Archer 1 Flashcards
The term that best describes the role of the nurse as the nurse actively upholds and protects the rights of individual clients and a group of clients is:
Advocacy
The individual’s right to make independent, informed decisions without any coercion:
Autonomy
Deontological ethics and Utilitarian ethics are a:
School of ethical thought and does not relate to the rights of individual clients and groups of clients.
The “Five Rights of Delegation” are:
The “right” task The “right” circumstances The “right” person The “right” directions and communication The “right” supervision and evaluation
A variance and a medical error that has, or could have, cause harm to the client:
Sentinel event
A medication is a serious effect to a medication that is often needed to be discontinued:
Adverse effect
Unexpected and unexplainable effect to a medication:
Idiosyncratic side effect
Are the legal documents that you must you consider when you are writing up the assignments for the day because the state laws about the differentiated practice of members of the nursing team outline what the RNs, LPNs, and unlicensed assistive personnel are legally permitted to do:
The state’s scopes of practice for RNs, LPNs and unlicensed assistive personnel
In the presence of vaginal bleeding, an _________ is contraindicated unless inside an environment prepared to do an emergency delivery or cesarean section. Also, the nurse is not allowed and properly trained to perform an _________ examination.
internal vaginal examination
In _________, there is filling and inflammation of lung spaces with asbestos fibers. These fibers move into the alveolar space and cause fibrosis, leading to increased production in secretions impairing gas exchange
Asbestosis
The client with insufficient platelets may manifest as having:
Frank bleeding or oozing of blood from puncture sites, wounds, and mucous membranes
Increased hemoglobin and hematocrit levels would be displayed when the client has received a:
transfusion of red blood cells
Adding lemon juice, which is high in vitamin C, seems to cancel the inhibitory effect of tannin on:
Iron absorption
It is okay to add lemon for iron absorption
The PMI in children is between:
The fourth and fifth intercostal spaces at the midclavicular line
A large discrepancy in arm and leg blood pressures indicate congenital heart defects like:
Coarctation of the aorta or other obstructive disorders. It is not a normal finding in pre-school children
A systolic click can be appreciated at the sternal border:
Mitral insufficiency and is not normal in children.
Pulses are elevated when breathing in, and decreases when breathing out is:
Is normal in the assessment of cardiac status in pre-school children
Blurring vision and epigastric pain are indicators that pregnancy induced hypertension (PIH) has become:
More severe and may precede the eclamptic phase
A common side effect of magnesium sulfate (MgS04) is:
Respiratory depression
Forcing the client into the “quiet” room constitutes _________, which is touching the client without consent.
Battery
Restricting the client from going out of the room is:
False imprisonment
Threatening a client resulting in fear, is an example of:
Assault
The normal urinary pH ranges from:
4.5 to 8
_________ presents with shivering, bradycardia or tachycardia. The patient may also be alert or may have lethargy or confusion.
Mild Hypothermia
_________ presents with decreased LOC or coma, hypoventilation, bradycardia, atrial fibrillation, hypovolemia, cessation of shivering, and possible hyperglycemia.
Moderate Hypothermia
_________ manifests as coma, fixed and dilated pupils, bradycardia, apnea, hypotension, ventricular fibrillation, asystole
Severe Hypotermia
Frostbite is hypothermia in the:
Extremities
Frostbitten areas may appear :
Red and swollen or may be pale in color. Blisters containing clear of bloody purple fluid may appear.
A newborn who has not passed meconium 24 hours after birth must be assessed for:
Intestinal obstruction or congenital abnormalities
Clients with Raynaud’s disease or any other peripheral vascular disease are contraindicated to receive:
Ephedrine or any other adrenergic agonist (ends in RINE and PHRINE)
_________ should be on standby to save the vein in case of infiltration.
Phentolamine
Should you dilute Dopamine (Intropin) before use if it is not prediluted?
Yes. Diluting the drug prevents tissue irritation on injection.
Should you shake the insulin vial before withdrawing insulin?
No! You should not shake the vial but gently rotate it to ensure uniform suspension of insulin
The insulin should be stored in:
A cool place away from direct sunlight.
A fixed and dilated pupil signifies:
An increase in ICP
Provides ethical guidelines regarding nursing practice:
The Code of Ethics
Describes the scope of nursing practice. It directs the philosophy and standards of nursing. The formulation of policies and procedures should be based on this document:
Nurse practice acts
Outlines the rights that are due to them when admitted and seeking health care:
The Patient’s Bill of Rights
Provides people with mental illness the civil liberties that are due to them:
The Rights for the Mentally Ill
Staff members are encouraged to participate in the decision-making process whenever possible. The majority of the decisions are made by the group, not the manager in this management style:
Democratic
Decisions are made with little or no staff input. The manager makes all the decisions in the unit:
Autocratic
Problems are identified by the manager and presented to the staff with several solutions. Staff members are encouraged to provide input however, the manager makes the final decision:
Participative
Little direction, structure, or support is provided by the manager in a _________ type of management. The manager abdicates responsibility and decision making whenever possible in this type of management.
Laissez-faire
A trochanter roll is placed on the outer _________ holds the hip in a neutral position and keeps the leg in normal alignment
Outer aspect of the thigh
“Standard hip precautions” to decrease the chance of hip dislocation following total hip arthroplasty (THA) are:
- No extreme hip flexion (sleep on back with pillows between legs)
- No internal or external rotation of the hip (use trochanter roll, avoid crosing the legs)
- No adduction of the hip
What are legal mandates in terms of narcotics and controlled substances?
The verification of the narcotic count at the beginning and the end of the shift and the secure locking of controlled substances to prevent diversion and theft
Licensed practical nurses can also witness a sign when an:
Opiate is spent (ex. Dilauded)
The RN assumes responsibility for all aspects of care for a patient or group of patients during a shift of attention, although care can be delegated. The RN works directly with the patient, family, and health care team members is an example of:
Total patient care model
The RN leads a team consisting of other RNs, LPNs, and NAPs, with team members providing direct patient care under the supervision of the team leader is an example of:
Team Nursing
An approach that coordinates health care services, linking patient/family to the needed services. Rather than providing direct patient care, the case manager typically supervises the care provided by the health care team is an example of:
Case management
The RN is assigned responsibility for a caseload of patients, developing the plan of care, and when working, providing care for the workload of patients throughout their hospital stay is an example of:
Primary Nursing
When a patient is on restraints, it is important to document:
Reason for use of restraints
Patient’s response to restraints
Helps determine the size, consistency, shape, and mobility of the fundus. This helps assess the contents and, thereby, fetal lie. If the fetal head or buttocks (breech) are felt in the fundus, then the fetus is in “vertical lie.” If those parts are not perceived, the fetus is likely in a “transverse lie.”
First maneuver (“Fundal Grip”)
Helps determine the direction to which fetal back is facing:
The second maneuver
Helps assess the part of the fetus at the inlet and its mobility. It helps determine if the presenting part is engaged. In the absence of engagement, a movable body part will be felt:
The third maneuver
Helps assess fetal descent. The nurse can determine the position of cephalic prominence (felt like a rounded body) about other body parts. In vertex presentation, the cephalic prominence is on the same side as the small pieces. In the face presentation, the cephalic prominence is on the same side as the back where the head is extended, and the face presents:
The fourth maneuver
Leopold’s maneuvers: Refers to Four specific steps in palpating the uterus, which helps the nurse to determine:
The fetal lie and the fetal presentation
The whooshing or blowing sound sometimes heard upon cardiac auscultation is known as:
A heart murmur and may indicate valve incompetency
Pericardial friction sounds like a:
Scratching sound caused by the conflict between the heart and pericardium
S3 is a third heart sound sometimes referred to as a:
Gallop
Intussusception is characterized by:
The telescoping of one area of the intestines into another
Intussusception occurs more frequently in:
In children, often male, than others.
Rectal prolapse occurs from:
Chronic constipation and weakened anal sphincter
Gluten-free foods include:
Meat, fish, eggs, some dairy, vegetables, corn, fruit, rice, and gluten-free flours.
Sulfamethoxazole is used to treat:
Urinary tract infections and should be taken with plenty of water. Each dose should be taken with a full glass of water.
A common side effect of using sulfamethoxazole and does not warrant a visit to the emergency department:
Dark brown urine
The discoloration of the abdomen and periumbilical area is known as Cullen’s sign and indicates _________ when it occurs in conjunction with other symptoms. Other findings include elevated white blood cell count, bilirubin, and urinary amylase levels.
Pancreatitis
In pancreatitis, bowel sounds are generally:
Diminished or absent.
Hypothyroidism causes a decreased:
Metabolic demand, so fewer calories are required.
Cancer, COPD, and cardiac failure all increase the:
Metabolic demands on the body and the need for added calories
Patients who are at risk for aspiration should be encouraged to swallow with their chin:
Down
Fluids should be held until the end of the meal, when at all possible with patients who are at risk for:
Aspiration
The most immediate postoperative risk factor for a thoracentesis is:
Pneumothorax
Symptoms of pneumothorax include:
Dyspnea, chest pain, shortness of breath, and pain
Order for taking off PPE:
Gloves. Goggles. Gown. Mask. Perform hand hygiene.
(Alphabetical Order)
Cardinal movements of labor and delivery? Order of occurrence.
Engagement Descent and flexion Internal Rotation Extension Restitution and external rotation Expulsion
The use of clocks and calendars helps with orientation and reduce the patient’s risk of developing:
Delirium
Anti-rejection medication will be taken for:
The rest of the patient’s life
Common anti-rejection or immunosuppressant drugs include:
Cyclosporine, prednisolone, azathioprine, tacrolimus, mycophenolate mofetil, and sirolimus
Shortness of breath and leg swelling are manifestations of:
Congestive Heart Failure (CHF)
The drug of choice in managing fluid overload in CHF is a:
loop-acting diuretic, Furosemide, or Lasix.
_________ is also used in managing non-cardiac peripheral edema, fluid retention, and ascites.
Furosemide
Thiazide diuretics are used in treating:
Hypertension
Hydrochlorothiazide is a:
Thiazide Diuretic
Thiazides are not the drug of choice in:
Heart Failure
Aldactone is a:
Potassium-sparing diuretic
_________ helps treat high blood pressure, edema, ascites, and treat conditions with high hormone aldosterone levels ( conn’s syndrome, primary hyperaldosteronism).
Aldactone
Signs of hydrocephalus:
Increased head circumference
Macewen’s sign
Setting sun eyes
A sunken anterior fontanelle would indicate:
Dehydration or low fluid volume status
In hydrocephalus, there is _________ fluid volume in the head, not decreased. The nurse would see a tense, _________.
Increase
Bulgine fontanelle
The term “Small for Gestational Age (SGA)” means that:
An infant’s weight is below the 10th percentile for the gestational age
An Low Birth Weight (LBW) infant is defined as an infant with:
A weight of less than 2500 grams at the time of birth
A Very Low Birth Weight (VLBW) infant is defined as the one with:
A weight less than 1500 grams at the time of birth
An Extremely Low Birth Weight (ELBW) infant is:
Less than 1000 grams at the time of birth
The _________ is considered average for gestational age
20th percentile
Infant’s size falling between 10th - 90th percentile is considered _________
Average
A 24-hour urine collection helps diagnose kidney problems. It is often done to see how much creatinine clears through the kidneys. It’s also done to measure:
Protein, hormones, minerals, and other chemical compounds
Small white bumps typically found on the noses and cheeks of newborns. They are very common, considered normal, and usually go away on their own:
Milia
The percussion sound heard over hollow organs. The small intestine and colon are hollow organs, and they predominate over most of the abdominal cavity:
Tympany
The sound heard by tapping on the surface of the chest. It is an exaggerated chest resonance heard in various abnormal pulmonary conditions:
Hyperresonance
A low-pitched, hollow sound, is usually heard over healthy lung tissue:
Resonance
Replaces resonance when fluid or solid tissue replaces air-containing lung tissues, such as occurs with pneumonia, pleural effusions, or tumors:
Dullness
Erickson’s Stages of Development. Stage of development for early childhood, which lasts from ages 2 to 3 years:
Autonomy vs. Shame and Doubt
When they are successful, for example, with a task like a toilet training, they feel independent, and it leads to a sense of autonomy. When they are not successful, they think they are a failure, and it results in shame and self-doubt.
Erickson’s Stages of Development. The typical stage of development for school-age children, which are 6 to 11-year-olds:
Industry vs. Inferiority
In this stage, children need to cope with new social and academic demands. When they are successful with this, they feel competent and achieve the industry. When they are not successful, they handle failure, and it results in inferiority.
Erickson’s Stages of Development. The typical stage of development for infancy, which lasts from birth to 18 months:
Trust vs. Mistrust
In this stage, children develop a sense of confidence when caregivers provide reliability, care, and affection. When infants do not have that, they will develop mistrust.
Erickson’s Stages of Development. The typical stage of development for preschool children, which are 3 to 5-year-olds:
Initiative vs. Guilt
In Initiative vs. guilt, children start to assert control and power over their environment. Success leads to initiative when they feel a sense of purpose, but children who try to exert too much power and experience disapproval end up feeling guilty.
In postpartum thrombophlebitis, you would expect to see weak ___ pulses in the affected leg
+1
You would expect to see ______ in a patient with postpartum thrombophlebitis.
Unilateral redness
In postpartum thrombophlebitis you should tell the patient to monitor for:
Edema in one leg
Tenderness
Development that moves from the center of the body outward to the extremities is:
Proximodistal
According to Freud’s psychosexual stages, children from 2-3 years old are in the:
Anal scene
This is the stage when toilet training occurs. If children can complete this activity, they pass out of the anal stage, but if they struggle, then they may become ‘stuck’ in their psychosexual development.
In Piaget’s Stages of Cognitive development, the ______________ stage occurs from 0 to 2 years old:
Sensorimotor stage
During this stage, the child learns to coordinate their senses with motor responses. They are curious about the world and use their senses to explore. They start to form language and use it for demands. They also develop object permanence
There is nothing wrong with storing vitamins and medicines together as long as they are both kept out of the reach of:
Children
“Spoon-shaped” nails associated with iron-deficiency anemia are known as _____________:
Koilonychia
Koilonychia is a condition of abnormally thin nails that have lost their standard shape and are instead spoon-shaped, or concave. They are also known as spoon nails. It is a sign of iron-deficiency anemia.
Can a patient take Warfarin during pregnancy?
NO
Is Warfarin safe in lactating/ breastfeeding women?
YES
Long term treatment with LMWH may decrease bone mineral density (osteopenia, osteoporosis) and increases the risk of:
Fractures
The presence of blisters and necrotic areas (blackish-red central portion) at the injection site may serve as a warning sign of a complication known as:
Heparin-Induced-Thrombocytopenia (HIT)
This is the area where you would auscultate the apical pulse of an infant:
4th intercostal space to the left of the sternum at the midclavicular line
This is the area where you would auscultate the apical pulse of an adult, but it is different for an infant:
5th intercostal space to the left of the sternum at the midclavicular line
A patient with Hypercalcemia would manifest which symptoms?
Polyuria, polydipsia, and dehydration
A patient experiencing hypercalcemia may have EKG changes such as:
A shortened QT interval and a prolonged PR interval.
