Med Surg Quizzes
Test for antibodies to hepatitis B. Administer hepatitis B vaccine. Give hepatitis B immune globulin.
After an unimmunized person is exposed to hepatitis B through a needle-stick injury, which actions will the nurse plan to take? (Select all that apply.)
Semi-Fowler's with legs extended on the bed
A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?
Schedule the patient for HCV genotype testing.
A patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection. Which action by the nurse is appropriate?
Monitor the patient for shortness of breath.
A patient is being treated for bleeding esophageal varices with balloon tamponade. Which nursing action will be included in the plan of care?
A bus trip to the Museum of Natural History
Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend?
Providing oral hygiene after a meal
For a patient who has cirrhosis, which nursing action can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP)?
A 55-yr-old patient with cirrhosis and ascites who has an oral temperature of 102° F (38.8° C)
Pegylated α-interferon (Pegasys) orally once daily
Albumin level
Which focused data should the nurse assess after identifying 4+ pitting edema on a patient who has cirrhosis?
Positive urine pregnancy test
A 36-yr-old female patient is receiving treatment for chronic hepatitis B with pegylated interferon (Pegasys). Which finding is important to communicate to the health care provider to suggest a change in therapy?
Capillary refill of < 3 seconds
A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use?
Alcohol abuse
A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. To what diagnosis does the nurse attribute these findings?
Conduct further assessment of the client's respiratory status
A home health nurse is visiting a client with severe chronic obstructive pulmonary disease (COPD) who is complaining of increased shortness of air. The client is on home oxygen at 2 L/min via an oxygen concentrator with a respiratory rate of 23 breaths/min. The most appropriate nursing action is to
Pneumonia
A male elderly client is admitted to an acute care facility with influenza. The nurse monitors the client closely for complications. What is the most common complication of influenza?
The client is alert and oriented
A nurse is caring for an 89-year-old client admitted with pneumonia. He has an IV of normal saline running at 100 mL/hr and antibiotics that were initiated in the emergency department 3 hours ago. He has oxygen at 2 liters/nasal cannula. What assessment finding by the nurse indicates that goals for a priority diagnosis have been met for this client?
Epigastric pain radiating to left shoulder
A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following is an expected finding?
Hand spasms present when blood pressure is checked
A nurse is completing the admission assessment of a client who has acute pancreatitis. Which of the following findings is the priority to be reported to the provider?
Patient who requires pain management for chronic pancreatitis
A nurse is considering which patient to admit to the same room as a patient who is hospitalized with acute rejection 3 weeks after a liver transplant. Which patient would be the best choice?
The blood stream
A nurse is educating a newly diagnosed diabetic patient about the function of the pancreas as it pertains to insulin and insulin control within the body, the nurse is correct when she educates the patient that hormones are released by the pancreas into
"Do you use any over-the-counter drugs?"
A patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies, but serologic testing is negative for viral causes of hepatitis. Which question by the nurse is appropriate?
Ask whether the patient has been screened for hepatitis C.
A patient born in 1955 had hepatitis A infection 1 year ago. According to Centers for Disease Control and Prevention (CDC) guidelines, which action should the nurse include in care when the patient is seen for a routine annual physical examination?
turn, cough, and deep breathe every 2 hours.
A patient had an incisional cholecystectomy 6 hours ago. The nurse will place the highest priority on assisting the patient to:
Asterixis and lethargy
A patient has been admitted with acute liver failure. Which assessment data are most important for the nurse to communicate to the health care provider?
Lipase
A patient has been continuously deficient on Vitamin D, the nurse is correct when she tell the patient that this enzyme is responsible for the breakdown of fat soluble Vitamins
<150
A patient is being discharged to home after a acute coronary event, the nurse is educating the patient on his diagnosis of mixed hyperlipidemia, the nurse is correct when she educates the patient on a healthy triglyceride level as
Normal electrical conduction with a heart rate less than 60
A patient is being transferred from the field by EMS, EMS calls in report as follows, "68 year-old-male picked up at home for sudden onset chest pain that radiates to his abdomen, electrocardiogram shows, Normal Sinus Bradycardia on the monitor with no ST elevation, the nurse is correct in interpreting this ECG report as
Lipase
A patient presents to the family wellness clinic and states that she has a history of acute pancreatitis, and has always had trouble absorbing fats and breaking the fats down, the nurse is correct in knowing that this enzyme working together with bile is responsible for the breakdown of fats
Stools test negative for occult blood.
A patient who has cirrhosis and esophageal varices is being treated with propranolol (Inderal). Which finding is the best indicator to the nurse that the medication has been effective?
Abdominal pain is decreased.
A patient with acute pancreatitis is NPO and has a nasogastric (NG) tube to suction. Which information obtained by the nurse indicates that these therapies have been effective?
Pegylated α-interferon (Pegasys) orally once daily
A patient with chronic hepatitis B infection has several medications prescribed. Which medication order requires clarification with the health care provider before administration?
Place the patient on a pressure-relief mattress.
A patient with cirrhosis has ascites and 4+ edema of the feet and legs. Which nursing action will be included in the plan of care?
Administer the spironolactone.
A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) due. Which action should the nurse take?
Anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)
A young adult contracts hepatitis from contaminated food. What should the nurse expect serologic testing to reveal during the acute (icteric) phase of the patient's illness?
Extreme anxiety
Before seeing a newly assigned female client with respiratory alkalosis, the nurse quickly reviews the client's medical history. Which condition is a predisposing factor for respiratory alkalosis?
Ask the patient to empty the bladder.
How should the nurse prepare a patient with ascites for paracentesis?
115 Coors Light's in one day
Mr. V presents to the ER with sudden onset (L) upper quadrant abdominal pain, that radiates to his (L) flank. There is no Cullen's sign or Grey Turner's sign. Mr. V is diagnosed with acute pancreatitis. You are obtaining the health history, what is the most likely cause for Mr. V's acute pancreatitis?
Get a wheelchair for the client
The client dx with anemia begins to complain of dyspnea when ambulating in the hall. Which intervention should the nurse implement first?
The stools may be very dark, and this can mask blood
The client was dx with iron-deficiency anemia is prescribed ferrous gluconate orally. Which should the nurse teach the client?
leukopenia
The nurse administering α-interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C will plan to monitor for:
Asthma
The nurse assesses a college-age client complaining of shortness of breath after jogging and tightness in his chest. Upon further questioning, the client denies a sore throat, fever, or productive cough. The nurse notifies the physician that this client's clinical manifestations are most likely related to
anti-HBs.
The nurse evaluates that administration of hepatitis B vaccine to a healthy patient has been effective when the patient's blood specimen reveals:
0.4mg SL every 5 minutes up to 3 doses
The nurse is administering nitroglycerine to a patient with angina, she is correct in knowing that nitroglycerine can be administered in the following
Vitamin B12 deficiency
The nurse is admitting a 24 year old American American female client with a dx of rule-out anemia. The client has a hx of gastric bypass surgery for obesity 4 years ago. Current assessment findings include height 5'5, wt. 75 kg, P 110, R 27, and BP 104/66; pale mucous membranes and dyspnea on exertion. Which type of anemia would the nurse suspect the client has developed?
White coat syndrome
The nurse is assessing a healthy 33 year old male with no medical history. The patient is in triage with a chief complaint of "headache." The nurse documents the following vital signs; BP 139/84, HR 87, RR 17, Temp 37.3, O2 99% on RA. The nurse is correct when identifying this patient as potentially having
AV node
The nurse is assessing a patient a SA malfunction where it is generating a weak impulse, the nurse assesses a HR of 47, she understands that the structure cell that is pacing the heart is
EKG
The nurse is assessing a patient at the start of her shift, when she is at the bedside the patient tells her that she, "cant catch her breath" and is feeling like her heart is "racing and skipping beats" the nurse is correct to anticipate this priority order from the provider
Initiate CPR
The nurse is assessing a patient in the ER that presented with sudden onset chest pain, she connects the patient on the monitor and notices the patient is in Ventricular fibrillation, she then sees the patient unresponsive with no pulse and continued ventricular fibrillation on the monitor, the nurses next step is
Zofran 4mg SL
The nurse is assessing a patient in the ER with acute pancreatitis, the patient has had nausea, vomiting, and anorexia. The nurse anticipates the provider ordering
Heart Rate 143
The nurse is assessing a patient in triage; the patient states that the reason for her visiting the ER was because of sudden onset chest pain that started this morning, while getting vital signs the nurse is correct in noting the most concerning vital sign is
Glucagon
The nurse is assessing a patient that presented to the ER for hypoglycemia, the nurse is correct in knowing that the hormone responsible for decreased levels of sugar in your body is
Obtain Vital Signs
The nurse is assessing a patient that presents to the ER for sudden onset chest pain. The nurse is correct when the first intervention for the patient is
Sodium 121
The nurse is assessing a patient that presents to the ER in acute pancreatitis, the patient has had nausea, anorexia, and emesis for the last 12 hours, the nurse is correct to be most concerned about
Primary hypertension
The nurse is assessing a patient with a history of hypertension, hyperlipidemia, and diabetes. The nurse obtains a set of vitals and the blood pressure is as follows; 137/83. The nurse is correct in documenting that this patient has
Place the end of the chest tube in a container of normal saline
The nurse is caring for a male client with a chest tube. If the chest drainage system is accidentally disconnected, what should the nurse plan to do?
The patient's hands flap back and forth when the arms are extended.
The nurse is caring for a patient who has cirrhosis. Which data obtained by the nurse during the assessment will be of most concern?
Administer prescribed opioids to relieve pain as needed.
The nurse is caring for a patient with pancreatic cancer. Which nursing action is the highest priority?
Respirations 28 shallow
The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical manifestations would be most indicative of the anemia?
Have complete blood count checked at the HCP's office
The nurse is discharging a client dx with anemia. Which discharge instruction should the nurse teach?
Primary prevention
The nurse is educating a 35-year-old patient who has no history of cardiovascular disease, does not smoke, and lives a healthy lifestyle on ways to prevent stroke, cardiovascular disease, and hypertension, the nurse is using what type of prevention for this patient
The coronary arteries
The nurse is educating a patient on the blood supply that oxygenates the heart and its mechanism, the nurse is correct when she educates the patient that the anatomical structures that supply blood to the heart are
The SA node
The nurse is educating a patient who was recently diagnosed with A-fib about the conduction system of the heart, she is correct when she states that the first electrical impulse is initiated by
Right Ventricle
The nurse is educating a patient who was recently diagnosed with heart failure about the anatomy of the heart, the nurse is correct in educating the patient about the structure that supplies deoxygenated blood through the pulmonary artery for oxygenation being
Aspirin 162-325mg
The nurse is expecting a patient with a confirmed ST elevated MI on the monitor to be brought in by EMS, the nurse notes that she needs to have this medication ready to administer as soon as the patient presents with a suspected STEMI
Male age 75
The nurse is holding an educational event for new students on orientation at her local hospital, she is correct in letting her students know that the individual at highest risk for a acute coronary syndrome is
Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie
The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?
Beta agonist
The nurse is instructing a client with moderate persistent asthma on the proper method for using MDI's (multi-dose inhalers). Which medication should be administered FIRST?
Unstable angina
The nurse is managing a patient in triage due to presenting with chest pain while exercising, the nurse understands that she must suspect an acute coronary syndrome, she does an ECG and there is no ST elevation and the patient states that he still has pain even at rest. The nurse considers this to be
Previous history of MI
The nurse is obtaining history on a patient which presents for sudden onset acute chest pain, when interviewing the patient the most concerning subjective data is
Mitral
The nurse is performing a cardiac assessment on a patient, she is using her stethoscope and is assessing the point of maximal impulse, the nurse is correct when she assesses this landmark
Maintaining normal respiratory function
The nurse is planning care for a patient with acute severe pancreatitis. What is the highest priority patient outcome?
Atrial Depolarization
The nurse is reviewing a ECG strip for a patient that presented with chest pain. She is correct in knowing that the P wave in an ECG strips, represents
Platelets 98
The nurse is reviewing lab values for a patient admitted with pneumonia, the nurse is correct to be most concerned about this lab value
Elevated WBC's
The nurse is reviewing lab values for a patient with pneumonia, what is an expected finding?
"I can take a shower and walk around the house tomorrow."
The nurse recognizes that teaching a patient following a laparoscopic cholecystectomy has been effective when the patient makes which statement?
Pace activities according to tolerance
The nurse writes a client problem of "activity intolerance" for a client dx with anemia. Which intervention should the nurse implement?
Ammonia levels
What is most important for the nurse to monitor to detect possible complications in a patient with severe cirrhosis who has bleeding esophageal varices?
Cigarette smoking
What risk factor will the nurse specifically ask about when a patient is being admitted with acute pancreatitis?
Mealtime
What should the nurse teach a patient with chronic pancreatitis is the time to take the prescribed pancrelipase (Viokase)?
Measures for improving appetite
What topic should the nurse plan to teach the patient diagnosed with acute hepatitis B?
Check the calcium level in the chart.
When taking the blood pressure (BP) on the right arm of a patient who has severe acute pancreatitis, the nurse notices carpal spasms of the patient's right hand. Which action should the nurse take next?
Avoid smoking near the client
When teaching a client with chronic obstructive pulmonary disease about oxygen by cannula, the nurse should also instruct the client's family to
Check blood pressure and heart rate.
Which action should the nurse in the emergency department take first for a new patient who is vomiting blood?
Ask the patient to extend both arms forward.
Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic encephalopathy?
Review the patient's current medication list.
Which action will be included in the care for a patient who has recently been diagnosed with asymptomatic nonalcoholic fatty liver disease (NAFLD)?
Schedule for liver cancer screening every 6 months.
Which action will the nurse include in the plan of care for a patient who has been diagnosed with chronic hepatitis B?
Palpable abdominal mass
Which assessment finding is of most concern for a patient with acute pancreatitis?
Muscle twitching and finger numbness
Which assessment finding would the nurse need to report most quickly to the health care provider regarding a patient who has acute pancreatitis?
The patient's stools are tan colored.
Which assessment information will be most important for the nurse to report to the health care provider about a patient who has acute cholecystitis?
Fewer episodes of bleeding varices
Which finding indicates to the nurse that a patient's transjugular intrahepatic portosystemic shunt (TIPS) placed 3 months ago has been effective?
The patient is alert and oriented.
Which finding indicates to the nurse that lactulose is effective for an older adult who has advanced cirrhosis?
Temperature 100.8° F (38.2° C)
Which finding is most important for the nurse to communicate to the health care provider about a patient who received a liver transplant 1 week ago?
Maintain adequate nutrition.
Which goal has the highest priority in the plan of care for a 26-yr-old patient who was admitted with viral hepatitis, has severe anorexia and fatigue, and is homeless?
The patient used IV drugs about 20 years ago.
Which information from a 70-yr-old patient during a health history indicates to the nurse that the patient should be screened for hepatitis C?
Lipase
Which laboratory test result will the nurse monitor to evaluate the effects of therapy for a patient who has acute pancreatitis?
The medication will prevent irritation of the enlarged veins.
Which response by the nurse best explains the purpose of ranitidine (Zantac) for a patient who was admitted with bleeding esophageal varices?
Which topic is most important to include in teaching for a 41-yr-old patient diagnosed with early alcoholic cirrhosis?
Which topic is most important to include in teaching for a 41-yr-old patient diagnosed with early alcoholic cirrhosis?
