Question Trainer #1

Front 1

fontanelle
should feel like?

Back 1

should feel soft and flat; fullness or bulging indicates?
-closes when?

Hint 1

-increased intracranial pressure
fontanelle is closed by 2 to 3 months

Front 2

umbilical cord falls off when?

Back 2

falls off within 1 to 2 weeks; no tub baths until the cord falls off

Front 3

circumcision care

Back 3

don’t remove exudate; clean with warm water

Front 4

motor reflex is?
disappears when?

Back 4

extended her extremities and returned them to their previous position. disappears after 3 to 4 months

Front 5

hemophilia

Back 5

sex-linked disorder bleeding disorder. transmitted to male by female carrier, recessive trait. (Mother recessive gene to son).
Most common: Factor 8 deficiency
-precautions?

Hint 5

avoid contact sports.
tx joint pain, Do Not use aspirin
avoid IM injections
monitor for bleeding (bruising, pallor)

Front 6

pincer grasp
present when?

Back 6

present at 9 months of age

Front 7

infant sitting with support

Back 7

6-month-old should sit with help

Front 8

Tripling of the birth weight

Back 8

present at 1 year

Front 9

endotracheal tube suctioning

Back 9

inserted until resistance is met
never suction longer than 10–15 seconds
withdraw 0.4 to 0.8 inches (1 to 2 cm), and apply intermittent suction with twirling motion

Front 10

projection

Back 10

attributing one’s thoughts or impulses to another

Front 11

displacement

Back 11

shifting of emotion concerning person or object to another neutral or less dangerous person or object

Front 12

sublimation

Back 12

diversion of unacceptable drives into socially acceptable channels

Front 13

internalization

Back 13

incorporation of someone else’s opinion as one’s own

Front 14

rationalization

Back 14

attempt to make behavior appear to be the result of logical thinking

Front 15

intellectualization

Back 15

excessive reasoning or logic used to avoid experiencing disturbing feelings

Front 16

reaction formation

Back 16

development of conscious attitudes and behavior patterns into opposite of what one really wants to do

Front 17

symbolization

Back 17

something represents something else

Front 18

positive VDRL

Back 18

Venereal Disease Research Laboratory test or VDRL is a blood test for syphilis.
Instruct the client on the importance of taking the penicillin for the prescribed time.

Front 19

sufficient ROM is?

Back 19

assists the elderly to carry out activities of daily living (ADLs).

Front 20

fetal alcohol syndrome: s/s

Back 20

small head circumference
low birth weight
undeveloped cheekbones
feeding difficulties and poor sucking ability
respiratory distress related to preterm birth,
neurologic damage,
small trachea,
floppy epiglottis

Front 21

hydromorphone hydrochloride (Dilaudid)

Back 21

narcotic analgesic used for moderate to severe pain, monitor vital signs frequently

Hint 21

s/e Hypotension and respiratory depression

Front 22

urine glucose levels in elderly

Back 22

the level at which glucose starts to appear in the urine increases, leading to false-negative readings (may be 0-180); results in elevated glucose levels.

Front 23

ultrasound in pregnancy does what?

Back 23

ultrasound detects the gestational age

Front 24

what test evaluates fetal lung development?

Back 24

lecithin/sphingomyelin (L/S) ratio by an amniocentesis. lecithin exceeds sphingomyelin by 2 to 1

Front 25

tx of pediculosis capitis (head lice)

Back 25

-1% gamma benzene hexachloride (Kwell) shampoo
-very hot water and a special detergent (RID) need to be used for cleansing clothing and personal belongings
-repeated 5 to 7 days after first application. repeat after eggs hatch
-tx w/ permethrin 1% crème rinse (Nix) kills both lice and nits after one application and does not need to be repeated.

Front 26

enema procedure

Back 26

-tube should be inserted no more than 4 inches
-patient left side-lying (Sim's) with knee flexed: allows solution to flow downward along the natural curve of the sigmoid colon and rectum, which improves retention of solution

Front 27

respiratory distress of the newborn looks like:

Back 27

Expiratory wheezing and substernal retractions

Front 28

laryngotracheobronchitis (LTB) breathing looks like:

Back 28

Inspiratory stridor and restlessness: characterized by edema and inflammation of upper airways

Front 29

diabetic ketoacidosis breathing c/b:

Back 29

Kussmaul respirations

Front 30

chlorpromazine hydrochloride (Thorazine)

Back 30

antipsychotic medication

s/e?

Hint 30

side effects include akathisia (motor restlessness), dystonias (protrusion of tongue, abnormal posturing), pseudoparkinsonism (tremors, rigidity), and dyskinesia (stiff neck, difficulty swallowing)

if so: decrease med or give Cogentin

Front 31

priority nursing diagnosis for a client with a tracheostomy:

Back 31

ineffective airway clearance because loss of the upper airway increases the amount and viscosity of secretions

Front 32

hypoparathyroidism

Back 32

decreased secretion of parathyroid hormone; indications include tetany, muscular irritability, carpopedal spasms, dysphagia, paresthesia, and laryngeal spasm

diet?

Hint 32

diet for the client should provide high calcium and low phosphorus because the parathyroid controls calcium balance

Front 33

complete triad seen with pre-eclampsia, (early pre-eclampsia s/s)

Back 33

hypertension (140/90 or increase of 30/15)
edema (generalized)
proteinuria (1+ or 2+)

Front 34

Severe pre-eclampsia s/s:

Back 34

headache, epigastric pain, extreme irratibilty, sudden onset of edema, hemorrhage, pulmonary edema
hyperflexia
HELLP (hemolysis, elevated live enzymes, low platelet count)
proteinuria (3+ to 4+)
hypertension

Front 35

eclampsia (no longer pre) s/s

Back 35

hypertension
proteinuria
oliguria, blurred vision
SEIZURES, tonic clonic generalized

Front 36

complications of IV drug abuse:

Back 36

CELLULITIS is a common complication because of skin popping or using an infected drug apparatus

Front 37

with a CVA things you cannot prevent as a nurse are:

Back 37

Inability to talk.
Loss of the gag reflex
Inability to open the affected eye

Front 38

with CVA things a nurse can help to prevent are:

Back 38

Corneal abrasion: b/c client will be unable to close eye voluntarily; when facial nerve (cranial nerve VII) is affected, the lacrimal gland will no longer supply secretions that protect eye

Front 39

gr. X is?

Back 39

10 grains = how many mg?

Hint 39

600 mg

Front 40

side effects associated with antipsychotic agents:

Back 40

Restlessness, shuffling gait, involuntary muscle movements
Elevated white blood cell count, fever, orthostatic hypotension

Front 41

lithium

Back 41

tx bipolar disorder; mainly to control mainc episodes

normal blood target level?
Check serum levels when?
dose during depressive state?
should not take/ or take with?
early vs. severe s/s of toxicity?

Hint 41

-Normal blood target level: 1-1.5
-Check serum levels: 2-3 weekly when started, then 1x month when on maintaince. Draw in the AM prior to dose
-1/2 dose during depressive state
-Drink 2,500 to 3,000 fluid intake
-get adequate sodium intake
-GI effects reduced if taken with meals
-early toxic s/e: Fine tremors, nausea, vomiting, diarrhea.
-severe toxic s/e: Ataxia, confusion, seizures--require promt tx!

Front 42

things to remember about lithium toxicty:

Back 42

toxicity is very similar DI,
need to increase water and increase Na, therefore you do not want alot of K+

Front 43

reflux due to a hiatal hernia

Back 43

withhold food and fluids just before going to bed b/c You are less likely to awaken during the night with heartburn if the stomach is empty.

Front 44

elderly adults have problems with constipation b/c

Back 44

reduced gastrointestinal motility due to decreased muscle tone, decreased exercise; other factors include prolonged use of laxatives, ignoring urge to defecate, side effect of medications, emotional problems, insufficient fluid intake, and excessive dietary fat

Front 45

Solitary play

Back 45

describes play for an infant

Front 46

Parallel play

Back 46

describes play for a toddler

Front 47

Associative play

Back 47

play that characterizes 4-year-olds

Front 48

Addison's disease

Back 48

adrenal glands produce too little cortisol and often insufficient levels of aldosterone as well
AKA: adrenal insufficiency or hypocortisolism

s/s?
tx: ?

Hint 48

muscle weakness/fatigue
weight loss, pathologic fractures
darking of skin= hyperpigmentation
low BP
low blood sugar
low sodium
low blood volume
high potassium

tx: hormone replacement

Front 49

Addison's crisis

Back 49

acute adrenal failure

s/s?
tx?

Hint 49

could lead to shock: Restlessness and rapid, weak pulse
n/v
ab pain
fever
and extremeness of all s/s of disease

tx: give hydrocortisone
fluids
glucose
k+ binding with excretion meds

Front 50

mother’s fourth stage of labor, the nurse should palpate the client’s fundus where?

Back 50

uterus is normally contracted and palpable at the umbilicus

descends on finger breath each day
should be at pelvic organ by day 10!

Front 51

postoperative cataract client

Back 51

sudden changes in position, constipation, vomiting, stooping, or bending over is not advised b/c?

Hint 51

increase the INTROCULAR pressure and put pressure on the suture line.

*not all pts get implants!

Front 52

cataract s/s?

Back 52

objects blurred
decrease color
glares
pupil changes from BLACK to GRAY to WHITE

if implant do what?
if no implant do what?

Hint 52

if implant= pupil remains constricted!

if no implant (aphakic)= pupil remains dialted!

Front 53

cataract EXTRAcapsular vs. INTRAcapsular extraction?

Back 53

e: cut through anterior capsule to expose the opaque lens: most common

i: cut out entire lens and capsule: greater risk for retinal detachment.

Front 54

BEST indication of an alcohol problem in a client hospitalized for another physical illness is?

Back 54

client who has several complaints of pain that do not appear to be correlated to the admissions problem requires further investigation; tremors, elevated temperature, and pain symptoms are indicative of an alcohol-related problem

Front 55

pituitary dwarfism looks like?
(hypopituitarism)

Back 55

-small size but normal body proportions
-delayed sexual maturity: appear younger than chronological age
-fine, smooth skin
-features delicate!

what is it c/b?

Hint 55

hyposecretion of growth hormone, occurs before maturity.

complication: diabetes (?)
tx: human growth hormone replacement, thyroid growth replacement, testosterone

Front 56

mannitol (Osmitrol)

Back 56

osmotic diuretic; increases urinary output and decreases intracranial pressure

Front 57

Integrity versus despair and disgust

Back 57

appropriate for ages 65 and older

Front 58

Generativity versus stagnation

Back 58

stage of development for 45 to 64 years of age

Front 59

Intimacy versus isolation

Back 59

appropriate for the young adult

Front 60

Identity versus role diffusion.

Back 60

appropriate for the adolescent

Front 61

ceftriaxone sodium (Rocephin)

Back 61

cephalosporin: antibiotic

What is important to monitor?

Hint 61

long-term use of Rocephin can cause overgrowth of organisms; monitoring of tongue and oral cavity is recommended

Front 62

hypothyroidism: watch out for?

Back 62

-cannot tolerate cold temperatures
-very sensitive to narcotics, barbiturates, and anesthetics
-requires high fiber, high cellulose foods to prevent constipation

Front 63

Rinne tests

Back 63

The stem of a vibrating tuning fork is held against the mastoid bone until the child indicates that she can no longer hear the sound. Then the tuning fork is moved in front of the auditory canal.

Hint 63

air conduction is better than bone conduction

Front 64

Weber test

Back 64

The stem of a vibrating tuning fork is held in the middle of the forehead, and the pts hearing is assessed in both ears.

Front 65

type 1 diabetes decreased vision caused by?

Back 65

gradual destruction occurs because of deterioration of the retinal vessels

Front 66

clomiphene citrate (Clomid)

Back 66

induces ovulation by altering estrogen and stimulating follicular growth to produce a mature ovum

Front 67

naproxen sodium (Naprosyn)

Back 67

NSAID (nonsteroidal anti-inflammatory drug) used as analgesic

s/e: ?

Hint 67

headache, dizziness, gastrointestinal distress, pruritus, and rash

Fluid retention
nephrotoxicity

Front 68

DM pt post-op gets SQ insulin (when they are only on oral meds) means:

Back 68

inability to control diabetes mellitus by diet and oral agents, coupled with surgically induced metabolic changes, being NPO both before and after surgery, and the infusion of intravenous fluids necessitates temporary control by insulin.

Front 69

Most important info for a rehab nurse to KNOW on a new admission?

Back 69

The client’s personal goals for rehabilitation: it is important for the nurse to understand what the client expects from the rehabilitation program for future success

Front 70

hormone that produces the "flight or fight" response?

Back 70

epinephrine

Front 71

hormone that regulating the calcium metabolism is?

Back 71

parathyroid hormone parathormone

Front 72

hormone that converts proteins and fat into glucose is?

Back 72

cortisol; is also an anti-inflammatory agent

Front 73

hormone that enhances musculoskeletal activity

Back 73

action of norepinephrine

Front 74

delusions of reference

Back 74

false belief that public events or people are directly related to the individual

Front 75

delusions of persecution

Back 75

elusion is a strongly held belief that is not validated by reality; the idea that his brother is trying to steal his property is a belief not validated by reality

Front 76

verapamil (Calan)

Back 76

tx for supraventricular tachcardias
Antihypertensive: CaChannel Blocker

Most important tocheck for what prior to giving?
Avoid?

Hint 76

check HR!!

Avoid grapefruit juice

Front 77

out of these four which is most often used intravenously:
Benzodiazepines.
Barbiturates.
Narcotics.

Back 77

Narcotics.

Front 78

Breast feeding mother should increase their calorie intake by ?

Back 78

500 calories

Front 79

chest tubes:
suction control chamber

Back 79

1st tube
There is continuous bubbling in the suction control chamber.
fill with sterile water to the 20cm level, or as ordered by doc.

Front 80

chest tubes:
collection chamber

Back 80

3rd tube
postop, more than 100cc/hr would be expected

Front 81

chest tubes:
water seal chamber

Back 81

2nd tube
fluctuates with respirations:
-inspiration=increased negative pressure in the pleural cavity= increases the water level.
-expiration=decreased pleural pressure =decreases the water level.

Front 82

chest tubes:
If chest tube becomes dislodged..?

Back 82

apply pressure over the insertion site with a dressing that is tented on one side to allow for the escape of air.

Front 83

chest tubes:
If the tube becomes disconnected from the drainage system...?

Back 83

cut the contaminated tip off the tubing using sterile scissors, and immerse the end of the chest tube in 2 cm sterile water until system can be reestablished. Cut off the contaminated tip of the tubing before inserting it into sterile saline. This will prevent air from returning to the chest by maintaining the water-seal.

Front 84

chest tubes are clamped when?

Back 84

Chest tubes are clamped ONLY MOMENTARILY to check for air leaks and to change the drainage apparatus.

Front 85

continuous bubbling in the water-seal chamber means?

Back 85

This indicates a leak in the drainage system. need to check for location of leak; clamp tubing close to chest and check for bubbling, and then clamp tubing close to container and check for bubbling

Front 86

Chest tubes:
are placed b/c?

Back 86

Are placed in the pleural space to drain air and blood so the lung can re-expand. The drainage system consists of one or more chest tubes. The collection container is placed below the chest and a water seal is used to keep air from entering the chest.

Front 87

if fluctuations in the chamber stop moving, this could mean..?

Back 87

1. lund re-expanded
2. tubing is obstructed
3. loop hangs below rest of tubing
4. suction is not working.

Front 88

allergic reaction is characterized by

Back 88

wheezing, urticaria (hives), facial flushing, and epiglottal edema

Front 89

indicative of a hemolytic transfusion reaction?

Back 89

Chills, hypotension, lower back discomfort.

Front 90

action of cardiac glycosides such as digoxin is?

Back 90

Increases the force of myocardial contraction.

Front 91

pacemaker purpose

Back 91

acts to regulate cardiac rhythm= Increases the cardiac output.

Front 92

action of antiarrhythmics such as quinidine

Back 92

Prevents premature ventricular contractions (PVCs)

Front 93

action of diuretics such as Lasix

Back 93

Prevents systemic overload.

Front 94

to prepare for a plasma cholesterol screening?

Back 94

-normal diet the week before
-avoid alcohol
-only sips of water are permitted for 12 hours before plasma cholesterol screening to achieve accurate results

Front 95

Diets for lead poisioning:

Back 95

High in calcium and vit D= help body absorb less lead
High in iron=" "
High in Vit C= helps the body absorbs more iron=which will them absorb less lead.

Front 96

Stages of loss or terminal illness

Back 96

5 stages:
1. Denial and isolation
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Front 97

intravenous pyelogram (IVP)

Back 97

provides x-ray visualization of kidneys, ureters, and bladder

pre-op?
post-op?

Hint 97

preop: bowel prep, npo after midnight, check allergies for iodine or shellfish, eggs, milk
-may have c/o of salty taste or burning

post-op:
watch for s/s of reactions to dye (edema, itching, wheezing, dyspnea.

Front 98

Natural passive immunity

Back 98

occurs when antibodies are passed from mother to fetus via placenta, colostrum, and breast milk

Front 99

Artificial active immunity

Back 99

small amounts of specific antigens are used for vaccination; body responds by actively making antibodies

Front 100

Natural active immunity

Back 100

antigen enters the body without human assistance; body responds by actively making antibodies

Front 101

Artificial passive immunity

Back 101

involves injection with antibodies that were produced in another person or animal; used to protect person exposed to serious disease.

Front 102

SHARE is what kind of support group?

Back 102

a support group for parents who have lost a newborn or have experienced a miscarriage

Front 103

SIDS is what kind of support group?

Back 103

support group for parents who have had an infant die from sudden infant death syndrome.

Front 104

RESOLVE is what kind of support group?

Back 104

support group for infertile clients

Front 105

CANDLELIGHTERS is what kind of support group?

Back 105

support group for families who have lost a child to cancer.

Front 106

colostomy irrigations:

Back 106

-do at SAME time each day=helps create normal pattern of elmination
-do Once a day
-catheter is never inserted more than 4inches
-should be at body temp.

Front 107

apraxia is

Back 107

is loss of purposeful movement in the absence of motor or sensory impairment; when it affects an ADL, such as dressing, the client may not be able to put clothes on properly

Front 108

Ataxia is

Back 108

describes a lack of muscle coordination during voluntary movements, such as walking or picking up objects.
it can affect your movements, your speech, your eye movements and your ability to swallow.

Front 109

s/s of fractured right hip?

Back 109

The leg appears to be shortened and is adducted and externally rotated.