final Flashcards
(173 cards)
1
Q
nitrofurantoin contraindication
A
when Cr is <30
2
Q
terazosin administered when
A
at bedtime
3
Q
Sodium polystyrene sulfonate
A
An osmotic laxative that evacuates potassium from the bowel
Expect diarrhea
Do not administer to patients with hypoactive bowel/paralytic ileus (can cause bowel necrosis)
4
Q
epoietin alfa MOA and ed
A
rises Hgb.hct
will turn stool black
5
Q
atorvastatin MOA
A
lowers LDL
6
Q
gemfibrozil moa
A
lowers triglcycerides and inc HDL
7
Q
most common med for drug allergy
A
penicillin
8
Q
cephalosporin ed
A
no alcohol
9
Q
what med used for MRSA
A
vancomycin
10
Q
gentamycin ed
A
can cause nephrotixicty, ototoxicity
11
Q
fluorquinolone AE
A
tendon rupture
12
Q
how to check skin on dark person
A
check hands
13
Q
when to assess pts in acute, long term or home care
A
acute is q 24, long term is weekly and home is every visit
14
Q
how often to reposition patient
A
bed - 2 hours
chair - 1 hour
15
Q
When admitting a patient with acute glomerulonephritis, it is most important that the nurse ask the patient about
a. recent sore throat and fever.
b. history of high blood pressure.
c. frequency of bladder infections.
d. family history of kidney stones.
A
a
16
Q
A patient is admitted to the hospital with new onset nephrotic syndrome. Which assessment data will the nurse expect to find related to this illness?
a. Poor skin turgor
b. High urine ketones
c. Recent weight gain
d. Low blood pressure
A
c because edema
17
Q
A patient’s renal calculus is analyzed as being very high in uric acid. To prevent recurrence of stones, the nurse teaches the patient to avoid eating
a. milk and dairy products.
b. legumes and dried fruits.
c. organ meats and sardines.
d. spinach, chocolate, and tea.
A
c - Organ meats and fish such as sardines increase purine levels
18
Q
To prevent the recurrence of renal calculi, the nurse teaches the patient to:
a. use a filter to strain all urine.
b. avoid dietary sources of calcium.
c. drink diuretic fluids such as coffee.
d. have 2000 to 3000 mL of fluid a day.
A
d
19
Q
A patient in the hospital has a history of functional urinary incontinence. Which nursing action will be included in the plan of care?
a. Place a bedside commode near the patient’s bed.
b. Demonstrate the use of the Credé maneuver to the patient.
c. Use an ultrasound scanner to check postvoiding residuals.
d. Teach the use of Kegel exercises to strengthen the pelvic floor.
A
a
20
Q
When assessing the patient who has a lower urinary tract infection (UTI), the nurse will initially ask about
a. nausea.
b. flank pain.
c. poor urine output.
d. pain with urination.
A
d
21
Q
Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider?
a. Foul-smelling urine
b. Complaint of flank pain
c. Blood pressure 88/45 mm Hg
d. Temperature 100.1° F (57.8° C)
A
c- he low blood pressure indicates that urosepsis and septic shock may be occurring
22
Q
A patient with renal calculi is hospitalized with gross hematuria and severe colicky left flank pain. Which nursing action will be of highest priority at this time?
a. Encourage oral fluid intake.
b. Administer prescribed analgesics.
c. Monitor temperature every 4 hours.
d. Give antiemetics as needed for nausea.
A
b
23
Q
- The nurse teaches the female paitent who has frequent UTIs that she should
a. take tub baths with bubble bath
b.urinate before and after sexual intercourse
c.take prophylactic sufonamides for the rest of her life
d. restrict fluid intake to prevent the need for frequent voiding
A
b
24
Q
4.One of the nruse’s most important roles in relation to acute poststreptococcal golmerulonephritis is to
a. promote early diagnosis and treatment of sore throats and skin lesions
b.encourage patients to obtain antibiotic therapy for upper respiratory tract infections
c.teach patients with APSGN that long term prophylactic antibiotic therapy is necessary to prevent recurrence
d.monitor patients for respiratory symptoms that indicate the disease is affecting the alveolar basement membrane
A
a
25
10. A patient with ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes:
a.encourage the patient to drink fruit juices and milk
b.encouraging fluids of at least 2-3 L/day after nausea has subsided
c. irrigating the nephrostomy tube with 10ml of NS solution as needed
d. notifying the physician if nephrostomy tube drainage is more than 30ml/hr
b
26
The patient with chronic kidney disease is considering whether to use peritoneal dialysis (PD) or hemodialysis (HD). What are advantages of PD when compared to HD (select all that apply)?
a. Less protein loss
b. Rapid fluid removal
c. Less cardiovascular stress
d. Decreased hyperlipidemia
e. Requires fewer dietary restrictions
ce
27
Priority Decision: During the immediate postoperative care of a recipient of a kidney transplant, what should the nurse expect to do?
a. Regulate fluid intake hourly based on urine output.
b. Monitor urine-tinged drainage on abdominal dressing.
c. Medicate the patient frequently for incisional flank pain.
d. Remove the urinary catheter to evaluate the ureteral implant
a
28
The home care nurse visits a 34-year-old woman receiving peritoneal dialysis. Which statement, if made by the patient, indicates a need for immediate follow-up by the nurse?
A. "Drain time is faster if I rub my abdomen."
B."The fluid draining from the catheter is cloudy."
C."The drainage is bloody when I have my period."
D."I wash around the catheter with soap and water."
b
29
Which patient should be taught preventive measures for CKD by the nurse because this patient is most likely to develop CKD?
A.A 50-year-old white female with hypertension
B.A 61-year-old Native American male with diabetes
C.A 40-year-old Hispanic female with cardiovascular disease
D.A 28-year-old African American female with a urinary tract infection
b
30
A patient with rheumatoid arthritis has been taking corticosteroids for 11 months. Which nursing action is most likely to detect early signs of infection in this patient?
a. Monitor white blood cell count.
b. Check the skin for areas of redness.
c. Check the temperature every 2 hours.
d. Ask about fatigue or feelings of malaise.
d
31
A patient arrives in the emergency department with a swollen ankle after an injury incurred while playing soccer. Which action by the nurse is most appropriate?
a. Elevate the ankle above heart level.
b. Apply a warm moist pack to the ankle.
c. Assess the ankle's range of motion (ROM).
d. Assess whether the patient can bear weight on the affected ankle.
a
32
After receiving a change-of-shift report, which patient should the nurse assess first?
a. The patient who has multiple black wounds on the feet and ankles
b. The newly admitted patient with a stage IV pressure ulcer on the coccyx
c. The patient who has been receiving chemotherapy and has a temperature of 102° F
d. The patient who needs to be medicated with multiple analgesics before a scheduled dressing change
c
33
An older adult patient is transferred from the nursing home with a black wound on her heel. What immediate wound therapy does the nurse anticipate providing to this patient?
A) Dress it with an absorbent dressing for exudate.
B) Handle the wound gently and let it dry out to heal.
C) Debride the nonviable, eschar tissue to allow healing.
D) Use negative-pressure wound (vacuum) therapy to facilitate healing.
c
34
A patient has been provided with a compression dressing in an attempt to facilitate rapid healing of an ankle sprain. What is a priority nursing assessment?
A)Frequent examination of the character and quantity of exudate
B) Monitoring for signs and symptoms of local or systemic infections
C) Assessment of the patient's circulation distal to the location of the dressing
D) Assessment of the range of motion of the ankle and the patient's activity tolerance
c
35
To which patient should the nurse plan to administer round-the-clock antipyretic drugs?
A) A 76-yr-old patient with bacterial meningitis and a temperature of 104.2°F
B) An 82-yr-old patient after hip replacement surgery and a temperature of 100.4°F
C) A 14-yr-old patient with infectious mononucleosis and a temperature of 101.6°F
D) A 59-yr-old patient with an acute myocardial infarction and a temperature of 99.8°F
a
36
The nurse teaches a patient diagnosed with systemic lupus erythematosus (SLE) about plasmapheresis. What instructions about plasmapheresis should the nurse include in the teaching plan?
a. Plasmapheresis will eliminate eosinophils and basophils from blood.
b. Plasmapheresis will remove antibody-antigen complexes from circulation.
c. Plasmapheresis will prevent foreign antibodies from damaging various body tissues.
d. Plasmapheresis will decrease the damage to organs caused by attacking T lymphocytes.
b
37
The nurse is caring for a patient undergoing plasmapheresis. The nurse should assess the patient for which clinical manifestation?
a. Shortness of breath
b. High blood pressure
c. Transfusion reaction
d. Numbness and tingling
d
38
The nurse teaches a patient about drug therapy after a kidney transplant. Which statement by the patient would indicate a need for further instructions?
a. "After a couple of years, it is likely that I will be able to stop taking the cyclosporine."
b. "If I develop an acute rejection episode, I will need to have other types of drugs given IV."
c. "I need to be monitored closely because I have a greater chance of developing malignant tumors."
d. "The drugs are given in combination because they inhibit different ways the kidney can be rejected."
a
39
A patient is admitted to the hospital with acute rejection of a kidney transplant. Which intervention will the nurse prepare for this patient?
a. Administration of immunosuppressant medications
b. Insertion of an arteriovenous graft for hemodialysis
c. Placement of the patient on the transplant waiting list
d. A blood draw for human leukocyte antigen (HLA) matching
a
40
A patient who is receiving immunotherapy has just received an allergen injection. Which assessment finding is most important to communicate to the health care provider?
a. The patient's IgG level is increased.
b. The injection site is red and swollen.
c. The patient's allergy symptoms have not improved.
d. There is a 2-cm wheal at the site of the allergen injection.
d
41
The reason newborns are protected for the first 6 months of life from bacterial infection is because of the maternal transmission of:
A. IgG
B. IgA
C. IgM
D. IgE
a
42
In a type 1 hypersensitivity reaction, the primary immunologic disorder appears to be:
A. binding of IgG to an antigen on the cell surface
B. deposit of antigen-antibody complexes in small vessels
C. release of cytokines to interact with specific antigens
D. release of chemical mediators from IgE-bound mast cells and basophils
d
43
The nurse advises a friend who asks him to administer his allergy shots that:
A. it is illegal for nurses to administer injections outside of a medical setting
B. he is qualified to do it if the friend has epinephrine in an injectible syringe provided with his extract
C. avoiding the allergens is a much more effective way of controlling allergens, and allergy shots are not usually effective
D. immunotherapy should only be administered in a setting where emergency equipment and drugs are available
d
44
The most common cause of secondary immunodeficiencies is:
A. drugs
B. stress
C. malnutrition
D. human immunodeficiency virus
a
45
1. Emerging and reemerging infections affect health care by (select all that apply)
a. reevaluating vaccine practices.
b. revealing antimicrobial resistance.
c. limiting antibiotics to those with life-threatening infection.
d. challenging researchers to discover new antimicrobial therapies.
abd
46
4. During HIV infection
a. reverse transcriptase helps HIV fuse with the CD4+ T cell.
b. HIV RNA uses the CD4+ T cell's mitochondria to replicate.
c. the immune system is impaired predominantly by the eventual widespread destruction of CD4+ T cells.
d. a long period of dormancy develops during which HIV cannot be found in the blood and there is little viral replication.
c
47
6. A diagnosis of AIDS is made when an HIV-infected patient has
a. a CD4+ T cell count below 200/µL.
b. a high level of HIV in the blood and saliva.
c. lipodystrophy with metabolic abnormalities.
d. oral hairy leukoplakia, an infection caused by Epstein-Barr virus.
a
48
8. HIV antiretroviral drugs are used to
a. cure acute HIV infection.
b. decrease viral RNA levels.
c. treat opportunistic diseases.
d. decrease pain and symptoms in terminal disease.
b
49
9. Opportunistic diseases in HIV infection
a. are usually benign.
b. are generally slow to develop and progress.
c. occur in the presence of immunosuppression.
d. are curable with appropriate drug interventions
c
50
12. What is the most appropriate nursing intervention to help an HIV-infected patient adhere to a treatment regimen?
a. "Set up" a drug pillbox for the patient every week.
b. Give the patient a video and a brochure to view and read at home.
c. Tell the patient that the side effects of the drugs are bad but that they go away after a while.
d. Assess the patient's routines and find adherence cues that fit into the patient's life circumstances.
d
51
3. The nurse has experienced a recent increase in the incidence of hospital care-associated infections (HAIs) on the unit. Which nursing action should be prioritized in the response to this trend?
A. Use of gloves during patient contact
B. Frequent and thorough hand washing
C. Prophylactic, broad-spectrum antibiotics
D. Fitting and appropriate use of N95 masks
b
52
4. The nurse teaches the staff ensuring that standard precautions should be used when providing care for which type of patient?
A. All patients regardless of diagnosis
B. Pediatric and gerontologic patients
C. Patients who are immunocompromised
D. Patients with a history of infectious diseases
a
53
7. A pregnant woman who was tested and diagnosed with human immunodeficiency virus (HIV) infection is very upset. What should the nurse teach this patient about her baby's risk of being born with HIV infection?
A. "The baby will probably be infected with HIV."
B. "Only an abortion will keep your baby from having HIV."
C. "Treatment with antiretroviral therapy will decrease the baby's chance of HIV infection."
D. "The duration and frequency of contact with the organism will determine if the baby gets HIV infection."
c
54
14. The nurse is providing postoperative care for a patient with human immunodeficiency virus (HIV) infection after an appendectomy. What type of precautions should the nurse observe to prevent the transmission of this disease?
A. Droplet precautions
B. Contact precautions
C. Airborne precautions
D. Standard precautions
d
55
16. The nurse is monitoring the effectiveness of antiretroviral therapy (ART) for a patient with acquired immunodeficiency syndrome (AIDS). What laboratory study result indicates the medications are effective?
A. Increased viral load
B. Decreased neutrophil count
C. Increased CD4+ T cell count
D. Decreased white blood cell count
c
56
17. A patient has acquired immunodeficiency syndrome (AIDS) and the viral load is reported as undetectable. What patient teaching should be provided by the nurse related to this laboratory study result?
A. The patient has the virus present and can transmit the infection to others.
B. The patient is not able to transmit the virus to others through sexual contact.
C. The patient will be prescribed lower doses of antiretroviral medications for 2 months.
D. The syndrome has been cured, and the patient will be able to discontinue all medications.
a
57
what type of rxn is latex
1 and IV
58
Which statement by a nurse to a patient newly diagnosed w/ type 2 diabetes is correct?
a) Insulin is not used to control blood glucose in patient w/ type 2 diabetes
b) Complications of type 2 diabetes are less serious than those of type 1 diabetes
c) Changes in diet and exercise may control blood glucose levels in type 2 diabetes
d) Type 2 diabetes is usually diagnosed when the patient is admitted w/ hyperglycemic coma
c
59
A 48 y/o male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL. The nurse will plan to teach the patient about
a) self-monitoring of blood glucose
b) using low doses of regular insulin
c) lifestyle changes to lower blood glucose
d) effects of oral hypoglycemic medications
c
60
In order to assist an older diabetic patient to engage in moderate daily exercise, which action is most important for the nurse to take?
a) Determine what type of activities the patient enjoys
b) Remind the patient that exercise will improve self-esteem
c) Teach the patient about the effects of exercise on glucose level
d) Give the patient a list of activities that are moderate in intensity
a
61
An unresponsive patient w/ type 2 diabetes is brought to the ED and diagnosed w/ hyperosmolar hyperglycemia syndrome (HHS). The nurse will anticipate the need to
a) give a bolus of 50% dextrose
b) insert a large-bore IV catheter
c) initiate oxygen by nasal cannula
d) administer glargine (Lantus) insulin
b
62
After change-of-shift report, which patient should the nurse assess first?
a) 19 y/o w/ type 1 diabetes who has an A1C of 12%
b) 23 y/o w/ type 1 diabetes who has a blood glucose of 40 mg/dL
c) 40 y/o who is pregnancy and whose oral glucose tolerance test is 202 mg/dL
d) 50 y/o who uses exenatide (Byetta) and is complaining of acute abdominal pain
b
63
6 ss of SIADH
Results in reabsorption of water into the circulation
Fluid retention
Serum hypoosmolality
Dilutional hyponatremia
Hypochloremia
Concentrated urine
64
positioning for SIADH patient
HOB flat
65
SIADH vs DI
66
7. The nurse determines that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient makes which statement?
a. "I need to shop for foods low in sodium and avoid adding salt to food."
b. "I should weigh myself daily and report any sudden weight loss or gain."
c. "I need to limit my fluid intake to no more than 1 quart of liquids a day."
d. "I should eat foods high in potassium because diuretics cause potassium loss."
a - they need Na
67
13. A 62-yr-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The nurse instructs the patient
a. about radioactive precautions to take with all body secretions.
b. that symptoms of hyperthyroidism should be relieved in about a week.
c. that symptoms of hypothyroidism may occur as the RAI therapy takes effect.
d. to discontinue the antithyroid medications taken before the radioactive therapy.
c
68
14. Which nursing assessment of a 70-yr-old patient is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid)?
a. Fluid balance
b. Apical pulse rate
c. Nutritional intake
d. Orientation and alertness
b
69
20. Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care provider before administering levothyroxine (Synthroid)?
a. Increased thyroxine (T4) level
b. Blood pressure 112/62 mm Hg
c. Distant and difficult to hear heart sounds
d. Elevated thyroid stimulating hormone level
a
70
The nurse admits a patient to the hospital in Addisonian crisis. Which patient statement supports the need to plan additional teaching?
a. "I frequently eat at restaurants, and my food has a lot of added salt."
b. "I had the flu earlier this week, so I couldn't take the hydrocortisone."
c. "I always double my dose of hydrocortisone on the days that I go for a long run."
d. "I take twice as much hydrocortisone in the morning dose as I do in the afternoon."
b
71
25. A 29-yr-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy. Which information about the prednisone is most important for the nurse to include?
a. "Weigh yourself daily to monitor for weight gain."
b. "The prednisone dose should be decreased gradually."
c. "A weight-bearing exercise program will help minimize risk for osteoporosis."
d. "Call the health care provider if you have mood changes with the prednisone."
b
72
29. Which intervention will the nurse include in the plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?
a. Encourage fluids to 2 to 3 L/day.
b. Monitor for increasing peripheral edema.
c. Offer the patient hard candies to suck on.
d. Keep head of bed elevated to 30 degrees.
c
73
35. A 37-yr-old patient has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy. Which information about the patient is most important to communicate to the surgeon?
a. Difficult to awaken.
b. Increasing neck swelling.
c. Reports 7/10 incisional pain.
d. Cardiac rate 112 beats/minute.
b
74
43. Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?
a. Patient's blood pressure is 148/94 mm Hg.
b. Patient has bilateral 2+ pitting ankle edema.
c. Patient stopped taking the medication 2 days ago.
d. Patient has not been taking the prescribed vitamin D.
c
75
A 61-year-old patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 AM. The nurse shares in the morning report that the day shift staff should check the tube for patency at what times?
A) 7:00 AM, 10:00 AM, and 1:00 PM
B) 8:00 AM, 12:00 PM, and 4:00 PM
C) 9:00 AM and 3:00 PM
D) 9:00 AM, 12:00 PM, and 3:00 PM
b
76
An important nursing intervention for a patient with a small intestinal obstruction who has an NG tube is to
a. offer ice chips to suck PRN.
b. provide mouth care every 1 to 2 hours.
c. irrigate the tube with normal saline every 8 hours.
d. keep the patient supine with the head of the bed elevated 30 degrees.
b
77
When evaluating the patient’s understanding about the care of the ileostomy, what statement by the patient indicates the patient needs more teaching?
A) “I will be able to regulate when I have stools.”
B) “I will be able to wear the pouch until it leaks.”
C) “Dried fruit and popcorn must be chewed very well.”
D) “The drainage from my stoma can damage my skin.”
a
78
what to ask patient with IBS
about food intolerances
79
Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several episodes of bloody diarrhea?
stool culutre
80
After several days of antibiotic therapy, an older hospitalized patient develops watery
diarrhea. Which action should the nurse take first?
a. Notify the health care provider.
b. Obtain a stool specimen for analysis.
c. Teach the patient about hand-washing.
d. Place the patient on contact precautions.
d
81
what does nurse do after EGD
test gag reflex
82
The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement?
1. Provide a low-residue diet.
2.Monitor intravenous fluids.
3.Assess vital signs daily.
4.Administer antacids orally
b
83
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy
abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to
a. administer IV metoclopramide (Reglan).
b. discontinue the patient’s oral food intake.
c. administer cobalamin (vitamin B12) injections.
d. teach the patient about total colectomy surgery.
b
84
education for pt with UC
high risk for colorectal cancer so need frequent screening
85
What should the nurse teach the patient with diverticulosis to do?
a. Use anticholinergic drugs routinely to prevent bowel spasm.
b. Have an annual colonoscopy to detect malignant changes in the lesions.
c. Maintain a high-fiber diet and use bulk laxatives to increase fecal volume.
d. Exclude whole grain breads and cereals from the diet to prevent irritating the bowel.
c
86
Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)?
a. “You will need to remain on a bland diet.”
b. “Avoid foods that cause pain after you eat them.”
c. “High-protein foods are least likely to cause you pain.”
d. “You should avoid eating any raw fruits and vegetables.
b
87
Which of the following would be an expected outcome for a client with peptic ulcer disease? The client will:
1. Demonstrate appropriate use of analgesics to control pain.
2. Explain the rationale for eliminating alcohol from the diet.
3. Verbalize the importance of monitoring hemoglobin and hematocrit every 3 months.
4. Eliminate contact sports from his or her lifestyle.
b
88
The nurse is teaching the patient a client with a peptic ulcer discharge instructions. The client asks the nurse which type of analgesic he may take. Which of the following responses by the
nurse would be most accurate?
1. Aspirin
2. Acetaminophen
3. Naproxen
4. Ibuprofen
b
89
A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take?
a. Irrigate the NG tube.
b. Check the vital signs.
c. Give the ordered antacid.
d. Elevate the foot of the bed.
b
90
A young adult patient is admitted to the hospital for evaluation of right lower quadrant
abdominal pain with nausea and vomiting. Which action should the nurse take?
a. Assist the patient to cough and deep breathe.
b. Palpate the abdomen for rebound tenderness.
c. Suggest the patient lie on the side, flexing the right leg.
d. Encourage the patient to sip clear, noncarbonated liquids.
c
91
Which assessment should the nurse perform first for a patient who just vomited bright red blood?
a. Measuring the quantity of emesis
b. Palpating the abdomen for distention
c. Auscultating the chest for breath sounds
d. Taking the blood pressure (BP) and pulse
d
92
The nurse will anticipate preparing a 71-year-old female patient who is vomiting “coffee-ground” emesis for
a. endoscopy.
b. angiography.
c. barium studies.
d. gastric analysis.
a
93
To prepare a patient with ascites for paracentesis, the nurse
a. places the patient on NPO status.
b. assists the patient to lie flat in bed.
c. asks the patient to empty the bladder.
d. positions the patient on the right side.
c
94
Which action should the nurse take to evaluate treatment effectiveness for a patient who has
hepatic encephalopathy?
a. Request that the patient stand on one foot.
b. Ask the patient to extend both arms forward.
c. Request that the patient walk with eyes closed.
d. Ask the patient to perform the Valsalva maneuver.
b
95
Which nursing assessment finding in a patient who recently started taking hormone replacement therapy (HRT) requires discussion with the health care provider about a change in therapy?
a. Breast tenderness
b. Left calf swelling
c. Weight gain of 3 lb
d. Intermittent spotting
b
96
Which topic will the nurse include in the preoperative teaching for a patient admitted for an abdominal hysterectomy?
a. Purpose of ambulation and leg exercises *
b. Adverse effects of systemic chemotherapy
c. Decrease in vaginal sensation after surgery
d. Symptoms caused by the drop in estrogen level
a
97
7 s/s of UTI
fever
chills
dysuria
hematuria
cloudy foul smelling urine
loss of appetite
confusion
98
3 pos labs for UTI
nitrates, WBC, leukocyte esterase
99
pylenophritis s/s 1 distinguished
CVA tenderness and flank pain
100
what is most important to monitor for in pylenophiritis
urosepsis so vitals q 4 hours
101
nephrotic syndrome
proteinuria with edema in glomerulonephritis
102
4 s.s of renal colic
kindey stone dance
cool moist skin
flank pain
n/v
103
diet for kidney stones
reduce Na
104
after a stone passes, what is priority
fluids
105
food to avoid for kidney stones
Ca
oxalate
purines
106
meds to treat kidney stones
alpha adrenergic blockers like terazosin
107
tx for acute urinary retention
indwelling catheter - emergency
108
7 r/f for CKD
cardiovascular disease
diabetes
ethnic minority
nephrotxic drugs
fam hx
HTN
109
definition of CKD
he presence of kidney damage or a decreased GFR less than 60 mL/min/1.73 m2 for longer than 3 months
110
how tx acute hyperkalemia
IV glucose and insulin or IV 10% calcium gluconate
111
5 things to control for CKD
HTN, hyperparathyroid, CKD-MBD, anemia, dyslipidemia
112
3 tx for CKD-MBD
limit phosphates(meat and dairy)
give phosphate binders
supplement Vitamin d
113
when is dialysis used
when gfr <15
114
if there is cloudy effluent during periotoneal dialysis
abx stat - it is peritonitis
115
how to check patency of AV graft
feel thrill hear bruit
116
important caution for AV grafts
no bp sticks or cuffs
117
loratidine education
antihistamine- take before s.s
118
phenylephrine ed
decongestant- can cause rebound congestion
119
primary vs secondary response to pathogen
primary: igG and igM raise
secondary: igG raises drastically
120
SLE, RA, glomerulonephritis (AI) hypersens rxn
3
121
what is plasmapheresis
when is it used
3 SE and how to prevent them
replaces plasma with saline, LR, albumin
used for AI when meds dont work
albumin replacement can deplete immunoglobulin stores for weeks
hypotension- give slowly and vasalvagal
citrate toxicity
122
main cause of seconary immunodef
meds
123
loratidine
class
use
ed 2
2nd gen antihistamine
controls edema and itching in allergies
take b4 symptoms or right when they appear
does NOT cause drowsiness
124
The nurse provides care for a client with Addison disease. The nurse assesses for which of the following conditions most importantly?
dysrhythmias
125
A client is recovering from a subtotal thyroidectomy. The nurse identifies which symptom indicating damage to the parathyroid gland?
hypocalcemia
126
The nurse counsels a client about preparation for a subtotal thyroidectomy. The client was prescribed an iodine solution to take prior to the surgery, and asks the nurse why this is necessary?
prevents post op hemorrhage
127
is Na and K high or low in SIADH
low Na and high K
128
is Na and K high or low in DI
high NA and low K
129
is Na and K high or low in cushings
high Na, low K+
130
is Na and K high or low in addisons
low Na, high K
131
is Na and K high or low in DKA
low K , low Na
132
is Na and K high or low in HHS**
low K
133
9 ss of SIADH
hyponatremia
urinary retention
serum HYPOosmolality
fluid retention
tachycardia
anorexia
n/v
lethargy
polydypsia
134
what to monitor for with vasopressin
liver function tests
135
7 SS OF DI
high osmolality
high urine output (polyuria >2L)
low urine SG
HYPER natremia
fatigue
weakeness
polydypsia
136
nutrition for DI
lower Na in diet
137
lab value for acromegaly
INC GH
138
if pt has bucchal swelling, salivating, n/v what is happening and what to do
too much iodine, discontinue it
139
9 ss of cushings
HIGH BP (HTN)
edema
purple striae
increased infection risk
buffalo hump
trunchal obesity
thin arms and legs
moon face
HYPERNATREMIA
140
2 labs for addisons
low cortisol and low aldosterone
141
5 ss of addisons
bronze skin
N/v
exhaustion
cramps
salt cravings
142
what is most important to monitor after adrenalectomy
F and E
143
if pt is unresponsive with low BG what to do
give dextrose and glucagon
144
how to dx diabetes
H1ac (2-3 mo fasting)
or 8 hour fast and <99 is normal and 100-125 is prediabetes
145
exercise teaching for diabetics
dont exercise if BG > 300
exercise 1 hr after meal
monitor before during after exercise
146
if pt calls and has n/v diarrhea is sick what to do
monitor BG every 2-4 hours
147
5 triggers to SCD
low O2
infection (most common)
stress
altitude
surgery
148
how to prevent SCD crisis
O2 to reverse initial sickling
149
thrombocytopenia vs hemophillia
Thrombocytopenia - reduction of platelets
Hemophilia - genetic disorder caused by a defective or deficient coagulation factor
150
cause and incidence of hemophillia
autosomal recessive genetic
if mom has it then sons have 50% chance
if dad has it and he has daughters then the daughters are carriers and their sons have 50%
151
thrombocytopenia vs hemophillia labs
thrombo: low platlets , normal labs
hemophillia : no clotting factors, normal PT and platlets but prolonged PTT
152
when is neutropenia dx
ANC <1000
153
how to prevent febrile non hemolytic rxn
Give diphenhydramine and acetaminophen 30 minutes prior;
154
what to do if occlusion in CL 3
looks like precipitate- change position, flush w/ NSS, thrombolytic therapy
155
priority for lymphedema
no BP sticks
156
if pt with CL has infection
culutures
157
SCD crisis s/s 4
pallor
joint swelling
fever
abdominal pain
158
A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement indicates that additional teaching about GERD is needed?
a. "I take antacids between meals and at bedtime each night."
b. "I sleep with the head of the bed elevated on 4-inch blocks."
c. "I eat small meals during the day and have a bedtime snack."
d. "I quit smoking several years ago, but I still chew a lot of gum."
c
159
Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?
a. "Peppermint tea may reduce your symptoms."
b. "Keep the head of your bed elevated on blocks."
c. "You should avoid eating between meals to reduce acid secretion."
d. "Vigorous physical activities may increase the incidence of reflux."
b
160
The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement?
1. Provide a low-residue diet.
2.Monitor intravenous fluids.
3.Assess vital signs daily.
4.Administer antacids orally
b
161
The nurse is caring for a female client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?
a. regular diet
b. skim milk
c. nothing by mouth
d. clear liquids
c
162
An important nursing intervention for a patient with a small intestinal obstruction who has an NG tube is to
a. offer ice chips to suck PRN.
b. provide mouth care every 1 to 2 hours.
c. irrigate the tube with normal saline every 8 hours.
d. keep the patient supine with the head of the bed elevated 30 degrees.
b
163
how to give meds with enteral feedings
no meds WITH formula, should dissolve tabs in water
164
When obtaining a nursing history from the patient with colorectal cancer, the nurse should specifically ask the patient about
diet
165
priority intervention for peritonitis
IV access to prevent hypovolemic shock
166
if someone is vomiting bright red blood
priority is NPO and IV access to prevent hypovolemic shock
167
addisons vs cushings labs
168
if decreased outflow or bladder spasm of CBI
turn up irrigation
169
prostatitis tx
abx orally for 4-12 weeks
170
when to use sildenafil
when sexual stimualtion will occur
171
what to do if prolonged diarrheA
stool culture
172
what med should nurse question for diarrhea from ecoli
loperamide
173
UC can increase risk of
colorectal cancer
