Adult Acute Exam 3
Which strategy can the nurse teach the patient to eliminate the risk for HIV transmission? a. Using sterile equipment to inject drugs b. Cleaning equipment used to inject drugs c. Taking lamivudine (Epivir) during pregnancy d. Using latex or polyurethane barriers to cover genitalia during sexual contact
a
Priority nursing actions when caring for a hospitalized patient with a new-onset temperature of 102.2°F (39°C) and severe neutropenia include (select all that apply) a. starting the prescribed antibiotic STAT. b. drawing peripheral and central line blood cultures. c. ongoing monitoring of the patient's vital signs for septic shock. d. taking a full set of vital signs and notifying the physician immediately. e. administering transfusions of WBCs treated to decrease immunogenicity.
a, b, c, d
In assessing patients for STIs, the nurse needs to know that many STIs can be asymptomatic. Which STIs can be asymptomatic? (select all that apply) a. Syphilisb. Gonorrheac. Genital wartsd. Genital herpese. Chlamydial infection
a, b, c, d, e
Which populations have a higher risk for acquiring sexually transmitted infections (STIs)? (select all that apply) a. Transgender personsb. Young adults (age < 25)c. Men who have sex with mend. Men in long-term care facilities e. Women in correctional facilities
a, b, c, e
Emerging and reemerging infections affect health care by (select all that apply) a. reevaluating vaccine practices. b. revealing antimicrobial resistance. c. limiting antibiotics to those with life-threatening infection. d. challenging researchers to discover new antimicrobial therapies.
a, b, d
Nursing interventions for a patient with severe anemia related to peptic ulcer disease include (select all that apply) a. instructions for high-iron diet.b. taking vital signs every 8 hours.c. monitoring stools for occult blood.d. teaching self-injection of erythropoietin.e. administration of cobalamin (vitamin B12) injections.
a, c
The nurse recognizes that an increase in which lab value raises the suspicion for a DVT? a. D-Dimer b. BNP c. Troponin d. WBC
a. D-Dimer
Which of the following should you include in your patient education for the day? Select all that apply. a. Do not allow sick family members to visit you in the hospital b. Do not eat fresh fruit or vegetables at this time c. Use non-electric razors when shaving d. Blow your nose often to avoid congestion build up e. Avoid raw food such as sushi
a. Do not allow sick family members to visit you in the hospital b. Do not eat fresh fruit or vegetables at this time e. Avoid raw food such as sushi
A patient with newly discovered high BP has an average reading of 158/98 mm Hg after 3 months of exercise and diet modifications. Which management strategy will be a priority for this patient? a. Drug therapy will be needed because the BP is still not at goal. b. BP monitoring should continue for 3 months to confirm a diagnosis of hypertension. c. Lifestyle changes are less important since they were not effective, and drugs will be started. d. More changes in the patient's lifestyle are needed for a longer time before starting drug therapy.
a. Drug therapy will be needed because the BP is still not at goal.
Which of the following is a common cause of sinus tachycardia? a. Fever b. Medications like diltiazem c. Hypertension d. Medications like verapamil
a. Fever diltiazem and verapamil are Ca channel blockers
A barrier to hospice referrals for patients with stage D heart failure is a. family member refusal. b. scarcity of hospice facilities. c. history of pacemaker placement. d. difficulty in estimating prognosis.
d. difficulty in estimating prognosis.
The following vital signs are obtained: BP 158/86, HR 94, RR 20, Sa02 98% on room air, T 97.6F. You recognize that which of the following is the likely cause for the abnormal vital signs above? a. Severe back pain rated 10/10 b. The patient's age of 72 years c. Gradually worsening fatigue d. History of hyperlipidemia
a. Severe back pain rated 10/10
Which of the following interventions would a nurse anticipate initiating for a patient with a new diagnosis of premature ventricular contractions? a. Supplemental oxygen for pulse oximtery less than 94% b. Administering IV atropine c. Administering SubQ epinephrine d. Preparing the patient for pacemaker insertion
a. Supplemental oxygen for pulse oximtery less than 94%
While assessing a client with heart failure, the nurse notes that the client is dyspneic and auscultates coarse crackles in the lungs. How would the nurse correlate with these findings to heart failure? a. These are findings indicate symptoms of left-sided heart failure b. These are findings indicate symptoms of right-sided heart failure c. These are findings indicate a secondary diagnosis of pneumonia d. These findings correlate with both right and left heart failure
a. These are findings indicate symptoms of left-sided heart failure Back up in left ventricle so much into left atrium and not lungs
True/False: Sexually transmitted infections are increasing in incidence within the United States. a. True b. False
a. True
True/False: There is an HPV vaccine that has been shown to prevent cervical cancer and genital warts that is approved by the CDC. a. True b. False
a. True
Anaphylaxis represents which type of hypersensitivity reaction? a. Type 1 b. Type 2 c. Type 3 d. Type 4
a. Type 1
Which statements accurately describe heart failure with preserved ejection fraction (HFpEF)? (select all that apply) a. Uncontrolled hypertension is the primary cause. b. Left ventricular ejection fraction may be within normal limits. c. The pathophysiology involves ventricular relaxation and filling. d. Multiple evidence-based therapies have been shown to decrease mortality. e. Therapies focus on symptom control and treatment of underlying conditions.
a. Uncontrolled hypertension is the primary cause. b. Left ventricular ejection fraction may be within normal limits. c. The pathophysiology involves ventricular relaxation and filling. e. Therapies focus on symptom control and treatment of underlying conditions.
A nurse should recognize that which of the following medications is often used as part of the interprofessional treatment plan for a patient with atrial fibrillation a. Warfarin b. Epinephrine c. Cefepime d. Atropine
a. Warfarin Prevent clots; use epi for symptomatic Brady; atropine for sinus Brady
An anticoagulant such as warfarin that interferes with prothrombin production will alter the clotting mechanism during a. platelet aggregation.b. activation of thrombin.c. the release of tissue thromboplastin.d. stimulation of factor activation complex.
b
HIV antiretroviral drugs are used to a. cure acute HIV infection.b. decrease viral RNA levels.c. treat opportunistic diseases. d. decrease symptoms in terminal disease.
b
If a lymph node is palpated, what is a normal finding? a. Hard, fixed nodesb. Firm, mobile nodesc. Enlarged, tender nodes d. Hard, nontender nodes
b
To prevent fever and shivering during an infusion of rituximab (Rituxan), the nurse should premedicate the patient with a. aspirin.b. acetaminophen.c. sodium bicarbonate.d. meperidine (Demerol).
b
When obtaining assessment data from a patient with a microcytic, hypochromic anemia, the nurse would ask the patient about a. folic acid intake.b. dietary intake of iron.c. a history of gastric surgery.d. a history of sickle cell anemia.
b
When reviewing a patient's hematologic laboratory values after a splenectomy, the nurse would expect to find a. RBC abnormalities.b. increased WBC count.c. decreased hemoglobin. d. decreased platelet count.
b
Which of the following orders for your patient would you question? a. Prednisone 40mg PO daily b. Allopurinol 300mg PO daily c. Aspirin 81mg PO daily d. Metoprolol 25mg PO twice a day
c. Aspirin 81mg PO daily
define ST elevation
seen on ECG representing cardiac infarct/occlusion
A characteristic of the stage of progression in cancer development is a. oncogenic viral transformation of target cells. b. a reversible steady growth facilitated by carcinogens. c. a period of latency before clinical detection of cancer. d. proliferation of cancer cells despite host control mechanisms.
d
A patient has a spinal cord injury at T4. Vital signs include falling blood pressure with bradycardia. The nurse recognizes that the patient is experiencing a. a relative hypervolemia.b. an absolute hypovolemia.c. neurogenic shock from low blood flow.d. neurogenic shock from massive vasodilation.
d
A patient on chemotherapy for 10 weeks started at a weight of 121 lb. She now weighs 118 lb and has no sense of taste. Which nursing intervention would be a priority? a. Discuss with the provider the need for parenteral nutrition. b. Teach the patient to eat foods that are fatty, fried, or high in calories. c. Tell the patient to drink a nutritional supplement beverage three times a day. d. Have the patient try various spices and seasonings to enhance the flavor of food.
d
Association between HLA antigens and diseases is most commonly found in what disease conditions? a. Cancersb. Infectious diseasesc. Neurologic diseasesd. Autoimmune disorders
d
Because myelodysplastic syndrome arises from the pluripotent hematopoietic stem cell in the bone marrow, laboratory results the nurse would expect to find include a(n) a. excess of T cells. b. excess of platelets. c. deficiency of granulocytes.d. deficiency of all cellular blood components.
d
Cancer arising from granulocytic cells in the bone marrow will have the primary effect of causing a. risk for hemorrhage.b. altered oxygenation.c. decreased production of antibodies. d. decreased phagocytosis of bacteria.
d
Complications of transfusions that can be decreased by using leukocyte depletion or reduction of RBC transfusion are a. chills and hemolysis.b. leukostasis and neutrophilia.c. fluid overload and pulmonary edema. d. transmission of cytomegalovirus and fever.
d
The function of monocytes in immunity is related to their ability to a. stimulate the production of T and B lymphocytes. b. make antibodies after exposure to foreign substances. c. bind antigens and stimulate natural killer cell activation. d. capture antigens by phagocytosis and present them to lymphocytes.
d
The most accurate assessment parameters for the nurse to use to determine adequate tissue perfusion in the patient with MODS are a. blood pressure, pulse, and respirations. b. breath sounds, blood pressure, and body temperature. c. pulse pressure, level of consciousness, and pupillary response. d. level of consciousness, urine output, and skin color and temperature.
d
The most common type of leukemia in adults in western countries is a. acute myelocytic leukemia.b. acute lymphocytic leukemia.c. chronic myelocytic leukemia. d. chronic lymphocytic leukemia.
d
match: 1. Methicillin-resistant staphylococcus aureus (MRSA) 2. Vancomycin-resistant enterococci (VRE) 3. Clostridium difficile (c.diff) 4. Influenza a. droplet precautions b. contact precautions c. enhanced contact precautions
1b, 2b, 3c, 1a
Match: 1. SA node 2. AV node 3. Perkinje fibers a. Located at the end of the conducting system in the ventricular walls b. Serves as the pacemaker of the heart and sets the normal adult HR at 60-100 bpm c. Located at the junction between atria and ventricles and serves as the gatekeeper controlling ventricular response rate to electrical impulses
1b, 2c, 3a
The nurse is caring for a patient admitted with tertiary syphilis with heart failure as a complication. During their assessment, the nurse notes the following: HR 115, BP 98/62, RR 20, Temperature 38.6C, and O2 saturation 97% on 2L 02 via NC. The patient is lethargic, but wakes when the nurse speaks to the patient. Labs from this morning reveal a WBC of 14K, Plt 162K, and H/H 14.5/45. When calculating the MEWS score for this patient to evaluate for sepsis risk, what number would the nurse document?
6
The reason newborns are protected for the first 3 months of life from bacterial infections is because of the maternal transmission of a. IgA. b. IgE. c. IgG. d. IgM.
c
define remodeling
changes in structure of the heart due to pressure or volume overload or cardiac injury
define orthopnea
dyspnea in a recumbant position relieved by sitting up
Which of the following parts of the parasympathetic nervous system helps control heart rate? a. sciatic nerve b. vagus nerve c. trigeminal nerve d. your last nerve
b. vagus nerve Back of throat into stomach; helps with GI stuff (why bradycardic when bearing down or vomiting)
The nurse is caring for a patient newly admitted with heart failure secondary to dilated cardiomyopathy. Which intervention would be a priority? a. Encourage caregivers to learn CPR. b. Consider a consultation with hospice for palliative care. c. Monitor the patient's response to prescribed medications. d. Arrange for the patient to enter a cardiac rehabilitation program.
c. Monitor the patient's response to prescribed medications.
A client admitted with acute heart failure has a new prescription for furosemide. For which of the following lab values would prompt the nurse to reach out to the healthcare provider prior to administering this medication? a. Blood glucose of 68 b. Creatinine of 0.98 c. Potassium of 3.0 d. Sodium of 145
c. Potassium of 3.0 Advocate for K replacement if pt have scheduled (multi-time) furosemide
Which of the following statements is true regarding the phases of the cardiac action potential as observed via ECG tracing? a. The QRS complex is often hidden by the strength of atrial repolarization b. Shortened QT intervals are often associated with slow heart rates c. The P wave represents atrial depolarization and contraction d. The T wave should be taller than the QRS, narrow, and pointed
c. The P wave represents atrial depolarization and contraction
Which of the following statements is true regarding the phases of the cardiac action potential as observed via ECG tracing? a. The QRS complex is often hidden by the strength of atrial repolarization b. Shortened QT intervals are often associated with slow heart rates c. The P wave represents atrial depolarization and contraction d. The T wave should be taller than the QRS, narrow, and pointed
c. The P wave represents atrial depolarization and contraction
Which of the following symptoms related to gonorrhea would the nurse expect patients to report most often? a. Rash in groin b. Intense suprapubic pain c. Sore throat d. Dysuria
d. Dysuria Especially male patients with dysuria, gonorrhea is like first thing they test for
An untreated gonococcal infection can result in which of the following complications for patients? Select all that apply. a. Infertility b. Pelvic cancer c. Bartholin's gland infection d. Epididymitis e. Pelvic Inflammatory Disease
a. Infertility c. Bartholin's gland infection d. Epididymitis e. Pelvic Inflammatory Disease
The nurse is caring for a stable client with an infected abrasion on the left thigh following a motorized scooter accident. They recognize this represents which type of infection? a. Localized b. Disseminated c. Systemic d. Hospital-acquired
a. Localized
Based on the diagnosis of multiple myeloma, which of the following orders is most important for you to prioritize in the care of the client? a. Maintain continuous IV fluid of normal saline at 100ml/hr b. Acetaminophen 325mg PO q6h PRN fever c. Perform CHG bath twice daily d. Maintain Purewick in place for duration of stay to calculate accurate I&0
a. Maintain continuous IV fluid of normal saline at 100ml/hr
Which of the following statements is true regarding ECG paper timing? a. Time is measured from left to right across the cardiac waveform b. Voltage is measured vertically and time horizontally c. Each small box represents 1 second of time d. Each large box represents 0.04 seconds
a. Time is measured from left to right across the cardiac waveform
A nurse is completing medication reconcillation on a newly admitted patient and recognizes that which of the following is most likely related to the patient's history of atrial fibrillation? a. Famotidine b. Metoprolol c. Simvastatin d. Furosemide
b. Metoprolol
Which clinical findings should the nurse expect in a person with an acute lower extremity VTE? (select all that apply) a. Pallor and coolness of foot and calf b. Mild to moderate calf pain and tenderness c. Grossly decreased or absent pedal pulses d. Unilateral edema and induration of the thigh e. Palpable cord along a superficial varicose vein
b. Mild to moderate calf pain and tenderness d. Unilateral edema and induration of the thigh
Which heart valve sound is heard best at the left midclavicular line at the level of the fifth ICS? a. Aortic b. Mitral c. Tricuspid d. Pulmonic
b. Mitral
Based on these findings, you suspect your patient has which of the following conditions? a. Acute myeloid leukemia b. Multiple myeloma c. Chronic lymphoid leukemia d. Thrombocytopenia
b. Multiple myeloma
A 70-year-old male patient has multiple myeloma. His wife calls to report that he sleeps most of the day, is confused when awake, and reports nausea and constipation. Which complication of cancer is this most likely caused by? a. Hypercalcemiab. Tumor lysis syndromec. Spinal cord compressiond. Superior vena cava syndrome
a
A complication of the hyperviscosity of polycythemia is a. thrombosis.b. cardiomyopathy.c. pulmonary edema. d. disseminated intravascular coagulation (DIC).
a
A diagnosis of AIDS is made when an HIV-infected patient has a. a CD4+ T cell count below 200/μL. b. a high level of HIV in the blood and saliva. c. lipodystrophy with metabolic abnormalities. d. oral hairy leukoplakia, an infection caused by Epstein- Barr virus.
a
A patient has recently been diagnosed with early stages of breast cancer. What is most appropriate for the nurse to focus on? a. Maintaining the patient's hope b. Preparing a will and advance directives c. Discussing replacement child care for the patient's children d. Discussing the patient's past experiences with her grandmother's cancer
a
Significant information from the patient's health history that relates to the hematologic system includes a. jaundice.b. bladder surgery.c. early menopause.d. multiple pregnancies.
a
The most common cause of secondary immunodeficiencies is a. drugs. b. stress.c. malnutrition.d. human immunodeficiency virus.
a
The nurse is alerted to possible anaphylactic shock immediately after a patient has received IM penicillin by the development of a. edema and itching at the injection site.b. sneezing and itching of the nose and eyes. c. a wheal-and-flare reaction at the injection site. d. chest tightness and production of thick sputum.
a
The nurse is obtaining a subjective data assessment from a woman reported as a sexual contact of a man with chlamydial infection. The nurse understands that symptoms of chlamydial infection in women a. are often absent. b. are similar to those of genital herpes. c. include a macular palmar rash in the later stages. d. may involve chancres inside the vagina that are not visible.
a
The primary protective role of the immune system related to malignant cells is a. surveillance for cells with tumor-associated antigens. b. binding with free antigens released by all cancer cells. c. producing blocking factors that immobilize cancer cells. d. reacting to a new set of antigenic determinants on cancer cells.
a
Transmission of HIV from an infected person to another most often occurs because of a. unprotected anal or vaginal sexual intercourse. b. low levels of virus in the blood and high levels of CD4+ T cells. c. transmission from mother to infant during labor and delivery and breastfeeding. d. sharing eating utensils, dry kissing, hugging, using toilet seats, or shaking hands.
a
When caring for a patient with thrombocytopenia, the nurse instructs the patient to a. dab his or her nose instead of blowing. b. be careful when shaving with a safety razor. c. continue with physical activities to stimulate thrombopoiesis. d. avoid aspirin because it may mask the fever that occurs with thrombocytopenia.
a
When reviewing laboratory results of an older patient with an infection, the nurse would expect to find a. mild leukocytosis.b. decreased platelet count.c. increased hemoglobin and hematocrit levels.d. decreased erythrocyte sedimentation rate (ESR).
a
The nursing management of a patient in sickle cell crisis includes (select all that apply) a. monitoring CBC.b. optimal pain management and O2 therapy. c. blood transfusions if needed and iron chelation.d. rest as needed and deep vein thrombosis prophylaxis. e. administration of IV iron and diet high in iron content.
a, b, c, d
Treatment modalities for the management of cardiogenic shock include (select all that apply) a. dobutamine to increase myocardial contractility. b. vasopressors to increase systemic vascular resistance. c. circulatory assist devices such as an intraaortic balloon pump. d. corticosteroids to stabilize the cell wall in the infarcted myocardium. e. Trendelenburg positioning to facilitate venous return and increase preload.
a, c
What features of cancer cells distinguish them from normal cells (select all that apply)? a. Cells lack contact inhibition. b. Cells undergo rapid proliferation. c. Cells return to a previous undifferentiated state. d. Proliferation occurs when there is a need for more cells. e. New proteins characteristic of embryonic stage emerge on cell membrane.
a, c, e
Interventions to prevent health care-associated infections include (select all that apply) a. following hand-washing protocols.b. limiting visitors to persons over age 18.c. placing high-risk patients in private rooms.d. decontaminating equipment used for patient care. e. appropriately using personal protective equipment.
a, d, e
Nursing care for a patient immediately after a bone marrow biopsy and aspiration includes (select all that apply) a. giving analgesics as needed. b. preparing to start a blood transfusion. c. giving preprocedure and postprocedure antibiotic medications. d. having the patient lie still to keep the sterile pressure dressing intact. e. monitoring vital signs and assessing the site for excess drainage or bleeding.
a, d, e
Which statement by the client indicates additional teaching is needed regarding testing for genital herpes? a. "I'm looking forward to my antibody test results to determine where my site of infection is." b. "My antibody test will likely show positive about 3 months after infection." c. "Viral testing is not always required for diagnosis for herpes." d. "I can receive the diagnosis of herpes following my physical exam with my healthcare provider when the lesions are present."
a. "I'm looking forward to my antibody test results to determine where my site of infection is."
Anaphylaxis is considered a Type _____ hypersensitivity reaction mediated by ______. a. 1 / IgE b. 1 / IgM c. 2 / IgE d. 3 / IgE
a. 1 / IgE
Which of the following statements about P-waves is correct? a. A waveform with normal P-waves originated in the SA node b. P-waves are not always visible in normal sinus rhythm c. P-waves should be less than 0.5 seconds in width d. Counting P-waves provides an accurate ventricular rate
a. A waveform with normal P-waves originated in the SA node
A patient has a severe blockage in his right coronary artery. Which heart structures are most likely to be affected by this blockage (select all that apply)? a. AV node b. Left ventricle c. Coronary sinus d. Right ventricle e. Pulmonic valve
a. AV node b. Left ventricle d. Right ventricle
Which of the following orders for your patient would you question? a. Amoxicillin 500mg PO TID for MRSA infection b. Vancomycin 1gm IV q12h for MRSA infection c. Acetaminophen 650mg PO TID PRN d. Normal saline 100ml/hr continuous infusion
a. Amoxicillin 500mg PO TID for MRSA infection
Which of the following are considered inclusion criteria for thrombolytic therapy in a patient with acute coronary syndrome? Select all that apply. (check all that apply) a. Chest pain onset less than 12 hours ago b. Elevation in CK-MB c. Presence of microscopic hematuria d. EKG with ST elevations consistent with MI e. ST-depression on EKG in at least 5 leads
a. Chest pain onset less than 12 hours ago d. EKG with ST elevations consistent with MI
What other clinical manifestations would you assess for on exam? Select all that apply. a. Epistaxis b. Gingival bleeding c. Joint pain d. Bluish discoloration around the mouth e. Swelling in bilateral lower legs
a. Epistaxis b. Gingival bleeding c. Joint pain
The nurse would expect which of the following symptoms when assessing their patient with newly diagnosed acute leukemia? (check all that apply) a. Fatigue b. Bradypnea c. Pallor d. Janeway lesions e. Ecchymosis
a. Fatigue c. Pallor e. Ecchymosis
Which of the following infections is considered viral? a. Genital herpes b. Chlamydia c. Trichomoniasis d. Gonorrhea
a. Genital herpes
Which is a priority nursing intervention for a patient during the acute phase of rheumatic fever? a. Giving IV antibiotics as prescribed b. Managing pain with opioid analgesics c. Encouraging fluid intake for hydration d. Performing frequent active range-of-motion exercises
a. Giving IV antibiotics as prescribed
Which of the following is not a serious complication of untreated Chlamydia? a. Infective Endocarditis b. Reactive arthritis c. Infertility d. Pelvic Inflammatory Disease
a. Infective Endocarditis
A patient is admitted to the hospital in a hypertensive emergency (BP 244/142 mm Hg). Sodium nitroprusside is started to treat the elevated BP. Which management strategies would be most appropriate for this patient? (select all that apply) a. Measuring hourly urine output b. Continuous BP monitoring with an arterial line c. Decreasing the MAP by 50% within the first hour d. Maintaining bed rest and giving tranquilizers to lower the BP e. Assessing the patient for signs and symptoms of heart failure and changes in mental status
a. Measuring hourly urine output b. Continuous BP monitoring with an arterial line e. Assessing the patient for signs and symptoms of heart failure and changes in mental status
Which instruction is a key aspect of teaching for the patient on anticoagulant therapy? a. Monitor for and report any signs of bleeding. b. Do not take acetaminophen (Tylenol) for a headache. c. Decrease your dietary intake of foods containing vitamin K. d. Arrange to have blood drawn twice a week to check drug effects.
a. Monitor for and report any signs of bleeding.
A patient with chronic heart failure and atrial fibrillation is treated with low-dose digitalis and a loop diuretic. What does the nurse need to do to prevent complications of this drug combination? (select all that apply) a. Monitor serum potassium levels. b. Teach the patient how to take a pulse rate. c. Withhold digitalis if pulse rhythm is irregular. d. Keep an accurate measure of intake and output. e. Teach the patient about dietary potassium restrictions.
a. Monitor serum potassium levels. b. Teach the patient how to take a pulse rate.
Which nursing responsibilities are priorities when caring for a patient returning from a cardiac catheterization (select all that apply)? a. Monitoring vital signs and ECG b. Checking the catheter insertion site and distal pulses c. Helping the patient to ambulate to the bathroom to void d. Telling the patient that he will be sleepy from the general anesthesia e. Teaching the patient about the risks of the radioactive isotope injection
a. Monitoring vital signs and ECG b. Checking the catheter insertion site and distal pulses
A patient with infective endocarditis develops sudden left leg pain with pallor, paresthesia, and a loss of peripheral pulses. What should be the nurse's initial action? a. Notify the HCP of the change in perfusion. b. Start anticoagulant therapy with IV heparin. c. Elevate the leg to improve the venous return. d. Position the patient in reverse Trendelenburg.
a. Notify the HCP of the change in perfusion.
A patient is diagnosed with mitral stenosis and new-onset atrial fibrillation. Which interventions could the nurse delegate to unlicensed assistive personnel (UAP)? (select all that apply) a. Obtain and record daily weight. b. Determine apical-radial pulse rate. c. Observe for overt signs of bleeding. d. Teach the patient how to get a Medic Alert device. e. Obtain and record vital signs, including pulse oximetry.
a. Obtain and record daily weight. c. Observe for overt signs of bleeding. e. Obtain and record vital signs, including pulse oximetry.
A patient is admitted to the ICU with a diagnosis of NSTEMI. Which drugs(s) would the nurse expect the patient to receive? (select all that apply) a. Oral statin therapy b. Antiplatelet therapy c Thrombolytic therapy d. Prophylactic antibiotics e. Intravenous nitroglycerin
a. Oral statin therapy b. Antiplatelet therapy e. Intravenous nitroglycerin
The nurse recognizes which of the following patients is at highest risk for PID? a. Patient receiving treatment for asymptomatic chlamydial infection b. Patient returning for a three month recheck following a trichomoniasis infection c. Patient who reports having two new partners in the last 6 months d. Patient undergoing treatment for bacterial vaginosis following completion of antibiotic therapy
a. Patient receiving treatment for asymptomatic chlamydial infection
You are teaching the PCA working with you on the unit about bleeding precautions. Which of the following topics would you want to include in your education? a. Patient should use electric razors only b. Advise the patient to avoid blowing their nose c. Allow patient to continue to floss their teeth d. Apply pressure firmly for several minutes after needle sticks or IV removal e. Notify the nurse right away if they note any blood in the urine or stool
a. Patient should use electric razors only b. Advise the patient to avoid blowing their nose d. Apply pressure firmly for several minutes after needle sticks or IV removal e. Notify the nurse right away if they note any blood in the urine or stool
Which of the following lab values would be monitored for in a patient on furosemide? a. Potassium b. Hemoglobin A1C c. White blood cells d. Troponin I
a. Potassium
During physical exam, the nurse notes a single chancre on assessment. The nurse recognizes this is most consistent with which stage of syphilis? a. Primary b. Secondary c. Tertiary d. Late
a. Primary
You review the patient's medication list in the EMR. Which of the following medications would concern you in your treatment of this patient? a. Propanolol 20mg twice a day b. Pantoprazole 20mg daily c. Loratidine 10mg daily d. Albuterol HFA 2 puffs every four hours as needed
a. Propanolol 20mg twice a day
Which of the following clinical manifestations indicate a potential complication of pericarditis (cardiac tamponade or pericardial effusion)? Select all that apply. a. Pulsus Paradoxus b. Janeway lesion c. narrow pulse pressure d. hiccups e. hoarseness f. distant heart sounds
a. Pulsus Paradoxus c. narrow pulse pressure d. hiccups e. hoarseness f. distant heart sounds Cardiac tapenade constricted by fluid in pericardial sac (more than 5-10mL) and prevents heart from filling (Spandex on the heart); dec perfusion; good backed up to enter the heart — cant fill between beats
Which BP-regulating mechanism(s) can result in the development of hypertension if defective? (select all that apply) a. Release of norepinephrine b. Secretion of prostaglandins c. Stimulation of the sympathetic nervous system d. Stimulation of the parasympathetic nervous system e. Activation of the renin-angiotensin-aldosterone system
a. Release of norepinephrine c. Stimulation of the sympathetic nervous system e. Activation of the renin-angiotensin-aldosterone system
Which signs and symptoms should the nurse expect to find when assessing a patient with infective endocarditis who uses IV cocaine? (select all that apply) a. Retinal hemorrhages b. Splinter hemorrhages c. Presence of Osler's nodes d. Painless nodules over bony prominences e. Erythematous macules on the palms and soles
a. Retinal hemorrhages b. Splinter hemorrhages c. Presence of Osler's nodes e. Erythematous macules on the palms and soles
When a person's blood pressure rises, the homeostatic mechanism to compensate for an elevation involves stimulation of a. baroreceptors that inhibit the sympathetic nervous system, causing vasodilation. b. chemoreceptors that inhibit the sympathetic nervous system, causing vasodilation. c. baroreceptors that inhibit the parasympathetic nervous system, causing vasodilation. d. chemoreceptors that stimulate the sympathetic nervous system, causing an increased heart rate.
a. baroreceptors that inhibit the sympathetic nervous system, causing vasodilation.
which information would the nurse include when teaching a client with multiple myeloma who has questions about the disease and treatment? a. blood transfusions may be necessary b. calcium supplements are typically prescribed c. fluid restrictions are frequently needed d. avoidance of ultraviolet rays is recommended
a. blood transfusions may be necessary
When assessing a patient, you note a pulse deficit of 23 beats. This finding may be caused by a. dysrhythmias. b. heart murmurs. c. gallop rhythms. d. pericardial friction rubs.
a. dysrhythmias.
which action will the nurse take first when treating a client who is having an anaphylactic reaction? a. give epinephrine 0.5mg intramuscularly b. infuse normal saline 500mL intravenously c. inject methylprednisolone 120mg intravenously d. administer oxygen through a non-rebreather mask
a. give epinephrine 0.5mg intramuscularly
When teaching a patient about the long-term consequences of rheumatic fever, the nurse should discuss the possibility of a. valvular heart disease. b. pulmonary hypertension. c. superior vena cava syndrome. d. hypertrophy of the right ventricle.
a. valvular heart disease.
define normal ejection fraction
amount of blood leaving left ventricles (55-60%)
A 78-yr-old man with a history of diabetes has confusion and temperature of 104°F (40°C). There is a wound on his right heel with purulent drainage. After an infusion of 3 L of normal saline solution, his assessment findings are BP 84/40 mm Hg; heart rate 110; respiratory rate 42 and shallow; CO 8 L/min; and PAWP 4 mm Hg. This patient's symptoms are most likely indicative of a. sepsis.b. septic shock.c. multiple organ dysfunction syndrome.d. systemic inflammatory response syndrome.
b
A person who lives at a high altitude may normally have an increased Hgb and RBC count because a. high altitudes cause vascular fluid loss, leading to hemoconcentration. b. hypoxia caused by decreased atmospheric O2 stimulates erythropoiesis. c. the function of the spleen in removing old RBCs is impaired at high altitudes. d. impaired production of platelets leads to proportionally higher red cell counts.
b
Provide emotional support to a patient with an STI by a. offering information on how safer sexual practices can prevent STIs. b. showing concern when listening to the patient who expresses negative feelings. c. reassuring the patient that the disease is highly curable with appropriate treatment. d. helping the patient who received an STI from their sexual partner in forgiving the partner.
b
The nurse explains to a patient undergoing brachytherapy of the cervix that she a. must undergo simulation to locate the treatment area. b. requires the use of radioactive precautions during nursing care. c. may have desquamation of the skin on the abdomen and upper legs. d. requires shielding of the ovaries during treatment to prevent ovarian damage.
b
Which statements about metabolic side effects of ART are true (select all that apply)? a. These are annoying symptoms that are ultimately harmless. b. ART-related body changes include fat redistribution and peripheral wasting. c. Lipid problems include increases in triglycerides and decreases in high-density cholesterol. d. Insulin resistance and hyperlipidemia can be treated with drugs to control glucose and cholesterol. e. Compared to uninfected people, insulin resistance and hyperlipidemia are harder to treat in HIV-infected patients.
b, c, d
In a person having an acute rejection of a transplanted kidney, what would help the nurse understand the course of events (select all that apply)? a. A new transplant should be considered. b. Acute rejection can be treated with OKT3. c. Repeated episodes of acute rejection can lead to chronic rejection. d. Corticosteroids are the most successful drugs used to treat acute rejection. e. Acute rejection is common after a transplant and can be treated with drug therapy.
b, c, e
A primary HSV infection differs from recurrent HSV episodes in that (select all that apply) a. only primary infections are sexually transmitted. b. symptoms are less severe during recurrent episodes. c. transmission of the virus to a fetus is less likely during primary infection. d. systemic manifestations, such as fever and myalgia, are more common in primary infection. e. lesions from recurrent HSV are more likely to transmit the virus than lesions from primary HSV.
b, d
You are performing discharge teaching to your patient. Which of the following statements would indicate further teaching is needed? a. "I need to follow-up with my oncologist in the next few days as scheduled for repeat blood work." b. "I can visit my grandkids when they have mild respiratory colds as long as there is no fever." c. "I will continue to use my electric razor until my provider tells me otherwise." d. "I should wash my hands often and complete all of my antibiotics."
b. "I can visit my grandkids when they have mild respiratory colds as long as there is no fever."
After teaching about ways to decrease risk factors for CAD, the nurse recognizes that further instruction is needed when the patient says a. "I can keep my blood pressure normal with medication." b. "I would like to add weight lifting to my exercise program." c. "I can change my diet to decrease my intake of saturated fats." d. "I will change my lifestyle to reduce activities that increase my stress."
b. "I would like to add weight lifting to my exercise program."
which statement made by the nurse will be most signficant when teaching strategies to reduce the risk for developing antibiotic-resistant infections? a. "wash your hands frequently with warm soapy water" b. "do not skip any prescribed doses of your antibiotics" c. "do not save unfinished antibiotics for later use" d. "do not stop taking antibiotics when you feel better"
b. "do not skip any prescribed doses of your antibiotics"
Which patient is at highest risk for venous thromboembolism (VTE)? a. A 62-yr-old man with spider veins who is having arthroscopic knee surgery b. A 32-yr-old woman who smokes, takes oral contraceptives, and is planning a trip to Europe c. A 26-yr-old woman who is 3 days postpartum and received maintenance IV fluids for 12 hours during her labor d. An active 72-yr-old man at home recovering from transurethral resection of the prostate for benign prostatic hyperplasia
b. A 32-yr-old woman who smokes, takes oral contraceptives, and is planning a trip to Europe
Which of the following is not a modifiable risk factor or acute coronary syndrome? a. Smoking b. Age c. Obesity d. Substance Abuse
b. Age
A nurse performs an 12 lead ECG on a client with chest pain. In reviewing the results, the nurse notes an ST elevation in certain views of the ECG. How does the nurse interpret this information? a. This is a normal finding. b. An ST elevation indicates infarction associated with an MI c. An ST elevation indicates the patient had a previous MI d. An ST elevation is associated with unstable angina
b. An ST elevation indicates infarction associated with an MI The leads show where in the heart (which artery) is blocked; if in every lead it would be pericarditis (better when lean forward)
The nurse recognizes that drenching night sweats, fever, and weight loss at the time of diagnosis in their patient with lymphoma is called: a. A symptoms b. B symptoms c. T symptoms d. M symptoms
b. B symptoms
Which of the following tests can you anticipate being ordered by the provider based on this clinical scenario? a. Urine culture and sensitivity b. Bone marrow biopsy c. CT of the brain d. Electrocardiogram
b. Bone marrow biopsy
In the patient with supraventricular tachycardia, which assessment indicates decreased cardiac output? a. Hypertension and dyspnea b. Chest pain and palpitations c. Abdominal distention and tachypnea d. Bounding pulses and a systolic murmur
b. Chest pain and palpitations
Which of the following statements is true related to chlamydial infections? a. Previous infections provide natural immunity to repeat infections b. Chlamydial infections can be asymptomatic c. Chlamydia is the least common reportable STI in the US d. Chlamydia is caused by a virus
b. Chlamydial infections can be asymptomatic
When teaching a patient about rest pain with PAD, what should the nurse explain as the cause of the pain? a. Vasospasm of cutaneous arteries in the feet. b. Decrease in blood flow to the nerves of the feet. c. Increase in retrograde venous perfusion to the lower legs. d. Constriction in blood flow to leg muscles during exercise.
b. Decrease in blood flow to the nerves of the feet.
A nurse is caring for a client diagnosed with infective endocarditis. Which of the following manifestations would be a priority for the nurse to monitor? a. Anorexia b. Dyspnea c. Fever d. Malaise
b. Dyspnea Dyspnea often priority (ABCs)
While obtaining subjective assessment data from a patient with hypertension, the nurse recognizes that a modifiable risk factor for the development of hypertension is a. A low-calcium diet. b. Excess alcohol intake. c. A family history of hypertension. d. Consumption of a high-protein diet.
b. Excess alcohol intake.
Which of the following symptoms describes Janeway's lesions? a. Pea-sized red, painful lesions on fingertips b. Flat, red painless spots on fingertips c. Black streaks in fingernails d. Lesions in the retina
b. Flat, red painless spots on fingertips
Patients are at risk for which complications in the first year after heart transplantation? (select all that apply) a. Cancer b. Infection c. Rejection d. Vasculopathy e. Sudden cardiac death
b. Infection c. Rejection e. Sudden cardiac death
Which of the following statements about a normal QRS complex is true? a. It should have a round and smooth appearance on the ECG tracing b. It represents ventricular depolarization and contraction c. A missing part (Q, R, or S) on ECG tracing signifies severe cardiac disease d. Each QRS should be wider/longer than 0.20 seconds or 1 big ECG box
b. It represents ventricular depolarization and contraction
The nurse is caring for a patient who is 2 days post MI. The patient reports that she is experiencing chest pain when she takes a deep breath. Which action would be a priority? a. Notify the provider STAT and obtain a 12-lead ECG. b. Obtain vital signs and auscultate for a pericardial friction rub. c. Apply high-flow O2 by face mask and auscultate breath sounds. d. Medicate the patient with as-needed analgesic and reevaluate in 30 minutes.
b. Obtain vital signs and auscultate for a pericardial friction rub.
For which of the following cardiac rhythms would synchronized cardioversion be an appropriate treatment option? a. Sinus Bradycardia b. Paroxysmal Supraventricular Tachycardia c. Ventricular Fibrillation d. Asystole
b. Paroxysmal Supraventricular Tachycardia Patient is awake and has a little bit of versaid; sinus Brady get pacemaker; defibrillate v-fib (not synchronized)
A P wave on an ECG represents an impulse arising at the a. SA node and repolarizing the atria. b. SA node and depolarizing the atria. c. AV node and depolarizing the atria. d. AV node and spreading to the bundle of His.
b. SA node and depolarizing the atria.
Which clinical manifestations can the nurse expect to see in both patients with Buerger's disease and patients with Raynaud's phenomenon? (select all that apply) a. Intermittent low-grade fevers b. Sensitivity to cold temperatures c. Gangrenous ulcers on fingertips d. Color changes of fingers and toes e. Episodes of superficial vein thrombosis
b. Sensitivity to cold temperatures c. Gangrenous ulcers on fingertips d. Color changes of fingers and toes
Which subjective data related to the cardiovascular system should be obtained from the patient (select all that apply)? a. Annual income b. Smoking history c. Religious preference d. Number of pillows used to sleep e. Blood for basic laboratory studies
b. Smoking history c. Religious preference d. Number of pillows used to sleep
Complete this equation: Cardiac output (CO) equals... a. Blood pressure (BP) x Heart Rate (HR) b. Stroke Volume (SV) x Heart Rate (HR) c. Respiratory Rate (RR) x Stroke Volume (SV) d. Preload x Stroke Volume (SV)
b. Stroke Volume (SV) x Heart Rate (HR)
A patient is admitted to the hospital with a diagnosis of abdominal aortic aneurysm. Which signs and symptoms would suggest that the aneurysm has ruptured? a. Rapid onset of shortness of breath and hemoptysis b. Sudden, severe low back pain and bruising along his flank c. Gradually increasing substernal chest pain and diaphoresis d. Sudden, patchy blue mottling on feet and toes and rest pain
b. Sudden, severe low back pain and bruising along his flank
Which patient teaching points should the nurse include when providing discharge instructions to a patient with a new permanent pacemaker and the caregiver? (select all that apply) a. Avoid or limit air travel. b. Take and record a daily pulse rate. c. Obtain and wear a Medic Alert ID device at all times. d. Avoid lifting arm on the side of the pacemaker above shoulder. e. Do not use a microwave oven because it interferes with pacemaker function.
b. Take and record a daily pulse rate. c. Obtain and wear a Medic Alert ID device at all times. d. Avoid lifting arm on the side of the pacemaker above shoulder.
A nurse is interpreting a patient's heart rate from a 6-second telemetry strip with 7 equally spaced R-waves. Which of the following statements is correct? a. The patient has a bradycardic rhythm b. The patient's heart rate appears to be 70/bpm c. The patient has a heart rate of 42/bpm d. The nurse also needs to count T-waves to make a correct interpretation
b. The patient's heart rate appears to be 70/bpm
A 50-year-old woman who weighs 95 kg has a history of tobacco use, high blood pressure, high sodium intake, and sedentary lifestyle. Which is the most important risk factor for peripheral artery disease (PAD) to address in the nursing plan of care? a. Salt intake b. Tobacco use c. Excess weight d. Sedentary lifestyle
b. Tobacco use
In teaching a patient about coronary artery disease, the nurse explains that the changes that occur in this disorder include (select all that apply) a. diffuse involvement of plaque formation in coronary veins. b. abnormal levels of cholesterol, especially low-density lipoproteins. c. accumulation of lipid and fibrous tissue within the coronary arteries. d. development of angina due to a decreased blood supply to the heart muscle. e. chronic vasoconstriction of coronary arteries leading to permanent vasospasm.
b. abnormal levels of cholesterol, especially low-density lipoproteins. c. accumulation of lipid and fibrous tissue within the coronary arteries. d. development of angina due to a decreased blood supply to the heart muscle.
which priority action would the nurse perform when caring for a client with suspected anaphylaxis? a. obtain full set of vital signs b. assess airway and oxygenation c. determine level of consciousness d. notify the client's HCP
b. assess airway and oxygenation
a client has a platelet count of 49,000/mL. the nurse would instruct the client to avoid which activity? a. ambulation b. blowing the nose c. visiting with children d. eating fresh fruits and vegetables
b. blowing the nose
A hospitalized patient with a history of chronic stable angina tells the nurse that she is having chest pain. The nurse bases his actions on the knowledge that ischemia a. will always progress to myocardial infarction. b. can be relieved by rest, nitroglycerin, or both. c. is often associated with vomiting and extreme fatigue. d. indicates that irreversible myocardial damage is occurring.
b. can be relieved by rest, nitroglycerin, or both.
which information about Hodgkin lymphoma will the nurse use when responding to the spouse of a 22-yo client who is being tested for Hodgkin lymphoma who tells the nurse, "don't you think it is unlikely for someone like my spouse to have cancer?" a. more likely to affect women than men b. diagnosed during adolescence and young adulthood c. primarily a disease of older rather than younger adults d. more common among populations of Asian heritage
b. diagnosed during adolescence and young adulthood
The part of the vascular system responsible for hemostasis is the a. thin capillary vessels. b. endothelial layer of the arteries. c. elastic middle layer of the veins. d. smooth muscle of the arterial wall.
b. endothelial layer of the arteries.
which confirmatory test would the nurse anticipate for a client with a tentative diagnosis of Hodgkin disease? a. bone scan b. lymph node biopsy c. computed tomography (CT) scan d. radioactive iodine (131I) uptake study
b. lymph node biopsy
A patient is undergoing plasmapheresis for treatment of systemic lupus erythematosus. The nurse explains that plasmapheresis is used in treatment to a. remove T lymphocytes in her blood that are producing antinuclear antibodies. b. remove normal particles in her blood that are being damaged by autoantibodies. c. exchange her plasma that contains antinuclear antibodies with a substitute fluid. d. replace viral-damaged cellular components of her blood with replacement whole blood.
c
A patient on chemotherapy and radiation for head and neck cancer has a WBC count of 1.9 × 103/μL, hemoglobin of 10.8 g/dL, and a platelet count of 99 × 103/μL. Based on the CBC results, what is the most serious clinical finding? a. Cough, rhinitis, and sore throat b. Fatigue, nausea, and skin redness at site of radiation c. Temperature of 101.9° F, fatigue, and shortness of breath d. Skin redness at site of radiation, headache, and constipation
c
A patient with multiple myeloma becomes confused and lethargic. The nurse would expect that these clinical manifestations may be explained by diagnostic results that indicatea. hyperkalemia. b. hyperuricemia. c. hypercalcemia. d. CNS myeloma.
c
DIC is a disorder in which a. the coagulation pathway is genetically altered, leading to thrombus formation in all major blood vessels. b. an underlying disease depletes hemolytic factors in the blood, leading to diffuse thrombotic episodes and infarcts. c. a disease process stimulates coagulation processes with resultant thrombosis, as well as depletion of clotting factors, leading to diffuse clotting and hemorrhage. d. an inherited predisposition causes a deficiency of clotting factors that leads to overstimulation of coagulation processes in the vasculature.
c
During HIV infection a. reverse transcriptase helps HIV fuse with the CD4+ T cell. b. HIV RNA uses the CD4+ T cell's mitochondria to replicate. c. the immune system is impaired predominantly by the eventual widespread destruction of CD4+ T cells. d. a long period of dormancy develops during which HIV cannot be found in the blood and there is little viral replication.
c
In a severely anemic patient, the nurse would expect to find a. cyanosis and cardiomegaly.b. pulmonary edema and fibrosis.c. dyspnea at rest and tachycardia.d. ventricular dysrhythmias and wheezing.
c
Opportunistic diseases in HIV infectiona. are usually benign.b. are generally slow to develop and progress.c. occur in the presence of immunosuppression.d. are curable with appropriate drug interventions.
c
The goals of cancer treatment are based on the principle that a. surgery is the single most effective treatment for cancer. b. initial treatment is always directed toward cure of the cancer. c. a combination of treatment modalities is effective for controlling many cancers. d. although cancer cure is rare, quality of life can be increased with treatment modalities.
c
The nurse is aware that a major difference between Hodgkin's lymphoma and non-Hodgkin's lymphoma is that a. Hodgkin's lymphoma occurs only in young adults. b. Hodgkin's lymphoma is considered potentially curable. c. non-Hodgkin's lymphoma can manifest in multiple areas. d. non-Hodgkin's lymphoma is treated only with radiation therapy.
c
Trends in the incidence and death rates of cancer include the fact that a. a higher percent of women than men have lung cancer. b. lung cancer is the most common type of cancer in men. c. blacks have a higher death rate from cancer than whites. d. breast cancer is the leading cause of cancer deaths in women.
c
While assessing the lymph nodes, the nurse shoulda. apply gentle, firm pressure to deep lymph nodes.b. palpate the deep cervical and supraclavicular nodes last. c. lightly palpate superficial lymph nodes with the pads of the fingers. d. use the tips of the second, third, and fourth fingers to apply deep palpation.
c
You are taking care of a male patient who has the following laboratory values from his CBC: WBC 6.5 × 103/ μL, Hgb 13.4 g/dL, Hct 40%, platelets 50 × 103/μL. What are you most concerned about? a. The patient is neutropenic.b. The patient has an infection.c. There is an increased risk for bleeding.d. Fall risk precautions are needed due to anemia.
c
Which of the following statements by a 65 year old female client indicates teaching is sufficient regarding STIs? a. "I should start my oral contraceptive to prevent pregnancy as soon as I'm sexually active." b. "I do not need to use a condom because I'm unable to get pregnant after experiencing menopause." c. "I should utilize a barrier method each time to prevent sexually transmitted infections." d. "I should stop being intimate with my partner altogether to prevent the risk of sexually transmitted infections."
c. "I should utilize a barrier method each time to prevent sexually transmitted infections."
Which of the following statements is true concerning infections caused by human papilloma virus (HPV)? a. Widely available vaccines can prevent all types of HPV b. The warts of HPV infections are always easily observed during assessment c. Most types of HPV do not cause genitourinary cancers d. Removal of visible HPV warts often cures the infection
c. Most types of HPV do not cause genitourinary cancers Theres a lot a lot and not all of them cause cancer, so we are juts worried about the ones that do
The patient is diagnosed with 'ITP' and asks the nurse what caused this to happen. What is the best response? a. "This condition occurs within a few days after beginning heparin therapy." b. "This condition is caused by the deficiency in a plasma enzyme that leads to increased platelet clumping. It's hard to tell what causes it, but it may be medication related." c. "It is caused by abnormal destruction of your circulating platelets caused by antiplatelet antibodies made by your immune system and impaired platelet production." d. "It is caused by failure of the bone marrow to produce platelets in the right quantity."
c. "It is caused by abnormal destruction of your circulating platelets caused by antiplatelet antibodies made by your immune system and impaired platelet production."
The nurse expects the cardiac biomarker troponin to rise how soon after onset of chest pain in a patient with NSTEMI or STEMI? a. 2-3 hours b. 1-2 hours c. 4-6 hours d. 10 - 24 hours
c. 4-6 hours
Based on this presentation, which initial action should you prioritize as the nurse? a. Initiate a peripheral IV to administer medications b. Draw lab work, including a CBC and BMP, to further evaluate c. Administer 0.5mg epinephrine intramuscularly d. Administer ondansetron 4mg sublingual for vomiting
c. Administer 0.5mg epinephrine intramuscularly
Which priority intervention would the nurse do first when caring for a patient with new onset anaphylaxis? a. Administer benadryl 50mg PO STAT b. Assess vital signs every 30 minutes c. Administer epinephrine 0.5mg IM STAT d. Place the patient in a supine position
c. Administer epinephrine 0.5mg IM STAT
What are the priority nursing interventions 8 hours after an abdominal aortic aneurysm repair? a. Assessing nutritional status and dietary preferences b. Initiating IV heparin and monitoring anticoagulation c. Administering IV fluids and watching kidney function d. Elevating the legs and applying compression stockings
c. Administering IV fluids and watching kidney function
A patient is recovering from an uncomplicated MI. Which rehabilitation guideline is a priority to include in the teaching plan? a. Refrain from sexual activity for a minimum of 3 weeks. b. Plan a diet program that aims for a 1- to 2-lb weight loss per week. c. Begin an exercise program that aims for at least 5 30- minute sessions per week. d. Consider the use of erectile agents and prophylactic NTG before engaging in sexual activity.
c. Begin an exercise program that aims for at least 5 30- minute sessions per week.
which diagnostic test result will the nurse expect when caring for a client with multiple myeloma? a. occult blood in the stool b. low serum calcium levels c. Bence Jones protein in the urine d. positive bacterial culture of sputum
c. Bence Jones protein in the urine
Which of the following is considered diagnostic for multiple myeloma? a. Reed-Sternberg cells b. Philadelphia chromosome c. Bence Jones proteins d. Osler's nodes
c. Bence Jones proteins
Which of the following findings would likely be found in this patient's urine results? a. Positive RBCs b. Positive leukoesterase c. Bence-Jones proteins d. Glucosuria
c. Bence-Jones proteins
Based on the lab results and symptoms reported by the patient, you should expect which of the following diagnostic studies to be ordered for your patient in the emergency department? a. Chest X-ray b. MR angiography of the abdomen c. CT of the lumbar spine d. Ultrasound of bilateral lower legs
c. CT of the lumbar spine
The nurse preparing to administer medication to treat gonorrhea should anticipate which of the following orders? a. Doxycycline b. Amoxicillin c. Ceftriaxone d. Levofloxacin
c. Ceftriaxone
You recognize that which of the following precautions should be instituted for your patient? Select all that apply. a. Droplet precautions b. Contact precautions c. Compromised host precautions d. Bleeding precautions
c. Compromised host precautions d. Bleeding precautions
What is the first priority of interprofessional care for a patient with a suspected acute aortic dissection? a. Reduce anxiety. b. Monitor chest pain. c. Control blood pressure. d. Increase myocardial contractility.
c. Control blood pressure.
The nurse anticipates which of the following initial diagnostic studies in their client with acute heart failure? a. V/Q Scan b. CT of the chest c. Echocardiogram d. Troponin and CK-MB
c. Echocardiogram
A nurse is caring for a client diagnosed with unstable angina who reports chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers 1 sublingual nitroglycerin tablet. After 5 min, the client states that his chest pain is now a severity of 3. Which of the following actions should the nurse prioritize first? a. Call a code b. Continue to monitor c. Give the patient another sublingual nitroglycerin tablet d. Administer aspirin 325mg PO x once
c. Give the patient another sublingual nitroglycerin tablet Patient still in pain (pain caused by ischemia to heart); know nitro helped and can give every 5 mins 3 times (goal to get pain to 0) Imdur given as long acting PO nitro
The nurse recognizes which of the following statements is accurate regarding HSV infection? a. HSV1 infections can only occur in the mouth. b. HSV2 can only occur in the genital region. c. HSV1 or HSV2 can cause genital, anal, or orolabial infections. d. HSV2 infections generally occur "above the waist"
c. HSV1 or HSV2 can cause genital, anal, or orolabial infections.
The nurse is caring for a patient with acute decompensated heart failure who is receiving IV dobutamine. Why would this drug be prescribed? (select all that apply) a. It dilates renal blood vessels. b. It will increase the heart rate. c. Heart contractility will improve. d. Dobutamine is a selective β-agonist. e. It increases systemic vascular resistance.
c. Heart contractility will improve. d. Dobutamine is a selective β-agonist.
Which of the following clinical manifestations is generally associated with the secondary stage of syphilis? a. Chancre b. Heart failure c. Maculopapular rash d. Gummas
c. Maculopapular rash Chancre in primary (very infectious); gummas are like tumors in tertiary
What action is necessary based on the MEWS score? a. Call a SWAT/Rapid Response b. No action is necessary c. Notify the charge nurse and provider now and repeat vital signs in 2 hours d. Repeat vital signs in one hour and prepare for transfer
c. Notify the charge nurse and provider now and repeat vital signs in 2 hours
Which of the following statements about PVCs is true? a. They are often caused by antidysrhythmic medication administration b. Treatment usually includes insertion of a permanent pacemaker c. They might not generate enough cardiac output to cause adequate peripheral perfusion d. They are generally considered benign and unconcerning
c. They might not generate enough cardiac output to cause adequate peripheral perfusion Comes from ventricular electricity, but starts in ventricles (up and over) instead of SA (down and out); might not generate a squeeze; treatment is antidysrhythmic medications; a bunch of these in a row = v-tach
For which of the following cardiac rhythms would defibrillation be an appropriate intervention? a. Asystole b. Supraventricular tachycardia c. Ventricular fibrillation d. Symptomatic bradycardia
c. Ventricular fibrillation
The nurse recognizes that which of the following is not a key factor included in Virchow's Triad, which describes the pathophysiology of DVT development? a. hypercoagulability b. venous stasis c. cardiac output d. endothelial damage
c. cardiac output a: (infection/sepsis can cause inflammatory process that triggers hypercoag; or traumatically injured in or out of hospital like surgery) b: (laying down like most of the time, limited ambulation; need contraction of skeletal muscle and valves to flow back to heart) d: (septic or invasive procedures)
An expected finding in the assessment of an 81-year-old patient is a. a narrowed pulse pressure. b. diminished carotid artery pulses. c. difficulty isolating the apical pulse. d. an increased heart rate in response to stress.
c. difficulty isolating the apical pulse.
which clinical manifestation would the nurse expect to find in a client with a new diagnosis of acute lymphocytic leukemia (ALL)? a. alopecia b. insomnia c. ecchymosis d. hypertension
c. ecchymosis
The most common finding in people at risk for sudden cardiac death is a. aortic valve disease. b. mitral valve disease. c. left ventricular dysfunction. d. atherosclerotic heart disease.
c. left ventricular dysfunction.
which assessment finding in a client with acute lymphoblastic leukemia receiving chemotherapy would alert the nurse to the possible development of thrombocytopenia? SATA a. fever b. diarrhea c. melena d. hematuria e. ecchymosis
c. melena d. hematuria e. ecchymosis
A patient admitted with syncope has continuous ECG monitoring. An examination of the rhythm strip reveals the following: atrial rate 74 beats/min and regular; ventricular rate 62 beats/min and irregular; P wave normal shape; PR interval lengthens progressively until a P wave is not conducted; QRS normal shape. The priority nursing intervention would be to a. give epinephrine 1 mg IV push. b. prepare for synchronized cardioversion. c. observe for symptoms of hypotension or angina. d. apply transcutaneous pacemaker pads on the patient.
c. observe for symptoms of hypotension or angina.
A patient with a tricuspid valve disorder has impaired blood flow between the a. vena cava and right atrium. b. left atrium and left ventricle. c. right atrium and right ventricle. d. right ventricle and pulmonary artery.
c. right atrium and right ventricle.
Important teaching for the patient scheduled for a radiofrequency catheter ablation procedure includes explaining that a. ventricular bradycardia may be induced and treated during the procedure. b. catheter will be placed in both femoral arteries to allow double-catheter use. c. the procedure will destroy areas of the conduction system that are causing rapid heart rhythms. d. general anesthetic will be given to prevent the awareness of any "sudden cardiac death" experiences.
c. the procedure will destroy areas of the conduction system that are causing rapid heart rhythms.
Explain to the patient with gonorrhea that treatment will include both ceftriaxone and azithromycin because a. azithromycin helps prevent recurrent infections. b. some patients do not respond to oral drugs alone. c. coverage with more than one antibiotic will prevent reinfection. d. the increasing rates of drug resistance requires using at least 2 drugs.
d
In a type I hypersensitivity reaction the primary immunologic disorder appears to be a. binding of IgG to an antigen on a cell surface. b. deposit of antigen-antibody complexes in small vessels. c. release of cytokines used to interact with specific antigens. d. release of chemical mediators from IgE-bound mast cells and basophils.
d
Multiple drugs are often used in combinations to treat leukemia and lymphoma because a. there are fewer toxic and side effects. b. the chance that one drug will be effective is increased. c. the drugs are more effective without causing side effects. d. the drugs work by different mechanisms to maximize killing of cancer cells.
d
Screening for HIV infection generally involves a. detecting CD8+ cytotoxic T cells in saliva. b. laboratory analysis of saliva to detect CD4+ T cells.c. analysis of lymph tissues for the presence of HIV RNA. d. laboratory analysis of blood to detect HIV antigen and/or antibody.
d
The most effective method of administering a chemotherapy agent that is a vesicant is to a. give it orally.b. give it intraarterially.c. use an Ommaya reservoir.d. use a central venous access device.
d
The nurse counsels the patient receiving radiation therapy or chemotherapy that a. effective birth control methods should be used for the rest of the patient's life. b. after successful treatment, patients can expect a return to their previous level of function. c. the cycle of fatigue-depression-fatigue that may occur during treatment may be reduced by restricting activity. d. nausea and vomiting can usually be managed with antiemetic drugs, diet modification, and other interventions.
d
The nurse is caring for a 59-year-old woman who had surgery 1 day ago to remove an ovarian cancer mass. The patient is awaiting the pathology report. She is tearful and says that she is scared to die. The most effective nursing intervention at this point is to use this opportunity to a. motivate change in an unhealthy lifestyle. b. teach her about the 7 warning signs of cancer. c. discuss healthy stress relief and coping practices. d. let her communicate about the meaning of this experience.
d
The nurse tells a friend who asks him to administer his allergy shots that a. it is illegal for nurses to administer injections outside of a medical setting. b. he is qualified to do it if the friend has epinephrine in an injectable syringe provided with his extract. c. avoiding the allergens is a more effective way of controlling allergies, and allergy shots are not usually effective. d. immunotherapy should only be administered in a setting where emergency equipment and drugs are available.
d
The nurse would expect that a patient with von Willebrand disease undergoing surgery would be treated with administration of vWF and a. thrombin. b. factor VI. c. factor VII. d. factor VIII.
d
To prevent the infection and transmission of STIs, the nurse's teaching plan would include an explanation of a. the appropriate use of oral contraceptives.b. the need for annual Pap tests for women with HPV.c. sexual positions that can be used to avoid infection.d. sexual practices that are considered high-risk behaviors.
d
What accurately describes rejection after transplantation? a. Hyperacute rejection can be treated with OKT3. b. Acute rejection can be treated with sirolimus or tacrolimus. c. Chronic rejection can be treated with tacrolimus or cyclosporine. d. Hyperacute reaction can be avoided if crossmatching is done before transplantation.
d
What is the most appropriate nursing intervention to help an HIV-infected patient adhere to a treatment regimen? a. Set up a drug pillbox for the patient every week. b. Give the patient a video and a brochure to view and read at home. c. Tell the patient that side effects of ART are bad but that they go away. d. Assess the patient's routines and find adherence cues that fit into the patient's life circumstances.
d
Your patient is notified by the provider that she has multiple myeloma. Once the provider leaves, the patient asks you to tell her more about this condition. Which of the following is the best response? a. "Your provider will be back tomorrow and can explain it again to you then." b. "I will write down the name of the condition so you can Google it." c. "It is a disorder of the bone marrow that produces too many leukocytes." d. "It is a disorder where cancerous plasma cells grow in the bone marrow and potentially destroy bone."
d. "It is a disorder where cancerous plasma cells grow in the bone marrow and potentially destroy bone."
The nurse recognizes that normal ejection fraction (EF) ranges from which of the following? a. 75-85% b. 70-75% c. 45-55% d. 55-65%
d. 55-65%
During weekly hospital clinicals, a nursing student would be able to assess the current cardiac rhythm for which of the following patients? a. A patient who is awake, confused, with easily palpable peripheral pulses b. A patient who is asleep but on continuous pulse oximetry c. A patient admitted for chest pain with a copy of their most recent EKG in their paper chart d. A patient who is ambulating in the hallway with PT on remote telemetry monitoring
d. A patient who is ambulating in the hallway with PT on remote telemetry monitoring O2 sat and peripheral pulse only shows pulse rate not rhythm
Which medical condition would you suspect based on this patient's presentation? a. Acute gastroenteritis b. Sepsis due to VRE infection c. Acute myeloid leukemia d. Anaphylaxis
d. Anaphylaxis
The nurse is planning care and teaching for a patient with venous leg ulcers. What is the most important patient action in healing and control of this condition? a. Following activity guidelines. b. Using moist environment dressings. c. Taking horse chestnut seed extract daily. d. Applying graduated compression stockings.
d. Applying graduated compression stockings.
A new patient is brought into your clinic setting. You notice small red dots on a quick physical assessment. Which lab test would you anticipate being ordered and why? a. AST/ALT to evaluate liver function b. BMP to assess kidney function c. Albumin to evaluate total protein d. CBC to evaluate platelet level
d. CBC to evaluate platelet level
The telemetry technician calls the nurse to report that a patient's cardiac rhythm just changed to ventricular tachycardia. Which of the following actions should the nurse take first? a. Call pharmacy and tell them to send an IV heparin infusion b. Message the physician and recommend they order amiodarone c. Ask the nurse tech/PCA/UAP to go check the patient's telemetry leads d. Go to the bedside and assess the patient
d. Go to the bedside and assess the patient
As the nurse, you understand that his chemotherapy would be considered: a. Maintenance b. Post-induction c. Post-remission d. Induction
d. Induction
In teaching a patient with hypertension about controlling the illness, the nurse recognizes that a. All patients with elevated BP need drug therapy. b. Obese persons must achieve a normal weight to lower BP. c. It is not necessary to limit salt in the diet if taking a diuretic. d. Lifestyle modifications are needed for all persons with elevated BP.
d. Lifestyle modifications are needed for all persons with elevated BP.
As the nurse, you recognize which of the following goals of care is of upmost importance in managing anaphylaxis? a. Resolution of urticaria (hives) b. Maintain adequate IV access c. Monitoring vital signs frequently d. Maintain an open airway
d. Maintain an open airway
Which of the following is a common causative factor of symptomatic sinus bradycardia? a. Hyperthermia b. Aerobic exercise training c. Acute infection/sepsis d. Medications like metoprolol
d. Medications like metoprolol Aerobic exercise training causes asymptomatic bradycardia
Which of the following is true regarding sinus tachycardia (ST)? a. Common causes include overdose of beta-blockers b. ST is defined as a heart rate over 90/bpm c. ST is often caused by an increase in cardiac afterload d. Not all episodes of ST need medical treatment
d. Not all episodes of ST need medical treatment
Which of the following is a hallmark finding of pericarditis? a. Splinter hemorrhages b. S3/S4 on auscultation c. Weight gain d. Pericardial friction rub
d. Pericardial friction rub
Which of the following is not a source for stem cells for bone marrow transplant? a. Peripheral blood b. Umbilical cord c. Bone marrow d. Plasma blood donations
d. Plasma blood donations
What compensatory mechanism involved in both chronic heart failure and acute decompensated heart failure leads to fluid retention and edema? a. Ventricular dilation b. Ventricular hypertrophy c. Increased systemic blood pressure d. Renin-angiotensin-aldosterone activation
d. Renin-angiotensin-aldosterone activation
Which of the following represents the correct normal pathway of a cardiac action potential? a. Perkinje fibers to SA node to bundle branches b. Bundle of His to SA node to Perkinje fibers c. Left bundle branch to right bundle branch to AV node d. SA node to AV node to Bundle of His
d. SA node to AV node to Bundle of His
Which treatment should the nurse anticipate for an otherwise healthy person with an initial VTE? a. IV argatroban as an inpatient b. IV unfractionated heparin as an inpatient c. Subcutaneous unfractionated heparin as an outpatient d. Subcutaneous low-molecular-weight heparin as an outpatient
d. Subcutaneous low-molecular-weight heparin as an outpatient
A priority consideration in the management of the older adult with hypertension is to a. Prevent primary hypertension from converting to secondary hypertension. b. Recognize that the older adult is less likely to adhere to the drug therapy regimen than a younger adult. c. Ensure that the patient receives larger initial doses of antihypertensive drugs because of impaired absorption. d. Use precise technique in assessing the BP of the patient because of the possible presence of an auscultatory gap.
d. Use precise technique in assessing the BP of the patient because of the possible presence of an auscultatory gap.
A nurse would anticipate which of the following medications to be prescribed for a patient diagnosed with primary (initial) infection of genital herpes (HSV-2)? a. ceftriaxone b. Azithromycin c. metronidazole d. acyclovir
d. acyclovir Others are antibiotics, and we need an antiviral
The ECG monitor of a patient in the cardiac care unit after an MI shows ventricular bigeminy with a rate of 50 beats/min. The nurse would a. perform defibrillation. b. administer IV amiodarone. c. prepare for temporary pacemaker insertion. d. assess the patient's response to the dysrhythmia.
d. assess the patient's response to the dysrhythmia.
Priority nursing management for a patient with myocarditis includes interventions related to a. meticulous skin care. b. antibiotic prophylaxis. c. tight glycemic control. d. oxygenation and ventilation.
d. oxygenation and ventilation.
The nurse prepares a patient for synchronized cardioversion knowing that cardioversion differs from defibrillation in that a. defibrillation delivers a lower dose of electrical energy. b. cardioversion is a treatment for atrial bradydysrhythmias. c. defibrillation is synchronized to deliver a shock during the QRS complex. d. patients should be sedated if cardioversion is done on a nonemergency basis.
d. patients should be sedated if cardioversion is done on a nonemergency basis.
define paroxysmal nocturnal dyspnea
episodic sudden dyspnea that awakens a patient at night
define STEMI
myocardial infarction with evidence of ST elevation on EGC tracing and positive cardiac biomarker
define non-STEMI
myocardial infarction with no evidence of ST elevation on ECG tracing and positive cardiac biomarkers
define ST depression
seen on ECG representing cardiac ischemia
