Medical Flashcards
How would you deal with an anxious patient. How would you provide Nursing care?
A) giving him hospital regulations
B) telling him there’s nothing to be afraid of
C) give him information on his condition and forward him onto a website
D) act in a calm reassuring manner and provide information in a way he would understand in regard to the operation he may have and routines
D) because calmness enables us to have a gentle manner, a soothing voice, and display quiet dependability in all that we do. It enables us to have an attitude of composed alertness to the ever-changing needs of patients and practice situations and to have confidence in our ability to meet these needs.
The first management priority for spinal injury is
A) Pain
B) Altered sexuality
C) Spinal Immbolisation
D) Urinary Catherisation
C) Spinal Immbolisation
A client who sustains a fracture dislocation of the cervical spine will most probably have
A) Tetraplegia
B) Hemiplegia
C) Paraplegia
D) Monoplegia
A) Tetraplegia
You find a patient crying after finding out that she has a permanent spinal injury due to a car accident. She says she doesn’t want to live anymore now she can’t walk. What can you do?
A) Tell her to harden up
B) “There are people dealing with worse crap than you”
C) Become worried that she will follow through with her want to end her life, and race to find RN
D) Recognise this as being part of the stages of grief
D)
Denial
Anger
Bargaining
Depression
Acceptance
How to work out the volume when you administer IM:
Strength x Volume of Stock solution / Stock strength= volume required
Before moving a patient, you will find they will cooperate if
A) they are in an agreeable mood
B) Are praised when activities are completed
C) Received enough analgesia (pain relief) to promote freedom from pain
D) Warned about complications if activities are not performed.
C) Received enough analgesia (pain relief) to promote freedom from pain
What is the purpose of an NGT after bowel surgery?
A) Feeding
B) Irrigation
C) Inflation
D) Aspiration
D) Aspiration
Which activity can an EN legally do?
A) Prime the line prior to IV tubing being changed.
B) Report to a registered nurse that the IV fluid is low.
C) Discontinue an IV infusion to dress/undress a client.
D) Change the IV bag if directed by a registered nurse.
A) Prime the line prior to IV tubing being changed.
Sam, aged 20 years, is being assessed following a head injury. The earliest sign of increasing intracranial pressure is
A) a rapid pulse.
B) a change in the level of consciousness
C) Hypertension
D) hypoxaemia.
B) a change in the level of consciousness
During the primary assessment of Sam, the nurse should
A) palpate the abdomen
B) assess the level of consciousness
C) examine the neck for rigidity or stiffness
D) determine whether he has underlying medical conditions
B) assess the level of consciousness
The primary goal of withholding food and fluids before surgery is to prevent
A) aspiration
B) distension
C) infection
D) obstruction.
A) aspiration
Peri-operative instruction that is a legal requirement for all patients is:
A) techniques for deep breathing and coughing.
B) descriptions of the planned surgical procedure
C) physical procedures or preparation required before surgery
D) being nil by mouth after midnight on the day of surgery.
B) descriptions of the planned surgical procedure
You are asked by your RN to assess Mr N who has just arrived back from PACU onto the ward. The priority assessment would be to check
A) bleeding from the wound site
B) vital signs and level of consciousness.
C) if the pain relief medication is due.
D) the IV infusion rate is correct.
B) vital signs and level of consciousness.
Pain assessment is part of an enrolled nurse’s scope of practice. To assess Mr N’s level of pain, you would
A) ask Mr N if he has any severe pain.
B) use a pain scale to assess the pain level.
C) decide by your observation that Mr N has pain.
D) ask Mr N to point to where the pain is.
B) use a pain scale to assess the pain level.
To detect shock, you will observe Mr N for
A) increasing blood pressure, slowing pulse rate.
B) increasing pulse rate, decreasing blood pressure.
C) increasing blood pressure, slowing respiratory rate, slowing pulse rate.
D) increasing respiratory rate, slowing pulse rate, decreasing blood pressure.
B) increasing pulse rate, decreasing blood pressure.
Fifteen minutes after a blood transfusion has begun Mr N complains of difficulty breathing. You should first
A) notify Mr N’s physician.
B) stop the transfusion immediately.
C) assess Mr N’s vital signs.
D) obtain a blood specimen from Mr N.
B) stop the transfusion immediately.
Following surgery for a left total hip replacement Mr N’s left leg should
A) be supported with pillows under the knee.
B) be maintained in abduction.
C) be exercised hourly to prevent DVT from occurring.
D) be maintained in adduction
B) be maintained in abduction.
Mr N, aged 73 years, is admitted to the ward after falling over. A diagnosis of fractured left neck of femur is made. Of the following, which would you expect Mr N to have?
A) Shortening, external rotation, pain.
B) Shortening, abnormal movement, ankle oedema.
C) Pain, flexion deformity, slow venous return.
D) Muscle spasm, slow venous return, external rotation.
A) Shortening, external rotation, pain.
You are performing a basic neurovascular assessment so you can report back to the RN. Which of the following would you assess?
A) Colour, warmth, movement, sensation, verbal response.
B) Pain, sensation, colour, movement, level of consciousness.
C) Warmth, movement, sensation, pain, colour.
D) Colour, degree of shock, pain, sensation, movement.
C) Warmth, movement, sensation, pain, colour.
Mr N can’t feel pressure applied to his toes and complains of tingling. These signs indicate
A) pressure on a nerve.
B) analgesic overdose.
C) improper alignment of the fracture.
D) low pain threshold.
A) pressure on a nerve.
Mr N has been scheduled to undergo surgery for a total hip replacement the next day. 30 31 Mr N’s surgeon asks you to complete the consent form. What would you do?
A) Obtain verbal consent from Mr N and ask the doctor to sign the form.
B) Get consent from Mr N, it is your legal responsibility to obtain consent from your client before the operation.
C) Refuse, stating you are not allowed to obtain written consent for procedures.
D) Ask the registered nurse to do it as you are busy with other clients.
C) Refuse, stating you are not allowed to obtain written consent for procedures.
During a pre-operative nursing assessment, the enrolled nurse is alerted to the possibility of a compromised respiratory function during the peri-operative phase in the patient with
A) obesity.
B) dehydration.
C) enlarged liver.
D) decreased peripheral pulse volume.
A) obesity.
Ten minutes after John has received his preoperative sedative medication by intramuscular injection, he asks to get up to go to the bathroom to urinate. The most appropriate action by the nurse is to
A) offer him a urinal and position him in bed to promote voiding.
B) assist him to the bathroom.
C) tell him to try to “hold on” because he will be catheterised at the beginning of the surgical procedure.
D) allow him up to go to the bathroom because the onset of the effect of the medication takes more than 10 minutes
B) assist him to the bathroom.
Postoperatively you check to ensure John’s vacuum drain is draining properly. The purpose of the redivac/redinom/vacuum drain is to
A) provide for assessment of the quality of the drainage.
B) prevent formation of a hematoma.
C) accurately measures the amount of drainage.
D) provides a closed sterile gravity flow system.
B) prevent formation of a hematoma.
John is now one day post abdominal surgery. While caring for him on the first postoperative day, you notice new bright red drainage about 6 cm in diameter on his dressing. In response to this finding you should
A) take John’s vital signs then notify RN.
B) notify the RN of a potential haemorrhage.
C) remove the dressing and assess the surgical incision.
D) recheck the dressing in one hour for increased drainage.
C) remove the dressing and assess the surgical incision.
You are closely monitoring John postoperatively. You would become most concerned with which of the following signs, which could indicate an evolving complication?
A) Blood pressure of 110/70 mm Hg and a pulse of 86 beats per minute.
B) Increasing restlessness.
C) Hyperactive passing of flatus.
D) A negative Homan’s sign
B) Increasing restlessness.
Postoperative abdominal distension is usually a result of
A) patient having consumed food.
B) incorrect body positioning.
C) gas accumulating in the bowel.
D) the type of anaesthetic administered.
C) gas accumulating in the bowel.
Which of the following would be considered normal for the first postoperative day following abdominal surgery?
A) Pain over incision site when coughing.
B) Frequency and burning after urination.
C) Dyspnoea.
D) Yellow green drainage from wound.
A) Pain over incision site when coughing.
Which nursing intervention will prevent atrophy of Mr N’s leg muscles?
A) Encourage isometric leg muscle exercises hourly.
B) Passive stimulation by the nursing staff hourly.
C) Encourage him to move about in the bed hourly.
D) Active massage to the calf and thigh muscles hourly.
A) Encourage isometric leg muscle exercises hourly.
The most common postoperative respiratory complication in the elderly patient is
A) pleurisy.
B) hypoxaemia.
C) pulmonary oedema.
D) pneumonia.
D) pneumonia.
An indication urinary retention is occurring in the postoperative period is that
A) a person is unable to hold more than 10 ml of urine in the bladder.
B) patient complains of painful distended lower abdomen.
C) the bladder is unable to hold urine because of frequent bladder spasms.
D) 100 to 200 ml or urine is voided every 2 to 3 hours.
B) patient complains of painful distended lower abdomen.
The following questions refer to the nursing management of the surgical patient: John (54 years) is scheduled to go to the theatre for a bowel resection. He tells you that he is “scared about having this operation” as his mother died after an operation years ago. Which response would be the most appropriate?
A) “Everything will be fine. Surgical techniques have greatly improved since your mother had surgery.”
B) “Think positive! Positive thoughts have been shown to influence a positive surgical outcome.”
C) “Tell me more about what happened to your mother.”
D) “Have you discussed these feelings with anyone else?”
C) “Tell me more about what happened to your mother.”
The nurse provides preoperative teaching for John before his abdominal surgery. Essential education for the patient to know for the first two post-op days includes
A) how to care for the wound.
B) how to deep breathe and cough.
C) what medications will be used during surgery.
D) what drains and tubes will be present after surgery.
E) All of the above (A students suggested answer)
B) how to deep breathe and cough.
Anti-embolic stockings are applied to John’s lower limbs. The purpose of elasticised hosiery is to
A) decrease venous return.
B) relieve the persistent cramping pain in the legs.
C) support the lower legs.
D) promote venous return.
D) promote venous return.
Mrs Swindle has now been on continuous oxygen for 24 hours. It is considered best practice to
A) humidify the oxygen before delivery.
B) pad the elastic bands of the masks.
C) Stop the continuous oxygen
D) ensure Mrs Swindle’s apical pulse is measured.
B) pad the elastic bands of the masks.
You should encourage Mrs Swindle to increase her fluid intake because it
A) decreases the amount of bacteria in the lungs.
B) dilutes the medication given to treat the disease.
C) thins the respiratory secretions.
D) decreases inflammation of the airways
C) thins the respiratory secretions.
How to calculate DPM
The drops per minute would be calculated as total volume, divided by time (in minutes), multiplied by the drop factor
Mrs Swindle’s pneumonia has resolved. You are aware that Mrs Swindle’s respiratory centre is now stimulated by
A) oxygen.
B) ability to breath.
C) rate of respirations.
D) carbon dioxide.
D) carbon dioxide.
The registered nurse asks you to give Mrs Swindle her lunchtime medications. She hands you the container with the medication in it. What do you do?
A) Take the medication and give it to Mrs Swindle as you can give medications under the delegation of the registered nurse.
B) Tell the registered nurse you cannot do this because you are busy but if she leaves them next to the drug trolley you will give them in 5 minutes.
C) Refuse to give the medication as you do not know what the medications are and you have not seen the prescription.
D) Give the medication and then check the prescription with the registered nurse.
C) Refuse to give the medication as you do not know what the medications are and you have not seen the prescription.
The registered nurse asks you to give Mrs Swindle her lunchtime medications. She hands you the container with the medication in it. What do you do?
A) Take the medication and give it to Mrs Swindle as you can give medications under the delegation of the registered nurse.
B) Tell the registered nurse you cannot do this because you are busy but if she leaves them next to the drug trolley you will give them in 5 minutes.
C) Refuse to give the medication as you do not know what the medications are and you have not seen the prescription.
D) Give the medication and then check the prescription with the registered nurse.
C) Refuse to give the medication as you do not know what the medications are and you have not seen the prescription.
What is a Myocardial Infarction?
Heart attack
What happens during an Angina?
The heart goes into spasm, and eases with O2 and meds. It eases with rest, GTN spray/ Anginine tablets, however, the patient may experience headaches.
What causes ischemic heart disease?
happens when the major blood vessels in the heart get narrow and stiff.
What is a Myocarditis?
Inflammation and damage of the heart muscle caused by an infection
What is atherosclerosis?
It’s when the arteries harden which causes Thrombosis, Angina, Ischemic Heart Disease, Intermittent claudication, stroke, and myocardial infarction.
What happens during congestive heart failure?
Blood is not flowing around the body effectively. This causes a backlog of blood and pressure buildup.
What is hypertension?
High blood pressure
What is hypotension?
Low blood pressure.
What is a systolic pressure?
Greatest pressure in the arterial system
What is diastolic pressure?
Least pressure against the arterial wall
What is objective data in nursing?
The definition of objective data is the collection of medical data that is measurable and substantiated. This subset of data can be collected using the five senses in a clinical setting. Observation serves as the basis for objective data. The phrase “signs and symptoms” is considered the “signs” of the patient’s reason for care.
What is subjective data in nursing?
Subjective and objective data are two complementary measurements of information that can give a complete portrayal of a patient’s medical status. Both data points are valuable and should be accounted for.
Subjective data is verbal or written information provided by the patient or their family. This information is compiled through interviews, ongoing assessments, admissions processes, and questionnaires. Subjective data is considered biased because it can be hard to verify independently.
What are the 4 stages of operative nursing?
Pre op- Before
Intra op- During
Post op- After
Peri op- Around
What is diagnostic surgery?
Exploration to confirm.
What is ablative surgery?
Removal of disease
What is reconstructive surgery?
Restoration of what was lost
What is cosmetic surgery?
A personal choice for change
What is palliative surgery?
Alleviating or reducing symptoms
What is DVT?
Deep Vein Thrombosis
What effect does Propofol cause?
It is a relaxant and pain relief- the brain stops registering pain.
What treats high cholesterol?
Simvastatin
What prevents DVT and blood clots?
Clexane/ Enoxparin
What is ischemia?
Restriction in blood supply to tissues, muscles or organ of the body.
A clot is called?
Infarction
What is the difference between modifiable and non-modifiable?
What can be changed or adapted and what cannot change.
What is an acute coronary syndrome treatment?
Airway Breathing Circulation followed by Morphine Oxygen Nitrate and Aspirin -then monitor.
What happens during a stroke?
Rapid death of brain tissue due to disturbance in blood supply
What is hypoxia?
Condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level.
What are the three layers/mater of the brain?
Arachnoid
Pia
Dura
What are meninges?
The four membranes that envelope the brain and spinal cord. They protect the central nervous system.
What are the 6 types of Traumatic Brain Injury?
Closed (injury caused by outside trauma)
Open (penetrating trauma)
Concussion (brief loss of neuro function)
Contusion (bleeding on the surface of brain)
Diffuse Axonal (tearing of brains nerve fibres)
Focal (direct impact resulting in haematoma)
What are the types of spinal cord injury?
Tetraplegia (inability to voluntarily move the upper or lower parts of the body and causes the patient unable to breathe on their own)
Paraplegia (affects all or parts of the torso, legs, and pelvic organs)
Quadriplegia (paralysis from the next down)
