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80 Cards in this Set
- Front
- Back
What is the primary purpose and criteria for a nursing license?
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What is the primary purpose and criteria for a nursing license?
- protect the pulic |
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what is the most effective way to evaluate pain?
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what is the most effective way to evaluate pain?
- face scale |
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What statement is the appropriate documentation of a hospitalized client?
- "small pressure ulcer noted on the right heel?" - "client had a good day" - "client seems to be mad the phyician" - "client skin is warm and cool" |
What statement is the appropriate documentation of a hospitalized client?
- "small pressure ulcer noted on the right heel?" - "client had a good day" - "client seems to be mad the phyician" - ANSWER: "client skin is warm and cool" |
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What structures or organs is found the dorsal cavity?
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What structures or organs is found the dorsal cavity?
- spinal column, vertebrae |
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What would be the most likely cause of a pressure ulcer fails to heal?
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What would be the most likely cause of a pressure ulcer fails to heal?
- nutrition (protein) |
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What is the most important aspect of hand washing?
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What is the most important aspect of hand washing?
- friction |
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When you are taking client history, in order to guide questioning what do you want to know first?
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When you are taking client history, in order to guide questioning what do you want to know first?
- why have you come into the hospital today |
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When assessing a client to determine risk for fall, what assessment do you have to make?
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When assessing a client to determine risk for fall, what assessment do you have to make?
- gait and balance |
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when comparing apical and radial pulse, the difference b/w the two is what?
WHAT IS THE PULSE PRESSURE? |
when comparing apical and radial pulse, the difference b/w the two is what?
- pulse deficit WHAT IS THE PULSE PRESSURE? - difference b/w systolic and dystolic pressure - narrow= shock, widen= ICP (intra cerebral pressure) |
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Know how to chart:
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Know how to chart:
- first initial, lastname, SVN |
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How do u clean dentures?
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Clean dentures...
- towel in sink, soft brush |
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what is the best way to prevent pressure ulcers?
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what is the best way to prevent pressure ulcers?
- turn every 2 hours |
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the best way of controlling external bleeding is?
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the best way of controlling external bleeding is?
- direct pressure |
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you have a unconscious pt, how do you brush their teeth?
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you have a unconscious pt, how do you brush their teeth?
- side lying head lowered |
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what is the rationale for pt teaching?
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what is the rationale for pt teaching? (why do we include the pt in the discussion)
- pt feedback - knowing level of their understanding |
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Your using tepid water for sponge bath, what degrees of heat is the water?
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Your using tepid water for sponge bath, what degrees of heat is the water?
- 80-90 degrees |
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What is the most important action to take before you remove a Foley catheter?
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What is the most important action to take before you remove a foley catheter?
- deflate the balloon |
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What kind of respiratory precaustion do use when you have an airborne disease?
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What kind of respiratory precaustion do use when you have an airborne disease?
- a mask |
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What is sterile field?
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What is sterile field?
- don't turn back, 1 inch around perimeters, when holding an object hold 12 above field, keep above chest area - When opening a sterile pack, first flap goes away from you, last flap toward you |
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What would you expect an incision line to look like 1 day after surgery?
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What would you expect an incision line to look like 1 day after surgery?
- swelling and redness |
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You are making round, checking on pts, you walk into a room and find an elderly lady on floor unresponsive, what do you do?
- call for help - stay w/ pt - shake and shout pt |
You are making round, checking on pts, you walk into a room and find an elderly lady on floor unresponsive, what do you do?
- call for help - stay w/ pt - ANSWER: shake and shout pt |
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WHAT IS THE BEST SITE TO INJECT B12?
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WHAT IS THE BEST SITE TO INJECT B12?
- ventral gluteus |
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How would you instruct a pt to do a skin assessment? What do u tell them to look for?
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How would you instruct a pt to do a skin assessment?
- when they are showering WHAT ARE THEY LOOKING FOR? - abnormalitiesl; what they haven't seen before |
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Neighbor run out w/ burning clothes, what do you do?
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Neighbor run out w/ burning clothes, what do you do?
- stop, drop and roll (smother flames) |
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What type of client is at greatest risk for pressure ulcers?
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What type of client is at greatest risk for pressure ulcers?
- bed bound - malnourished - thin |
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Where is the first place to determine skin color changes in an african american?
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Where is the first place to determine skin color changes in an african american?
- oral mucousa (central part of the body) |
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What is the most common cause of skin cancer?
HOW DO YOU PREVENT SKIN CANCER? |
What is the most common cause of skin cancer?
- ultra violet light HOW DO YOU PREVENT SKIN CANCER? - sunscreen, wear hat - vitamin D deficiency |
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What causes scabies?
WHAT DOES IT LOOK LIKE? |
What causes scabies?
- female itch mite WHAT DOES IT LOOK LIKE? - brown linear lesions (wavy brown lines) - put pt in contact isolation |
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Slow healing artrial foot ulcer would be described as?
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Slow healing artrial foot ulcer would be described as?
- chronic |
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What would be the profile of a pt who is at risk to malignant melanoma?
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What would be the profile of a pt who is at risk to malignant melanoma?
- light skin, blue eyes, freckles, red hair |
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You observe round blister like lesions filled w/ clear fluid, what kind of lesion is it?
PUS FILLED? |
You observe round blister like lesions filled w/ clear fluid, what kind of lesion is it?
- vesicle PUS FILLED? - pustule |
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Classify different kind of skin grafts...
WHAT IS AUTO GRAFT? WHAT IS A ALLOGRAFT? WHAT IS A HOMOGRAFT? WHAT IS A XENOGRAFT? |
Classify different kind of skin grafts...
WHAT IS AUTO GRAFT? - graft taken from one part of the body to another part of body (same person) WHAT IS A ALLOGRAFT? - graft taken from another person to another person WHAT IS A HOMOGRAFT? - graft taken from the same species WHAT IS A XENOGRAFT? - graft taken from a different species |
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What is the best way to talk to a pt who is hearing impaired?
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What is the best way to talk to a pt who is hearing impaired?
- speak slowly and softly, face pt |
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Pt comes into clinic complaining of dry irritated eyes, what is the first action you need to take?
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Pt comes into clinic complaining of dry irritated eyes, what is the first action you need to take?
- assess for redness or discharge |
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Why is it important to treat glaucoma?
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Why is it important to treat glaucoma?
- to prevent blindness |
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When you are applying eye ointment, how do you perform the task? Applying eye drops?
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When you are applying eye ointment, how do you perform the task?
- put on gloves - apply thin layer of ointment from inner canthus to outer - put pt supine or head slightly back APPLYING EYE DROPS? - apply drops in the conjuctitable sack - apply pressure over lacrimal duct - more than one drop of same med, wait one minute per eye, different meds 5 min |
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when applying antibiotic and corticosteriod, which do u apply first?
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when applying antibiotic and corticosteriod, apply antibiotic first then corticosteroid.
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what is the name of the fracture when one bone fragment is forced into another bone?
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what is the name of the fracture when one bone fragment is forced into another bone?
- impacted |
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What is the typical pain that a pt has w/ a herinated disk?
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What is the typical pain that a pt has w/ a herinated disk?
- pain radiating from the buttocks down the leg |
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Pt has a hip fracture that has a nail holding bone together, what position do you keep the legs?
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Pt has a hip fracture that has a nail holding bone together, what position do you keep the legs?
- abduction (away from the body) |
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What assessment best indicates aspirin toxicity?
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What assessment best indicates aspirin toxicity?
- tinnitus (ringing of the ears) |
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What physical finding would be early indication/manifestation of a fat embolism?
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What physical finding would be early indication/manifestation of a fat embolus?
- respiratory distress |
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Your discharging a pt who had a total hip replacement, why are you going to provide with a rised toilet seat?
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Your discharging a pt who had a total hip replacement, why are you going to provide with a rised toliet seat?
- don't want hip flexed |
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What signs would you expect to find when a pt has fallen out of bed and fractured hip?
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What signs would you expect to find when a pt has fallen out of bed and fractured hip?
- affected leg is shorter and turned outward |
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How would you assess nerves of the extremity of a pt who has a cast from ankle to thigh?
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How would you assess nerves of the extremity of a pt who has a cast from ankle to thigh?
- toes or toenails |
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What color and consistency is the stool of a pt who has a peptic ulcer?
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What color and consistency is the stool of a pt who has a peptic ulcer?
- black tarry stool |
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pt w/ ulcertive colitis, what kind of stool do they have?
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pt w/ ulcertive colitis, what kind of stool do they have?
- mucous and blood |
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What technique is best for confirming a fecal impaction?
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What technique is best for confirming a fecal impaction?
- your digit (inserting a gloved finger into the rectum) |
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Your pt is complaining of abdominal pain, your assessing the abdomen, pt has pain b/w illiac crest and embolitus, what do we call that point?
WHEN YOU PALPATE THE ABDOMEN, WHAT IS THE PT GOING TO COMPLAIN ABOUT? |
Your pt is complaining of abdominal pain, your assessing the abdomen, pt has pain b/w illiac crest and embolitus, what do we call that point?
- mcburny's point WHEN YOU PALPATE THE ABDOMEN, WHAT IS THE PT GOING TO COMPLAIN ABOUT? - rebound pain |
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When your bleeding from the upper GI tract what is the color of the stool?
and LOWER GI? |
When your bleeding from the upper GI tract what is the color of the stool?
- black LOWER GI - red |
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Your teaching a pt who has chrone's disease, and you tell him that he should be on a fiber controlled diet, pt asks what is fiber?
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Your teaching a pt who has chrone's disease, and you tell him that he should be on a fiber controlled diet, pt asks what is fiber?
- fiber is the undigestible parts of a plant |
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What is herniorrhaphy?
WHAT ASSESSMENT DO YOU DO AFTER HERNIORRHAPHY? |
What is herniorrhaphy?
- a surgery to correct a hernia WHAT ASSESSMENT DO YOU DO AFTER HERNIORRHAPHY? - bowel sounds, urinary retention |
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ur client has end-stage liver failure, what do you expect is elevated in the lab tests?
WHAT DRUG DO YOU GIVE TO REDUCE AMMONIA LEVELS |
ur client has end-stage liver failure, what do you expect is elevated in the lab tests?
- ammonia level WHAT DRUG DO YOU GIVE TO REDUCE AMMONIA LEVELS - lactalose |
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pt has appendicitis, before coming into hospital, pt applied heating pad to abdomen, what could this lead to?
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pt has appendicitis, before coming into hospital, pt applied heating pad to abdomen, what could this lead to?
- rupture |
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pt has subtotal thyroidectomy, pt says lips feel numb and tingling, what electrolyte is deficiency?
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pt has subtotal thyroidectomy, pt says lips feel numb and tingling, what electrolyte is deficiency?
- calcium, hypocalcemia - chevostek sign (tapping of the cheek) - trousseau's sign (fingers twist) |
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female pt has UTI, second infection w/in six months, during pt teaching what do you teach?
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female pt has UTI, second infection w/in six months, during pt teaching what do you teach?
- take showers not baths - wipe front to back - cotton underwear - pee before and after sex - drink lots of fluid, cranberry juice |
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what is paracentesis?
WHAT DO YOU DO WITH THE FLUID? |
what is paracentesis?
- drain fluid from abdomen WHAT DO YOU DO WITH THE FLUID? - record the amount, color, consistency, odor |
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Before inserting a foley catheter, what questions do you ask the pt?
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Before inserting a foley catheter, what questions do you ask the pt?
- allergies to iodine and latex |
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what is dysuria?
OLIGURIA? AURIA? PYURIA? POLYURIA? |
what is dysuria?
- painful urination OLIGURIA? - little urine AURIA? - no urine PYURIA? - puss in urine POLYURIA? - too much urine |
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Your assessing a AV fistula
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your assessing a AV fistula
- feel for a thrill, listen for a bruit |
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What is a urolithiasis?
WHAT DO YOU DO W/ THE URINE? |
What is a urolithiasis?
- kidney stones WHAT DO YOU DO W/ THE URINE? - strain it |
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Doctor orders lasix, how do you know lasix has desired affect?
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Doctor orders lasix, how do you know lasix has desired affect?
- increased urinary output |
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pt has had a TURP procedure, what does this stand for?
COLOR OF URINE? |
pt has had a TURP procedure, what does this stand for?
- transurethrial resection of the prostate COLOR OF URINE? - bloody |
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In renal failure, what would you expect the BP to do?
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In renal failure, what would you expect the BP to do?
- increase - because of fluid overload |
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What is one of the most potential complication of peritoneal dialysis?
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What is one of the most potential complication of peritoneal dialysis?
- peritonitis (infection) |
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pt has renal failure, what complication symptom of renal failure would the nurse be expected to observe?
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pt has renal failure, what complication symptom of renal failure would the nurse be expected to observe?
- anemic ESSENTIAL TO MEASURE I&O |
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What are the stages of renal failure?
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Stages of renal failure
- Oliguric - Diurectic - Recovery |
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we just had an earthquake, first action is what?
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we just had an earthquake, first action is what?
- find instructions and follow |
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pt comes into ER w/ deep laceration bleeding perfusely, what do you do?
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pt comes into ER w/ deep laceration bleeding perfusely, what do you do?
- apply pressure |
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what are the s/s of hypovolemic shock?
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what are the s/s of hypovolemic shock?
- BP decrease - pulse and respiration increase - urine output decreases |
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When you have a laceration in the skin, what is important for you to ask the pt?
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When you have a laceration in the skin, what is important for you to ask the pt?
- when was your last tetnus shot |
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In hypovelmic shock, the early symptom of hypovelemic shock is what?
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In hypovelmic shock, the early symptom of hypovelemic shock is what?
- narrow pulse pressure |
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pt has informed consent, what is this implying?
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pt has informed consent, what is this implying?
- knows the risks, benefits and alternatives |
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pt has had abdominal pain and comes back to post anesthesia care unit, what is the first thing you assess?
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pt has had abdominal pain and comes back to post anethesia care unit, what is the first thing you assess?
- airway |
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how soon before surgery would you be giving pre-op meds?
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how soon before surgery would you be giving pre-op meds?
- 30 min |
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who job is it to explain surgical procedure?
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who job is it to explain surgical procedure?
- Surgeon |
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pt is going in for abdominal surgery, before you medicate, what do you want to make sure the pt does? WHY?
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pt is going in for abdominal surgery, before you medicate, what do you want to make sure the pt does?
- voids WHY? - we don't want laceration of bladder |
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What is the problem of vomiting post op?
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What is the problem of vomiting post op?
- aspiration |
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What is the primary reason surface hair is shaved?
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What is the primary reason surface hair is shaved?
- reduce chances of infection |
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To prevent complications following abdominal surgery, what do we do with the pts?
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To prevent complications following abdominal surgery, what do we do with the pts?
- turn, cough, deep breathe, incentive spirometer |