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24 Cards in this Set

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1. While caring for a patient who has cirrhosis of the liver, the nurse should recommend meals that are which of the following?
High in fiber
Low in carbohydrates
High in fluids
Low in sodium
Correct answer: Low in sodium
Explanation: A low sodium diet will help to reduce fluid retention, which contributes to ascites.
5. It is important for the nurse to do which of the following when caring for a patient who is taking Colace (docusate sodium)?
Encourage a bland diet
Encourage at least 2500 ml of fluid daily
Give a cleansing enema PRN
Encourage a high protein diet
Correct answer: Encourage at least 2500 ml of fluid daily
Explanation: For this medication to work properly, it is essential that the patient receive at least 2500 ml of fluid daily.
7. What is the earliest symptom of a fat embolism?
Weakness on the left side of the face
Confusion
Difficulty breathing
Pain in right shoulder
Correct answer: Confusion
Explanation: A fat emboism causes low arterial oxegen levels which will result in confusion.
1. While caring for a client with PVD, the nurse should assess for all of the following except:
Pain
Peripheral pulses
Skin temperature
Tachycardia
Correct answer: Tachycardia
Explanation: While caring for a patient with PVD, the nurse should assess for pain, peripheral pulses, and skin temperature.
5. What is the earliest symptom of a fat embolism?
Weakness on the left side of the face
Confusion
Difficulty breathing
Pain in right shoulder
Correct answer: Confusion
Explanation: A fat emboism causes low arterial oxegen levels which will result in confusion.
7. While caring for a patient who just underwent a cholecystectomy, how should the nurse position the patient to relieve pain?
Trendelenburg
High Fowler's
Laying on right side
Laying on left side
Correct answer: Laying on left side
Explanation: A patient who just underwent a cholecystectomy should be positioned laying on their left side to relieve pain.
In which of the following conditions would the nurse expect to assess steatorrhea (fatty stools)?

gastritis
duodenal ulcer
irritable bowel syndrome
malabsorption syndrome
malabsorption syndrome
Which of the following assessment findings would the nurse expect in a client diagnosed with osteomyelitis?

petechiae over the chest and abnormal ABG results
negative blood culture results and a normal temperature
leukocytosis and localized bone pain
hyperuricemia and pruritus
leukocytosis and localized bone pain
When monitoring a client for early signs of increasing intracranial pressure, the nurse should be particularly alert for which of the following?

elevated temperature
pupillary changes
difficulty arousing the client
decreased blood pressure
difficulty arousing the client
Which of the following would be the most important consideration in providing emergency care to a person with a possible cervical spinal injury?

monitoring vital signs every 5 minutes
immobilizing the head and spine in proper alignment
placing the neck in position of flexion
checking to see if the client can move his toes
immobilizing the head and spine in proper alignment
A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?
A: Diverticulosis
B: Hypercalcaemia
C: Hypocalcaemia
D: Irritable bowel syndrome
(B) Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion.
A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?
A: IgA B: IgD
C: IgE D: IgG
IgG is the only immunoglobulin that can cross the placental barrier.
A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in?
A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation
B) Initiative vs. guilt- 3-6 years old
A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in?
A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation
Trust vs. Mistrust- 12-18 months old
A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal?
A: 11 year old male – 90 b.p.m, 22 resp/min. , 100/70 mm Hg
B: 13 year old female – 105 b.p.m., 22 resp/min., 105/60 mm Hg
C: 5 year old male- 102 b.p.m, 24 resp/min., 90/65 mm Hg
D: 6 year old female- 100 b.p.m., 26 resp/min., 90/70mm Hg
(B) HR and Respirations are slightly increased. BP is down.
A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute?
A: Decreased HR
B: Paresthesias
C: Muscle weakness of the extremities
D: Migranes
(D) Answer choices A-C were symptoms of acute hyperkalemia.
A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?
A: Vomiting
B: Extreme Thirst
C: Weight gain
D: Acetone breath smell
(C) Weight loss would be expected.
A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?

A: Yersinia pestis
B: Helicobacter pyroli
C: Vibrio cholera
D: Hemophilus aegyptius
(D) Choice A is linked to Plague, Choice B is linked to peptic ulcers, Choice C is linked to Cholera.
A 20 year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first?
A: Blood sugar check
B: CT scan
C: Blood cultures
D: Arterial blood gases
(C) Blood cultures would be performed to investigate the fever and rash symptoms.
A mother is inquiring about her child’s ability to potty train. Which of the following factors is the most important aspect of toilet training?
A: The age of the child
B: The child ability to understand instruction.
C: The overall mental and physical abilities of the child.
D: Frequent attempts with positive reinforcement
(C) Age is not the greatest factor in potty training. The overall mental and physical abilities of the child is the most important factor.
A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank 20 minutes. Which of the following is the most important instruction the nurse can give the parent?
A: This too shall pass.
B: Take the child immediately to the ER
C: Contact the Poison Control Center quickly
D: Give the child syrup of ipecac
(C) The poison control center will have an exact plan of action for this child.
Acetaminophen (Tylenol)
Therapeutic: 1-30 mcg/ml
Toxic: >200 mcg/ml
Contraindicated in:
Liver disease
Side Effects of Toxicity:
Hepatic Necrosis
Digitoxin
Contraindicated in:
Uncontrolled ventricular arrhythmias, AV block
Side Effects of Toxicity:
Abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias.
How should the nurse position a patient who has a ruptured appendix?
Supine
Trendelenburg
High Fowler's
Semi-Fowler's
Correct answer: Semi-Fowler's
Explanation: This promotes the flow of drainage to the pelvic region.