Nur 212: Life Span 2 (Practice Exam B)

Front 1

What is the primary focus of cognitive therapy?

Back 1

current problems

Front 2

Inability to sleep through the night or w/out nightmares is a common sx of what?

Back 2

PTSD

Front 3

What is the nurse demonstrating when she conveys an observation of the patient to help the patient better understand personal thoughts and feelings?

Back 3

reflection

Front 4

How is a developmental crisis assessed?

Back 4

compares information about the student's current maturation level with her chronological age

Front 5

Diabetes is what type of disorder?

Back 5

hormonal

Front 6

If secondary anxiety is present due to the physiological disease process, it is a result of what?

Back 6

a hormonal disorder

Front 7

Using all 5 senses to create a relaxing environment to help manage stress describes what technique?

Back 7

guided imagery

Front 8

What is biofeedback?

Back 8

provides prompt and exact info on muscle activity, brain waves, skin temp, hheart rate, BP, etc. This requires instrumentation.

Front 9

What is meditation?

Back 9

a discipline for training the mind to develop a great calm and then using that calm to gain insight into ones experience

Front 10

What is progressive relaxation?

Back 10

combines deep relaxation of muscles and a specific method of breathinng in a continous progressive and sequential manner

Front 11

What characteristic is most common in succesful resolution of the grief response?

Back 11

good self esteem

Front 12

WHat is the most important nsg intervention during the nurses initial interaction with a pt who is experiencing auditory hallucinations?

Back 12

determine what the voices are saying to the pt.

Front 13

An excess of what can exacerbate the sx of schizophrenia in a psychotic pt?

Back 13

dopamine

Front 14

What is the therapeutic level of lithium?

Back 14

.4-1

Front 15

hand tremors and slight thirst are common sx when at a therapeutic level of whiich drug?

Back 15

lithium

Front 16

What wouls be an appropriate expected outcome for a 5 year old child who is autistic and has a nsg diagnosis of social isolation?

Back 16

the child will make attempts to offer toys to peers

Front 17

Amenorrhea occurs with what eating disorder?

Back 17

anorexia

Front 18

purging and binge eating are criteria for what eating disorder?

Back 18

anorexia and bulimia

Front 19

What is sublimation?

Back 19

transforming impulses into something constructive

Front 20

What is displacement?

Back 20

moving an impulse from one object to target another

Front 21

What is rationalization?

Back 21

finding a rationalization for questionable behavior

Front 22

What is repression?

Back 22

banishing a memory so pt doesnt feel pain, sorrow or sadness

Front 23

A person whoo values self-control highly will react to stress as a threat. What is the initial stress reaction for these people?

Back 23

anxiety

Front 24

According to the psychodynamic theory when individuals are predisposed to depression who experience stress can react with what?

Back 24

depression

Front 25

hostility represents an escalation from what?

Back 25

anxiety

Front 26

According to sullivans interpersonal theory what does anxiety come from?

Back 26

from tension that arises from social insecurity or blocks to satisfaction.

Front 27

How does sullivan define needs?

Back 27

the need for satisfaction

Front 28

Sullivan discusses "the bad me" as what?

Back 28

developing in response to anxiety producing appraisals from others

Front 29

Sullivan discusses "the good me" as what?

Back 29

representing that part of the personality that develops in response to rewarding appraisals from others.

Front 30

What is the goal of family therapy as a component of tx for a pt who has schizophrenia?

Back 30

reduce the familys stress level

Front 31

Which intervention should be priority when finding a suicidal pt attempting to kill himself?

Back 31

assign one-to-one arms length monitoring

Front 32

What are 2 common side effects of tricyclic antidepressants?

Back 32

1. orthostatic hypotension as a result of the alphaadrenergic blockade
2.dry mouth

Front 33

What is an appropriate outcome for an 8 year old chil with ADD who has a low tolerance for frustration?

Back 33

the cild will increase verbal expression of feelings to others

Front 34

What lab test must be monitored in a pt receiving valproic acid therapy for bipolar disorder?

Back 34

hepatic function

Front 35

Is valproate used in pts with cardiac or renal impairement?

Back 35

yes, with caution

Front 36

What is the primary goal for a patient in a preliminary stage of recovery from substance abuse?

Back 36

acknowledgement of the problem, this is necessary for succesful tx

Front 37

impulsiveness is a behavioral characteristic of what 2 disorders?

Back 37

antisocial personality disorder & borderline personality disorder

Front 38

LAck of empathy is a behavioral charqcteristic of what?

Back 38

narcissistic personality disorder

Front 39

Suicidal actions are characteristic of what?

Back 39

borderline personality disorder

Front 40

Lack of remorse is characteristic of what?

Back 40

antisocial personality disorder

Front 41

abandonment by a spouse would most likely result in self destructive behavior in a person with which disorder?

Back 41

borderline personality disorder

Front 42

a pt with anorexia is likely to experience difficulty with what developmental achievement?

Back 42

individual autonomy, becuse they have difficulty with self-image and with trusting themselves

Front 43

What is associated with an increased risk for violence among pts with schizophrenia?

Back 43

substance abuse

Front 44

Substance abuse is also associated with what 2 other negative outcomes?

Back 44

homelessness and violence

Front 45

A pt admitted for depression who now announces she feels great, and acts irratically in a very good mood jumping around etc, rapidly changes topics of concentration should lead the nurse to suspect the pt has what condition?

Back 45

bipolar disorder, an acute phase of the manic stage of bipolar disorder

Front 46

Can checking a depressed pts room for potentially harmful objects be assigned to a STNA?

Back 46

yes

Front 47

What type of therapy is an active, directive, time limited structured approach that addresses current problems such as chronic pain?

Back 47

cognitive therapy

Front 48

A pt whose been discharged to a group home following a prolonged stay in a psychiatric institution is likely to experience difficulty with what?

Back 48

initiating a change in the daily schedule, because institutions result in a person having little ability to exercise change or problem solving skills

Front 49

Why is it important for the nurse to be aware of the thoughts of a pt who has delusions of being an important political leader ?

Back 49

to identify factors that may influence the pts behavior

Front 50

What does conversion disorder involve?

Back 50

unexplained sx or defects affecting voluntary motor or sensory function suggesting a neurological or other general medical condition

Front 51

What do vegetative signs of depression include?

Back 51

change in bowel movements, eating habits, sleep disturbances, and disinterest in sex

Front 52

Inflexible response to stress is a behavior comman to what type of disorders?

Back 52

all 3 clusters of personality disorders

Front 53

avoiding social relationships can be seen in what 3 things?

Back 53

cluter A-paranoid
cluster B-antisocial and borderline
cluster C-avoidant personality disorders

Front 54

inability to tolerate being alone can be seen in what disorders?

Back 54

histrionic, & narcissistic & dependent personality disorders

Front 55

Fear of being exploited or harmed can be seen in what?

Back 55

all conditions in cluster A and obsessive compulsive disorder in cluster c

Front 56

Rapid pressured speech is one of the most common initial findings during the onset of what

Back 56

the manic phase in bipolar disorder

Front 57

other common findings of the manic phase in bipolar disorder are what?

Back 57

elated mood, increased activity, and reduced sleep

Front 58

What is neologistic speech?

Back 58

newly made up words or an every day word used in an idiosyncratic way

Front 59

What is poverty of speech?

Back 59

reduced amount of talking and is one of the negative sx of schizophrenia?

Front 60

unresponsiveness to the environment by a child who is emotionally disturbed indicates what?

Back 60

a severe problem and requires intervention

Front 61

Lithium is a mood stabilizer that is especially effective in what?

Back 61

reducing delusions of grandeur

Front 62

What are delusions of grandeur?

Back 62

a delusion (common in paranoia) that you are much greater and more powerful and influential than you really are

Front 63

What is the most important nsg intervention for a pt in an acute manic phase?

Back 63

provide a safe environment

Front 64

What is apraxia?

Back 64

inability to perform purposeful movements

Front 65

What is agnosia?

Back 65

inability to recognize objects or people . It usually begins as trouble with sensory recognition of objects , and in the later stages includes inability to recognize loved ones

Front 66

What is mnemonic disturbance ?

Back 66

memory impairment , primarily having to do with events

Front 67

What is the purpose of setting limits with a patient who displays manipulative behavior?

Back 67

to allow the pt to demonstrate limit setting on their own manipulative behaviors, so pt can gain control and take responsibility

Front 68

Based on Maslows Heirarchy of needs what should be the nursing diagnosis for an older adult pt with alzheimers

Back 68

risk for injury related to impaired judgement

Front 69

respite care directly addresses what?

Back 69

role strain

Front 70

nurses often use reminiscence therapy to help older adults achieve which of Eriksons psychosocial developmental goals?

Back 70

integrity

Front 71

the crisis of identity versus role confusion occurs in who?

Back 71

adolescence

Front 72

The crisis of industry versus inferiority occurs in who?

Back 72

school age years

Front 73

The crisis of integrity versus despair occurs in who?

Back 73

older adults

Front 74

The crisis of intimacy versus isolation occurs in who?

Back 74

early adulthood

Front 75

How would the nurse evaluate improvement in the self care activities of a pt with dementia?

Back 75

Ask the nursing assistant how much of the bath was completed independently

Front 76

What is the best way to evaluate improvement in self care activities?

Back 76

observe the patients change in the level of independent action

Front 77

What setting are you most likely to encounter pts with delerium?

Back 77

long term care facility for older adults

Front 78

What is the difference between acute confusion and dementia?

Back 78

acute confusion has a sudden onset and dementia is insidious

Front 79

What is aan appropriate short term outcome foor a pt withh alzheimers?

Back 79

participate in activities

Front 80

What intervention is most important in a discharge plan for a person newly diagnosed with early stage alzheimers dementia?

Back 80

maintain a consistent daily routine because it reduces confusion and discomfort and allows the patient a greater sense of control and thus, of self-esteem

Front 81

What causes pruritus in the pt with biliary cirrhosis of the liver?

Back 81

retention of bile salts

Front 82

What is biliary chirosis?

Back 82

the result of chronic biliary obstruction and infection

Front 83

Is it okay to have caffeine for a pt with pancreatitis?

Back 83

no because it increases pancreatic and gastric secretions

Front 84

What diet should be followed for a pt with pancreatitis?

Back 84

high carbs, low protein, and low fat foods

Front 85

Why would a nurse need to assess for pain with food in a pt receiving pancrelipase for chronic pancreatitis?

Back 85

because it is a replacement for pancreatic enzymes that helps to digest and absorb fat, proteins, and carbs. the nurse needs to assess this to determine the effectiveness of the meds

Front 86

What is lipodystrophy?

Back 86

a localized reaction at the site of insulin injections. If insulin is injected into scarred areas, absorption may be delayed

Front 87

What is the indication for giving a pt lactulose?

Back 87

to promote excretion of ammonia in the stool

Front 88

What nursing action is priority when planning home care for a visually impaired diabetic pt?

Back 88

assess the pts ability to perform a reliable capillary puncture at regular intervals to perform on an ongoing basis

Front 89

A pt at a high risk for developing cholelithiasis is who?

Back 89

a pt with diabetes

Front 90

A pt with nephrotic syndrome is at risk for what?

Back 90

infection, thrombooembolism, pumonary emboli, acute renal failure, and accelerated atherosclerosis

Front 91

What is a pt with thrombocytopenia at risk for?

Back 91

bleeding and petechiae

Front 92

A ot with scleroderma may manifest sx of what conditions?

Back 92

crest syndrome, raynauds phenomenon, esophageal hardening and dysfunction, sclerodactyly and telangiectasis

Front 93

What is precose prescribed for?

Back 93

diabetes

Front 94

When should precose be taken?

Back 94

immediately before a meal because it affects food absorptionn

Front 95

a diabetic patient with an unsteady gait associated with a decreased sensation to light touch is displaying sxc of what?

Back 95

diabetic neuropathy

Front 96

voiding in small amounts is an example of what type of neuropathy?

Back 96

autonomic

Front 97

an inability to concentrate could be related to what in relation to diabetes?

Back 97

hypo or hyperglycemia

Front 98

Can a pt with diabetic neuropathy display tremors of the hands?

Back 98

no, unrelated

Front 99

a pt displaying manifestations of cholecystitis should be questioned about the recent ingetstion of which drug?

Back 99

erythromycin

Front 100

What are common side effects of erythromycin?

Back 100

NVD and ab pain

Front 101

erythromycin side effects are similiar to sx what condition?

Back 101

cholecystitis

Front 102

What is the expected therapeutic effect of glucagon given to a diabetic pt with LOC?

Back 102

transitory hyperglycemia--accelerates the breakdown of glycogen to glucogen in the liver.

Front 103

clay colored stool following what type of procedure indicates a problem?

Back 103

choledochostomy

Front 104

Many pts with liver disease have what type of problems in relation to vascular issues?

Back 104

clotting defects and are at risk for bleeding

Front 105

Is it normal for a pt to run a low grade fever in the first 24 hrs following an open cholecystectomy?

Back 105

yes

Front 106

WHat is an acceptable hourly urinary out for a pt following a cholecystectomy?

Back 106

30 ml/hour

Front 107

what is the normal urinary output?

Back 107

35 ml/hour

Front 108

Within 24 hours following a cholecystectomy what type of drainage will a pt have from the surgical dressing and fromt he t tube?

Back 108

dressing=small amount serous drainage
t tube=gold-colored drainage

Front 109

What nsg intervention is important foor a home care nurse to continue following a discharged pt with acute pancreatitis?

Back 109

reinforce the importance of the patients fluid and nutritional intake

Front 110

What type of diet should be followed following acute pancreatitis?

Back 110

high carb, low protein, low fat diet, eliminate alcohol, and avoid excessive use of spicy foods and caffeine

Front 111

What testing is required prior to surgery?

Back 111

prothrombin time, partial thromboplatin time, and platelet counts performed

Front 112

What will the pt be asked to do before insertion of the needle for a liver biopsy?

Back 112

take several deep breaths and finally exhale and hold breath at the end of exhalation while the doctor begins to insert needle

Front 113

Could a pt experience pain in the right shoulder during or after a liver biopsy?

Back 113

no

Front 114

Following a liver biopsy what will the pt do?

Back 114

lie on the right side with a pillow under the costal margin

Front 115

When should a diabetic pt test his blood sugar in relation to exercise?

Back 115

before and after

Front 116

What is an acceptable blood sugar range before exercizing?

Back 116

150-250

Front 117

What inspection should be done by a diabetic pt after exercizing?

Back 117

inspect feet

Front 118

What type of diet should be followed for a pt with chronic pancreatitis?

Back 118

high carbs, low fat, low protein diet

Front 119

What typre of injections will a pt get with chronic pancreatitis?

Back 119

vit. B12

Front 120

How often should pt wth chronic pancreatitis monitor his weight?

Back 120

daily

Front 121

Can a pt with chronic pancreatitis have whine at dinner?

Back 121

yes one glass

Front 122

A patient with pancreatic dysfunction will display which clinical manifestations?

Back 122

hypocalcemia, elevated temp, elevated WBC's, hyperglycemia

Front 123

By what mechanism does propranolol prevent hemorrhage from esophageal varices?

Back 123

it is a beta blocking agent that acts to decrease portal pressure and has been shown to decrease esophageal varices

Front 124

What does a pt need for inital tx of signs of hypoglycemia?

Back 124

15 g of a fast acting concentrated source of a carb (4-6 ounces of OJ,6-10 pieces of hard candy

Front 125

Within 30-60 minutes of initial sx of hypoglycemia are resolved what should be done?

Back 125

eat a light snack

Front 126

What drug given for tx of diabetes acts by delaying absorption of glucose in the intestinal tract?

Back 126

precose

Front 127

What does micronase, glucatrol and dymelor do for a diabetic pt ?

Back 127

acts by directly stimulating the pancreas to secrete insulin

Front 128

What is the contributing factor in a patient with cushings to the development of diabetes?

Back 128

excessive cortisol causes increased gluconeogenesis

Front 129

What ismuscle waisting caused by?

Back 129

excessive protein catabolism

Front 130

Production of ACTH by malignancies may cause what?

Back 130

cushings syndrome

Front 131

increased breakdown of tissue protein and increased excretion of nitrogen lead to what?

Back 131

muscle breakdown, thin skin, and decreased bone density

Front 132

What problem could occur when receiving dialysis and why?

Back 132

leg cramps--muscle cramping occurs because of rapid fluids and electrolytes loss from the extracellular space

Front 133

When receiving dialysis, signs of change in consciousness, restlesness, and headache could indicate what?

Back 133

development of disequilibrium

Front 134

Is a potential complication of dialysis tx high or low BP?

Back 134

hypotension

Front 135

What does decreased erythropoietin production cause?

Back 135

anemia

Front 136

ESRD causes waste products to accumulate in the blood at toxic levels resulting in what related to what?

Back 136

fatigue related to decreased erythropoietin

Front 137

Can ESRD cause anorexia?

Back 137

yes, the ptsw nutrition must be carefully planned to ensure fluid and electrolyte balance

Front 138

What does a decreased serum osmolarity indicate?

Back 138

hyponatremia

Front 139

A pt with diabetes produced what kind of urine?

Back 139

large volumes of very dilute urine with little mineral content

Front 140

A patient with flid voume defecit will have what kind of BUN?

Back 140

increased

Front 141

A diabetic pt with fluid volume defecit will have what type of serum sodium level and why?

Back 141

increased, because a patient with diabetes is not excreting sodium, the substance builds up iin the blood stream producing increase serum sodium levels

Front 142

What is priority when assessing a pt with pheochromocytoma?

Back 142

vitals, becuase this pt can have high BP and other cardiovascular problems

Front 143

Pheochromocytoma is characterized by what 3 things?

Back 143

headache, diaphoresiis (may be flushed), and palpitations

Front 144

is a pt with pheochromocytoma at an increased risk for having hyperglycemia?

Back 144

yes

Front 145

Which would be an appropriate tx for a pt who has acute renal failure r/t prolonged dehydration with a K+ level of 6.4?

Back 145

kayexalate, it is a cation-exchange resin used in general in cases of hyperkalemia. It can be used with caution for patients who have acute renal failure

Front 146

What does Methimazole treat?

Back 146

hyperthyroidism

Front 147

What is Dibenzyline?

Back 147

an alphablocker used to treat hypertension in pts with pheochromocytoma

Front 148

What is methylprednisolone?

Back 148

a glucocorticoid used in secondary renal insufficiency

Front 149

Hypotension and its associated lightheadedness is a typical finding in patients with what disease?

Back 149

addisons

Front 150

Addisons causes what 2 things?

Back 150

anorexia and emaciation

Front 151

Increased facial hair and acne are characteristics of what disease?

Back 151

cushings

Front 152

emotional lability is characteristic in what 2 diseases?

Back 152

cushings and hyperthyroidism

Front 153

CHronic mania is a possible problem in what ?

Back 153

hyperthyroidism

Front 154

Which vital is monitored closely in a patient who is receiving epoetin alfa for the tx of anemia associated with chronic renal failure?

Back 154

BP, because this drug can cause hypertension, especially when just starting med

Front 155

What is the expected effect of administering epoetin alfa to a pt with chronic renal failure?

Back 155

an increase in RBC's because this drug raises the hematocrit (a measure of circulating RBC's)

Front 156

WHy would you monitor serum glucose in a pt who has undergone a bilateral adrenalectomy and is receiving glucocorticoid replacement?

Back 156

becuase a pt taking glucocorticoids is at risk for glucose intolerance and hyperglycemia

Front 157

A pt taking glucocorticoids should avoid what type of food?

Back 157

k+ because this pt is at risk for maintaining potassium

Front 158

What type of diet should a pt with graves disease have?

Back 158

high calorie and high protein due to high metabolic rate and peristalsis

Front 159

What is Lugols solution?

Back 159

an iodine prep administered to reduce blood loss by reducing vascularity and size of the thyroid gland

Front 160

A pt with graves has an excess of what circulating levels?

Back 160

T3 and T4

Front 161

WHat drug could be used to decrease serum TSH levels?

Back 161

levothyroxine

Front 162

Which statement best indicates that levothyroxine sodium therapy for a pt with hypothyroidism hhas been effective?

Back 162

i felt warm so I opened the wiindow, because this type of pt would usually be cold

Front 163

What is important to do when treating the elderly for hypthyroidism?

Back 163

start with low dose and increase them gradually is necessary to avoid cardiovascular and neurological side effects

Front 164

What problem in the integument system is common in chronic renal failure?

Back 164

pruritus with dry flaky skin

Front 165

What is an angioma?

Back 165

benign skin tumors that have no known relationship to chronic renal failure

Front 166

What is seborrhea?

Back 166

dermatitis that has wet and dry forms. The dry form is dandruff. This will sometimes acompany chronic renal failure

Front 167

What is pemphigus?

Back 167

an autoimmune disease with genetic factors

Front 168

Is autosomal dominant polycystic kidney disease an inherited disorder?

Back 168

yes, common

Front 169

Does autosomal dominant polycystic kidney disease get progressively worse with age?

Back 169

yes

Front 170

What renal sx acompany autosomal dominant polycystic kidney disease ?

Back 170

hematuria and renal stones if disease is untrewated it can lead to ESRD

Front 171

What type of condition is autosomal dominant polycystic kidney disease ?

Back 171

chroniic with no specific tx

Front 172

What sx are common in autosomal dominant polycystic kidney disease?

Back 172

ab or lumbar pain, heating pad is appropriATE

Front 173

What should the nurse inform the pt about developing a moonface while in corticosteroid therapy?

Back 173

most changes are temporary and will diapear when tx is over with

Front 174

What is acromegaly?

Back 174

result of oversecretion of growth hormone occuring after the epiphyseal plates have closed--that is, in adult hood

Front 175

What is cretinism?

Back 175

stunted physical and mental growth due to insufficient thyroid hormone secretion

Front 176

What is gigantism?

Back 176

result of oversecretion of growth hormone during childhood

Front 177

A masklike face is a characteristic of what condition?

Back 177

severe hypothyroidism

Front 178

What should be available in the room of a pt having a partial thyroidectomy and why?

Back 178

trach tray, suction and IV calcium gluconate because this pt is at risk for a breathing emergency because of swelling of the throat, hematoma, or nerve injury, these things should be availabe post op always

Front 179

What is propylthiouracil?

Back 179

antithyroid med

Front 180

a nasogastric tube and a hemovac could be used for a pt that had what type of surgery?

Back 180

abdominal

Front 181

What is the most important assessment in a pt with renal failure that gained 5 lbs in a day?

Back 181

assess breath sounds, fluid build up could lead to heart failure or pulmoonary edema

Front 182

WHat is amphojel used for?

Back 182

to manage excess phosphorus in a patient with renal failure

Front 183

Kayexelate can treat what?

Back 183

hyper k+ from renal failure

Front 184

In a pt with renal failure would they have high or low calcium

Back 184

low

Front 185

When teaching a newly diagnosed elderly pt about glucose monioring who should be present?

Back 185

another family member for help