203 Multiple Choice Flashcards
Following diagnostic testing, a patient with recurring heartburn and indigestion is diagnosed with a hiatal hernia. The nurse explains to the patient that this condition involves
A. Extension of the oesophagus through the diaphragm
B. Displacement of the duodenum through the stomach to the oesophagus
C. Twisting of the stomach around the oesophagus, occluding the oesophagus
D. Protrusion of the stomach into the oesophagus through an opening in the diaphragm
D. Protrusion of the stomach into the oesophagus through an opening in the diaphragm
A patient with a severe allergic reaction is treated with adrenaline. The nurse recognises that the rational for the use of adrenaline is that adrenaline opposes the effects of A. Histamine B. Lymphokines C. Interleukin-2 D. Lysosomal enzymes
A. Histamine
The braden and Norton scales are used in the clinical area to
A. Assess the skin in patients to identify any pressures area risk
B. Assess the patients own physical ability to take care of skin
C. Assess the pressure ulcer once developed
D. Assess the wound care of patients with pressure ulcers
A. Assess the skin in patients to identify any pressures area risk
When assessing a patient with a neurological disorder using the Glasgow coma scale, the nurse is obtaining general information related to the
A. Level of consciousness
B. Presence of cerebral oedema
C. Presence of corneal and pupillary reflexes
D. Intergrated functions of the cerebral cortex
A. Level of consciousness
When using the AORC observation chart, observations falling in which colour box according to the escalation protocol necessitates activating a medical emergency A. Orange B. Blue C. Purple D. Yellow
C. Purple
A Prima facie rule in ethics includes all the following except A. Beneficence B. Justice C. Benevolence D. Autonomy
C. Benevolence
- Non maleficence and beneficence fix the physicians primary obligations to the patient and triumph over the patients preferences and decision making rights
True
False
False
Which of the following is not a rationale for the practice of intermittent self catheterisation
A. To reduce the risk of infection
B. To allow the patient to be catheter free between catheterisation a
C. To prevent bladder over distension and incontinence
D. To reduce irritation on the neck of the bladder from the balloon of an indwelling urinary catheter
D. To reduce irritation on the neck of the bladder from the balloon of an indwelling urinary catheter
Which of the following is not a common cause of upper GI bleeding A. Mallory Weiss tear B. Neoplasia C. Drugs such as NSAIDS and alcohol D. Chrohns disease
Chrons disease
Which of the following is incorrect in regard to H.pylori
A. H.pylori is present in 90% of all patients with duodenal ulcers
B. H.pylori in 75-80% patients with gastric ulcers
C. Routine eradication of H.polyri for all not recommended due to suspected protective benefits
D. H.polyri is only found in stomach, duodenum and jejunum of colonised people.
D. H.polyri is only found in stomach, duodenum and jejunum of colonised people.
Oesophageal varices are
A. Formed as a direct result of liver dysfunction increasing splanchnic pressure in the GIT
B. Formed as a direct result of dysfunction decreasing the formation of essential clotting factors such as factor vII and xi
C. Formed as a direct result of liver dysfunction resulting in raised oesophageal venous pressure
D. Formed as a direct result of liver dysfunction reducing portal vein and intrahepatic resistance
C. Formed as a direct result of liver dysfunction resulting in raised oesophageal venous pressure
Which obtaining a nursing history from a patient with inflammatory bowel disease, the nurse recognises that the patient most likely has ulcerative colitis rather than chrons disease when the patient reports experiencing A. Weight loss B. Bloody diarrhoea C. Abdominal pain and cramping D. The onset of the disease at age 20
B. Blood diarrhoea
A patient has a newly formed ileostomy for treatment of ulcerative colitis, in teaching the patient about the care of her ileostomy the nurse informs the patient that she should
A. Restrict fluid intake to prevent constant liquid drainage from the stoma
B. Change the pouch everyday to prevent leakage of contents onto the skin
C. Maintain as normal diet as possible, avoiding foods that cause gas or diarrhoea
D. Irrigate the ileostomy daily or every other day to avoid having to wear a drainage appliance
C. Maintain as normal diet as possible, avoiding foods that cause gas or diarrhoea
When the nurse applies a stimulus to an unconscious patient, the patient responds by stiffly extending and abructing the arms and hyperpronating the wrists. The nurse interprets the finding as:
A. Decorticate posturing indicating an interruption of voluntary motor tracts
B. Decerebrate posturing indicating an interruption of voluntary motor tracts
C. Decorticate posturing indicating a disruption of motor fibres in the midbrain and brainstem
D. Decerebrate posturing indicating a disruption of motor fibres in the midbrain and brainstem
D. Decerebrate posturing indicating a disruption of motor fibres in the midbrain and brainstem
A patient is admitted to the emergency department, with the possible fractures of the bones of the left lower extremity. Prior to initiating treatment for the patient, it is most important for the nurse to
A. Splint the lower leg
B. Elevate the injured limb
C. Check neurovascular status distal to the injury
D. Assess the patients tetanus immunisation status
C. Check neurovascular status distal to the injury
A postoperative patient states that “it hurts to much to deep breath and cough every 2 hours” and refuses to carry out this activity. An appropriate intervention by the nurse is to
A. Tell the patient that it is the nurses responsibility to prevent respiratory complications and insist that she cough and deep breathe
B. Enlist the help of the physician in reinforcing the need to cough and deep breathe
C. Explain what happens to the lungs postoperatively and why the exercise is important
D. Respect the patients wishes and turn the patient side to side more frequently
C. Explain what happens to the lungs postoperatively and why the exercise is important
Temperature, heart rate and blood pressure do not need to be checked one hour after commencement of a blood transfusion
True
False
False
