Chapter 12

Question 1

medical patient applies to any person who is receiving diagnostic, therapeutic, and/or supportive care for a condition that is not managed by surgical, orthopedic, psychiatric, or maternity-related therapy.

Answer 1

Loss of appetite, food intolerance, digestive
disturbances, lack of exercise, and even
excessive weight gain influence a medical
patient’s intake requirements.

Question 2

Reference
materials are also available to all personnel
handling medications, including the Physician’s
Desk Reference, the Nursing Drug Handbook
and a hospital formulary.

Answer 2

In some disease conditions, the patient is
unable to tolerate food or fluids or may lose
these through vomiting, diarrhea, or both. In
these cases, replacement fluids as well as
nutrients are an important part of the patient’s
medical management

Question 3

There are several disease
conditions in which fluid restrictions are
important aspects of the patient’s therapy such
as preeclampsia and severe chronic obstructive
pulmonary disease (COPD).

Answer 3

It is customary to require the signature of a parent or legal guardian if the patient is under 18 years of age, unless the patient is married or a member of the Armed Forces. In these latter two cases, the patient may sign the permit, regardless of age.

Question 4

A SF 522 must be completed before any preoperative medications are administered.

Answer 4

The operative (or intra-operative) phase begins the moment the patient is taken into the operating room. Two of the major factors to consider at this phase are positioning and anesthesia.

Question 5

A health care provider can reasonably expect that all patients admitted for surgical procedures will exhibit which of the following characteristics?

1. Be very demanding
2. Be apathetic and passive
3. Exhibit violent behavior
4. Be fearful and anxious

Answer 5

All patients approaching surgery are fearful

and anxious.

Question 6

A medical patient is prescribed therapeutic bed rest primarily for what reason?

1. To inhibit the development of circulatory problems
2. To prevent depression and apathy
3. To prevent further damage to body systems
4. To inhibit the development of respiratory problems

Answer 6

The primary reason for prescribing rest as a therapeutic measure for the medical patient is to prevent further damage to the body or body part when the normal demand of use exceeds the ability to respond.

Question 7

SF 522, Request for Administration of Anesthesia and for Performance of Operations and other Procedures, is normally signed by a parent, legal guardian, or spouse EXCEPT when?

1. The patient is able to do so
2. Over 16 years of age but under 18
3. Over 18 years of age but under 21
4. A member of the Armed Forces

Answer 7

A SF 522 must be completed before any preoperative medications are administered. If the patient is not capable of signing the document, a parent, legal guardian, or spouse may sign it. It is customary to require the signature of a parent or legal guardian if the patient is under 18 years of age, unless the patient is married or a member of the Armed Forces. In these latter two cases, the patient may sign the permit, regardless of age.

Question 8

When a regional anesthetic is administered, the patient can expect what effect?

1. Motor, but not sensory perception will diminish
2. Pain will be reduced or eliminated in the body part injected or swabbed
3. Level of consciousness will decline
4. The entire body will become numb

Answer 8

Pain will be reduced or eliminated in the body part injected or swabbed

Question 9

In general anesthesia, a stimulation of vital signs is evidence of what level of anesthesia induction?

1. Stage 1
2. Stage 2
3. Stage 3
4. Stage 4

Answer 9

Stage 2 is the stage of excitement. During this period there is a variety of reactions involving muscular activity and delirium. At this stage, the vital signs show evidence of physiological stimulation. It is important to remember that during this stage the patient may respond violently to very little stimulation.

Question 10

In the immediate postoperative recovery phase, a patient’s skin color may be indicative of all of the following EXCEPT what?

1. The patient’s ability to recover from the anesthetic agent
2. Postoperative hemorrhage
3. Degradation of respiratory function
4. The development of shock

Answer 10

The patient’s ability to recover from the anesthetic agent
• Monitoring skin color changes
o Check dressings and casts frequently to ensure they are not interfering with normal blood circulation to the area
o Notify a physician or nurse of general skin color changes that may indicate airway obstruction, hemorrhage, or shock

Question 11

When permitted, postoperative patients should be encouraged to ambulate to improve the functions of which of the following physiologic systems?

1. Renal system
2. Digestive system
3. Cardiopulmonary system
4. All of the above

Answer 11

All of the above

Question 12

When caring for a young, otherwise healthy orthopedic patient requiring immobilization, the HM can anticipate all of the following EXCEPT what?

1. Symptoms of emotional stress
2. Frequent complaints of sore or aching pain
3. Periods of dizziness associated with disorientation
4. A deterioration of skin tone and function

Answer 12

Periods of dizziness associated with disorientation

Question 13

Unless otherwise directed by the physician, when one is applying a cast to an arm, the patient’s wrists is generally in which of the following positions?

1. Extended about 10 degrees
2. In the neutral position
3. Flexed about 30 degrees
4. In any of the above; specific position is immaterial

Answer 13

Depending on the location and type of fracture, the physician may order a specific position for the arm to be casted. Generally, the wrist is in a neutral (straight) position, with the fingers slightly flexed in the position of function.

Question 14

Cane height is measured from the floor to the ______ .

1. Hand
2. Hip
3. Top of the femur
4. Wrist

Answer 14

Use the unaffected side, approximate cane height can be determined by measuring distance from wrist to floor, when standing with arms at the sides.

Question 15

The cane is used on the unaffected side of the body.

1. True
2. False

Answer 15

True

Question 16

Crutches should be fitted so that the patient’s elbows are maintained with a ______ to _____ degree bend.

1. 15 to 30
2. 20 to 30
3. 15 to 25
4. 30 to 45

Answer 16

Keep elbow flexed at side to 15° to 30°

Question 17

When climbing stairs the patient should be taught to go “up with the bad and down with the good.”

1. True
2. False

Answer 17

False
The phrase “up with the good, down with the bad” is often used to help patients recall the appropriate step pattern for stair climbing or traversing a street side curb

Question 18

Which of the following are safe to walk on with crutches without much thought to safety?

1. Uneven sidewalk
2. Thick carpet
3. Hardwood floor with throw rugs
4. None of the above

Answer 18

None of the above

Question 19

Which ambulatory device provides the most stability?

1. Walkers
2. Canes
3. Quad Cane
4. Crutches

Answer 19

When patients require maximum stability and support from an ambulation device, walkers are typically indicated.

Question 20

A patient who has been fitted with a cast should be instructed to return to the medical treatment facility as soon as possible under which of the following circumstances?

1. The cast becomes soiled
2. The extremity affected by the cast is numb
3. The itching becomes unbearable
4. The cast gets wet

Answer 20

The extremity affected by the cast is numb

Question 21

In the theory of death and dying, it is suggested that most people exhibit five stages. The stage where the terminal patient becomes concerned about the state of his or her affairs and family members is known as the stage of ______ .

1. Denial
2. Acceptance
3. Bargaining
4. Depression

Answer 21

Once patients realize that bargaining is futile, they enter into the stage of depression. In addition to grieving because of their personal loss, it is at this point that patients become concerned about their family and “putting affairs in order.”

The first stage, denial,
The next stage is anger. This is a period of hostility and questioning: “Why me
The third stage is bargaining.

Once patients realize that bargaining is
futile, they enter into the stage of depression.

The final stage comes when the patient reaches acceptance of death and is prepared for it.

Question 22

Patient falls may be avoided by taking which of the following preventive measures?

1. Proper use of bed/gurney side rails
2. Keeping floors dry and uncluttered
3. Instructing patients on the proper use of walking aids (crutches, canes, etc.)
4. All of the above

Answer 22

All of the above

Question 23

Electrical and electronic equipment poses significant injury hazards. Of the following, which is the authorized means of reducing this hazard?

1. Repairing frayed cords with electrical tape to prevent shock
2. Using personal electronics if the look in good repair
3. Having medical repair perform electrical safety checks on all new equipment
4. Using only two-prong, nongrounded electrical plugs

Answer 23

Having medical repair perform electrical safety checks on all new equipment

Question 24

Skin contact burns can be caused by ice bags or hypothermia blankets.

1. True
2. False

Answer 24

True

Question 25

Environmental hygiene is directed toward producing a healthy environment and includes such practices as maintaining unit cleanliness and ________ .

1. Providing for adequate ventilation
2. Limiting noise levels
3. Proper disposal of soiled articles
4. All of the above

Answer 25

All of the above

Question 26

Concurrent cleaning is the disinfection and sterilization of patient supplies and equipment during hospitalization.

Answer 26

Terminal cleaning is the disinfection and sterilization of patient supplies and equipment after the patient is discharged from the unit or hospital.

Question 27

maintaining a healthy climate, good ventilation is necessary in controlling and eliminating disagreeable odors.

Answer 27

In isolation rooms ensure that there is proper negative pressure by checking wall gages and evaluating the airflow.

Question 28

Both The Joint Commission (TJC) and the National Safety Council of the American Hospital Association (AHA) have identified four major types of accidents that continually occur to patients. These hazards consist of falls, electrical shocks, physical and chemical burns, and fire and explosions.

Answer 28

End