough providing hydration

what should the nurse do to keep the chest tubes from becoming occluded

prevent dependent loops

a nursing diagnosis for the patient with a new laryngectomy would be Social isolation related to impaired verbal communication related to removal of the larynx. what is an appropriate nursing intervention?

provide a pad and pencil or magic slate

pt with long term emphysema is admitted with secondary diagnosis of cor pulmonale.

pt will present with edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation

only insulin can be administered IV

regular

The nurse explained that a pneumatic retinoplexyis a repair of a retinal detachment using a bubble of _______to put pressure on the damage retina

Gas

What portion of the nephron is involved with the alteration

Glomerous of the bowman capsule

What should the nurse instructed patient to do before obtaining the urine specimen the urine for a culture

Obtain a clean catch specimen

The patient age 43 has cancer of the urinary bladder he has received a cystectomy with an illeal conduit which characteristics would be considered normal for his urine

Clear amber with mucus shreds

Irrigate with normal saline solution for 20 minutes

Conductive hearing loss

A patient has returned his room after a thyroidectomy with signs of a thyroid crisis during thyroid crisis exaggerated hyperthyroid manifestations my lead to the development of the potential little complication of

Congestive heart failure

What do miotic eyedrops do for a patient with glaucoma?

Constrict the pupil and open the canal of Schlemm

pt treated fro hypothyroidism should be instructed to eat well balanced meals including intake of iodine. which food contains iodine

Eggs

What should the nurse include in the plan of care following a tympanoplasty?

Elevating head of bed with operative side facing upward

The home health patient complains of tearing and a feeling of dryness in the right eye nurse assesses that the eyelid is turned in word and the Scalera is red the nurse documents this as the presence of

Entropion

The total removal of an eye is

Enucleation

What diagnosis test for diabetes provides a measure of glucose levels for the previous 8 to 12 weeks

HB A1 C

The nurse teaching a patient with type one diabetes about early signs of insulin reaction would include information about

Hunger and trembling sensation

The nurse assessing a patient who is taking furosemide finds an irregular pulse this is likely a sign of

Hypokalemia

A home health patient with end-stage renal this order has a nursing diagnosis of powerlessness related to life-threatening disease which nursing intervention would be most helpful

Include patient in making a plan of care

What should the nurse encourage bearing any other contraindication when teaching a patient how to decrease the chance of further problems with urolothiasis

Increase his fluid intake

How should the nurse advise a patient who has severe vertigo from labyrinthitis

Lie immobile and hold the head in one position until the vertigo lessens

A 56-year-old patient with cancer of the bladder is recovering from a cystectomy with a new Illeal conduit. what is the important aspect in nursing interventions of the patient with any Ileal conduit

Maintaining skin integrity

The patient is on postoperative day one after having undergone a TURP procedure he has continuous bladder irrigation actual urine output during continuous bladder irrigation is calculated by

Measuring total output and deducting the amount of irrigating solution used

A patient has come to the clinic because it in large hands and feet in Ammenoria an increase hair growth the symptoms are most likely indicate problems with

Pituitary gland

Activity intolerance related to an imbalance between the oxygen supply and demand

Plan care to provide optimum test

What must a patient do following a left vitrectomy

Position self in a face-down position for 4 to 5 days

The patient is scheduled for transuretheral of the prostate during pre-operative teaching what should the nurse emphasize about what the patient can expect after procedure

Red drainage from catheter

What should the nurse remind the hearing aid wearer to do when the nurse hears a whistling hearing aid?

Reinsert the ear mold

What is a long-term complication of diabetes

Renal failure

Because the kidneys are located in proximity to the vertebrae and are protected by the babes their location in documentation is referred to as

Retroparatpneal

What is the postoperative position for a person who has had a thyroidectomy

Semi Fowler

The physician orders and 1800 cal diabetic diet and 40 units of Humulin N insulin subcutaneously daily for a patient with diabetes why would a mid afternoon snack of milk and crackers be given

To prevent an insulin reaction

when nurse inflates the sphygmomanometer cuff exceeding the systolic blood pressure and observes a carpal spasm

Trousseau sign

What would a nurse do when the patient arrives in the pacu after a left stapedectomy

Turned a patient to his right side leave the bed flat medication immediately upon the complaint of nausea

What would you patient with hyperthyroidism be prescribed the drug met them Methimazole

Two block production of thyroid hormones

Which precaution should the nurse take when caring for a patient who is being treated with radioactive iodine

Wait three days after those before assigning a private nurse to care for this patient

how does pursed lips breathing assist patients with asthma during an attack

it opens bronchioles by backflow air pressure

age related changes in the older adult that make them @ risk for respiratory diseases

kyphosis decreases in pulmonary blood flow stasis pooling of secretions reduced number of cilia

administering long acting insulin once a day, provides insulin coverage for 24 hrs.

lantus

important precaution should nurse include when instructing emphysema on the use of home oxygen

limit 1 to 2 L oxygen flow

The nurse takes into consideration that the Weber test indicated a conductive hearing loss in a patient because the patient reported hearing the tone:

louder in his affected ear.

what should nurse include provision for the postoperative care of the pt who has thyroidectomy

maintaining anatomic position doing voice check every 2 hours checking for bleeding at the sides and the back of the head

How will the kidneys behave in respiratory acidosis

retain bicarbonate to increase the pH

What is an appropriate nursing diagnosis for a patient who has recently been diagnosed with acromegaly

risk for trauma

instructions should be included in the discharge instruction for a 47 year old with hypothyroidism

seeing the physician regularly for follow up care

assessing an 11 year old who has asthma attack expects to hear adventitious sounds of

sibilant wheezes

pt be postponed after thoracentesis is completed and the dressing applied

side lying unaffected side

what is the purpose of the cilia?

sweep debris toward nasal cavity

If patient is receiving cholorothiazide A diuretic for hypertension what nursing action is most important for prevention of complications

Is this for hypokalemia

One of the housekeepers splashes a chemical in the eyes. What should be the first priority

Irrigate with normal saline solution for 20 minutes

The home health nurse suggested use of complementary and alternative therapies to prevent and or treat urinary tract infections which is an example of such a therapy

Cranberry juice

As the body breaks down proteins nitrogen wastes are broken down into urea ammonia and

Creatinine

Why is otitis media found more frequently and children 6 to 36 months

Estucian tubes and children are shorter and straighter

Patient was the status is receiving pyridium for pain and is avoiding a bright red orange urine what should the nurse do

Explain to the patient that this is normal

Which may contribute to otitis media

Exposure to cigarette smoke allergies upper respiratory infections

Which test will furnish immediate feedback for a new diagnosed diabetic who is not yet under control

Fasting blood sugar FBS

Why are pediatric patients especially girls susceptible to urinary tract infections

Females have a short and proximal urethra in relation to the vagina

The nurse is aware that a person ages there is a loss of _______mechanism of the Kidney to decrease and loss of nephrons

Filtering

Which action to reduce the risk of skin impairment secondary to urinary incontinence

Frequent toileting and meticulous skin care

Which of the following signs of fluid overload in the patient

Increased pulse rate increase daily weight edema labored respirations

As the nurse and a dietitian review a female patients diet plan with her she shouts that with her diabetes and now the kidney failure there is just nothing she can eat she says she might as well eat what she wants because there is nothing she can do to help herself . based on the patient's response which nursing diagnosis does the nurse identify

Ineffective coping related to sense of powerlessness

The patient is a 20-year-old college student who has type one diabetes and normally walks each evening as part of an exercise regimen the patient plans to enroll in a swimming class which adjustment should be made based on this information

Monitor glucose level before during and after swimming to determine the need for alterations in food or insulin

Why are your urinary tract infections common in older adults

Older adults her we can muscular in the bladder and urethra older adults have urinary stasis the effects of medications of meds sucas as diurtetics The effects medication such as diuretics

The 62-year-old home health patient who is recovering from eye surgery complains of a feeling of "grittiness" in the eye and is having blurred vision. The eyes are reddened and have stringy mucus. What do these complaints indicate?

Sjögren syndrome

how should the nurse administer insulin to prevent lipohypertrophy

at room temperature

major advantage of video assisted throacoscopic surgery (VATS)

surgeon can remove tumors of the lung through a small keyhole incision

pt age 22 admitted with acute asthma, patient shows a pulse oximetry level of SaO2 of 82%

there is only 82% of oxygen bound to the hemoglobin compared with the amount available

preoperative teaching should a nurse include for a person scheduled for a partial laryngectomy

tracheal suction will be frequent presence of a temporary tracheotomy surgery involves removal of a diseased vocal cord some speech will be retained

The nurse is reviewing the urine analysis report on an assigned a patient the nurse recognizes which of the following to be normal

turbidity clear PH 6 glucose negative

young man who has bronchoscopy 1 hr ago and asks when he can eat.

when gag reflex returns


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