Med surg test 5 study questions
Which of the following are common signs of an allergic reaction to Alteplase? Select all that apply. A Itching B Hives C Bleeding D Swollen tongue/angioedema E Nausea/vomiting F Hypertension
A, B, D, E Bleeding is a side effect of Alteplase, not an allergic reaction. Hypertension is not related to Alteplase administration.
Seizures are a result of increased _______ activity and decreased _______ activity. A. Norepinephrine; GABA B. GABA; Glutamate C. GABA; Dopamine D. Glutamate; GABA
D
A nurse at a rehabilitation center is planning care for a client who had a left hemispheric cerebrovascular accident (CVA) 3 weeks ago. Which of the following goals should the nurse include in the client's rehabilitation program? a. Establish the ability to communicate effectively. b. Compensate for loss of depth perception. c. Learn to control impulsive behavior. d. Improve left-side motor function.
A
What is the nurse's most important intervention for a patient having a tonic-clonic seizure? a. Protect the patient from further injury b. Time the duration of the seizure c. Note the origin of seizure activity d. Insert a padded tongue blade to prevent the patient from biting his tongue
A
Which hearing test is used to determine conductive OR sensorineural hearing loss? A. Weber test B. Perimetry C. Rinne test D. Tonometry
A
Order: Infuse 800mL NS. The drop factor is 14 gtt/mL. The infusion rate is 18 gtt/min. Calculate the number of hours to infuse. Round to the nearest whole number. A 10 hours B 11.67 hours C 12 hours D 11 hours
A 800mL 14gtt 1min 1hr = 800(14)(hr) = 11,200(hr) = 10.3 = 10 mL 18gtt 60min 18(60) 1080
Your patient with a terminal diagnosis tells you, "I don't know why I even bother with these medications. I'm dead anyway." Which stage of Kubler-Ross' Stages of Grief is your patient in? A Depression B Denial C Anger D Bargaining E Acceptance
A A patient who sees no use in carrying on or making the best of the time they have left is in the Depression stage.
Your non-coherent end-of-life patient has an elevated BP, is breathing rapidly, and is restless. What intervention should you plan to make after your assessment? A Administer pain medication B Suction the patient's mouth and nose C Encourage the patient to eat D Sit the patient upright
A Elevated BP, rapid respirations, and restlessness in a non-coherent end-of-life patient indicates pain. Administering a pain medication will help to comfort the patient and let them rest.
A patient with specific organ dysfunction related to cancer may require: A Supplementation of enzymes or vitamins normally produced by that organ B An organ transplant C A full liquid diet D TPN via a PICC line
A Specific organ dysfunction related to cancer may result in a deficiency in that organ's ability to do its job. The patient may require supplementation of enzymes, vitamins, or other interventions to assist in the normal function of that organ.
A patient who has a ______ hemispheric stroke would have issues with visual/spatial awareness. A patient who has a ______ hemispheric stroke would have issues with speech or understanding language. A Right; left B Left; right C Left; generalized D Generalized
A The right hemisphere controls visual/spatial awareness; a stroke here may lead to a patient not being able to recognize faces of his family members, his house or neighborhood, etc. The left hemisphere controls speech/language; a stroke here may lead to the patient becoming aphasic, or unable to understand what is being said to him.
Which of the following medications are used to treat an allergic reaction in a patient? Select all that apply. A Epinephrine B Antihistamines C Aspirin D Metoprolol E Corticosteroids F Morphine
A, B, E Epinephrine, antihistamines, and corticosteroids are used to treat an allergic reaction.
Which of the following are not signs or symptoms of peripheral neuropathy? Select all that apply. A Loss of sensation to pressure B Loss of sensation to temperature C Burning sensation D Loss of ability to move independently E "Clopping" or dragging of the feet when walking F History of frequent falls
A, D Loss of sensation to temperature, burning sensation, "clopping" or dragging of the feet when walking, and history of frequent falls are all signs or symptoms of peripheral neuropathy. Loss of sensation to pressure and loss of ability to move independently are not signs or symptoms of peripheral neuropathy.
Which of the following is not true regarding hospice? Select all that apply. A Hospice care is for anyone with a chronic illness B Hospice care is restricted to those with a life expectancy of </= 6 months C Hospice requires a certification of terminal illness by an MD D You cannot be "discharged" from hospice care while still alive E You cannot re-establish hospice care if you have been discharged from it F Hospice care is focused on comfort, quality-promoting interventions, not diagnostic or curative interventions
A, D, E Hospice care is for anyone with terminal illness. You can be discharged from hospice while still alive. You can re-establish hospice care once discharged from it, once the disease process worsens and life expectancy shortens.
Which of the following are seizures that last >5-10 minutes and aren't likely to stop without intervention? A. Epilepsy B. Status epilepticus C. Focal with awareness seizures D. Generalized seizures
B
Your patient is complaining of cloudy vision, and "patches of haze that make it really hard to see." You know this is often the complaint of patients with which of the following diseases? A Glaucoma B Cataracts C Retinopathy D Blepharitis
B Cataracts are characterized by clouding of the lens which cause blurred, hazy vision.
Which of the following is the best way to help with social isolation of a patient with chronic or terminal illness? A Frequent phone calls B In person visits C Email correspondence D Online support groups
B Face to face, in person visits have been shown to be the most effective intervention for reducing social isolation in chronic or terminal illness patients.
Which of the following is the priority for the RN for patients with sensory deficits (hearing or vision)? A Following MD orders in a timely manner B Preventing injury related to deficits C Ensuring medication adherence D Maintaining a rapport with the patient
B The priority for the RN with patients with sensory deficits is to prevent injury to the patient due to those deficits.
Which of the following emotions are expected in a patient post-amputation of the left leg? Select all that apply. A Relieved B Angry C Hostile D Happiness E Joy F Bitterness G Grief
B, C, F, G Amputation surgeries often leave a patient feeling angry, hostile, bitter, and in a state of grief. All of these are expected during their experience, and the RN should provide comfort and other resources as necessary.
Which of the following *is* an explanation for peripheral neuropathy? A. Demyelination of the skeletal muscle B. Bone degeneration leads to musculoskeletal weakness C. Axon degeneration D. Osteoporosis
C
_______ is a disease with optic nerve damage; _______ is a disease of loss of lens clarity. A. Cataracts; meningitis B. Optic neuropathy; glaucome C. Glaucoma; cataracts D. Optic neuropathy; cataracts
C
Your patient states she has an overwhelming urge to take her Norco even when her pain is at a tolerable rating on a 0-10 scale. What do you suspect she is suffering from? A Intractable pain B Tolerance C Addiction D Drug seeking behavior
C A patient with a psychological need/desire to take pain medication without a physical need for it is suffering from addiction.
Your patient is requiring an IV fluid bolus. The MD orders 1L of NS to infuse over the next 3 hours. There are no IV pumps available. You have tubing with a drip factor of 16 gtt/mL. How many drops (gtt) per minute will you need to infuse the bolus in the given time frame? Round to the nearest whole number. A 70 gtt/min B 88 gtt/min C 90 gtt/min D 89 gtt/min
D 1L 1000mL 1hr 16gtt = 1(1000)(1)(16)(gtt) = 16,000(gtt) = 88.88 = 89 1L 3hrs 60min 1mL 1(3)(60)(min) 180(min)
Why must the RN teach the patient not to abruptly stop antiseizure medications, like Valproic acid or Phenytoin? A The patient will go through withdrawals B The patient is at risk for confusion, delirium, and suicide C There is no risk; the patient may stop the medications when seizures stop D The patient is at risk for status epilepticus
D Patients must not abruptly stop antiseizure medications, or they risk developing status epilepticus.
Your patient is experiencing grief. When assessing their grief, which of the following would not require intervention by the nurse? A Complicated grief B Disenfranchised grief C Prolonged grief D Uncomplicated grief
D Uncomplicated or healthy grief is a normal part of the human experience and does not require intervention; just support and empathy.
Which vital sign should the nurse monitor for an abnormality that could lead to a seizure? A O2 saturation B Blood pressure C Pulse D Temperature
D An elevated temperature can often lead to a seizure.
Your patient with terminal cancer makes the statement, "I've been to see my family lawyer to make sure my will and other final documents are in place. Now I can look forward to one more Christmas with my kids." Which state of Kubler-Ross' Stages of Grief is your patient in? A Depression B Denial C Anger D Bargaining E Acceptance
E A patient who is making steps to settle their affairs and is at peace with the time they have left is in the Acceptance stage.
True or False: Conductive hearing loss results in the loss of ability to hear low pitched sounds. T True F False
F False. Conductive hearing loss results in the loss of ability to hear high pitched sounds.
True or False: Treating glaucoma will reverse vision loss. T True F False
F False. Treating glaucoma slows the progression of vision loss, but does not reverse the damage already done.
True or false: Palliative care cannot be given with curative treatment. T True F False
F Palliative care can be given alongside curative treatment.
True or false: The dosage of an opioid pain medication is limited to 10mg/day in an end-of-life patient. T True F False
F There is no limit to opioid pain medication dosage in end-of-life patients.
True or False: it is recommended to put a tongue depressor in the mouth of a seizing person, to protect his/her airway and tongue. T True F False
F This is false. You should never put anything in the mouth of a seizing person.
True or False: a patient who is post-op from an eye surgery will have weight-bearing restrictions. T True F False
T True. To prevent elevating intraocular pressure, the patient will have restrictions on weight-bearing/lifting.
A nurse is caring for a pancreatic cancer patient who is at the end of life and is experiencing dyspnea. Which of the following actions should the nurse take? a. Administer an opioid narcotic to the patient b. Perform nasotracheal suctioning for the patient c. Place the head of the patient's bed flat d. Increase the heat in the patient's room
a
What is the nurse's priority while caring for a patient recently diagnosed with primary open-angle glaucoma? a. Preventing the risk for injury related to peripheral vision loss b. Treating chronic pain related to increased intraocular pressure c. Addressing the adverse effects of medication d. Teaching related to the new diagnosis of glaucoma
a
A nurse is caring for a client who has a terminal diagnosis and a 3-month life expectancy. The client appears cheerful and states they are looking forward to a vacation next year. The nurse should identify that the client is experiencing which of the following Kubler-Ross stages of grief? a. Depression b. Denial c. Anger d. Bargaining
b
A nurse is caring for a client who is at the end of life. Which of the following actions should the nurse take to support the client's dignity? SATA a. Perform nasopharyngeal suctioning to clear the patient's secretions b. Give the patient privacy when providing care c. Demonstrate empathy when caring for the patient d. Utilize HIPPA standards e. Tell the patient their condition will improve
b, c, d
A nurse at an ophthalmology clinic is providing teaching to a client who has open angle glaucoma and a new prescription for timolol eye drops. Which of the following instructions should the nurse provide? a. It is to be applied when the client is experiencing eye pain. b. it will be used until the client's intraocular pressure returns to normal. c. It should be applied on a regular schedule for the rest of the client's life. d. It's to be used for approximately 10 days, followed by a gradual tapering off.
c
A 56 year old patient presents with stroke-like symptos; started 45 minutes of admission. PMI; HTN treated with an ACE Inhibitor, Alteplase 68mg IV/hr, At the end of the alteplase infusion, the nurse notes the patient's tongue is swollen. What is the nurse's priority action? a. Document this is a normal finding for the patient b. Draw ABGs and prepare to intubate c. Have the patient chew ice chips every 15 minutes d. Administer antihistamines, intravenous corticosteroids, and/or epinephrine
d
A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation? a. They not been taking the medication properly b. They is experiencing episodes of confusion. c. They has become addicted to the medication. d. They developed a tolerance to the medication.
d
A nurse is teaching a class about the physical manifestations of grief. Which of the following manifestations should the nurse include? a. Bradycardia b. Increased ability to concentrate c. Blurred vision d. Insomnia
d