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Exam 3 practice
Tess Nicholson
Quiz por Tess Nicholson, atualizado more than 1 year ago
Tess Nicholson
Criado por Tess Nicholson mais de 8 anos atrás
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Questão 1

Questão
A nurse identifies that a patient needs FURTHER teaching on crohn's disease when she states:
Responda
  • " My Prednisone will have to be weaned down slowly."
  • "All layers of the bowel are effected increasing my risk for serious complications, so we need to treat flares seriously."
  • "I can't wait till i get my ileostomy and colectomy and i won't have to be sick anymore."
  • "I will have to have a yearly TB test and should not get a live vaccine while I am on the infliximab (Remicaid)."

Questão 2

Questão
A nurse would realize that which THREE Interventions would NOT be indicated in a patient with a diagnosis of uncomplicated C-Diff
Responda
  • ondansetron (Zofran)
  • loperamide (Imodium)
  • Contact precautions & dedicating equipment
  • Fx hand hygiene with alcohol based hand rub
  • IV vancomycin
  • metronidazole (Flagyl)
  • Stool transplant

Questão 3

Questão
A patient with IBD has presented in the ER with multiple odd infections in the past 4 months. You expect the ER did a shitty job of taking a medical hx (and protecting this pt) and that the patient is on 1 or more of the following drugs THAT INCREASE THE RISK FOR INFECTION SPECIFICALLY?
Responda
  • Methylprednisolone
  • Sulfasalazine (Azulfidine)
  • adalimumab (Humira)
  • 6MP (mecaptopurine)
  • mesalamine (asacol)
  • octreotide (sandostatin)
  • methotrexate

Questão 4

Questão
The most appropriate diet for a nurse to teach a patient about who is in an acute diverticulitis episode that was just cleared to be advanced from NPO?
Responda
  • Low residue
  • high fiber
  • Low acid
  • High protein for wound healing
  • low fiber

Questão 5

Questão
The first nursing intervention for a patient postop from an uncomplicated colostomy the first time the nurse hears bowel sounds is for the nurse to?
Responda
  • measure abdominal girth
  • call the surgeon so he can place the order to advance the diet
  • assess the patient for cramping
  • change the perioperative pouch to a reusable pouch

Questão 6

Questão
Select for me the forms of Hepatitis that have vaccines, if you have not noticed these are also the forms of hepatitis that once you recover from them you are granted the gift of lifelong immunity.
Responda
  • Hep A: ( vowel transmits by bowel)
  • Hep B: (Body fluids: semen, blood and saliva)
  • Hep C: (Crack & Cock: Blood + Semen)

Questão 7

Questão
Due to the common and serious Side effect/ adverse effect of alpha Interferon (used to treat Hep C and Hep B chronic carriers) What medication would a nurse not be surprised to see also on her patient's med list who was on this drug?
Responda
  • Clonidine (Catapres)
  • Captopril (Capoten)
  • Nitroglycerin
  • Fluoxetine (Prozac)

Questão 8

Questão
A patient with cirrhosis is suffering from new hepatic encephalopathy due to digesting blood from bleeding hepatic varices. Which of the patients clinical manifestations are directly related to the encephalopathy
Responda
  • Serum ammonia: 111 mcg/dl
  • asterixis
  • Elevated bilirubin
  • jaundice
  • fetor hepatis
  • lethargy and confusion
  • ascites
  • bloody emesis

Questão 9

Questão
In a patient with liver failure, the #1 thing to treat first would be?
Responda
  • ascites and low albumin
  • hepatic encephalopathy
  • bleeding esophageal varices
  • poor glycogen storage and hypoglycemic events
  • Jaundice and elevated bilirubin

Questão 10

Questão
All of the following are appropriate nursing interventions for liver failure except?
Responda
  • Keeping scissors at the bedside and deflating the esophageal balloon of a Sengstaken Blakemore tube every 8-12 hours
  • Setting up nitroglycerin to be on standby when administering vasopressin (pitressin) to a patient with bleeding esophageal varices
  • Encouraging a pt. who is post TIPS procedure to use a warm back on back ord abdominal pain to reduce discomfort
  • Titrating lactulose (cephulac) to produce 3-4 loose stools a day
  • Infusing fresh frozen plasma before packed red cells
  • Encouragin the pt with ascites to rest in the semi-fowlers position

Questão 11

Questão
A pt. presents to the ER with epigastric pain that gets worse with eating. Temp: 38.0 C, WBC: 18; Amylase: 160; Lipase: 190 (elevated); ALT: 44 (High); AST: 45 (high); GGT: 34 (high). Upon entering the room you notice that her skin appears yellow and she has scratch marks over her arms and face. You will expect the testing to show that this patient has which condition?
Responda
  • Acute pancreatitis with biliary obstruction
  • Cirohsis
  • Liver failure
  • Chronic Pancreatitis

Questão 12

Questão
The nurse realized there is a need for further pt teaching about a T-tube when the pt. states?
Responda
  • "I will let you know if the drainage stops and i feel pain and like I'm going to puke."
  • "I think i will just hang the drain bag from my IV pole when my wife and I walk in the hall."
  • "Someone should be in to empty the bag at least every 8 hours."
  • "The fluid should be bloody then turn green-brown."

Questão 13

Questão
Which diagnostic procedure can be a cause of pancreatitis?
Responda
  • ERCP
  • HIDA scan
  • Colonoscopy
  • IVP

Questão 14

Questão
In pancreatitis, electrolyte abnormalities may occur. Which of the following may occur?
Responda
  • Increased Calcium
  • Decreased glucose
  • Increased insulin
  • Decreased calcium

Questão 15

Questão
2 large squares and 3 little squares across on EKG paper would be how much time?
Responda
  • .52 seconds
  • .3 seconds
  • .16 seconds
  • .12 seconds

Questão 16

Questão
Identify the following that apply to this image
Image:
26c38e63-e79c-46f2-ad7d-eff30994ead0 (image/png)
Responda
  • Normal .12-.20
  • Normal .34-.43
  • Prolonged with Heart block
  • QT Interval
  • If prolonged there is a high risk for VTACH
  • PR Interval
  • Represents AV conduction time

Questão 17

Questão
This represents the depolarization of both ventricles (select all that apply)
Image:
8c6910d4-0325-4265-9ab3-619d90a6afe8 (image/png)
Responda
  • Normal: .34-.43
  • Normal .12-.20
  • <.12
  • QT Interval
  • QRS Complex

Questão 18

Questão
Identify me:
Image:
d982a6e3-66dd-4653-a8ff-de02d37f452d (image/jpeg)
Responda
  • Asystole
  • Ventricular Tachycardia
  • Atrial Fibrillation
  • Ventricular Fibrillation

Questão 19

Questão
Identify me.
Image:
320c54e6-a892-4625-af37-9590131d1c70 (image/jpeg)
Responda
  • Asystole
  • Ventricular tachycardia
  • Ventricular Fibrillation
  • Complete 3rd degree heart block

Questão 20

Questão
A student nurse is describing the rhythm she saw on the monitor to her instructor " His heart rate was like 165, seemed regular, i couldn't really see a p wave or count the PR interval, and the QRS was wide, it looked like little mountains, all in a row." The instructor's eyes go wide and she runs down the hall. Why does she scream for a code as she runs?
Responda
  • It is Ventricular Tachycardia
  • It is Asystole
  • It is Atrial fibrillation
  • It is ventricular fibrillation

Questão 21

Questão
Select all the instances (4) when it would not be appropriate to deliver a shock (Defibrillation of syncrohinized cardioversion respectively) to a patient
Responda
  • a patient in VTACH who is awake and alert
  • a patient in asystole found unresponsive in the parking lot
  • a patient found unresponsive in the cafeteria in V-fib
  • While doctor is placing an EJ line in patient's neck who is in VTACH and unresponsive
  • A pt in Aflutter who arrived at the ER and has been experiencing symptoms for the past 15 hours
  • A person in A-fib who arrived at the ER who is on no meds and has been having symptoms for 4 days.

Questão 22

Questão
You would expect a patient to be treated more aggressively for Premature ventricular contractions in all the following situations expect?
Responda
  • Trigeminy pattern
  • Couplet pattern
  • PVC falls on T wave
  • PVC's are multifocal

Questão 23

Questão
The teacher notes the students understood the lecture about the differences between Afib and Aflutter when they stated the following?
Responda
  • "Aflutter is more organized with contractions that originate from one place while Afib is much more irregular with quivers that originate from multiple atrial cells."
  • "Afib doesn't need to be treated with anticoagulants but aflutter does."
  • "Afib is less common, Aflutter is very common
  • "Aflutter requires defibrillation due to its organized pattern while Afib requires synchronized cardioversion to reset its irregular pattern."

Questão 24

Questão
Medications you would expect to administer to a patient with Afib include
Responda
  • Protamine Sulfate
  • Cardizem (Diltazem)
  • warfarin (Coumadin)
  • furosemide (Lasix)
  • amiodarone (cordorone)

Questão 25

Questão
The most helpful thing a nurse can say to a patient who is experiencing panic induced by the administration of adenosine for supraventricular tachycardia is?
Responda
  • "You will be fine."
  • " Adenosine is a very safe drug it will be out of your system in no time."
  • "Lots of patients feel this way when they get this drug."
  • "I know it's frightening, the medication is making you feel this way. You are safe, this will last a short time. You are safe, I will stay right here with you."

Questão 26

Questão
A pt with third degree heart block had a pacemaker inserted. You know what he needs further teaching when he states?
Responda
  • "The whole microwave thing is just a myth."
  • "I really will miss flying to see my folks in california."
  • "I shouldnt raise my left arm above my shoulder till the doc says."
  • "I shouldn't have an MRI."
  • "I will carry my card and keep my bracelet on."

Questão 27

Questão
Select the findings in the patient's chart that match a diagnosis of Infective endocarditis (4)
Responda
  • 2 blood cultures drawn 30 min apart from 2 diff sites
  • elevated bilirubin
  • low platlets
  • protein in the urine
  • aortic and mitral vale murmurs
  • pericardial friction rub
  • fever
  • Chest xray: cardiomegaly

Questão 28

Questão
A patient with idiopathic pericarditis who is suffering from the complication of cardiac tamponade would be suffering with all of the following symptoms EXCEPT?
Responda
  • Pulses paradoxus
  • Roth's spots
  • muffled heart sounds
  • restlessness & anxiety

Questão 29

Questão
Rheumatic heart disease can be prevented by?
Responda
  • placing patients on bedrest when troponin levels are elevated
  • screening all men over 50 for cardiomyopathy
  • vaccinating children against the Coxsackie A virus
  • early identification and tx of strep

Questão 30

Questão
A male college athlete died of sudden cardiac death, the newspaper says it was r/t cardiomyopathy. The student nurse realizes this type of cardiomyopathy was most likely?
Responda
  • Dilated: Total ventricular dilation and atrial englargement
  • hypertrophic: left ventricular hypertrophy w/o ventricular dilation
  • Restrictive: impaired diastolic filling
  • Takotsubo

Questão 31

Questão
A patient with an aortic stenosis is receiving a biologic pig valve. He has been educated that it must be replaced every 10 years or so. What med therapy should he be educated about?
Responda
  • Anticoagulants
  • prophylactic antibiotics for dental procedures
  • beta blockers to decrease the heart's workload
  • digoxin to improve contractility

Questão 32

Questão
How would a nurse differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)?
Responda
  • GAD is acute, Panic d/o is chronic
  • Chest pain is common in GAD, while it doesn't happen often in panic d/o
  • Hyperventilating is a hallmark sign of GAD but doesn't happen often in panic d/o
  • Depersonalization is commonly seen in panic disorder and absent in GAD.

Questão 33

Questão
Which 3 treatments are most appropriate for a pt with Generalized anxiety disorder (GAD)?
Responda
  • Long-term treatment with diazepam (Valium)
  • Acute symptom control with citalopram (Celexa)
  • Long-term treatment with buspirone (BuSpar)
  • Acute symptom control with ziprasidone (Geodon)
  • Ongoing Cognitive Behavioral Therapy
  • Long-term Treatment with an SSRI

Questão 34

Questão
A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization?
Responda
  • The client will refrain from ritualistic behaviors during daylight hours.
  • The client will wake early enough to complete rituals prior to breakfast.
  • The client will participate in three unit activities by day 3.
  • The client will substitute a productive activity for rituals by day 1.

Questão 35

Questão
A nurse has been caring for a client diagnosed with generalized anxiety disorder (GAD). Which of the following nursing interventions would address this client's symptoms? (Select all that apply, which is all but one.)
Responda
  • A. Encourage the client to recognize the signs of escalating anxiety.
  • B. Encourage the client to avoid any situation that causes stress.
  • C. Encourage the client to employ newly learned relaxation techniques.
  • D. Encourage the client to cognitively reframe thoughts about situations that generate anxiety.
  • E. Encourage the client to avoid caffeinated products.

Questão 36

Questão
A client who is a veteran of the Gulf War is being assessed by a nurse for post-traumatic stress disorder (PTSD). Which of the following client symptoms would support this diagnosis? (Select all that apply,)
Responda
  • A. The client has experienced symptoms of the disorder for 2 weeks.
  • B. The client fears a physical integrity threat to self.
  • C. The client feels detached and estranged from others.
  • D. The client experiences fear and helplessness.
  • E. The client is lethargic and somnolent.

Questão 37

Questão
A client diagnosed with social phobia has an outcome that states, "Client will voluntarily participate in group activities with peers by day 3." Which would be an appropriate intrapersonal intervention by the nurse to assist the client to achieve this outcome?
Responda
  • 1. Offer PRN lorazepam (Ativan) 1 hour before group begins.
  • 2. Attend group with client to assist in decreasing anxiety.
  • 3. Encourage discussion about fears related to socialization.
  • 4. Role-play scenarios that may occur in group to decrease anxiety.

Questão 38

Questão
A pt presents to the unit with the following symptoms. He must check to make sure that doors lock 10 times, he has thoughts about germs that invade his waking moments and he washes his hands every half hour with a home made vinegar based soap. Identify the obsession.
Responda
  • handwashing every hour with home made soap
  • checking doors locked 10 times
  • thoughts about germs

Questão 39

Questão
Identify the abnormal urinalysis result: Color: amber yellow pH: 6.0 Glucose: - Bilirubin: - Specific Gravity: 1.02 WBC: 9
Responda
  • Specific Gravity: 1.02
  • WBC: 9
  • Bilirubin: -
  • Glucose: -
  • pH: 6.0
  • Color: amber yellow

Questão 40

Questão
A pt. who had a cytoscopy calls the office urgently stating that it burns when she pees and that she must be hemorrhaging because her pee is pink. What do you say?
Responda
  • This is normal after a cytoscopy, drink adequate amounts of fluids and it should resolve in a day or two.
  • Please come in so we can get a IVP
  • We are going to send you to get a U/A at a lab right away
  • This is a sign of bleeding go to your local ER as soon as possible.

Questão 41

Questão
Part of the diagnosis for glomerulonephritis includes?
Responda
  • diagnosis by exclusion
  • recurrent UTIs
  • Hx of strep
  • Hx of longterm diuretic use

Questão 42

Questão
Those with increased risk factors for urinary calculi include all EXCEPT?
Responda
  • Large protein intake
  • Excessive intake of tea or fruit juice
  • sedentary or immobility
  • cold climate, northeast
  • low fluid intake

Questão 43

Questão
heavy feeling in abdomen, htn, heamturia and UTI all are signs of
Responda
  • renal artery stenosis
  • bladder cancer
  • Polycystic kidney disease
  • glomerulonephritis

Questão 44

Questão
Normal results when assessing the urinary system include all but?
Responda
  • palpable right kidney
  • no CVA tenderness during fist percussion
  • no bruits over each CVA
  • skin turgor: instant recoil

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