Exam 6

Question 1

You have a pt what has had a heart attack. What is the best description of how you would teach your pt.

Answer 1

independent nursing interventions

Question 2

You have a pt. with high cholesterol. Which is important for a nurse to consider when teaching an adult client?

Answer 2

adults are more oriented to learning when the material is useful immediately

Question 3

What statement by a mother reflects readiness to learn?

Answer 3

“I want to make sure my husband is here in case I don’t hear everything that’s said.”

Question 4

Which medications would you want to discontinue with a client thats having delayed wound healing?

Answer 4

corticosteroids

Question 5

An 85 year old pt with poor skin turgor slips down in their bed. What action is appropriate to prevent skin breakdown?

Answer 5

lifting instead of pulling

Question 6

You have a pt who has a wound, what instructions are important to include with this pt? Select all that apply.

Answer 6

notify heat trauma(tenderness), wash hands, tell your pt they need vitamin A, C, B, Zinc

Question 7

You have a pt with a pressure ulcer. How do you take care of them? SATA

Answer 7

shift weight frequently, assess for moisture, protect skin from shearing, keep items within reach, keep pt close to the nurses station.

Question 8

What is the size of a vesicle?

Answer 8

0.4

Question 9

What is the main nursing intervention when caring for a pt with tinea pedis?

Answer 9

dry between the toes

Question 10

What is clotrimazole used for?

Answer 10

used to treat skin infections such as athletes food, jock itch, ring worm

Question 11

Impetigo

Answer 11

honey crusted exudate

Question 12

What is important in treading head lice?

Answer 12

treat all areas

Question 13

A school nurse is teaching instructors on signs of head lice. SATA

Answer 13

scalp excoriation, nits in the hair

Question 14

What is priority when a pt starts itching after a medication?

Answer 14

check throat(breathing)

Question 15

What should you always clarify when you are doing steps for wound healing?

Answer 15

your instructions(repeat back, or family member repeat back)

Question 16

What is purosanguinous?

Answer 16

pus and red blood cells

Question 17

You have a pt with an acute exacerbation of psoriasis of 25% of the body. What kind of medication would you give?

Answer 17

oral steroids

Question 18

You are giving a teaching session for a pt who has had an acute exacerbation of psoriasis. What is the main factor that causes this?

Answer 18

stress

Question 19

What assessment tools would you use to identify a pt at risk for pressure injuries?

Answer 19

norton or braden scale

Question 20

For someone who does not want to have dark spots on their skin when they get older. What would you tell them when they are younger to prevent this?

Answer 20

sunscreen and limit sun exposure

Question 21

A pt has a white yeast infection on the tongue. What would you consider from the pt history?

Answer 21

chemotherapy

Question 22

You have a pt that just had surgery, and all of a sudden they hear a pop and bump comes out. What phase is this in the post op time?

Answer 22

proliferative

Question 23

If a pt has a bed sore what do you need to make sure they do?

Answer 23

keep weight off of the wound

Question 24

You have an older pt with poor nutritional intake they are having all the signs of wound healing. Which actions would you address for this client?

Answer 24

look at diet, plenty of fluids, dietary consult

Question 25

You have a pt with COPD who is scheduled for a knee replacement. What is important for this client?

Answer 25

post op care, assess wound(in care plan)

Question 26

You are caring for a pt with pressure ulcers. What are interventions you should do?

Answer 26

keep heals off the bed, frequent toileting schedule, use barrier cream

Question 27

What does a stage 1 pressure ulcer look like?

Answer 27

nonblanchable

Question 28

When caring for a pt with a stage 3 pressure ulcer. What are things you would do?

Answer 28

keep pt clean and urine off wound, avoid placing in a side lying position, manage their pain

Question 29

What would you see in a pt with a stage 2 pressure injury?

Answer 29

ulceration, red wound, it extents to the dermis

Question 30

If a pt has a rash, red bumps from an irritant, what would this be called?

Answer 30

contact dermatitis

Question 31

If a pt has drainage from a skin lesion what would you expect to get from them?

Answer 31

a culture

Question 32

You have a pt who has just had surgery and something just popped. What position would you put your patient in?

Answer 32

knees bent(notify provider)

Question 33

When you are checking for edema and you create an indention. What is this called?

Answer 33

pitting edema

Question 34

A nurse knows that which wounds heal by tertiary intentions?

Answer 34

wound left open and closed later with sutures

Question 35

Which medication is used for insomnia?

Answer 35

zolpidem

Question 36

What is an adolescents internal clock is associated with what?

Answer 36

puberty

Question 37

What effects can be caused from long term sleep deprivation?

Answer 37

increased blood pressure, weight gain

Question 38

What is a sign that is associated with sleep apnea?

Answer 38

snoring

Question 39

If a pt doesn't get enough sleep, what will the nurse consider?

Answer 39

they will not do well during the daytime

Question 40

What do sleep studies report?

Answer 40

biophysical changes that occur during sleep

Question 41

What are some complications of sleep deprivation?

Answer 41

hallucinations, disorientation

Question 42

A nurse is preparing to access a 1 yr old client for discomfort. What should the nurse do?

Answer 42

parent should hold the kid

Question 43

What is a clinical manifestation of fibromyalgia?

Answer 43

acute pain

Question 44

When a client is prescribed to wear a CPAP machine at night, what should a nurse encourage?

Answer 44

relaxation techniques(make sure mask works, and start off slowly)

Question 45

What skin alterations might you see at birth?

Answer 45

Mongolian spots, stork bites

Question 46

You are providing discharge teaching for an 82 yr old pt. What factors do you need to assess?

Answer 46

motivation(will they listen), vision, cognition

Question 47

What happens when you massage a client/

Answer 47

causes harm to compromising areas

Question 48

If you are concerned about a client getting bedsores, what kind of assessment data would you collect?

Answer 48

dementia, client is bed bound, albumin level