med a - final exam

The nurse is obtaining a health history of a child suspected of tuberculosis. What question would the nurse ask first about the child's cough?

"How long has your child had a cough?"

The nurse is providing care for a 14-year-old girl with severe acne. The girl expresses sadness and distress about her appearance. Which response by the nurse would be most appropriate?

"Many people feel this way; I know someone who can help."

A 62-year-old man with emphysema does not understand the need to stop smoking at this age because lung problems already exist. Which would be the best response to his statement?

"Once you stop smoking, your body will begin to repair some of the damage to your lungs."

A patient with a seizure disorder asks the purpose of staying awake all night before having an electroencephalogram (EEG) in the morning. What should the nurse explain to this patient?

"Sleep deprivation can cause a seizure, which will be helpful during the test."

The school nurse is planning a teaching session with the parents of students to reduce the spread of the influenza virus throughout the school. What should the nurse include when teaching the parents about minimizing the chance of spread of influenza? Select all that apply.

."Cover your cough" education 2.Appropriate hand hygiene 4.Sanitizing high-touch items to kill pathogens

A nurse is developing a plan of care for a child who is admitted to the hospital for surgery. The child is visually impaired. What would be most appropriate for the nurse to include in the child's plan of care? Select all that apply

1.Explaining instructions using simple and specific terms the child understands 2.Allowing the child to explore the postoperative equipment with his hands 4.Using the child's body parts to refer to the area where he may have postoperative pain

The nurse is providing care to a child with folliculitis. What would the nurse expect to administer?

2. Topical mupirocin

The nurse is providing care to several children who have been brought to the clinic by the parents reporting cold-like symptoms. The nurse would most likely suspect sinusitis in which child?

A 7-year-old with halitosis and thick, yellow nasal discharge

Which statement by the patient with suspected osteomyelitis indicates that teaching was effective?

A bone biopsy is the best way to diagnose this disease"

The nurse is teaching the parent of a child with cystic fibrosis about nutrition requirements for the child. What should be included in this teaching?

A. "Feed your child foods that are high in protein." D. "Give your child high-calorie foods and snacks." E. "Give pancreatic enzymes with meals."

A child is in the emergency department with an asthma exacerbation. Upon auscultation the nurse is unable to hear air movement in the lungs. What action should the nurse take first?

Administer a beta-2 adrenergic agonist

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm?

Albuterol

A child has been prescribed a nasal cannula for oxygen delivery. What should the nurse do before applying the cannula?

Assess patency of the nares

A group of nursing students are reviewing information about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding of the information when they identify which finding?

Children develop hypoxemia more rapidly than adults do.

A child with a pneumothorax has a chest tube attached to a water seal system. When assessing the child, the nurse notices that the chest tube has become disconnected from the drainage system. What would the nurse do first?

Clamp the chest tube.

When performing the physical examination of a child with cystic fibrosis, what would the nurse expect to assess?

Decreased tactile fremitus

A child is hospitalized with pneumonia. The nurse assesses an increase in the work of breathing and in the respiratory rate. What intervention should the nurse do first to help this child?

Elevate the head of the bed

A middle-aged person with scoliosis asks why exercises are prescribed when the pain is already severe. How should the nurse respond to this patient?

Exercise can reverse and prevent the progression of the spinal deformity."

A nurse is administering 100% oxygen to a child with a pneumothorax based on the understanding that this treatment is used primarily for which reason?

Hasten air reabsorptio

A nurse is preparing a teaching plan for the family of a child with allergic rhinitis. When describing the immune reaction that occurs, the nurse would identify the role of which immunoglobulin?

IgE

The nurse is discussing discharge instructions with the parents of a 6-year-old who had a tonsillectomy. What is the most important thing to stress

Inspect the throat for bleeding.

A child is brought to the emergency department by his parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. What would the nurse have most likely assessed?

Inspiratory stridor

The nurse is educating the parents of a 7-year-old boy with asthma about the medications that have been prescribed. Which drug would the nurse identify as an adjunct to a b2-adrenergic agonist for treatment of bronchospasm

Ipratropium

A nursing instructor is preparing a class on chronic lung disease. What information would the instructor include when describing this disorder?

It is seen most commonly in premature infants.

A child with a seizure disorder will be discharged home from the hospital on the drug levetiracetam. What discharge instruction is the most important for the nurse to provide the parent?

Notify the health care provider if child experiences poor coordination

A patient returns to the clinic for an evaluation 2 weeks after total hip replacement. Which statement by the patient indicates the need for further teaching?

Now that I am stronger, I no longer need to use the raised toilet seat."

In caring for a patient with severe hip pain the patient is diagnosed with osteoarthritis (OA), what does the nurse teach the patient about this disease process?

OA causes a decrease in joint fluid that affects the cartilage"

The nurse is preparing to perform a physical examination of a child with asthma. Which technique would the nurse be least likely to perform?

Palpation

A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally?

Pancreatic enzymes

The nurse is preparing to provide tracheostomy care to an infant. After gathering the necessary equipment, what would the nurse do next?

Position the infant supine with a towel roll under the neck

A hospitalized child suddenly begins reporting "my chest hurts," is tachypneic, and has tachycardia. The nurse auscultates the lung sounds and finds absent breath sounds on one side. After notifying the health care provide what action would the nurse take first?

Prepare for chest tube insertion

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which test as most helpful in determining the extent of the child's hypoxia?

Pulse oximetry

The nurse is examining a 5-year-old. Which sign or symptom is a reliable first indication of respiratory illness in children?

Rapid, shallow breathing

A parent asks the nurse about immunizing her 7-month-old daughter against the flu. Which response by the nurse would be most appropriate?

Since your daughter is older than 6 months, she should get the vaccine every year."

In providing preoperative teaching to a patient with smoking history, which information does the nurse include in the teaching plan to encourage the patient not to smoke before surgery?

Smoking increases your risk of respiratory depression during surgery."

The nurse is caring for a 3-year-old girl with a respiratory disorder. The nurse anticipates the need for providing supplemental oxygen to the child when performing which action?

Suctioning a tracheostomy tube

The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as:

Sunsetting

Bacterial pneumonia is suspected in a 4-year-old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized?

Tachypnea with retractions

A child is in the emergency department with a head injury obtained in a motor vehicle crash. The glascow coma scale assessment is rated at 10 (3 eye opening, 3 motor, 4 verbal). How should the nurse interpret these findings?

The child's eyes open to verbal stimuli, is confused and flexes with painful stimul

After teaching a class about the differences in the skin of infants and adults, the nurse determines that additional teaching is necessary when the class states:

The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented."

A patient is in skeletal traction secondary to a fracture of the left femur. When the patient's spouse asks about the purpose of traction, which response by the nurse is best?

This type of traction aids in realigning the bone."

The nurse is assessing a 5-year-old girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, what would be least appropriate for the nurse to perform?

Visualizing the throat

A nurse is assessing the skin of a child with cellulitis. What would the nurse expect to find?

Warmth at skin disruption site

A patient is diagnosed with myasthenia gravis. What information does the nurse include in an explantion of this disease process?

Your body has a disorder that destroys receptor sites at the neuromuscular junction, leading to decreased nerve conduction."

a 10 month od infant is brought to the emergency department by the parents after they found the infant face down in the bathtub . the parent states , i just let the bathroom to answer my phone , when i came back , i found my infant. which nursing action is priotity ?

assess the infants resp rate

the physician has ordered rectal diazepam for a 2 yr boy with status epliepticus . which intructions is essential for the nurse to teach the parents ?

monitor their childs level of sedation

In providing health education to a group of middle school students, how does the nurse describe the function of the epiglottis?

prevent the entry of solids and liquids into the lungs

A child requires supplemental oxygen therapy at 8 liters per minute. Which delivery device would the nurse most likely expect to be used

simple mask

A child is brought to the emergency department after sustaining a concussion . the child is to be discharged home with his aprents . what would the nurse include in the childs discharge instructions

wake hime up every 2 hours to check movement and repsonses

The nurse provides education to a patient who is diagnosed with scoliosis and scheduled for surgical correction. Which patient statement indicates the need for additional teaching regarding postoperative e care?

· "I can drink a glass of wine each evening to help me relax."

Which patient statement indicates the need for additional teaching for the patient being discharged after a total knee replacement (TKR)?

· "I need to increase my intake of green, leafy vegetables to aid healing."

The nurse provides education to a patient who is prescribed an aerochamber for the treatment of asthma. Which patient statement indicates the need for additional teaching?

· "I should hear a whistling sound as I inhale the medication"

Which statement by the patient scheduled for an open reduction and internal fixation (ORIF) of a compound fracture of the femur indicates the need for further teaching?

· "I will have to be in traction after this surgery."

Which statement by the patient diagnosed with a second-degree sprain indicates the need for further teaching?

· "I will need to rest my ankle for 24 hours."

The nurse provides education to a patient who is diagnosed with osteoporosis and prescribed ibandronate (Boniva). Which patient statement indicates the need for additional teaching?

· "I will take my medication with food."

In teaching the patient about post-operative pain management, which statement by the nurse is best?

· "It is important that you request pain medication before the pain gets too severe."

The nurse correlates which etiology to a diagnosed low-energy fracture in 65-year-old patient?

· A fall

The nurse correlates which data from a patient's history to a diagnosis of bronchitis?

· A history of progressive dyspnea

The nurse provides care for a patient diagnosed with myasthenia gravis (MG). Which is the priority when administering the prescribed dose of pyridostigmine (Mestinon)?

· Administering the medication 30 to 60 minutes before each meal

A patient with an ischemic stroke is being considered for recombinant tissue plasminogen activator (rt-PA). The nurse recognizes which factors as contraindications to this treatment? SATA

· Age 83 years · 10- year history of type 2 diabetes mellitus · Takes warfarin sodium for atrial fibrillation

A patient is being prepared for a Tensilon test. What does the nurse ensure is available before the beginning of this test?

· Atropine sulfate

The nurse is providing care to a patient diagnosed with emphysema. Which clinical manifestation does the nurse correlate with this diagnosis?

· Barrel chest

The nurse working in the community health clinic places a purified protein derivative (PPD or Mantoux) test on an adult's forearm and instructs him to return when for reading of the response?

· Between 48 and 72 hours after placement of the PPD

The nurse correlates which finding in a patient's history as the highest risk for a stroke?

· Blood pressure 182/90 mm Hg

The nurse correlates which clinical manifestation in the patient diagnosed with a basilar skull fracture?

· Bruising around the ears

The community health nurse is preparing an educational program for local residents. Which information does the nurse include about chronic obstructive pulmonary disease (COPD)? SATA

· Cigarette smoking is the leading cause of COPD · Approximately 80% to 90% of deaths from COPD are related to smoking · Less than 5% of all COPD cases are caused by deficiency in alpha-1 antitrypsin

While playing tennis a patient fell and sustained a nondisplaced fracture of the right elbow. The nurse prepares the patient for which treatment?

· Closed reduction and cast

The nurse correlates the mechanism of action of which medication to the treatment of a patient diagnosed with muscular dystrophy (MD)?

· Cortisol

The nurse correlates that the patient with which type of musculoskeletal trauma has the highest risk of developing rhabdomyolysis?

· Crush injury of the pelvis

A patient in the operating room develops malignant hyperthermia. The nurse prepares which medication for administration to treat this medical emergency?

· Dantrolene

A patient recovering from an ischemic stroke is prescribed verapamil (Calan). The nurse teaches the patient that this medication works by which action?

· Decreases blood pressure

The nurse prepares the patient with suspected osteoporosis for which diagnostic test?

· Dual-energy x-ray absorptiometry (DEXA) scan

The nurse correlates which diagnostic result as a consistent with the diagnosis of cystic fibrosis?

· Elevated sodium levels in sweat

The nurse provides care to a patient who is admitted to confirm a suspected diagnosis of myasthenia gravis (MG). Which medication prescription does the nurse question for this patient?

· Erythromycin

The nurse assesses a patient who is admitted after a traumatic brain injury (TBI) to the frontal lobe. The nurse correlates which clinical manifestations to damage to this area of the brain?

· Expressive speech difficulty

A patient with myasthenia gravis is experiencing sweating and pallor. After administering edrophonium (Tensilon), which finding suggests the patient is experiencing a cholinergic crisis?

· Fasciculations

A patient recovering from surgery to repair a fractured femur is experiencing extreme pain and pulselessness. The nurse recognizes which treatment is indicated for this patient?

· Fasciotomy

A patient has an injury where one side of the bone is bent, and the other is fractured. How does the nurse document this fracture?

· Greentstick

The nurse is caring for a patient who is experiencing dyspnea. Which position would be most effective if incorporated in the patient's care?

· Head of bed elevated 80

The nurse is assessing a patient who is diagnosed with tuberculosis. Which assessment finding supports this diagnosis?

· Hemoptysis

Which task is inappropriate for the nurse to delegate to the unlicensed assistive personnel (UAP) during the intraoperative period of care

· Identifying the patient before the procedure

The nurse is reviewing discharge instructions for a patient with myasthenia gravis. What should the nurse emphasize regarding medication?

· Keep extra doses of medication in the car.

A patient is undergoing a surgical procedure. Based on the figure, which intraoperative position does this represent?

· Low lithotomy

The nurse recognizes which of the following structures as parts of the brainstem? SATA

· Medulla oblongata · Midbrain · Pons

In using the Braden Scale to assess a patient's skin, which category does the nurse recognize as the most sensitive indicator for risk of pressure injury?

· Mobility

In providing care to the patient with an aseptic nonunion of a fracture, the nurse correlates which prescribed medication as a potential cause of this complication?

· NSAIDS

The nurse administers the preoperative medication to the patient 1 hour before elective surgery and then discovers the preoperative consent is not signed. Which action by the nurse is the most appropriate?

· Notify the healthcare provider that surgery will need to be canceled

In providing care to a patient diagnosed with osteoporosis, the nurse correlates which pathophysiological mechanisms to this disease process?

· Osteoclastic activity is greater than osteoblastic activity

Which interdisciplinary team member does the nurse consult regarding the proper use of a continuous passive motion (CPM) machine in the patient recovering from total hip replacement surgery?

· Physical therapist

A patient with myasthenia gravis has lost 6 kg of weight over the last 2 months. What should the nurse suggest to improve this patient's nutritional status?

· Plan medication doses to occur before meals

The nurse correlates which mechanism of action for the administration of parathyroid hormone in the patient with osteoporosis?

· Protects against gonadotropin-releasing hormone agonist related to bone loss

Which clinical manifestation in the patient with chronic obstructive pulmonary disease (COPD) is more indicative of emphysema?

· Reddish complexion

A patient recovering from surgery to repair a fractured hip is placed in skin traction. The nurse corrleates which data to the effectiveness of the traction?

· Reduction in muscle spasms

The nurse provides care to a patient who is diagnosed with Parkinson's disease (PD). Which patient data support the implementation of fall precautions in the plan of care? SATA

· Rigidity · Tremors · Orthostatic hypotension

The nurse monitors for which clinical manifestation in the patient admitted with tuberculosis?

· Rust-colored sputum

The nurse correlates which potential risk factors to the development of several lacerations over the coccyx area?

· Shearing

The nurse monitors for which gastrointestinal clinical manifestations in the patient diagnosed with cystic fibrosis?

· Steatorrhea

The nurse needs to provide a strong stimulus to illicit a response however, the patient drifts back to unresponsiveness. What term should the nurse use to document this patient's level of responsiveness?

· Stupor

The results of patient's biopsy indicate a malignant growth. The nurse prepares the patient for which treatment?

· Surgical removal of the lesion

A patient is prescribed alendronate (Fosamax). What instruction does the nurse provide to the patient about this medication?

· Take on an empty stomach

The nurse is planning discharge instructions for a patient recovering from surgery to debulk a brain tumor. What is the rationale for teaching the patient about self-monitoring of capillary blood glucose level?

· Taking steroid medication

A patient with Parkinson's disease is prescribed carbidopa/levodopa (Sinemet). Which clinical manifestation should the nurse expect to be most affected with this medication?

· Tremors

In reviewing orders written for a patient with myasthenia gravis, which medication order should the nurse question before administering? SATA

· Verapamil · Erythromycin · Nicotine patch

The nurse is assessing a patient's postoperative wound and finds it has separated from the suture lie with extrusion of the bowel through the opening. How does the nurse document this finding?

· Wound evisceration

The nurse correlates dry, itchy, burning skin in an older patient to which age-related change in the integumentary system?

· Xerosis

The nurse presents information about total joint replacement to a new clinical staff. Which clinical conditions does the nurse include in the presentation as those that are indications for this procedure? SATA

• Osteroarthritis • Rheumatoid arthritis • Avascular necrosis of the femoral head

Chest percussion and postural drainage would be an appropriate intervention for which condition?

• Pneumonia