Med surg

Decrease plasma testosterone levels 67. Agerelated in male - Andropause - decease of testosterone - Management is testosterone replacement theory

. Which of the following are age - related changes affecting the male reproductive system?

ADEK is not absorbed -> k is needed for clotting factors production -> bleeding. Absence of bilirubin causes gray colored stool. May lead to obstructive jaundice kasi bumalik bilirubin sa small intestine leading to jaundiced skin

8. Fats not emulsified leading to steatorrhea.

85. Milk of magnesia - cause of impaired kidney, cannot be excreted.

85. The client with chronic renal failure told the nurse , he takes milk of magnesia at home for constipation. The nurse suggests that the client switch to psyllium hydrophilic muciloid because:

T1, N1, and M0

A 42 year old female patient with breast cancer has tumor that is minimal in size and extension , has minimal regional lymph nodes involved, and has no distant metastasis. Using the TNM system the tumor is staged as:

The reduction of clotting factors synthesized in the liver

A 42- year old male patient recently diagnosed with liver cancer requires close monitoring for bleeding abnormalities due to:

can lead to orthostatic hypotension or vital signs fluctuation

A client Parkinson's disease has been prescribed with levodopa. The nurse should know that this drug?

Restores the balance of energy (asian) Acupuncture closes gate of pain impulse - medical (gate control theory)

A client from China tells the nurse, "If I could be among my people, I could receive acupuncture for this pain" The nurse should understand that acupuncture in the Asian culture is based on theory that it:

Orthostatic hypotension

A client is being switched from levodopa to carbidopa - levodopa (Sinemet). The nurse should monitor the client for which of the following possible adverse reactions that can occur during the period of medication change and dosage adjustment?

Administration of erythropoietin

A client is currently receiving chemotherapy treatments. Which of the following adjunct interventions would be useful in decreasing the risk of thrombocytopenia?

42. Limbic system - governs emotions. During stroke sa part na yon, laughing or crying episode. Divert client's attention

A client is experiencing mood swings after CVA and often has episodes of tearfulness that are distressing to the family. Which is the best technique for the nurse to instruct the family members to try when the client experiences a crying episode?

Take antacid 1-3 hours after meals (peak of acid production) to neutralize acid production.

A client is taking an antacid for treatment of peptic ulcer disease . Which of the following statements best indicates that the client understands how to correctly take the antacid?

Chills 72. During cystoscope, a device is inserted in a urinary bladder. Urinary bladder is a sterile organ. This may lead to infection if it pushes bacteria

A client is to have a cystoscopy to rule out cancer of the bladder . Which of the following symptoms would indicate that the client has developed a complication after cystoscopy?

10. Cholecystectomy - may inexplore sa common bile duct and removed stones. Namaga common bile duct, di makapsok bile, so nilagyan ng t tube. Bile is drained out of the body. Konti na lang pupunta sa small intestine.

A client undergoes a traditional cholecystectomy and choledochotomy and returns from surgery with a T- tube . To evaluate the effectiveness of the T-tube , the nurse should understand that the primary reason for the T-tube is to accomplish which of the following goals?

73. Removal of urinary bladder - reservoir of urine. Ileum (from the abdomen) is anastomosed from the ureters.

A client who has been diagnosed with bladder cancer is scheduled for an ileal conduit. Preoperatively , the nurse reinforces the cleint's understanding of the surgical procedure by explaining that an ileal conduit:

Sunken eyeballs

A client with Crohn's disease experiences rectal bleeding along with 15 - 20 watery stools per day. Which of the following signs would be indicative of dehydration?

31. Cushing - high sugar, salt, and sex hormones RESTRICT SODIUM

A client with Cushing's disease needs to modify dietary intake to control symptoms. In addition to increasing protein, which strategy would be most appropriate?

26. Poor wound healing due to decreased circulation from blood thickening. Corn should be managed by a doctor or podiatrist

A client with Diabetes Mellitus asks the nurse to recommend something to remove corns from his toes. The nurse should advise him to:

19. Sengstaken Blake more tube compresses esophageal varices. Kinukuha rin blood and food by lavage.

A client with cirrhosis vomits bright red blood and the physician decides to insert a Sengstaken - Blakemore tube. The nurse should explain to the client that the tube acts by:

Increased bowel movements 21. Lactulose - increase peristaltic movement to remove ammonia in the GI.

A client's serum ammonia level is elevated and the physician orders 30 ml. of lactulose. Which of the following side- effects of this drug would the nurse expect to see?

dissecting aneurysm

A condition in which the inner layers of an artery, such as the aorta, become separated, allowing blood (at high pressures) to flow between the layers.

29. Nurse should instruct client to increase frequency of self monitoring

A female client with type 1 DM is experiencing minor illness with the flu. The nurse should instruct the client:

30. Chills increase ICP because muscles contract (shivering)

A female patient is treated for increased ICP . It is important for the patient to avoid hypothermia due to which of the following?

Agranulocytosis

A life-threatening drop in white blood cells. This condition is sometimes produced by the atypical antipsychotic drug clozapine or PTU (anti thyroid)

40. Reduce HTN and high blood cholesterol levels

A male patient with CVA is prescribed medication to treat the disorder. The patient wants to know what other measures may help reduce CVA. Which of the following is an accurate suggestion for the patient?

56. Obtain client's consent when testing for HIV. Even if rapid kit pa yan. Nice if may pre and post counseling

A patient comes in to get an ELISA test done because her physician suspects AIDS. Which of the following nursing actions is essential before an ELISA test is performed?

68. TURP - inserted in urethra. Prostate gland occur -> namaga -> stricture

A patient is to undergo a TURP for BPH. Which of the following is accurate with regard to a TURP?

) " The 81 mg of aspirin daily will help protect you from a stroke or a heart attack"

A patient refuses to take 81 mg of aspirin ordered by the physician and states , " I do not have any pain." What statement by the nurse would be most helpful?

24. Melatonin - decreases as we age. (Pineal gland)

A patient visits the clinic to seek treatment for disturbed sleep cycles and depressed mood. Which glands and hormones help in regulating sleep cycles and mood?

Low blood glucose levels

A patient with DM is prescribed to switch from animal to synthesized human insulin. Which of the following factors should the nurse monitor when caring for the patient?

45. ROM and then balik sa neutral position to prevent DIC in disuse syndrome

A patient with neurologic disorder is at risk for disuse syndrome due to musculoskeletal inactivity and neuromuscular impairment. Which of the following nursing interventions facilitates the functional use of the limbs?

39. Help patient with dysphasia sit upright when eating and feed slowly

A patient with neurological disorder has difficulty swallowing. The nurse should take special care of the patient's diet because of potential risk of imbalanced nutrition in the patient. Which of the following measures may be taken by the nurse to ensure that the patient's diet allows for easy swallowing?

31. SIADH - water retention - cerebral edema

A patient with neurological infection develops cerebral edema from SIADH . Which of the following is an important nursing action for this patient?

Bleeding

A patient with thrombocyte count of 60,000/ul would be at risk for which of the following conditions?

84. Amphogel- binds phosphate on the intestine. (For renal failure)

Aluminum hydroxide(Amphojel) is prescribed for the client with chronic renal failure (CRF) to take at home. What is the purpose of giving this drug to a client with CRF?

36. EEG - measures electrical activity of brain. Avoid sedatives and stimulants.

An electroencephalogram (EEG) is ordered for the client. Which nursing intervention does the nurse take when the client is served a breakfast consisting of a soft - boiled egg, toast with butter , orange juice and coffee on the morning of the EEG?

Increased sex hormone

An obese woman is at greater risk of developing breast cancer because of the resulting :

42. Cerebral aneurysm - hemorrhagic (rupture of BV) - Aneurysm - can rupture and may lead to hemorrhagic stroke. First 2 weeks is crucial Baja magrupture ulit

Aneurysm rebleeding occurs most frequently during which timeframe after the initial hemorrhage?

TRUE

Another indication for Bilroth 1 and 2, is chronic irritation , which may lead to malignancy, then gastric carcinoma. If may tumor or cancer na yung area, it should be removed (antrectomy). When the antrum is removed, anastomose it .

350 cell/mm3

Antiretroviral medications should be offered to individuals with T- cell counts of less than:

Sedatives

Benzodiazepines, barbiturates

Arteriovenous malformation, trauma, intracerebral aneurysm rupture

Causes hemorrhagic stroke

34. Watch client for first 24 hours after intracranial surgery

Cerebral edema peaks at which timeframe post intracranial surgery?

6. DURING ANTICANCER TRATMENT, THERE IS LYSIS OR DESTRUCTION OF CELLS. This liberates potassium and uric acid. The more maraming uric acid sa blood, masnahihirapan Ang kidney sa excretion

Chemotherapeutic agents have which effect associated with the renal system?

Spinal route, lower dose

Chronic pain

Thromboplastin is released from the injured vessel wall

Coagulation activated by the extrinsic pathway is initiated when:

Shifting of plasma into the interstitial apartment

Dehydration occurs during the first 48 hours of burns. Which of the following is the primary cause of dehydration?

25. SIADH - dilutional hyponatremia (madami tubing sa blood, low sodium)

Dilutional hyponatremia occurs in which disorder?

Widespread coagulation and bleeding in the vascular compartment

Disseminated intravascular coagulation (DIC) is characterized by:

antacid will decrease effect of other medications.

Do not mix antacid with other drugs because

Take it an hour before or an hour after any medication.

Do not take antacid with any other medication.

81. During peritoneal dialysis, lag wala na naddrain, change position of client side to side.

During dialysis, the nurse observes that the flow of dialysate stops before all the solution has drained out. The nurse should :

Give food that is difficult to digest. (High protein, moderate fats). Do not give simple sugar or simple carbohydrates.

Explosive diarrhea therapeutic

postdrome phase of migraine

Feeling drained, washed out 24-48 hours

3 months

Following a BMT the patient should be monitored for at least:

9. Increased restlessness - earliest manifestation of approaching death because the brain is suffering from decreased oxygenation

For individuals known to be dying by virtue of age and /or diagnoses which of the following signs indicate approaching death?

Using a picture board

For the client who is experiencing expressive aphasia, which nursing intervention is most helpful in promoting communication?

Allogenic

From relatives

Completed stroke

Full force na complication

warm bath or shower in the morning

Management for early morning stiffness

to manage diarrhea and dehydration, answer inflammatory process by giving anti inflammatory in the form of steroids.

Management in IBD, ulcerative colitis, and Crohn's disease is

Eases muscle spasms 58. Massage constricts BV, muscle relaxation

Massage promotes increased circulation and softening of connective tissues. It also has which of the following effects?

Alpha-glucosidase inhibitors

Inhibit absorption of glucose in small intestine

Biguanides (Metformin)

Inhibit glucose production in liver

30 mins.

Initial dialysis should be done for

brain herniation, which happens because of further increase in ICP, BRAIN RISSUE IS PUSHED DOWNWARD TO THE SPINAL CORD downward or caudaly

Late compensation of increased ICP

deformed form of hands, limited motion of joint, and crippling deformity

Late manifestation of rheumatoid arthritis

Akinesia, bradykinesia, and rigidity

Late sign of Parkinson's disease

barium enema

Lower GI series or

increase fluid intake

If Intravenous pyelogram -

Gray

If a gallstone becomes lodged in the common bile duct , the nurse should anticipate that the client's stools would most likely become what color?

44. Allow drainage to flow freely onto the gauze

In case of CSF drainage, which of the following instructions should the nurse give a patient with a skull fracture?

91. In case of fire, priority action of nurse is to rescue client, activate alarm, confine fire, and extinguish the fire

In case of fire, what is the priority action by the nurse?

* door to balloon. Best time to start inflationg the ballon pagdating na pagdating sa ER and Kalam nadiagnose na Ang client. - 60 mins

In order to be effective , percutaneous transluminal coronary angioplasty(PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction?

10. Adjunctive therapy - imagery and progressive relaxation

In spite of administering the prescribed pain medication, a dying patient is still in pain due to fear and anxiety. Which of the following nursing interventions should a nurse use to potentiate the effects of pain medication?

It allows for DNA - damaged cells to survive

In what manner does dysfunctional apoptosis contribute to the development of cancer?

auto regulation

Increased ICP earliest compensation

Suprapubic pain, dysuria, and urinary retention

UTI Symptoms

1. Basic problem in heart failure is there is decrease force in cardiac contractility, altering oxygenation and tissue perfusion.

When assessing a client with heart failure, which of the following findings do he nurse report to the physician?

58. HIV testing will detect antibodies lang against AIDS. AFTER 3-6 months after exposure because of the window period

When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean that?

The establishment of a dedicated vascular system

When cancer cells metastasize, whether a tumor develops depends on

Visual acuity, age, reading ability, and level of understanding

When choosing an appropriate pain scale to use for your patient , consider his

60. During mix of fetal blood, there is transfer na of virus

When do most perinatal HIV infections occur?

Round the clock

When pain is expected to occur for more than 12 out of 24 hours , which type of dose schedule is indicated?

67. Two point gait pattern - left crutch, right foot together or simultaneous.

When preparing the teaching plan for a client about crutch walking using a two - pint gait pattern, which of the following would the nurse include?

Pancreatitis - their release of trypsin. Trypsin eats its own pancreas (auto digestion). Immediately after injury, decrease enzyme production. NPO and lavage patient

When providing care for a client with acute pancreatitis, the nurse would anticipate which of the following orders?

Hypersensitivity/ autoimmunity

When the body produces antibodies against its own tissue , it is:

9. Decreased clotting production -> bleeding

When the client's common bile duct is obstructed , the nurse should evaluate the client for signs of which of the following complications?

48. Keep suction machine available at bedside

When the nurse performs oral hygiene for an unconscious client, which nursing intervention is the priority?

Encourage the client to speak slowly, speak distinctly, and repeat indistinguishable words Do not ask client to speak louder when tired because this may lead to respiratory exhaustion

When the nurse talks with a client with MS who has slurred speech, which nursing intervention is contraindicated ?

The establishment of a dedicated vascular system

When treating breast cancer , identification of the sentinel node is important because;

This facilitates lymphatic mapping

When treating breast cancer , identification of the sentinel node is important because;

92. Mechanical degradement - 1% or less burn (palm lang) Surgical debridement - OR techniques, anaesthetucs - 1% or more burn WET TO DRY para maabsoeb - an aesthetic - remove

Mechanical debridement of burns is done by which of the following methods?

51. Give a constrictor medication. * TRIPTANS - sumatriptan (Imetrex)

Medication for migraine headaches

The development of a secondary tumor

Metastasis is defined as:

Aura Prodromal Pain Recovery

Migraine headache phases

Cocaine

Which abnormalities commonly causes ischemic stroke?

drowsiness

Which clinical manifestation does the nurse expect in the client in the post - ictal phase of grandmal seizure?

CK - MB goes back to normal after 3 days

Which diagnostic of myocardial infarction remains elevated for as long as 3 days?

Troponin 2-3 weeks

Which diagnostic of myocardial infarction remains elevated for as long as 3 weeks?

17. Purpose is to regenerate liver cells in the early inflammation stage by giving high carb, high cal. At the later stage, when ammonia is high, decrease protein intake.

Which diet should be implemented to a client who is in the early stages of cirrhosis?

Ulcerative colitis is under chronic inflammatory bowel disorder. If there is inflammation of bowel, you cannot reabsorb water back to circulation. Water nasa stool pa din (diarrhea).

Which goal for the client's care should take priority during the first day of hospitalization for an exacerbation of ulcerative colitis?

44. Parkinson's is a degenerative, progressive. There is no cure. Maximize remaining function of client.

Which goal is the most realistic and appropriate for a client diagnosed with Parkinson's disease?

26. Anti hyperthyroidism medication - methimazole and PTU (non teratogenic)

Which medication is the treatment of choice for pregnant women diagnosed with hyperthyroidism?

66. Exceeding prescribed exercise program

Which of the following activities would the nurse instruct the client with low back pain to avoid?

Ketones

Which of the following are byproducts of fat breakdown, which accumulate in the blood and urine?

Sulfonylureas

Which of the following categories of oral antidiabetic agents exert their primary action by directly stimulating the pancreas to secrete insulin?

- cell cycle specific - s (duplication of chromosome) or m phase (separation of cancer cells)

Which of the following classes of antineoplastic agents is cell- cycle specific?

50. Electrical burns - cardiac dysrhythmias

Which of the following complications is common for victims of electrical burns?

Transient Ischemic Attack (TIA) 24 hours or less - Transient ischemic attack

Which of the following conditions occurs when there is bleeding between tha dura mater and arachnoid membrane?

12. If the patient is experiencing chest pain, ask for them to describe it

Which of the following data is necessary to collect if the patient is experiencing chest pain?

Cushing's disease 22. High sugar, salt, and sex hormones (glucocorticoids, mineralocorticoids, and adrenocorticoids)

Which of the following disorders is characterized by a group of symptoms produced by an excess of free circulating cortisol from adrenal cortex?

If there is excess in secretion of somatotropin or growth hormone before closure of epiphyseal plate - GIANTISM. after closure or in adult na - ACROMEGALY

Which of the following disorders results from excessive secretion of somatotropin?

4. Following bone marrow transplant, the bone marrow from client give to the blood vessel of recipient -> medullary cavity or long bone (migration), until it will produce its own WBC, platelet, and RBC. This is possible for around 3 months. Monitor patient for 3 months.

Which of the following does a nurse thoroughly evaluate before a bone marrow transplant(BMT) procedure?

30. Addison's disease - decreased sugar, salt, and sex hormones

Which of the following findings would be typical of Addison's disease?

52. After skin grafting, there is posisibility of skin adhesion. It has to be wrapped. Very important is pressure garment

Which of the following instructions should a nurse provide a patient with burns who has undergone a skin grafting?

96. Indomethacin - nsaids - risk for bleeding

Which of the following is a contraindication to Indocin ( indomethacin) Therapy.

46. Degeneration of motor tracts kasi wala ng information narerecive Ang muscle - ALS

Which of the following is a degenerative neurologic dosorder?

cryptorchidism

Which of the following is a failure of one or both of the testes to descend into the scrotum?

51. Burn Rule of 9s 11 X 9 = 99% 1% genitalia Chest -9% Pal,pm 1%

Which of the following is a quick assessment technique to assess the percentage of burn injury?

11. Sign of approaching death - change in vital signs - irregular breathing patterns

Which of the following is a sign of approaching death?

5. Type of procedure that uses liquid nitrogen to freeze tissue that causes cell destruction. CRYOSURGERY

Which of the following is a type of procedure that uses liquid nitrogen to freeze tissue that causes cell destruction?

Greater ROM Increases endorphin release Joint inflexibility

Which of the following is a usual effect of exercise?

Benign prostatic hypertrophy High blood sugar Hypertension

Which of the following is an indication of cardura (Doxazosin)?

Tremors

Which of the following is an initial sign of Parkinson's disease?

Peyronie's disease

Which of the following is associated with build up of fibrous plaques in the sheath of the corpus cavernosum causing curvature of the penis when it is erect?

35. After head injury, posterior pituitary gland may not function. May decrease or not produce ADH -> Diabetes inspidus

Which of the following is most effective in assessing the client with a head injury for the development of diabetes insipidus?

98. Rifabutin (mycobutin) - prevention of aids opportunistic infection

Which of the following is the drug of choice as prophylaxis for disseminated Mycobacterium Avium Complex in persons with advance HIV infection?

18. Intermittent Claudication - pain upon walking because of arterial insufficiency (blood supply sa lower extremities, decreasing oxygenation, leading to anaerobic metabolism leading to lactic acid production)

Which of the following is the most important postoperative assessment parameter for patients undergoing cardiac surgery?

Humalog

Which of the following is the most rapid acting insulin?

The individual will have decreased numbers of CD4 cells or helper T cells

Which of the following is true when describing a patient with AIDS?

61. CD4 count is the basis king kailangan na ni patient ng antiretroviral therapy

Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy?

28. Adrenalactomy - possible side effect hypoglycemia, hypotension

Which of the following may occur in the postoperative period of an adrenalectomy because of sudden withdraw of excessive amounts of cathecolamines?

48. Never use anticoagulants because of possible cerebral bleeding

Which of the following medication classifications should be avoided in the treatment of brain tumors?

Protamine sulfate

Which of the following medications is an antidote to heparin (parenteral)?

Clopidogrel TICLOPIDINE (TICLIN) Given to patient with angina and allergic to aspirin. According to AHA, give baby aspirin or 81-82 mg. This is to prevent aggregation of platelet

Which of the following medications is given to patients diagnosed with angina and is allergic to aspirin?

49. Parkinson's - levodopa (centrally acting) Carbidopa (peripherally acting)

Which of the following medications is the most effective agent in the treatment of Parkinson's disease?

Psyllium hydrophilic mucoloid

Which of the following medications would the nurse anticipate administering to a client with diverticular disease?

57. CMV may lead to blindness

Which of the following microorganisms is known to cause retinitis in people with AIDS?

82. During dialysis, blood goes to dialysate machine -> monitor BP

Which of the following nursing interventions should be included in the client's care plan during dialysis therapy?

32. Semi Fowler - promote venous drainage

Which of the following positions should be utilized after intracranial surgery?

) CA 125

Which of the following serum markers have proven to be beneficial in identifying ovarian cancer?

Take prescribed antibiotics

Which of the following should be included as part of the home care instructions for a patient with epididymitis and orchitis?

) Do not mix with other insulins

Which of the following should be included in the teaching plan for a patient receiving glargine(Lantus), "peakless" basal insulin?

75. To control odor in the urine collecting bag, use a weak vinegar

Which of the following solutions will be useful to help control odor in the urine collecting bag after it has been cleaned?

It allows lower doses than other administration routes

Which of the following statements about intrathecal drug delivery of pain medication is true?

16. Goal of rehabilitation for patient with MI is to maximize remaining function and improve quality of life or patient

Which of the following statements reflect a goal of rehabilitation for the patient with an MI?

38. Teach patient how to say the words. Speak slowly and clearly to assist patient in formation of sounds for expressive aphasia

Which of the following statements reflect nursing management of the patient with expressive aphasia?

59. KY jelly, water soluble para Hindi puputok Ang condom

Which of the following substances may be used to lubricate a condom?

Painless hematuria 71. Bladder cancer - painless hematuria. Can be microscopic or gross

Which of the following symptoms is the most common clinical finding associated with bladder cancer?

Orchiectomy

Which of the following terms refers to the surgical removal of one of the testes?

Elevated blood glucose levels contribute to complications of diabetes, such as diminished vision

Which of the following would be included in the teaching plan for a patient diagnosed with DM?

Competency in injecting insulin

Which of the following would be inconsistent as a cause of DKA?

Aura

Which phase of a migraine headache usually lasts less than an hour?

Maximum recommended daily dose is 4000 mg.

Which statement about acetaminophen is true?

Lowers opioid doses

Which statement about epidural analgesia is true?

Involves use of hands ro eliminate painful forces from the patient's nerdy field - adjunctive therapy for pain. Passing of hands over affected area to reduce pain or anxiety of patient

Which statement best describes therapeutic touch?

Herniation

Which term refers to the shifting of brain tissue from an area of high pressure to an area of low pressure?

Palliative

Which type of surgery is utilized in an attempt to relieve complications of cancer?

Autologous

Which type of vaccine uses the patient's own cancer cells, which are prepared for injection , back into the patient?

Inner - sustains most damage

Which zone of burn injury sustains the most damage?

Huntington's

basal ganglia and cerebral cortex nagdegenerate -> leads to cognitive and behavioral problem

Glioma

bone tumor involving glial cells.

Psyllium hydrophilic mucilloid (Metamucil)

bulk forming laxative

Bilroth 2 (gastrojejunostomy)

anasatomised to the jejunum

TRUE

antacid is given as a maintenance dose not only during stomach pains

- early manifestation: morning stiffness

On a visit to the clinic , a client reports the onset of early symptom of rheumatoid arthritis?

Pain rating scale place a line - Visual Analog Scale

On which pain rating scale does the patient place a line to indicate his current pain level?

14. Pancreatic enzyme should be given with meals to ensure digestion of food and nutrients.

Pancreatic enzyme replacements are ordered for the client with chronic pancreatitis. When should the nurse instruct the client to take them to obtain the most therapeutic effect?

- Dura - Arachnoid - Pia - Epidural space - Subdural - Subarachnoid (intrathecal)

Parts of the spinal cord

Cretinism

condition of congenital hypothyroidism in children that results in a lack of mental development and dwarfed physical stature; the thyroid gland is either congenitally absent or imperfectly developed DECREASED T3 and T4

Thizolidinediones

Rosiglitazone (avandia) - increase insulin receptor insensitivity

Suggest using alternative forms of sexual expression and intimacy

Sexual problems can be troublesome to clients with CRF. Which one of the following strategies would be most useful in helping a client cope with such a problem?

True

Subarachnoid bleeding or hemorrhage - MOT HEMATOMA kasi may CSF... still becomes liquid. Nagcclot lang sa subdueral and epidural

Prodromal Migraine Phase

Subtle changes that warn an upcoming migraine, including constipation, mood changes, food cravings, neck stiffness, increased thirst and urination or frequent yawning Few months to days

79. In clients with renal failure, Nausea is the result of high BUN (end product of protein metabolism). The urea can travel to the mouth, bacteria acts on it, ammonia -> vomiting

The client with chronic renal failure complains of feeling nauseated at least part of everyday. The nurse should explain that the nausea is the result of:

94. Take antibiotics with a glass of water to prevent renal calculi or crystallization

The client with respiratory tract infection will take erythromycin. Which of the following health teaching should the nurse provide to the client?

27. NPH - intermediate

The client with type 1 DM is taught to take isophane insulin NPH (Humulin N) at 5pm each day. The client should be instructed that the greatest risk for hypoglycemia will occur at what time?

Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting

The mother of a newborn infant questions why her baby needs a vitamin K injection immediately after birth. The nurse explains that vitamin K is needed because;

25. Ask patient to speak in an hourly basis, laryngeal nerve damage

The nurse asks the client to state her name as soon as she regains consciousness postoperatively after a subtotal thyroidectomy and at each assessment . The nurse does this primarily to monitor for signs of which of the following?

43. Halo sign - CSF leak

The nurse assesses the dressing of a patient with a basal skull fracture and notes the halo sign. The nurse knows that this sign is indicative of which of the following conditions?

13. Apex beat - left 5th ics, midclavicular line

The nurse auscultates the apex beat at which of the following anatomical locations?

Relieves muscular spasticity 46. Baclofen - centrally acting muscle relaxant

The nurse determines that Baclofen is accomplishing its intended purposes for a client with MS when it achieves which of the following?

76. 2 hours or more, expired na urine ng client because it became alkaline and nagka bacteria na. DISCARD IT. Obtain a new specimen

The nurse finds a container with the client's urine specimen sitting on a corner in the bathroom. The client states that the specimen has been sitting in the bathroom for at least 2 hours. What would be the nurse's most appropriate action?

86. Lower down protein (BUN) Lower down potassium (at risk for cardiac arrest) Low sodium (edema)

The nurse helps the client with CRF develop a home diet plan with the goal of helping the client maintain adequate nutritional intake. Which of the following diets would be most appropriate for a client with CRF ?

Rapid removal of solutes may lead to disequilibrium syndrome. Leads to increased ICP due to pulling of fluid from blood going to the brain. Complication of HEMODIALYSIS

The nurse initiates the client's first hemodialysis treatment. The client develops a headache, confusion and nausea. These symptoms indicate which of the following potential complications?

16. During early stage of cirrhosis, there is inflammation. The manifestation is still vague or non specific. Loss of appetite, fever, chilling. inflammatory condition, walang gana kumain.

The nurse is assessing a client who is in the early stage of cirrhosis of the liver . Which of the following signs would the nurse anticipate finding?

53. Dressing is changed once daily,

The nurse is caring for a patient with a burn injury. How often should the nurse change the dressing?

78. Clean catch urine - midstream. Client must clean labia, void into toilet, and urinate in specimen cup

The nurse is instructing the student nurse on the correct technique for obtaining a clean - catch urine culture from a client. Which of the following statements indicates that the student nurse has understood the instructions?

Liver cirrhosis is progressive and irreversible. Rest and diet are supportive therapy.

The nurse is providing discharge instructions for the client with cirrhosis. Which of the following statements best indicates that the client has understood the teaching?

Return of swallowing reflex is subjective. Liquid diet may lead to imbalance nutrition

The nurse is teaching the family of the client with dysphagia about decreasing the risk of aspiration while eating. Which of the following strategies is inappropriate?

In acute pancreatitis (bangngot) , there is now necrotic tissue after auto digestion. Which attracts calcium from the blood. Pagnakuha na calcium, nagkahypocalcemia na is client. Nagkaroon ng tetanic respiratory contraction

The nurse notes that a client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse interpret the significance of these symptoms?

49. So it won't dry, completely close it then put eye patch

The nurse observes the client's right eye does not close totally. Based on this finding, which nursing intervention is most appropriate?

. Protect eyes with dark colored eye glasses

The nurse should teach the client to prevent corneal irritation from mild exopthalmos by:

15. Ineffective digestion - steatorrhea

The nurse should teach the client with chronic pancreatitis to monitor the effectiveness of pancreatic enzyme replacement therapy by doing which of the following?

20. In hepatic encephalopathy, the liver fails to convert ammonia to urea, we want to decreases formation of ammonia by blocking the bacteria in the intestine by giving neomycin. And lactulose to decrease excretion of ammonia to GIT.

The physician orders oral neomycin and neomycin enema for the client with cirrhosis. The nurse understands that the purpose of this therapy is to:

excessive norepinephrine and epinephrine. Client is With palpitation + headache + HTN

The typical triad of manifestations seen in a patient diagnosed with pheochromocytoma includes all of the following except:

TRUE

There is possibility of bleeding, which may lead to perforation. When there is perforation, pyloric antrum should be removed and the remaining stomach will be anastomosed to the small instestine.

Vasodilation

Thermotherapy in pain management causes which of the following effects?

Thrombolytic therapy dissolves clot - initiate within 3 hours because we want to see if hemorrhagic or clot. Do not give if hemorrhagic

Thrombolytic therapy should be initiated within what time frame of an ischemic stroke for best functional outcome?

Amicar

Thrombolytic toxicity antidote:

69. Pull out cast padding What you can do: - elevate cast above heart initially Exercise joints above and below cast Apply ice for 10 minutes to control edema for the first 24 hours

Regardless of the type of cast material used, the nurse identifies a knowledge deficit when the client makes which of the following statements about the care of his cast?

Pheocychromotoma

excessive norepinephrine and epinephrine. Client is With palpitation + headache + HTN

Lugol's solution - potassium Iodide and SSKI

given prreoperativeky to decrease vascular it's and zip of gland to prevent bleeding.

Tachy, diarrhea, tremors, weight loss, heat intolerance, diaphoresis, exophthalmos

hyperthyroidism, increased metabolic rate, increased ATP (insomnia):

Akinesia

inability to initiate movement

Osteomyelitis

infection of bone

Diverticulitis

inflammation of the diverticula

Monro-Kellie hypothesis

inside the skull, ICP is maintained at 5-15 mmHg because you have the brain, CSF, and blood

Vinca alkaloids

m phase

Severe + adjunctive therapy-

morphine and meperidine.

Stable

occurs with exercise. Can be managed with rest and nitroglycerin

secular aneurysm

one-sided

Mild narcotic + adjunctive therapy

opioid analgesics- centrally acting - ex. Codeine

Diverticula disease

out pouching's of colonic mucosa through the muscle layers of the colon wall

Diverticula disease

outpouching due to intraluminal pressure in the sigmoid colon (LLQ pain)

Stroke in evolution

padagdag nang padagdag Ang symptoms ng client

migraine headache

paroxysmal (sudden, periodic) attacks of mostly unilateral headache, often accompanied by disordered vision, nausea, or vomiting, lasting hours or days and caused by dilation of arteries (4-72 hours);

Aura of migraine

phase of cortical dysfunction preceded by a wave of spreading vasoconstriction -> visual bright lights most common -> may also have hemiparesis, numbness, confusion, dysphasia -> lasts 10-30 minutes followed by throbbing headache

Retrovir (zidovudine) - anti HIV -

prevents hiv replication

Paget's

problem in bone

Vertebral column

protects the spinal cord

Bilroth 1 (gastroduodenostomy)

remaining stomach is anastasmosed to the duodenum

hydrocele

sac of clear fluid in the scrotum

bradykinesia

slow movement

phimosis

stenosis or narrowing of foreskin so that it cannot be retracted over the glans penis

hydrocelectomy HAI-droh-seel-EK-toh-mee

surgical removal of a hydrocele

pyloric antrum

The most common site of ulceration is at the.

Hyperoxygenate before and after suctioning

What is the priority nursing intervention when suctioning an unconscious client to maintain cerebral perfusion?

Ticlopidine

What medication is used to prevent platelet aggregation?

Oral to decrease discomfort

What's the preferred administration route for pain medication?

* Unstable - occurs even at rest

When a patient diagnosed with angina pectoris complains that he is experiencing chest pain more frequently even at rest, the period of pain is longer, and it takes less stress for the pain to occur, the nurse recognizes that the patient is describing which type of angina?

32. Multiple injuries - highest priority is to establish an airway

When an unconscious client with multiple injuries arrives in the emergency room, which of the following nursing interventions receives the highest priority?

varicocele

enlarged veins of the spermatic cord

TRIPTANS - sumatriptan (Imetrex)

* Primary effect constricts blood vessels, which may constrict the coronary artery -> ischemia -> chest pain

Establish an airway

- May be cervical spinal cord injury - May be pneumothorax - May there be positive pressure in the pleural cavity and di na managing a client

- mild

- NSAIDs + adjunctive therapy (relaxation, aromatherapy, acupuncture, etc)- locally acting - mere amid acid, paracetamol, acetaminophen...GI IRRITANTS

Antimetabolites

- S phase - Ex. Methotrexate

Increased ICP earliest compensation

- Vasoconstriction and increased CSF absorption

Thromboangitis obliterans

- buerger's disease or inflammation and subsequent blockage of small and medium sized arteries

It is given the meningeal spaces.

- medication is not injected in the spinal cord.

Crohn's disease

(15-20 watery stools per day)

Ulcerative colitis

(>6 watery stools per day)

DI

(hemoconcentration Pheocychromotoma - excessive norepinephrine and epinephrine. Client is With palpitation + headache + HTN

30 mins

* Door to injection - best time to give theombolytic agent -

like a gauze in antibiotics. Good for 5 days

Acticoat antimicrobial barrier dressings used in the treatment of burn wounds can be left in place for which time frame?

IV route

Acute pain

) Epithelial cells

Adult cancers are different in origin from childhood cancers in that adult cancers originate from:

wala na gall bladder. Para maemulsify yung fats give low fat diet to prevent steatorrhea. Roasted beef

After a cholecystectomy it is recommended that the client follows a low-fat diet at home. Which of the following foods would be most appropriate to include in a low-fat diet?

60. Cold compress for first three days para walang pamamaga

After an injury , cryotherapy helps reduce pain and edema when used for:

74. Pelvic surgery - spinal- after surgery, limited movement of leg which may cause thrombophlebitis

After surgery for an ileal conduit, the nurse should closely evaluate the client for the occurrence of which of the following complications related to pelvic surgery?

When remaining stomach is anastamosed to the small intestine, the food will empty rapidly to the small intestine (there was no time for food to be partially digested and turned to an isotonic product). The food is a hypertonic agent because it is not partially digested, it will pull the fluid of the blood vessel towards the small intestine decreasing the blood volume (vasomotor).

As a result of gastric resection , the client is at risk for development of Dumping syndrome. The nurse would prepare a plan of care for this client based on knowledge that this problem stems primarily from which of the following gastrointestinal changes?

flat encephalogram

CONFIRMATION OF DEATH:

Dwarfism

Decreased secretion of GH in childhood

PPI and h2 antagonist ex. esomeprazole nexium

Decreases acid production:

give a laxative agent after procedure.

Contrast dye is used, which may lead to constpation,

47. Corticosteroids - may reduce cerebral edema. DEXAMETHASONE can cross BBB

Corticosteroids are used in the management of brain tumors to

95. Dalteparin (Fragmin) - low molecular heparin - Subq, lower abdomen

Dalteparin (Fragmin) is best injected in which of the following sites?

DOB

Damage to phrenic nerve/cervical are ->

- Danger: compression of medulla oblong at a and pons -> cardiac problem and respirator problem

Danger of caudaly

respiratory arrest

Hematoma may compress medulla or pons ->

Pull Aim Squeeze Sweep side to side

How to use fire extinguisher

Metabolic acidosis

Hyponatremia occurs in burns because sodium is trapped in the edema fluids. Which of the following acid-base imbalances more likely will occur?

Syngenic

Identical twin

Avoid administering aspirin and nsaids

The father of a 2 - year old boy recently diagnosed with hemophilia A asks about preventing complications for the boy. What education should the nurse provide/

antacid

Neutralizes acid production:

Normal CD4 count - 500-1500 If less than 350, Ang CD4 count, give antiretroviral therapy, kasi it is hepatotoxic. If ok Namin cd4 count, maintain healthy lifestyle lang

Normal CD4 count

5-15 mmHg

Normal ICP:

Vessel spasm Formation of the platelet plug ( Clot retraction Clot dissolution

The first stage of hemostasis is:

Pancreatic cance

Presently there are no diagnostic screening tools available for:

Diverticulitis management

Prevent constipation to decrease intraluminal pressure.

23. PTU is an anti thyroid medication for patients with hyperthyroidism. Give to patient with Graves' disease. Report agranulocytosis, the patient may be at risk for developing infection. Sore throat indicates infection.

Propylthiouracil (PTU) is prescribed for a client with Grave's disease to decrease circulating thyroid hormone. The nurse should teach the client to immediately report which of the following signs and symptoms?

Radiosensitive tumors that are fast growing

Radiation therapy has the greatest impact on:

explosive diarrhea.

Rapid emptying may cause

False

The ELISA is a more sensitive assay than the western blot when assessing for the presence of antibodies to specific viral antigens, such as HIV.

The disease and treatment

The characteristic fatigue of cancer is generally a result of :

The basic problem in migraine headache is that there is dilation of cranial blood vessels. This can increase the intracranial pressure, irritate nerve. Endings, causing headache.

The client asks the nurse why she has migraine headache. What is the nurse's best response?

. Nurse should position client to promote venuous drainage. Semi fowler's (30-45 deg angle)

The client has a sustained ICP of 20 mmHg. The nurse should position the client:

albumin, decreasing colloid osmotic pressure. Fluid away from Bv.

The client has developed ascites. The nurse should recognize that the pathologic basis for the development of ascites in clients with cirrhosis is portal hypertension and:

93. Use sterile gloves para Hindi maabsorb

The client has extensive body burns. Which of the following nursing actions is most appropriate when applying antimicrobials in the area.

99. Avandia - oral hypoglycemic agent - hepatotoxic Check liver enzymes periodically

The client is prescribed to take Avandia (Rosiglitazone). Which of the following patient teachings should be included?

Upper GI series or barium swallow.

The client is scheduled to have an upper GIT series . Which of the following treatments should the nurse anticipate after the examination?

Securing an airway

The client was rescued from a fire in his room. He was observed to have nasal singed hair. Which of the following should be given highest priority when caring for this client?

68. Methocarbamol - Is just like Baclofen - Muscle relaxant

The client with a fractured tibia has been taking methocarbamol. When teaching the client about this drug, which of the following would the nurse include as the drug's primary effect?

70. Client is paralyzed - bone demineralization - calcium goes to blood - hypercalcemia/renal stone

The client with a spinal cord injury asks the nurse why the dietician has recommended that she decrease her total daily intake of calcium. Which of the following responses by the nurse would provide the most accurate information?

28. Hum along - rapid acting. Best time to eat - base sa onset. With 10-15 minutes

The diabetic client who is taking insulin Lispro (Humalog) injections would be advised to eat:

80. Dialysate solution must be warmed to dilate BP to diffuse toxic products to the dialysate solution. This also increases permeability of capillaries

The dialysate solution is warmed before use in peritoneal dialysis primarily to:

Decreasing prothrombin and other procoagulation factors

The drug warfarin exerts its action by :

Vitamin K

Warfarin - oral, ANTIDOTE

starting pain before painful stimulus

What does preemptive analgesia refer to?

33. Basil liar skull fracture due to subarachnoid damage may lead to leaking of CSF ear (Otrorhea ) or nose (rhinorrhea). Collect using a collective pad and give to the lab (+) halo sign, CSF

What is the correct nursing intervention when a client with a head injury begins to have clear drainage from his nose?

83. In peritoneal dialysis, doctor inserts peritoneal catheter just below the umbilicus. - Complication: PERITONITIS

What is the most potentially dangerous complication of peritoneal dialysis?

38. Part of GCS and CN III function, pupil size and pupillary responses

What is the priority nursing assessment in the first 24 hours after admission for the client with thrombotic CVA?

priapism

a painful erection that lasts 4 hours or more but is not accompanied by sexual excitement

fusiform aneurysm

dilation of the entire circumference of the artery

Thrombolytic

dissolves clot - alteplase, urokinase, abokinase, - possible massive bleeding-

Prinzmetal or variant -

vasospasm, walang bara , biglang nagconstrict Ang coronary artery

Bowen disease

very early form of skin cancer, which is easily curable and characterized by a red, scaly patch on the skin; also called squamous cell carcinoma in situ May affect glans penis