Med Surg exam 2-Final Review

Which prescribed medication for the patient recovering from a traumatic amputation does the nurse correlate to the treatment of phantom limb pain? Muscle relaxants Opioids Gabapentin Ibuprofen

Gabapentin

Which exposure by the nurse is most likely to require post-exposure prophylaxis when the patient's human immunodeficiency virus (HIV) status is unknown? Splash into the eyes while emptying a bedpan containing stool Bite to the arm that does not result in open skin Needle stick with a needle and syringe used for a venipuncture Contamination of open skin lesions with patient vaginal secretions

Needle stick with a needle and syringe used for a venipuncture

This is a chronic bone disorder. Normally, there is a process in which your bones break down and then regrow Paget's disease Osteoporosis Gout Rickets

Paget's disease

The nurse monitors for which clinical manifestations of neurovascular compromise in the patient with an injured ankle? Select all that apply. Paralysis Pain Pressure Pulselessness Purulence

Paralysis Pain Pressure Pulselessness

The nurse correlates which clinical manifestations to the diagnosis of rheumatoid arthritis? Tophi Bouchard's nodes Heberden's Nodes Swan-neck deformity

Swan-neck deformity

The nurse is preparing a teaching tool for a community health program. What does the nurse include as a risk factor for the development of carpal tunnel syndrome (CTS)? Work that is repetative Male gender Works as a marketing manager Age younger than 20

Work that is repetative

A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the nurse, "I feel obsessed with morbid thoughts about dying." Which response by the nurse is appropriate? "It is important to focus on the good things about your life now." "Thinking about dying will not improve the course of AIDS." "Do you think that taking an antidepressant might be helpful?" "Can you tell me more about the thoughts that you are having?"

"Can you tell me more about the thoughts that you are having?"

A patient who uses injectable illegal drugs asks the nurse how to prevent acquired immunodeficiency syndrome (AIDS). Which response by the nurse is most accurate? "Ask those who share equipment to be tested for HIV." "Consider participating in a needle-exchange program." "Clean drug injection equipment before each use." "Avoid sexual intercourse when using injectable drugs."

"Consider participating in a needle-exchange program."

The nurse is conducting an in-service on the spread of infection in the hospital environment. Which statement does the nurse include regarding the most common mode of pathogen transmission? "Airborne transmission is the most common mode." "Vector-borne transmission is the most common mode." "Contact transmission is the most common mode." "Vehicle transmission is the most common mode."

"Contact transmission is the most common mode."

Which statement by a patient would alert the nurse to a risk for decreased immune function? "I usually eat eggs or meat for at least two meals a day." "I had a chest x-ray 6 months ago." "I take one baby aspirin every day to prevent stroke." "I had my spleen removed after a car accident."

"I had my spleen removed after a car accident."

The nurse provides education to patient who is diagnosed with an ankle sprain. Which patient statement indicates the need for further l teaching? "I will not need to rest my ankle." "I will apply ice to my ankle for 30 minutes three to four times a day." "I will keep the compression bandage in place to decrease further swelling." "I will elevate my ankle to decrease the dependent swelling that may occur."

"I will not need to rest my ankle."

The nurse is teaching a patient about the different routes of transmission. Which patient statement indicates correct understanding of contact transmission? "It occurs when I get bit by a tick or other insect." "It occurs when I ingest food containing a disease-carrying organism." "It occurs when I come into contact with pathogens in the air." "It occurs when I come in direct contact with a pathogen."

"It occurs when I come in direct contact with a pathogen."

The nurse is teaching a patient about the different routes of transmission. Which patient statement indicates correct understanding of airborne transmission? "It occurs when I come into contact with pathogens by breathing." "It occurs when I come in direct contact with a pathogen." "It occurs when I get bit by a tick or other insect." "It occurs when I ingest food containing a disease-carrying organism."

"It occurs when I come into contact with pathogens by breathing."

The nurse is teaching a patient about the different routes of transmission. Which patient statement indicates correct understanding of vehicle transmission? "It occurs when I ingest food containing a disease-carrying organism." "It occurs when I come into contact with pathogens in the air." "It occurs when I come in direct contact with a pathogen." "It occurs when I get bit by a tick or other insect."

"It occurs when I ingest food containing a disease-carrying organism."

Which statement by the patient with rheumatoid arthritis indicates the need for further teaching? "It is okay to take ibuprofen for the pain." "My immunosuppressive medications need to be increased if I get an infection." "I can use analgesics to help decrease the pain." "I may have to take steroids if I have a rheumatoid arthritis (RA) flare."

"My immunosuppressive medications need to be increased if I get an infection."

A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP) and a CD4+ count of less than 200 cells/mL. Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), which statement by the nurse is correct? The patient meets the criteria for a diagnosis of acute HIV infection." "The patient has developed acquired immunodeficiency syndrome (AIDS)." "The patient will likely develop symptomatic HIV infection within 1 year." "The patient will be diagnosed with asymptomatic chronic HIV infection."

"The patient has developed acquired immunodeficiency syndrome (AIDS)."

The sister of a patient diagnosed with BRCA gene-related breast cancer asks the nurse, "Do you think I should be tested for the gene?" Which response by the nurse is most appropriate? "There are many things to consider before deciding to have genetic testing. I recommend you speak to a genetic counselor before you make a decision on genetic testing." "In most cases, breast cancer is not caused by having the BRCA gene." "First you should decide whether you are willing to have a bilateral mastectomy." "It depends on how you will feel if the test is positive for the BRCA gene."

"There are many things to consider before deciding to have genetic testing. I recommend you speak to a genetic counselor before you make a decision on genetic testing."

A middle-aged female patient has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the patient is visibly surprised and embarrassed by this offer. How should the nurse best respond? "You're being offered this testing because you are actually in the prime demographic for HIV infection." "This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history." "The rationale for this testing is so that you can begin treatment as soon as testing comes back, if it's positive." "Most women with HIV don't know they have the disease. If you have it, it's important we catch it early."

"This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history."

The nurse is advising a patient who was exposed 4 days ago to human immunodeficiency virus (HIV) through unprotected sexual intercourse. The patient's antigen-antibody test has just been reported as negative for HIV. What information should the nurse give to this patient? "We won't know for about 10 years if you have HIV infection." "You do not need to fear infecting others." "You will need to be retested in 2 weeks." "With no symptoms and this negative test, you do not have HIV."

"You will need to be retested in 2 weeks."

Which of the following patients is MOST at risk for osteoporosis -A 40-year-old male of medium build who is physically active and has a job that entails physical labor with no family history of osteoporosis and is a social drinker, and has a slightly low Vitamin D level and had a knee replacement 2 years ago -A 65 year old post-menopausal Asian woman of thin stature who smokes a pack of cigarettes a day, drinks a glass of wine a night, has a diagnosis of hypothyroidism, and whose mother had osteoporosis -A 30 year old female of medium build who denies a history of smoking but is a social drinker, premenopausal, with a grandmother who has a history of osteoporosis and is diagnosed with anxiety and depression -A 23-year-old male athlete of large stature who has had a past history of knee and ankle injury and occasional use of alcohol and marijuana at parties with no significant medical history

-A 65 year old post menopausal Asian woman of thin stature who smokes a pack of cigarettes a day, drinks a glass of wine a night, has a diagnosis of hypothyroidism and whose mother had osteoporosis

The nurse is assisting with the secondary survey of a patient with 50% total body surface area electrical burns. Which test would be a priority for this patient? Computed tomography (CT) scan of the head 12-lead electrocardiogram Chest x-ray Bronchoscopy

12-lead electrocardiogram

The nurse determines which patient is at the highest risk for the development of osteoporosis? 52-year old African American male with a history of inflammatory bowel disease 55-year old Caucasian patient with a BMI of 17 and a history of hyperthyroidism 60-year old Asian male who works as a tailor 48-year old Hispanic female with a body mass index (BMI) of 35 and a history of hyperparathyroidism

55-year old Caucasian patient with a BMI of 17 and history of hyperthyroidism

In the rule of nines for burn injuries the head makes up what percentage of the total body surface area? 4.5% 9% 27% 1%

9%

Which patient would benefit from education about HIV pre exposure prophylaxis (PrEP)? A 33-yr-old hospice worker who received a needle stick injury 3 hours ago. A 60-yr-old male in a monogamous relationship with an HIV-uninfected partner. A 23-yr-old woman living with HIV infection. A 52-yr-old recently single woman just diagnosed with chlamydia

A 52-yr-old recently single woman just diagnosed with chlamydia

A classic symptom of Systemic Lupus Erythematosus (SLE) is A butterfly rash on the cheeks or nose Malaria Blood Clots in bilateral lower extremities Dyspnea and Tachycardia

A butterfly rash on the cheeks or nose

A patient with an exacerbation of Gout on their right great toe comes to the emergency room. Which medication is the most common mediation used to treat Gout that might he be prescribed? Tylenol Uric Acid Allopurinol Loop Diuretics

Allopurinol

In assessing a patient's muscle function, the nurse asks the patient to raise the arm horizontally away from the body. What voluntary movement is the nurse assessing? Adduction Abduction Circumduction Eversion

Abduction

A patient in the health care provider's office for allergen testing using the cutaneous scratch method develops itching and swelling at the skin site and is having difficulty breathing. Which action should the nurse plan to take first? Assess the patient's use of new skin products. Monitor the patient's edema. Administer a dose of epinephrine. Obtain a prescription for oral antihistamines.

Administer a dose of epinephrine.

The nurse is caring for a patient with a history of latex allergies. The patient develops audible wheezing, pruritus, urticaria, and signs of angioedema. Which is the priority intervention for this patient? Notify the healthcare provider Administer prescribed diphenhydramine (Benadryl) by mouth every 4 hours Obtain a complete set of vital signs. Administer prescribed epinephrine 1:1,000 by subcutaneous injection per the healthcare provider's orders.

Administer prescribed epinephrine 1:1,000 by subcutaneous injection per the healthcare provider's orders.

In providing care to a patient admitted with a suspected inhalation injury, what nursing action in the priority? Administering 100% humidified oxygen Administering intravenous lactated Ringer's fluid Turning in bed every 2 hours Monitoring intake and output

Administering 100% humidified oxygen

Some complications of healing are Dehiscence Adhesions All of the above Contractures

All of the above

Some factors that can delay wound healing are None of the above Anemia, obesity, mechanical friction, advanced age All of the above Corticosteroids, diabetes, poor circulation, smoking

All of the above

A patient is anxious and reports difficulty breathing after being stung by a wasp. What is the nurse's priority action? Remove the stinger from the site. Provide high-flow oxygen. Administer antihistamines. Assess the patient's airway.

Assess the patient's airway.

A patient arrives in the emergency room and is alert and oriented with burns to the upper chest and bilateral upper extremities. She reports severe pain. Which nursing action is the priority? Auscultate the patients chest Insert a peripheral IV Monitor the patients ECG tracing Provide instructions for the patient controlled analgesia use

Auscultate the patients chest

The nurse monitors for which clinical manifestation in the patient diagnosed with Paget's disease? Hyperreactive reflexes Bone deformity Muscle atrophy Joint stiffness

Bone deformity

The nurse monitors for which of the following clinical manifestations in the patient diagnosed with osteoarthritis? Raynaud's phenomenon Bouchard's nodes Butterfly rash Gout

Bouchard's nodes

The nurse correlates which laboratory result to an increased risk for fracture in the adult patient? High Serum magnesium Low Serum calcium Low Serum creatinine High Serum albumin

Low Serum calcium

Vitamin D and these supplements must be taken together in order to be absorbed and metabolized properly Vitamin B 12 and Vitamin C Calcium and Phosphorus Protein and Phosphorus Vitamin C and Calcium

Calcium and Phosphorus

What is the priority nursing action to decrease the risk of a blood transfusion reaction from a patient receiving incompatible blood? Documenting the procedure in the health record Verifying the patient's identity using two identifiers Assessing the patient's vital signs before starting the transfusion Checking the bag to ensure it is the correct blood type

Checking the bag to ensure it is the correct blood type

Complications of fracture include Select all that apply Compartment Syndrome Fat embolism Hemodialysis Hemorrhage

Compartment Syndrome Fat embolism Hemorrhage

Which of the following statements are true about a fat embolism It occurs within the first two hours of the fracture It is the same thing as compartment syndrome Dyspnea, respiratory failure, tachycardia and low grade fever There are no signs and symptoms

Dyspnea, respiratory failure, tachycardia and low grade fever

A patient arrives in the emergency department with a swollen ankle after a soccer injury. Which action by the nurse is appropriate? Apply a warm moist pack to the ankle. Elevate the ankle above heart level. Assess the ankle's passive range of motion (ROM). Ask the patient to try bearing weight on the ankle.

Elevate the ankle above heart level.

The nurse administers a large dose of the prescribed opioid analgesic in preparation for a dressing change for a patient with significant burn injury. What is the nurse's priority in this situation? Ensuring a bag and mask is at the bedside Evaluating the patient's level of pain after medication administration Asking the patient, "Are you allergic to any medications?" Documenting the level of pain before medication administration

Ensuring a bag and mask is at the bedside

A patient comes to the emergency room in the morning with Intense joint pain in his big toe. He says he woke up that way and denied injury. Upon assessment the area is noted to be red, swollen and warm with limited range of motion. The patients laboratory results show an elevated uric acid level. You suspect the patient has a diagnosis of Gout Psoriatic Arthritis Osteoporosis Rheumatoid Arthritis

Gout

Which of the following diet promotes best proper wound healing High protein, high carbohydrates, high vitamin C High protein, low carbohydrates, low vitamin C Low protein, high carbohydrates, high vitamin C Low protein, low carbohydrates, high vitamin C

High protein, high carbohydrates, high vitamin C

What actions does the nurse implement when providing care to a patient with a suspected acute bone injury? Select all that apply. Immobilize the wrist. Apply a cold pack to the wrist. Monitor for bleeding. Ask the patient to rate the pain using an appropriate scale. Elevate the wrist below the level of the heart.

Immobilize the wrist. Apply a cold pack to the wrist. Monitor for bleeding. Ask the patient to rate the pain using an appropriate scale.

During a wound assessment it is important for the nurse to Measure the length, width, and depth of the wound every time the wound dressing is changed Measure the length, width, and depth of the wound every week Measure the length, width, and depth of the wound only on admission None of the above

Measure the length, width, and depth of the wound every time the wound dressing is changed

A patient has full-thickness burns over 30% of total body surface area. Which intervention to address the patient's comfort does the nurse question? Medicate for pain around the clock. Apply medicated ointment to all areas. Elevate injured extremities. Elevate the head of the bed 30 degrees.

Medicate for pain around the clock.

A pregnant woman with asymptomatic chronic human immunodeficiency virus (HIV) infection is seen at the clinic. The patient states, "I am very nervous about making my baby sick." Which information will the nurse include when teaching the patient? Because it is an early stage of HIV infection, the infant will not contract HIV. The antiretroviral medications used to treat HIV infection are teratogenic. Most infants born to HIV-positive mothers are not infected with the virus. Her newborn will be born with HIV and will likely not survive

Most infants born to HIV-positive mothers are not infected with the virus.

The nurse monitors for which skin changes in the patient diagnosed with type 2 diabetes mellitus (DM)? Finger clubbing Wet wounds from the ankle to the mid-calf Numbness in the extremities Dermatitis

Numbness in the extremities

The nurse monitors for which assessment findings in the patient admitted with superficial partial-thickness burns over both anterior lower arms? Open or closed blisters, mild edema, easily blanches Waxy appearance and cherry red color Dry leathery appearance and pale or brown color Dry with no blisters

Open or closed blisters, mild edema, easily blanches

A slow progressive noninflammatory disorder of the synovial joints that can manifest with Bouchard's Nodes Osteopenia Osteoporosis Gout Osteoarthritis

Osteoarthritis

Alendronate or Fosamax is take either once daily or once weekly to prevent Osteoporosis Gout Rheumatoid Arthritis Psoriatic Arthritis

Osteoporosis

Immediately after the nurse administers an intradermal injection of an allergen on the forearm, the patient reports itching at the site, weakness, and dizziness. What action should the nurse take first? Place a tourniquet above the site. Administer subcutaneous epinephrine. Apply antiinflammatory cream. Reschedule the patient's other allergen tests.

Place a tourniquet above the site.

When a newly diagnosed patient with SLE (Systemic Lupus Erythematosus) asks what she can do to avoid flare-ups you would tell her to avoid which of the following Select all that apply Driving after dark Prolonged sun exposure Emotional stress Drying soaps

Prolonged sun exposure Emotional stress Drying soaps

The nurse is caring for a patient with a major burn on the right arm. Which function of the skin is most affected by this injury? Excretion Metabolism Sensation Protection

Protection

What are the local manifestations of the inflammatory response? Decreased pulse and respiratory rate, pain, increased range of motion Purulent drainage, cyanosis, pain, decreased WBC count, Redness, heat, pain, swelling, loss of function Bleeding, pain, vomiting

Redness, heat, pain, swelling, loss of function

A patient comes in to the emergency room with a cut that he got while chopping wood five days ago. What symptoms would indicate that the wound is infected? Redness, swelling, purulent drainage No bleeding, wound edges are well approximated, no foul odor Elevated pulse, respirations and blood pressure Bleeding, pain, jagged wound edges

Redness, swelling, purulent drainage

A patient informed of a positive rapid screening test result for human immunodeficiency virus (HIV) is anxious and does not appear to hear what the nurse is saying. What action by the nurse is mostimportant at this time? Inform the patient about the available treatments. Teach the patient how to manage a possible drug regimen. Remind the patient to return for retesting to verify the results. Ask the patient to identify those persons who had intimate contact.

Remind the patient to return for retesting to verify the results.

Which clinical manifestations does the nurse assess for in the patient diagnosed with gout? Heberden's nodes Ulnar deviation Reports of severe pain, redness and swelling in the great toe Raynaud's phenomenon

Reports of severe pain, redness and swelling in the great toe

This disorder is a chronic systemic autoimmune disease that causes inflammation of connective tissues in the synovial joints Rheumatoid Arthritis Lupus Osteoarthritis Gout

Rheumatoid Arthritis

This arthritis is caused by microorganisms that have invaded the joint cavity and the most common causative agent is staphylococcus aureus Rheumatoid Arthritis Septic Arthritis Osteoarthritis Ankylosing Spondylitis

Septic Arthritis

When a spleen is removed long term effects are that the patient will be at higher risk of Serious infections Hematuria Dyspnea Liver Failure

Serious infections

A victim of a house fire is brought to the emergency department for burn treatment. The nurse correlates which assessment to an inhalation injury? Soot on the face Singed nasal hair Heart rate 98 bpm Coughing

Singed nasal hair

The nurse is reviewing statistics about the frequency of anterior cruciate ligament (ACL) tears. Which sports activity has the greatest risk of this type of injury? Swimming Soccer Baseball Weightlifting

Soccer

Which of the following statements most accurately describes Compartment Syndrome Increased blood flow to the inured area which decreases swelling and prevents infection Swelling that occurs post injury and causes increased pressure within a limited space that requires immediate attention Prevents infection after a fracture by decreasing swelling Indicates a normal inflammatory response and requires no intervention

Swelling that occurs post injury and causes increased pressure within a limited space that requires immediate attention

The patient enters the outpatient clinic and states to the triage nurse, "I think I have the flu. I'm so tired, I have no appetite, and everything hurts." The triage nurse assesses the patient and finds a butterfly rash over the bridge of nose and on the cheeks. Then nurse correlates this data with the clinical manifestations of which disorder? Gout Systemic lupus erythematosus Lyme disease Fibromyalgia

Systemic lupus erythematosus

The nurse identifies the nursing diagnosis of Chronic Pain for a patient with fibromyalgia. Which manifestation supports this nursing diagnosis? Pain from eye strain Tender points in the knees Chest pain Pain from a severe skin rash

Tender points in the knees

The nurse monitors for which clinical manifestations in the patient with suspected compartment syndrome? Select all that apply. The patient's pulses are bounding. The patient's limb is red. The patient reports a feeling of pressure. The patient reports pain. The patient reports numbness.

The patient reports a feeling of pressure. The patient reports pain. The patient reports numbness.

A patient was involved in a motor vehicle crash and is admitted to the hospital with internal bleeding. An exploratory laparotomy is performed and it is discovered that the patients spleen has ruptured. and must be removed. The patient asks the nurse what the function of the spleen was. What is the nurse going tp tell the patient about the functions of the spleen? -The spleen is vital for preventing clotting issues and so you will need to take blood thinners for the rest of your life to prevent blood clots -The spleen is necessary for digestion and so you must remain on a special diet for the rest of your life -Like the appendix, the spleen has no functions in the body so that's why we can remove it -The spleen has many functions such as filtering the blood and helping to fight certain infections

The spleen has many functions such as filtering the blood, and helping to fight certain infections

During the tertiary intention phase of healing The wound is left open or the primary wound becomes infected and is opened; after the infection is controlled it is sutured The wound has wide, irregular margins—edges cannot be approximated The wound is caused by shear, friction, and/or blunt force The wound is pink and vascular but friable with an increased risk of dehiscence

The wound is left open or primary wound becomes infected and is opened; after the infection is controlled it is sutured

A patient presents to the emergency room seeking treatment for radiation burns. What needs to be considered before providing care to this patient? Duration of contact with the agent Temperature to which the skin is heated Type, dose, and length of exposure Pathway of flow through the body

Type, dose, and length of exposure

What is the most effective way to prevent the spread of infection Eat a well balanced diet Instruct the patient to avoid large crowds and people who are sick Use a negative pressure wound vac Wash your hands

Wash your hands

Corticosteroids are a risk factor for which disorder osteoporosis septic arthritis rheumatoid arthritis osteoarthritis

osteoporosis

A basic principle of wound management for all open wounds is to apply topical antimicrobials to prevent wound infection. remove wound exudate with frequent dressing changes. protect new granulation and epithelial tissue. use occlusive dressings to prevent wound contamination.

protect new granulation and epithelial tissue.