Final Exam Review
How long are most transdermal patches effective?
72 hours.
A client has pneumonia that is worsening and needs an antibiotic administered rapidly. The client is also at risk for fluid overload. Which of the following IV devices would most likely be used for this client?
A controlled pump - IV bolus.
In what group is colon cancer more common?
Age 50 and above is equally prone for women and men
water soluble vitamins
B vitamins and vitamin C
What is the best explanation for the function of the glomerulus?
Basic filtration use - removes wastes, forming glomerular filtrate.
The nurse helps a client to overcome stress and pressure. A nurse is caring for a client with stress. The client has been divorced recently and is caring for school-age children. The nurse is providing education to the client about the responsibilities of the client at this time. What are the responsibilities that the nurse needs to include in the teaching of this client?
Be prepared to take new responsibilities, review possible employment opportunities, discuss current daily child care when mother is working.
What is a function of the pancreas that the nurse needs to know to help explain the pathology of the pancreas to a client?
Behind the stomach, between duodenum and spleen. Function is to make pancreatic juice/enzyme that breaks down sugars, fats, and starches.
Where is the best place to place sterile gloved hands?
Between waist and nipple.
An external catheter is secured to a client's penis to collect urine. How should the nurse care for the client?
Change every 24 hours, monitor for redness, infection.
How do controlled substances need to be handled by the nurse?
Chart everything, make sure controlled substances are locked - give correct dosage and route.
Which stage of family life is the client entering as they are getting ready to adopt a child in 1 week?
Childbearing.
Which clients would the nurse monitor for stomatitis?
Client undergoing bone marrow transplant or those with decreased immune system.
What is the best explanation for the function of the loop of Henle?
Concentrates salts by reabsorbing water by osmosis.
Which priority nursing action must the nurse perform before digoxin administration?
Count apical pulse / heart rate for a full minute.
A nurse is caring for a client with urge incontinence. What should the nurse include in the client education?
Decrease fluid intake and try kegel exercises to strengthen pelvic muscles.
What agent would be best for the nurse to use to wipe down the bedside table which has been used to complete a dressing change?
Disinfectant wipe - bleach or phenol.
A couple with young children asks the nurse about the factors that contribute to a strong family unit. What instruction is of the highest priority for the nurse to provide to the parents?
Dual parenting and close parent-child relationship.
Age is more than an accumulation of years. The aging process affects people in different ways. To fully adapt to aging and thrive in this new stage, older adults must confront many lifestyle changes. A student nurse has been asked to prepare a postclinical report on lifestyle changes in the older and aging population. What lifestyle changes should the student nurse incorporate into the report?
Eat a clean diet, use meds for prevention/management, good sleep, yearly body screening, stay physically active and socialize.
What condition would lead inadequate erythropoietin production?
End stage renal disease.
What should the nurse suggest to a teenage client to help him overcome peer pressure?
Ensure they have someone in their family to model safe habits/practices, active/non-judgmental listening.
what is the differences between enteral and parenteral medication administration.
Enteral involves esophagus, stomach and GI tract. Parenteral involves peripheral and central veins.
What should the nurse tell the client that EER means, as related to daily food patterns and caloric intake across the lifespan?
Estimated Energy Requirement - It is the average energy intake to maintain energy balance. EER is matched to a person's lifestyle, weight height, age/sex group.
What foods are eaten on an ovo-vegetarian diet?
Excludes all animal products except eggs.
The nurse is administering prescribed medication to an elderly client who tells the nurse that "this is not the color of the pill I normally take." What action should the nurse take in this situation?
Explain to the client that generic comes in different colors and administer drugs.
What should a nurse do before administering a medication the nurse is not familiar with?
Familiarize indications, dosage, contraindication, route of administration.
What is the proper sequence for the pathway of urine in the kidney?
Filtration, to absorption, to secretion
A nurse is caring for a client with severe cardiovascular disease that has been placed on a 1,500-mL fluid restriction. Which is the most important therapeutic nursing intervention that the nurse should monitor in this client?
Fluid restriction - make sure to be thorough with monitoring fluid input and output.
Which test uses a collected urine specimen to indicate glomerular filtration rate and renal insufficiency?
GFR blood test is taken to test glomerular filter rate - albumin test is for renal insufficiency.
The endocrine system has close interrelationships with other body systems. Nonendocrine glands and organs secrete hormones. Based on this information, the nurse tells the client that which other structures or organs produce specific hormones?
Heart, liver, kidneys.
Which is the best explanation to the client about the hormonal function of the placenta?
Helps provide nutrients to the fetus and stimulates milk glands in the breasts.
Specific properties of water make it important in body chemistry. It is important that the student nurse is able to identify the functions of water to aid in understanding the rationales underlying nursing interventions. What are the functions of water that the student nurse needs to review for the upcoming unit examination on fluid and electrolyte imbalances?
Helps regulate body temperature, carries nutrients and oxygen to the cells, keeps tissue of the eyes, nose and mouth moist. Water is needed to replenish lost fluid from sweat. Water is necessary for all bodily functions - composes large % of cellular makeup.
Which is an example of a health condition that a fat-controlled diet would be prescribed for?
High cholesterol or high triglyceride.
Arterial blood gases are measured in a laboratory test to determine the extent of compensation by the buffer system. There are major regulatory systems of body pH. Which information best describes the physiologic regulatory system?
Homeostasis - to maintain, the body employs physiological adaptations (ex: maintaining acid balance).
Which is a significant finding that a nurse should monitor when caring for a client who is taking glucocorticoids?
Hyperglycemia, Hypertension, Redistributed fat / cushing syndrome
Which symptoms of circulatory overload should the nurse carefully monitor the client during and after a tap water enema is administered?
Hypertension, edema, tachycardia, pulmonary edema
Which endocrine disorder can lead to hypocalcemia?
Hypothyroidism - absent or low concentrations of PTH.
The nurse is monitoring an IV line for a client who is receiving IV antibiotics. Which of the following is a recommended guideline when caring for the client receiving IV therapy?
IV's are sterile procedures - do not let air into tubing (pulmonary embolism).
The nurse has noted polydipsia on the history of the client for whom the primary care provider has ordered fluid restriction. Which suggestion is best to help the client with compliance?
Ice chips - tell patient, due to restriction and underlying conditions, that is all that can be given. Tell patient to split their fluids and take small amounts throughout the day.
A diabetic client is admitted to a healthcare facility for diarrhea, nausea, vomiting, and altered mental status. The arterial blood gas (ABG) report of the client shows decreased pH and decreased HCO3-. What immediate action should the nurse take?
Immediately notify physician and mention potassium supplementation for IV bicarbonate.
What information would be the most helpful to include about milk and milk products when educating clients about their nutritional needs?
Includes vitamins such as calcium, phosphorus, vitamin A/D, potassium, protein
When documenting the medical history of a young client with a mouth ulcer, the nurse finds that the client is homosexual and is scared of revealing this to his family. Which is the most appropriate nursing intervention when assessing this client?
Inquire about the symptoms of the mouth ulcer.
What is the best explanation of Erikson's theory of psychosocial development during the early adult period?
Intimacy vs isolation
What measure should the nurse employ when caring for a patient with an ileal conduit for urinary diversion following bladder removal?
Keep diversion clean/infection control, do not change daily.
Which are symptoms the nurse should monitor when caring for the client diagnosed with ketoacidosis?
Kussmaul Breathing, frequent urination, excessive thirst, fruity breath from ketones, fatigue/lethargy, belly pain, nausea/vomiting
A nurse is taking care of an 88-year-old client who is obsessed with the proper functioning of the bowels. The client complains of constipation. What is an effect of aging on the digestive system that a nurse needs to know in treating such a client?
Lack of fluids, poor diet, lack of physical activity, use of drugs
What condition would you suspect in a client who has bilirubin present in urine?
Liver dysfunction, hepatitis.
A nonvegetarian client, after a minor heart attack, has decided to turn lacto-ovo-vegetarian by eliminating all meat from his diet. What appropriate instruction should the nurse give such a client?
Make sure patient is getting enough iron/proteins - eat a low fat diet.
Which therapeutic nursing intervention should be considered when feeding a client with a swallowing disorder?
Make sure they don't choke - don't speed them up/no rushing.
Which is an appropriate nursing consideration for the patient with fluid volume excess who has edematous skin?
Movement, elevation, compression, reduce salt intake.
A nurse is preparing to administer Xylocaine to a client. The medication is packaged in an ampule. What should the nurse do with the unused portion of the Xylocaine?
Must be disposed properly - as hazardous waste.
Which is an intermediate-acting insulin?
NPH
A client has been prescribed a medication that also has a sedative effect. What time of the day is best for the client to take the medication?
Night time - before bed
What is a pessary?
Non surgical option for females with stress urinary incontinence - small plastic device inserted into vagina, pressure of device pushes against vaginal wall to support neck of bladder and inhibit urinary leakage.
An 8-year-old child is experiencing pain following tonsillectomy. Which of the following drugs would be an appropriate pain reliever for this client?
Nonsalicylates, tylenol, atasol.
According to Piaget's theory of cognitive development, children from ages 2 to 7 are in the preoperational major level of cognitive development. Which would be an explanation given by the parents to the nurse of children in the preoperational stage?
Not aware of the connection of their actions and things that happen outside of their control. (no understanding of consequences and how things are related/not related)
What are examples of non-sterile body areas?
Outer skin, throat, vagina, sputum
what is the difference between peripheral parenteral nutrition and total parenteral nutrition.
PPN goes into the peripheral vein when oral intake is inadequate, and TPN goes into the blood circulation into the GI tract.
What is amitriptyline (Elavil) prescribed to treat in the diabetic patient?
Painful peripheral neuropathy.
For which clients would a nurse who is an enterostomal therapist be consulted
Patient with ileostomy.
Which is a recommended guideline for the administration of an orally disintegrating tablet?
Place disintegrating tablet on tongue to dissolve instantly to ensure compliance with medication. Instruct client not to chew or break it up - it will interfere with timing of the drug release.
What are the effects of protein-calorie malnutrition (PCM) on a client?
Prolonged hospitalization, longer healing time, lowered resistance to infections.
The nurse is caring for a young client who was in a motor vehicle accident. The client is dying and the family is inconsolable. The nurse understands that the client and the family are not rooted in any organized religion. What is the best kind of spiritual support that the nurse can provide to the client and the family?
Provide emotional support.
Why do adolescents take risks with their health and relationships?
Related to peer pressure, feeling invincible.
What are the consequences of a high-sodium diet?
Risk of hypertension, cardiovascular diseases, and osteoporosis.
At which level would anabolic steroids be placed according to the DEA classification system of Schedule of Controlled Substances?
Schedule 3.
Which is the most likely characteristic of a communal family?
Several people living together, minimized contact with outside community, self sufficient, shares resources, work, and responsibilities.
During an assessment, a 40-year-old client who is a fireman discusses retirement concerns with the nurse and asks for suggestions. The client owns three homes and is single at the present time. Which is the highest priority suggestion for the nurse to give the client?
Social isolation is a concern for retirement - do something to make sure you're not lonely - find ways to connect socially.
What role should the nurse play in a situation when the client has bathroom privileges but requires assistance in going to the bathroom?
Stand-by assistance to get out of bed, into the bathroom, get on and off the toilet, help perform peri care as needed, and help back onto the bed.
Which technique is appropriate for the placement of a urinary catheter prior to surgery into a client
Surgical / sterile asepsis
What is deglutition
Swallowing
Which is a common dietary practice that the nurse needs to consider in the care of a Latino American?
Tend to eat high carbs/fat diets - risk of diabetes, and cardiac problems.
A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development?
The fourth and final stage - age 12 to adulthood. Can think abstract, complex problem solving, understand double meaning/jokes, theories, philosophies, develop conclusions
A client who had a wound on her left thigh developed a scar following healing. When would deep scarring most likely occur in the client?
Third intention healing.
Several factors can initiate the pain response. What is the best response by a student nurse for possible physical causes of pain?
Trauma, surgical incision, tumor growth.
Which test would be ordered for a client with severe GERD to determine the extent of damage caused by the disorder?
Upper endoscopy.
How does urine's specific gravity related to overhydrating?
Urine specific gravity is to show concentration of urine - the lower the number, the more of an indication of hydration/overhydration.
What are the principal causes of edema?
Venous obstruction, arteriolar dilation, increased vascular volume
What causes pernicious anemia?
Vitamin b12 deficiency.
fat soluble vitamins
Vitamins A, D, E, K
Which information should be included in client teaching regarding preventive foot care measures?
Wash feet daily, no soaking, dry thoroughly (esp between toes), manage gently with lotion, cut nails with healthcare provider permission. NEVER pick at sores or rough spots - no walking barefoot, use lamb wool between overlapping toes.
Which are the 5 universal characteristics of families?
a small social system, perform certain basic functions, has structure, has its own cultural values and rules, moves through stages in its life cycle
Many challenges face the older adult client. A client tells the nurse of concerns about finances since retirement. The client shares difficulties that are being experienced because of limited financial resources. Based on these data and the challenges for older people, what data would be most accurate for incorporation of a discussion about finances for the client?
adjusting to new lifestyle of a fixed income
How can you best describe the occurrence of Type 1 Diabetes?
autoimmune - destruction of B cells
For which clients is digital removal of feces contraindicated?
cardiac conditions, pregnant women, prostate surgery, abdominal repair, reconstructive surgery, bleeding tendencies
Age is more than an accumulation of years. The aging process affects people in different ways. To fully adapt to aging and thrive in this new stage, older adults must confront many lifestyle changes. A student nurse has been asked to prepare a post clinical report on lifestyle changes in the older and aging population. What lifestyle changes should the student nurse incorporate into the report?
changes in body function/abilities, adapt to new eating habits - increased income is the only thing not to include
function of the hypothalamus in the endocrine system?
controls hunger, body temp, thirst, fatigue, circadian rhythm
What foods will most likely be avoided by the client who states they are lactose intolerant?
dairy foods.
The nurse is caring for an aged client who is dying. The client has not accepted death and is acting out in interactions with the nurse. What phase of grieving is the client in?
denial and anger stage.
Which hormones are released by the adrenal medulla that mimics the action of the sympathetic nervous system?
epinephrine and norepinephrine
What type of asepsis should the nurse practice when administering medications through a GI tube to a client?
medical asepsis.
Which pain medication classification would be appropriate for the nurse to administer to the client with moderate to severe pain?
narcotic analgesic
The client has been admitted to the emergency room in respiratory distress. The blood gases reveal that there is poor movement of gas across the alveolar-capillary membrane. Based on this information, the clinical signs and symptoms are most likely a result of which issue?
osmosis
What is the best description of chronic pain based on the categories identified by The International Association for the Study of Pain (IASP)?
pain that continues for 6 months or more, persistent, intermittent or limited
Which individual exerts the most lasting influence on the ongoing development of the adolescent?
peer group
Which is the correct sequence for bladder training with closed urinary drainage?
place patient in supine position. clamp catheter, slowly unclamp for draining. do not forget to wear gloves - record tolerance.
complete proteins are what
proteins high quality proteins that provide all essential amino acids
incomplete proteins are what
proteins that lack one or more of the essential amino acids.
Which is a major electrolyte in ECF that influences the distribution of water and maintains acid-base balance and nerve function?
sodium
A young male client is diagnosed with terminal cancer. The client is violent when the nurse approaches and is experiencing anger and rage as a result of the impending death. Based on the data collected, how does the nurse best explain the client's reaction?
stages of grief.
Diffusion, osmosis, active transport, endocytosis, exocytosis is what
the types of movements across cellular membrane
