Summer Final Exam Review

A female patient with chronic hypertension is admitted to the emergency department with a sudden rise in BP. Which question is the priority for the nurse to ask the patient?

"Do you have a headache or confusion?"

The nurse teaches about drug therapy after a kidney transplant. Which statement by the patient would indicate a need for further instruction?

"after a couple years, it is likely that I will be able to stop taking the cyclosporine"

A patient who uses injectable illegal drugs asks the nurse about preventing AIDS. Which response by the nurse is best?

"it is important to participate in a needle-exchange program"

active immunity

A form of acquired immunity in which the body produces its own antibodies against disease-causing antigens.

A 25-year-old female is admitted to the ER in anaphylactic shock due to a bee sting. According to the patient's mother, the patient is severely allergic to bees and was recently stung by one. This type of anaphylactic reaction is known as a?*

A. Type I Hypersensivity Reaction

DNA bases

Adenine, Thymine, Guanine, Cytosine

DNA fingerprinting begins extracting DNA from

Blood, saliva, and semen

The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement, if made by the patient, indicates that teaching was effective? a. "The biopsy will remove the cancer in my prostate gland." b. "The biopsy will determine how much longer I have to live." c. "The biopsy will help decide the treatment for my enlarged prostate." d. "The biopsy will indicate whether the cancer has spread to other organs."

C. "The biopsy will help decide the treatment for my enlarged prostate."

A woman in her late thirties has been having unusually heavy menstrual periods combined with occasional urine and stool leakage over the last few weeks. On further enquiry, she reveals that she also has postcoital pain and bleeding. To which of the following diagnoses do you think the investigations are most likely to lead?

Cervical cancer

Atopic Dermatitis (Eczema)

Excess inflammation; dry skin, redness, and itching from allergies and irritants.

A patient is being evaluated for possible atopic dermatitis. The nurse expects elevation of which lab value?

IgE

A nurse is preparing a presentation about cervical cancer for a local woman's group. Which of the following would the nurse include as a possible risk factor for the development of cervical cancer?

Infection with human papilloma virus (HPV)

4th degree burns

Involves injury to muscle and bone, edema and pain absent, no blisters

NSAIDs contraindications

Known drug allergy Patients with documented aspirin allergy must not receive NSAIDs. Conditions that place the patient at risk for bleeding: Vitamin K deficiency Peptic ulcer disease

Which of the following is a term used to describe excessive menstrual bleeding?

Menorrhagia

Which of the following is the most effective treatment for trichomoniasis?

Metronidazole (Flagyl)

Veronica, a 17-year-old high school student, has a history of dysmenorrhea. During her monthly menses, she experiences incapacitating cramping and passes large clots. Veronica's primary care physician explains to her and her mother that he will initiate conservative treatment. What interventions would you expect the physician to recommend?

NSAID use

Which test would be use to see if infants are HIV + or if the antibodies are from the mother

PCR

Lymphoblastic leukemia is treated with which type of gene therapy

Tisagenlecleucel (Kymriah)

A patient has been diagnosed with a vaginal infection and received a prescription for metronidazole (Flagyl). The nurse knows that this is the recommended treatment for a vaginal infection caused by what organism?

Trichomonas vaginalis

After change-of-shift report, which patient should the nurse assess first?

a 23-yr-old patient with type 1 diabetes who has a blood glucose of 40

When admitting a patient, which patient would the nurse discuss predisposition genetics testing with?

a middle aged woman, whose mother died of breast cancer at the age of 48

priapism

a painful erection that lasts 4 hours or more but is not accompanied by sexual excitement

A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse teaches the patient about management of the skin reaction. Which statement, if made by the patient, indicates the teaching was effective? a. "I can buy some aloe vera gel to use on the area." b. "I will expose the treatment area to a sun lamp daily." c. "I can use ice packs to relieve itching in the treatment area." d. "I will scrub the area with warm water to remove the scales."

a. "I can buy some aloe vera gel to use on the area."

A patient is being evaluated for possible atopic dermatitis. The nurse expects elevation of which laboratory value? a. IgE b. IgA c. Basophils d. Neutrophils

a. IgE

AMD

age-related macular degeneration

IgE

allergy

A 30-yr-old patient has a new diagnosis of type 2 diabetes. When should the nurse recommend the patient schedule a dilated eye exam?

as soon as possible

IgA

autoimmune

Which patient statement indicates a need for further teaching about extended-release zolpidem (Ambien CR)? a. "I should take the medication on an empty stomach." b. "I will take the medication 1 to 2 hours before bedtime." c. "I should not take this medication unless I can sleep for at least 6 hours." d. "I will schedule activities that require mental alertness for later in the day."

b. "I will take the medication 1 to 2 hours before bedtime."

The home health nurse cares for an alert and oriented older adult patient with a history of dehydration. Which instructions should the nurse give this patient related to fluid intake? a. "Drink more fluids in the late evening." b. "Increase fluids if your mouth feels dry." c. "More fluids are needed if you feel thirsty." d. "If you feel confused, you need more to drink."

b. "Increase fluids if your mouth feels dry."

A patient with new-onset confusion and hyponatremia is being admitted. When making room assignments, the charge nurse should take which action? a. Assign the patient to a semi-private room. b. Assign the patient to a room near the nurse's station. c. Place the patient in a room nearest to the water fountain. d. Place the patient on telemetry to monitor for peaked T waves.

b. Assign the patient to a room near the nurse's station.

The nurse is caring for a patient with a massive burn injury and possible hypovolemia. Which assessment data will be of most concern to the nurse? a. Urine output is 30 mL/hr. b. Blood pressure is 90/40 mm Hg. c. Oral fluid intake is 100 mL for the past 8 hours. d. There is prolonged skin tenting over the sternum

b. Blood pressure is 90/40 mm Hg.

Which example should the nurse use to explain an infant's "passive immunity" to a new mother? a. Vaccinations b. Breastfeeding c. Stem cells in peripheral blood d. Exposure to communicable diseases

b. Breastfeeding

An older adult patient who is malnourished presents to the emergency department with a serum protein level of 5.2 g/dL. The nurse would expect which clinical manifestation? a. Pallor b. Edema c. Confusion d. Restlessness

b. Edema

IV potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with severe hypokalemia. Which action should the nurse take? a. Administer the KCl as a rapid IV bolus. b. Infuse the KCl at a rate of 10 mEq/hour. c. Only give the KCl through a central venous line. d. Discontinue cardiac monitoring during the infusion

b. Infuse the KCl at a rate of 10 mEq/hour.

The nurse provides discharge instructions to a patient who has an immune deficiency involving the T lymphocytes. Which health screening should the nurse include in the teaching plan for this patient? a. Screening for allergies b. Screening for malignancies c. Screening for antibody deficiencies d. Screening for autoimmune disorders

b. Screening for malignancies

A patient who has a small cell carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should notify the health care provider about which assessment finding? a. Serum hematocrit of 42% b. Serum sodium level of 120 mg/dL c. Reported weight gain of 2.2 lb (1 kg) d. Urinary output of 280 mL during past 8 hours

b. Serum sodium level of 120 mg/dL

The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take? a. Infuse the medication over a short period of time. b. Stop the infusion if swelling is observed at the site. c. Administer the chemotherapy through a small-bore catheter. d. Hold the medication unless a central venous line is available.

b. Stop the infusion if swelling is observed at the site

A patient with sleep apnea who uses a continuous positive airway pressure (CPAP) device is preparing to have inpatient surgery. Which instructions should the nurse provide to the patient? a. Schedule a preoperative sleep study. b. Take your home device to the hospital. c. Expect intubation with mechanical ventilation after surgery. d. Avoid requesting pain medication while you are hospitalized.

b. Take your home device to the hospital.

The nurse is performing an eye examination on a 76-yr-old patient. The nurse should refer the patient for a more extensive assessment based on which finding? a. The patient's sclerae are light yellow. b. The patient reports persistent photophobia. c. The pupil recovers slowly after responding to a bright light. d. There is a whitish gray ring encircling the periphery of the iris

b. The patient reports persistent photophobia.

An active 32-yr-old male who has type 1 diabetes is being seen in the endocrine clinic. Which finding indicates a need for the nurse to discuss a possible a change in therapy with the health care provider? a. Hemoglobin A1C level of 6.2% b. Blood pressure of 140/88 mmHg c. Heart rate at rest of 58 beats/minute d. High density lipoprotein (HDL) level of 65 mg/dL

b. bp of 140/88

A patient with multiple draining wounds is admitted for hypovolemia. Which assessment would be the most accurate way for the nurse to evaluate fluid balance? a. Skin turgor b. Daily weight c. Urine output d. Edema presence

b. daily weight

fibrocystic changes

benign fluid-filled cyst formation caused by ductal enlargement

Which information about intradermal skin testing should the nurse teach to a patient with possible allergies? a. "Do not eat anything for about 6 hours before the testing." b. "Take an oral antihistamine about an hour before the testing." c. "Plan to wait in the clinic for 20 to 30 minutes after the testing." d. "Reaction to the testing will take about 48 to 72 hours to occur."

c. "Plan to wait in the clinic for 20 to 30 minutes after the testing."

Which of these patients being seen at the human immunodeficiency virus (HIV) clinic should the nurse assess first? a. Patient whose latest CD4+ count is 250/µL b. Patient whose rapid HIV-antibody test is positive c. Patient who has had 10 liquid stools in the last 24 hours d. Patient who has nausea from prescribed antiretroviral drugs

c. patient who has had 10 liquid stools in the last 24 hours

with HIV patients

check CD4 count (helper T cells)

The health care provider asks the nurse whether a patient's angioedema has responded to prescribed therapies. Which assessment should the nurse perform?

check for swelling of the patients lips and tongue

A patient who has type 1 diabetes plans to swim laps for an hour daily at 1pm. What advice should the nurse plan to give to the patient?

check glucose levels before, during, and after swimming

The health care provider suspects the Somogyi effect in a 50 year old patient whose 6am glucose is 230. Which action will the nurse teach the patient to take?

check the blood glucose during the night

aysmptomatic STIs

chlamydia, gonorrhea, HSV, HPV

Which information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs? a. Choose flat-soled leather shoes. b. Set heating pads on a low temperature. c. Use callus remover for corns or calluses. d. Soak feet in warm water for an hour each day.

choose fla-soled leather shoes

Addison's disease symptoms

chronic fatigue, muscle weakness, anorexia, nausea, vomiting, diarrhea, hypotension, hypoglycemia, sweating, irritability, weight loss

cataract

clouding of the lens of the eye

paraphimosis

condition in which a retracted prepuce cannot be pulled forward to cover the glans;

Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient. Which statement by the patient indicates that the teaching about this medication has been effective? a. "I will try to drink at least 8 glasses of water every day." b. "I will use a salt substitute to decrease my sodium intake." c. "I will increase my intake of potassium-containing foods." d. "I will drink apple juice instead of orange juice for breakfast."

d. "I will drink apple juice instead of orange juice for breakfast."

Which action will be included in the plan of care when the nurse is caring for a patient who is receiving nicardipine (Cardene) to treat a hypertensive emergency? a. Organize nursing activities so that the patient has undisturbed sleep for 8 hours at night. b. Keep the patient NPO to prevent aspiration caused by nausea and possible vomiting. c. Assist the patient up in the chair for meals to avoid complications associated with immobility. d. Use an automated noninvasive blood pressure machine to obtain frequent measurements

d. Use an automated noninvasive blood pressure machine to obtain frequent measurements

NSAIDs

decrease production of prostaglandins

use of viagra and nitrate

decreases BP

3rd degree burns

destroys entire skin layer, burn is gray-white or black

BP is highest

during the day

A middle aged male patient has recently been diagnosed with Huntington's disease. The nurse would provide what education about the children's possibility of inheriting the disease?

each child has a 50% chance of inheriting the disease

2nd degree burns

epidermis and upper dermis are damaged, skin is red with blisters

Cushing syndrome symptoms

fatty hump between shoulders, a rounded face, and pink or purple stretch marks on skin, thinning fragile skin, slow healing of cuts, insect bites and infections, acne, decreased libido, decreased fertility, irregular or absent menstrual periods, fatigue, muscle weakness, cognitive difficulties, and headaches.

IgM

first to increase in immune response

male symptom of gonnorhea

foul smelling discharge

mennohagia

get a CBC

warfarin interactions

ginkgo biloba, garlic, st. johns wart

The nurse administered 4 oz of orange juice to an alert patient whose blood glucose was 62. 15 mins later, the blood glucose is 67. Which action should the nurse take next?

give the patient 4-6 oz more orange juice

Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide?

glyburide stimulates insulin production and release from the pancreas

GSC report to me

gonorrhea, syphilis, & chlamydia

glaucoma

increased intraocular pressure results in damage to the retina and optic nerve with loss of vision

hypernatremia

increased temp, weakness, disorientation, dilusions, hypotension, tachycardia. give hypotonic solution.

potential problems of PID

infertility, & ectopic pregnancy

An unresponsive patient who has type 2 diabetes is brought to the ED and diagnosed with hyperosmolar hyperglycemia syndrome (HHS). What should the nurse anticipate doing?

inserting an IV catheter

hyponatremia

low sodium

nadir

lowest point

What is the role of adult stem cells?

maintain and repair the bodies tissue

Knowledge of carrier status of a genetic disorder may influence a person's

marriage and childbearing status

risk factors of cancer

non-modifiable- Age, Genetics, sex specific Modifiable - Pa inactivity, obesity,tobacco use, poor nutrient intake, excessive sun exposure, toxic environment exposure.

primary dysmennorhea

occurs during menstruation; usually entails overproduction of prostaglandins (chemicals which cause uterine muscles to contract). Abdominal aches, cramps, backache, headache, nausea, diarrhea, fatigue, irritability, nervousness.

1st degree burns

only epidermis is damaged, skin is red and swollen

neuropathic pain

pain from damage to neurons of either the peripheral or central nervous system

PCA pump

patient controlled analgesic administered intravenously with a machine

peyronie

penile bending and pain on erection

stereognosis

perceiving the form of an object by the sense of touch

treatment for scabies

permethrin cream

Stem cells can be classified as which of the following

pluripotent, unipotent, toripotent

secondary dysmennorhea

prior to or during menstruation; constant, often spasmodic lower ab pain which can extend to back and thighs. Caused by factors other than prostaglandins, inc. presence of IUD (intrauterine device); PID (pelvic inflammatory disease); benign uterine tumors; obstruction of cervical opening; or endometriosis.

Gene therapy is used for

providing normal functioning gene to person with pathogenic gene variant

hydrocele

scrotal swelling caused by a collection of fluid

phimosis

stenosis or narrowing of foreskin so that it cannot be retracted over the glans penis

primary wound healing

sutures, minimal tissue loss; edges well approximated

poriception

the ability to see, hear, or become aware of something through the senses.

A patient who has type 2 diabetes is being prepared for an elective coronary angiogram. Which info would the nurse anticipate might lead to rescheduling the test?

the patient took the prescribed metformin today

passive immunity

the short-term immunity that results from the introduction of antibodies from another person or animal.

Levothyroxine (Synthroid)

thyroid hormone

alluprinol

used to treat gout

secondary wound healing

wound heals on own, extensive tissue damage, not approximated or infected

tertiary wound healing

wound is kept open for 3-5 days to allow edema or infection to resolveor to allow removal of exudate. wound fills with granulation tissue wound is sutured late and a wide scar results