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176 Cards in this Set
- Front
- Back
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For the client that needs surgery or medical attention-the nurse knows...
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The client has the right to refuse.
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Client is in a manic state and is being verbal and laughing loudly or inappropiately. The nurse will...
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Gain the client's cooperation by calming him down by talking to him.
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What is a high indicator that a client will exhibt abusive behaviors?
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The client has a past history of abuse or being abused.
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Patient is very anxious, the nurse's goal is to....
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Decrease or reduce the patient's anxiety to tolerable amount.
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Your patient is very fearful. What priority action will you plan to perform?
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Meet with the patient often for his reassurance and perform status checks on his well-being.
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Patient tells the nurse that the antidepresant he is on makes him very sleepy. What should the nurse do next?
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Consult with the doctor to see about a change in the timing of the administration of the medication.
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Patient suffers a traumatic event. When should they begin therapy and how long should they continue in therapy?
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Begin right after the event and continue the therapy as long as it is needed.
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Client has suicidal ideations with a history of attempts. What should the nurse assess first?
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If they are currently wanting to hurt themself; if they have a plan to for hurting themself.
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What is the first action you take with a patient that is sucidial?
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Establish a mutually agreed upon "no harm to self" contract.
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To help the depressed client what should the nurse do?
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Provide him with an individual schedule of daily activities.
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A patient is terminal and the nurse must explain to the family that the patient is in the process of passing. What does the nurse expect to see as a reaction from the family?
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Anticipatory grief.
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Client asks the nurse what the purpose or reason of group therapy is?
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To provide support from people with similar, same, or similiar-like problems to each other.
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Client with alcohol addiction states she does not want to attend AA because of all the drunks. What is the nurse's best response?
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Group will help to provide support to remain sober through sponsorship and a structured program.
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What is the benefit of a self-help group?
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Assists the client to develop coping skills and shows the client that others have the same or similar issues as the client and that they are not alone.
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Client that have anti-social disorder tend to be good at?
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Academia
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You gain __________ when you learn to look at yourself through the preception of others.
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insight; self-awareness; prespective; sense of self; ability to identify undesireable behaviors, etc.
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Client suffering from anorexia has?
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Low self-esteem; distorted body image
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If you witness an UAP violating HIPPA what should you do?
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Report it to their nurse manager
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ECT is used to treat what main disorder?
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Depression
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Client has just undergone ECT prodecure. What do you do after verifying their safety?
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Orient them to place, person, time, etc. Short-term memory loss is expected.
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What should you teach a patient receiving xanax?
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Do not operate or drive machinery.
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Nurse performing in the role of a manager. What does the nurse need to know?
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Not only does the nurse need to have clinical knowledge but also have the ability to instruct others.
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Nurse managers need to understand what 2 legal responsibilities when it comes to making assignments?
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Must assess how much supervision is needed and if the staff is compentent to perform the needed skills.
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What does nonmaleficence mean?
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Doing no harm either intentially or not.
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What is benefiance?
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Doing good for the sake of doing good.
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What must a nurse do before leaving the floor to take a break?
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Make sure that your patients have another nurse assigned to care for them during your absence.
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What does empowerment do for the nurse?
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It provides the nurse with a sense of self-determination; increases confidence; team mindset (us, we and not I or me).
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Patient is terminal, wife wants him to die with dignity. What must be done?
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Patient's wishes must be known and provided in the form of a legal document--living will, advanced directive.
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What is an example of effective communication?
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Client feedback.
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What does the term "tort" mean?
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A wrongful act committed against a person or their property
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Quasi-intentional tort is what?
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Something that someone in their right mind would not do. A voluntary act that directly causes injury or anguish without meaning to harm or cause distress. For example: breech of confidentiality.
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What is an intentional tort?
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False imprisonment (taking a patient's clothes to prevent leaving the hospital)
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Voluntary commitment
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Rules: Patient can only leave if they are not a danger to themselves or others -- need administration to approve their leave.
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Involuntary commitment
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Patient has the right to a court trial and legal representation.
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Board of Nursing does all...
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monitor CEU compliance and approval of CEU
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What is culture?
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attitudes, values, and behaviors
integrated pattern of behavior that is learned and passed down to future generations and includes thoughts, speak, actions, and artefacts. |
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What should the nurse do to help prevent respiratory infection?
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suction the patient
mantains airway and promotes gas exchange by removing excretions that pt cannot clarify himself/herself |
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What is chronic otitis media?
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fullness of the ear
inflammation of the inner ear: swelling irritation purulent drainage chronic and usually follows episodes of acute otitis media |
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When teaching the patient taking bactrim what should be included?
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take it as prescribed/finish the whole regimen
also called: Trimethoprensulfamethoaxacoli ask pt drink a full glass of water, push fluid while taking it, cause photosensitivity, ask for allergies. |
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Patient presents with a CVA in ER what is the priority nursing action?
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assess respiratory status
pt must be evaluated within 10 minutes of arrival and priority is ABC's time is: brain tissue damage |
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Dilantin (phenytoin)
(Antiepileptic: Seizures) Before the nurse gives the patient Dilantin, what should she assess for? |
assess respiratory status, mental status, and seizure activity.
It causes gastric distress, gingival hyperplasia, anemia, ataxia, nystagmus. Labs to watch: CBC, Calcium, and therapeutic drug values |
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Patient is prescribed steroids, what is the nursing goal?
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Prevent infection
The medication is to Reduce inflammation Corticosteroids have both antinflammatory and immunosuppressive effects |
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Patient presents with a right -sided stroke what will the nurse find in her assessment?
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Left sided visual, preceptual, depth and distance distrubances. Patient will have trouble reading body language and preforming their ADLs.
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The patient with MS will have damge to what?
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Damage to the mylelin sheath.
Auto immune, eats away the mylelin sheath and interfers with nerve conduction. |
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Patientes with Myasthenia gravis will suffer from what type of neuro defect?
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Defect in transmission of neuromuscular junction.
Chronic condition--fatigue, weakness, in muscles that are intervated by the cranical nerves. Remissions and flare ups, effects women more so at 20 - 30 years old. |
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Brain tumors
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Occurs anywhere within the brain structure, however, cerebral tumors are more common. Primary tumors within the brain rarely metz. Secondary brain tumors are from metz. 40-70 years old have greatly risk.
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Child presents with froglike sound and drooling what should the nurse's actions be?
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Notify the MD and prepare to intubate.
Acute epiglotitis is life-threathening rare complication of pharyngitis. If stridor present have seen by doctor ASAP; have trach tray ready at bedside. |
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Newborn diagnosised with a myelomenigocele what is the nursing priority?
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Measure head circumference daily.
Protect the pouch by applying sterile wet dressing. Neurogenic bladder. Prevention is folic acid. |
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If drainage is clear or cloudy check to see if it is CSF by checking for the presence of ____ in the fluid?
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glucose
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Hoffman's syndrome
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Child has difficulty rising from a squatting position and cannot climb stairs due to muscle weakness and atrophy.
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Who sets the Standards of Care for the nursing profession?
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Board of nursing
BON is the enforcement agency; ANA and the nurse practice act, |
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A an infant born with a mylelonmenigocele will have what renal issue?
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neurogenic bladder
high risk for hydrocephalus; high risk for latex allergies. |
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Yalom Theory
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Psychological group therapy that focuses on the following: alturism; catharisis; universiality; existential factors responsible for one's own actions; self awareness; psycho-drama; family reinaction; guidence from group; identification through becoming self-aware by modeling of correct behavior from other group members; positive outlook gained through seeing the improvement of others causing an instillation of hope; empathy gained through interactions with others.
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ALS (Lou Gehrigh's Disease)
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40 to 70 years old, men more than women, adult onset upper and lower motor neuron disease. S&S: muscle weakness; wasting; spasticity; leads to paralysis; no cure. Maintain fuction and quality of life.
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What antipsychotic medication can cause maligant hyperthermia?
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lithium
Presents as: muscle termors, unstable blood pressure; changes in LOC; deliurm; coma. |
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Patient's diagnosed with hypercortisol (Cushing's) are at risk for?
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skin breakdown, infection, GI ulcers
women more than men; decreased metabolism; buffulo hump; moon face; trunkal obesity; thin skin; decreased immune response; hair growth in areas of face, etc, increased glucose. |
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What is the function of the parathyroid gland?
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Excrets parathyroid hormone which regulates serum calcium blood levels within the body.
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Damage to Cranial nerve two affects the patient's muscular control over the eyelid but does not cause what type of change?
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Does not cause changes in the patient's ability to use facial expressions.
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What is the clinical presentation of hypoglycemia?
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Paitent will be shaky
BGL of less than 50-60 S&S: Irribility; shaky; seziures; hypotenisve; termors; cool, clammy, skin; sweating -- Provide juice, candy |
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What three classic signs does a patient with Diabetes (hyperglycemia) present with?
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ployuria, ploydipsia, polyphagia
300 or more BGL HA; drowines; weakness; stupor; dry and hot skin |
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What is the basic action taking place in the brain during a seizure?
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abnormal electrical discharge
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What does a cerebral angiogram allow the doctor to see?
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To visualize circulation of the brain, head, or neck checking for blockage of the artery. Contrast medium used, check for iodine allergy (shellfish).
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Steriods used in treatment of ICP , what is the desired result?(brain edema) (manitol)
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Results in decreased edema of the brain.
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Client with migraine headache will present with which symptoms?
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visual disturbances
photophobia, aura |
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Client is on anticonvulsants, what is the prority teaching?
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Do not abruptly stop the medication. It must be tappered over time.
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Client presents with a masklike apperance which is indicitive of
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Parkinson's
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Parkinson's clients will have the following key features:
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stooped posuture; slow and shuffling gait, pill rolling, termors; soft low-pitch speech.
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Parkinson's is caused by
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A decrease in the neurotransmitter, dopamine. Progressive disorder that results in degeneration of neurons.
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What is a nursing action to assist in the decreasing of ICP?
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Elevate HOB by 30 degrees (semi-fowlers position)
maintain head in midline, neutral position. Avoid flexing the neck; during turning of patient use the log roll technique. |
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If spinal shock is unresolved the client progresses to a state of
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hyperesthesia
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Client has spinal cord injury to T-5 and presents with a B/P of 185/95 what is the nursing priority?
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Assess for bladder distention.
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Autonomic Dyserflexia
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Damaged done to spinal cord through injury, invloves the sympathetic nervous system. If client present with increasing vials (BP, resp, etc) check for bladder distention and/or fecal impaction.
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What is the drug of choice to decrease inflammation and preserve function in a client presenting with a spinal cord injury?
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methylprenisolone (Solumedrol)
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What methods are used to prevent complications of a CVA (immobility)?
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Apply TED hose to prevent venous stasis ulcers
Ambulate patient as soon as safe to do so Place SCD's on the patient (Ted hose) to prevent venious statis ulcers and promote blood return Reposition q2 hours |
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Client demostrates understanding of self-care post CVA when they
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Use the unaffected side to assist the affected side with ROMs.
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Guillian barre and myasthenia gravis both have the following characterics in common.
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Both disease processes affect the respiratory system and cause muscle weakness with paraylsis.
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Newborn (0-30 days) presents with a heart rate of 162. What is the priorty action of the nurse?
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Document the finding is the only action taken.
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What should the nurse teach the UAP that upsets a client with Parkinson's when the UAP performs ADLs for the client?
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Teach the UAP to allow the client to be as independant as possible and to praise the client for attempting their own ADLs.
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What is the priority nursing action when repositioning a patient with Cushing's?
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Use a lift sheet and not the patient's arms (no pulling on the patient) due to brittle bones.
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What is the difference between MS and Gullian barre?
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In MS the patient will experience dysarthria (difficulity with speech).
MS targets the Central Nervous System (CNS) while Guillain-Barre targets the Peripheral Nervous System (PNS). |
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Patient that suffers a CVA on the right side will have problems in what area of the brain?
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Wernickes area the area that stores and houses language (patient will have issues with comprehision of the written or spoken word).
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Dilantin
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Used to treat sezuires. Therapuetic level is 10-20 mcg/ml. Do not use with alochol and do not stop taking suddenly, maintain good oral hygeine. Advise patient to wear medical alert braclet.
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MAOI's are used to treat which type of depressive disorder?
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atypical depression
MAOI drug examples: Marplan, Nardil |
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What presidoses a client to the likeihood of developing pancreatitis?
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Chronic alcohol use.
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Diabetes insipidus clients will present with
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Ployuria (causes dehydration) and ploydypsia (increased thrist).
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Client presents with an inhalation burn what might be the outward signs?
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Singed nasal hair; burns to face, neck or chest, soot or ash on the face.
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What is the nursing priority for a patient with inhalation burns?
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Nurse should be prepared to maintain patent airway with possible intubation.
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A four-year old presents with burn injuries to the ER, they are at risk for?
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Fluid imbalance
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Name one type of mixed cardiac defect?
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Transposition of great arteries
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What are the postop care functions for a thyroidectomy.
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HOB elevated 30 degree
vitals q 15 min and then q 30 min until stable Use sandbag or pillows to stablize neck Suction as necessary |
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What would you use to irrigate a patient's eyes that has expothalamos?
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Warm water
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Patient with acromegaly presents with enlarger liver upon assessment. What is the nursing action required?
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Document finding.
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Client presents with a high fever what is the nursing priorty to assess for?
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maligant hyperthermia (caused by drugs used for general anesthesia). S&S: hypercalcemia, hyperkalemia which can lead to cardiac dsyrythmias.
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Client is experiencing sudden sever pain in the abdomen post-operatively with distention. What is the action of the nurse?
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Notify doctor.
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Where to assess the patient for scabies?
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Assess for lessions between fingers; elbows; wrist; linerar burrowing. Sever itching, wrose at night, contiagous, last 2 to 3 weeks.
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Client present with moles on skin what should the nurse ask the client?
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Have your moles changed in appearance? size, shape, location, color, border. (Refer to derm if they are bluish in color, with irregular color).
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Client states they have a presistent rash. The nurse should ask the patient what?
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What is your occupation?
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Nurse assesses patient with a cast and finds normal pulses. What is the next step the nurse should do?
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Elevate the arm.
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Patient has a cast and is complaining of swelling in the extermity. What is the nursing action needed?
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Check for pulse distal to cast, cap refil, temp of limb, then if normal elevate the arm.
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What is contraindicated for a patient in skeltal traction?
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Performing ROM to the affected area.
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What are positive signs for a residual limb post amputation?
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Pink and warm to the touch.
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In what position to you place a patient post operatively after eye surgery?
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Prone with the affected eye up
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What medication is contraindicated for patients that have had eye surgery?
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ASA due to the risk of increased bleeding.
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Patient needs further education post-operatively after eye surgery when they state?
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I will place items on high shelfs to keep them away from my child.
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For a patient with macular degeneration where is the best place to place the TV?
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To either side
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Client presents with an obstruction in the ear. What should the nurse not do?
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Do not provide irrigation
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What is the correct nursing action when administring eye drops to a patient?
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Hold the inner canthus to prevent systemic absorption.
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Client states that they experience a sudden flash of light in their eye and now see dots floating around. The nurse should assess for
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Retinal detachment/tear.
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Client is unable to close the lid of their right eye. The nurse should assess for damage to which cranial nerve?
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C II
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Medication for glaucoma -- used to test the patient for the disorder.
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ocular dialators
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What occurs in tetralogy of fallot?
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There is a decrease of available O2 and the child has to squat to breath better.
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Patient with sensory-based hearing loss asks the nurse about a hearing aid. The nurse states?
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Sorry, but with your type of hearing loss a hearing aid will not help.
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What puts a patient at greater risk for post-surgical incision or wound dehishence?
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Flatus (gas build up)
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What is the purpose of a low residual diet?
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Produces less stool in the bowel.
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An adult female has deficiency of most anterior pituritary hormones what is most important to ask the patient about her history?
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Have you had a postpartum hemorrhage?
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What is a critical teaching point to tell a client that is taking lithium?
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To call the doctor if they experience nausea and vomiting.
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Crisis before resolution
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Will take four days
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For safety of bedridden clients what should the nursing action be to prevent injury?
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Use a lift-sheet when moving the patient in bed.
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Menieres disease
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tinnitus, vertigo, decreased hearing --can be brought on by too much sodium in the diet.
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Regurgitation patient is at risk for what?
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Aspiration of regurgitated contents from the stomach into the lungs. Can pose a greater risk for the client of developing aspriation pneumonia.
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The nurse should suspect pyloric stenosis in an infant if there are what signs?
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Visible peristalsiss (or palpable) usually seen after feeding...the stomach is trying to force it's content through the narrowed ployric opening.
Projectile vomiting |
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The nurse should withhold the medication called accutane when?
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If the client is pregnant.
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Crohns disease is different to diagnose due to which characteristics?
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There are periods of remission and exacerbation.
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Assess the client with chronic or repeative bladder infections for what condition?
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Bladder retention with urinary statis which causes a buildup of bacteria in the residual urine.
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When assessing a patient what is the last thing you assess for?
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Pain.
Airway Breathing Circulation Pain |
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Patient with chronic gastritis is concerned about gastric cancer.
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Tell them that with proper disease mgt there is little risk of developing gastric cancer.
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Patient was in an MVA and suffered a compresion fracture. They are at higher risk for developing?
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paralytic ileus
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Osteoporosis
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Women are more at risk
-post menaposal -small frame -cuasain |
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A patient that is diagnosed with osteoporosis is at greater risk for what?
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Pathological fractures
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The nurse cares for a unconcious child what is the top nursing priority for preventing skin tears?
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Use a lift-sheet when moving or transfering the patient.
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Client is diagnosed with rheumatic fever. What is the usual cause of this illness?
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Streptococcus pyogenes
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Patient is post-operative hip replacement. What is the nursing priority for this patient?
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Avoid dislodgement of the prosthesis.
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Patient has a residual limb with placement of a prosthesis. What is the nursing action needed to prevent redden area on stump?
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Apply extra gauze to provide cushioning and prevention of skin breakdown.
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Nurse is placing an NG tube in a patient, what should she ask the patient to do as she is inserting it?
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Ask patient to swallow
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Patient's with an irritated stoma should be taught to?
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Expose the stoma to air but not to clean it with betadine
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Patient is having a gastroscopy prodecure done what should the nurse do before the patient goes for this procedure?
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Placement of an NG-tube.
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What is the clinical presentation of psoriasis?
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Thick reddened papules covered with white-slivery scales.
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Patient presents with unilateral lession that are painful, this is indicative of?
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herpes zoster (shingles)
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Botulism is often caused by?
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Honey
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When providing patient teaching to a patient that suffers from gout it is important to instruct them to avoid eating?
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Organ meat such as liver, kidney, gizzards.
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One possible cause of ascites is the collection of ______in the peritional cavity.
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Protein or other fluid.
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Patient diagnosed with cholecystitis should be advised by the nurse to restrict what from their diet?
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Limit fat intake and increase fluids.
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Post-operative patient who had a cholectomy is at a higher risk for developing?
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paralytic ileus
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The nurse receives orders to make a patient NPO. What teaching does she need to provide the patient?
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Teach patient that NPO means they may have nothing my mouth=no foods, no drinks (including water)
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The nurse is caring for a child that is not eatting. The nurse should do what?
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Offer the child food and snacks often during their shift.
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The nurse knows that if a patient is on dilantin they need to be instructed to perform?
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Good oral care to prevent gum disease.
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A patient suffering from liver complications will present with what abnormal labs?
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Elevated PT and INR
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A patient that is taking which pain reliever is at great risk for developing disorders relating to the hepatorenal systems?
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Acetaminophen
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Teaching for a patient suffering from gout should include avoiding which OTC pain reliever?
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ASA (due to it's rapid changing of uric acid levels).
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A client post-operative from a gastric surgical procedure (gasrtic bypass or colon resection)is at greater risk for developing what complication?
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Dumping syndrome
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Client suffering from musculoskeletal disorder what is the priorty?
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Assessing for fatigue
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When providing teaching to an older client with RA the nurse includes what in her teaching plan?
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Repetitive movement based activities such as crocheting and working jigsaw puzzles increase the risk of excerbation.
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Client has a prolonged PT reported on his last lab results. What medication would the nurse identify as the cause of this?
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Coumadin
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What is a complication of hyperparathyroidism?
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Dehydration
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Terminal caner patient what is the restriction on pain medication administration?
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As long as there is no other treatment that will help the patient, there is no restriction on pain medication administration.
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Having study done (possibly gallbadder study)
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Drink plenty of fluids (to facilitate flushing out of dye or barium)
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Client that presents with liver problems that has an albumin lab value of 2.8 is correct when he states he will have what to eat?
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Spinach salad
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What major organ is most often affected by lupus?
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Kidney (and the heart)
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What is a rheumatic disease?
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Any disease that invloves the muscloskelteal system.
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Teaching for a patient on Lithium should include teaching him to call the doctor if he experiences?
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Nausea and vomitting
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Patients diagnosed with osteoporosis are at greater risk for developing what type of fracture?
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Pathological
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A patient that presents with digoxin toxicity will have the following symptoms.
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Confusion
Irregular pulse Loss of appetite Nausea, vomiting, diarrhea Palpitations Visual changes (unusual) Blind spots in vision Blurred vision Changes in color perception Halos or rings of light around objects Seeing lights or bright spots |
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What is it when a patient experiences a "blackout?"
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It is a period of time that the patient cannot recall.
Patient has lost all memory of that timeframe. |
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A patient that is suffering from alcoholism is correct when he states?
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"I need help."
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What classic symptoms will the nurse see in a client with alcohol withdrawal?
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Tachycardia and diaphresis
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What are the four classic presentation signs that are required for a diagnosis of Tertalogy of Fallot?
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Pulmonic stenosis, right ventricular hypertrophy, overriding aorta, ventricular septal defect
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What is an example of normal developmental play for a two year old?
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Building a tower of blocks
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What is it termed when a new nursing graduate is on the job and is having a difficult time adjusting?
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Reality Shock
(cuz there ain't no such place as NCLEX land, lol) |
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What is one way for a nurse to manager burnout?
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Talk over things with her manager
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When a process or procedure change is needed what type of leadership is needed?
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Authoritative
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What is transformational leadership?
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Demorcratic, participative, visionary (getting the employees to buy into the change)
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The purpose of leadership is for a team or group to?
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Acheive a goal
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A nurse comes up on a traffic accident and should or should not stop to offer aid?
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May not stop if she is unable to provide aid or feels unsafe. If she stops to offer aid then she is protected by the Good Samaritain Law and is not liable.
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A nurse is responsible for ensuring the consent has been signed for a surgical procedure. What is the purpose of her signature on the consent form?
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It simply means that she witnessed the patient sign the form.
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A nurse must assess what in a patient before they witness the patient sign a consent form?
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That the patient is cognitant and able to understand the information provided by the doctor.
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An RN should be assigned to what type of patient with immunocomprise?
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HIV/AIDS
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