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125 Cards in this Set

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After a through examination, the physician suspects that your patient may have developed rheumatic fever following an infection with beta-hemolytic streptococci. Which of the following lab tests to confirm the diagnosis is he most likely to order?
C-reactive protein
During your assessment of a three-year-old, you discover the presence of Koplik's spots. She most likely is suffering from what disease?
rubeola
Lottie Charleston had a total hip replacement yesterday. Today she is in good spirits and has reported very little discomfort. You have just finished making her bed, and as you adjust the sheets to make sure she has plenty of toe room, you notice that one of her legs appears to be shorter than the other. You should immediately
notify the physician
Your doctor is going to perform a blood test to rule out the presence of a sexually transmitted disease. Which STD can be diagnosed in this manner?
syphilis
After Jed Hampton was diagnosed with Lyme disease, he was given a prescription for a form of tetracycline. He should be taught to
never take the medication with any mineral preparatlon(e.g., vitamins with iron) or with any type of dairy product
Martha Samuels has notices a flat spot, less than one centimeter, on her right forearm. It has a different color than normal pigment. This is termed a
macule
A fifteen year old boy is being seen at the health department clinic today for a routine sports physical. He will also receive an Immunization while he is there. Which one will he most likely receive?
DT
A patient with frostbite would be most in need of which intervention to help prevent complications?
bed cradle
Two year old Billy Johnson has meningitis. He needs to remain quiet and get as much rest as possible. Which intervention is most appropriate in his case?
decrease environmental stimuli of all forms
Marc Townsend had rheumatic heart disease as a child. He is most likely to be prone to have all of the following residual symptoms as an adult except
chorea
Upon physical examination, you notice that your patient has the classic symptoms of Rocky Mountain Spotted Fever. He is complaining of joint and muscle pain and has
had a sudden onset of an extremely elevated body temperature
Greg Hammer had a go-kart wreck going nearly twenty miles per hour. He hit his head on the ground several times as the go-kart rolled over. He has been admitted for observation but now his ICP is rising rapidly. Which drug will the physician most likely order?
mannitol
Your patient is being given her preoperative medication, including an anticholinergic. What is the primary purpose for this type of medication?
reduce secretion of saliva and gastric juices
Martha Grayson has been having recurrent urinary tract infections over the past three years. She suspects that she has another UTI. Which symptom would you most expect for her to exhibit
frequency
Four year old Helena Kessler has viral rhinitis. Her mother should be told to carry out the following interventions (3)
administer Tylenol, not aspirin, if her temperature goes up, offer her favorite fluids frequently and wash your hands and her hands frequently
Michael Avery was admitted to the burn unit three days ago after suffering second and third degree burns in a house fire. As you empty his bedpan, you notice that he has begun to have black stools. This changes is most likely caused by
the development of a Curling's ulcer
Following the administration of the oral polio vaccine there is a remote possibility that the live virus can be transmitted through direct contact with the child's
feces
Which immunization is least likely to be given to a ten year old?
pertussis (whooping cough)
Fred Valer is having draining from his incision that contains and accumulation of dead cell debris, white blood cells and dead bacteria. The proper term to use to chart this type of drainage is
purulent
Harvey Keller, who had never received a tetanus immunization, contracted tetanus following a minor injury. What type of wound did he most likely have?
a puncture wound on his thigh
Reye's syndrome can cause permanent changes in mental status. These changes are most often related to an increase in which level?
ammonia
The doctor has told the patient that his wound should heal by third intention. What is his most likely diagnosis?
duodenal ulcer
Three day old Suzanna Delk acquired which type of immunoglobulin prior to birth?
IgG
Your burn patient is in the hypovolemic phase following her injury. Which finding is consistent with this stage?
hyperkalemia
During your initial interview with the mother of a child who is about to receive an MMR vaccine, you should ask specifically if the child has ever shown any allergy or sensitivity to
eggs or chicken feathers
Nelson Carlisle is going for nuclear magnetic resonance imaging this afternoon. In preparation, he should be given which information?
You will be asked to lie still on a flat platform which moves through a magnetized tube.
The organism that is thought to cause Reye's syndrome is a
virus
You have been told to monitor your patient for respiratory sufficiency. Which type of assessment is the best indicator of respiratory status?
ABGs
All of the following have been exposed to an active case of rubella. Who is most at risk?
Unborn fetus
Some illnesses and some medications can cause an extrapyramidal effect. This effect is caused by degeneration of parts of the
basal ganglia
As you care for the older adults in the retirement village where you work, you should remember that all of the following are common changes associated with aging (3)
sensation of pain may be diminished or absent, infection may cause little or no elevation in body temperature and hypersensitive reactions to antigens are delayed
Hilda Bennett is going to have a supratentorial craniotomy. You should tell her that in the immediate postoperative period following surgery, she can expect to
rest in Fowler's position with a pillow under her shoulders
Linda Myles has just had a full-thickness skin graft. How should you care for the site in the immediate postoperative period?
keep the site covered with a bulky occlusive dressing
Kendra Hendricks has called the Poison Control Center where you work. Her three-year-old son has just swallowed over 50 acetaminophen (Tylenol) tablets. She should be instructed to
give Ipecac and water as directed on the bottle
Jay Fowler has cholecystitis. The doctor has order vitamin K administration Q.I.D. The purpose of this order is to minimize the tendency for (3)
bleeding, itching and jaundice
Hematopoietic radiation trauma would most likely produce which symptom?
thrombocytopenia
Lizzie Cantrella has been diagnosed with toxic shock syndrome. This disorder is well known to significantly after which level?
magnesium
Which symptoms would be most consistent with a diagnosis of cholelithiasis?
ultrasound shows stones in the common bile duct
Mononucleosis is caused by which organism?
Epstein-Barr virus
The most important nursing intervention for a patient with extensive second degree burns is
maintenance of adequate ventilation
Martha Gennison is 75 pounds overweight. Prior to signing the surgical consent before her abdominal cholecystectomy, the physician warned her that she is at increased risk for complications following surgery as a direct result of her obesity. He would say that because
lack of adequate blood supply common in adipose tissue impedes the wound healing process
On this shift, you will be taking care of a patient who suffered a C7 spinal injury. You know that he will most likely be able to
control his head and neck muscles
Mrs. Williams is considering having cataract surgery. She should be told that during the immediate postoperative period, she will be expected to (3)
remain on complete bedrest, avoid lying on her stomach and avoid sneezing and coughing
Michael Peterson is a 2-day-old infant born to a cocaine-addicted mother. Which symptoms would he be most likely to manifest as a result of his mother's addiction?
irritability, respiratory alkalosis, hyperacusia, rhinorrhea
The patient Just brought in by ambulance is suffering from severe carbon monoxide poisoning which was the result of a failed suicide attempt. Which finding regarding skin color is most consistent with this diagnosis?
cherry red mucus membranes and skin undertones
Mr. Filmore is a 79 year old man who is taking all of the following medications. During this visit, he is reporting yellow vision. Which medication is known to cause this type of vision change?
Lanoxin
Chester Kline is taking all of the following medications: amoxicillin, lanoxin, prednisone and valium. He is at increased risk for illness because all of the following may reduce the body's natural defenses except
Lanoxin
What type of diet is recommended for a patient who is taking probenecid and colchicine (Colbenemid)?
alkaline/ash
Lillian Copas is being discharged today after having an abdominal cholecystectomy. During her discharge instructions, she should be told to report which finding to the physician immediately?
leakage around the tube
The physician suspects that Seth Adams Is suffering from Crohn's disease. Which diagnostic test will he most likely order to confirm his suspicions?
biopsy
Patients with urinary tract Infections are often given phenazopyridine (Pyridium) because this medication helps
Minimize pain of bladder spasm
Margaret Adams has been diagnosed with myasthenia gravis. Her the majority of her symptoms are caused by
inadequate acetylcholine release
Your patient is at high risk for hemorrhagic shock. These three are common symptoms
restlessness, hypotension and decrease in hematocrit
Which diet would be most appropriate to recommend for a patient with glomerulonephritis?
high calorie, low-sodium, protein-modified
As you are doing your weekly grocery shopping, you notice a woman lying on the floor having a grand mal seizure. You should
turn her on her side
Terry Hanson was born with necrotizing enterocolitis and underwent a surgical removal of the affected bowel when he was an infant. He was left with a bowel of inadequate length. Which lifelong vitamin deficiency is common in this type of situation?
B12
Your patient is suffering from chronic glomerulonephritis. Which laboratory finding is most consistent with this disease process?
hypoalbuminemia
Martha Dodson is being given zoster immune globulin to stimulate her immunity to
varicella
Your patient who suffers from Meniere's disease is having an increased amount of discomfort. You should recommend which intervention?
use of diphenhydramine (Benedryl)
After taking his prescribed medications to treat active tuberculosis. the physician has order laboratory tests to detect the presence of side effects common to these drugs. Which tests did he most likely order?
SGOT/SGPT
The opportunistic infection most commonly affecting people with AIDS is
Pneumocystis carinii
Kendra Alford has been hospitalized following an overdose of acetaminophen (Tylenol). Which organ has been most likely affected as a result?
liver
Which statement is true regarding the use of a Jackson-Pratt drain?
You must squeeze and expel air before recapping after draining.
Betsy Caine is a 36-year-old with multiple sclerosis. Her husband, Bill, has been her primary caretaker since she was diagnosed 8 years ago. To help her relieve muscle spasms he
helps her take a hot bath
All of the following may cause a reactivation of tuberculosis (3)
AIDS, leukemia and Hodgkin's disease
Bertha Stephenson's husband of 38 years has just suffered a massive stroke that has left him in a coma. To help her cope with her husband's condition, your best intervention would be to
help her identify and mobilize her support network
You are reading the nurses notes about the patient you will be caring for on this shift. You were told in report that his abdominal wound is healing by secondary intention. Which finding is abnormal?
"edges of incision appear black in spots"
As a result of a skiing accident, your patient is suffering from hypothermia among other injuries. Which symptom is not consistent with the diagnosis of hypothermia?
alkaiosis
Your patient has is recovering from second-degree bums. Which foods should you recommend to promote healing?
meat, milk and citrus fruits
Five year old Mark Potter has strep throat again for the third time this winter. He has no known allergies, so he will most likely be given which medication?
Pen Vee K (penicillin)
Kenneth Fields has been faithfully taking the medicines the physician prescribed for his tuberculosis. At what point should he consider himself to be no longer contagious?
2-4 weeks after beginning the prescriptions
Harold Kennedy has been in the hospital for 24 hours after suffering major burns. Which of the following lab reports would be most onsistent with his condition?
metabolic acidosis with increased Hgb., Hct., K+ and decreased Na+
Hilda Bentley has a UTI. As most nurses do, you have suggested to her that drinking cranberry juice could be beneficial. You should tell her that drinking cranberry juice will
acidify her urine
Risks are present in nearly every occupation. Which career would carry the most risk for becoming infected with hepatitis C?
phlebotomy
Which statement regarding the phenomenon of pain is most accurate?
pain may increase in direct proportion to an increasing anxiety level
Joline Sanders is using miotic eye drops to control her glaucoma. The purpose of this type of medication is to
increase outflow of aqueous humor
Joyce Stem has been diagnosed with vaginal candidiasis and has been given a prescription for Monostat. She should be instructed to
Insert the medication while lying flat and remain flat for 15-20 minutes after insertion
Mr. Martin is being seen by a hearing specialist to be fitted with a hearing aid. When questioned about his hearing loss, he said, ''My hearing has become steadily worse every year for the past several years. t can't say exactly when I started having a problem." This type of hearing loss is caused by
otosclerosis
Jerry Thomson has just been admitted to your unit with pyelonephritis. As you prepare to empty his urinal, you would suspect that his urine will have which type of characteristic odor?
fishy
Felicia Sanchez is a fifteen year old girl who has been performing self- catheterization to become continent. Which statement best indicates that she has achieved her goal?
"I don't have any dribbling between catheterizations any more."
Kayla Rogers has been diagnosed with mononucleosis after testing positive using a Mono-Spot. She should be told to avoid strenuous activities because excess strain can damage which organ?
spleen
Larry Underwood has been admitted to your unit in respiratory isolation with a diagnosis of "rule out tuberculosis". Which laboratory finding would be indicative that the physician's suspicions are correct?
positive AFB culture
Orville Canter, a 78 year old, was Involved in a motor vehicle accident this afternoon. Now his is going into shock. Which type of shock is he most likely to exhibit?
hypovolemic shock
The nurse who had your patient during the previous shift charted, "eschar prevent at the wound site." She was referring to which finding?
necrotic slough
All of the following laboratory results indicate the presence of an infection (3)
elevated white blood cell count, a CBC with a differential count showing a "shift to the left" and elevation in sedimentation rate
You are giving Mrs. Johnson a bed bath on the third day after her cholecystectomy. Suddenly a sudden gush of serosanguineous drainage erupts from her incision site. The complication is most likely caused by
wound dehiscence
Which of the following is least likely to play a part in the transmission of Hepatitis A?
urine
Came Stevens is a fjve-year-old with the flu. She has been vomiting and is running a temperature of 101.2F. She also has a nonproductive cough and stuffy nose. All of the following are appropriate interventions (3)
encourage her intake of favorite fluids to replace fluids lost to vomiting, stay on bedrest to help her regain her strength and give her a dose on an expectorant for the nonproductive cough
Jill Oppenheim, a fifteen-year-old cheerleader has been admitted to your unit with possible meningitis. Which laboratory finding on spinal fluid would confirm the diagnosis?
increased white cell count in the spinal fluid
Mrs. Simpson was admitted to your unit with a spontaneous fracture of her right hip that caused her to fall. This type of fracture is most closely associated with which disorder?
osteoporosis
Your patient is complaining of a symptom that causes you to suspect that he is developing compartment syndrome. Which symptom is he most likely exhibiting?
intractable excruciating pain
You are conducting a discharge teach session for a patient who has gout. All of the following are appropriate interventions (3)
apply ice to the joints to relieve pain
Lacey Spellman is a three-year-old being seen in the emergency room. She is very apprehensive and seems afraid of the nurses. She has been diagnosed with a spiral fractures of her right arm and has bruises on the left side other face. Which nursing diagnosis would be most appropriate?
suspected child abuse related to type and number of injuries
Martin Gregory has lesions on his chest that are thought to be caused by herpes zoster. This type of disorder in an adult is thought be caused by the reactivation of an organism which also causes which childhood disease?
chicken pox
After being involved in a motor vehicle accident the doctor is concerned that your patient may have suffered a ruptured spleen. Which symptom would be most indicative of this condition?
left shoulder pain
After being involved in a motor vehicle accident the doctor is concerned that your patient may have suffered a ruptured spleen. Which symptom would be most indicative of this condition?
left shoulder pain
As you prepare to administer the MMR to a child, you know you should give it
intramuscularly by deep Z-track technique
Martha Gentry has an open, draining wound on her leg that needs to be debrided. The best way to debride a wound during a dressing change is to
remove the dressing without wetting it
After an extended illness, your patient has become septic. All of the following symptoms are common in septicemia (3)
chills, elevated temperature and generalized malaise
Which of the following patients should receive a flu vaccine today?
72 year-old with cardiovascular disease
Which behavior is frequently observed in adoescents who have acquired sexually transmitted diseases (STDs)?
Adolescents deny having the disease (due to stigma and threat to relationships)
A patient develops diarrhea several days after being treated for a severe respiratory infection. Which information is needed by the nurse to assess teh cause of the diarrhea?
The medications used for treatment of the infection (such as antibiotics)
Which discharge instruction should the nurse include in the plan of care for a patient with a urinary tract infection?
Drink 2-3 liters of fluid daily.
Which pathophysiological factor accounts for the increased incidence of opportunisitic infectionis and tumors among patients with acquired immunodeficiency syndrome (AIDS)?
A decreased number of T-helper cells
The nurse is evaluating a patient who is on warfarin sodium (Coumadin) therapy. Which patient behavior indicates the need for further instruction regarding the medication?
Taking ibuprofen for a headache (NSAIDS can produce gastric irritation and possible bleeding)
Why should tetanus toxoid be administered to a patient who has a puncture wound?
To stimulate antibody production
The parents of a four-year-old child who has varicella express concern about scarring and ask haow to best discourage their child from scratching. Which suggestion by the nurse would be most appropriate?
Teach the child to apply pressure to pruritic areas.
What is the rationale for using the multiple puncture skin test for tuberculosis?
To screen large groups.
When administering the initial parenteral dose of amphotericin B to a patient with severe histoplasmosis, the nurse should monitor the patient for which side effect?
Shaking chills (evidence of anaphylactic shock)
Which assessment of a patient with severe frostbite should receive priority?
Neurovascular
Immediately following an above-the-knee amputation, a patient has rigid cast dressing applied. Which observation indicates the desired outcome of this treatment?
Uniform compression of the stump (desired for early fitting of a prothesis)
Which assessment indicates that a wound is healing by secondary intention?
The wound base contains granulation tissue.
Which assessment data whould lead the nurse to suspect that a toddler may have recently ingested a caustic substance?
White, swollen oral mucosa
Which nursing measure is appropriate when providing immediate care to a patient with a thermal burn?
Soak the burned area briefly in cold water.
Which action should the nurse take when caring for an older adult who has suffered heatstroke?
Administer a cool sponge bath.
What is the expected effect of an antacid such as aluminum hydroxide (Amphojel) on the stomach?
It decreases gastric acidity
Which is the first sign of altered neurological status related to brain injury?
Change in the level of consciousness
The nurse is taking the history of a patient who is scheduled for magnetic resonance imaging (MRI). Which data whould the nurse consider significant when preparing the patient for the MRI?
Claustrophobia
The nurse performs a neurovascular assessment on a seven-year-old child who had a cast applied for a fractured tibia. Which evidence indicates possible neurovascular compromise?
Compaint of pain on movement of the toes.
Which class of medications is generally administered to reduce cerebral edema?
Corticosteroids (they reduce cerebral edema by acting as an anti-inflammatory)
The nurse is caring for a patient who has a history of multiple sclerosis with numerous exacerbations of the condition. Which instruction should the nurse give to this patient?
Avoid emotionally stressful situations.
Which statement best describes decerebrate posture?
The arms and legs are extended, with pronation of the hands and feet (Decerebrate posture results from damage or trauma at the midbrain. The arms and legs are extended, with pronation of the hands and feet)
Which condition describes a swayback posture of the lumbar spine?
Lordosis (excessive curvature of the lumbar spine)
Which assessment confirms the presence of gout?
Presence of urate crystals in joint cavity aspirate
Which action should the nurse take when caring for a patient witha newly applied cast?
Keep the cast uncovered. (An exothermic reaction occurs when the plaster is placed in water prepatory to application. This heat can cause discomfort to the patient. The cast is left uncovered to facilitate drying and thus cooling.)