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74 Cards in this Set

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1.) A preoperative client with emphysema is receiving oxygen at 2L/min via nasal cannula when the client reports shortness of breath. The spouse asks the client to increase the oxygen intake to help the client breath easier. Which response by the nurse is appropriate?
a. Explain to the spouse that high concentration of oxygen may depress breathing.
2.) Which of the following arterial blood gas (ABG) reports would the nurse expect in a client advanced chronic obstructive pulmonary disease (COPD)?
d. pH 7.30, PaCO2 60mmHg, PaO2 70mmHg, HCO3 30mEq/l
3.) For a patient with advance chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?
c. Using a high-flow venture mask to deliver oxygen as prescribed
4.) The nurse is making home visit to 70 year old client with emphysema .The nurse would call the client’s primary care provider if which of the follow was present?
b. More frequent cough with change in the character of the secretions
5.) A nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which of the following would the nurse expect to note on assessment of the client?
b. A hyperinflated chest noted on the chest x-ray
The nurse is teaching the client the appropriate way to use a metered dose inhaler. Which action indicates the client needs additional teaching?
c) The client waits 15 seconds before using the inhaler a second time.
A male patient is admitted to the health care facility for treatment of chronic obstructive pulmonary disease. Which nursing diagnosis is most important for this patient?
d.) Impaired gas exchange related to airflow obstruction
A home health nurse who performs a careful safety assessment of the home of a COPD patient to prevent harm to the patient is acting in accord with which of the principles of bioethics?
e.)Nonmaleficence
1. A nurse is caring for a client who had a myocardial infarction (MI) 24 hour? At this time, it is essential for the nurse to look for which of the following?
c. Ventricular dysrhythmias
2. Modification of lifestyle behaviors to help manage hypertension does not include which of the following? (select all that apply)
d. Alcohol intake with meals
3. Which of the following is the most common symptom of myocardial infarction?
a. Chest pain
4. What is the primary reason for administering morphine to a patient with myocardial infarction?
d. To decrease oxygen demand on the client’s heart
5. What supplemental medication is most frequently ordered in conjunction with furosemide (Lasix)?
c. Potassium
6. Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage?
d. Electrocardiogram
7. Ms. Jones has been diagnosed with angina and told to follow a low-cholesterol diet. Which of the following meals should a nurse tell the client would be best on her low-cholesterol diet?
c. Spaghetti with tomato sauce, salad and skim milk
8. Which of the following findings will help a nurse distinguish angina from an MI?
a. Angina can be relieved by rest and nitroglycerin.
9. Along with persistent, crushing chest pain, which signs/symptoms would make a nurse suspect that the client is experiencing a myocardial infarction?
b. Diaphoresis and cool, clammy skin
10. A client is diagnosed with myocardial infarction. Which referral would be appropriate for the client?
c. Cardiac rehabilitation
11. The nurse is caring for a client diagnosed with myocardial infarction who is experiencing chest pain. Which interventions should the nurse implement? (select all that apply)
b. Administer an aspirin orally
c. Apply oxygen via a nasal cannula
12. The client diagnosed with a myocardial infarction asks the nurse, “Why do I have to rest and take it easy? My chest doesn’t hurt anymore.” Which statement would be the nurse’s best response?
a. “Your heart is damaged and needs four (4) to six (6) weeks to heal.”
13. When planning emergent care for a patient with a suspected MI, the nurse will anticipate administration of
a. Oxygen, nitroglycerin, aspirin, and morphine
1.) A patient is unconscious and does not respond to pressure on nail beds or supra orbital ridges. His Babinski reflex shows fanning of his toes. With loud noises, the patient extends his arms and legs rigidly, rotating them inward. What is his Glascow Coma Scale score?
C. 4
With loud noises, your patient extends his arms and legs rigidly, rotating them inward. You learned about two types of posturing. What type of posturing is your patient presenting with? Which type of posturing is the worst?
D. The patient is presenting with Decerebrate and Decerebrate is the worst.
.) A patient’s CT indicated a herniation of the brain stem. This would also be indicated by:
B. His right pupil being fixed and dilated, the left being sluggish at 3 mm
.) A patient has damage associated with his CVA on the right side of his brain. Where should the patient’s lunch tray be placed to best meet the needs of the patient?
B. On the patient’s right
You are completing a neurological assessment of an unconscious patient. What cranial nerves are being assessed by checking the pupils, eye movements, and corneal reflex?
B. V and VII
A patient presents to the ED with BP 199/84, HR 53, RR 12. Pt has unequal pupils and does not respond to pressure on nail beds. With these findings which of the following is an appropriate description of a diagnostic test (how would you describe it to the patient)?
C. It is a test the combines a series of x-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside your body
What is the third leading cause of death in both men and women?
C. CVA
.) If a patient wishes to donate his Organs after death he must
Have an advanced Directive
or
Have the consent of his living family members
.) Which medication (s) is used to treat an ischemic stroke?
A. Antiplatelet medications
B. Anticoagulant medications
C. Thrombolytic medications
D. All of the above
.) Which of the following places clients at an increased risk for having a CVA?
A. HTN
B. DM
C. Hyperlipidemia
D. All of the above
What are the signs of a stroke?
A. Numbness or weakness of the face, arms, and legs, sudden confusion and headache.
1. What is the therapeutic range for Lithium?
d. 0.6-1.2
2. A client diagnosed with Bipolar Disorder who has been taking lithium for 10 months calls the clinic and tells the nurse, “I’ve had nausea, vomiting and diarrhea but I don’t think I have the flu.” What is the best response for the nurse to give this patient at this time?
d. Instruct the client to withhold his next dose of lithium until levels can be drawn
3. Which of the following is the most commonly prescribed medication for the treatment of bipolar disorder?
c. Lithium
4. A nurse is working in an inpatient mental health facility. Which of the following patients presents the highest priority for intervention?
b. A bipolar patient who reports insomnia
5. A nurse caring for a patient who starts exhibiting aggressive behaviors on the unit realizes the top priority is to
e. remove dangerous objects from the patient’s environment
6. A nurse knows that a patient has lithium toxicity when the patient
c. has muscle twitching
A nurse is teaching the family of a patient with bipolar disorder to recognize the signs of acute mania. Which of the following is an example of this demonstration that the family should report?
d. Inability to sleep
8. A client with bipolar disorder has recently started taking lithium. The nurse knows her instruction on the drug has been effective when the client states
d. “I should eat a regular diet with normal amounts of salt and fluids”
1. An appropriate nursing diagnosis for a client with Addison’s disease would include which of the following assessments?
a. Risk for injury
2. Nursing care for a client with Addison’s disease may include which of the following goals?
e. Participating in relaxation techniques
3. The nurse enters the room of a 43-year old woman who has just been diagnosed with Addison’s disease. Which of the following assessment findings should be reported to the physician immediately?
b. A blood glucose of 47
4. A nurse is preparing to provide instructions to a client with Addison’s disease regarding diet therapy. The nurse knows that which of the following diets most likely would be prescribed for this client?
c. Normal sodium diet
5. The nurse is aware that which of the following statements made by the client indicates a correct understanding of steroid therapy for Addison’s Disease?
a. “I’ll take the medicine in the morning because if I take it at night it might keep me awake.”
6. A female patient is admitted to the hospital with a diagnosis of Addison’s disease. She exhibits signs and symptoms of hypotension, hypoglycemia, and low sodium. She asks the nurse why she is hypotensive. The nurse is correct when she tells the patient that hypotension is caused by a decrease in production of
d. Mineralocorticoids
7. A patient with Addison’s disease asks the nurse to discuss with him the characteristics of the disease. Which of the following statements by the nurse is MOST accurate? “Addison’s disease is characterized by
a. Decreased mineralocorticoid, gluccocorticoid, and androgen secretion.”
8. The nurse knows that the patient understands the signs and symptoms of Addison’s disease when he states
b. Bronze coloration of the skin, postural hypotension, decreased tolerance to minor stress, poor coordination, hypoglycemia, and craving for salt
1. The nurse is assigned to a client with acquired immunodeficiency syndrome (AIDS). When handling the client’s blood and body fluids, the nurse uses standard precautions, which include:
C. Disposing of needles uncapped.
2. A nurse is caring for a patient with AIDS and detects early infection with Pneumocystis jiroveci by monitoring the pt for which clinical manifestation?
B. Cough
3. Which of the following clients is/are at the greatest risk for contracting HIV infection?
D. A non-exclusive couple in their mid-60's who occasionally use condoms.
4. Tyrone wakes up confused sometimes. Which of the following nursing diagnoses is of the highest priority?
D. Risk for injury
5. A nurse is teaching a client with acquired immunodeficiency syndrome (AIDS) how to avoid food-borne illnesses. The nurse instructs the client to avoid acquiring infection from food by avoiding which of the following items?
A. Raw oysters
6. Which of the following lab results confirms that the patient has AIDS?
B. CDT4 189/mm3
7. A patient has had a positive enzyme-linked immunosorbent assay (ELISA) test result. The patient asks what will be done next, what will the nurse’s response be?
E. A Western blot will be done to confirm these findings.
8. Which of the following drugs has a combination of three antiretroviral agents in one tablet/capsule?
B. Atripla
A client fractured his femur yesterday. Monitoring for which following potential complications must be included in the plan of care?
d. Fat emboli syndrome
2) The nurse is assisting a physician with the removal of a chest tube. What should the nurse instruct the client to do?
d. Perform Valsalva maneuver during removal
3) As the result of a tension pneumothorax, air continues to accumulate and the intrapleural pressure rises, which
d. will cause the mediastinum to shift away from the affected side and decrease venous return
4) A client had a cast applied 2 hr ago for a fractured left femur. Which of the following findings indicate the possibility of compartment syndrome?
d. Pain is unrelieved by second dose of oral narcotic
5) Which of the following measures best determines that a patient who had a pneumothorax no longer needs a chest tube?
d. The water-seal chamber doesn’t fluctuate when no suction is applied.
6) Nurse caring for a client with a pneumothorax and who has had a chest tube inserted notes continues gentle bubbling in the suction control chamber. What action is appropriate?
a. Do nothing, because this is an expected finding
7. Identify the six components of a neurovascular assessment
c. Pain, pallor, paresthesia, polar, paralysis, pulses
8. A pt is admitted to the ED with a pneumothorax. His ABGs are as follows: pH 7.47, PaO2 58, PaCO2 32, HCO3 22. What is your interpretation of these results?
b. Respiratory Alkalosis
1. Acute renal failure caused by parenchymal damage to the glomeruli or kidney tubules results in all of the following except:
B. An increased urine specific gravity
2. Oliguria is a clinical sign of acute renal failure that refers to a daily urine output of:
C. Less than 400mL
3. A fall in both Co2- and blood pH indicates what state accompanying renal function?
A. Metabolic acidosis
4. Hyperkalemia is a serious electrolyte imbalance that occurs in acute renal failure and results from:
D. All of the above
5. Dietary intervention for renal failure includes limiting the intake of:
A. Fluid
B. Protein
C. Sodium and potassium
D. All of the above
6. If pt reports dizziness and shortness of breath during dialysis then dialysis should immediately be stopped:
True or False
True
7. Which is true in regards of Acute vs. Chronic Renal Failure?
Chronic Renal Failure requires a Kidney Transplant and Acute Renal failure doesn’t require kidney transplant
8. Signs and Symptoms associated with Renal Failure
Decrease urine output
b. Hyperkalemia
c. Anemia
d. Edema
e. All the above
7. Which is true in regards of Acute vs. Chronic Renal Failure?
Chronic Renal Failure requires a Kidney Transplant and Acute Renal failure doesn’t require kidney transplant
8. Signs and Symptoms associated with Renal Failure
Decrease urine output
b. Hyperkalemia
c. Anemia
d. Edema
e. All the above