Med Surg Exam 2 Questions from back of book

A Diabetes Nurse Educator is providing a class on diabetes for the dieticians and staff nurses. The nurse educator discusses the American Diabetes Association (ADA) recommendations for levels of caloric intake. What do the ADA's recommendations include?

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

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?

6 to 12 months

In most cases how long will it take your body to destroy a clot?

7-10 days

A newly admitted patient with type 1 diabetes asks the nurse what caused her diabetes. The nurse is explaining to the patient the etiology of type 1 diabetes. Which of the following explanations is appropriate?

"Destruction of special cells in the pancreas causes a decrease in insulin production and the level of glucose (sugar) in the bloodstream increases because the body lacks insulin to break down the glucose."

A 63-year-old female client is scheduled for vocal cord stripping to treat a lesion on her vocal cord. Which of the following statements indicates that the client has realistic postoperative expectations following this surgery?

"I know my voice will sound hoarse."

A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:

"I should become involved in a weight loss program."

The Diabetic Educator is teaching a patient about type 2 diabetes. The Educator recognizes the patient understands the primary treatment for type 2 diabetes when the patient states what?

"I will follow the weight loss plan designed by the dietitian."

A 23-year-old college athlete is recovering in the postanesthesia care unit from a tonsillectomy. After an overnight stay in the hospital due to increased secretions and vomitting, you deliver his client education and accompanying paperwork. Which of the client's comments, listed below, indicates a need for additional education?

"If I'm vomiting, I'll drink lemon-lime soda to keep myself hydrated."

An adolescent, newly diagnosed with type 1 diabetes, asks the nurse what caused the diabetes. What would be the nurse's best response?

"The causes of type 1 diabetes are genetic, immunologic, and environmental."

What are two issues you can have when suctioning a patient?

-lungs are fragile and they can bleed -be careful you are taking their air out tip***when suctioning hold your own breath when you need a breath your patient needs a breath too!

What protects the Respiratory System?

-nasal hairs and turbinates (bones) -mucous membranes -cilia -alveolar macrophages -irritant receptors in nose and airways

What are 2 reasons a ventilator goes off? (starts ringing)

-pressure is to high pt. is coughing at this point and needs suction. -the ventilator is disconnected (pressure is to low

What are some examples of increased risk of respiratory infection?

-weakened and atrophied respiratory muscles -reduced elastic recoil of lung tissue -deteriorating cilia -decreased cough reflex -reduced effectiveness of alveolar macrophages -reduced number of alveoli

place the following steps in the correct sequential order for obtaining a sputum specimen for culture.

1. Check the order for the test 2.obtain the appropriate container 3.teach the patient to inhale deeply several times 4. have the patient cough deeply from the lungs. 5. send the specimen immediately to the lab

A nurse is reviewing discharge teaching with a client who has Cushing's syndrome. WHich statement by the client indicates that the instructions related to dietary management were understood? 1."I can eat foods that contain potassium" 2."I will need to limit the amount of protein in my diet" 3."I am fortunate that I can eat all the salty foods I enjoy" 4."I am fortunate that I do not need to follow any special diet"

1."I can eat foods that contain potassium"

A community health nurse visits a client at home. Prednisone 10mg orally daily has been prescribed for the client and the nurse reinforces teaching for the client about the medication. WHich statement, if made by the client, indicates that further teaching is necessary? 1."I can take aspirin or my antihistamine if I need it" 2."I need to take the medication every day at the same time" 3."I need to avoid coffee, tea, cola and chocolate in my diet" 4. "if I gain more than 5 pounds a week, I will call my doctor?

1."I can take aspirin or my antihistamine if I need it"

The nurse is preparing a list of home care instructions for the client who has been hospitalized and treated for TB. Choose the instructions that the nurse will include on the list. Select all that apply. 1.Activities should be resumed gradually. 2.Avoid contact with other individuals, except family members, for at least 6 months 3.a sputum culture is needed every 2 to 4 weeks once medication therapy is initiated 4.respiratory isolation is not necessary because family members have already been exposed 5.Cover the mouth and nose when coughing or sneezing and confine used tissues to plastic bags 6.when one sputum culture is negative, the client is no longer considered infectious and can usually return to his or her former employment.

1.Activities should be resumed gradually. 3.a sputum culture is needed every 2 to 4 weeks once medication therapy is initiated 4.respiratory isolation is not necessary because family members have already been exposed 5.Cover the mouth and nose when coughing or sneezing and confine used tissues to plastic bags

Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication? 1.Alcohol 2.Organ Meats 3.Whole-grain cereals 4.Carbonated beverages

1.Alcohol

A hospitalized client with type 1 diabetes received NPH and regular insulin 2 hours ago at 7:30 am. The client calls the nurse and reports that he is feeling hungry, shaky and weak. The client ate breakfast at 8:00 and is due to eat lunch at noon. List, in order of priority, the actions that the nurse would take. __take the client's vital signs __retest the client's blood glucose level __check the client's blood glucose level __give the client half a cup of fruit juice to drink __give the client a small snack of carbs and protein __document the client's complaints, the actions taken, and the outcome

1.Check the client's blood glucose level 2.Give the client half a cup of fruit juice to drink 3.take the client's vital signs 4.retest the clients blood glucose level 5.give the client a small snack of carbs and protein 6.Document the client's complaints, the actions, and the outcome

Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response? 1.Decreased urinary output 2.Decreased blood pressure 3.Decreased peripheral edema 4.Decreased blood glucose level

1.Decreased urinary output

The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes. THe client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medication. the nurse should reinforce which instructions to the client? Select All that Apply. 1.Diarrhea can occur secondary to the metformin. 2.The repaglinide is not taken if a meal is skipped. 3.The repaglinide is taken 30 minutes before eating. 4.Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes. 5.Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide 6.Muscle pain is an expected side effect of metformin and may be treated with acetainophen (Tylenol)

1.Diarrhea can occur secondary to the metformin. 2.The repaglinide is not taken if a meal is skipped. 3.The repaglinide is taken 30 minutes before eating. 4.Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes.

When a nurse notes that a client with type 1 diabetes has lipodystrophy on both upper thighs, what information should the nurse obtain from the client? 1.Plan of injection rotation 2.Consistency of aspiration 3.Preparation of the injection site 4.Angle at which the medication is administered.

1.Plan of injection rotation

A nurse is monitoring a client who has been newly diagnosed with diabetes for signs of complication. which of the following, if exhibited by the client, would indicate hyperglycemia and thus warrant health care provider notification? 1.Polyuria 2.Bradycardia 3.Diaphoresis 4.Hypertension

1.Polyuria

A client with diabetes mellitus visits a health care clinic. the clinets diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dl. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia? 1.Prednisone 2.Phenelzine (Nardil) 3.Atenolol (Tenormin) 4. Allopurinol (zyloprim)

1.Prednisone

Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and TB. The nurse monitors for which side effects of the medication? Select all that apply. 1.Signs of hepatitis 2.Flu-like syndrome 3.low neutrophil count 4.Vitaim B6 deficiency 5.ocular pain or blurred vision 6.tingling and numbness of the fingers

1.Signs of hepatitis 2.Flu-like syndrome 3.low neutrophil count 5.ocular pain or blurred vision

A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching? 1.Withdraws the NPH insulin first 2.Withdraws the regular insulin first 3.Injects air into NPH insulin vial first 4.Injects an amount of air equal to the desired dose of insulin into the vial

1.Withdraws the NPH insulin first

A nurse is assigned to care for a client after a left pneumonectomy. which one of the follow positions would be contraindicated for this client? 1.on the side 2.in a low fowler's position 3.in a semi-fowler's position 4.with the head of the bed elevated 40 degrees

1.on the side

a nurse notes that a hospitalized client has experienced a positive reaction to the mantoux skin test. which action by the nurse is the priority? 1.report findings 2.document the finding in the client's record 3.call the employee health service department 4.call the radiology department for a chest x-ray

1.report findings

A nurse is caring for a client with diabetes mellitus. The client has a blood glucose level of 40 mg/dL. Which of the following rapidly absorbed carbohydrate would be most effective?

1/2 cup fruit juice or regular soft drink

An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:

10 to 15 g of a simple carbohydrate.

diabetes is diagnosed when the fasting blood glucose is greater than _______mg/dl.

126 mg/dl

A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer:

15 to 20 g of a fast-acting carbohydrate such as orange juice.

a nurse is caring for a client with emphysema who is receiving oxygen. the nurse checks the oxygen flow rate to ensure that it does not exceed. 1. 1 Liter/min 2. 2 Liter/min 3. 6 Liter/min 4. 10 Liter/min

2. 2 LIer/min

A client is taking Humulin NPH insulin daily every morning. the nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is: 1. 2 to 4 hours after administration 2. 4 to 12 hours after administration 3. 16 to 18 hours after administration 4. 18 to 24 hours after administration

2. 4 to 12 hours after administration

Cycloserine (Seromycin) is added to the medication regimen for a client with TB. Which of the following would the nurse include in the client-teaching plan regarding this medication? 1.to take the medication before meals 2. to return to the clinic weekly for serum drug level testing 3.it is not necessary to call the health care provider if a skin rash occurs. 4.it is not necessary to restrict alcohol intake with this medication

2. to return to the clinic weekly for serum drug level testing

A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. THe nurse tells the client to: 1.Freeze the insulin 2.Refrigerate the insulin 3.Store the insulin in a dark, dry place. 4.Keep the insulin at room temperature

2.Refrigerate the insulin

A client who has been newly diagnosed with diabetes has been stabilized with daily insulin injections. WHich information should the nurse teach when carrying out plans for discharge? 1.Keep insulin vials refrigerated at all times. 2.Rotate the insulin injection sites systematically. 3.Increase the amount of insulin before unusual exercise 4.Monitor the urine acetone level to determine the insulin dosage

2.Rotate the insulin injection sites systematically.

A nurse reinforces teaching with a client with diabetes mellitus regarding differentiating between hypoglycemia and ketoacidosis. THe client demonstrates an understanding of the teaching by stating that glucose will be taken if which symptom develops. 1.Polyuria 2.Shakiness 3.Blurred vision 4.Fruity breath odor

2.Shakiness

The low-pressure alarm sounds on the ventilator The nurse checks the client and then attempts to determine the cause of the alarm but is unsuccessful. Which initial action will the nurse take? 1.Administer oxygen 2.Ventilate the client manually 3.check the client's vital signs 4.start cardiopulmonary resuscitation (CPR)

2.Ventilate the client manually

A nurse is reading the results of a mantoux skin test on a client with no documented health problems. the site has no induration and a 1-mm area of echymosis. the nurse interprets tha the result is: 1.positive 2.negative 3.uncertain 4.borderline

2.negative

a client has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesis, and tingling in the extremities. The nurse interprets that the client is experiencing: 1.Hypercalcemia 2.peripheral neuritis 3.small blood vessel spasm 4.impaired peripheral circulation

2.peripheral neuritis

a nurse has given a client taking ethambutol (Myambutol) information about the medication. the nurse determines that the client understands the instructions if the client states that he or she will immediately report: 1.impaired sense of hearing 2.problems with visual acuity 3.Gastrointestinal side effects 4.orange-red discoloration of body secretions

2.problems with visual acuity

a client is to begin a 6 month course of therapy with isoniazid (INH). a nurse plans to teach the client to: 1.drink alcohol in small amounts only 2.report yellow eyes or skin immediately 3.increase intake of swiss or aged cheeses 4.avoid vitamin supplements during therapy

2.report yellow eyes or skin immediately

a nurse is caring for a client after a pulmonary angiography catheter insertion into the left groin. the nurse monitors for an allergic reaction to the contrast medium by noting the presence of: 1.hypothermia 2.respiratory distress 3.hematoma in the left groin 4.discomfort in the left groin

2.respiratory distress

a client has a prescription to take guaifensesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will: 1.watch for irritability as a side effect 2.take the tablet with a full glass of water 3.take an extra dose if the cough is accompanied by fever 4.crush the sustained-release tablet if immediate relief is needed

2.take the tablet with a full glass of water

The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. THe nurse knows that which of the following is the appropriate intervention? 1.THe medication is administered within 60 minutes before the morning and evening meal. 2.the medication is withheld and the HCP is called to question prescription for the client. 3.The client is monitored for gastrointestinal side effects after administration of the medication. 4.the insulin is withdrawn from the Penlet into an insulin syringe to prepare for administration

2.the medication is withheld and the HCP is called to question prescription for the client.

As a nurse educator, you have been invited to your local senior center to discuss health-maintaining strategies for older adults. During your education session on nutrition, you approach the subject of diabetes mellitus, its symptoms and consequences. What is the incidence of Type 2 diabetes in newly diagnosed cases?

20%

What does room air equal?

21%

Know lungs sounds

29.4 -pg 600

When the nurse is teaching a client who has been newly diagnosed with type 1 diabetes, which statement by the client would indicate that teaching has been effective? 1."I will stop taking my insulin if I'm too sick to eat." 2."I will decrease my insulin dose during times of illness" 3."I I will adjust my insulin dose according to the level of glucose in my urine" 4."I will notify my health care provider if my blood glucose level is greater than 250 mg/dl"

3."I I will adjust my insulin dose according to the level of glucose in my urine"

A nurse provides dietary instructions to a client with diabetes regarding the prescribed diabetic diet. Which statement, if made by the client indicates the need for further teaching? 1. "I'll eat a balanced meal plan" 2. "I need to drink diet soft drinks" 3."I need to buy special dietetic foods" 4.I will snack on fruit instead of cake"

3."I need to buy special dietetic foods"

A nurse is assisting with preparing a teaching plan for the client with diabetes regarding proper foot care. WHich instruction should be included in the plan of care? 1.Soak the feet in hot water 2.Avoid using soap to wash the feet 3.Apply a moisturizing lotion to dry feet but not between the toes. 4. Always have a podiatrist cut your toenails, never cut them yourself

3.Apply a moisturizing lotion to dry feet but not between the toes.

A nurse is reinforcing instructions with a client with diabetes who is recovering from diabetic ketoacidosis regarding measures to prevent a recurrence. WHich instruction is important for the nurse to emphasize? 1.Eat six small meals daily 2.test the urine ketone levels 3.Monitor blood glucose levels frequently 4.receive appropriate follow-up health care

3.Monitor blood glucose levels frequently

A nurse is gathering data on a client with diagnosis of TB. THe nurse reviews the results of which diagnostic test that will confirm this diagnosis? 1.Chest X-Ray 2.Bronchoscopy 3.Sputum culture 4.Tuberculin skin test

3.Sputum culture

Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the the client's history? 1.Neuralgia 2.INsomnia 3.Use of nitroglycerin 4.Use of Multivitamins

3.Use of nitroglycerin

a nurse is caring for several clients with respiratory disorders. which client is at least risk for developing a TB infection? 1.an uninsured man who is homeless 2.a woman newly immigrated from korea 3.a man who is an inspector for the US postal service 4.an older woman admitted from a long-term care facility

3.a man who is an inspector for the US postal service

a client has been started on long-term therapy with rifampin. A nurse teaches the client that the medication: 1.should always be taken with food or antacids 2.should be double-dosed if one does is forgotten 3.causes orange discoloration of sweat, tears, urine and feces 4.may be discontinued independently if symptoms are gone in 3 months

3.causes orange discoloration of sweat, tears, urine and feces

a client with TB is being started on anti TB therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed? 1.electrolyte levels 2.coagulation times 3.liver enzyme levels 4.serum creatinine level

3.liver enzyme levels

A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after the transfer to the nursing unit from the postanesthesia care unit. After asministration of the medication, the nurse checks the client for: 1.pupilary changes 2.scattered lung wheezes 3.sudden increase in pain 4.sudden episodes of diarrhea

3.sudden increase in pain

Which of the following identifies the route of transmission of TB? 1.hand to mouth 2.then enteric route 3.the airborne route 4.blood and body fluids

3.the airborne route

a nurse reinforced discharge teaching with a client who was diagnosed with TB and has been on medication for 1 1/2 weeks. the nurse knows that the client makes which statement? 1."I can't shop at the mall for he next 6 months" 2."i need to continue medication therapy for 2 months" 3."I can return to work if a sputum culture comes back negative" 4."I should not be contagious after 2 to 3 weeks of medication therapy"

4."I should not be contagious after 2 to 3 weeks of medication therapy"

A client with type 1 diabetes calls the nurse to report recurrent episodes of hypoglycemia. WHich statement by the client indicates a correct understanding of NPH insulin and exercise? 1."I should not exercise after lunch" 2."I should not exercise after breakfast" 3."I should not exercise in the late evening" 4."I should not exercise in the late afternoon"

4."I should not exercise in the late afternoon" pg. 571 NCLEX *

a nurse is instructing a client about pursed lip breathing, and the client asks the nurse about its purpose. the nurse tells the client that the primary purpose of pursed lip breathing is to: 1.promote oxygen intake 2.strengthen the diaphragm 3.strengthen the intercostal muscles 4.promote carbon dioxide elimination

4.promote carbon dioxide elimination

a nurse is providing discharge instructions to the client with pulmonary sarcoidosis. THe nurse knows that the client understands the information if the client verbalizes which early sign of exacerbation? 1.fever 2.fatigue 3.weight loss 4.shortness of breath

4.shortness of breath

A nurse is providing instructions to a hospitalized client with a diagnosis of emphysema about positions that will enhance the effectiveness of breathing during dyspneic periods. Which position will the nurse instruct the client to assume? 1.sitting up in bed 2.side-lying in bed 3.sitting in a recliner chair 4.sitting on the side of the bed, leaning on an overbed table

4.sitting on the side of the bed, leaning on an overbed table

a client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer. The nurse should have which item available for possible use after giving this medication? 1.Ambu bag 2.Intubation tray 3.Nasogastric tube 4.suction equipment

4.suction equipment

a client being discharged from the hospital to home with a diagnosis of TB is worried about the possibility of infecting the family and others. THe nurse determines that the client would get the most reassurance from the knowledge that: 1.the family does not need therapy, and the client will not be contagious after 1 month of medication therapy 2.the family does not need therapy, and the client will not be contagious after 6 consecutive weeks of medication therapy. 3.the family will receive prophylactic therapy, and the client will not be contagious after 1 continuous week of medication therapy. 4.the family will receive prophylactic therapy, and the client will not be contagious after 2 to 3 consecutive weeks of medication therapy

4.the family will receive prophylactic therapy, and the client will not be contagious after 2 to 3 consecutive weeks of medication therapy

As a nurse educator, you have been invited to your local senior center to discuss health-maintaining strategies for older adults. During your education session on nutrition, you approach the subject of diabetes mellitus, its symptoms and consequences. What is the prevalence of type 1 diabetes?

5% to 10% of all diagnosed cases

You are triaging patients in the emergency department when a patient comes in stating she was in a boating accident about 3 hours ago. Now the patient has complaints including headache, fatigue, and the feeling that she "just isn't breathing enough." You note that the patient is restless and tachycardic with an elevated blood pressure. What would you suspect the patient is in the early stages of?

Acute respiratory failure

Which of the following types of lung cancer is the most prevalent carcinoma of the lung for both men and women?

Adenocarcinoma

A mother calls the clinic asking for a prescription for Amoxicillin for her 2-year-old son who has what you suspect is viral rhinitis. What should you tell this mother?

Antibiotics should not be used because they do not affect the virus or reduce the incidence of bacterial complications

An elderly patient comes to the clinic with her daughter. The patient is a diabetic and is concerned about foot care. The nurse goes over foot care with the patient and her daughter as the nurse realizes that foot care is extremely important. Why would the nurse feel that foot care is so important to this patient?

Avoiding the complications associated with foot ulcers may mean the difference between institutionalization and continued independent living.

What should you check if your patient on oxygen suddenly becomes confused?

Be sure the oxygen is connected, that the cannula is in place. if it is not it can result in hypoxia and confusion.

A patient has just been diagnosed with type 2 diabetes. The physician has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the physician prescribe for this patient?

Biguanide

Rosella Ramirez, a 67-year-old female, is presenting at the ED where your practice nursing, with her fourth major nosebleed of the day. The physician examines her physically and orders blood tests. She has no history of hypertension, trauma or cocaine use. What could be the cause of her nosebleeds which are so difficult to control?

Blood dyscrasias

Which assessment finding puts a client at increased risk for epistaxis?

Cocaine Use

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?

Coma, anxiety, confusion, headache, and cool, moist skin

Which of the following terms refers to lung tissue that has become more solid in nature due to a collapse of alveoli or an infectious process?

Consolidation

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

Control calorie intake to attain a reasonable body weight.

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

Do not mix with other insulins

A nurse on a postsurgical unit is aware of the high incidence of pulmonary embolism (PE) among hospitalized patients. What nursing action has the greatest potential to prevent PE among hospital patients?

Early ambulation and the use of compression stockings

A 60-year-old man has been diagnosed with obstructive sleep apnea (OSA) based on his clinical symptoms and polysomnographic findings. What intervention should the nurse perform to assist this patient in the management of his health problem?

Encouraging the patient to avoid alcohol and hypnotic medications

Which of the following is a priority nursing intervention that the nurse should perform for a patient who has undergone surgery for a nasal obstruction?

Ensure mouth breathing

A 48-year-old client has just undergone surgery for a nasal obstruction. Which of the following nursing interventions should you, as his nurse, perform to promote the client's safety and recuperation?

Ensure mouth breathing.

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

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

A client has a red pharyngeal membrane, reddened tonsils, and enlarged cervical lymph nodes. The client also reports malaise and sore throat. The nurse needs to assess first for:

Fever

An adolescent patient tells the nurse at school that he is feeling nervous and hungry. The school nurse assesses the patient and finds he has tachycardia and is diaphoretic. What should the school nurse administer?

Fruit juice, 4 to 6 oz

How do you place your patient who is having an air emboli?

Head down! All other situations - HEAD UP!

What is the difference between heparin and coumadin?

Heparin - Fast Acting (out of system in 6 hours) Coumadin - takes 3 days to start working its used more as a maintenance

Which combination of adverse effects should a nurse monitor for when administering I.V. insulin to a client with diabetic ketoacidosis?

Hypokalemia and hypoglycemia

A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites?

Insulin is absorbed more rapidly at abdominal injection sites than at other sites.

NPH is an example of which type of insulin?

Intermediate-acting

A client who has been diagnosed with an early glottis cancer would most likely undergo which type of surgery?

Laser microsurgery

You are a clinic nurse doing patient education for clinic patients. A patient visits the clinic and is diagnosed with acute laryngitis. What should you instruct the patient to do?

Limit speech

The Diabetic Educator is assessing a hospitalized patient to see if it is necessary to reinforce parts of the patient's knowledge of basic diabetic self-care skills. What would be an appropriate way for the Diabetic Educator to assess the patient's knowledge of nutritional therapy in diabetes mellitus?

Monitor the patient's daily food menus.

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia?

Nervousness, diaphoresis, and confusion

In what patients does hyperosmolar nonketotic syndrome occur?

Older people with either type 2 diabetes or no known history of diabetes

A 36-year-old mother of six has been recently diagnosed with type 2 diabetes. She reports increased hunger and food consumption while continuing to lose weight. What is the term used to describe this condition?

Polyphagia

A patient has been brought to the emergency department by the paramedics. The patient is suspected of having acute respiratory distress syndrome. What should the nurse anticipate?

Preparing to assist with intubating the patient

Which of the following clinical characteristics is associated with Type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus [IDDM])?

Presence of islet cell antibodies

Lobes

Right side - 3 lobes Left side - 2 lobes & the heart

Pneumonia

S/S - fever, chills, chest pain, dyspnea, productive cough, crackles and wheezes Diagnostic Tests - chest x-ray - sputum cultures Therapeutic measures - antibiotics, supplemental oxygen, bronchodilators, expectorants, rest, fluids. Complications - pleurisy , pleural effusion, atelectasis Priority Nursing Diagnosis - impaired gas exchange, ineffective airway clearance, activity intolerance

A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?

Serum glucose level of 52 mg/dl

A client with diabetes mellitus is receiving an oral antidiabetic agent. Which of the following aspects should the nurse observe when caring for the client?

Signs of hypoglycemia

A patient comes to the emergency department and is admitted with epistaxis. Pressure has been applied to the patient's midline septum for 10 minutes, but the bleeding continues. What treatments may be used to control the bleeding?

Silver nitrate applicators

A nurse is in the cafeteria at work. A fellow worker at another table suddenly stands up, leans forward with hands crossed at the neck, and makes gasping noises. The nurse first

Stands behind the worker, who has hands across the neck

A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia?

Sweating, tremors, and tachycardia

Which of the following may be a potential cause of hypoglycemia in the patient diagnosed with diabetes mellitus

The patient has not consumed food and continues to take insulin or oral antidiabetic medications.

Which of the following techniques does a nurse suggest to a patient with pleurisy while teaching about splinting the chest wall?

Turn onto affected side.

Which of the following interventions regarding nutrition is implemented for patients who have undergone laryngectomy?

Use enteral feedings after the procedure

A 43-year-old client has had a laryngectomy as treatment for laryngeal cancer. Which of the following nutritional interventions should be implemented for the client?

Use enteral feedings after the procedure.

It is cold season and you have been asked to provide an educational event for the PTO of the local elementary school. You are talking about URIs and their treatments. What would you include in teaching about the treatment of pharyngitis?

Use of warm saline gargles or throat irrigations

What should the dressing of a chest tube be drenched in?

Vaseline.

a patient who is preparing for surgery asks the nurse why his physician took him off his oral hypoglycemic and placed him on sliding-scale insulin. Which response by the nurse is best? a. "it helps us maintain better control of your blood glucose during surgery. you will most be back on your pills before you go home" b. "the stress of surgery often exacerbates diabetes. we will teach you how to give insulin before you go home" c."oral hypoglycemics are ineffective during times of stress. insulin is the only way to keep your blood glucose under control" d.the oral agents must not be controlling your blood glucose any longer. I will check and see which insulin you will be going home on"

a. "it helps us maintain better control of your blood glucose during surgery. you will most be back on your pills before you go home"

for which of the following blood glucose results would the nurse administer a fast sugar? a.48 b.80 c.126 d. 223

a. 48

During inhalation which of the following muscle contractions takes place to enlarge the chest cavity from top to bottom? a.Diaphragm moves down b.External intercoastal muscles move down c.diaphragm moves up d.internal intercostal muscles move up

a. Diaphragm moves down

after a laryngectomy, which of the following assessments takes priority? a. airway patency b. nutritional status c. lung sounds d. patient acceptance of surgery

a. airway patency

the nurse knows that the patient understands teaching related to prevention of influenza transmission when the patient demonstrates which behaviors? Select all that apply. a. washing hands frequently b. covering the nose and mouth during coughing or sneezing. c. taking acetaminophen as ordered d. drinking extra fluids e. avoiding sharing eating utensils with others f. taking antibiotics until the entire prescription is finished.

a. washing hands frequently b. covering the nose and mouth during coughing or sneezing. e. avoiding sharing eating utensils with others

a patient is admitted to the hospital with shortness of breath. the nurse notes increasing confusion and combativeness during the past hour. which of the following actions is appropriate first? a.assess the patient; check to see if the oxygen is flowing correctly. b. flowing correctly c. page the physician stat d. put up the patients side rails and apply soft restraints d.administer an intramuscular sedative

a.assess the patient; check to see if the oxygen is flowing correctly.

which of the following is the best definition of diabetes mellitus? a.it is a disease in which high blood glucose results from defective insulin secretion or action. b.it is a disease that causes polyuria and polydipsia c.it is a disease characterized by macrovascular and microvascular complications d. it is a complex disease of protein and fat metabolism

a.it is a disease in which high blood glucose results from defective insulin secretion or action.

protein in the urine is a sign of which long-term complication of diabetes? a.nephropathy b. neuropathy c.retinopathy d.gastroparesis

a.nephropathy

Which of the following communication methods will not work for the patient with a laryngectomy? a.placing a finger over the stoma b. providing a special valve that diverts air into the esophagus c.obtaining a picture board d. teaching the patient esophageal speech

a.placing a finger over a stoma

a patient with end-stage COPD has a nursing diagnosis of Impaired Gas Exchange. Which assessment finding shows that interventions have been effective? a.the patient's Sp02 is 97% on 2 liters of oxygen. b. the patient appears comfortable c.the patient is coughing up copious white sputum d. the patient is able to move in bed without difficulty

a.the patient's Sp02 is 97% on 2 liters of oxygen.

Goblet Cells

are gobs of goobers

What should you ask the physician if he/she orders a "Sputum for AFB", this is when tuberculosis is suspected caused by acid-fast bacillus (AFB)?

ask the physician if the patient should be placed in isolation while waiting for the test results.

which instruction is correct when teaching a patient how to use a metered-dose inhaler? a."inhale deeply, place canister in mouth, depress top of canister, exhale" b.exhale, place the canister in mouth, depress canister and inhale at the same time" c."cough, place the canister in mouth, inhale deeply, cough again." d. "exhale, depress canister, place in mouth, inhale deeply"

b. "exhale, place the canister in mouth, depress canister and inhale at the same time"

which is the best explanation by a nurse for why a physician did not prescribe antibiotics for influenza? a."most cases of influenza are caused by antibiotic-resistent bacteria" b."influenza is caused by viruses" c. "antibiotics have too many serious side effects" d."antibiotics can interact with other medications used for influenza"

b. "influenza is caused by viruses"

Which of the following assessment findings does the nurse expect in the patient with emphysema? a. purulent sputum b. diminished breath sounds c. generalized edema d. dull chest pain

b. diminished breath sounds

Which of the following is a risk factor for type 2 diabetes mellitus? a. cardiovascular disease b. obesity c. age younger than 40 years d. virus exposure

b. obesity

Which meal plan is best for the patient with reactive hypoglycemia? a.high-carb meals b.small, frequent meals c.avoidance of fats and proteins d.three medium to large meals daily

b.small, frequent meals

Which of the following interventions is most appropriate for the patient with an ineffective breathing pattern? a.encourage the patient to cough and deep breathe. b.teach the patient controlled diaphragmatic breathing c.encourage oral fluids d.allow the patient to rest between activities

b.teach the patient controlled diaphragmatic breathing

which of the following terms is used to describe violin like sounds heard on chest auscultation? a.crackles b.wheezes c.friction rub d.stridor

b.wheezes

What medications do you have to be careful with on asthma patients?

beta blockers

A nurse is explaining the action of insulin to a client with diabetes mellitus. During client teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when she states that insulin is secreted from the:

beta cells of the pancreas.

Deteriorating cilia in the respiratory tract predispose the elderly to which of the following? a.chronic hypoxia b. pulmonary hypertension c. respiratory infection d. decreased ventilation

c. Respiratory infection

which of the following assessment findings in the patient with pneumonia most indicates a need to remind the patient to cough and deep breathe? a. the patient reports chest pain b.the patient has removed her oxygen c. the patient develops coarse wheezes and crackles d. the patient has a fever of 101

c. The patient develops coarse wheezes and crackles

A patient with recurrent pneumothorax is scheduled to have a pleurodesis done in one hour. WHich nursing intervention should take priority at this time? a. encourage fluids b. encourage coughing and deep breathing c. administer a prn analgesic as ordered d.administer a prn bronchodilator as ordered.

c. administer a prn analgesic as ordered

a patient asks the nurse why he doesn't feel sick even though his TB test is positive. The nurse knows the patient has been diagnosed with LTBI. which explanation is best to provide the patient. a."TB often does not make people feel sick, but it is contagious nevertheless" b."you have latent disease, which just stays in your system but won't ever make you sick" c."you have TB infection, but not active disease. As long as your immune system stays strong, it can keep the infection from making you sick" d.even though you do not feel sick, the positive test shows that you have the disease and must be treated"

c."you have TB infection, but not active disease. As long as your immune system stays strong, it can keep the infection from making you sick"

What is the best way for patients to avoid long-term complications of diabetes? a.see the doctor for a complete checkup every 6 months. b.check feed daily c.maintain premeal blood glucose levels under 130 mg/dl d.follow a strict meal plan for diabetes

c.maintain premeal blood glucose levels under 130 mg/dl

Place the steps for mixing insulin in correct sequential order a.draw up cloudy insulin b.draw up clear insulin c.roll cloudy vial d.inject air into cloudy insulin e. inject air into clear insulin f. clean vial tops with alcohol

c.roll cloudy vial f. clean vial tops with alcohol e. inject air into clear insulin d.inject air into cloudy insulin b.draw up clear insulin a.draw up cloudy insulin

Once you have been positive for TB how will they check you every 5 years?

chest x-ray if you are not positive than you should get a PPD yearly.

What is pulmonary hypertension?

chest x-ray and the right side is super large.

What is atelectasis?

collapsed alveoli

how should the nurse record smoking history on a patient who has smoked 2.5 packs of cigarettes per day for 10 years? a.patient has smoked cigarettes for 10 years. b.patient smokes 2.5 packs of cigarettes per day. c.patient has a 12.5 pack-year smoking history d.patient has a 25 pack-year smoking history

d. Patient has a 25 pack -year smoking history.

which of the following symptoms is most commonly associated with hyperglycemia? a. Tremor b. Flank pain c. sweating d. polyuria

d. polyuria

which of the following positions is recommended for a patient experiencing a nosebleed? a.lying down with feet elevated b. sitting up with neck fully extended c. lying down with a small pillow under the head d. sitting up leaning slightly forward

d. sitting up leaning slightly forward

which of the following responses is correct when a patient asks why her physician didn't order a new antiviral drug for flu symptoms that started 3 days ago? a. "antiviral drugs are for AIDS, not the flu" b. "the side effects of the antiviral drugs are worse than having the flu" c. "antiviral drugs are only for children" d. "these drugs work only if you start them within 48 hours after flu symptoms start"

d."these drugs work only if you start them within 48 hours after flu symptoms start"

a patient with shortness of breath is being tested for lung cancer. which diagnostic test will be most conclusive? a.chest x-ray b.MRI c.Sputum culture d.biopsy

d.Biopsy

which of the following is a normal value for oxygen saturation? a. less than 60% b.61%-85% c.86%-95% d.more than 95%

d.more than 95%

Which breakfast menu is most appropriate for a patient with diabetes? a.two eggs, two strips bacon, orange juice, coffee b.oatmeal with artificial sweetner, whole-grain toast, tea c.one half grapefruit, cranberry juice, bagel with sugar-free jelly d.one slice whole-grain toast with peanut butter, skim milk, orange juice

d.one slice whole-grain toast with peanut butter, skim milk, orange juice

When caring for a client who has just had a total laryngectomy, the nurse should plan to:

develop an alternative communication method.

Nursing Care Tip

exposure to radon gas is a significant risk factor to lung cancer. it can be found in homes and there are kits to buy that will tell you if you have it at home or not.

What is in the 1st container ?

fluid and it can be pus, blood, or green

Respiratory/Metabolic Acidosis/Alkalosis

get from last quizlet

If their is a problem with the ventilator and you don't know what to do?

get the Ambu bag connect and manually bag them as u also call for help.

What are symptoms of laryngeal cancer?

hoarsness, sore throat, cough, halitosis, weight decrease

Arin (blood thiner)

if given you must check and document if there is signs of bleeding.

Remember 50!

if the Pa02 falls below 50 and the Pac02 is above 50, the patient is in trouble and the physician needs to be notified STAT!

A patient visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, the nurse instructs the patient to

increase fluid intake.

When a patient is using a partial rebreather or non-breather mask how full is the bag supposed to always be?

it is never allowed to collapse to less than half full

How can you test for Cystic Fibrosis?

kiss test - forehead taste salty Cystic Fibrosis patients must ONLY TAKE Motrin and must get a flu shot yearly.

What can you do to make it easier to identify the color of sputum?

line an emesis basin with a white tissue.

Sniffling, nasal discharge, coughing, and sneezing...young Patrick Lee presents at your local free clinic with the above symptoms, which are keeping him awake at night, interrupting his feedings and are making him (and his mother) miserable. After the physician's exam, he is diagnosed with rhinovirus - a common virus. How many strains of this virus cause coryza?

more than 100

What will determine a patient being diagnosed with chronic bronchitis?

patient must have 3months out of the year and 2 years in a row.

Who is very prone now a days for emboli's?

people who fly for long hours - around the world.

review table 30.1

pg 626

Review Nursing plan

pg. 614-615

Know the skin test reaction

pg. 643 Table 31.2

What is a sign of Pulmonary emboli that is not proven but Ms. Wheeler has seen often?

pink from the nipple up and cyanotic below.

What do you do if a patient is having an emboli?

put head up in high fowlers, give oxygen and call the doctor asap.

What is corpulnary

right side heart failure

How do you locate a traveling clot?

scan, xray, doppler

A client asks a nurse a question about the Mantoux test for tuberculosis. The nurse should base her response on the fact that the:

skin test doesn't differentiate between active and dormant tuberculosis infection.

What would a nurse advise a patient going home with a tracheostomy?

stay out of dusty areas keep head of bed at 45 degrees

Ineffective airway clearance related to presence of ventilator- patient not able to cough.

suction according to agency policy remind the patient to cough and deep breathe regularyl administer analgesics as ordered for pain (it will help control cough if pain is controlled)

What do you look for in a patient with post nasal surgery?

swallowing blood, temp,have them drink fluids.. box 30.1

What is a tip in teaching a patient to do pursed-lip breathing?

teach them to smell the roses while inhaling slowly through the nose, and blow out the candle while exhaling (remind them not to let the wax splatter) this will keep them blowing slowly and gently.

Is a nurse able to discontinue a CPAP machine?

the nurse will NOT ever discontinue without a physician's order. A CPAPA is truly a ventilator.

What is a Passy-Muir?

tracheostomy speaking valve

IF using a short acting bronchodilator and a corticosteroid inhaler which should be used first?

use the bronchodilator first. this opens the airways and allows for better distribution of the corticosteroid in the lungs.

Color of sputum?

yellow- streptocococcus/bacterial pneumonia green - infection clear - viral

Is suctioning a trach patient a sterile procedure?

yes

Should you do a sputum culture prior to antibiotics?

yes

Which of the following factors will cause hypoglycemia in a client with diabetes? Select all that apply.

• Client has not consumed food and continues to take insulin or oral antidiabetic medications. • Client has not consumed sufficient calories. • Client has been exercising more than usual.

Late symptoms of laryngeal cancer include which of the following. Select all that apply.

• Dysphagia • Dyspnea • Persistent hoarseness

Which of the following are clinical manifestations associated with obstructive sleep apnea (OSA)? Select all that apply.

• Insomnia • Arrhythmias • Loud snoring • Excessive daytime sleepiness • Impotence

MaryAnn Merrill, a 65-year-old female, has a 60-pack-year history and is diagnosed with emphysema. MaryAnn is 100 lbs. overweight and is having significant problems with fatigue and oxygenation. As her nurse, why would you encourage her to lose weight?

• To improve breathing • To lessen fatigue

A 37-year-old client has been diagnosed with pre-diabetes. Following his physician visit, where he received the diagnosis, you begin your client education session to discuss treatment strategies. How can the client delay or avoid type 2 diabetes?

• Weight loss • Increased physical activity