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96 Cards in this Set

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  • Back
Kenneth Jones, a 78 year old, has just been given his second dose of DDAVP. Which change in his condition is most likely related to this type of medication?
Decrease in urinary output
Margaret Benjamin is a 54-year-old diagnosed with hyperthyroidism. Which of the following symptoms would you most likely expect her to exhibit?
Tachycardia and hyperpyrexia
Kelly Singleton is a slim, 24-year old mother of two, admitted to your unit after she passed out while watching a parade on Main Street. She is complaining of muscle weakness, constipation and a constantly dry mouth. Upon examination, you notice that her mucous membranes are dry and her skin turgor is poor. Her blood pressure is 88/40. Based on her presenting symptoms, which disorder is she most likely to have?
Diabetes insipidus
Betty Henderson's husband died over a year ago but she is still having a difficult time coming to terms with his death. She reports that she engages in all of the following activities daily. Which of them is the best evidence that she is experiencing unresolved grief?
"I still set a place for him at the meal table every day."
You have just received the laboratory report back on Mr. Goodman. His ESR (erythrocyte sedimentation rate) is increased. This finding is most likely the result of
Inflammatory responses
Lester Pauley is a 57-year-old in the advanced stages of cirrhosis of the liver. As a part of his daily care, you are to assess for ascites. The anatomical landmark that provides for the most accurate assessment is the
Martin farley has been diagnosed as having an "an antisocial personality". He is least likely to exhibit which personality trait?
Difficulty controlling anger
Keith Buckner is a 36-year-old who owns his own sign painting business. He has a great deal of difficulty dealing with some of his business clients who work in high-rise office buildings. Every time he tries to use an elevator, he experiences severe nausea, often to the point of vomiting, followed by a period of weakness and vertigo. Which type of disorder is he experiencing?
Michelle Rather is a very shy, withdrawn 18 year old. You have just learned that when her father died four months ago, she refused to go to the funeral and has not been to the gravesite. Which statement would be most therapeutic?
"Tell me about your father."
Your patient has a difficult time communicating following a severe stroke. He usually speaks in word patterns known as "word salad”. When you greet him with his evening supper tray and say, "Good evening, Mr. Kinner” his most likely answer will be
"Good often yes kind front."
Rachel Thomas, who is in a diabetic coma, is en route to the emergency room via ambulance. The paramedics radio in her vital signs and other presenting symptoms. Which two symptoms would be consistent with her diagnosis?
Heart rate 124, capillary blood sugar 493
As a part of a behavior modification program, Jeffery Hanson, is given a chocolate chip cookie as a reward for his increased participation in a volley ball game. In this type of program, the purpose of a reward is to
Act as an incentive for continued improvement
Kayla Sanger, a 3-year-old girl, assigned to you while she is in the day surgery unit, is to have tubes inserted into her ears. You know the biggest fear facing children in this age group is the fear of
Jerry Nelson, a 61 year old, is an adult-onset diabetic he has been receiving Diabinese orally at home. During his hospitalization for coronary bypass surgery, he has been receiving insulin injections instead. Which statement would be most appropriate in this situation?
"Most likely you will resume taking your Diabinese again here at the hospital before you go home and will not need to take insulin injections at home”
You have been working with a teenager who has been recently diagnosed with diabetes mellitus. Which statement is evidence that your teaching has been effective
"I know that the more I exercise the less insulin my body requires”
Jeffery Anderson is a federal worker and a survivor of the Oklahoma City bombing. As a result of his ordeal, he is still suffering from post traumatic stress syndrome. Which symptom is most common In this disorder?
Heightened startle reflex
You have been instructed to help prepare Tony Hill for electroconvulsive treatment therapy. You know that preparing him for this type of treatment is similar to the way you would prepare a patient for
General anesthesia
Larry Darcy is a 24-year old patient in a psychiatric unit. Larry tends to use projection extensively as a coping mechanism. What is most likely to be true based on the information you have about Larry?
"Larry is basically insecure."
Tom Sullivan had an ECT treatment two hours ago. Which kind of pain should be reported immediately to the physician?
Back pain
Jimmy Lawson a 15-year-old, insists upon being called "James", his given name. Which statement also indicates that he is trying to establish his own identity?
"My parents think I should be a doctor, but I'm going to be a teacher."
Inez Romero is going to begin receiving outpatient radioactive iodine (RAI) treatments today. During the patient and family teaching session, you should include which statement?
"You should avoid prolonged contact with other people for few days after each treatment."
Fallon Dickson has a compulsion for handwashing Every time he touches bare skin on his body or on any one else, he feels compelled to wash his hands. Which of the following interventions would be more beneficial when caring for Fallon?
Allow time for him to complete his handwashing.
Josephine Markum has been suffering from hallucinations off and on all of her life. This time she was hospitalized after she began stabbing herself with a fork trying to fight off the pirates she sees that are attacking her. "Help! there are pirates all around me...floating in the air. can’t you hear that music? It's so loud!" Which of the following statements is most theraputic?
"I do not see the pirates you see or hear the music you hear."
"My brother Mark has hemophilia, but I have been tested and I do not. Now that my wife and I are ready to have children, we would like to know what the chances are that our children will have hemophilia?"
"Since hemophilia is carried and passed along only by the female, your children are not at risk unless your wife carries the trait."
As a new graduate, you are caring for a patient who had a parathyroidectomy and is now four hours post-op. Suddenly, your preceptor tells you that your patient is developing a complication common to patients following a parathyroidectomy. You know you will most likely have to administer which type of medication?
Jeannette and Mike O’Riley would like to know more about the rhythm method as a form of birth control. Among other things, she should be told to take her temperature
Daily, as soon as she wakes up and before arising from bed.
Henry Adams has been diagnosed as a schizophrenic, paranoid type. Which type of thought pattern is he least likely to manifest?
Depression is a complex disorder and affects each individual differently. One way depression does not manifest itself is
Unreasonable fear
Susie Benson, a 3-year-old with cystic fibrosis, is beginning her first day at a new day care and preschool center. Which type of stools should the workers at the center be told to expect from her?
Large, pale
Jon Davis is a 17-year-old amputee who lost his leg in a recent motorcycle accident. After being hospitalized for 6 days, he still refuses to look at his stump or take part in dressing changes. He refuses to answer questions with anything more than a nod. Your goal of care should be toward helping him to
Acknowledge and accept what has happened to him
Linda Carlson is taking Lithium to help control her bipolar disorder. She and her family should be instructed to notify the physician if she experiences
Excessive urinary output
Ken Stuart has been unemployed for over six months since the factory where he was working closed. He and his wife Marion have been taking care of their three children on her paycheck alone. Three weeks ago the restaurant where Marion works burned down. Which statement shows that Ken has been dealing with the stress in a positive manner?
"We get food from our church’s food pantry and the ombudsman has paid our utilities for this month. I worked a couple day jobs last week so we could put gas in the car."
One of these individuals was just admitted to the hospital with disease. Which one is most at risk?
42 year old woman who weighs 194 pounds
Lester Salinger, a patient with Parkinsonism, has been taking Levodopa. Over the past few weeks, Lester has begun walking with a slow, shuffling gait. This change is most likely a side effect of the drug. The physician will most likely
prescribe which type of medication to control this symptom?
Melinda Peterson is a sixteen year old newly diagnosed diabetic. You are assisting her to develop a dietary plan. To increase the likelihood that she will comply with the diet plan you should
Include her current dietary preferences as much as possible
Tom Johnson, a patient on the psychiatric unit, was admitted after he locked himself in his car and wouldn’t come out because the voices in his head told him that someone was waiting outside to hurt him. He has not reported any auditory hallucinations recently and his discharge date has been set for Friday of this week. On Tuesday during his nurse-patient therapy Session which is in the termination phase, he suddenly reported that the voices were back and telling him that he has to remain in the unit. What most likely prompted the auditory hallucinations to recur?
Difficulty dealing with separation anxiety could cause them to recur.
Paula Woods has been admitted with a diagnosis of possible acute glomerulonephritis. Of the following findings, which is most indicative of this disorder?
Increased antistreptolysin (ASO) titer
As a part of your patient teaching for six-year-old Johnny Fields, you have brought a boy doll and bandages to play with. You will help him use role-play to demonstrate what will occur during his upcoming surgery. Role play and pretend in this situation are used to
Help the child find a way to cope with his fear
At the end of every television show, Maggie Dole gets up and checks to make certain her front and back doors are securely locked, even though she has not gone out of the house all day. This type of behavior serves what purpose?
Decreases anxiety levels
Hilda Deik has a particular ritual she performs every time she enters or leaves a room. As her nurse, you should
Allow her to perform her rituals as long as she abides by the rules of the unit.
Lisa Feldman is seen in the emergency room after being raped in the hospital parking lot as she left work earlier this evening. Which area should you assess first when trying to determine her ability to cope with the trauma?
Coping mechanisms she has successfully used in the past
Bertha Keller has been diagnosed with an inoperable tumor. Her doctors have told her that this type of cancer usually advances rapidly. After going through the initial phases of the grief process, Bertha has come to the stage of acceptance. Which outward sign would be most indicative of this grief stage?
Kimberly Wilson is a fifteen year old who loves ice skating. She has recently been diagnosed with juvenile onset diabetes mellitus. She should be told
She can continue ice skating, as usual
Henry Miller is taking an MAO inhibitor. He should be taught to avoid all of the following except
Harold Carson, a 78-year old who is deaf, will be taking a phenothiazine at home when he is discharged from the hospital. Due to the side effects usually seen in older adults who take this type of medication, he and his family should be told to notify the physician if which symptoms occur?
Tardive dyskinesia
As the psychiatrist leaves the room following a session with Mark Hill, he begins pacing, cursing and then threatens to kill himself As his nurse for the rest of the shift, which statement would be most therapeutic at this time?
"I'll just stay here with you for a while but you don’t have to talk to me if you don't want to."
Lela Vickers, an 84 year old with senile dementia, is unable to communicate her thoughts and needs because she is only able to use clang phrases when speaking In response to your "Hello Mrs. Vickers," greeting, which statement would she be most likely to make?
"Hello, yellow, fellow, smell, tell, bell.”
Harvey Alexander was brought into the emergency room in insulin shock. He would be least likely to have which symptoms?
Acetone breath
After suffering from severe depression for several months, Marby Jefferson was admitted to the psychiatric unit when she no longer was able to perform her own activities of daily living. Now, three weeks after admission, she seems happy and upbeat. She talks and laughs with the staff and interacts with other patients. As a result of this change in her condition, you should
Observe for a possible suicide attempt
As you are doing patient teaching with an older diabetic, you are explaining about peripheral vascular problems that can develop. Your patient asks, "What can I do to help prevent these problems? Your response should be
"Examine your skin every day looking for signs of irritation or lesions."
Stacey and Bill had been extremely excited about the first of their first child. Unfortunately, she was born at 33 weeks of gestation and died just minutes after birth. Stacey is sitting in a chair alone in her room, crying quietly. When you enter the room, the most therapeutic comment for you to make would be
"I'll just sit here with you here for a while."
Leo Parrisher is a sixteen-year-old who been in several foster homes during his young life. Now he has been admitted to the drug treatment program where you work. Since he has a great deal of difficulty verbalizing his feelings, you should suggest which of the following activities that will help him express his feelings?
Draw or paint pictures in the art room
Dick Morgan has received a total of 8 doses of Cephulac. You know that his condition is improving when
He becomes more alert and oriented (Cephulac is lactulose)
Mark Rogers has been admitted to the psychiatric unit following a failed suicide attempt as a result of severe depression. The staff should take which type of attitude when dealing with him
Quiet, calm and respectful
As you are passing medications on the evening shift, your patient states, "This afternoon, the president of the United States called me to ask my advice." When you chart about this conversation you should write
Patient states, "This afternoon the president of the United States called me to ask my advice."
Behavioral symptoms are the way most psychiatric disorders are manifested. All of the following are true about psychiatric behavioral symptoms except
Are intentional
According to Erikson, the toddler years are the time when which developmental task is usually accomplished?
Maggie Reynolds is a 28-year-old lawyer who is worried about being passed over for a partnership in the firm because she has had to take time off periodically to attend to family duties. She is married to a physician and they have three young children. People who know her say that she has boundless energy and is an expert at balancing both a career and motherhood, However, she has begun to have severe heartburn, no matter what she includes in her diet. In this situation, the stomach distress may be a psycho-physiological response called
Henry Jefferson is receiving corticosteroid administration. Which of the following side effects is least likely to occur?
To best facilitate communication between the nurse and the patient, initially the nurse should
Come to the bedside and lightly touch the patient's arm
You are in the process of completing a comprehensive health history and physical examination of Chester Simms. He will be moving into an assisted living facility following the death of his wife of 52 years. Throughout the interview he periodically gets tears in his eyes and is unable to look at you or answer your questions momentarily. He is most likely experiencing which stage in the grief process?
During middle school and high school, exploring homosexual desires is
Equally common in both boys and girls
Jennifer Lyle is a 28-year-old nurse with ulcerative colitis. Which of the following should be her primary goal?
Stress reduction
Ronald Quincy will continue taking lithium after he is discharged today. During your discharge teaching with he and his family, you should stress the need for
Monthly blood tests to determine lithium levels
Yelsa Stenzon, a 45-year-old alcoholic, blames her drinking on her abusive husband and chronic poverty. This type of coping mechanism is called
Martin Gordon is a 54 year old insulin-dependent diabetic. You are conducting a patient teaching session to help him prevent some of the common complications of longstanding diabetes. He should be informed that diabetics are at increased risk for all of the following except
Henry Donalson has to follow a diet that restricts his intake of tyramine. Failure to adhere to the diet puts him at an increased risk for
Hypertensive crisis
Ralph Clemmons is determined to stop drinking. He has begun a treatment plan which includes the use of the drug disultiram (Antabuse). He should be taught that
Severe toxic reactions may occur if he drinks alcohol while taking this Medication.
As a new graduate, you have just taken a position on a psychiatric unit. When dealing with this type of patient, you know that the best tool you have to use is
Martha Quincy has come to the hospital complaining of being severely and chronically fatigued to the point that she has difficulty performing normal tasks associated with daily living. She states that she has gained about 18 pounds in the last two months even though her diet has not changed. She also complains of forgetfulness, constipation and always feeling cold. Based on these symptoms, which diagnosis would you suspect?
Margaret Higgins suffers from delusions of grandeur. She has just told you, "I live in a big mansion that cost several million dollars. Some very important movie stars lived there before me. Would you like to come visit me there someday?" Which statement would be most therapeutic?
"Tell me about how you are feeling right now”
Martha Nelson has been admitted for acute cholecystitis. She is most likely to report that her pain is in her
Back under her scapula
Hillary Rayburn has a simple goiter. Of the following, which is the most likely cause?
Lithium administration
Patricia Kinslow suffered blunt liver trauma in an automobile accident 12 hours ago. She should be closely observed for
Cecilia Benson is a 42-year-old with severe nephrotic syndrome. Individuals with this condition nearly always have which symptom?
Sammy Viceroy is taking fluphenazine hydrochloride (Prolixin). This medication is an
Josephine Carison suffers from a longstanding neurosis for which she has been hospitalized on numerous occasions. She is most in need of
Acceptance and a sense of belonging
Which intervention would be most effective for dealing with patient behavior in a psychiatric unit?
Expect all staff members to use a consistent approach
Carson Bentley is suffering from nephrotic syndrome. Which laboratory finding is least consistent with the disease process?
Communication is
Information exchange
Which of the following patients has the symptoms most indicative of Cushing's syndrome?
A female patient who complains of muscle weakness, emotional lability, increased glucose levels, acne, and changes in external gender characteristics
Antacids, such as Maalox, inhibit the absorption of oral phenothiazines such as fluphenazine hydrochloride (Prolixin). As you are checking the medication sheet for your patient, you notice that both are ordered for your patient. You should
Make certain that the Maalox and the Prolixin are given two hours apart
Jim Karson has been hospitalized for three days with complications related to his cirrhosis of the liver. He is being discharged to home today. Which statement by his daughter indicates that the family may need further instruction?
"I will help prevent dry skin and itching by keeping his skin clean and by using lotion to keep it lubricated."
Sarah Benson is a 61-year-old patient in the Community Hospice Program Her ovarian cancer has metastasized to her lungs and she is facing another round of chemotherapy and radiation. "I want to donate $10,000 to this hospice program since it has helped me and my family so much lately." Her offer of a donation most likely has been prompted by what stage in her grieving process?
Joey Morganstein has been taking his antidepressant medications regularly. Which finding is most indicative that the medications are effective?
His overall mood seems to be improved.
Denise Anderson had a thyroidectomy and is now 12 hours post-op. At this point, the most critical symptom to observe for is
Respiratory distress
Mr. Feldman has been put on a therapeutic regimen of chlorpromazine hydrochloride (Thorazine). He and his family should be instructed to observe him carefully for which common side effect?
Increased skin sensitivity to sun exposure
Bulimic patients most commonly
Eat abnormally large quantities of high calorie foods
As a new graduate nurse Beverly Thompson is wanting to do everything she can to become the best psychiatric nurse possible. You should tell her that for her patient's sake, which skill is most important for her to develop?
Communication skills
Ovada Villious has been admitted with renal calculi of unknown origin. As an independent nursing intervention, you should encourage her to
Increase her intake of water and other fluids
Delia Stuart is an 84-year-old woman with senile dementia. She imitates motions made by others, even though there is no meaning behind her actions. This type of behavior could be termed any of the following except
Rodney Cline is a five-year-old, diagnosed with leukemia. His condition just took a serious turn for the worse today. When you answer his call light, his mother screams at you, "What took you so long! He could have died! You and all the rest of the people around here are incompetent. I'll hate you" The most therapeutic response you could give would be to say
“You must be having some really strong feelings through all this. Lets talk about what you're feeling."
Psychic energy, as proposed by Freud, originate in the
The cause of schizophrenia is a widely debated topic. The most generally accepted theory holds that patients with schizophrenia show a(n)
Increase in dopamine levels or in the number of dopamine receptors
Keith Angelo is a 31-year-old schizophrenic patient in the psychiatric unit where you work. While you are in the room to change the linens on his bed, he states, "there are snakes are coming out of my arms and legs." Which response would be most therapeutic?
“I do not see any snakes coming out of your arms or legs."
You are helping the parents plan for their child's insulin needs. Which question would be most beneficial?
What is her usual daily schedule and what are her normal activities?