Med Surge Summative Exam2,3,4,6,24,25
A patient is scheduled for pulmonary function tests (PFTs) . What does the nurse tell the patient about the test?
PFT is useful to determine the cause of dyspnea
The nurse is preforming a skin assessment for a patient confined to bed and notes a reddened area over the ankle. How long does the nurse wait for the reddened area to fade before classifying it as pre ulcer or stage 1 pressure area.
3 min
When using McCaffrey and Pesaro's Hierarchy of pain measures which assessment data corresponds with behavioral signs
Frowning or grimacing doing repositioning
If a person retires between the age of 55 and 65 by what age are fun is most likely to become depleted causing strain on healthcare
80 to 85 years
Which group of older adults is classified as old old
85 to 99 years of age
A patient of Voice taking over the counter (OTC) medications unless the primary healthcare provider suggest the patient del Sol this is an example of what
A Health protecting behavior
Which statement about older adults and incontinence is correct
A bladder training program is often helpful in the management
Financial hardship, not insurance , I a source of stress and anxiety for older adult patients. Relocation, acute or chronic illness, and loss of significant others also causes stress and anxiety among older adults.
A health protecting behavior
The nurse is caring for patient who has a history of osteoarthritis and peptic ulcer disease which angalestic medication will the nurse anticipate administering to the patient.
Acetaminophen
Which nursing student response about frequent sources of stress and anxiety in older adult patients confirms the need for further teaching by the nursing instructor
Acute or chronic illness
A patient with chronic pain feels no relief with high dose Opiods and says 'I just can't manage living right now'. what intervention does the nurse anticipate the healthcare provider will order for the patient
Adding the duloxetine as adjuvant therapy
The nurse is caring for a patient who is receiving intravenous Hydromorephon. Prior to administration of the medication the patient's respiratory rate was 18 breaths per minute 10 minutes after receiving a dose of Hydro more phone the patient is on arousable and her respiratory rate is eight breaths per minute which action will the nurse implement immediately
Administer naloxone
The patient is receiving opioid analgesic medication via patient controlled analgesia (PCA) On occasion, the patient's spouse activates the PCA button. Which nursing action will the nurse implement immediately?
Advise the patient and his spouse that only the patient may activate the PCA
What might a patient with excessive immune response experience that a patient with decreased immune response is less likely to experience select all that apply
Allergies Autoimmune disease
Which group of drugs may cause delirium as an adverse side effect
Anticholinergic
The rehabilitation nurse at the hospital is also designated as a case manager for a patient which of the following is a duty of the nurse as a case manager
Assesses the layout of the patient's home
The nurse should educate patients at risk for clotting to use what measures to decrease the risk of complications? Select all that apply.
Avoid smoking Avoid crossing the legs. Avoid prolonged sitting . Observe symptoms in lower extremities .
In the role of patient advocate what does the nurse do first for the patient who reports pain
Believes the patient report of pain
Decreased function of which physiologic process calls retention of carbon dioxide
Gas exchange
What adverse effects will the nurse monitor for in patient taking nonsteroidal anti inflammatory drugs NSAIDS select all that apply
Gastric toxicity Thrombocytopenia Gastrointestinal ulcer
Which health problem dose rehabilitation programs most assist in
Cardiac
What is the most common problem faced by rehabilitation patients
Constipation
The nurse is performing a functional assessment for a patient what skills does the nurse classify as instrumental activities of daily living I ADLs
Cooking shopping housekeeping
Which term is used to describe pain quality
Cramping
What support is provided to a patient coping with a disability
Get counseling for the patient and family
What age related changes, Lee affect the metabolism of drugs in the body of older patient
Decrease in liver size
Patients who are late old and patience with alcoholism and/or disorders of Major body organs are at a higher risk of what
Delirium
Which condition places the patient at high risk for under treatment of pain
Delirium
Independence in bowel elimination requires cognition, manual dexterity, sensation, muscle control, and mobility. Good sleep, deep breathing, and nutritions diet are not factors that determine independence in bowel elimination.
Depression
Which Manifestations of Neglect does the nurse identify as most common in older adults
Depression
The Nurse is administering chemotherapeutic Drugs to the patient and noticed excessive bruising on the patient's arm the patient cannot recall injury to the area the nurse knows that this bruising may indicate which condition
Diminished clotting
An older adult patient is diagnosed with depression that the provider believes is due to insufficient serotonin in the brain this is described as what
Primary depression
What data indicatesWhat does static or postural hypotension in a patient
Drop of 10 MMHG in diastolic pressure between positions
Which nursing action reflects correct use of the Wong baker faces pain rating scale
Encouraging the patients to choose a cartoon face that best represents the pain
The nurse is establishing a plan of care for a hospitalized patient with chronic pain caused by fibromyalgia. Which nursing action does the nurse delegate to a nursing assistant?
Engagement in conversation about the patient's family to distract the patient
Which did the National Institute for occupational Saftey and Health NIOSH establish
Evidence based guidelines for saftey patient handling
Following surgery a patient has limited mobility. The nurse observes the patient for localized redness, swelling, and warmth to assess for which complication
Excessive clotting
The nurse is providing education to patient with recurring constipationWhat lifestyle intervention does the nurse suggest to the patient to stimulate peristalsis
Exercising frequently
A patient is brought to the hospital in a state of delirium which indicators on the checklist of nonverbal pain indicators see NPI does the nurse used to assess this patient's level of pain select all that apply
Facial expression Mental status changes Changes in interpersonal interactions
What is the most prominent hindrance to the rehabilitation of patients with cardiac disorders
Fear
What is the primary collaborative intervention for patients with fluid deficits?
Fluid replacement
A patient has lost weight since admission into the rehabilitation center one week ago there is a decrease in the serum prealbumin level. What nutritional recommendation does the nurse expect from the register dietitian for this patient
Hi Protein and high carbohydrate diet
What does the nurse infer if a patient scores a 2 on the Wong-Baker FACES pain rating scale ?
Hurts a little bit
The registered nurse is teaching a nursing student about interventions to prevent sleep disorders in an older patient. Which nursing student statement indicates a need for further teaching by the nurse?
I should encourage the patient to sleep langer during the daytime.
The nurse preceptor is teaching a nursing student about minimizing the effects of relocation trauma in Older adults which of the nursing student statements indicate a need for further teaching by the nurse preceptor
I should not involve the older patient in decision making
Which strategy represents correct use of behavioral signs as part of pain assessment
Identifying specific pain behaviors that are unique to the patient
Which patients are generally in capable of reporting their pain using self-report assessment tools
Immediately dying patients
What is the other term use for subarachnoid analegesia
Intrathecal
A postoperative patient is vomiting and states, 'I am having a lot of pain about a 7 on a scale of to 10. Which route of administration does the nurse choose to administer an analgesic to the patient?
Intravenous
A registered nurse ask a nursing student about the minimum data set MDS required by Medicare and Medicaid certified nursing homes which nursing student statement indicates a need for further teaching
It is evaluated specifically by the mobility of the resident patient
Fentanyl is a opioid which can be administered through the transdermal route to relieve pain which factors are considered disadvantages of the trans terminal route of OPiod administration
It needs to be supplemented with other analgesics analogically initially
Which factor affects the ability of older patients to process new information
Loss of vision
The nurse understands that signs of decreased peripheral perfusion most often occur where?
Lower extremities
Which term describes pain produced by Inflammation of the trigeminal nerve that is the fuse in nature extending across the various nerves that intervate the face
Projected
What is one way in which the baby boomer generation health affected the United States
Mark negative impact on the country's economy
Following a falla 62-year-old patient is admitted to the rehabilitation unit with a broken collarbone and a full leg brace. Which transfer technique is indicated for this patient?
Mechanical lift
For which do older adults pay to cover prescription drug costs
Medicare part D
which cognitive behavioral distractions can be useful in reducing a patient's focus on pain select all that apply
Medication Biofeedback Guided imagery
Which medication is listed on the beers criteria for potentially inappropriate medication use in older adults
Meperidine
Which type of drugs are appropriate for the nurse to recommend to patients experiencing constipation select all that apply
Mild laxatives Stool softeners Bulk forming agents
During which process of pain transition does an opioid analgesic medication inhibits pain by affecting central mechanism
Modulation
Which patient statement is consistent with the experience of visceral pain
My entire abdomen is cramping
Which is risk factor for opioid induced respiratory depression
Obstructive sleep apnea
The patient is struggling with use of eating utensilsWhich rehabilitation team member is brought in to help the patient with this problem?
Occupational therapist
Which evidence based nursing interventions should the nurse include in a plan of care in order to prevent agency associated pressure ulcers as per the National Patient Safety Goals (NPSGs) Salei all that apply
Offer nutritional support Reposition and provide support surfaces Avoid skin injury caused by friction or shearing forces
What is the fastest growing sub group of older adults
Old old
Which necessitates help a patient maintain healthy skin select all that apply
Oxygen Sensation Adequate food
The nurse is conducting a pain assessment which assessment data is the most reliable indicator of the patient's pain
Pain rating of 3 on 0 to 10 scale
The medical surgical nurse is coordinating transfer from acute care to community base care for a patient who requires rehabilitation which interdisciplinary team member will be the primary decision-maker in this transition
Patient
An older patient tells the nurse his son sometimes hit him with the patient does not keep his bedroom tidy. what problem does this indicate
Physical abuse
A patient who is using patient control analgesia PCA Is Ashley the nurse observes a family member pushing the PCA button for a sleeping patient what does the nurse say to the visitor
Please allow the patient to push the button when needed
The nurse is performing a pain assessment on an alert mechanically vented patient which patient behavior has the potential to provide the most useful assessment data for determining patient intensity
Plinking
The nurse is mentoring a nursing student about best practices for safe patient handling SPH what practice does the nurse teach the student
Put the beer at waist level for Care and Hip level for movement of the patient
The nurse is caring for a patient at high risk for decreased perfusion what lifestyle Interventions does the nurse teach the patient in order to decrease the risk select all that apply
Quitting smoking Maintaining bed rest Regular cardiovascular exercise
Which term describes pain that occurs along a specific nerve or nerves
Radiating
Which term describes pain that originates at the site of a herniated cervical disc and extends into the arm hand and fingers
Radiating
Which pain is felt alone a specific nerve or nerves
Radiation pain
Which chronic condition does the nurse expect to find in a 70-year-old patient Salei all that apply
Stroke Arthritis Coronary heart disease
Which data is most reliable for use in assessment of a patient's pain
Subject patient report
The nurse understands that which laboratory test are most useful in detecting auto immune disease Select all that apply
Rheumatoid factor Antinuclear antibody
Which tool is available to help the nurse focus on factors that increase an older persons risk for falling
STRATIFY
The nurse is caring for a patient with flaccid bowel caused by lower motor neuron spinal cord injury. How does the nurse encourage bowel movements and prevent constipation in the patient
Schedule a bowel program as per the patients previous routine
The nurse is preparing a care plan for a patient with lower back pain and hypothyroidism who has been prescribed acetaminophen Which instruction would the nurse give regarding this medication
Schedule regular renal and liver function test number one
What behaviors differentiate a social smoker from an active smoker?
Social smokers claim to prefer the company of non-smokers
The nurse is teaching a patient about the administration of a prescribed liquid form of acetaminophen what information does the nurse include when advising this patient
Take a maximum up to 4000 MG/ day
If the nurse working in the hospital suspects physical abuse or neglect of another patient who should the nurse notify
The hospital social worker
A patient rates they're paying at a two or three on the pain rating scale on a calibrated 0 to 10 how does the nurse interpret this finding
The patient has mild pain
Members of the clergy may be part of the rehabilitation team that helps restore and maintain the patients function to the greatest extent possible what role do they play
They help in spiritual assessments and care of the patient.
During a physical examination, the nurse identifies palpable mass in the patient's breast. What type of assessment may be used to identify the type of cells that are present in the mass?
Tissue biopsy
What should the nurse include in the assessment when looking for signs of skin breakdown including pressure ulcers
Tissue integrity
Why was the Americans with disability act passed Select all that apply
To make employers offer assistance to the disabled employee So encourage disabled people to resume normal activities in the workplace
Which time is used to describe pain duration
Transient
A soldiers returning from overseas after sustaining injuries from a roadside bomb explosion which condition does the nurse expect to see in this patient
Traumatic brain injury
An older adult patient is being treated for depression following a recent major loss which type of treatment would be contradicted in this patient
Tricyclics antidepressant drugs
What easily observable physical signs may indicate malnutrition select all that apply
Very dry skin Brittle hair and nails
After administering a dose of opioids, the nurse evaluates the patient using the Pashto Opioid Sedation Scale (POSS) and documents a . What patient behavior does this indicate?
Wake and alert
The physical therapist is teaching a paraplegic patient to become independent and transfer from the bed to the chair which equipment does the nurse expect the physical therapist to use
Wheelchair with removable arms
Which pain scale is most appropriate for the nurse to use my necessity pay in a six year old child
Wong baker faces
The nurse is attending to an Asian American patient who cannot communicate in English what all does the nurse use when assessing the Painof the patient
Wong baker faces pain rating scale
What is the nature of sputum in a smoker with chronic bronchitis?
mucoid