Unit 1, 2, 3, & 4 questions

"The nurse is caring for a 78-year-old female patient who is scheduled for surgery to remove her brain tumor. The patient is very apprehensive and keeps asking when she will get her preoperative medicine. The medicine is ordered to be given on call to OR. When would be the best time to give this medication?"

"After being notified by the OR and before any other preoperative preparations"

Possibly a test questions: "A nurse is assessing a patient who is suspected of having bronchiectasis. The nurse should consider which of the following potential causes? Select all that apply."

"Airway obstruction" "Pulmonary infections" "Genetic disorders"

"The nurse is caring for a patient who is postoperative day 2 following a total laryngectomy for supraglottic cancer. The nurse should prioritize what assessment?"

"Assessment of swallowing ability"

"A nurse is caring for a patient with hepatic encephalopathy. While making the initial shift assessment, the nurse notes that the patient has a flapping tremor of the hands. The nurse should document the presence of what sign of liver disease?"

"Asterixis"

"A nurse is documenting the results of assessment of a patient with bronchiectasis. What would the nurse most likely include in documentation"

"Clubbing of fingers" "Characteristic symptoms of bronchiectasis include chronic cough and production of purulent sputum in copious amounts. Clubbing of the fingers also is common because of respiratory insufficiency. Sudden pleuritic chest pain is a common manifestation of a pulmonary embolism. Wheezes on auscultation are common in patients with asthma. An increased A-P diameter is noted in patients with COPD"

"A nurse is caring for a patient who has been admitted with an exacerbation of chronic bronchiectasis. The nurse should expect to assess the patient for which of the following clinical manifestations?"

"Copious sputum production"

"A student nurse is preparing to care for a patient with bronchiectasis. The student nurse should recognize that this patient is likely to experience respiratory difficulties related to what pathophysiologic process?"

"Dilation of bronchi and bronchioles" "Bronchiectasis is a chronic, irreversible dilation of the bronchi and bronchioles that results from destruction of muscles and elastic connective tissue. It is not characterized by acute bronchospasm, alveolar distension, or excessive gas exchange"

Water level is rising and lowering with pt breaths "The nurse is assessing a patient who has a chest tube in place for the treatment of a pneumothorax. The nurse observes that the water level in the water seal rises and falls in rhythm with the patient's respirations. How should the nurse best respond to this assessment finding?"

"Document that the chest drainage system is operating as it is intended"

Pt has been receiving high-flow oxygen therapy for an extended time. What symptoms if oxygen toxicity. "The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). The patient has been receiving high-flow oxygen therapy for an extended time. What symptoms should the nurse anticipate if the patient were experiencing oxygen toxicity?

"Dyspnea and substernal pain" "Oxygen toxicity can occur when patient's receive too high a concentration of oxygen for an extended period. Symptoms include: dyspnea, substernal pain, restlessness, fatigue, and progressive respiratory difficulty"

Not sure if a test question: "An asthma nurse educator is working with a group of adolescent asthma patients. What intervention is most likely to prevent asthma exacerbations among these patient's?

"Educating patients about recognizing and avoiding asthma triggers"

"The nurse is admitting a patient to the medical surgical unit from the PACU. What should the nurse do to help the patient clear secretions and help prevent pneumonia?"

"Encourage the patient to use the incentive spirometer every 2 hours."

"The ED nurse is assessing a young gymnast who fell from a balance beam. The gymnast presents with a clear fluid leaking from a nose. What should the ED nurse suspect?

"Fracture of the cribriform plate"

"One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acute-care nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over 15 minutes. This intervention will achieve which of the following?"

"Help distinguish reduced renal blood flow from decreased renal function" Test kidney function, give fluid (100-200 mL NS) to see if there is increased U/O, BP and CVP (normal kidney function)

Not sure if a test question: "An asthma educator is teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. The educator should teach the patient that a peak flow meter measures what value?

"Highest airflow during a forced expiration"

I think this was a test question: "The nurse is caring for a patient who is scheduled to have a thoracotomy. When planning preoperative teaching, what information should the nurse communicate to the patient?"

"How to splint the incision when coughing"

"The nurse admits a patient to the PACU with a blood pressure of 132/90 mm Hg and a pulse of 68 beats per minute. After 30 minutes, the patients blood pressure is 94/47 mm Hg, and the pulse is 110. The nurse documents that the patients skin is cold, moist, and pale. Of what is the patient showing signs?"

"Hypovolemic shock"

Not sure if test question: "The nurse is doing discharge teaching in the ED with a patient who had a nosebleed. What should the nurse include in the discharge teaching of this patient?"

"In case of recurrence, apply direct pressure for 15 minutes"

"A nurse has been asked to give a workshop on COPD for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect?"

"Increases the amount of mucus production"

Incentive spirometry question, details on the ball rising in the tube

"Instruct the client to keep a tight mouth seal around mouthpiece and to inhale and hold breath for 3 to 5 seconds. As the client inhales, the needle of the spirometry machine will rise. This promotes lung expansion."

"A nurse is caring for a patient following knee surgery that was performed under a spinal anesthetic. What intervention should the nurse implement to prevent a spinal headache?"

"Keep the patient positioned supine"

Something about persistent coughing/change in coughing pattern "The nurse is assessing a patient who has a 35 pack-year history of cigarette smoking. In light of this known risk factor for lung cancer, what statement should prompt the nurse to refer the patient for further assessment?"

"Lately, I have this cough that just never seems to go away."

"A patient has questioned the nurses administration of IV normal saline, asking whether sterile water would be a more appropriate choice than saltwater. Under what circumstances would the nurse administer electrolyte-free water intravenously?"

"Never, because it rapidly enters red blood cells, causing them to rupture"

Not sure if a test question: "The nurse is reviewing the EHR of a patient with empyema. What health problem in the patient's history is most likely to have caused the empyema

"Pneumonia"

What situations would you place a chest tube in? "A nurse educator is reviewing the indication for chest drainage systems with a group of medical nurses. What indications should the nurses identify? Select all that apply."

"Post thoracotomy" "Spontaneous pneumothorax" "Chest trauma resulting in pneumothorax"

"A patient arrives in the ED with an attack of acute bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this patient's care?"

"Postural chest drainage" "Postural drainage is part of all treatment plans for bronchiectasis, because draining of the bronchiectatic areas by gravity reduces the amount of secretions and the degree of infection. Diuretics and IV fluids will not aid in the mobilization of secretions. Lung function testing may be indicated, but this assessment will not relieve the patient's symptoms"

"The nurse is caring for a patient on the medical surgical unit postoperative day 5. During each patient assessment, the nurse evaluates the patient for infection. Which of the following would be most indicative of infection?"

"Red, warm, tender incision"

"A 54-year-old man has just been diagnosed with small cell lung cancer. The patient asks why the doctor is not offering surgery as a treatment for his cancer. What fact about lung cancer treatment should inform the nurses response?"

"Small cell cancer of the lungs grows rapidly and metastasizes early and extensively."

"The nurse is caring for a 46-year-old patient recently diagnosed with the early stages of lung cancer. The nurse is aware that the preferred method of treating patients with non-small cell tumors is what?"

"Surgical resection" "Surgical resection is the preferred method of treating patients with localized non-small cell tumors with no evidence of metastatic spread and adequate cardiopulmonary function. The other listed treatment options may be considered, but surgery is preferred."

"The OR nurse is taking the patient into the OR when the patient informs the operating nurse that his grandmother spiked a 104F temp in the OR and nearly died 15 years ago. What relevance does this information have regarding the patient?"

"The patient may be at risk for malignant hyperthermia"

"A nurse is planning the care of a client with bronchiectasis. What goal of care should the nurse prioritize?"

"The patient will successfully mobilize pulmonary secretions."

"The nurse in the ED is caring for a man who has returned to the ED 4 days after receiving stitches for a knife wound is now infected, so the stitches were removed, and the wound is cleaned and packed with gauze. The ED doctor plans to have the man return tomorrow to remove the packing and restore the wound. You are aware that the wound will now heal by what means?"

"Third intention"

"The PACU nurse is caring for a patient who has arrived from the OR. During the initial assessment, the nurse observes that the patients skin has become blue and dusky. The nurse looks, listens, and feels for breathing, and determines the patient is not breathing. What is the priority intervention?"

"Treat the possible airway obstruction by tilting the head back and pushing forward on the angle of the lower jaw."

Not sure if a test question: "It is cold season and the school nurse has been asked to provide an educational event for the parent teacher organization of the local elementary school. What should the nurse include in teaching about the treatment of pharyngitis?"

"Use of warm saline gargles or throat irrigations can relieve symptoms"

"A patient is admitted to the ED complaining of severe abdominal pain, stating that he has been vomiting coffee-ground like emesis. The patient is diagnosed with a perforated gastric ulcer and is informed that he needs surgery. When can the patient most likely anticipate that the surgery will be scheduled?"

"Without delay because the bleed is emergent"

Nurse responsibilities post op before discharge. Select all that apply.

*Provide all discharge instructions in writing *Provide the nurses or surgeons contact information *Give prescriptions to the patient

Dehydration, constipation, and malnutrition can happen post op

...

Pt can't swallow, something wrong with them or had some procedure, one option was keep NPO

...

Change pt position frequently to stimulate respirations and promote circulation and comfort

....

Changing the chest tube

....

Nose bleed gauzes packed

....

How long is insulin good for?

28 days (1 month)

After the nurse teaches a patient about the recommended amounts of foods from animal and plant sources,which menu selections indicate that the initial instructions about diet have been understood?

3 oz of roasted pork, a cup of corn, and a cup of carrot sticks

The nurse is starting shift, which pt first

32 breaths per minute

A diabetes nurse educator is presenting the American Diabetes Association (ADA) recommendations for levels of caloric intake. What do the ADAs recommendations include?

50% to 60% of calories from carbohydrates, 20% to 30% from fat, and the remaining 10% to 20% from protein

A patient returns to the unit after neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours the nurse would notify the physician immediately for what?

60 mL of milky or cloudy drainage

Which of the following patients with type 1 diabetes is most likely to experience adequate glucose control?

A patient who adheres closely to a meal plan and meal schedule

___ is needed for energy, active transport, and requires phosphorus

ATP

Nurse caring for patient with order to discontinue admin of PN. What should the nurse do to prevent the occurrence of rebound hypoglycemia in the patient?

Administer an isotonic dextrose solution for 1 to 2 hours after discontinuing the PN

pt just had radical neck dissection, what priority assessment?

Airway

Hypoxemia, blood loss, and electrolyte imbalances can look like confusion and restlessness

All other possibilities must be ruled out before old people are diagnosed with confusion

A patient with dysphagia is scheduled for PEG tube insertion and asks the nurse how the tube will stay in place. What is the nurse's best response?

An internal retention disk secures the tube against the stomach wall.

Intrinsic factor deficiency

Anemia

The pt has chronic hyperinflated lungs, what kind of chest do they have?

Anterior and posterior chest walls are extended

Pts external bolster had white shiny patches

Anti fungal

Constipation, gonna give an enema, don't give it to who?

Appendicitis

I think something like this was on the test: Something about what you would assess for/have ready at the bedside when doing an insulin tolerance test for growth hormone.

Assess for hypoglycemia and hypotension Have ready 5-50% IV dextrose at bedside in case of severe hypoglycemia

Pleural effusion? Dullness and ? (many)

Assessment findings: Decreased/absent breath sounds, decreased fremitus, dull flat sound on percussion.

The ED nurse is assessing the resp function of a teenage girl who presented with acute shortness of breath. Auscultation reveals continuous wheezes during inspiration and expiration. This finding is most suggestive what?

Asthma

Small cell carcinoma

Because it metastasizes

A1 antitrypsin what does it indicated

COPD (emphysema)

Not sure if a test question: A nurse is caring for a patient with severe hemolytic jaundice. Laboratory tests show free bilirubin to be 24 mg/dL. For what complication is this patient at risk?

Central nervous system damage

A nurse is teaching a group of adults about screening and prevention of colorectal cancer. The nurse should describe which of the following as the most common sign of possible colon cancer?

Change in bowel habits

The nurse is administering total parenteral nutrition (TPN) to a client who underwent surgery for gastric cancer. Which of the nurse's assessments most directly addresses a major complication of TPN?

Checking the patient's capillary blood glucose levels regularly

A patient's health decline necessitates the use of total parenteral malnutrition. The patient has questioned the need for insertion of a central venous catheter, expressing a preference for a normal IV. The nurse should know that peripheral administration of high-concentration PN formulas is contraindicated because of the risk for what complication?

Chemical phlebitis

Something about COPD and barrel chest

Chest overexpansion front to back not side to side

A nurse is working with a child who is undergoing a diagnostic workup for suspected asthma. What are the signs and symptoms that are consistent with a diagnosis of asthma? Select all that apply.S

Chest tightness, wheezing

Drainage question, continuous bubbling

Chest tube is dislodged

Select all differences between Crohns and UC

Cobblestone, skip lesions, non-curable

Fam history of cancer, son wants to not die

Colonoscopy to look for polyps

A patient's new onset of dysphagia has required insertion of an NG tube for feeding; the nurse has modified the patients care plan accordingly. What intervention should the nurse include in the patient's plan of care?

Confirm placement of the tube prior to each medication administration

Swallow barium

Constipation, NOT yellow poop

A patient admitted with acute diverticulitis has experience a sudden increase in temperature and complains of a sudden onset of exquisite abdominal tenderness. The nurses rapid assessment reveals that the patient's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?

Contact the primary care provider promptly and report these signs of perforation

Sick day rules for insulin

Continue to take it as needed, don't stop taking, don't increase

Organ transplant question

Could be something about the patient being immunosuppressed and at high risk for infection

Disease that has skip lesions

Crohns

Give _______ _______ (________) to malignant hyperthermia pts

Dantrolene sodium (Dantrium)

I think was a test question: A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults. What factors contribute to this phenomenon? Select all that apply

Decreased kidney mass Decreased renal blood flow Decreased excretion of potassium

The nurse is conducting a presurgical interview for a patient with laryngeal cancer. The patient states that he drinks approximately six to eight shots of vodka per day. It is imperative that the nurse inform the surgical team so the patient can be assessed for what?

Delirium tremens

Pt in ED, head position question?

Do not tilt head back, tilt head forward to avoid aspiration on blood

Family is using PCA

Don't let them

pt feels pain 2 hrs after eating

Duodenal ulcer

A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a health promotion workshop. What action has the greatest potential to prevent esophageal cancer?

Early diagnosis and treatment of gastroesophageal reflux disease

Etiology for chronic gastritis

Eating too much spicy foods

An asthma nurse educator is working with a group of adolescent asthma patients. What intervention is most likely to prevent asthma exacerbations among these patients?

Educating patients about recognizing and avoiding asthma triggers

The nurse is doing a preoperative assessment of an 87-year-old man who is slated to have a right lung lobe resection to treat lung cancer. What underlying principle should guide the nurses preoperative assessment of an elderly patient?

Elderly patients have less physiologic reserve than younger patients

Venous stasis? = (Venous stasis, or venostasis, is a condition of slow blood flow in the veins, usually of the legs)

Encourage exercise to prevent after surgery

"The OR nurse is participating in the appendectomy of a 20 year-old female who has a dangerously low body mass index. The nurse recognizes the patients consequent risk for hypothermia. What action should the nurse implement to prevent the development of hypothermia?"

Ensure that IV fluids are warmed to the patients body temperature

Achalasia

Esophageal dilation

" Not sure if a test question You are the nurse caring for a patient who is to receive IV daunorubicin, a chemotherapeutic agent. You start the infusion and check the insertion site as per protocol. During your most recent check, you note that the IV has infiltrated so you stop the infusion. What is your main concern with this infiltration?"

Extravasation of the medication

The nurse is assessing the respiratory status of a patient who is experiencing an exacerbation of her emphysema symptoms. When preparing to auscultate, what breath sounds should the nurse anticipate?

Faint breath sounds with prolonged expiration

A patient presents to the clinic complaining of symptoms that suggest diabetes. What criteria would support checking blood levels for the diagnosis of diabetes?

Fasting plasma glucose greater than or equal to 126 mg/dL

Not sure if a test question: "As a clinic nurse, you are caring for a patient who has been prescribed an antibiotic for tonsillitis and has been instructed to take the antibiotic for 10 days. When you do a follow-up call with this patient, you are informed that the patient is feeling better and is stopping the medication after taking it for 4 days. What information should you provide to this patient?

Finish all the antibiotics to eliminate the organism completely.

You are caring for a patient who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Your parents plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow the nurse to assess what aspect of the patients health?

Fluid volume status SIADH causes fluid retention

During a health education session, a participant has asked about the hepatitis E virus. What prevention measure should the nurse recommend for preventing infection with this virus?

Following proper handwashing techniques

The nurse is caring for a patient who is postoperative from having a gastrostomy tube placed. What should the nurse do on a daily basis to prevent skin breakdown?

Gently rotate the tube

Give _______/______ __-__mg q __-__ minutes for opioid overdose

Give Narcan/naloxone 0.3-2mg q 2-3 minutes for opioid overdose

Administering albuterol with ipratropium

Give albuterol first (because it is fast-acting), then ipratropium.

Dumping syndrome, decreased skin turgor

Give bolus NS

Minimal invasive hernia repairment, what do?

Give fiber and fluids to prevent constipation

A student with diabetes tells the school nurse that he is feeling nervous and hungry. The nurse assesses the child and finds he has tachycardia and is diaphoretic with a blood glucose level of 50 mg/dL (2.8 mmol/L). What should the school nurse administer?

Half of a cup of juice, followed by cheese and crackers

Pee that dehydrated people excrete

High specific gravity, darker,

An asthma educator is teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. The educator should teach the patient that a peak flow meter measures what value?

Highest airflow during a forced expiration

A triage nurse in the emergency department is assessing a patient who presented with complaints of general malaise. Assessment reveals the presence of jaundice and increased abdominal girth. What assessment question best addresses the possible etiology of this patients presentation?

How many alcoholic drinks do you typically consume in a week?

A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal?

Hypocalcemia

The nurse is assessing the patient for presence of a Chvostek's sign. What electrolyte imbalance would a positive Chvostek's sign indicate?

Hypocalcemia

The nurse is assessing the patient for presence of a Trousseau's sign. What electrolyte imbalance would a positive Trousseau's sign indicate?

Hypocalcemia

"You are working on a burns unit and one of your acutely ill patients is exhibiting signs and symptoms of third spacing. Based on this change in status, you should expect the patient to exhibit signs and symptoms of what imbalance?"

Hypovolemia

A patient has been brought to the emergency department by paramedics after being found unconscious. The patients Medic Alert bracelet indicates that the patient has type 1 diabetes and the patients blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention?

IV administration of 50% dextrose in water

A nurse is participating in the emergency care of a patient who has just developed variceal bleeding. What intervention should the nurse anticipate

IV administration of octreotide (Sandostatin)

A patient with pheochromocytoma has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following?

IV corticosteroids

ADH

If elevated=hyponatremia

A nurse is conducting a class on how to self-manage insulin regimens. A patient asks how long a vial of insulin can be stored at room temperature before it goes bad. What would be the nurses best answer?

If you are going to use up the vial within 1 month it can be kept at room temperature.

A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measures should the educator promote? Select all that apply.

Immunization Use of standard precautions

A nurse is caring for a patient with liver failure and is performing an assessment in the knowledge of the patients increased risk of bleeding. The nurse recognizes that this risk is related to the patient's inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function?

Inability of the liver to use vitamin K

A critical care nurse is caring for a patient diagnosed with acute pancreatitis. The nurse knows the indications for starting PN are what?

Inability to take inadequate oral food or fluids within 7 days

Anesthesia awareness; obvious signs

Increase in BP, rapid HR, pt movement

A patient is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this patients care, which of the following nursing diagnoses should the nurse prioritize?

Ineffective Tissue Perfusion Related to Bowel Ischemia

"The nurse is creating the care plan for a 70-year-old obese patient who has been admitted to the postsurgical unit following a colon resection. This patients age and increased body mass index mean that she is at increased risk for what complication in the postoperative period?"

Infection

The clinic nurse is doing a preoperative assessment of a patient who will be undergoing outpatient cataract surgery with lens implantation in 1 week. While taking the patient's medical history, the nurse notes that this patient had a kidney transplant 8 years ago and that the patient is taking immunosuppressive drugs. For what is this patient at increased risk when having surgery?

Infection

A nurse is assessing a patient who has peptic ulcer disease. The patient requests more info about the typical causes of H. Pylori infection. What would it be appropriate for the nurse to instruct the patient?

Infection typically occurs due to ingestion of contaminated food and water

A pt has something on their tongue, have candidiasis, how did they get it

Inhaled corticosteroids. Always rinse mouth with water after use to avoid candidiasis.

A nurse is initiating PN to a postop patient who has developed complications. The nurse should initiate therapy by performing which of the following actions?

Initiating the infusion slowly and monitoring the patient's fluid and glucose tolerance

A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize?

Insertion of a nasogastric tube

Inspect abdomen

Inspect auscultate, percuss, palpate

A nurse is preparing to administer a patient's intravenous fat emulsion simultaneously with PN. Which principles should guide the nurse's action?

Intravenous fat emulsions may be infused simultaneously with PN through a Y-connector close to the infusion site and should not be filtered

Urine specific gravity

Is 1.010-1.025 high=dehydrated Measures kidney's ability to excrete/conserve H20

A patient with a diagnosis of esophageal varices has undergone endoscopy to gauge the progression of this complication of liver disease. Following the completion of this diagnostic test, what nursing intervention should the nurse perform?

Keep patient NPO until the patients gag reflex returns.

A patient is concerned about leakage of gastric contents out of the gastric sump tube the nurse has just inserted. What would the nurse do to prevent reflux gastric contents from coming through the blue vent of gastric sump tube?

Keep the vent lumen above the patient's waist

________ excrete/retain H+; _______ retain/excrete C02

Kidneys excrete/retain H+; lungs retain/excrete C02

What information will the nurse include for an overweight 35-year-old woman who is starting a weightloss plan?

Low carbohydrate diets lead to rapid weight loss but are difficult to maintain.

A staff educator is reviewing the causes of gastroesophageal reflux disease (GERD) with new staff nurses. What area of the GI tract should the educator identify as the cause of reduced pressure associated with GERD?

Lower esophageal sphincter

A patient has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurses care plan should prioritize which of the following outcomes?

Maintaining fluid and electrolyte balance

Patient comes in having eaten a bunch of baking soda. With it all being in the stomach, what acid-base state is the patient in?

Metabolic alkalosis

Old person comes in w/renal issues, something about K+

Monitor the ECG

Not sure if a test question: "The critical care nurse is precepting a new nurse on the unit. Together they are caring for a patient who has a tracheostomy tube and is receiving mechanical ventilation. What action should the critical care nurse recommend when caring for the cuff?

Monitor the pressure in the cuff at least every 8 hours

A patient newly diagnosed with type 2 diabetes is attending a nutrition class. What general guideline would be important to teach the patients at this class?

Most calories should be derived from carbohydrates.

Sm bwl obstruction

NG tube ready

AIDs and white lesions

Notify physician

"A patient is 2 hours postoperative with a Foley catheter in situ. The last hourly urine output recorded for this patient was 10 mL. The tubing of the Foley is patent. What should the nurse do?"

Notify the physician and continue to monitor the hourly urine output closely

A nurse is caring for a patient with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the patients ability to prepare and self-administer insulin?

Observe the patient drawing up and administering the insulin.

Pt has hereditary angioedema "The occupational health nurse is obtaining a patient history during a pre-employment physical. During the history, the patient states that he has hereditary angioedema. The nurse should identify what implication of this health condition?"

Obstruction of airway "It can cause life-threatening airway obstruction"

"During the care of a preoperative patient, the nurse has given the patient a preoperative benzodiazepine. The patient is now requesting to void. What action should the nurse take?"

Offer the patient a bedpan or urinal.

Not sure if a test question: The nurse is caring for a hospice patient who is scheduled for a surgical procedure to reduce the size of his spinal tumor in an effort to relieve his pain. The nurse should plan this patient care with the knowledge that his surgical procedure is classified as which of the following?

Palliative

Diagnostic imaging and physical assessment have revealed that a patient with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency interventions must be performed as soon as possible in order to prevent the development of what complication?

Peritonitis

Who is at greatest risk of aspiration?

Person with stroke

Preventative measure for pt

Pneumonia vaccine

Possibly "pt has SOB w/hypervolemia" Possibly: "overhydrated pt lung sounds"

Possibly "pt has SOB w/hypervolemia" =Stop IV infusion Possibly: "overhydrated pt lung sounds" =crackles

Old people have slower recovery from anesthesia due to reduced kidney function (filtration)

Post op confusion and delirium Fall risk

A patient's large bowel obstruction has failed to resolve spontaneously and the patients worsening condition has warranted admission to the medical unit. Which of the following aspect of nurse care is most appropriate for this patient?

Preparing the patient for surgical bowel resection

The nurses comprehensive assessment of a patient includes inspection for signs of oral cancer. What assessment finding is most characteristic of oral cancer in its early stages?

Presence of a painless sore with raised edges

Sucralfate

Protect stomach lining

"The nurse is performing an assessment on a patient who has been diagnosed with cancer of the larynx. Part of the nurses assessment addresses the patient's general state of nutrition. Which laboratory values would be assessed when determining the nutritional status of the patient? Select all that apply"

Protein level Albumin level Glucose level Lab values that assist in determining pt nutritional status are: albumin, protein, glucose, and electrolyte levels

The pt has pleurisy, what you expect to find?

Pt reports pain upon inhalation pleurisy - Inflammation of the tissues that line the lungs and chest cavity.

"A postoperative patient rapidly present with hypotension; rapid, thread pulse; oliguria, and cold, pale skin. The nurse suspects that the patient is experiencing a hemorrhage. What should be nurses first action?"

Quickly attempt to determine the cause of hemorrhage.

A patient who suffered a stroke had an NG tube inserted to facilitate feedings shortly after admission. The patient has since become comatose and the patients family asks the nurse why the physician recommending the removal of the patients NG tube and the insertion of a gastrostomy tube. What is the nurse's best response?

Regurgitation and aspiration are less likely

A nurse is caring for a patient with a nasogastric tube for feeding. During shift assessment, the nurse auscultates a new onset of bilateral lung crackles and notes a respiratory rate of 30 breaths per minute. The patient oxygen saturation is 89% by pulse oximetry. After ensuring the patient's immediate safety, what is the nurses most appropriate action?

Report possible signs of aspiration pneumonia to the primary care provider

A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause of which acid base imbalance?

Respiratory alkalosis

A patient with cancer of the tongue has had a radical neck dissection. What nursing assessment would be a priority for this patient?

Respiratory status and airway clearance

I think this was a test question: The surgical patient is a 35-year-old woman who has been administered general anesthesia. The nurse recognizes that the patient is in stage II (the excitement stage) of anesthesia. Which intervention would be most appropriate for the nurse to implement during this stage?

Restrain the patient

Risk of complication for what with NG tube?

Rhinosinusitis was not an option, answer was ulceration of nares (infection?)

Was there something about the common cold virus being shed 2 days before symptoms showed?

Rhinovirus easily spread/hard to stop...because^.....

Select all for appendicitis

Right lower pain, rebound tenderness, rovsing sign

A nurse is assessing a patient who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the patients pain, the nurse should anticipate that it may radiate to what region?

Right shoulder

Perforated ulcer abdomen

Rigid boardlike abdomen

A nurse is writing a care plan for a patient with a nasogastric tube in place for gastric decompression. What risk nursing diagnosis is the most appropriate component of the care plan?

Risk for Impaired Skin Integrity Related to the Presence of NG Tube

Not sure if a test question: A 90-year-old female patient is scheduled to undergo a partial mastectomy for the treatment of breast cancer. What nursing diagnosis should the nurse prioritize when planning this patients postoperative care?

Risk for Infection related to reduced immune function

Hyponatremia S/S

See electrolyte chart for all s/s Cold, clammy skin

General anesthesia stage II excite, know what the signs are and what to do

Signs: struggling, shouting, talking, singing, laughing, or crying. Pupils are dilated but still constrict if exposed to light, pulse is rapid, and respirations may be irregular. What to do: Anesthesiologist can help restrain patient or apply cricoid pressure in the case of vomiting to prevent aspiration.

How to prevent orthostatic falls

Sit them up on the edge of the bed for a few minutes

When can you discharge a pt from PACU? Select all that apply.

Stable blood pressure Sufficient oxygen saturation Adequate respiratory function

Similar to a test question: The nurse is caring for a 78-year-old man who has had an outpatient cholecystectomy. The nurse is getting him up for his first walk postoperatively. To decrease the potential for orthostatic hypotension and consequent falls, what should the nurse have the patient do?

Stand upright for 2 to 3 minutes prior to ambulating

A patient is SOB w/hypervolemia

Stop IV infusion

"The ED nurse is caring for an 11-year-old brought in my ambulance after having been hit by a car. The childs parents are thought to be en route to the hospital but have not yet arrived. No other family members are present and attempts to contact the parents have been unsuccessful. The child needs emergency surgery to save her life. How should the need for informed consent be addressed?"

Surgery should be done without informed consent."

Not sure if a test question: The perioperative nurse is constantly assessing the surgical patient for signs and symptoms of complications of surgery. Which symptom should first signal to the nurse the possibility that the patient is developing malignant hyperthermia?

Tachycardia

A patient who experienced an upper GI bleed due to gastritis has had the bleeding controlled and the patient's condition is now stable. For the next several hours, the nurse is caring for this patients should assess for what signs of recurrence?

Tachycardia, hypotension, tachypnea

A nurse is admitting a patient diagnosed with late-stage gastric cancer. The patients family is distraught and angry that she was not diagnosed earlier in the course of her disease. What factor contributes to the fact that gastric cancer is often detected at a later staged?

The early symptoms of gastric are usually not alarming or highly unusual

Not sure if a test question: A medical nurse educator is reviewing a patient's recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?

The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance

An older adult patient has been diagnosed with COPD. What characteristic of the patients current health status would preclude the safe and effective use of a metered-dose inhaler (MDI)?

The patient has severe arthritis in her hands.

A patient with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett's esophagus with minor cell changes. Which of the following principles should be integrated into the patients subsequent care?

The patient will require an upper endoscopy every 6 months to detect malignant changes

Maybe also something with a water deprivation test, like what does it test for or what to watch out for?

The test is to determine the different causes of diabetes insipidus by administering ADH Watch for dehydration (severe can occur with both central and nephrogenic DI). Discontinue and rehydrate if patient loses more than 2 kg of weight at any time.

A nurse caring for a patient with colorectal cancer is preparing the patient for upcoming surgery. The nurse administers cephalexin (Keflex) to the patient and explains what rationale?

To reduce intestinal bacteria levels

regular b12 injections, why?

Total gastrectomy

Not sure if a test question: The dressing surrounding a mastectomy patients Jackson-Pratt drain has scant drainage on it. The nurse believes that the amount of drainage on the dressing may be increasing. How can the nurse best confirm this suspicion?

Trace the outline of the drainage on the dressing for future comparison

Pt with severe COPD, education

Tripod position

What breaks down protein?

Trypsin

When do you collect a sputum sample?

Up awakening

Paracentesis

Urinary output 20 ml/hr should be reported

"foundation""basic principles" of gas exchange is?

Ventilation and perfusion

BNP? Pt is hip surgery, why BNP?

Ventricles stretched

Pt with severe COPD needs reliable and precise oxygen delivery

Venturi mask

A patient is postoperative day 1 following gastrostomy. The nurse is planning interventions to address the nursing diagnosis of Risk for Infection Related to Presence of Wound and Tube. What intervention is most appropriate?

Wash the area around the tube with soap and water daily

Water suction in what compartment causes suction?

Water in the water suction chamber

A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patients stools will have what characteristics?

Watery with blood and mucus

Possibly a test question "A nurses assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the patient is experiencing bronchospasm?

Wheezes or diminished breath sounds on auscultation

Not sure if a test questions: The nurse is caring for a trauma victim in the ED who will require emergency surgery due to injuries. Before the patient leaves the ED for the OR, the patient goes into cardiac arrest. The nurse assists in the successful resuscitation and proceeds to release the patient to the OR staff. When can the ED nurse perform the preoperative assessment?

When assisting with the resuscitation

Laryngectomy nursing priority

airway patency

Pt has chronic gastritis, what do you tell the patient

avoid aspirin

Hereditary angioedema

can cause life threatening airway obstruction

Select all something about old people

choose 3 decreased things

Letter A is audible instead of the letter E

egophony

What is a peptic ulcer

erosion of the stomach lining

Pt with laryngeal cancer has what?

hoarseness and low pitch voice

Calcitonin via IM for _____.

hypercalcemia

Keyexcalate question, I think it was like what electrolyte imbalance you would give it for, or maybe what medication you would give for ________.

hyperkalemia. It pulls all the potassium into the GI tract when you're pooping. Keyexcalate = for K+ excess

Calcium gluconate for _____.

hypocalcemia

Pt has cystic fibrosis

know about treatments, things like vibrating jackets, etc

Was there a communication question? Electric larynx, esophageal speech, tracheoesophageal puncture were options?

know them

A nurse is caring for a patient with a blocked bile duct from a tumor. What manifestation of obstructive jaundice should the nurse anticipate?

orange and foamy urine

Pt got out of surgery

risk for atelectasis

Hematocrit goes ___ if dehydrated

up

If you're dehydrated your hematocrit is ____

up