Med surg2 exam
A patient is being assessed for possible heart failure. Which of these laboratory results will provide support this diagnosis?
increased brain natriuetic peptide
The nurse is assessing a patient with chronic heart failure. The nurse would expect to identify which of these clinical manifestations?
inspiratory crackles
Rheumetic heart disease
is caused by untreated strept throat bacteria sits on heart. heart valve have been permanently damage by by rheumetic fever
which answer shows the pts needs more education: a pt w/ sinus tachycardia during pt education the pt state that its okay to take what?
is ok to take coffee
ETOH cirrhosis
lack B1(Thiamine
Mitral regurgitation involves blood flowing back from the _________________ into the ________________ during systole.
left ventircles left atrium
The nurse had attended a conference on the topic of Malabsorption. The nurse understand that malabsorption results from impaired absorption of which of the following? Select all that apply.
minerals fat vit carbs proteins
Pancreatitis Nursing intervention
monitor blood sugar 3x daily check labs: elevated lipase and amylase decrease calcium(Tetany), elevated billirubin
A patient is admitted with myocarditis. While performing the initial assessment, the nurse may find which clinical signs and symptoms. Select all that apply.
myocarditis pleuritic chest pain Pericardial friction rub
pancreatic cancer risk factor
older african american smoking s/s yellowing of the eye
The nurse is caring for a patient who has been diagnosed with patient is diagnosed with heart failure and is prescribed digoxin (Lanoxin) and furosemide (Lasix). Before administering the furosemide to the patient, which laboratory result should the healthcare provider to review?
potassium
Gi condition predispose pt for
precreatic cancer
nurse is caring for a client diagnosed with Anal Cancer. Which of the following symptoms will the nurse expect to find?
rectal bleeding
The nurse is educating a patient about the care related to a new diagnosis of mitral valve prolapse. What statement made by the client demonstrates understanding?
"I will avoid caffeine, alcohol, and smoking."
Which teaching point does the nurse include for a client with peripheral arterial disease (PAD)?
"Walk to the point of leg pain, resuming when the pain stops"
Hepatitis prevention
-Teach safe practice of preparing foods -Viral hepatitis is reported to health department -Encourage vaccination -Avoid high risk behaviors IV drug users
Hepatic cirrhosis
-ascites
Laparoscopic choley- post pocedures
-get pt to ambulate soon after procedure - if not PT will have gas bloated stomach and pain
Laparascopic discharge instruction
-instruct pt that they have 1-4 puncture sites -may return to normal work activities in one week -call MD for fever 101 -Diet teaching- no fried foods no fats - no bath take shower
hepatic cirrhosis nursing intervention
-measure abdominal girth and weight daily Monitor ammonia and creatine Monitor electrolytes daily Teach pt low sodium diet Teach pt to use electric razor and soft tooth brush (because liver produce clotting factor. Vitamin k)
The nurse is caring for a client admitted with acute pancreatitis. The nurse understands that which of the following should be included in the plan of care? Select all that apply.
...Checking for signs of hypocalcemia. Monitoring for infection, particularly respiratory tract infection
What is the normal duration of a QRS complex?
.12 seconds (3 small squares)
What is the duration of a normal PR-interval?
0.12-0.2 seconds (3-5 small squares)
heart failure nursing interventions
1) Teach pt to weigh each morning and call MD if its more than 5 2)Teach about meds enalaprils side effect :cough--> call doctor 3)No OTC for med for cough 4) Teach pt to read label and sodium restriction 15 grams/day
The nurse is caring for a patient who has been diagnosed with a recent diagnosis of heart failure has been prescribed furosemide (Lasix) in an effort to physiologically do what for the patient?
reduce preload
the nurse is educating a client with celiac disease on diet and nutrition. Which of the following should the nurse include as items the client can still eat? Select all that apply
rice soy bean potatoes dried bean everything except pasta
The nurse is caring for clients in the nursing home setting who are bedridden. In which of the following disorders would the nurse expect to assess sacral edema in a bedridden client?
right side heart failure
Which of the following is of the greatest VTE risk to an individual?
History VTE
Virchow's triad has the following components. Select all that apply
Hypercoagulability Stasis of blood flow Epithelial Injury
Septal involvement occurs in which type of cardiomyopathy?
Hypertrophic
gallbaldder
right upper epigastric pain If pain stop suddenly call MD
he nurse is caring for a patient who has been diagnosed with heart failure. Which statement, if made by the patient, supports the diagnosis of heart failure?
I get out of breath walking up a flight of stairs.
The nurse is caring for a patient who has physiological changes common in geriatric patients. The nurse understands that which of these factors may increase the risk of heart failure in older patients?
Impaired diastolic filling
Peripheral vascular disease Nursing diagnose
risk for injury related to decrease sensation
Ulcerative colitis
s/s-constant abdominal pain and distention
Cirrhosis s/s and lab check
s/s: Jaundice, purities -itchy skin - uses knuckles to rub not scratch with nails -check labs and give lactulose for elevated ammonia level
the nurse is caring for a client diagnosed with Anal Rectal Fissure. Which of the following symptoms will the nurse expect to find
severe anal pain
enalapril vs lisinopril
side effect lisinopril -angioedema enalapril-cough
The nurse is teaching a group of senior citizens about risk factors for heart failure. Which of these factors will the nurse include in the teaching? Select all that apply
sleep apnea obesity hypertension Hx pre-eclampsia high sodium intake
Irratable bowel syndrome risk factor
smoking , ETOH, fast food
W/ hepititsis B Nurse must practice
standard Precaution
tx for ulcerative colitis
steriods for inflammation during exacerbation
Myocarditis Nursing Interventions
Keep Head of Bed elevated and decrease Heart work load.
The nurse is caring for a client diagnosed with hyperbilirubinemia who is experiencing pruritus. Which of the following should be included in the client's plan of care?
Keeping the client's fingernails short and smooth
In preparation for discharge of a client with arterial insufficiency and Raynaud's disease, client teaching instructions should include:
Keeping the heat up so that the environment is warm
Buerger"s disease is characterized by all the following except:
Lipid deposits in the arteries
The nurse is assessing a client diagnosed with Irritable Bowel Syndrome (IBS). The nurse understand that a diagnosis is achieved by which of the following?
symptoms
Mitral valve prolapse/regurgitation
take antibiotic
what should you teach pt about pacemaker
temporary leads are attached to epicardium during surgery
the nurse has attended a conference on the subject of Anal Fistula. The nurse understands that an anal fistula is the abnormal tunnel leading from the
the anus or rectum
If there were 3 large squares in an R-R interval what would the heart rate be?
100bpm
A patient can have heart failure without being aware of it?
true
When teaching a patient about the long-term consequences of rheumatic fever, the nurse should discuss the possibility of?
valvular Heart disease
Peripheral arterial arterial disease
you should walk
The nurse is educating a client who has been diagnosed with cholecystitis. The nurse should include education on which of the following diets with fats and carbs in the education session?
Low-fat, high-carbohydrate meals
The nurse is caring for a client admitted with acute pancreatitis. Which of the following should be included in the clients plan of care?
Maintenance of nothing-by-mouth status and insertion of nasogastric (NG) tube with low intermittent suction
cholecystectomy
Monitor wound for evisceration, if evisceration, apply sterile soaked saline gauze
The nurse has attended an education session on types of heart failure. The nurse understands which of the following is not one of the types of heart failure?
Myocardial heart failure
Peripheral artery disease
Narrowing of the arteries of the upper and lower extermites
The nurse is assessing a client admitted with acute cholecystitis. Which of the following signs and symptom would the nurse assess for?
Nausea, vomiting, and anorexia (NAVeaus)
The nurse has attended a conference about short bowel syndrome (SBS). The nurse understands that SBS likely to develop in patients with a loss of
2/3 of the small intestines
The nurse is caring for a client who has been admitted with a diagnosis of cholelithiasis (gall stones). The nurse understands that the most common site for the gallstones to lodge is which of the following?
Neck of gallbladder
ceiliac disease diet?
No wheat
appendicitis intervention
Npo, morphine for pain promethazine for nausea bed rest w/ right leg flex post op adhesions
The nurse is preparing an educational session for student nurses on the differences between diverticulitis and diverticulosis. The nurse should ensure that the students understand that diverticulosis often has which of the following?
Often has no symptoms
Those who are in high risk of Heart Failure
Older adults, Males, African american , Hypertension
Priority nursing management for a patient with myocarditis includes interventions related to which of the following?
Oxygenation and ventilation
If a pt has Cardiovascular disease what should you screen for
PAD and Ask if have leg pain when ambulating(Intermittent claudation)
The nurse is assessing a client who has been admitted to the cardiac unit with a diagnosis of right ventricular failure. Which of the following assessment findings would the nurse expect to observe?
Peripheral edema , and Jugular vein distention
If a rhythm is described as sinus what does this indicate
Pwave precedes each QRS complex
What are the signs & symptoms of DVT? Select all that apply.
Redness heat swelling pain
The nurse is caring for a client with peripheral arterial disease (PAD). For which of symptoms does the nurse assess?
Reproducible leg pain with exercise
The nurse is educating a client with Irritable Bowel Disease (IBD) about the medication sulfasalazine (Asulfidine). Which of the following indicated the rationale for the use of sulfasalazine (Asulfidine) in clients with IBD?
Acts topically on the colon mucosa to decrease inflammation.
Which is a priority nursing intervention for a patient during the acute phase of rheumatic fever?
Administration of antibiotics as ordered
cornary arteries (Will most likely be PAD). who develops Cornary arteries?
African american develop early in life Heredity anuresym -Smoking anuersym
The nurse is caring for a patient who has been diagnosed with heart failure and has been prescribed digoxin (Lanoxin). Which of the following will the nurse include when teaching the patient about this medication? Select all that apply
Call the doctor's office if you experience nausea or lack of appetite." If your pulse is less than 60 beats per minute, do not take the medication." "Report any visual changes to the doctor's office immediately. "You should keep a record of your daily weights.
Which of the following heart muscle diseases is unrelated to other cardiovascular disease?
Cardiomyopathy
Ostomies/ Colostomy color check
Check stoma color pink not grey discolored
In the patient with a dysrhythmia, which assessment indicates decreased cardiac output (CO)
Chest pain and decreased mentation
The telemetry nurse is unable to read the telemetry monitor at the nurse's station. Which intervention should the telemetry nurse implement first?
Contact client on the call system
Hepatitis A discharge teaching
Discharge teaching pt and family to wash hands frequently
The nurse is educating a client on dietary therapy prior to discharge for a diagnosis of heart failure. Which of the following should the nurse include in her teaching plan? Select all that apply
Weigh yourself same time everyday avoid salt when preparing food examine label to determine sodium content
A female patient is diagnosed with deep-vein thrombosis. Which nursing diagnosis should receive the highest priority at this time?
Altered peripheral tissue perfusion related to venous congestion
The nurse is assessing a patient and feels a pulse with quick, sharp strokes that suddenly collapse. The nurse knows that this type of pulse is diagnostic for which disorder?
Aortic regurgitation
Peripheral vascular disease(PVD) arterial vs venous ulcers
Arterial: location sores: toes and feet:Intermittent claudication pain ,No edema, No pulse or weak pulse no drianage, round smooth sores, black eschar Venous: location of sores:Ankles: Dull achy pain, lower leg edema,Pulse present drainage, sores with irreuglar borders, yellow sugglish or ruddy skin
What is the definitive test used to diagnose an abdominal aortic aneurysm?
Arteriogram
The nurse is preparing to educate a client who has chronic pancreatitis abut pancreatic function. The nurse should include information on pancreatic lipase as it performs which of the following functions?
Breaks down fat into fatty acids and glycero
The nurse is caring for a client with left sided heart failure. The nurse understands that which of the following symptoms is most commonly associated with left-sided heart failure?
Crackles
The nurse is caring of a client who has symptoms of lactose intolerance. The nurse understands that which of the following symptoms should be included when assessing for lactose intolerance? Select all that apply.
Cramping abdominal pain Flatulence Diarrhea Bloating
A patient has had a successful heart transplant for end-stage heart disease. What immunosuppressant will be necessary for this patient to take to prevent rejection?
Cycloporine
Which of the following are signs of a rupturing AAA? Select all that apply
Decreased Hct Low Back Pain Decreased BP
The nurse is caring for a client admitted with heart failure. The nurse is filling out the care plan and understand that which of the following are appropriate nursing diagnosis for clients with heart failure?
Decreased cardiac output related to altered contractility, altered preload and/or altered stroke volume. Excess fluid volume related to increased venous pressure and decreased renal perfusion secondary to heart failure Impaired gas exchange related to increased preload and alveolar-capillary membrane changes
The nurse is administering an angiotensin converting enzyme (ACE) inhibitor to a patient diagnosed with heart failure. Which of the following describe the ways in which the ACE inhibitor is therapeutic for the patient who has heart failure? Select all that appl
Decreases myocardial remodelling Decreases cardiac workload Decreases cardiac preload
Venous Thromboembolism is a term for what type of condition?
Deep Vein Thrombosis and Pulmonary Embolism
The nurse is education a group of clients on the subject of Hemorrhoid's. The nurse should ensure the group understands that hemorrhoid's are caused by which of the following changes to hemorrhoidal veins?
Dialated
The nurse is assessing a client who has been diagnosed with Celiac disease. Which of the following are symptoms of celiac disease? Select all that apply.
Excessive gas diarrhea weight loss joint point everything except weight gain.
Which of the following aneurysms is composed of a collection of blood leaking completely out of an artery or vein but confined to the vessel by the surrounding tissue?
False
The nurse is planning an education session about pancreatic cancer. As part of the "risks" section the nurse should include which of the following? Select all that apply.
Family history of pancreatic cancer Chronic pancreatitis Diabetes mellitus Cigarette smoking
When teaching a patient about risk factors for AAA(aortic anuerysm), which of the following, if stated by the patient indicates correct understanding?
Genetic disorder
Apatient in coronary care unit develop ventricular fib , first action-
Give CPR
The nurse is caring for clients in an outpatient clinic. Which information should the nurse teach regarding the American Cancer Society's recommendations for the early detection of colon cancer?
Have a colonoscopy at age 50 and then once every five (5) to 10 years
Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions?
Heart Failure
Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy?
Heart Failure
Flu Vaccine for
Heart Failure, Aortic stenosis, Mitral Valve regurgitation, atrial fib, percarditis
If medical treatments fail, which of the following invasive procedures is necessary for treating cardiomyopathy?
Heart transplant
Tx for varicose veins
Sclerotherapy Teach PT that this is injection in veins
Ostomies: (Colostomy) stools are more.... and you should avoid.....
Stools are more formed Teach pt to avoid gassy food
Cholecystecotomy Nursing action-
T Tube connected to closed drianage system
pancreatitis tx:
TPN, Nurse must hang D10 if he TPN bag is not available change every 24 hours (New tubing every time you switch bag)
Sinus Tachycardia
Teach pt not to drink coffee
Venous insufficiency Teaching
Teach pt to flex and extend ankles if for a long period of time
Which of the following aneurysms is the most likely to dissect?
Thoracic
The nurse is assessing a client who has been diagnosed with ulcerative colitis. Which of the following signs and/or symptoms should the nurse expect to find during her assessment?
Twenty bloody stools a day.
The nurse is completing discharge planning for a client with hepatitis A. Which of the following information should be included for the family to reduce the risk of spread?
Using good sanitation with dishes and shared bathrooms
pericarditis assessment
Visible neck distention give Nsaid: Ibuprofen(Motrin)
The nurse is teaching a class about diverticulosis. Which interventions should the nurse discuss when teaching ways to prevent an acute exacerbation of diverticulosis? Select all that apply
Walk 30 minutes a day. increase fluid intake Eat a high-fibre diet
Illeostomy should teach pt to
Watery stools Teach pt to avoid high fiber stool Teachpt to avoid raisins (stool softner efffects) Olive popcorns Stringy vegetables
The nurse has attended a seminar about the clinical manifestations of acute pancreatitis. The nurse understands that this would include which of the following symptoms
abdominal pain
varicose veins
achy legs gets better when legs are sitting down or prop up bluish, buldging vein, twisting
The nurse has attended an education session on aging and cardiac problems. The nurse understands which of the following are most likely to be early signs of cardiac problems in older persons? Select all that apply.
aggitation altered mental status frequent falls
mitral regurgitation
ask if any recent dental work has been down teaach them to complete all their antibiotic medication for strept throat (Prophylactic antibiotic)
Aortic Stenosis assessment
assess level of conciousness and it may indicate that the condition is worsen
The nurse is caring for a client in end-stage renal failure. The nurse understands there is a high risk of hepatic encephalopathy. Which of the following interventions should the nurse implement? Select all that apply
assessing the client's neurologic status every 2 hours Monitoring the client's handwriting daily Evaluating the client's serum ammonia level
Hepititis B is contracted through
blood and body fluids
if pt has a fib give them
blood thinners
how to dx cor pulmonae
chest xray
When a patient has a confirmed acute DVT what should they wear on their legs?
compression stockings
Hepitatis A can be contracted through
contracted by fecal oral
The nurse is caring for a client diagnosed with chronic pancreatitis. Which of the following interventions would be appropriate to reduce acute exacerbations of the pancreatitis
counseling to stop alcohol consumption
The nurse is caring for a patient who has been diagnosed with heart failure. The patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications should the nurse suspect is causing this issue?
digoxin
The nurse is assessing a client who has a diagnosis of ascites and now presents to the clinic with increased abdominal girth. The physician prescribes a diuretic and following administration which of the following is a priority action
doc. intake and output
Peritonitis Nurse intervention
est. IV, antibiotics, position w/ knee flexed
The nurse had attended a seminar on gallbladder associated diseases. The nurse understands that primary cancer of the gallbladder is common.T/F
false
The nurse is education a group of student nurses on cardiac disease. A student asks if Congestive Heart Failure and Heart Failure are the same. What should the nurse say?
false
