Acute and Chronic Illness Exam 1

A client scheduled for surgery asks why blood tests are being done to evaluate liver function. Which response will the nurse make?

"It is because the anesthesia you will receive is cleared through the liver."

A client is to receive intravenous immunoglobulin (IVIG). The infusion is started at 10 a.m. The nurse would be alert for signs and symptoms of an anaphylactic reaction during which time frame?

10:30 - 11 am

The herpes simplex virus type 1 (HSV-1), which produces a cold sore (fever blister), has an incubation period of

2-12 days

A 73-year-old client is admitted to the pulmonology unit of the hospital. She was admitted with pleural effusion and was "tapped" to drain the fluid to reduce her mediastinal pressure. How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub?

20 ml or less

For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery?

7 days before surgery

malignant hyperthermia

A hereditary condition of uncontrolled heat production that occurs when susceptible people receive certain anesthetic drugs.

laparotomy position

A supine position with only the upper torso exposed.

The nurse is reviewing information collected from a client during a preoperative assessment. Which condition(s) will the nurse highlight that increases the client's risk for a surgical complication? Select all that apply.

Asthma Arthritis Diabetes Body mass index 32

A client with acquired immune deficiency syndrome (AIDS) reports diarrhea after every meal. What is the nurse's best response?

Avoid residue, lactose, fat, and caffeine.

A nurse is reviewing the clinical pathway for a patient. Which of the following would the nurse most likely find? Select all that apply.

Diagnostic tests Medications Outcomes Patient teaching Assessments

What action by the nurse best encompasses the preoperative phase?

Educating clients on signs and symptoms of infection

Which blood test confirms the presence of antibodies to HIV?

Enzyme-linked immunosorbent assay (ELISA)

Nursing students are reviewing information about the various types of primary immunodeficiencies. The students demonstrate understanding of the material when they identify which of the following as an example of a primary immunodeficiency involving B-lymphocyte dysfunction?

IgA defficiency

Which substance may be used to lubricate a condom?

K-Y jelly

A client with acquired immune deficiency syndrome (AIDS) is exhibiting shortness of breath, cough, and fever. What type of infection will the nurse most likely suspect?

Pneumocystis jiroveci

A nurse is witnessing a client sign the consent form for surgery. After signing the consent form, the client starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate?

Request that the surgeon come and answer the questions.

A client is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist's instructions. Why does the client require special positioning for this type of anesthesia?

To prevent cerebrospinal fluid (CSF) leakage

When a client with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the client may show signs of alcohol withdrawal delirium during which time period?

Up to 72 hours after alcohol withdrawal

Which nutrient plays an important role in normal blood clotting?

Vitamin K

At what point does the preoperative period end?

When the client is transferred onto the operating table

A client is scheduled for a surgical procedure. When planning the client's care, the nurse should consider that which of the following conditions will increase the client's risk of complications after surgery?

a history of diabetes

A surgeon completes a total laryngectomy. Postoperatively, the nurse explains to the patient's family that:

a permanent tracheal stoma would be necessary

western blot assay

a very sensitive test used to detect small amounts of antibodies in the blood

pleural effusion

abnormal accumulation of fluid in the pleural space

The nurse is prioritizing a client's care plan based on Maslow's hierarchy of needs. What is an example of the nurse's first priority action?

administering pain medication to a client in acute pain

A client has just returned to the unit following abdominal surgery and is in significant pain. According to the nursing process, how frequently will the nurse perform assessments on this client?

as often as needed

A client receiving antiretroviral therapy reports "not urinating enough." What is the nurse's best action?

assess blood urea nitrogen and creatinine

The nurse is caring for a client whose most recent laboratory values reveal a neutrophil level of 21,000 mm3. When preparing to assess the client, the nurse should prioritize what assessment?

assessing the client for signs and symptoms of infection

when doest he preoperative phase begin and end

begins when the decision to proceed with surgery is made ends with transfer of the patient to the OR

when does the intraoperative phase begin and end

begins when the patient is transferred onto the OR bed ends with admission to post anesthesia care unit

when does the postoperative phase begin and end

begins with admission to the pacu ends with a follow up evaluation in the clinical setting

Which ethical principle refers to the duty to do good?

beneficence

BiPAP

bilevel positive airway pressure

A client is transferred from the postanesthesia care unit (PACU) to an inpatient care unit. What will the nurse assess first?

breathing

A client with acquired immune deficiency syndrome (AIDS) informs the nurse of difficulty eating and swallowing, and shows the nurse white patches in the mouth. What problem related to AIDS does the nurse understand the client has developed?

candidiasis

A nurse is caring for a bariatric client prior to a surgical procedure. What surgical complications would the nurse monitor the bariatric client for postoperatively? Select all that apply.

cardiovascular complications pulmonary complications

The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is:

chronic diarrhea

atelectasis

collapsed lung

More than 50% of individuals with this disease develop pernicious anemia

common variable immunodeficiency

CPAP

continuous positive airway pressure

what are some medications that could potentially effect the surgical experience

corticosteroids diuretics insulin antibiotics anticoagulants opioids

A client scheduled for surgery follows a vegan eating plan. For which potential postoperative complication will the nurse plan care for this client?

delayed wound healing

which medication classification must be assessed during the preoperative period because it can cause an electrolyte imbalance during surgery

diuretics

A client with osteoarthritis receives a recommendation to have joint replacement surgery. For which type of surgery will the nurse plan teaching for this client?

elective

A fractured skull would be classified under which category of surgery based on urgency?

emergent

Which term refers to the protrusion of abdominal organs through the surgical incision?

evisceration

hypercapnia

excessive carbon dioxide in the blood

What is the first step in becoming culturally competent

exploring ones own beliefs

The nursing assessment of the postoperative client reveals an incision that is well-approximated with sutures intact, minimal redness and edema, and absence of drainage. The nurse recognizes the wound is healing by:

first intention

GERD

gastroesophageal reflux disease; risk factor for laryngeal cancer, bile damages the squamos cells

what is the order of operations for donning surgical gear

gown mask goggles gloves

A nurse takes the initial history of a patient who is being examined for cancer of the larynx. Select the sign that is considered an early clinical indicator.

hoarseness of over two weeks duration

A patient with uncontrolled diabetes is scheduled for a surgical procedure. What chief life-threatening hazard should the nurse monitor for?

hypoglycemia

A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find?

hypokalemia

phase 1 pacu

immediate recovery phase, intesnsive nursing care is needed

rhinosinusitis

inflammation of the nares and paranasal sinuses, including frontal, ethmoid, maxillary, and sphenoid sinuses; replaces the term sinusitis

rhinitis

inflammation of the nose

pharyngitis

inflammation of the pharynx

A nurse in a hospice facility cares for clients with terminal illnesses and witnesses a great deal of pain and emotional distress. Which factor that affects healthcare ethics determines how the nurse must respond when a client asks for help in ending his or her suffering?

legislative and judicial decisions

trismus

lockjjaw

The nurse teaches the client that reducing the viral load will have what effect?

longer survival

trendelenburg position

lying on back with body tilted so that the head is lower than the feet

lithotomy position

lying on back with legs raised and feet in stirrups

HIV is harbored within which type of cell ?

lymphocyte

kaposi sarcoma

malignant, vascular, neoplastic growth characterized by cutaneous nodules

role of the circulating nurse in the surgical room

manages the OR and protects the patients safety and health my monitoring the activities of the surgical team - verifying consent

During surgery a patient develops hypothermia. The circulating nurse would monitor the patient closely for which of the following?

metabolic acidosis

epistaxis

nosebleed

phase 2 pacu

patient is prepared to transfer into an inpatient nursing unit, extended care, or discharge

The nurse positions the client in the lithotomy position in preparation for

perineal surgery

According to Maslow, which category of needs represents the most basic on the hierarchy?

physiologic needs

A nurse is caring for a client with human immunodeficiency virus (HIV). What would the nurse expect the health care provider to order to determine the effectiveness of treatment?

quantification of T-lymphocytes

medicamentosa

rebound nasal congestion brought on by extended use of topical decongestants like afrin

The nurse administers an injection to a client with AIDS. When finished, the nurse attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse?

report the incidence to a supervisor

A client taking abacavir has developed fever and rash. What is the priority nursing action?

report to the healthcare provider

Which adverse effect(s) should the nurse closely monitor in a client who has secondary immunodeficiencies due to immunosuppressive therapy?

respiratory or urinary system infections

A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?

risk for injury

The nurse is caring for a client who has a diagnosis of human immunodeficiency virus (HIV). Part of this client's teaching plan is educating the client about his or her medications. What is essential for the nurse to include in the teaching of this client regarding medications?

side effects of drug therapy

the scrub role

surgical hand scrub , setting up sterile table,preparing sutures, ligatures,and special equipment, keeping track of instruments , counts with circulating nurse to keep up

laryngectomy

surgical removal of the larynx

through which route are inhaled general anesthetics primarily eliminated

the lungs

veracity

truthfulness

example of curative surgery

tumor excision

A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?

use diaphragmatic breathing

larynx

voice box; most common type of cancer

A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test?

western blot assay

A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which post-surgical risk factor would decrease if the surgical client maintained strict blood glycemic control?

wound healing