Midterm med surg 1 lola

A nurse is admitting a patient with immune thrombocytopenic purpura to the unit. In completing the admission assessment, the nurse must be alert for what medications that potentially alter platelet function? Select all that apply.

Sulfa-containing medications Aspirin-based drugs NSAIDs

A student with diabetes tells the school nurse that he is feeling nervous and hungry. The nurse assesses the child and finds he has tachycardia and is diaphoretic with a blood glucose level of 50 mg/dL (2.8 mmol/L). What should the school nurse administer?

Half of a cup of juice, followed by cheese and crackers

When teaching your patient about insulin to cover mealtimes, which type of insulin will you describe?

Short acting. (ie...regular insulin with an onset of 1 hour and duration of 3 hours) (long acting or basal insulins are used for continuous control)

Which is considered an isotonic solution?

0.9% normal saline

The normal serum value for potassium is

3.5-5.0 mEq/L (3.5-5.0 mmol/L).

A patient with renal failure has decreased erythropoietin production. Upon analysis of the patient's complete blood count, the nurse will expect which of the following results?

A decreased hemoglobin and hematocrit

A patient comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?

A hemolytic anemia

The home care nurse is assessing the home environment of a patient who will be discharged from the hospital shortly after his laryngectomy. The nurse should inform the patient that he may need to arrange for the installation of which system in his home?

A humidification system

The public health nurse is administering Mantoux tests to children who are being registered for kindergarten in the community. How should the nurse administer this test?

Administer intradermal injections into the children's inner forearms.

When coming up with an educational plan for your patient who is newly diagnosed with diabetes, what should you begin with?

An assessment of the patient's understanding of his/her diagnosis.

The nurse is to make a room assignment for a client diagnosed with an upper respiratory infection. The other clients with empty beds in the room are listed in the accompanying chart. The best room assignment for the new client would be with Client

B

Which is a deformity of the chest that occurs as a result of overinflation of the lungs?

Barrel chest

A woman who is in her third trimester of pregnancy has been experiencing an exacerbation of iron-deficiency anemia in recent weeks. When providing the patient with nutritional guidelines and meal suggestions, what foods would be most likely to increase the woman's iron stores?

Beef liver accompanied by orange juice

Blood cells are primarily formed in what organ?

Bone Marrow

Which of the following clinical characteristics is associated with type 2 diabetes (previously referred to as non-insulin dependent diabetes mellitus [NIDDM])?

Can control blood glucose through diet and exercise

An 87-year-old patient has been hospitalized with pneumonia. Which nursing action would be a priority in this patient's plan of care?

Cautious hydration

The nurse is caring for a patient with hypernatremia. What complication of hypernatremia should the nurse continuously monitor for?

Cerebral edema

The nurse is caring for a client in the ICU who is receiving mechanical ventilation. Which nursing measure is implemented in an effort to reduce the client's risk of developing ventilator-associated pneumonia (VAP)?

Cleaning the client's mouth with chlorhexidine daily

A nurse is documenting the results of assessment of a patient with bronchiectasis. What would the nurse most likely include in documentation?

Clubbing of the fingers

Name a complication of Autonomic neuropathy often seen in long-term or uncontrolled diabetic patients.

Common (autonomic) neuropathies: 1. Delayed gastric emptying 2. Decreased sensations in the hands & feet 3. Inability to detect hypoglycemic symptoms 4. Decreased peripheral pulses 5. Increased peripheral vascular disease

Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus?

Confusion and seizures

A nurse is caring for a patient who has been admitted with an exacerbation of chronic bronchiectasis. The nurse should expect to assess the patient for which of the following clinical manifestations?

Copious sputum production

A patient with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this patient?

Decreased BP

A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care?

Encouraging increased fluid intake

A client is receiving mechanical ventilation. How frequently should the nurse auscultate the client's lungs to check for secretions?

Every 2 to 4 hours

Which of the following Lab values should the nurse assess first?

Fasting Blood Glucose = 126 mg/dl Glycosylated Hemoglobin = 7.2% Hemoglobin A1C = 6.8% Noon Blood Glucose = 58 mg/dl **Noon Blood Glucose = 58 mg/dl: (This patient is hypoglycemic and is going to need carbohydrate-containing beverage such as orange juice or glycerol)

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

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

The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimoto's thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?

Fatigue

Signs & Symptoms of Hematologic Disorders

Fatigue (worsens with severity) Shortness of Breath Pale Bleeding disorders / + Occult blood test (stool) AKA - guiac

An adult patient has been diagnosed with iron-deficiency anemia. What nursing diagnosis is most likely to apply to this patient's health status?

Fatigue related to decreased oxygen-carrying capacity

You are caring for a patient who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Your patient's plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow the nurse to assess what aspect of the patient's health?

Fluid volume status

In which of the following medical conditions would administering IV normal saline solution be inappropriate? Select all that apply.

Heart failure Pulmonary edema Renal impairment

The physician has ordered a fluid deprivation test for a patient suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments?

Heart rate and BP

A young adult patient has received the news that her treatment for Hodgkin lymphoma has been deemed successful and that no further treatment is necessary at this time. The care team should ensure that the patient receives regular health assessments in the future due to the risk of what complication?

Hematologic cancers

The nurse is describing normal RBC physiology to a patient who has a diagnosis of anemia. The nurse should explain that the RBCs consist primarily of which of the following?

Hemoglobin

What is the main component of RBC's?

Hemoglobin

The perioperative nurse has admitted a patient who has just underwent a tonsillectomy. The nurse's postoperative assessment should prioritize which of the following potential complications of this surgery?

Hemorrhage

A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding?

Highly dilute urine

The nurse's assessment of a patient with thyroidectomy suggests tetany and a review of the most recent blood work corroborate this finding. The nurse should prepare to administer what intervention?

IV calcium gluconate

The nurse is caring for a patient with a lower respiratory tract infection. When planning a focused respiratory assessment, the nurse should know that this type of infection most often causes what?

Impaired gas exchange

A patient with a hematologic disorder asks the nurse how the body forms blood cells. The nurse should describe a process that takes place where?

In the bone marrow

A nurse is providing education to a patient with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?

Iron will cause the stools to darken in color.

The occupational health nurse is obtaining a patient history during a pre-employment physical. During the history, the patient states that he has hereditary angioedema. The nurse should identify what implication of this health condition?

It can cause life-threatening airway obstruction.

The nurse is caring for a patient with a diagnosis of Addison's disease. What sign or symptom is most closely associated with this health problem?

Muscle weakness

Is Glipizide (Glucotrol) an oral or injectible type of insulin?

Oral

A nurse practitioner has provided care for three different patients with chronic pharyngitis over the past several months. Which patients are at greatest risk for developing chronic pharyngitis?

Patients who are habitual users of alcohol and tobacco

A client presents to a physician's office complaining of dyspnea with exertion, weakness, and coughing up blood. Further examination reveals peripheral edema, crackles, and jugular vein distention. The nurse anticipates the physician will make which diagnosis?

Pulmonary hypertension

The nurse is caring for a patient at risk for an addisonian crisis. For what associated signs and symptoms should the nurse monitor the patient? Select all that apply.

Rapid respiratory rate Hypotension Pallor

Describe Secondary Myelodysplastic Syndrome

Secondary MDS can occur at any age and results from prior toxic exposure to chemicals, including chemotherapeutic medications. Family history, sun exposure, and previous infections are unrelated to the pathophysiology of secondary MDS. Because the patient with MDS is at a high risk for infection and bleeding any early signs of infection or bleeding must be reported promptly.

A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety, how should the nurse best position the patient?

Semi-Fowler's with the head supported on two pillows

An older adult client is exhibiting many of the characteristic signs and symptoms of iron deficiency. In addition to a complete blood count, what diagnostic assessment should the nurse anticipate?

Stool for occult blood

A patient diagnosed with type 1 diabetes will be started on what medication ?

Sub-q Insulin

Describe the pathophysiology in type ii diabetes.

The body becomes resistant to the available insulin so glucose can't get into the cells.

An adult patient has tested positive for tuberculosis (TB). While providing patient teaching, what information should the nurse prioritize?

The importance of adhering closely to the prescribed medication regimen

A patient with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in cortisol levels. How should the nurse interpret this finding?

The patient's pituitary function is compromised.

A nurse is assessing a patient who has diabetes for the presence of peripheral neuropathy. The nurse should question the patient about what sign or symptom that would suggest the possible development of peripheral neuropathy?

The presence of a tingling sensation

While assessing the patient, the nurse observes constant bubbling in the water-seal chamber of the patient's closed chest-drainage system. What should the nurse conclude?

The system has an air leak.

A patient is exhibiting signs of a pneumothorax following tracheostomy. The surgeon inserts a chest tube into the anterior chest wall. What should the nurse tell the family is the primary purpose of this chest tube?

To remove air from the pleural space

A client has a serum calcium level of 7.2 mg/dl. During the physical examination, the nurse expects to assess:

Trousseau's sign.

In a nursing pathophysiology class the instructor is teaching about the regulation of fluid volume. How is fluid volume primarily regulated?

Urine excretion

The nurse is performing a shift assessment of a patient with aldosteronism. What assessments should the nurse include? Select all that apply.

Urine output Blood pressure

While caring for a patient with an endotracheal tube, the nurses recognizes that suctioning is required how often?

When adventitious breath sounds are auscultated

Which is an insensible mechanism of fluid loss?

breathing

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition?

confusion

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration?

dark concentrated urine

Which measure may increase complications for a client with COPD?

increased oxygen supply

A black client with asthma seeks emergency care for acute respiratory distress. Because of this client's dark skin, the nurse should assess for cyanosis by inspecting the:

mucous membranes.

Which set of arterial blood gas (ABG) results requires further investigation?

pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L

A client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis?

pH, 7.25; PaCO2 50 mm Hg

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately?

potassium

Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality?

sodium

Name One Class of oral medications used for type ii diabetes

sulfonylureas (Could also list: alpha glucosidase inhibitors, the glitizones, meglitinides, DP4 inhibitors, GLP1 Analogs, & Biguanides)

The amount of air inspired and expired with each breath is called:

tidal volume.

The nurse is teaching the client about use of the pictured item with a metered-dose inhaler (MDI). The nurse instructs the client as follows: (Select all that apply.)

-Take a slow, deep inhalation from the device. -Activate the MDI once. -The device may increase delivery of the MDI medication.

A client is admitted to the emergency department with a stab wound and is now presenting dyspnea, tachypnea, and sucking noise heard on inspiration and expiration. The nurse should care for the wound in which manner?

Apply airtight dressing.

A 42-year-old patient is admitted to the ED after an assault. The patient received blunt trauma to the face and has a suspected nasal fracture. Which of the following interventions should the nurse perform?

Apply ice and keep the patient's head elevated.

When assessing for substances that are known to harm workers' lungs, the occupational health nurse should assess their potential exposure to which of the following?

Asbestos

A patient has received a diagnosis of type 2 diabetes. The diabetes nurse has made contact with the patient and will implement a program of health education. What is the nurse's priority action?

Assess the patient's readiness to learn.

A student nurse is preparing to care for a patient with bronchiectasis. The student nurse should recognize that this patient is likely to experience respiratory difficulties related to what pathophysiologic process?

Dilation of bronchi and bronchioles

You are caring for a patient admitted with a diagnosis of acute kidney injury. When you review your patient's most recent laboratory reports, you note that the patient's magnesium levels are high. You should prioritize assessment for which of the following health problems?

Diminished deep tendon reflexes

The adrenal cortex is responsible for producing which substances?

Glucocorticoids and androgens

A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering?

0.45% NaCl

The clinic nurse is caring for a patient who has been diagnosed with emphysema and who has just had a pulmonary function test (PFT) ordered. The patient asks, "What exactly is this test for?" What would be the nurse's best response?

"A PFT measures how much air moves in and out of your lungs when you breathe."

A client with chronic obstructive pulmonary disease (COPD) reports increased shortness of breath and fatigue for 1 hour after awakening in the morning. Which of the following statements by the nurse would best help with the client's shortness of breath and fatigue?

"Delay self-care activities for 1 hour."

A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the patient should prioritize what question when addressing potential complications?

"Do you feel any muscle twitches or spasms?"

A client admitted to the facility for treatment for tuberculosis receives instructions about the disease. Which statement made by the client indicates the need for further instruction?

"I'll stay in isolation for 6 weeks."

A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond?

"Ketones will tell us if your body is using other tissues for energy."

An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as suggestive of diabetes?

"Lately, I drink and drink and can't seem to quench my thirst."

A clinic nurse is caring for a patient who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The patient asks the nurse what he could have done to minimize the risk of contracting this disease. What would be the nurse's best answer?

"The most important risk factor for COPD is cigarette smoking."

A new employee asks the occupational health nurse about measures to prevent inhalation exposure of the substances. Which statement by the nurse will decrease the patient's exposure risk to toxic substances?

"Wear protective attire and devices when working with a toxic substance."

Following an extensive diagnostic workup, an older adult patient has been diagnosed with a secondary myelodysplastic syndrome (MDS). What assessment question most directly addresses the potential etiology of this patient's health problem?

"Were you ever exposed to toxic chemicals in any of the jobs that you held?"

Describe how to teach your patient to inject their prescribed insulin of mixed Regular and NPH.

1. The patient should inject the appropriate amount of air into the insulin bottles after wiping tops with alcohol pads. 2. Regular insulin should be drawn up first then draw up the NPH into the syringe. 3. Subq needles are used so aspirating to check for blood is not necessary. 4. Rotating injection sites, not necessary because all insulin is human insulin and risk for lipodystrophy is very low. 5. Skin should be cleansed with alcohol pad prior to injecting.

A nurse is preparing a continuous insulin infusion for a child with diabetic ketoacidosis and a blood glucose level of 800 mg/dl. Which solution is the most appropriate at the beginning of therapy?

100 units of regular insulin in normal saline solution

A medical nurse is caring for a patient with type 1 diabetes. The patient's medication administration record includes the administration of regular insulin three times daily. Knowing that the patient's lunch tray will arrive at 11:45, when should the nurse administer the patient's insulin?

11:15

A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation?

15-mm induration

You are have an order to give Augmentin 375 mg p.o. q 8 hr. Augmentin is supplied from the pharmacy in a 75 mL bottle with a concentration of 250 mg/5 mL. How many mL's will you administer to your patient per dose?

7.5 mL

What is the normal blood glucose level?

80 - 110 meq/L

How many hours after your patient receives an injection of 70/30 Premix Nph/regular insulin should you watch for a hypoglycemic reaction?

9 to 11

What is normal A1c levels?

< 7 u/dl

A nurse is caring for a group of clients on a medical-surgical floor. Which client is at greatest risk for developing pneumonia?

A client with a nasogastric tube

What would the critical care nurse recognize as a condition that may indicate a patient's need to have a tracheostomy?

A patient requires permanent ventilation.

The nurse at a long-term care facility is assessing each of the residents. Which resident most likely faces the greatest risk for aspiration?

A resident who suffered a severe stroke several weeks ago

What is polycythemia Vera & how is it treated?

Because of the risk of DVT, patients with polycythemia vera should avoid tight and restrictive clothing. There is no need to avoid foods with vitamin K or to avoid higher altitudes. Activity levels should be maintained, but there is no specific need for ROM exercises. The course of polycythemia vera can be best ascertained by monitoring the patient's hematocrit, which should remain below 45%. Erythropoietin injections would exacerbate the condition.

Upon shift report, the nurse states the following laboratory values: pH, 7.44; PCO2, 30mmHg; and HCO3,21 mEq/L for a client with noted acid-base disturbances. Which acid-base imbalance do both nurses agree is the client's current state?

Compensated respiratory alkalosis

A diabetes nurse educator is teaching a group of patients with type 1 diabetes about "sick day rules." What guideline applies to periods of illness in a diabetic patient?

Do not eliminate insulin when nauseated and vomiting.

An elderly client is diagnosed with pulmonary tuberculosis. Upset and tearful, he asks the nurse how long he must be separated from his family. Which nursing diagnosis is most appropriate for this client?

Deficient knowledge (disease process and treatment regimen)

A nurse is evaluating the diagnostic study data of a patient with suspected cystic fibrosis (CF). Which of the following test results is associated with a diagnosis of cystic fibrosis?

Elevated sweat chloride concentration

The nurse is creating a plan of car for a patient diagnosed with acute laryngitis. What intervention should be included in the patient's plan of care?

Encourage the patient to limit speech whenever possible.

What assessment findings would you expect if you were caring for a patient in dka

Fruity odor to breath kussmal respirations Metabolic acidosis Nausea & vomiting confusion / lethargy

Your diabetic patient wants to start playing hockey 3 days a week for 2 hours at a time. What should you tell him regarding his diabetic regimen relating to his meals, insulin & glucose levels?

He needs to make sure to eat his scheduled meals but the increase in activity will affect his blood glucose so he needs to check his blood sugar levels before playing hockey, 1 hour into the game and at the end of the game to monitor his glucose levels and the effect the activity has on them. He should also have snacks available in the event of hypoglycemia while playing.

The nurse is caring for a patient whose recent unexplained weight loss and history of smoking have prompted diagnostic testing for cancer. What symptom is most closely associated with the early stages of laryngeal cancer?

Hoarseness

The nurse is caring for a patient who is scheduled to have a thoracotomy. When planning preoperative teaching, what information should the nurse communicate to the patient?

How to splint the incision when coughing

What is the dawn Effect?

Hyperglycemia beginning in the early morning hours when naturally occurring cortisol, glucose, and growth hormones begin to get released. (p.s - new evidence is suggesting the somogyi Effect isn't a real thing)

You are working on a burns unit and one of your acutely ill patients is exhibiting signs and symptoms of third spacing. Based on this change in status, you should expect the patient to exhibit signs and symptoms of what imbalance?

Hypovolemia

The nurse is caring for a patient in the ICU admitted with ARDS after exposure to toxic fumes from a hazardous spill at work. The patient has become hypotensive. What is the cause of this complication to the ARDS treatment?

Hypovolemia secondary to leakage of fluid into the interstitial spaces

A nurse has been asked to give a workshop on COPD for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect?

Increases the amount of mucus production

The nurse is planning for the care of a patient with acute tracheobronchitis. What nursing interventions should be included in the plan of care? (Select all that apply.)

Increasing fluid intake to remove secretions Encouraging the patient to remain in bed Using cool-vapor therapy to relieve laryngeal and tracheal irritation

Hemolytic Anemia

Jaundice Destroyed RBCs cause increased bilirubin Enlarged spleen and liver Hyperactive with macrophage phagocytosis of the defective RBCs Accumulation of hemoglobin molecules can obstruct renal tubules Tubular necrosis

The nurse recognizes that aspiration is a potential complication of a laryngectomy. How should the nurse best manage this risk?

Keep a complete suction setup at the bedside.

What are side effects of taking iron or complications?

Nausea, Constipation Dark stools

What does Hemoglobin a1C test for?

Overall control of glucose over 3 to 4 months

A firefighter was trapped in a fire and is admitted to the ICU for smoke inhalation. After 12 hours, the firefighter is exhibiting signs of ARDS and is intubated. What other supportive measures are initiated in a patient with ARDS?

Nutritional support

What is the main role of the B lymphocytes

Production of Antibodies

A patient with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the patient, the nurse should know that the patient's diminished thyroid function may have what effect?

Prolonged duration of effect

A nurse is educating a patient in anticipation of a procedure that will require a water-sealed chest drainage system. What should the nurse tell the patient and the family that this drainage system is used for?

Removing excess air and fluid

The home care nurse is monitoring a patient discharged home after resolution of a pulmonary embolus. For what potential complication would the home care nurse be most closely monitoring this patient?

Residual effects of compromised oxygenation

A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance?

Respiratory acidosis

A patient who is being treated for pneumonia starts complaining of sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect?

Respiratory acidosis

A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause of which acid-base imbalance?

Respiratory alkalosis

The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body?

Table salt

A nurse is planning care for a nephrology patient with a new nursing graduate. The nurse states, "A patient in renal failure partially loses the ability to regulate changes in pH." What is the cause of this partial inability?

The kidneys regenerate and reabsorb bicarbonate to maintain a stable pH.

You are studying for a physiology test over the respiratory system. What should you know about central chemoreceptors in the medulla?

They respond to changes in CO2 levels and hydrogen ion concentrations (pH) in the cerebrospinal fluid.

A patient is brought to the ED by ambulance after a motor vehicle accident in which the patient received blunt trauma to the chest. The patient is in acute respiratory failure, is intubated, and is transferred to the ICU. What parameters of care should the nurse monitor most closely? Select all that apply.

Vital signs Level of consciousness Arterial blood gases

A patient is admitted to the hospital with pernicious anemia. The nurse should prepare to administer which of the following medications?

Vitamin B12

Which of the following factors is the focus of nutrition intervention for patients with type 2 diabetes?

Weight loss

If your type I diabetic patient asks you why they are losing weight, what would you tell them?

Weight loss occurs because the body is no longer able to absorb glucose and starts to break down protein and fat for energy

A client admitted with multiple traumatic injuries receives massive fluid resuscitation. Later, the physician suspects that the client has aspirated stomach contents. The nurse knows that this client is at highest risk for:

acute respiratory distress syndrome (ARDS).

describe cells in megaloblastic anemia

these cells are abnormal in shape and structure. many are sequestered (trapped) while still in the bone marrow, and their rate of release is decreased. Some of these cells actually die in the marrow before they can be released into the circulation. This results in megaloblastic anemia. S/S - sore beefy, red tounge

A newly admitted patient with type 1 diabetes asks the nurse what caused her diabetes. When the nurse is explaining to the patient the etiology of type 1 diabetes, what process should the nurse describe?

"Destruction of special cells in the pancreas causes a decrease in insulin production. Glucose levels rise because insulin normally breaks it down."

You have just checked your patients glucose and find that it is 43. What symptoms will your patient most likely be demonstrating?

Anxiety, nervousness, shaky, sweaty, thready pulse

Patients on Metformin need to be cautioned of what diagnostic procedures?

Any procedure using IV contrast because it can lead to lactic acidosis

When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is:

"Diabetes can affect sensation in your feet and you can hurt yourself without realizing it."

A nurse is caring for a patient with COPD. The patient's medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. What assessment parameters suggest a consequent improvement in respiratory status? Select all that apply.

-Increased expiratory flow rate -Relief of dyspnea

A physician orders metaproterenol (Alupent) by metered-dose inhalation four times daily for a client with acute bronchitis. Which statement by the client indicates effective teaching about this medication?

"I need to hold my breath as long as possible after I take a deep inhalation."

An obese person is what percentage above ideal body weight? (or has a bmi greater than what?)

-Persons 20% above ideal body weight or with a BMI >30 is considered obese and high risk for type II diabetes. For example if a 5'4" female has an ideal body weight of 130 lbs. She would be obese at 156 lbs (20% of 130 = 26 lbs)

Which of the following is not associated with Pernicious Anemia?

Increased red meat (esp. liver) in the diet will improve symptoms

The nurse is assessing a patient who has a 35 pack-year history of cigarette smoking. In light of this known risk factor for lung cancer, what statement should prompt the nurse to refer the patient for further assessment?

"Lately, I have this cough that just never seems to go away."

The community health nurse is performing a home visit to an 84-year-old woman recovering from hip surgery. The nurse notes that the woman seems uncharacteristically confused and has dry mucous membranes. When asked about her fluid intake, the patient states, "I stop drinking water early in the day because it is just too difficult to get up during the night to go to the bathroom." What would be the nurse's best response?

"Limiting your fluids can create imbalances in your body that can result in confusion. Maybe we need to adjust the timing of your fluids."

An interdisciplinary team is planning the care of a patient with bronchiectasis. What aspects of care should the nurse anticipate? Select all that apply.

-Antimicrobial therapy -Chest physiotherapy - Smoking cessation

Which action by the nurse is most appropriate when a client demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?

Apply a compression dressing to the area.

What's the difference between Hodgkins & Non-Hodgkins Lymphoma?

-The main difference between Hodgkin's and non-Hodgkin's lymphoma is in the specific lymphocyte each involves. -If in examining the cells, the doctor detects the presence of a specific type of abnormal cell called a Reed-Sternberg cell, the lymphoma is classified as Hodgkin's. If the Reed-Sternberg cell is not present, the lymphoma is classified as non-Hodgkin's. -Non-Hodgkins more lethal -Survivors of Hodgkin lymphoma have a high risk of second cancers, with hematologic cancers being the most common The risk of infection is significant for these patients, not only from treatment-related myelosuppression but also from the defective immune response that results from the disease itself. Limiting infection exposure is thus necessary.

The nurse is assigned to care for a patient in the ICU who is diagnosed with status asthmaticus. Why does the nurse include fluid intake as being an important aspect of the plan of care? (Select all that apply.)

-To combat dehydration -To loosen secretions -To facilitate expectoration

Convert the following quantity to the equivalent unit indicated: 250 mcg = ______________ mg

0.25 mg

A patient with thoracic trauma is admitted to the ICU. The nurse notes the patient's chest and neck are swollen and there is a crackling sensation when palpated. The nurse consequently identifies the presence of subcutaneous emphysema. If this condition becomes severe and threatens airway patency, what intervention is indicated?

A tracheostomy

The client diagnosed with sickle cell anemia is experiencing a vaso-occlusive sickle cell crisis secondary to an infection. Which medical treatment should the nurse anticipate the HCP ordering for the client?

3.) Infuse D5W 0.33% NS at 150 ml/hr via IV pump

The nurse is assessing a patient whose respiratory disease in characterized by chronic hyperinflation of the lungs. What would the nurse most likely assess in this patient?

A barrel chest

The nurse is planning the care of a patient with a nutritional deficit and a diagnosis of megaloblastic anemia. The nurse should recognize that this patient's health problem is due to what?

Abnormalities in the structure and function RBCs

You are an ICU nurse caring for a client who was admitted with a diagnosis of smoke inhalation. You know that this client is at increased risk for which of the following?

Acute respiratory distress syndrome

A patient presents to the ED stating she was in a boating accident about 3 hours ago. Now the patient has complaints of headache, fatigue, and the feeling that he "just can't breathe enough." The nurse notes that the patient is restless and tachycardic with an elevated blood pressure. This patient may be in the early stages of what respiratory problem?

Acute respiratory failure

A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this client's airflow obstruction?

Administer an inhaled beta-adrenergic agonist

A hospital has been the site of an increased incidence of hospital-acquired pneumonia (HAP). What is an important measure for the prevention of HAP?

Administration of pneumococcal vaccine to vulnerable individuals

The nurse is performing an assessment on a patient who has been diagnosed with cancer of the larynx. Part of the nurse's assessment addresses the patient's general state of nutrition. Which laboratory values would be assessed when determining the nutritional status of the patient? Select all that apply.

Albumin level Protein level Glucose level

You are an occupational health nurse who is presenting a workshop on laryngeal cancer. What risk factors would you be sure to include in your workshop? Select all that apply.

Alcohol Tobacco Industrial pollutants

A diabetic nurse is working for the summer at a camp for adolescents with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote?

Always carry a form of fast-acting sugar.

Describe the characteristics of CLL (chronic lymphocytic leukemia)

An increased lymphocyte count (lymphocytosis) is always present in patients with CLL. Increased # of blast cells, chronic bone pain, and thrombocytopenia without evidence of bleeding may or may not be present, but those symptoms are not definitive for CLL like the high lymphocytes are. Patient w CLL can live a long time. Patients with ALL have a significantly shorter life expectancy and may require EOL care & support

A nurse is caring for a patient who has been hospitalized with an acute asthma exacerbation. What drugs should the nurse expect to be ordered for this patient to gain underlying control of persistent asthma?

Anti-inflammatory drugs

A nurse is educating a patient about the role of B lymphocytes. The nurse's description will include which of the following physiologic processes?

Antibody production

The nurse is caring for a patient who is postoperative day 2 following a total laryngectomy for supraglottic cancer. The nurse should prioritize what assessment?

Assessment of swallowing ability

A patient's plan of care specifies postural drainage. What action should the nurse perform when providing this noninvasive therapy?

Assist the patient into a position that will allow gravity to move secretions.

The nurse is planning the care for a patient at risk of developing pulmonary embolism. What nursing interventions should be included in the care plan? (Select all that apply.)

Assisting the patient to do leg elevations above the level of the heart Applying a sequential compression device Using elastic stockings, especially when decreased mobility would promote venous stasis

A perioperative nurse is caring for a postoperative patient. The patient has a shallow respiratory pattern and is reluctant to cough or to begin mobilizing. The nurse should address the patient's increased risk for what complication?

Atelectasis

A client with acute viral rhinosinusitis is being seen in a clinic. The nurse is providing discharge instructions and includes the following information:

Avoid air travel.

The nurse is aware that patients with sickle cell anemia benefit from understanding what situations can precipitate a sickle cell crisis. When teaching a patient with sickle cell anemia about strategies to prevent crises, what measures should the nurse recommend?

Avoiding cold temperatures and ensuring sufficient hydration

A clinic patient is being treated for polycythemia vera and the nurse is providing health education. What practice should the nurse recommend in order to prevent the complications of this health problem?

Avoiding tight and restrictive clothing on the legs

A nurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most closely associated with the characteristic signs and symptoms of asthma?

Bilateral wheezes

A nurse is reviewing the pathophysiology of cystic fibrosis (CF) in anticipation of a new admission. The nurse should identify what characteristic aspects of CF?

Bronchial mucus plugging, inflammation, and eventual bronchiectasis

The nurse is assessing a patient diagnosed with Graves' disease. What physical characteristics of Graves' disease would the nurse expect to find?

Bulging eyes

The nurse is caring for a patient who is scheduled for a lobectomy for a diagnosis of lung cancer. While assisting with a subclavian vein central line insertion, the nurse notes the client's oxygen saturation rapidly dropping. The patient complains of shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax include what?

Diminished or absent breath sounds on the affected side

A patient presents with general malaise, cough and hypoxia. The ordered chest x-ray returns as presented in the attached image. Based on these signs and symptoms, what diagnosis and interventions should the nurse anticipate?

Dx = Pneumonia. Treat with rest, fluids, oxygen and antibiotics.

Although many signs and symptoms lead to a diagnosis of emphysema, one symptom stands as the primary presenting symptom. Which of the following is the primary presenting symptom?

Dyspnea

An admitting nurse is assessing a patient with COPD. The nurse auscultates diminished breath sounds, which signify changes in the airway. These changes indicate to the nurse to monitor the patient for what?

Dyspnea and hypoxemia

The perioperative nurse is writing a care plan for a patient who has returned from surgery 2 hours prior. Which measure should the nurse implement to most decrease the patient's risk of developing pulmonary emboli (PE)?

Early ambulation

A client has suspected fluid accumulation in the pleural space of the lungs and is scheduled for a thoracentesis. The nurse will implement which of the following for this procedure? Select all that apply.

Educate the client about the need to cleanse the thoracic area. Apply pressure to the puncture site after the procedure. Complete a respiratory assessment after the procedure.

A nurse is caring for a patient who has sickle cell anemia and the nurse's assessment reveals the possibility of substance abuse. What is the nurse's most appropriate action?

Encourage the patient to seek care from a single provider for pain relief.

The nurse providing care for a patient with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk?

Establish falls prevention measures.

A patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on the critical care unit. The priority nursing diagnosis for a patient with this condition is what?

Excess fluid volume

A nurse is providing health education to an adolescent newly diagnosed with type 1 diabetes mellitus and her family. The nurse teaches the patient and family that which of the following nonpharmacologic measures will decrease the body's need for insulin?

Exercise

A client has chronic obstructive pulmonary disease (COPD) and is exhibiting shallow respirations of 32 breaths per minute, despite receiving nasal oxygen at 2 L/minute. To improve the client's shortness of breath, the nurse encourages the client to

Exhale slowly

A patient recovering from thoracic surgery is on long-term mechanical ventilation and becomes very frustrated when he tries to communicate. What intervention should the nurse perform to assist the patient?

Express empathy and then encourage the patient to write, use a picture board, or spell words with an alphabet board.

A nurse is caring for an adult client with numerous draining wounds from gunshots. The client's pulse rate has increased from 100 to 130 beats per minute over the last hour. The nurse should further assess the client for which of the following?

Extracellular fluid volume deficit

An older adult patient with type 2 diabetes is brought to the emergency department by his daughter. The patient is found to have a blood glucose level of 623 mg/dL. The patient's daughter reports that the patient recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority?

Fluid and electrolyte replacement

A clinic nurse is working with a patient who has a long-standing diagnosis of polycythemia vera. How can the nurse best gauge the course of the patient's disease?

Follow the trends of the patient's hematocrit.

While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the patient's vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see?

Hypertension and heart rate changes

A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal?

Hypocalcemia

The nurse is assessing the patient for the presence of a Chvostek's sign. What electrolyte imbalance would a positive Chvostek's sign indicate?

Hypocalcemia

You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect?

Hypocalcemia

A patient has been brought to the emergency department by paramedics after being found unconscious. The patient's Medic Alert bracelet indicates that the patient has type 1 diabetes and the patient's blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention?

IV administration of 50% dextrose in water

The nurse is doing discharge teaching in the ED with a patient who had a nosebleed. What should the nurse include in the discharge teaching of this patient?

In case of recurrence, apply direct pressure for 15 minutes.

The home care nurse is conducting patient teaching with a patient on corticosteroid therapy. To achieve consistency with the body's natural secretion of cortisol, when would the home care nurse instruct the patient to take his or her corticosteroids?

In the morning between 7 AM and 8 AM

A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient has a documented history of adrenal insufficiency. Considering the patient's history and current symptoms, the nurse should anticipate that the patient will be instructed to do which of the following?

Increase his intake of sodium until the GI symptoms improve.

A critical-care nurse is caring for a patient diagnosed with pneumonia as a surgical complication. The nurse's assessment reveals that the patient has an increased work of breathing due to copious tracheobronchial secretions. What should the nurse encourage the patient to do?

Increase oral fluids unless contraindicated.

An older adult patient is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL). What assessment finding is certain to be present if the patient has CLL?

Increased lymphocyte levels

The nurse is planning the care of a patient who is scheduled for a laryngectomy. The nurse should assign the highest priority to which postoperative nursing diagnosis?

Ineffective airway clearance related to airway alterations

A nursing student understands the importance of the psychosocial aspects of disease processes. When working with a patient with COPD, the student would rank which of the following nursing diagnoses as the MOST important when analyzing the psychosocial effects?

Ineffective coping related to anxiety

You are performing an admission assessment on an older adult patient newly admitted for end-stage liver disease. What principle should guide your assessment of the patient's skin turgor?

Inelastic skin turgor is a normal part of aging.

The nurse is assessing residents at a summer picnic at the nursing facility. The nurse expresses concern due to the high heat and humidity of the day. Although the facility is offering the residents plenty of fluids for fluid maintenance, the nurse is most concerned about which?

Insensible fluid loss

What nursing intervention is appropriate for your diabetic patient who has to miss a meal?

Instruct your patient that missing meals is not acceptable for the diabetic patient and that portable meals need to be carried and eaten at the appropriate times or schedules needs to be altered in order to eat on schedule.

A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer?

Lactated Ringer's solution

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate?

Limit sodium and water intake.

A client involved in a motor vehicle crash suffered a blunt injury to the chest wall and was brought to the emergency department. The nurse assesses the client for which clinical manifestation that would indicate the presence of a pneumothorax?

Sucking sound at the site of injury

A school nurse is teaching a group of high school students about risk factors for diabetes. Which of the following actions has the greatest potential to reduce an individual's risk for developing diabetes?

Lose weight, if obese.

What is the most effective method to prevent complications in your diabetic patients?

Maintaining Good Glucose control through proper diet, exercise, appropriate weight & medication regimen.

A patient with a history of type 1 diabetes has just been admitted to the critical care unit (CCU) for diabetic ketoacidosis. The CCU nurse should prioritize what assessment during the patient's initial phase of treatment?

Maintaining and monitoring the patient's fluid balance

What measures should a diabetic patient take who develops a secondary gastrointestinal illness?

May need to change insulin dose temporarily remain on diabetic diet if able drink non-caffienated beverages with carbs (ie...gatorade / jello) check blood sugars more frequently (q 3-4 hours) notify MD with changing symptoms (ie.fever, worsening diarrhea, cough)

An oncology nurse recognizes a patient's risk for fluid imbalance while the patient is undergoing treatment for leukemia. What relevant assessments should the nurse include in the patient's plan of care? Select all that apply.

Measuring and recording the patient's intake and output Measuring the patient's weight on a daily basis Monitoring the patient's electrolyte levels Auscultating the patient's lungs frequently

The nurse is assessing a new patient with complaints of overwhelming fatigue and a sore tongue that is visibly smooth and beefy red. This patient is demonstrating signs and symptoms associated with what form of what hematologic disorder?

Megaloblastic anemia

Vitamin B12 and folic acid deficiencies can lead to abnormally large erythrocytes called megaloblasts. What type of anemia is this called?

Megaloblastic anemia

A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?

Metabolic alkalosis

The medical nurse is creating the care plan of an adult patient requiring mechanical ventilation. What nursing action is most appropriate?

Monitor cuff pressure every 8 hours.

A patient is receiving thrombolytic therapy for the treatment of pulmonary emboli. What is the best way for the nurse to assess the patient's oxygenation status at the bedside?

Monitor pulse oximetry readings.

The critical care nurse is precepting a new nurse on the unit. Together they are caring for a patient who has a tracheostomy tube and is receiving mechanical ventilation. What action should the critical care nurse recommend when caring for the cuff?

Monitor the pressure in the cuff at least every 8 hours

A priority nursing intervention for a client with hypervolemia involves which of the following?

Monitoring respiratory status for signs and symptoms of pulmonary complications.

A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client?

No, sodium intake should be restricted.

Name some classes of medications that interfere with platelet function.

Sulfa drugs ASA NSAIDS Anti-platelet drugs (some statins, Plavix, Ticlid)

A nurse is caring for a patient with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the patient's ability to prepare and self-administer insulin?

Observe the patient drawing up and administering the insulin.

A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following?

Osmosis and osmolality

The nurse is explaining the safe and effective administration of nasal spray to a patient with seasonal allergies. What information is most important to include in this teaching?

Overuse of nasal spray may cause rebound congestion.

A patient with a history of cirrhosis is admitted to the ICU with a diagnosis of bleeding esophageal varices; an attempt to stop the bleeding has been only partially successful. What would the critical care nurse expect the care team to order for this patient?

Packed red blood cells (PRBCs)

A nurse is caring for a 6-year-old patient with cystic fibrosis. In order to enhance the child's nutritional status, what intervention should most likely be included in the plan of care?

Pancreatic enzyme supplementation with meals

The nurse is assessing a patient who frequently coughs after eating or drinking. How should the nurse best follow up this assessment finding?

Perform a swallowing assessment.

An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?

Platelets will aggregate at the injury site.

The nurse is caring for an 82-year-old patient with a diagnosis of tracheobronchitis. The patient begins complaining of right-sided chest pain that gets worse when he coughs or breathes deeply. Vital signs are within normal limits. What would you suspect this patient is experiencing?

Pleuritic pain

What symptoms would a patient with a blood Glucose of 342 mg/dl most likely be having and what would the first nursing intervention be for this patient?

Polyuria (Pee a lot), polydipsia (thirsty), Polyphagia (Hunger), hypovolemia (dizziness, light headedness), irritability stupor, coma (late stage) Initiate IV fluids (to reverse hypovolemia and hyperosmolar state)

Which electrolyte is a major cation in body fluid?

Potassium

A patient has been brought to the ED by the paramedics. The patient is suspected of having ARDS. What intervention should the nurse first anticipate?

Preparing to assist with intubating the patient

A nurse is teaching basic "survival skills" to a patient newly diagnosed with type 1 diabetes. What topic should the nurse address?

Recognition of hypoglycemia and hyperglycemia

The nurse is caring for a patient with status asthmaticus in the intensive care unit (ICU). What does the nurse anticipate observing for the blood gas results related to hyperventilation for this patient?

Respiratory alkalosis

A patient who involved in a workplace accident suffered a penetrating wound of the chest that led to acute respiratory failure. What goal of treatment should the care team prioritize when planning this patient's care?

Restoration of adequate gas exchange

A patient's diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin (Coumadin), an anticoagulant. When assessing the therapeutic response to this medication, what is the nurse's most appropriate action?

Review the patient's international normalized ratio (INR).

A patient with type 2 diabetes has been managing his blood glucose levels using diet and metformin (Glucophage). Following an ordered increase in the patient's daily dose of metformin, the nurse should prioritize which of the following assessments?

Reviewing the patient's creatinine and BUN levels

The nurse is caring for a 46-year-old patient recently diagnosed with the early stages of lung cancer. The nurse is aware that the preferred method of treating patients with non-small cell tumors is what?

Surgical resection

Cystic fibrosis (CF) is diagnosed by clinical signs and symptoms in addition to which test?

Sweat chloride concentration

You are developing a care plan for a patient with Cushing syndrome. What nursing diagnosis would have the highest priority in this care plan?

Risk for injury related to weakness

A nursing is planning the care of a patient with emphysema who will soon be discharged. What teaching should the nurse prioritize in the plan of care?

Setting realistic short-term and long-range goals

A nurse is caring for a patient who undergoing preliminary testing for a hematologic disorder. What sign or symptom most likely suggests a potential hematologic disorder?

Severe fatigue

A patient with emphysema is experiencing shortness of breath. To relieve this patient's symptoms, the nurse should assist her into what position?

Sitting upright, leaning forward slightly

The nurse caring for a patient recently diagnosed with lung disease encourages the patient not to smoke. What is the primary rationale behind this nursing action?

Smoking damages the ciliary cleansing mechanism.

A critical care nurse is caring for a patient with autoimmune hemolytic anemia. The patient is not responding to conservative treatments, and his condition is now becoming life threatening. The nurse is aware that a treatment option in this case may include what?

Splenectomy

A patient with hemolytic anemia is not responding to conservative therapies. What would be the next intervention?

Splenectomy

A patient with type 2 diabetes achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the patient has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment?

Stress has likely caused an increase in the patient's blood sugar levels.

The nurse is caring for a patient with Addison's disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?

The need for lifelong steroid replacement

A patient is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?

The need to report any signs or symptoms of infection promptly

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.

The ED nurse is assessing a patient complaining of dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung fields. What might this indicate?

The patient has a narrowed airway.

A patient with a myelodysplastic syndrome is being treated on the medical unit. What assessment finding should prompt the nurse to contact the patient's primary care provider?

The patient has an oral temperature of 37.5ºC (99.5ºF).

An older adult patient has been diagnosed with COPD. What characteristic of the patient's current health status would preclude the safe and effective use of a metered-dose inhaler (MDI)?

The patient has severe arthritis in her hands.

A patient is prescribed corticosteroid therapy. What would be priority information for the nurse to give the patient who is prescribed long-term corticosteroid therapy?

The patient is at an increased risk for developing infection.

The nurse is caring for a patient who has been in a motor vehicle accident and the care team suspects that the patient has developed pleurisy. Which of the nurse's assessment findings would best corroborate this diagnosis?

The patient's pain intensifies when he coughs or takes a deep breath.

A nurse is explaining to a patient with asthma what her new prescription for prednisone is used for. What would be the most accurate explanation that the nurse could give?

To gain prompt control of inadequately controlled, persistent asthma

A 15-year-old child is brought to the emergency department with symptoms of hyperglycemia and is subsequently diagnosed with diabetes. Based on the fact that the child's pancreatic beta cells are being destroyed, the patient would be diagnosed with what type of diabetes?

Type 1 diabetes

Describe DKA, why it occurs & which diabetic patients are at risk for it

Type 1 patients because its caused by having NO insulin leading to hyperglycemia. High blood sugars lead to glucosuria & osmotic diuresis. Fat & Proteins are used for energy because there isn't any stored glucose. The breakdown of fat is ketones and the breakdown of protein is lactic acid...both are very acidic compounds, hence the DKA

It is cold season and the school nurse been asked to provide an educational event for the parent teacher organization of the local elementary school. What should the nurse include in teaching about the treatment of pharyngitis?

Use of warm saline gargles or throat irrigations can relieve symptoms.

For a client with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?

Using a Venturi mask to deliver oxygen as ordered

A nurse is caring for a client who is at high risk for developing pneumonia. Which intervention should the nurse include on the client's care plan?

Using strict hand hygiene

A patient with a severe exacerbation of COPD requires reliable and precise oxygen delivery. Which mask will the nurse expect the physician to order?

Venturi mask

A client who is diagnosed with chronic respiratory failure will have which symptom?

dyspnea

Which nerve is implicated in the Chvostek's sign?

facial

A client presents with fatigue, nausea, vomiting, muscle weakness, and leg cramps. Laboratory values are as follows: Na + 147 mEq/L K + 3.0 mEq/L Cl - 112 mEq/L Mg ++ 2.3 mg/dL Ca ++ 1.5 mg/dL Which of the following is consistent with the client's findings?

hypokalemia

Which could be a potential cause of respiratory acidosis?

hypoventilation

A patient has completed the full course of treatment for acute lymphocytic leukemia and has failed to respond appreciably. When preparing for the patient's subsequent care, the nurse should perform what action?

identify the patient's specific wishes around end-of-life care.

The nurse is caring for a patient at risk for atelectasis. The nurse implements a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis?

incentive spirometry

Early signs of hypervolemia include

increased breathing effort and weight gain.

A client recovering from an acute asthma attack experiences respiratory alkalosis. The nurse measures a respiratory rate of 46 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 162/90 mm Hg, and a temperature of 98.6° F (37° C). To help correct respiratory alkalosis, the nurse should:

instruct the client to breathe into a paper bag.

A client with chronic obstructive pulmonary disease (COPD) is admitted to the medical-surgical unit. To help this client maintain a patent airway and achieve maximal gas exchange, the nurse should:

instruct the client to drink at least 2 L of fluid daily.

A patient has come to the OB/GYN clinic due to recent heavy menstrual flow. Because of the patient's consequent increase in RBC production, the nurse knows that the patient may need to increase her daily intake of what substance?

iron

A client visits the physician's office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves' disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterized by:

protruding eyes and a fixed stare.

A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects:

respiratory alkalosis.