NURSING PRAXIS REVIEW

While in a skilled nursing facility, a male client contracted scabies, which is diagnosed the day after discharge. The client is living at her daughter's home, where six other persons are living. During her visit to the clinic, she asks a staff nurse, "What should my family do?" The most accurate response from the nurse is:

"All family members will need to be treated."

Stages of burn rehabilitation:

1) Pre-hospital 2) Emergent 3) Acute 4) Rehabilitation

Human Papilloma Virus in AIDS patients is manifested as:

1) genital warts 2) flat warts 3) skin warts 4) neoplasms of the cervix, vagina, and penis

Which common conditions/factors lead to ARDS?

1) sepsis 2) pneumonia 3) injury to the chest/head 4) breathing in harmful fumes/smoke 5) inhaling vomited stomach contents

How many nurses must verify PCA?

2

Exceeding which serum cholesterol level significantly increases the risk of CAD?

200 mg/dl

How long do you monitor a patient with burns to the head and neck? why?

24 hours; swelling and edema can occur constricting airways

When a client has cervical halter traction to immobilize the cervical spine counteraction is provided by:

A) Elevating the foot of the bed B) Elevating the head of the bed C) Application of the pelvic girdle D) Lowering the head of the bed *B

The morning of the 2nd day postoperative following hip surgery, the nurse will ambulate the client. The first intervention is to:

A) Get the client up in a chair after dangling at the bedside B) Use a walker for balance when getting the client out of bed C) Have the client put minimal weight on the affected side when getting up D) Practice getting the client out of bed by having her slightly flex her hips *D

A female client on aspirin TID and prednisone 10mg BID for the last 2 years. The most important assessment question for the nurse to ask related to the client's drug therapy is whether she has:

A) Headaches B) Tarry stools C) blurred vision D) decreased appetite *B

When admitting a client with a fractured extremity, the nurse would focus the assessment on which of the following first?

A) The area proximal to the fracture B) The actual fracture site C) The area distal to the fracture D) The opposite extremity for baseline comparison *C

Which of the following individuals is least likely to be at risk for developing psoriasis?

A) a 32 y/o African American B) a woman experiencing menopause C) a client with a family hx of the disorder D) an individual experiencing emotional distress *A

The In which of the following exercises would the nurse instruct a client with an above the knee amputation to best prepare him for using crutches?

A) abdominal exercises B) isometric shoulder exercises C) quadriceps setting exercises D) triceps stretching exercises *D

Which condition most commonly results in CAD?

A) atherosclerosis B) DM C) myocardial infarction D) renal failure *A

Following a small-bowel resection, a male client develops fever and anemia. The surface surrounding the surgical wound is warm to the touch and necrotizing fasciitis is suspected. Another manifestation that would most suggest necrotizing fasciitis is:

A) erythema B) Leukocytosis C) Pressure-like pain D) swelling *C

A client who has been taking carisoprodol (Soma) at home for a fractured arm is admitted with a BP of 80/50, P 115bpm, and R 8/min and shallow, the nurse interprets these findings as indicating:

A) expected common side effects B) hypersensitivity rxn C) possible habituation effects D) hemorrhage from GI irritation *A

Which clinical manifestation would cause the nurse to suspect that the client is diagnosed with Systemic Lupus Erythematosus (SLE)?

A) joint edema and tenderness B) red, burning, tearing eyes C) chest tenderness w/ wheezing on expiration D) fever and night sweats *A

Which condition is a predisposing factor for respiratory alkalosis?

A) myasthenua gravis B) type 1 diabetes C) extreme anxiety D) narcotic overdose *C

The nurse is caring for a client with compound fractures of the tibia and fibula. Skeletal traction is applied. Which of these priorities should the nurse include in the care plan?

A) order a trapeze to increase the client's ambulation B) maintain the client in a flat, supine position at all times C) provide pin care at least every hour D) remove traction weights for 20min every 2 hours *C

To prevent foot drop in clients with Buck's traction, the nurse should:

A) place pillows under the client's heels B) Tuck the sheets into the foot of the bed C) Teach the client isometric exercises D) Ensure proper body positioning *D

A client with fracture develops compartment syndrome. When caring for the client, the nurse would be alert for which of the following signs of possible organ failure?

A) rales B) jaundice C) generalized edema D) dark, scanty urine *D

The decision to begin antiretroviral therapy is based on:

A) the CD4 cell count B) the plasma viral load C) the intensity of the patient's clinical symptoms D) all of the above *D

What does ARDS stand for?

Acute Respiratory Distress Syndrome

What is Buck's traction?

Buck's traction, which may be unilateral or bilateral, is used to immobilize, position, and align the lower extremity in the treatment of contractures and diseases of the hip and knee.

During the acute phase of a burn, the nurse should assess which of the following? Why?

Circulatory and respiratory status;

Which microorganism had been linked to meningitis in humans?

Cl. Difficile

What is meant by atelectasis? If occurs postoperative, what could cause it?

Collapse lung; hypoxia

After the first injection of an immunotherapy program, the nurse notices a large, red wheal on the client's arm, coughing, and expiratory wheezing. Which intervention should the nurse implement first?

Immediately, the nurse would determine that the client is experiencing anaphylaxis to the injection. The first action is to give 0.2-0.5ml of 1:1,000 epinephrine IM. Then, notify the health care provider, beginning O2 administration, and starting IV line following the initial injection of epinephrine administered.

In a client with a fractured femur, why do we ask them to wiggle their toes?

Method of assessing for circulatory impairment

What is pyelonephritis?

Neph = kidney Itis = infection

Why must a body be positioned 30degrees elevated post-mortem?

Not to leak fluids

What is the difference between closed and open angle glaucoma?

Open angle glaucoma is caused by a build-up of fluid due to blockage, causing pressure to build over time. *most common (open) Closed angle glaucoma, pressure occurs suddenly due to tumor - considered an emergency as peripheral vision loss goes unnoticed due to compensation of the body.

A female client with severe staph infection is receiving the aminoglycoside gentamicin sulcate (Garamycin) by IV. The nurse should assess the client for which adverse rxn to this drug?

Ototoxicity

When using a contrast medium with a procedure, what is the highest nursing priority?

Patient allergy to iodine/shellfish

Atherosclerosis impedes coronary blood flow by which mechanism?

Plaque obstructs blood flow

Why is a patient with Systemic Lupus Erythematosus (SLE) instructed to avoid steak?

This patient is at risk for CAD and hypertension, therefore advised of lifestyle changes to reduce risks including smoking cessation, prevention of obesity and hyperlipidemia, reduction of salt, fat, and cholesterol intake.

When the client is lying supine, the nurse will prevent external rotation of the lower extremities by using a:

Trochanter roll to the thigh

Which blood test is most indicative of cardiac damage?

Troponin I

T or F: Polyuria is a symptom of early renal insufficiency

True

T or F: people with sensorineural hearing loss also have difficulty understanding speech

True

T or F: Increased respirations & HR are normal signs of death, why?

True; a compensation mechanism

What is an expected lab finding in a client with gout?

Uric acid level >8mg/dl

A male client is to receive IV vancomycin (Vancocin). When preparing to administer this drug, the nurse should keep in mind that:

Vancomycin should be infused over 60-90min in a large volume of fluid

Can a nurse pronounce death?

Yes, but physician, nurse practitioner, and coroner must complete death certificate

Following an amputation, the advantage to the client for an immediate prosthesis fitting is:

a) Ability to ambulate sooner B) Less change of phantom limb sensation C) Dressing changes are not necessary D) Better fit of the prosthesis *A

What is included in the Rehabilitation Phase of a burn patient?

a) ROM exercise b) pressure bandages to maintain scarring c) itch relief d) psychological support (asses coping skills and family support)

What is the main concerns of the Emergent phase of a burn patient?

a) airway management b) fluid resuscitation (Parkland Formula) c) wound care (debridement, artificial skin) d) pain management

What are the goals of the Acute Phase of a burn patient?

a) would care (debridement, antimicrobial agents) b) excision and grafting c) pain management d) physical therapy (maintain joint function, prevent contractors)

What is allergic rhinitis?

an allergic rxn to inhaled airborne allergens

What is atopic dermatitis?

an inflammatory condition involving a skin rxn to irritants/allergens

Highest risk for cataracts:

diabetes, smoking, glucocorticoid steroid use

What is Homan's sign? What does it represent?

discomfort behind the knee on forced dorsiflexion of the foot; a sign of thrombosis in the lower limb

Most common symptom of rheumatoid arthritis..

early morning stiffness

What is the first priority care for a client exhibiting signs of a CAD?

enhance myocardial oxygenation

What does tonometry measure?

pressure within the eye

What is the purpose of a footplate with a traction?

prevent foot drop

When antibiotics are not producing the desired outcome for a client with osteomyelitis, the nurse interprets this a suggesting the occurrence of:

production of bacterial growth by avascular tissue

The major rationale for the use of acetylsalicylic acid (aspirin) in the treatment of rheumatoid arthritis is to:

reduce inflammation of the joints

What is the primary effect of methocarbamol (Robaxin)?

relief of muscle spasms

What is the most common symptom of closed angle glaucoma?

sudden, intense pain in the eye *considered an emergency

When evaluating all forms of traction, the nurse knows the direction of pull is controlled by:

the rope/pulley system

What is the primary reason for administering morphine to a client with an MI?

to decrease oxygen demand on the client's heart; will also decrease pain and anxiety while causing sedation to increase comfort

What is the most common HIV-related neurological complication?

toxoplasmosis

The nurse has taught the client with a below the knee amputation about prosthesis and stump care. The nurse evaluates that the client states to:

use a mirror to inspect all areas of the stump daily