Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

203D final > 203 D final > Flashcards

203 D final Flashcards

1
Q

Your assessing your patient and you note he has clinical manifestations of acromegaly what are they?

A

Deep voice, big tongue, large forehead, and coarse facial hair.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Patient is scheduled for transphenoidal pituitary adenoma pre op teaching will include?

A

No coughing or sneezing, no straws, report fluid drainage, do not brush teeth for a few days after surgery due to possibility of going through the nose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

You have a patient with fluids volume excess related to SIADH.

A

Maintain fluids restriction as ordered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Following a pituitary tumor removal you suspect the patient could develop DI when you discover that they have?

A

Specific gravity of 1.003.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Patient with a known DI and is on nasal desmopressin the nurse recognizes that the drug is not having an adequate therapeutic effect when the patient experiences?

A

Low Specific gravity of 1.002

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

An adult has hypoparathyroidism for 20 years the patient has come to the center for a check- up the nurse should assess the patient for?

A

Tetany

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In teaching the patient with hypo parathyroid about the disorder the nurse explains the blood calcium levels are altered because the role of the parathyroid hormone is to?

A

Stimulate bone reabsorption of calcium and increase the calcium in the body when blood calcium levels fall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Muscular twitching and hyperirritability of the nerves indicates tetany the nurse can test for this complication by?

A

Tapping the facial nerve just proximal to the ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In the pathophysiology of antidiuretic hormone problems indicate what assessment findings are SIADH?

A

Serum osmolality will be low,
urine output will be low,
and urine specific gravity will be high.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The nurse is assessing a 34 year old female who says she has a problem with constipation, cold all the time, always tired and can’t get anything done in addition she says her hair is falling out which of the following disorders does she have?

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The nurse teaches the client to monitor signs and symptoms for which potential complication after they have their parathyroid removed?

A

Hypocalcemia.
Works for bone resorption and on the kidneys to stimulate the resorption of calcium in the presence of vitamin D and in GI tract to bring back calcium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which medication would the nurse question in the patient diagnosis of untreated hypothyroidism?

A

Sedatives, already tired and slow may not wake up if you give them sedatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

You patient has been experiencing symptoms suggestive of hyperthyroidism which might include?

A

Tachycardia, heat intolerance, nervousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Your patient has a hyper-functioning thyroid which results in exophthalmos (buggy eyes). Nursing interventions should include which of the following?

A

Lubricating eye drops and instructing patient to blink often.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

You have a patient who is 72 years old and diagnosed with hypothyroidism and they are on synthroid which assessment is most important to continue to make during the initiation of the thyroid replacement?

A

Pulse rate and blood pressure, because we are basically giving them a stimulant that they have not had. They get tachycardic and hypertensive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If I have a patient that has DI the secretion of ADH is?

A

Low ADH secretion,
urine output high, serum osmolality is high,
specific gravity is low.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which of the following early manifestations are associated with hypopituitarism?

A

Headache, visual changes, loss of smell, N/V, seizures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Your caring for a patient in the recovery room looking for complications after they had a parathyroidectomy?

A

Vocal cord paralysis (laryngeal nerve damage), SIADH and DI, increased urine output greater than 100 ml/hr, hypocalcemia, hematoma at surgical site.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

SATA: A patient with hyperthyroidism could having a life threatening complication known as a thyroid storm what signs and symptoms might be seen for this diagnosis?

A

Agitation,
delirium with psychosis,
severe tachycardia and a temperature.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Patient that you are caring for has a Cushing’s syndrome and you are trying to explain to them about het dexamethasone suppression test that will be performed tomorrow what do you explain?

A

Administration of dexamethasone orally at 11pm and plasma cortisol level drawn at 8 am the next day.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A patient who is suspected of having a phenochromocytoma complains of sweating, palpitations, and headache which assessment is essential for the nurse to take first?

A

Check the blood pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which of the following applies to the patient with a phenochromocytoma?

A

Related to catecholamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Prior to discharge the physician prescribes hydrocortisone 10mg TID and Florinef 0.1 QD nursing education should focus on to consult the physician if they experience this side effect of glucocorticoid and florinef?

A

Rapid Weight gain and dependent edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Clinical manifestations of Addison’s disease include?

A

Anorexia, weight loss, hyperkalemia, hyperpigmentation, decreased resistance to stress.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

While caring for patient during an Addison’s crisis a priority goal of treatment would be?

A

Prevent shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which of the following signs and symptoms would indicate that a patient with Addison’s disease is receiving too much corticoid replacement?

A

moon face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The nurse is admitting a patient with SIADH which clinical manifestation would be reported to the MD?

A

A serum sodium of 112 and a headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The patient admitted with a history of vomiting for the past two days and unable to take their glucocorticoids the nurse should anticipate that?

A

The patient may develop adrenal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Teaching about corticosteroid therapy would include which of the following?

A

Don’t stop the medication, but taper off the medication as prescribed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

To measure the effectiveness of steroid therapy the serum cortisol level should be measured at?

A

8 am and 4pm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

A nursing assessment of a patient with Cushing’s syndrome reveals that the patient has trunk obesity then arms and legs an additional finding the nurse should expect would be?

A

Purplish red striae of the abdomen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A patient has developed Iatrogenic Cushing’s disease that what is the rationale for this problem?

A

Secondary to steroid, too much cortisol.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which type of food should the nurse advise the patient with hyper cortisol levels to avoid?

A

Caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

The patient ordered an IV hydrocortisone infusion to be started prior to the patient that is ending up with a bilateral adrenalectomy the nurse understands that the rational for this is?

A

Compensate for the sudden lack of hormones following surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Following bilateral adrenalectomy the highest priority assessment is?

A

Vital signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

You patient return from surgery after a bilateral adrenalectomy you notice the patient is sleepy, but easy to arouse. You notice an IV with hydrocortisone is still running at this time the nurse planning care for this patient knows it is essential to include which of the following nursing interventions?

A

monitor blood glucose levels to watch for the development for hyper and hypo glycemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Your patient is ready to discharge following a bilateral adrenalectomy the nurse determines that the patient understand the discharge instructions when they state?

A

I should wear a medical alert bracelet or necklace at all times.

38
Q

After receiving a change of shift report on the following patients which patient should the RN see first?

A

70 year old who recently started taking synthroid who has an irregular pulse of 130.

39
Q

Comatose patient is experiencing flexion of that arms wrist and fingers with abduction of the upper extremities this condition is assessed as?

A

Decorticate

40
Q

When the nurse is able to observe that patients tongue is midline this could be interpreted as?

A

Cranial nerve 12 –hypoglossal

41
Q

A patient who has a moderate contusion in a motor vehicle accident a day ago based on current Glasgow coma scale a score of 7 the nurse would include which of the following interventions in the care plan?

A

Decrease noxious stimuli, monitoring the vital signs, neurological status carefully, elevate HOB to 45 and position patient with good head and body alignment.

42
Q

When the physician obtains a specimen of spinal fluid via lumbar puncture it is important for the nurse to?

A

Number all the specimens drawn.

43
Q

When assessing a patient with a head injury the nurse notes that an early/ first signs of increase ICP is?

A

Change of LOC a little agitated or confused.

44
Q

A nurse identifies a nursing diagnosis for ineffective breathing airway related to loss of cranial nervous system function for a patient who has post traumatic brain swelling based on what finding?

A

Loss of cough and gag reflex

45
Q

The most significant observation to report when monitoring a patient with increased ICP is?

A

Decreased pulse, widening pulse pressure, and Cheyne stokes respirations ( Cushing’s triad)

46
Q

The nursing care plan includes elevating the head of the bed, positioning the patients head in straight alignment in order to reduce increased ICP the nurse recognizes that these actions are effective because they act by?

A

Promoting venous drainage/ return

47
Q

Your patient requires the insertion of an ICP monitor nursing responsibilities include?

A

Intervening when ICP pressure in greater than 18.

48
Q

After your patients craniotomy you patients family asks why a bone flap is necessary?

A

Accommodate post-operative brain swelling.

49
Q

The charge nurse observes an in-experienced staff nurse caring for a patient following a craniotomy for brain tumor which action by the in-experienced nurse requires the charge nurse to intervene?

A

Staff nurse suctions the patient every hour

50
Q

The patient suffered a sub arachnoid hemorrhage and complains of pain when moving his head the nursing diagnosis of pain would be related to?

A

Blood causing irritation to the meninges.

51
Q

A patient with a head injury opens his eyes to verbal stimuli, curses when stimulated, and does not respond to verbal command to move, but attempts to remove to painful stimuli the Glasgow coma scale is?

A

11

52
Q

During the assessment of a patient with a tumor of the left frontal lobe the nurse would expect to find?

A

Personality changes and judgement

53
Q

Which of the following types of brain tumors is most malignant?

A

Gliomultiforme

54
Q

Anti-convulsants medications must be taken in adequate amounts and on a regular schedule the method most commonly used to measure compliance and toxicity is?

A

Blood test for levels

55
Q

Flashing lights, spots in front of your eyes, numbness and tingling of the arms are all examples of?

A

Aura experience

56
Q

While discussing plans for the child’s discharge the nurse teaches the parents to take what actions when the child has a seizure, the nurse determines the teaching as effective when the father states?

A

Stay with her during the seizure and after it is over

57
Q

The nurse aide is attempting to put an oral airway into the mouth of a patient who is having a tonic-clonic seizure the nurse should take what action?

A

Tell the aide to stop trying to insert anything into the mouth

58
Q

In caring for a patient with epilepsy who is hospitalized and successfully treated for status epilepsy a precaution the nurse should include is?

A

Placing oxygen suction equipment at the beside

59
Q

A patient admitted after MVA with an open fracture of the femur in the OR she has a 60 minute period of hypotension. Post op labs BUN: 25 and creatinine of 1.2 additionally she was placed on a high dose of vancomycin in the recovery room. Today’s labs show a creatinine of 5.2 and a BUN 55 and no urine output what type of renal failure is this?

A

Intra-renal

60
Q

The patient scheduled for MRI because of a back injury which questions is essential for the nurse to ask?

A

Do you have metal in your body

61
Q

When developing a teaching plan for a patient scheduled for a spinal fusion which of the following should the nurse discuss with the patient?

A

The patient typically experiences more pain at the donor site then the fusion site.

62
Q

When the patient neck is flexed, flexion of the knees and hips is elicited. This is known as a?

A

Positive Brudzinski’s sign

63
Q

When assessing a patient with bacterial meningitis, which of the following should be immediately reported to the healthcare provider?

A

Blood pressure is 80/42

64
Q

Your patient is 24 presents to the emergency room with what is described as an exploding headache, photophobia and nausea these are classic signs and symptoms of?

A

Subarachnoid hemorrhage

65
Q

When placing a meal tray in front a patient who has sensory and perceptual problems of the right visual field during the rehabilitation phase the nurse should?

A

Stay with the patient and periodically draw her attention to the food on the right side of the tray.

66
Q

Stroke patient has received heparin intravenously for the past two days upon chart review the therapeutic level for heparin is 2 x the baseline PTT, today the PTT is less than 1.5 times his baseline PTT what is the appropriate action of the nurse?

A

Continue the heparin and notify the physician

67
Q

During your initial assessment you document a negative trousseau’s sign choose an answer that would indicate a negative signs?

A

When you inflate the BP cuff and occlude arterial, no carpel tunnel spasms

68
Q

A patient with a history of polycystic kidney disease has been admitted to the medical surgical unit following a post op knee surgery, which of the routine post-op orders is most important for the nurse to discuss with the physician?

A

Give Lovenox 60 mg Q 6 hours daily

69
Q

Which of the following is most important consideration when provided nursing care to a possible cervical spine injury?

A

Immobilize the head and spine keeping them in alignment

70
Q

You patient experiences a stab wound to S2-S4 region, this resulted in a lower motor neuron lesion he probably will experience?

A

Flaccid bladder

71
Q
  1. Your patient is 22 and re-admitted to the rehabilitation unit after a T4-incomplete spinal cord injury that occurred 6 months ago which technique displayed by your patient displays good technique regarding urinary care?
A

Checking for bladder distention frequently

72
Q

During the routine assessment the nurse auscultates the adolescent’s abdomen the nurse explains to the parents that this is necessary because patients with spinal cord injuries often develop?

A

Paralytic ileus.

73
Q

A patient with a T 2 spinal cord fracture beginning intensive rehabilitation one morning as the nurse prepares to assist her patient from bed to the wheelchair the patient tells the nurse that she does not feel like getting up and that she had a throbbing headache and she is slightly nauseated it is more important that the nurse?

A

Check the BP

74
Q

The nurse notes that the patients urinary appliance has pale yellow urine with large amounts of mucous how would the nurse best interpret this data?

A

The findings are normal for a patient with an ileal conduit.

75
Q

A positive Chovstek’s and trousseau’s sign is indication of?

A

Hypocalcemia

76
Q

Major complication for a patient with neurogenic bladder is?

A

Infection

77
Q
  1. In a home setting how can a patient who has a neurogenic bladder evaluate the effectiveness of the Valsalva maneuver for emptying the balder?
A

Catheter for post-void residual

78
Q

SATA: When you are assessing your patient’s hemodialysis access site during your morning assessment, which findings would be complications of your graft site?

A

Local bleeding at the site,
thrombus
yellow-greenish fluid at the site.

79
Q

A patient with impaired renal function has secondary hypertension the nurse understands that one of the causes of hypertension results from?

A

Increased RAAS production

80
Q

During assessment of the patient with a disorder of urinary system the nurse identifies a potential nephrotoxic agent when the patient reports the frequent use of?

A

NSAIDS

81
Q

Patient with a history of renal calculi and hospitalized with gross hematuria and severe colicky flank pain which radiates to his testicles the physician scheduled IV push dilaudid, straining all urine, encourage fluids too 500cc a day, the nurse gives the highest priority to the nursing diagnosis of?

A

Pain

82
Q

A patient urinalysis indicates a large amounts of protein in the urine the nurse recognizes that this finding most likely indicates damage to the?

A

Glomerulus

83
Q

A patient with renal disease is schedule for a creatinine clearance test the in preparing for the test the nurse?

A

Obtains samples and instructs patient on a 24 hour urine collection

84
Q

During a 24 hour urine collection one voided specimen is inadvertently discarded the nurse should?

A

Start over

85
Q

Pre- renal causes of acute renal failure include?

A

Hypotension, hypovolemia, cardiac pump failure

86
Q

When taking a history of a patient diagnosed with acute glomerulonephritis the nurse notes the potential cause is when the patient states?

A

I had a throat infection with a group A streptococcal

87
Q

Which of the following is an oliguric phase of acute renal failure and the nurse care plan should include?

A

Control of fluids

88
Q

A patient who lives alone with nausea and vomiting for 5 days today the neighbor finds him weak and feverish. Presents to the ER with BP 78/50, urine output 50 ml after straight cath, BUN 72, and creatinine 1.6. This is considered acute renal failure based on what you know the cause of the renal failure is dehydration so it is?

A

pre-renal

89
Q

In preparation for hemodialysis a patient with an AV fistula in the left arm you are going to post operatively assess for?

A

Auscultate the fistula for the bruit

90
Q

When teaching a patient about home peritoneal dialysis the nurse should explain that the primary concept of the prevention of peritonitis is to?

A

Maintain aseptic techniques

91
Q

A spouse of the patient with chronic renal failure confides to the nurse that the patient has been confused, irritable, paranoid, and that as a results the spouse is thinking about divorce based on this information the nurse would most like make which of the following nursing diagnosis?

A

Altered family process related to effect of chronic renal failure

92
Q

Post- operative management of renal transplant patients includes?

A

Aspetic technique to avoid infection,
isolation room when immunosuppression (highest), hourly output of urine to monitor kidney function.

All the above is the answer

203D final (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions