ADULT health midterm

PT normal range

11-12.5 seconds

PTT normal range

25-35 seconds

Antiretroviral medications as postexposureprophylaxis for health care workers are started withinhow many hours of exposure?

72

BNP (brain natriuretic peptide)

<100 pg/mL or ng/L desired >100 positive >400 severe HF -BNP is ordered to help determine HF and is a more sensitive test than ANP. It is a neurohormone secreted primarily by cardiac ventricles and increases in response to volume expansion and pressure overload.

A nurse would question the accuracy of a pulse oximetry evaluation in which of the following conditions?

A client experiencing hypothermia

A patient was seen in the clinic for hypertension and received a prescription for a new antihypertensive medication. The patient arrived in the emergency department a few hours after taking the medication with severe angioedema. What medication prescribed may be responsible for the reaction?

Angiotensin-converting enzyme (ACE) inhibitor

A patient presents to the walk-in clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the patient that angina is most often attributable to what cause?

Coronary arteriosclerosis

The nurse is caring for a client receiving insulin isophane suspension (NPH) at breakfast. What is an important dietary consideration for the nurse to keep in mind?

Encourage midday snack.

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?

Hypercapnia, hypoventilation, and hypoxemia

Frothy pink sputum is a sign of?

Pulmonary Edema as a result of Left sided heart failure.

Which of the following body substances causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle?

histamine

signs and symptoms of poor perfusion and cardiac output

muscle weakness, decreased, exercise tolerance, cyanosis, pallor, cool extremeeties, resting tachycardia, anorexia, nausea, unexplained weight loss

Complications of COPD

pneumoniachronic atelectasispneumothoraxcor pulmonale

A patient has just been diagnosed with type 2 diabetes. The physician has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the physician prescribe for this patient?

A biguanide

Contact dermatitis is considered a type IV hypersensitivity reaction. The nurse is aware that this classification is characterized by which of the following?

A delayed-type hypersensitivity that is mediated by T cells

What site can ABGs be obtained from?

A puncture at the radial artery

A nurse's assessment reveals that a client with chronic obstructive pulmonary disease may be experiencing bronchospasm. Which assessment findings would suggest that the client is experiencing bronchospasm? Select all that apply.

B. Wheezes or diminished breath sounds on auscultation E. Labored and rapid breathing

The nurse is assessing a client whose respiratory disease is characterized by chronic hyperinflation of the lungs. Which physical characteristic would the nurse most likely observe in this client?

Barrel chest

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

Stage 1 of HIV infection

CD4+ cell count of at least 500-1500- Flu-like illness; occurs one to six weeks after infection- Mild symptoms- Infected person can infect other people

What to monitor in furosemide

Careful monitoring of the patient's clinical condition, daily weight, fluids intake, urine output, electrolytes, i.e., potassium and magnesium, kidney function monitoring with serum creatinine and serum blood urea nitrogen level

The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer?

Diphenhydramine (Benadryl)

Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin?

Do not mix with other insulins

the process of adaptive immunity manifested by the production of antibodies by B lymphocytes

Humoral immunity

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

A gerontologic nurse is caring for an older adult patient who has a diagnosis of pneumonia. What age-related change increases older adults susceptibility to respiratory infections?

Impaired ciliary action

A patient diagnosed with diabetic ketoacidosis would be expected to have which type of respiratory pattern?

Kussmaul respirations

what to monitor on lisinopril

Monitor serum potassium, blood pressure, and blood urea nitrogen/serum creatinine

Upon palpation of the sinus area, what would the nurse identify as a normal finding?

No sensation during palpation

The most common infection in peoplewith AIDS is

Pneumocystis pneumonia

The HCP has prescribed thrombolytic therapy for the client diagnosed with a myocardial infarction. Which data indicate the medication is effective?

Reperfusion dysrhythmias (premature ventricular contractions) indicate the tissue is viable, which indicates the medication is effective.

A client's decreased mobility has been attributed to an autoimmune reaction originating in the synovial tissue, which caused the formation of pannus. This client has been diagnosed with which health problem?

Rheumatoid arthritis (RA)

the nurse is caring for a client diagnosed with asthma. While performing the shift assessment, the nurse auscultates breath sounds including sibilant wheezes, which are continuous musical sounds. What characteristics describe sibilant wheezes?

They can be heard during inspiration and expiration

when should furosemide be taken

in the morning

A patient's medication regimen for the treatment of hypertension includes hydrochlorothiazide. Following administration of this medication, the nurse should anticipate what effect?

increased urine output

The nurse is in the radiology unit of the hospital. The nurse is caring for a client who is scheduled for a lung scan. The nurse knows that lung scans need the use of radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for?

iodine allergy

Signs of cardiac tamponade

jugular vein distention muffled heart sounds decreased cardiac output

In Aortic Stenosis, resistance to blood flow cause what?

left ventricular hypertrophy

Glucagon

maintains blood glucose byincreasing the release of glucose from the liver into theblood

aortic stenosis

narrowing of the aorta

A client experiences a head injury in a motor vehicle accident. The client's level of consciousness is declining, and respirations have become slow and shallow. When monitoring a client's respiratory status, which area of the brain would the nurse realize is responsible for the rate and depth?

pons

Condition in which capillary fluid moves into alveoli

pulmonary edema

the nurse is caring for a client whose respiratory status has declined since shift report. The client has tachypnea, is restless, and displays cyanosis. Which diagnostic test should be assessed first?

pulse oximetry

Blood bypasses lungs in what cardiac disorder?

right to left shunt

cor pulmonale

right ventricular hypertrophy and heart failure due to pulmonary hypertension

The nurse should recognize a patients risk for impaired immune function if the patient has undergone surgical removal of which of the following?

spleen

usually, babasilar crackles that do not clear with coughing are detected in

the early phase of left ventricular HF

pulmonary congestion occurs when

the left ventricle cannot effectively pump blood out of the ventricle into the aorta and systemic circulation.

Clinical Manifestations of COPD

-Three primary symptoms-Chronic cough-Sputum production-Dyspnea-Weight loss due to dyspnea-"Barrel chest"

Stage 3 HIV

-confirmed HIV infection & CD4 T-cell <200 cells/mm3 OR-CD4 T-cell <14%-AIDS defining illness present

troponin normal range

0-0.4

INR normal range

0.8-1.2

During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously been immunized for mumps. What type of immunity does she possess?

Acquired immunity

A nurse has administered a childs scheduled vaccination for rubella. This vaccination will cause the child to develop which of the following

Active acquired immunity

A nurse is assessing a client who is suspected of having bronchiectasis. The nurse should consider which of the following potential causes? Select all that apply.

Airway obstructionPulmonary infectionsGenetic disorders

The nurse is caring for a client with recurrent hemoptysis who has undergone a bronchoscopy. Immediately following the procedure, the nurse should complete which action?

Assess the client for a cough reflex

Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy?

B6

Defect involving a narrowing of the aorta

Coarctation of the Aorta

Glargine side effects

Confusion, agitation, tremors, fatigue, hunger

A patient is receiving a transfusion of packed red blood cells. Shortly after initiation of the transfusion, the patient begins to exhibit signs and symptoms of a transfusion reaction. The patient is suffering from which type of hypersensitivity?

Cytotoxic (type II)

A nurse is performing a focused assessment on a client with bronchiectasis. Which are the most prevalent signs and symptoms of this condition? Select all that apply.

D. Copious, purulent sputum E. Chronic cough

The nurse enters the room of a client who is being monitored with pulse oximetry. Which of the following factors may alter the oximetry results?

Diagnosis of peripheral vascular disease

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

Dilation of bronchi and bronchioles

A clinic nurse is caring for a client newly diagnosed with fibromyalgia. When developing a care plan for this client, which nursing diagnosis should the nurse prioritize?

Fatigue related to pain

nurse has been asked to give a workshop on chronic obstructive pulmonary disease for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has which pathophysiologic effect?

Increases the amount of mucus produced

Which type of insulin acts most quickly?

Lispro

A nurse is teaching a client with asthma about the proper use of the prescribed inhaled corticosteroid. Which adverse effect should the nurse be sure to address in client teaching?

Oral candidiasis

A patient comes to the emergency department complaining of a knifelike pain when taking a deep breath. What does this type of pain likely indicate to the nurse?

Pleurisy

The nurse is instructing a hospitalized client with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during dysgenic periods. Which position should the nurse instruct the client to assume

Sitting up and leaning on an over bed table

The most recent blood work of a patient with a longstanding diagnosis of type 1 diabetes has shown the presence of microalbuminuria. What is the nurse's most appropriate action?

Teach the patient about actions to slow the progression of nephropathy

stroke volume

The amount of blood ejected from the heart in one contraction.

A nurse is planning the care of a client with bronchiectasis. What goal of care should the nurse prioritize?

The client will successfully mobilize pulmonary secretions.

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

A patient with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the patient about what potential adverse effects?

Throbbing headache or dizziness

A nurse is planning client education for a client being discharged home with a diagnosis of rheumatoid arthritis. The client has been prescribed antimalarials for treatment, so the nurse knows to teach the client to self-monitor for what adverse effect?

Visual changes

The nurse is caring for an 82-year-old patient. The nurse knows that changes in cardiac structure and function occur in older adults. What is a normal change expected in the aging heart of an older adult?

Widening of the aorta

The nurse working in the radiology clinic is assisting with a pulmonary angiography. The nurse knows that when when monitoring clients after a pulmonary angiography, what should the physician be notified about?

absent distal pulses

A patient with pericarditis has just been admitted to the CCU. The nurse planning the patient's care should prioritize what nursing diagnosis?

acute pain

The resistance to ejection of blood from the ventricle

afterload

Acute-onset bronchial asthma causes wheezing and breathlessness as a result of which of the following?

airway inflammation

Which of the following is a prescription antihistamine that is not contraindicated in narrow-angle glaucoma?

allegra

protamine sulfate

antidote for heparin

Three distinct characteristics of Rheumatologic Disorders

autoimmunity inflammation degeneration

Which of the following is a contraindication for immunotherapy?

beta blocker

inhibit the production of glucose by the liver and are in used in type 2 diabetes to control blood glucose levels

binguanides

Blue bloaters are associated with what condition?

bronchitis

mitral stenosis

calcified mitral valve impedes forward flow of blood into left ventricle during diastole

Vitamin K uses

can make warfarin less effective

The emergency nurse is admitting a patient experiencing a GI bleed who is believed to be in the compensatory stage of shock. What assessment finding would be most consistent with the early stage of compensation?

cool, clammy skin

The nurse is caring for a patient with a pulmonary disorder. What observation by the nurse is indicative of a very late symptom of hypoxia

cyanosis

Chronic Obstructive Pulmonary Disorders in which Enlargement of air spaces and destruction of lung tissue

emphysema

Pink puffers are associated with what condition?

emphysema

Which chronic obstructive pulmonary disease primarily affects the alveoli?

emphysema

hypercapnia

excessive carbon dioxide in the blood

What do alpha cells secrete?

glucagon

spontaneous pneumothorax

the rupture of a weakened area of the lung, which allows air to escape into the pleural space occurs without an obvious etiology such as trauma or iatrogenic causes

During emphysema, neutrophils in alveoli secrete what?

trypsin

The nurse documents breath sounds that are soft, with inspiratory sounds longer than expiratory and found over the periphery of the lungs. Which of the following will the nurse chart?

vesicular

Preload

volume of blood in ventricles at end of diastole

The nurse is performing chest auscultation for a patient with asthma. How does the nurse describe the high-pitched, sibilant, musical sounds that are heard?

wheezes