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Medical-Surgical Nursing in Canada

Description

Med-Surg
M W
Quiz by M W, updated more than 1 year ago
M W
Created by M W almost 6 years ago
125
0

Resource summary

Question 1

Question
Which intraoperative complication is a widespread activation of the clotting cascade that results in the formation of clots in small blood vessels throughout the body, which as it consumes clotting factors and platelets disrupts normal clotting and can result in severe bleeding from various sites?
Answer
  • Malignant hyperthermia
  • Anaphylaxis
  • Disseminated intravascular coagulation
  • Medullary depression

Question 2

Question
If detected, which catastrophic event in the OR will result in anesthesia and surgery being halted, 100% oxygen administered, and client will be treated with dantrolene sodium?
Answer
  • Malignant hyperthermia
  • Anaphylaxis
  • Disseminated intravascular coagulation
  • Medullary depression

Question 3

Question
Malignant hyperthermia is a rare inherited disease where hyper metabolism of skeletal muscle resulting in altered control of intracellular calcium can occur in response to exposure to succinylcholine, a general anesthesia, but may also be triggered by trauma, heat and stress. This results in hyperthermia with rigidity of skeletal muscles. It can result in cardiac arrest and death. What is/are the first sign(s) of this occurring?
Answer
  • A rise in body temperature
  • Hypercarbia, tachypnea, and tachycardia
  • Hypercarbia, bradypnea, and bradycardia
  • Hypercarbia, tachypnea, and bradycardia

Question 4

Question
What is the most common cause of post-operative hypoxemia?
Answer
  • Pulmonary edema
  • Pneumonia
  • Atelactasis
  • Early ambulation

Question 5

Question
Most common immediate post-op complication include:
Answer
  • Hypotension
  • Hypertension
  • Dysrhythmias
  • Pneumonia
  • Atelectasis

Question 6

Question
Which of the following are interventions to prevent deep vein thrombosis and pulmonary emboli?
Answer
  • Leg exercises
  • Elastic stockings or compressive devices
  • Unfractionated or low-molecular weight heparin
  • Early ambulation

Question 7

Question
A transient cessation of bowel mobility that prevents effective passage of intestinal contents; typically resolves in 2-3 days with supportive treatment. Which condition is this?
Answer
  • Paralytic ileus
  • Postoperative ileus

Question 8

Question
Small bowel obstruction that results when peristalsis stops; bowel lumen remains patent, but contents of intestine are not propelled forward, producing severe nausea and vomiting; may be caused by neurogenic or muscular impairment. Which condition is this?
Answer
  • Paralytic ileus
  • Postoperative ileus

Question 9

Question
Meaghan, 26, should remain NPO after her abdominal surgery until
Answer
  • return of gag reflex
  • return of level of consciousness
  • return of bowel sounds
  • return of flatus

Question 10

Question
If no catheter, the post-operative patient is expected to void __________ within 6-8 hours after surgery.
Answer
  • 150 mL
  • 300 mL
  • 100 mL
  • 200 mL

Question 11

Question
Drainage from surgical wounds should change from sanguineous to serosanguineous to serous with progressively less output with surgical wound healing.
Answer
  • True
  • False

Question 12

Question
Infants and the elderly are at a higher risk for fluid-related problems/imbalances.
Answer
  • True
  • False

Question 13

Question
Potassium's normal range lab values are [blank_start]3.5[blank_end] - [blank_start]5.0[blank_end] mmol/L.
Answer
  • 3.5
  • 5.0

Question 14

Question
Sodium's normal range lab values are [blank_start]135[blank_end] - [blank_start]145[blank_end] mmol/L.
Answer
  • 135
  • 145

Question 15

Question
Normal arterial plasma pH is [blank_start]7.35[blank_end] - [blank_start]7.45[blank_end]
Answer
  • 7.35
  • 7.45

Question 16

Question
In arterial blood gases, a normal range for PaCO2 is [blank_start]35[blank_end] - [blank_start]45[blank_end] mmHg.
Answer
  • 35
  • 45

Question 17

Question
In arterial blood gases, a normal range for HCO3 is [blank_start]21[blank_end] - [blank_start]28[blank_end] mmol/L.
Answer
  • 21
  • 28

Question 18

Question
When using arterial blood gases and pH to determine acid-base imbalances, remember the acronym ROME: respiratory opposite metabolic equal.
Answer
  • True
  • False

Question 19

Question
Hypotonic solution results in cellular [blank_start]swelling[blank_end].
Answer
  • swelling
  • shrinking

Question 20

Question
Hypertonic solution results in cellular [blank_start]shrinking[blank_end].
Answer
  • shrinking
  • swelling

Question 21

Question
Serum creatinine levels [blank_start]increase[blank_end] when renal function decreases.
Answer
  • increase
  • decrease

Question 22

Question
Sudden body weight change is an excellent indicator of overall fluid volume. One litre of water weighs ______.
Answer
  • 1 lb.
  • 1 kg
  • 1 mg
  • 2 lbs.

Question 23

Question
The average daily urine output is 1500 mL, or 1 mL/kg/hr.
Answer
  • True
  • False

Question 24

Question
These are clinical presentations of fluid volume deficit, or hypovolemia:
Answer
  • dry mucous membranes
  • poor skin turgor
  • tachycardia
  • postural hypotension
  • distended neck veins
  • confusion
  • concentrated urine
  • weak, rapid heart rate

Question 25

Question
These are clinical presentations of fluid volume excess, or hypervolemia:
Answer
  • edema
  • distended neck veins
  • adventitious lung sounds
  • weak, rapid heart rate
  • tachycardia
  • weight loss
  • increased urine output

Question 26

Question
[blank_start]Hyponatremia[blank_end] is a frequently overlooked cause of confusion in the elderly.
Answer
  • Hyponatremia
  • Hypokalemia
  • Hypernatremia
  • Hyperkalemia

Question 27

Question
Which electrolyte imbalance has the following clinical manifestations: fatigue, N/V, decreased bowel mobility; parenthesis, decreased reflexes, muscle weakness, leg cramps, polyuria; weak, irregular pulse; ECG changes; hyperglycemia.
Answer
  • Hypocalcemia
  • Hypokalemia
  • Hyperkalemia
  • Hypernatremia

Question 28

Question
Which medication, in hyperkalemia, binds to potassium for excretion in feces?
Answer
  • Kayexalate
  • Naloxone
  • Dantrolene sodium
  • Vitamin K

Question 29

Question
Chvostek's and Trousseau signs are used to detect hypocalcemia, which often presents with numbness and tingling in extremities and around the mouth, as well as hyper reflexes and muscle cramps. [blank_start]Chvostek's sign[blank_end] is the twitching of the facial muscles in response to tapping over the area of the facial nerve. [blank_start]Trousseau's sign[blank_end] is carpopedal spasm caused by inflating the blood-pressure cuff to a level above systolic pressure for 3 minutes.
Answer
  • Chvostek's sign
  • Trousseau's sign
  • Trousseau's sign
  • Chvostek's sign

Question 30

Question
Metabolic acidosis is most commonly caused by renal failure. With acidosis, hyperkalemia may occur as potassium shifts out of the cell.
Answer
  • True
  • False

Question 31

Question
Metabolic alkalosis is most commonly caused by severe vomiting or excessive gastric suction. Hypokalemia will produce alkalosis.
Answer
  • True
  • False

Question 32

Question
Respiratory acidosis is always caused by a respiratory problem (hypoventilation) with inadequate excretion of CO2. Treatment is aimed at improving ventilation.
Answer
  • True
  • False

Question 33

Question
Respiratory alkalosis is caused by hyperventilation.
Answer
  • True
  • False

Question 34

Question
The RPN should not take blood pressures, nor should blood draws be done, on the extremity with the PICC line.
Answer
  • True
  • False

Question 35

Question
Clinical manifestations of infiltration include swelling, pallor and coolness, and pain at insertion site. Treatment for the peripheral IV site complication of infiltration is to stop the infusion and discontinue the IV, then elevate the affected extremity.
Answer
  • True
  • False

Question 36

Question
Extravasation, similar to infiltration but with an administration of a vesicant or irritant solution/medication into the surrounding tissues. Clinical manifestations are similar to infiltration, but blistering and necrosis of tissue can occur. Treatment for the peripheral IV site complication of extravasation is stopping the infusion and notifying the physician immediately, but leaving the IV cannula in place with warm or cold compresses based on the medication.
Answer
  • True
  • False

Question 37

Question
Phlebitis, manifesting as pain, swelling and a reddened area around the insertion site or along the path of the vein is treated by discontinuing the IV and applying a warm moist compress.
Answer
  • True
  • False

Question 38

Question
Thrombophlebitis is the presence of a clot plus inflammation. Manifests the same as phlebitis but client may experience immobility of the extremity because of pain, sluggish flow rate. Treatment is to discontinue the IV, initially apply cold compress followed by warm compress.
Answer
  • True
  • False

Question 39

Question
Treatment for the peripheral IV site complication of a hematoma is to discontinue the IV, apply pressure with a sterile dressing and ice to prevent extension of the hematoma.
Answer
  • True
  • False

Question 40

Question
Treatment for the peripheral IV site complication of an air embolism is clamping the cannula, placing the client on left hand side in Trendelenburg position, assessing vital signs, administering oxygen and notifying the physician.
Answer
  • True
  • False

Question 41

Question
For blood product administration, a larger diameter cannula is needed, usually 18-20 gauge.
Answer
  • True
  • False

Question 42

Question
For most IV therapy a 22 gauge catheter is sufficient.
Answer
  • True
  • False

Question 43

Question
The RPN should monitor the client and IV site _______ for signs of systemic and local complications related to peripheral IV therapy.
Answer
  • every 1-2 hours
  • every 4-6 hours
  • every half hour
  • qshift

Question 44

Question
Total parenteral nutrition tubing should be changed every 24 hours.
Answer
  • True
  • False

Question 45

Question
IV line tubing should be changed no more frequently than at a _______ hour interval, but at least every 7 days or immediately if contamination occurs.
Answer
  • 24
  • 96
  • 36
  • 48

Question 46

Question
You are caring for a 72-year-old female who underwent a hysterectomy, salpingo-oopherectomy, and bilateral pelvic lymph node dissection (LND). She is post-op day 2. You received handover this morning and the night nurse told you that the patient has had a low urine output. During your assessment, you notice that her extremities are cold, her BP is low, her HR is high, and she seems restless. You suspect that the patient may be experiencing...
Answer
  • Hemorrhage
  • Orthostatic hypotension
  • Emergent delerium
  • Hypovolemic shock

Question 47

Question
Signs & symptoms of ______________ shock include narrowing pulse pressure, tachypnea, hypotension, decreased urinary output, weak & thready pulse, hypoactive or absent bowel sounds, decreased cerebral perfusion (anxiety, confusion) and skin hypoperfusion (pale, cool, clammy).
Answer
  • Cardiogenic
  • Hypovolemic
  • Anaphylactic
  • Neurogenic

Question 48

Question
Signs & symptoms of ____________ shock include narrowing pulse pressure, tachycardia, tachypnea with crackles, hypotension and peripheral hypoperfusion.
Answer
  • Cardiogenic
  • Hypovolemic
  • Anaphylactic
  • Neurogenic

Question 49

Question
Signs & symptoms of ____________ shock include hypotension, bradycardia, skin dry with poikilothermia, temperature and dysregulation (risk for hypothermia).
Answer
  • Cardiogenic
  • Hypovolemic
  • Anaphylactic
  • Neurogenic

Question 50

Question
Signs & symptoms of ____________ shock include wheezing, stridor, flushing, pruritus, urticaria, respiratory distress and circulatory failure, sense of impending doom, chest pain, and swelling of the lips and tongue.
Answer
  • Cardiogenic
  • Hypovolemic
  • Anaphylactic
  • Neurogenic

Question 51

Question
Septic shock manifests with tachypnea/hyperventilation, temperature dysregulation, decreased urine output, altered neurological status, GI dysfunction, and respiratory failure is common.
Answer
  • True
  • False

Question 52

Question
Normal pulse pressure is 30-40 mmHg.
Answer
  • True
  • False

Question 53

Question
A modified Trendelenburg position (head elevated, feet elevated 30 degrees) is recommended for hypovolemic shock to promote venous return and increases circulating blood volume.
Answer
  • True
  • False

Question 54

Question
Blood is infused within 30 mins of pickup from blood bank and over 6 hours with Y-tubing.
Answer
  • True
  • False

Question 55

Question
Blood transfusion is recommended when Hgb is below 70 g/L.
Answer
  • True
  • False

Question 56

Question
Plasma is infused immediately after thawed, as rapidly as tolerated over 30-60 mins and is compatible for all with "O" type or own ABO group.
Answer
  • True
  • False

Question 57

Question
Blood should be infused slowly to start, no greater than 2 mL/min for first 15 minutes as most reactions occur within first 50 mL of administration.
Answer
  • True
  • False

Question 58

Question
________ reaction usually occurs when blood is transfused too quickly, presents with hypertension, bounding pulse, distended jugular veins, dyspnea, and restlessness/confusion. Nursing management is to stop transfusion, administer diuretics, apply O2 as needed and restart infusion slowly as directed.
Answer
  • TRALI
  • TACO
  • Febrile non-hemolytic
  • Acute hemolytic

Question 59

Question
____________ reaction in blood transfusion typically occurs within 2 hours of infusion and usually resolves within 24-72 hours. Manifests as hypoxia and bilateral pulmonary edema. Nursing management is to stop the transfusion, provide O2, and mechanical ventilation is required in 75% of cases.
Answer
  • TRALI
  • TACO
  • Acute hemolytic
  • Febrile non-hemolytic

Question 60

Question
Which of the following should the RPN teach the patient to avoid 72 hours prior to a fecal occult blood test?
Answer
  • Red meat
  • Vitamin C
  • NSAIDs
  • Poultry/fish

Question 61

Question
Post procedural education for a barium enema includes teaching the patient that bowel movements should change from chalky white/gray progressively to normal colour.
Answer
  • True
  • False

Question 62

Question
Ileostomy pouch should be emptied when _____ full.
Answer
  • 1/3
  • almost
  • 3/4
  • 1/4

Question 63

Question
Ostomy appliances should be changed ever 5-7 days and should be early in the morning before breakfast or 2-4 hrs after a meal.
Answer
  • True
  • False

Question 64

Question
Patients receiving enteral feedings should have HOB elevated 30-45 degrees during meal and for at least 30 mins afterwards to prevent risk of aspiration
Answer
  • True
  • False

Question 65

Question
Autonomic dysreflexia occurs in persons with an injury above T6. Symptoms include: severe pounding headache, sudden increase in blood pressure, profuse diaphoresis above level of injury, bradycardia.
Answer
  • True
  • False
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