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Athabasca Nurs 400 > athabasca nurs 400 > Flashcards

athabasca nurs 400 Flashcards

1
Q

the nurse is caring for a patient with a chest tube during the assessment palpates a crackling area (crepitus) around the insertion site. What to do?

A

draw a circle around the area to see if the subcutaneous emphysema is resolving

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2
Q

assessing the clients understanding of medication use. A medication that may cause a complication with diabetes?

A

steroids

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3
Q

pt has aortic stenosis, feeling tired, naps daily. Apical heart sounds 2cm left of mediclavicular line. Crackles lower lungs.B/P 110/90. Wt gn 5.5 lbs in 24 hours. Number one priority?

A

crackles

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4
Q

care of ileostomy. Pt at risk for anemia; because?

A

iron absorption depends on simultaneous bile salt absorption in the terminal ileum

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5
Q

pt with end stage pancreatic cancer decides to terminate medical intervention. what to expect when consulting palliative care?

A

referral for bereavement

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6
Q

evaluating pin insertion/skeletal traction. what indicates complication?

A

loose pins

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7
Q

48 hours post lower lobectomy, receiving morphine via PCA. c/o pain left thorax - worse with coughing

A

check pca

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8
Q

asthma pt/ beclomethasone inhaler. To assess if client is rinsing mouth look for?

A

thrush

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9
Q

pt had chemo. WBC count 2300mm. HGB 98 platelets 80,000, potassium 3.8. symptom that takes priority?

A

Fever

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10
Q

ICU pt. Jugular vein distention noted

A

++poor cardiac output

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11
Q

Parkinsons pt. rx levadopa makes improvement in what area?

A

muscle rigidity

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12
Q

evaluation of cranial nerves on routine exam. To assess cranial nerve X11 ( hypoglossia) nurse should test?

A

protrude tongue

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13
Q

which WBC is most numerous?

A

neutrophils

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14
Q

nurse should teach client about what potential risk factor for the development of colon cancer?

A

history of inflammatory disease

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15
Q

diabetes pt says if I avoid carbs my diet will be okay. Nurse should reply on the knowledge that diabetes affects which nutrients

A

carbs

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16
Q

focused assessment of bladder cancer includes looking for what common sign?

A

hematuria

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17
Q

how to explain to female elderly decreasing in height

A

related to menopause and loss of bone density

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18
Q

21 days post hemicolectomy. pt having difficulty maintaining an adequate intake of metabolic needs for optimal healing. The nurse should recommend?

A

nasogastric feeding tube with protein supplement

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19
Q

which combination of adverse affect should be monitored when administering IV insulin to a patient with diabetic ketoacidosis

A

hypoglycemia and hyperkalemia

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20
Q

a client is scheduled to receive PHY through a nasogastric tube and has a tube feeding supplement bed is elevated to 30 degrees. prior to administering med nurse should?

A

flush with water

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21
Q

medical nurse educator is reviewing a clients recent episode of metabolic acidosis with members of the nursing staff. what should the educator describe as the role of the kidneys in metabolic acidosis? (acid)

A

kidneys excrete hydrogen (acid pee) ions and conserve bicarbonate (tums) ions to help restore balance

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22
Q

A client has been prescribed hydrochlorothiazide (potasium conserver) to treat heart failure. The nurse should tell the client to report…

A

muscle weakness ( pee out potasium, lack of potasium)

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23
Q

a client with venous insufficiency develops varicose veins in both legs. Which statement about varicose veins is accurate?

A

the severity of discomfort isnt related to the size of varicoities.

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24
Q

Primary cancer prevention program an oncology nurse answers questions from the public at a health laryngeal cancer

A

laryngeal cancer is one of the most preventable types of cancer

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25
Q

client with thrombocytopenia secondary to leukemia develops epistatxis, The nurse should instruct

A

sit up lean forward

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26
Q

nurse is caring for a client with a chest tube inserted 12 hours ago for tx of pleural effusion. Which assessment is more determining the clients response to the treatment?

A

breathing dif

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27
Q

a client with venous insufficiency

A

the severity of discomfort isnt related to the size of varicosites

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28
Q

A client with a serum glucose level of 618 mg/dl is admitted to the facility. He’s awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6º F (38.1º C), heart rate of 116 beats/minute, and blood pressure of 108/70 mm Hg. Based on these assessment findings, which nursing diagnosis takes the highest priority?

A

deficient fluid volume related to osmotic diuresis

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29
Q

which registered nurse should be assigned to the patient who had a chest tube yesterday?

A

cardiovascular

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30
Q

pt reports dull headache, and dizziness, increased pulse rate. The results of arterial bld gas analysis are aa follows; PH pressure of carbon dioxide 50mm, 6.7kpa, bicarbonate 24. These findings indicate which of the following imbalances?

A

respiratory acidosis

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31
Q

the nurse should teach the patient with hep A

A

increase carbs and protein diet

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32
Q

routine check up for aids pt; most common cancer

A

Kaposi sarcoma

33
Q

pt with choleithasis has a gallstones lodge in common bile duct. When assessing the client the nurse expects to note;

A

pale stools.. clay like

34
Q

which one of the following expected outcomes about nutrition would be appropriate for a client who has had a total gastrectomy for gastric cancer?

A

learn self admin of feeds every 4

35
Q

pt with trach tube, 3 days post insertion, what should nurse do?

A

sterile catheter each time suctioning

36
Q

pt with T5 spinal injury. Pt on bed rest, foley catheter. C/o headache, diaphoresis/ nausea. What is the nursing priority?

A

removing any stimulus to skin

37
Q

which of the following assessment findings in an elderly client require intervention?

A

change in mole/ elevated irregularly shaped mole

38
Q

pt with blistering wounds cause NYD chemical agent. Intervention?

A

irrigate with water

39
Q

assessment of pt with tracheotomy tube. Pt has bilateral upper lobe ronchi. Unable to cough up secretions. Intervention?

A

sterile suction

40
Q

pt dx with skull fracture post MVA, presents with increased drowsiness. Pt is at risk for?

A

concussion

41
Q

complication of trach tube

A

damage to laryngeal nerve

42
Q

pt with above knee amputation, develops dime size red spot on dressing 45 minutes post recovery.

A

reinforce dressing

43
Q

stroke pt, transferred to rehab. Neurological deficit that could lead to skin break down?

A

inability to express need r

incontinence

44
Q

Pt with right hip fracture, right hip pain, unable to move. Further assess right leg to determine..

A

Shorter than unaffected leg

45
Q

Humlin 70/30 contains what ?

A

70% NPH and 30% regular

46
Q

elderly pt thrombotic CVA, right side flaccid. When planning care rehab starts with?

A

on admission

47
Q

pt being treated for iron deficiency anemia with ferrous sulfate. Assess for use of which medicine? ( when anemia continues)

A

aluminum hydroxide

48
Q

pt receiving antibiotics to treat gram negative bacterial infection.pt having adverse effect d/t desctuction of norm flora in stomach

A

diahrea

49
Q

assessing a client with atrial septal defect (ASD). What requires immediate intervention?

A

bubbling in water chamber or

serous drainage in chamber

50
Q

Nurse planning a discharge, for stroke patient with right sided weakness. Family concerned about continued rehab on discharge

A

Inform case manager

51
Q

Client with COPD develops cor pulmonale. What assessment data would alert the nurse

A

Edema and neck vein distended

52
Q

Or undergoes cystoscope, which assessment is most appropriate

A

Asses urine for excessive bleeding

53
Q

Pt with chest tube. Chest tube accidentally disconnects. What to do?

A

Clamp it

54
Q

W/C Pt comes for follow up of pressure ulcers on buttocks. Family changing hydocolliod drsgs every 3-5 days. Past few weeks, less time in chair, use of cushion. During follow up, no cushion, dry dressing, how should nurse respond?

A

Ask client to explain treatment regimine

55
Q

After evaluating a pt for hypertension, doc orders 50mg atenol. What therapeutic effect is expected?

A

Decreased cardiac output, decrease systolic and diastolic

56
Q

Pt with abdominal distension, sharp pains, distinct rhythmic pulsation to mid line. Vss. Prioritiy intervention

A

Asculate for bruit and notify doc of findings

57
Q

Nurse teaches pt with type 1 diabetes, maintaining stable blood glucose levels. Nurse should suggest ? To minimize the rise in bold sugars post meals

A

Fiver
Meats
Dairy

58
Q

How long does iv Lasix take to work on heart failure

A

30-60 min

59
Q

Post transverse colectomy. Anxious, pain 8/10, sbg 7.8

A

Priority pain. Give morphine

60
Q

Developing a long term care plan for the client with multiple sclerosis, nurse should teach prevention of?

A

Contractures

61
Q 
On admission 
PH 7.2 
PA02 64, PaCO2 60 and HCO3-22. 
Chest tube inserted oxygen at 4l, 30 min post repeat abgs=
Ph 7.3 
pao2 76, 
paco2 50, 
hco3 22
A

Improving resp status

62
Q

Colchine for gout, watch for ? adverse reaction

A

Diarrhea

63
Q

0xygen is at 2l/min for COPD.y?

A

Co2 retention—

64
Q

Terminal cancer patient in hospice. How to treat nausea and vomiting

A

Iv antiemetic

65
Q

Pt prescribed hydrochlorothizide

Tell patient to watch for

A

Weakness

66
Q

60yr old in ER. Substernal chest pain. Radiates to shoulder and left arm. Dx of acute MI. Admission rx of o2 4l/p nasal cannula, Cbc, 12 lead ecg, chest radiograph, 2mg morphine.
First task?

A

Morphine

67
Q

Oxygen at 2l per min for COPD because?

Low therapy because

A

H

68
Q

The nurse is checking laboratory values on a patient who has crackling rales in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which of the following laboratory values does the nurse expect to be abnormal?

A

B-type natriuretic peptide (BNP).

The client’s symptoms suggest heart failure. BNP is a neurohormone that is released from the ventricles when the ventricles experience increased pressure and stretch, such as in heart failure. A BNP level greater than 51 pg/mL is often associated with mild heart failure; and, as the BNP level increases, the severity of heart failure increases. Potassium levels are not affected by heart failure. CRP is an indicator of inflammation. It is used to help predict the risk of coronary artery disease. There is no indication that the client has an increased CRP. There is no indication that the client is experiencing bleeding or clotting abnormalities, such as those seen with an abnormal platelet count.

69
Q

a fourth hear sound indicates

A

failure of ventricle ( weak) to eject all blood

70
Q

pt day 3, post abd surgery. no bowel movement but passing gas.

A

ambulate 3x per day

71
Q

er patient acute heart failure. What lab values do you check prior to admin medication.

A

platelets

72
Q

pt with rib fractures, pneuomothroax, chest tube.
fluid in water seal column fluctuating with each breath.
A client’s chest tube is connected to a chest tube drainage system with a water seal. The nurse notes that the fluid in the water-seal column is fluctuating with each breath that the client takes. The fluctuation means that

A

the chest tube system is functioning properly.
Fluctuation of fluid with respirations in the water-seal column indicates that the system is functioning properly. If an obstruction were present in the chest tube, fluid fluctuation would be absent. Subcutaneous emphysema occurs when air pockets can be palpated beneath the client’s skin around the chest tube insertion site. A leak in the system is indicated when bubbling occurs in the water-seal column.

73
Q

seeks medical attention after developing acute abdominal pain

A

auscultate with bell of stethoscope

74
Q

The nurse has just received change-of-shift report about these four patients. Which patient should the nurse assess first?

A

older adult tia

75
Q

nurse is preparing to administer blood to a client who requires postoperative blood replacement. the nurse should use a blood administration set that

A

must be filtered

76
Q

newly diagnosed with radiation induced thrombocytopenia the nurse should include which intervention in the care plan

A

inspect skin for petechie

77
Q

doctor told my wife cervical cancer is curable. Is he just trying to make us feel better

A

true cure rate is almost 100%

78
Q

client has severe diarrhea that has lasted for two days nurse should assess for

A

arrhythmia

Athabasca Nurs 400 (2 decks)

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