Med-Surg
Indicators of hypovolemic shock associated with internal bleeding include all of the following except:
bradycardia
Bone formation is enhanced by:
calcium intake, muscular activity, and wt bearing.
shallow ulcer with a red border and white or gray center
canker sore
reddened circumscribed lesion that ulcerates and becomes encrusted
chancre
When delegating tasks to an unlicensed assistant the nurse understands that the assistant:
collects clinical data
reddened area or rash associated with itching
contact dermatitis
Cancer of the esophagus occurs primarily in:
black men over 50 years of age
A nurse at the scene of an industrial explosion uses "field triage" to categorize victims for treatment. A pt in need of emergent care would be tagged using the color:
red
A patient has the following arterial blood gas results: pH 7.52; PaCO2 30mmHg; HCO3-24mEq/L. The nurse determines that the results indicate:
respiratory alkalosis
John, 16 yo, is brought to the ER after a vehicular accident. He is pronounced dead on arrival (DOA). When his parents arrive at the hospital, the nurse should:
speak to both parents together and encourage them to support each other and express their emotions freely.
When assessing a client with appendicitis, which statement is most likely to elicit information?
"tell me how you feel"
Latent syphilitic lesions may still be treated with penicillin G benzathine up to:
1 year
The estimated intake of calcium to prevent bone loss for a postmenapausal woman is _____ mg/day. The actual intake is about _____mg/day.
1,200/400
When performing a GI assessment the nurse uses which examination sequence?
1. Inspection (visualization) 2. Auscultation (listening) 3. Percussion (tapping) 4. Palpation (examing with hands)
The elderly who are major consumers of emergency health care, account for about _____million visits to the ER.
100
Each year nosocomial infections affect about____ patients
2 million
The average 75yo woman who suffers with osteoporosis has lost about ____ of her cortical bone.
25%
Back Pain is classified as "chronic" when the pain lasts longer than _____ without improvement.
3 months
Near-drowning is the third leading cause of unintentional death in about_____ of children under 4 years of age.
40%
Preventive orthodontics for malocclusion is usually started at age:
5
The ingestion of fluoridated water effectively prevents and reduces the incidence of dental caries. Fluoridation decreases dental caries by:
60%
The rehydration goal for a 70kg pt who has moderate dehydration would be ____ ml over 4 hours.
7,000
Progressive deterioration of body systems occurs when hypothermia lowers the body temperature to:
95 degrees
A client is diagnosed with hyperthyroidism. The nurse expects to find signs and symptoms similar to:
Adrenergic stimulation
The bacterium with significant nosocomial potential that is gram-positive, spore-forming, and highly resistant to antimicrobial therapy is:
Clostridium difficle
The nurse is caring for a client with a postoperative wound evisceration. Which action should the nurse perform first?
Cover the protruding organ with moist sterile gauze
The antibiotic of choice for the medical management of Legionnaire's disease is:
Erthromycin
A common bacterial cause of diarrhea that has been linked recently to the ingestion of undercooked beef is:
Escherichia coli
The nurse is planning care for a client with acute hepatitis A. What is the primary mode of transmission?
Fecal contamination and oral ingestion
A 20 yo college student is admitted to the ED for evaluation of abdominal pain with nausea and vomiting. She has a WBC of 14,000/uL and an ESR of 30mm/hr. Appendicitis is suspected when physical examination reveals localized pain in McBurney's point located:
Halfway between the umbilicus and right iliac crest
A 54 yo client is admitted for venous ulceration unresponsive to tx. Which of the following is the nurse most likely to find during an assessment of this client?
Heavy exudate
A nurse who elicits a positive Chvostek's sign would suspect that the patient has which condition?
Hypocalcemia
A client with AIDS develop Pneumocystis jiroveci (carinii) pneumonia. Which nursing diagnosis has the highest priority?
Impaired gas exchange
When performing and assessment, the nurse identifies the following signs and symptoms: impaired coordination, decreased muscle strength, limited range of motion, and reluctance to move. Based on these findings the nurse adds which of the following to the plan of care?
Impaired physical mobility
A client undergoes placement of a cast for a fractured radius. The nurse suspects compartment syndrome (Compartment syndrome occurs when excessive pressure builds up inside an enclosed muscle space in the body. Compartment syndrome usually results from bleeding or swelling after an injury. The dangerously high pressure in compartment syndrome impedes the flow of blood to and from the affected tissues). if the client experiences pain that:
Intensifies with exertion of the arm
A client with an arterial ulcer over the left lateral malleolus complains of pain a the ulcer site. The nurse caring for this client understands that the pains is caused most commonly by which of the following?
Ischemia
A 78 yo client has a history of osteoarthritis. Which signs and symptoms would the nurse expect to find on assessment?
Joint pain, creptitus, Heberdens nodes/swelling, joint pain, tenderness on palpation
The intervertebral disks that are subject to the > mechanical stress and > degenerative changes are:
L4 to L5
The nurse is caring for a client with an active upper GI bleed. What is the appropriate diet for this client?
Nothing by mouth/NPO
A client with intractable asthma develops Cushing's syndrome. This complication can most likely be attributed to long-term or excessive use of:
Prednisone
A gram-positive organism that is less virulent than a gram-negative organism is:
Staphylococcus aureus
MRSA is a common nosocomial infection caused by____ the most frequently occuring pathogen identified with this disorder.
Staphylococcus aureus
Most cases of osteomyelitis are caused by:
Staphylococcus aureus
When prioritizing client care based on Maslow's hierarchy of needs, the nurse's first priority would be:
Using two nurses to transfer the client (safety)
The information that is most important for the nurse to obtain during the initial assessment of a client admitted to the emergency department with vomiting of bright red blood is:
Vital signs and symptoms of hypovolemia
The multiple myeloma tumor has its origin and principal location in the:
bone marrow
The most common symptoms of osteomalacia are:
bone pain and tenderness
A client receives a right hip prosthesis after a fall. In the immediate postoperative period, the nurse should maintain the leg in a(n):
abducted position
The nurse suspects that a pt who presents with the symptoms of food "sticking" in the lower portion of the esophagus may have the motility disorder known as:
achalasia
white overgrowth of horny layer of epidermis
actinic chelitis
Intervention for a person who has swallowed strong acid includes all of the following except:
administering an irritant that will stimulate vomiting
Clinical indicators for emergency endotracheal intubation include:
airway obstruction
A common lesion of the mouth that is also referred to as a canker sore is:
aphthous stomatitis
The initial nursing measure for the control of hemorrhage caused by trauma is to:
apply firm pressure over the involved area or artery
Nursing management for a crushing lower extremity wound includes:
applying a clean dressing to protect the wound, elevating the site to limit the accumulation of fluid in the interstitial spaces, splinting the wound in a position of rest to prevent motion
Neoplasms of the salivary glands:
are normally malignant and are treated by surgical excision, commonly recur, and recurrences are more malignant than the original tumor, are usually always treated with radiation
A common postoperative complication of esophageal surgery for cancer is:
aspiration pneumonia
Nursing measures for a penetrating abdominal injury would include:
assessing for manifestations of hemorrhage, covering and protruding viscera with sterile dressings soaked in normal saline solution, looking for any associated chest injury
Nursing measures for an extremity fracture would include.
assessing for manifestations of shock, immobilizing the fracture site, palpating peripheral pulses
After undergoing a procedure requiring general anesthesia the client is most at risk for:
atelectasis (Almost everyone who has surgery has some atelectasis from anesthesia. Anesthesia changes your regular pattern of breathing and the absorption of gases and pressures, which may combine to cause some degree of collapse of the tiny air sacs (alveoli) in your lungs).
The transmission route for HIV is through:
contaminated blood, semen and vaginal secretions, maternal-fetal blood
An overgrowth of the horny layer of epidermis on the foot is called a:
corn
Which nursing diagnosis is most likely for a client with an acute episode of diabetes insipidus?
deficient fluid volume
Usually the first symptom associated with esophageal disease is:
dysphagia
Actinic chelitis is a lip lesion that results from sun exposure and can lead to squamous cell carcinoma.
erythema, fissuring, and white hyperkeratosis
Identify the sequence of medical or nursing management for a patient who experiences multiple injuries.
establish an airway, control hemorrhage, prevent hypovolemic shock assess for head injuries.
The first priority in treating any pt in the ER is:
establishing an airway
Appropriate nursing actions when caring for a pt with a primary malignant bone tumor would include all of the following except:
estimating the size and location of the mass daily by vigorously palpating the affected area.
A hiatal hernia involves a(n):
extension of the esophagus through the diaphragm
A client with pneumonia in the right lower lobe is prescribed percussion and postural drainage. When performing the procedure, the nurse should position the client:
flat with the foot of the bed higher than the head
Postoperative nursing care for drainage of a dentoalveolar or periapical abscess includes all of the following except:
fluid restriction for the first 48 hrs because the gums are swollen and painful
A common disease of oral tissue characterized by painful, inflamed and swollen gums is:
gingivitis
painful, inflamed, swollen gums
gingivitis
white patches with rough, hairlike projections
hairy leukoplakia
The single most important means of preventing the spread of infection is:
handwashing
Rose, a 19 yo student, had been sexually assaulted. When assisting with the physical examination, the nurse should do all of the following except:
have the pt shower or wash the perineal area before the examination
The most common cause of shock in emergency situations is:
hypovolemia
A triage nurse in the emergency department determines that a pt with dyspnea and dehydration is not in a life-threatening situation. The triage category that the nurse would choose is:
immediate
The typical lesion in oral cancer can be described as a(n):
indurated ulcer
The term for onychocryptosis, a common foot condition is:
ingrown toenail
Signs and symptoms of osteomyelitis may include all of the following except:
leukopenia, swelling, and purulent drainage
hyperkeratotic white patches usually in buccal mucosa
leukoplakia
ulcerated and painful, white papules
lichen planus
The nurse should encourage a pt with low back pain to do all of the following except:
lie prone with legs slightly elevated
A pt has experienced blunt abdominal trauma from a motor vehicle crash. The nurses assess the pt with the knowledge that the most frequently injured solid abdominal organ is the:
liver
A person diagnosed with Legionnaire's disease would have a primary infection in his or her.
lungs
A client in balanced suspension traction for a femur fracture needs to be repositioned toward the HOB. During repositioning, the nurse should:
maintain the same degree of traction tension
Carpal tunnel syndrome is a neuropathy characterized by:
median nerve compression at the wrist
The most common site for cancer of the oral cavity is the:
mouth
The most common benign bone tumor is a(n):
osteochondroma
Which of the following arterial blood gasses (ABGs) would the nurse expect to see when a client has respirations of 6/min and develops acidosis?
pH7.29, PaCO2 62mmHg, HCO3-26mEq/L
The most commonly inflamed salivary gland is the:
parotid
A client with persistent vomiting of 3 days duration is seen in the urgent care center because of increasing weakness. Ringer's lactate solution IV is started, and an arterial blood gas (ABG) analysis is ordered. Results of the ABGs that would be expected include:
ph 7.6; PCO2 30mm HG; HCO3 40mEq/L
A client with peptic ulcer disease secondary to chronic NSAID use is prescribed misoprostol (Cytotec). The nurse would be most accurate in informing the client that the drug:
protects the stomach lining
When lifting objects, pts with low back pain should be encouraged to maximize the use of the :
quadriceps
The incidence of most dental caries is directly related to an increase in the dietary intake of:
sugar
The best position to ease low back pain is:
supine with the knees slightly flexed and the HOB elevated 30 degrees
The specific tx for chronic osteomyelitis would probably be:
surgical removal of the sequestrum
The leading cause of death in children and adults under age 44 is:
trauma
An oropharyngeal airway should be inserted:
upside down and then rotated 180 degrees
