Med Surg Quiz #1
Which item is characteristics of a malignant tumor? Select all that apply a Invades other body areas b Rare reoccurrence c Usually encapsulated d Can often be removed e Unlike parent cells
a Invades other body areas e Unlike parent cells
Four patients develop changes in skin appearance. Which patient should the nurse see first? a Patient A with bluish color around the lips b Patient B with yellow color of the skin and sclera c Patient C with erythema of the face and neck d Patient D with dark brown spots on the chest
a Patient A with bluish color around the lips
The nurse is making a room assignment for a patient admitted with pancytopenia. Which patient would be the best roommate? Select an answer and submit. a Patient with digoxin toxicity b Patient with viral pneumonia c Patient with shingles d Patient with cellulitis
a Patient with digoxin toxicity
A 58 year old client presents in the ER a BP of 210/140, vomiting and confusion. Which category should the nurse assign to this client? a Urgent b Non-urgent c Emergent d Semi-urgent
c Emergent
Which instruction is appropriate for the nurse to provide the patient with multiple myeloma who is scheduled for discharge? a Maintain bedrest to decrease oxygen demand b Restrict fluid to 1000 ml/day c Maintain a low-fiber, high calorie diet with small frequent meals d Notify physician if nausea and constipation persist
d Notify physician if nausea and constipation persist
Math the correct name of the tumor with the body location area. Carcinoma Leukemia Sarcoma Lymphoma
Carcinoma -skin and tissues Leukemia - Blood Sarcoma - bone Lymphoma - Immune system
What is the most specific method of diagnosing a malignancy? a Serum laboratory tests b MRI c CAT scan d Biopsy
d Biopsy
The nurse is conducting cancer screening. Which client is at greatest risk for skin cancer? a a 45-year-old health care worker b a 15-year-old high school student c a 30-year-old store manager d a 60-year-old mountain biker
d a 60-year-old mountain biker
The client is undergoing brachytherapy for treatment of prostate cancer. Which action is most appropriate by the nurse? a Spend only 30 minutes per day with the client b Encourage family members to visit the client c Review with the client skin care regarding the radiation field marks d Discuss with the client strategies to deal with the expected alopecia
a Spend only 30 minutes per day with the client
Which instructions are appropriate for the nurse to provide to the patient undergoing chemotherapy? Select all that apply a Strict hand washing at all times. b Encourage fresh fruits and vegetables c Observe stool for change in color d Contact health care provider for minor cold symptoms
a Strict hand washing at all times. c Observe stool for change in color d Contact health care provider for minor cold symptoms
True or False: Approximately 25% of nursing errors are the result of poor clinical judgment. Write T for True or F for False
F
The nurse smells smoke in a closet at the end of the unit. Which actions should the nurse take? Place in order of completion Rescue the patient Sound the Alarm Close the doors Extinguish the Fire
RACE
True or False: Approximately 50% of the novice nurses are involved in making clinical judgment errors. Write T for True and F for False
T
Write T for True or F for false Hodgkins disease is characterized by the presence of Reed-Sternberg cells located in the lymph nodes.
T
A nurse is caring for a patient with a platelet count of 20,000. Which of the following is the priority intervention? a Assess for spontaneous bleeding b Administer aspirin c Initiate neutropenic precautions d Restrict visitors
a Assess for spontaneous bleeding
Which manifestations can be warning signs of cancer? Select all that apply. a Change in bowel habits b Breast lump c Difficulty swallowing d Change in mole size or color e Nagging cough
a Change in bowel habits b Breast lump c Difficulty swallowing d Change in mole size or color e Nagging cough
According to the video's discussion, which items need to be considered when incorporating the right of delegation circumstance? Select all that apply. a Client needs b Available resources c Required supervision d Competency level e Degree of directions
a Client needs b Available resources c Required supervision d Competency level
Which tasks should the registered nurse delegate to the unlicensed assistive personnel (UAP)? Select all that apply. a Empty foley bag b Refill water pitcher c Assess vital signs d Ask the patient if the pain med helped e Ambulate the patient to the bathroom
a Empty foley bag b Refill water pitcher e Ambulate the patient to the bathroom
The nurse is instructing a patient on the side effects of chemotherapy. Which instructions are important to provide to the patient? Select all that apply. a Hair returning after experiencing alopecia will most likely be a different texture. b Please report any elevated temperature to the physician c Excessive fatigue and sore throat can be anticipated. d Take your antiemetic medication only if vomiting occurs
a Hair returning after experiencing alopecia will most likely be a different texture. b Please report any elevated temperature to the physician
The patient is undergoing external radiation for lung cancer. Which patient statements warrants further intervention by the nurse? a "I will continue to use my favorite soap." b "The skin marks (radiation tattoo) will not be removed." c "No swimming pools for me until my skin heals." d "I will be careful not to put hot water on my skin during treatment."
a "I will continue to use my favorite soap."
The nurse working is in the urgent care center. Which client should the nurse see first? a A 40 year old client who is wheezing after eating peanuts b An 18 year old client who thinks he might have a broken arm from playing football c A 35 year old client who is complaining of sore throat, pain with swallowing and a fever d A 60 year old client who is complaining pain and has purulent drainage around incision from recently knee surgery
a A 40 year old client who is wheezing after eating peanuts
The nurse is caring for a patient with neutropenia. Which tasks should the nurse assign to the UAP? Select all that apply. a Take vital signs every 4 hours b Report temperature greater than 100.4 F c Ask the patient about a sore throat or urinary burning d Gather supplies to prepare the protective isolation room e Report any superinfection such as thrush f Practice good hand-washing technique
a Take vital signs every 4 hours b Report temperature greater than 100.4 F d Gather supplies to prepare the protective isolation room f Practice good hand-washing technique
Which tasks are appropriate to delegate to the UAP? Select all that apply a Taking vitals signs on the clients on the unit. b Record the weight on the client admitted with dehydration c Applying the anti-fungal lotion to the client's foot d Transporting the client with chest pain on a cardiac monitor to Radiology
a Taking vitals signs on the clients on the unit. b Record the weight on the client admitted with dehydration
The RN delegated the task of teaching the client about the new ostomy to the UAP. Which statement is correct regarding this delegation? a The RN violated several rights of delegation. b The delegation is appropriate once the RN provides the correct instruction to the UAP. c The UAP can complete this task as long as the RN provides appropriate supervision. d The RN needs to delegate this task the LPN since the UAP cannot complete ostomy care.
a The RN violated several rights of delegation.
Which statement by the patient indicates teaching about chemotherapy was effective? a "I know everyone loses their hair with chemo." b "I know it is important that I monitor my temperature." c "I know I should eat whatever I want so I don't lose weight while on chemo." d "I understand I skip a chemo treatment if I don't feel well."
b "I know it is important that I monitor my temperature."
Which patient statement indicates to the nurse the patient understands teaching regarding Pernicious Anemia? a My symptoms will improve with my oral B12 supplements." b "I may get sick unless I take my B12 injections as ordered." c "If my anemia is not improved, I will need a bone marrow transplant." d "I will need to enhance my diet with dairy and fortified cereals."
b "I may get sick unless I take my B12 injections as ordered."
The nurse is starting the 3PM shift. Which client on the oncology unit should the nurse see first? a 38-year-old client receiving internal radiation therapy for cervical cancer b 40-year-old received initial dose of high dose chemotherapy this morning c 23-year-old scheduled for placement of a central line catheter d 70-year-old needs discharge instructions on care of surgical incision
b 40-year-old received initial dose of high dose chemotherapy this morning
The nurse is working in the clinic when four patients approach the desk to be seen. Which patient should the nurse see first? a An ambulatory 25 year old, slightly dazed with a bandaged head wound b A 15 year old with a fever, stiff neck, severe headache and is vomiting c A 35 year old jogger with a twisted ankle with no apparent deformity d A 50 year old complaining of moderate abdominal pain and nausea
b A 15 year old with a fever, stiff neck, severe headache and is vomiting
The student nurse is sharing knowledge of Leukemia with peers during post conference. Which statement by the student warrants clarification by the instructor? a Condition etiology is thought to be a combination of genetics and environmental influences b Accumulation of mature white blood cells c Overcrowding occurs in the bone marrow d Pancytopenia can occur
b Accumulation of mature white blood cells
The RN is working with an UAP and LPN. Which assignment is most appropriate to assign to the LPN? a Emptying the bed pain on the post-op patient who on bedrest b Assessing the bowel sounds on the patient with a fracture foot c Taking pulse ox on the patient with chronic lung disease d Transporting the patient with chest pain to the intensive care unit
b Assessing the bowel sounds on the patient with a fracture foot
The RN is working with an UAP and LPN. Which assignment is most appropriate to assign to the LPN? a Emptying a urine catheter bag on a immobile patient b Assessing the lungs on a patient with a fractured arm c Taking vital signs on the post-op patient d Teaching a newly diagnosed patient about diabetes
b Assessing the lungs on a patient with a fractured arm
The RN is working with an UAP and LPN. Which assignment is most appropriate to assign to the LPN? a Emptying a urine catheter bag on a immobile patient b Assessing the lungs on a patient with leg cellulitis c Taking vital signs on the post-op patient d Teaching a newly diagnosed patient about diabetes
b Assessing the lungs on a patient with leg cellulitis
An adult client is brought in by ambulance after a motor vehicle accident. The client is unconscious, on a backboard with the neck immobilized and is bleeding profusely from a large gash on the head. What action should the nurse take first? a Stop the bleeding b Check airway c Take vital signs d Verify neurological status
b Check airway
The nurse is starting the 7AM-3PM shift. Which nursing action takes priority? a Bathing the client scheduled for the OR in an hour b Checking on the client who was admitted with chest discomfort and received Nitroglycerin 15 minutes ago. c Consulting with physical therapy on the client who underwent a knee replacement yesterday d Teaching insulin administration to the newly diagnosed client with diabetes
b Checking on the client who was admitted with chest discomfort and received Nitroglycerin 15 minutes ago.
The charge nurse must assign an unlicensed assistive personnel (UAP) to help care for a patient with non-Hodgkin's Lymphoma experiencing neutropenia. Which factor has the most impact in assigning a UAP to care for this patient? The nursing assistant ... a Is in her first trimester of pregnancy b Has reported a scratchy throat and for 2 days c Has no experience with this patient's specific care precautions d Has generalized fear of isolation clients
b Has reported a scratchy throat and for 2 days
Which client task can the registered nurse assign to the unlicensed assistive personnel (UAP)? a Monitoring the client use an incentive spirometer after surgery b Obtain a stool sample from a client admitted with gastroenteritis c Obtain a urine sample from an indwelling catheter d Asking the client with indigestion about spicy food intake during the last 24 hours
b Obtain a stool sample from a client admitted with gastroenteritis
The patient is a long-term facility with anemia reports chronic fatigue and dizziness. Which activity can be safely delegated to the UAP? Select an answer and submit. a Monitor the patient's response to normal activities of daily living b Obtaining the patient's blood pressure and pulse with position changes c Determine which self care activities the patient can perform independently d Assist the patient in selecting a diet that will improve strength
b Obtaining the patient's blood pressure and pulse with position changes
When caring for the patient undergoing brachytherapy for prostate cancer, which actions should the nurse take? Select all that apply. a Limit the time with the patient to 1 hour b Place patient in a private room with a private bath c Wear the dosimeter badge when entering the patient's room d Reminding pregnant women to stay 6 feet away from the patient when visiting e Remind patient to avoid perfumed lotions and soaps
b Place patient in a private room with a private bath c Wear the dosimeter badge when entering the patient's room
The registered nurse (RN) requests the unlicensed assistive personnel (UAP) ambulate a client with orthostatic hypotension and weakness, up and down the hall after breakfast and lunch for 10 minutes and to report back when task completed. Which right of delegation did the RN violate? a Right task b Right circumstance c Right direction d Right supervision
b Right circumstance
The student nurse is discussing brachytherapy to her peers during post-conference. Which statement by the student warrants further teaching by the instructor? a The two types of brachytherapy is low dose and high dose b Similar to external radiation, the patient does not give off radiation c The implants may be temporary or permanent d Discomfort at the brachytherapy site can occur
b Similar to external radiation, the patient does not give off radiation
Which patients experiencing cancer can be placed together as roommates? Select all that apply. a The patient who has a very low neutrophil count b The patient who underwent tumor shrinking to relieve pressure c The patient who just underwent a bone marrow transplantation d The patient who is undergoing brachytherapy for prostate cancer e The patient with terminal cancer who is receiving en-of-life care f The patient who had a laminectomy for spinal cord compression
b The patient who underwent tumor shrinking to relieve pressure f The patient who had a laminectomy for spinal cord compression
A charge nurse recognizes that the new RN's is in need of further education regarding delegation of client care when charge nurse overhears the RN makes which statement to the UAP? a "Make sure you wear gloves when you emptying the foley bag." b "Prepare a sitz bath for Mrs. Jones who has a perineal laceration." c "When changing Mr. Jones, socks, let me know if there is any further drainage on the toes." d "The supplies to perform post mortem care are in the closet down the hall."
c "When changing Mr. Jones, socks, let me know if there is any further drainage on the toes."
Which client should the emergency room nurse list as urgent? a Client A admitted to ER with chest discomfort and shortness of breath b Client B admitted with slurred speech and left side weakness c Client C admitted with abdominal pain and right-sided rebound tenderness d Client D admitted with ear pain and sinus congestion with fever
c Client C admitted with abdominal pain and right-sided rebound tenderness
The patient in the clinic presents with a history of GI bleed, a hemoglobin of 7.8 mg/dL along with heart palpitations and HR of 102 bpm. Which additional manifestations should the nurse anticipate in this patient? a Diarrhea b Jaundice c Dyspnea d Sensitivity to cold
c Dyspnea
Which nursing activity can be delegated by the RN to the LPN working together caring for patients with cardiac conditions? a Explain the reasons for frequent rest periods b Evaluate the patient's understanding of their cardiac condition c Monitor the BP and pulse ox before and after the patient ambulates d Teach the patient which activities is appropriate for their cardiac condition
c Monitor the BP and pulse ox before and after the patient ambulates
The charge nurse is working with a licensed practice nurse (LPN), unlicensed assistive personnel (UAP) and another registered nurse (RN). Which patient assignment is appropriate to delegate to the other RN? a Patient A with an arm fracture needs assisting with feeding and bathing b Patient B with diabetes and a wound infection needs the daily insulin injection c Patient C needs his chest pain re-assessed before giving a second dose of medication d Patient D with chronic bronchitis needs transportation to radiology for a chest X-Ray
c Patient C needs his chest pain re-assessed before giving a second dose of medication
Which action is the most important when caring for a neutropenic patient? Select an answer and submit. a Don a disposable mask in the room b Limit patient contact to 30 minutes at a time c Perform proper hand hygiene d Remove fresh flowers in room
c Perform proper hand hygiene
Immediately following a storm that has passed, the nurse along with the rescue team is searching for injured people. A victim lying next to a broken natural gas main is not breathing and bleeding heavily from his leg wound. Which action should the nurse take first? a Start rescue breathing and CPR b Apply pressure to the wound c Remove the victim from the immediate area d Leave this patient and check another patient less injured.
c Remove the victim from the immediate area
The chronic pain patient reports to the charge nurse that the nurses have not been responding to requests for pain medication. Which action should the charge nurse take first? a Check the MARs and nurses notes for the past several days b Request the nurse educator provide an in-service about pain management c Perform a complete pain assessment and history on the patient d Have a conference with the nurses responsible for the patient's care
d Have a conference with the nurses responsible for the patient's care
Which type of item tests several aspects of the clinical scenario within a single test item and involves selecting a response from one or more of the selected columns? a Enhanced Hot Spot b Extended Drop and Drag c Cloze (Drop Down) d Matrix/Grid
d Matrix/Grid
A nurse is caring for a group of clients on the medical-surgical unit with the help of one float registered nurse (RN), one unlicensed assistive personnel (UAP), and one licensed practical/vocational nurse (LPN/LVN). Which assignment, if delegated by the nurse, would be inappropriate? a Delegate the LPN to assess the bowel sounds on a post-op knee surgery client b Assign the LPN to administer the daily inhaler to a client scheduled for a chest X-Ray. c Assign the float RN to a client with diabetes and urinary frequency d Request that the UAP ask the client about indigestion after eating lunch
d Request that the UAP ask the client about indigestion after eating lunch
The registered nurse (RN) is working with a Licensed Practical Nurse (LPN) and an Unlicensed Assistive Personnel (UAP). Which action by the RN violates the 5 rights of delegation? a The RN asks the UAP to take vital signs on the patient returning from a radiation treatment. b The RN asks the LPN to administer Motrin po to the patient who complained of a sore ankle. c The RN asks the UAP to take the urine specimen to the lab. d The RN asks the LPN to evaluate the patient's pain who received nitroglycerin for complaint of chest discomfort
d The RN asks the LPN to evaluate the patient's pain who received nitroglycerin for complaint of chest discomfort
When is the best time to administer the antiemetic for the patient undergoing chemotherapy? a When the client begins to feel nauseated b After completion of the treatment regimen c At the same time the chemotherapeutic agent d Thirty minutes before chemotherapy is started
d Thirty minutes before chemotherapy is started
Which nursing intervention is appropriate for the patient with multiple myeloma? a provide frequent mouth care b monitor the red blood cell count c encourage cough and deep breathing d increase fluids
d increase fluids
According to the video's discussion, which term is not included in components of appropriate delegation directions? a Clear b Concise c Complete d Correct e Careful
e Careful
