Blue Book 2

Question 1

Patients on levodopa should avoid, which vitamin

Answer 1

B6 pyridoxine (beef liver, salmon, tuna, organ meats)

Question 2

Levodopa might make patient’s urine

Answer 2

Very dark

Question 3

Pernicious anemia pts lack which vitamin
What factor do they lack
What doesn’t mature due to this lack of this factor?

Answer 3

B12
Intrinsic factor
RBC, they become anemic

Question 4

Classic and unique signs of pernicious anemia

Answer 4

Beefy red tongue
Numbness and tingling of the hands
Sores in the mouth
Chest pain

Question 5

Sensory motor stage age

Answer 5

Birth - 2

Question 6

Concrete operational thinking age

Answer 6

7-11

Question 7

Preoperational, thinking age (preschool)

Answer 7

3-5

Question 8

Placenta previa pain?
When does the bleeding start?
Three complications
Hospitalization?

Answer 8

Painless placenta previa
Third trimester
Shock, maternal death, fetal death
Yes, always if bleeding

Question 9

Which impaired gas exchange is most common in pneumonia

Answer 9

Respiratory alkalosis. Because the hyperventilation blows off more CO2 in the consolidation traps in the blood.

Question 10

Polycythemia vera is an increase in ___, ____ and ____

Answer 10

A blood disease with an increase in erythrocytes, leukocytes and platelets

Question 11

Pts with polycythemia vera have which kind of complexion
What will their diet look like?
What are three signs of polycythemia vera?
What oral problem will these patients have?
What organ will be enlarged?

Answer 11

Ruddy red, almost a purple

Low iron

Headache, weakness, and itching

Bleeding mucous membranes

Question 12

Due to increased destruction of red blood cells seen in polycythemia vera what acid blood level will be increased

Answer 12

Uric acid levels will be high.

Remember, uric acid levels are always high when cells are being destroyed as in hemolysis, chemotherapy or radiation therapy

Question 13

Pregnancy increases or decreases the bodies insulin requirements, why?

Can oral hypoglycemic be used during pregnancy?

During pregnancy, what complication is most dangerous for the fetus of a diabetic, why

Answer 13

Increases, hormones of pregnancy work against insulin

No, they are teratogenic

Ketosis, in utero ; hypoglycemia after delivery. Brain cells die without glucose, resulting in brain damage.

Question 14

Preeclampsia makes the neuromuscular system more or less irritable

What vision problem will these patients have

What types of precautions will be in effect?

Answer 14

More

Blurred vision

Seizure precautions; suction machine in the room, 02 in room, padded side rails up x four, must stay on unit, ambulation with supervision only, no more than one pillow

Question 15

When is pre-eclampsia called eclampsia

Answer 15

Once convulsions have occurred

Question 16

Premature rupture of membranes is a ___ break in the amniotic sac ___ the ___ of contractions

What is the danger with PROM?

Answer 16

Spontaneous, before, onset

Infection

Question 17

Amniotic fluid is acidic or alkaline

Answer 17

Alkaline

Question 18

Pulmonary edema is a common complication of which disorder

Pulmonary edema, usually results from ____ failure

Four signs of pulmonary edema

Answer 18

Cardiovascular

Left ventricle

Dyspnea on exertion
Paroxysmal nocturnal dyspnea
Orthopnea
Coughing

Question 19

In pulmonary edema is the heart rate tachycardic or bradycardic

What drug is used in pulmonary edema to reduce fluid in the lungs

What drug is used to increase ventilation in pulmonary edema

Since pulmonary edema, is caused by left ventricular failure, what drug is given

Why would morphine be given

Answer 19

Tachycardic

Diuretic

Aminophylline (bronchodilator)

Digitalis

To decrease apprehension and decrease preload, resting the heart

Question 20

Pulmonary embolus is an obstruction of the pulmonary ___ bed by a dislodged ___ or a foreign substance (air, fat, tumor)

Where do the emboli that cause pulmonary embolus usually come from?

What treatment modality can lead to pulmonary embolus

What drug class can lead to pulmonary embolus

Answer 20

Capillary, thrombus

The legs

Bed rest

Oral contraceptives

Question 21

What heart problems can lead to pulmonary embolus

What genetic problems can lead to pulmonary embolus

First sign of pulmonary embolus; will the heart rate increase or decrease

Two major treatments of pulmonary embolus.

Answer 21

Atrial fibrillation (R atrial fibrillation, L atrial fibrillation, causes cerebral embolus)

Sickle cell anemia

Dyspnea; increase

02 and anticoagulants

Question 22

I’m coming in is therapeutic, the INR should be between ___ & ___

Answer 22

2.0 and 3.0

Question 23

What is Lovenox?

Answer 23

A low-dose heparin used for anticoagulation and postop thrombophlebitis prevention, not for use in pulmonary embolus

Question 24

What is pyelonephritis?

What organism causes this?

What are the symptoms that polynephritis and cystitis have in common

Answer 24

And bacterial infection of the kidneys

E. coli

Frequency, urgency, burning, cloudy foul, smelling urine

Question 25

Five s/s with polynephritis not seen with cystitis What is the big danger with polynephritis? How is polynephritis prevented 

Answer 25

Fever, flank pain, increase white blood count, malaise, chills, HTN Permanent scarring and kidney damage By preventing or treating all cystitis’s (UTIs)

Question 26

What test is done to confirm a diagnosis of pyloric stenosis Why does the pyloric valve becomes to notes in pyloric stenosis? What position should a child with pyloristenosis be after feeding? What type of vomiting do you see in patients with pyloric stenosis? Is it bile stained?

Answer 26

Upper G.I. series (barium swallow) It hypertrophies Right side with HOB up Projectile, not bile stained

Question 27

Typical Child with pyloric stenosis Symptoms of pyloric stenosis, most commonly appear at age ___ to ___

Answer 27

First born full-term white boy 4 to 6 weeks

Question 28

Purpose of a wound drain

Answer 28

Remove secretions from the area so healing occurs

Question 29

What is another name for second intention?

Answer 29

Granulation

Question 30

Scoliosis most commonly effects How many hours a day should a patient wear a Milwaukee brace?

Answer 30

Teenage girls 23 hours

Question 31

What are the number one and number two causes of sickle cell crisis The most common type of crisis that occurs is a ___-____ crisis In this crisis, the vessels become included with _____ _____ Why do the crescent shape RBCs cause occlusion of the vessels

Answer 31

Hypoxia and dehydration Vaso-occlusive Abnormal red blood cells They come together and create a sludge

Question 32

Top three priorities in care of a patient with sickle cell crisis Why can’t a sickle cell patient not take aspirin Sickle cell anemia symptoms do not appear before the age of ___ months, due to the presence of ___ ____ Sickle cell anemia, most commonly seen in what race

Answer 32

Oxygenation, hydration, and pain control Can cause acidosis, which makes the crisis and sickly worse Six, fetal hemoglobin Black

Question 33

What is spinal shock? When does this occur? And how long will it last?

Answer 33

Common occurrence in spinal cord injury in which the spinal cord swells above, and below the level of injury Immediately or within two hours of injury; five days to three months

Question 34

What is spinal cord injury is at level of ___ or ___ patient will be a quadriplegic

Answer 34

C1 or C8

Question 35

When the spinal cord injury is between ____ and ___ there is permanent respiratory paralysis

Answer 35

C1 and C4

Question 36

Spinal cord injury in the thoracic/lumbar region’s result in If airway obstruction occurs at the accident site and he suspects spinal cord injury what maneuver is used to open the airway

Answer 36

Paraplegia Modified jaw thrust

Question 37

Why should a patient with an order to be up move slowly with a spinal cord injury?

Answer 37

Because of severe orthostatic hypotension

Question 38

Patient with neurogenic bladder needs to be straight catheterized every how many hours Patience with spinal cord injury will have flaccid or spastic muscles Three drugs used to treat spasms

Answer 38

Six Spastic Baclofen, Valium, dantrium* (* also treats malignant hyperthermia)

Question 39

What is autonomic dysreflexia or hyperreflexia What are the s/s What would you do first what would you do second for these patients?

Answer 39

A common complication of quadriplegics in response to a full bladder or bowel Sweating headache, nausea and vomiting, gooseflesh and severe hypertension Raise HOB, second, check the bladder and bowel

Question 40

What position should the client be during a spinal tap? Activity restriction necessary after a lumbar puncture Purpose of spinal taps

Answer 40

Lateral recumbent on the right side Lie flat for 6 to 12 hours To measure or relieve pressure and obtain a CSF sample

Question 41

How much section should be used for a child? How much suction should be used for an adult?

Answer 41

80 to 100 120 to 150

Question 42

Late syphilis attacks which three body organs? What organism causes syphilis? What is the most common signs of Neurosyphilis?

Answer 42

Liver, heart and brain Treponema palladium Ataxia (gait problems)

Question 43

What is the most common cause of mastoiditis? 4 s/s of mastoiditis Common side effect of mastoidectomy; major concern

Answer 43

Chronic Otis media Drainage from ear, high fever, headache and ear pain tenderness over mastoid process Dizziness/vertigo ; safety

Question 44

Virulence means

Answer 44

Ability of an organism to produce disease

Question 45

Emulsion is a mixture of ___ and ___

Answer 45

Oil and water

Question 46

A drug given by the parenteral route, acts outside the G.I. tract, true or false For most common parenteral route of administration

Answer 46

T SQ, IM, IV, ID (intradermal)

Question 47

Maximum cc administered per IM into the deltoid of an adult Which type of medication’s are given by Z track; how long is a needle kept inside during Z track injection?

Answer 47

1cc Irritating or staining; 10 seconds

Question 48

Two sites for intradermal injections; primarily used for what

Answer 48

Inner forearm and upper back; skin testing

Question 49

Rectal suppository is inserted ____ in an adult, and ____ in a child

Answer 49

4; 2

Question 50

Does Tagamet need to be given with meals? Does Zantac need to be given with meals?

Answer 50

Yes, for Tagamet; No for Zantac