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N320 -Med/Surg Drexel > TopHat in-class Week 2 - F&E > Flashcards

TopHat in-class Week 2 - F&E Flashcards

1
Q

fluid calculation

The patient with renal failures shows a weight gain of 2 kg since the last appointment. The nurse recognizes that the patient is retaining how many liters of fluid?

A - 0.5
B - 1
C - 2
D - 3

A

C - 2

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2
Q

organs and fluid loss

Mark all that apply: The patient presents with chronic lung disease accompanied by a fever and vomiting. As a result the nurse understands that the patient is loosing additional fluid through…
Multiple answers:
You can select more than one option

A - kidneys
B - lungs
C - skin
D - gastrointestinal tract

A

B - lungs
C - skin
D - gastrointestinal tract

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3
Q

priority electrolyte value

The nurse is reviewing a patient’s morning lab results. Which result is of highest concern?

A - Serum Na+ of 150 meq/L
B - Serum K+ of 3.1 meq/L
C - Serum Mg+ of 4.0 mg/dL
D - Serum Ca+ of 10.0 mg/dl

A

C - Serum Mg+ of 4.0 mg/dL

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4
Q

urinalysis results

The nurse is assessing the urine on a patient who is dehydrated. Which urine result supports the patient’s condition?

A - Urine is cloudy
B - Urine specific gravity is 1.032
C - Urine contains protein
D - Urine pH is 7.5

A

B - Urine specific gravity is 1.032

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5
Q

Nursing diagnosis - F&E

The patient is manifesting signs such as HR bounding, crackles in lungs bilaterally, and edema in the lower extremities. Which nursing diagnosis is most appropriate for this patient’s condition?

A - Alteration in cardiac output
B - Fluid volume excess
C - Impaired gas exchange
D - Alteration in urinary output

A

B - Fluid volume excess

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6
Q

FVE - findings

A patient is diagnosed with fluid volume excess. Which assessment findings support this nursing diagnosis? Select all that apply
Multiple answers:
You can select more than one option

A - BUN 6 mg/dL
B - Heart rate: 95
C - Blood pressure: 140/90
D - Creatinine 1.0 mg/dL

A

A - BUN 6 mg/dL

C - Blood pressure: 140/90

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7
Q

ab electrolyte v/d

The client has been vomiting and has numerous episodes of diarrhea. Which lab test should the nurse monitor?

A - Serum calcium
B - Serum phosphorus
C - Serum potassium
D - Serum creatinine

A

C - Serum potassium

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8
Q

patient with hyponatremia

The clinic nurse is assessing the following patients. Which one would the nurse expect to have a low sodium level?

A - A 5-year old with vomiting and diarrhea for the past twenty-four hours.
B - A 45-year old marathon runner who is drinking water because of excessive sweating after a long run
C - A 60-year old taking prednisone for lung disease
D - A 10-year old eating potato chips and pretzels.

A

B - A 45-year old marathon runner who is drinking water because of excessive sweating after a long run

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9
Q

F&E - magnesium

Which patient condition should have the highest priority for teaching regarding foods that contain magnesium?

A - Severe hemorrhage
B - Diabetes insipidus
C - Adrenal insufficiency
D - Oliguric renal disease

A

D - Oliguric renal disease

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10
Q

F&E - K+

The patient’s laboratory report today indicates severe hypokalemia. Nursing assessment indicates that heart rhythm is irregular. In addition to notifying the health care provider, which action should the nurse take next?

A - Examine heel area for skin breakdown
B - Establish seizure precautions
C - Institute fall precautions
D - Administer Kayexelate

A

B - Establish seizure precautions

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11
Q

electrolytes - kidneys & decrease blood flow

A patient is experiencing hypotension and the nurse closely monitors the patients electrolytes in response to decreased blood flow to the kidneys. Which electrolytes should the nurse closely monitor as a result of kidney’s response to this decrease blood flow?

A - Sodium, calcium and phosphorus
B - Sodium, potassium and chloride
C - Calcium phosphorus and magnesium
D - Magnesium, potassium and sodium

A

B - Sodium, potassium and chloride

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12
Q

F&E - Priority

Which patient fluid & electrolyte finding should the nurse report immediately to the physician?

A - Swollen ankles in the patient with chronic heart failure
B - Positive Chvostek’s sign in the patient with Vitamin D deficiency
C - Constipation in the patient with advanced bone cancer
D - Increased thirst in the patient taking a new diuretic

A

B - Positive Chvostek’s sign in the patient with Vitamin D deficiency

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13
Q

F&E - assessment - lab

The patient is receiving tube feedings due to a jaw surgery. What change in assessment findings should prompt the nurse to request an order for serum sodium level?
A - Development of ankle or sacral edema
B - Increased blood pressure
C - Postural hypotension and bradycardia
D - Decreased level of consciousness
A

D - Decreased level of consciousness

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14
Q

priority action

An adult patient is brought into the emergency room with a head laceration and is bleeding profusely. Her left ankle is deformed and splinted. The patient’s vital signs are BP 98/50, HR 116, RR 18. What is the first action by the nurse?

A - Start an IV line for fluids
B - Check pedal pulses on the injured leg
C - Get the ECG and place on cardiac monitor
D - Check her neurological status

A

A - Start an IV line for fluids

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15
Q

The nurse is questioning the hydration status of Frank. Which action should the nurse take first to confirm if Frank is experiencing fluid volume deficit?

A - Assess the heart rate
B - Check the serum Creatinine level
C - Measure urine output during the last hour
D - Ask Frank how much water he consumed in the last 4 hours

A

A - Assess the heart rate

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16
Q

Frank - dehydration labs

It is determined that Frank is experiencing dehydration. Which lab values will support dehydration in Frank? Select all that apply.
Multiple answers:
You can select more than one option

A - Na+ 148
B - BUN 35
C - Urine specific gravity 1.005
D - Elevated Hemoglobin

A

A - Na+ 148

B - BUN 35

17
Q

Frank - IV fluid

The nurse is assessing Frank before hanging an IV solution of 0.9% NaCl with KCl. Which assessment finding warrants the nurse to hold the IV KCL and contact the physician?

A - Blood pressure 98/58
B - Urine output of 10 mL/hr
C - Weight loss of 0.5 kg
D - Dry mucous membranes and skin tenting

A

B - Urine output of 10 mL/hr

18
Q

Frank - appendicitis - OR

It is determined that Frank has appendicitis and requires surgery. Which statement by Frank warrants further teaching by the nurse?

A - “I am looking forward to eating as soon as this operation is over.”
B - “It looks like I will be in the hospital for a few more days.”
C - “I will need to get up and walk around as soon as possible after the operation.”
D - “I may have a drain after the operation if my appendix ruptured.”

A

A - “I am looking forward to eating as soon as this operation is over.”

19
Q

Frank - Preop history

The nurse is completing a pre-op history on Frank. Which statements by Frank warrant further action by the nurse? Select all that apply.
Multiple answers:
You can select more than one option

A - “ I am scheduled to go the dentist next week for my decayed cavity.”
B - “My arthritis has been acting up so I restarted my over the counter pain meds.”
C - “My last cigarette was about 40 years ago after I experienced bronchitis.”
D - “I sleep fine at night thanks to my home remedies”

A

A - “ I am scheduled to go the dentist next week for my decayed cavity.”
B - “My arthritis has been acting up so I restarted my over the counter pain meds.”
D - “I sleep fine at night thanks to my home remedies”

20
Q

Frank - allergies

During the pre-op history Frank mentions to the nurse that he is allergic to codeine. Which action should the nurse take next?

A - Apply an allergy bracelet on Frank
B - Notify the surgeon
C - Document the allergy on the MAR
D - Ask Frank about the outcome when codeine is taken

A

D - Ask Frank about the outcome when codeine is taken

21
Q

Frank - Pre-op - delegation

The nursing is preparing Frank for the OR. Which task can the RN delegate to the UAP?

A - Complete the preoperative checklist
B - Assess Frank’s vital signs
C - Teach Frank about cough and deep breathing
D - Assist Frank to change into a hospital gown

A

D - Assist Frank to change into a hospital gown

22
Q

Frank -pre-op lab assessment

Frank’s latest serum lab values are available. Which lab findings requires the nurse to contact the physician prior to surgery?

A - Sodium 140 mEq/L
B - Potassium 3.5 mEq/L
C - Calcium 7.8 mg/dL
D
Chloride 99 mEq/L
A

C - Calcium 7.8 mg/dL

23
Q

Frank - pre-op teaching

The nurse recognizes several things should be taught to the patient prior to surgery but time is limited in Frank’s case since he is scheduled for surgery in a few hours. Which item is essential for the nurse to teach Frank pre-op?

A - Use of incentive spirometer
B - Use of the PCA device
C - The number of drains to expect post-op
D - Range of motion exercises

A

A - Use of incentive spirometer

24
Q

Frank - OR patient assignments

Frank is in the OR. A newly trained nurse is assigned to work with the charge nurse. Which patient assignment would be best to assign to the new nurse?

A - Patient A who is returning from a hernia repair
B - Patient B is scheduled for open-heart surgery
C - Patient C is scheduled for a breast biopsy
D - Patient D is 4 hours post-op for laser eye surgery

A

C - Patient C is scheduled for a breast biopsy

25
Q

Frank - OR condition

While under anesthesia, Frank starts to develop a temp of 102 and tachycardia. Which intervention should the OR circulating anticipate?

A - Requesting a defibrillator
B - Administering an antibiotic
C - Obtaining a blood glucose level
D - Mixing Dantrolene

A

D - Mixing Dantrolene

26
Q

Frank post-op goals

Which priority postoperative goal would be an expected outcome for Frank who had general anesthesia? Frank will..

A - be able to sit in the chair for 30 minutes
B - have a pulse ox reading of 95% on room air
C - have a urine output of at least 30 mL/hr
D - will report relief of post-op pain using a scale of 0-10.

A

B - have a pulse ox reading of 95% on room air

27
Q

Frank - post op priority

Which problem should the nurse prioritize for Frank day (1) post-op?

A - Potential for hemorrhage
B - Potential for Injury
C - Potential for Fluid Volume Excess
D - Potential for Infection

A

A - Potential for hemorrhage

28
Q

Frank - 1 day post-op

It is now 24 hours after Frank returned from surgery. His vital signs are T-99.8 F, P-92, RR-24, and BP 148/80. Incision dressing is dry and intact. Pain is 3 (scale of 0-10) and Course rhonci auscultated bilaterally. Which action is most appropriate by the nurse?

A - Encourage Frank to cough and deep breather every hour
B - Change the dressing and assess the wound for infection
C - Encourage Frank to ambulate at least once daily
D - Administer pain medication at the next scheduled time.

A

A - Encourage Frank to cough and deep breather every hour

29
Q

Frank - Post-op patient assignments

On the medical surgical unit, which patient would be best to assigned to the new graduate nurse?

A - The 10 year old patient post tonsillectomy with swallowing frequently and a fever
B - Frank who is 2 days post-op with a Penrose drain scheduled to be removed
C - The 80 year old patient 2 day post-op hip replacement who will be ambulating for the first time
D - The 55 year old patent with bowel obstruction and acute heart failure

A

B - Frank who is 2 days post-op with a Penrose drain scheduled to be removed

30
Q

Frank - incision

When visiting Frank, he mentioned to the nurse that his incision feels funny after he coughed. Which actions are appropriate by the nurse? Select all that apply.
Multiple answers:
You can select more than one option

A - Ask Frank lie down on the bed and examine his incision
B - Teach Frank about using a pillow over the abdomen to splint his incision
C - Inform Frank not to worry. It is normal to expect tension on an abdominal incision
D - Inform the health care provider of Frank’s complaints

A

A - Ask Frank lie down on the bed and examine his incision

B - Teach Frank about using a pillow over the abdomen to splint his incision

N320 -Med/Surg Drexel (35 decks)

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