Exam 2 Practice Exam Flashcards
diarrhea is likely to cause what -lyte issues
potassium
older adult just started on beta blocker the nurse should teach what
orthostatic hypo
elderly + diuretics = you manage what
volume level
intermitten claudication
muscular, cramp-type pain in the extremities consistently reproduced with the same degree of exercise or activity and relieved by rest
what to get the patient to eat
Family involvement and home-cooked favorite foods may help the patient to eat
Having visitors at mealtimes may make eating more pleasant and increase the patient’s appetite
hypertension target organ getting worse =
vessel damage
Arterial insufficiency may result in
gangrene
To identify complications or worsening hypertension, the patient is questioned about
target organ relation
elderly s/s of gallstones
The elderly patient may not exhibit the typical symptoms of fever, pain, chills jaundice, and nausea and vomiting.
*Symptoms of biliary tract disease in the elderly may be accompanied or preceded by those of septic shock, which include oliguria, hypotension, change in mental status, tachycardia, and tachypnea.
fecal occult blood test
- which drug to avoid
NSAIDS
how to verify NG placement
There are a variety of methods to check tube placement. The safest way to confirm placement is to utilize a combination of assessment methods.
“Use a combination of at least two accepted methods for confirming placement.”
A nurse is providing care for a patient who is postoperative day 2 following gastric surgery. The nurse’s assessment should be planned in light of the possibility of what potential complications?
pneumonia
metabolic imbalances
atelectasis
- chronic gastritis is not a surgical complication
When pulses cannot be reliably palpated
a hand-held continuous wave (CW) Doppler ultrasound device may be used to hear (insonate) the blood flow in vessels
The nurse is preparing to administer warfarin (Coumadin) to a client with deep vein thrombophlebitis (DVT). Which laboratory value would most clearly indicate that the patient’s warfarin is at therapeutic levels?
International normalized ratio (INR) between 2 and 3
Warfarin is also considered to be at therapeutic levels when the client’s PT is
1.5 to 2 times the control.
Higher values (INR, PT) indicate increased risk of
bleeding and hemorrhage
lower values (INR PT) indicate increased risk of
blood clot formation
a falling hematocrit in a client taking warfarin may be a sign of
hemorrhage
Prehypertension is defined
systolic BP of 120 to 139 mm Hg or diastolic BP of 80 to 89 mm Hg.
The nurse is caring for a patient who has just returned from the ERCP removal of gallstones. The nurse should monitor the patient for signs of what complications?
Bleeding and perforation
ERCP removal of gallstones peritonitis how common
less common
UC stools
Watery with blood and mucous
A patient’s sigmoidoscopy has been successfully completed and the patient is preparing to return home. Which of the following teaching points should the nurse include in the patient’s discharge education?
The patient can resume a normal routine immediately.
what do we asses about constipation
activity
food
fluid
fiber
A healthy, viable stoma should be
hiny and pink to bright red.
The nurse has performed a thorough nursing assessment of the care of a patient with chronic leg ulcers. The nurse’s assessment should include which of the following components? Select all that apply.
Comparison of temperature in the patient’s legs
Bilateral comparison of peripheral pulses
Location and type of pain Identification of mobility limitations
The patient with a diagnosis of appendicitis has an acute risk of
infection related to the possibility of rupture
A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize?
insertion of a NG tube
what are not indicated with an bowel obstruction
enemas, suppositories, laxatives
Oral cancers are often associated with the use of
alcohol and tobacco, which when used together have a synergistic carcinogenic effect
are Diabetes, dentures, dental caries, and GERD risk for oral cancer
no
An occupational health nurse is providing an educational event and has been asked by an administrative worker about the risk of varicose veins. What should the nurse suggest as a proactive preventative measure for varicose veins?
Walk for several minutes every hour to promote circulation.
varicose veins and crossing legs
contraindicated
why not do elevation to help prevent varicose veins
only helps blood passively return to the heart and does not maintain competency of the value sin the vein
ankle compression socks and varicose veins
Wearing tight ankle socks is contraindicated for patients with, or at risk for, varicose veins; socks that are below the muscles of the calf do not promote venous return, the socks simply capture the blood and promote venous stasis.
Signs of impending rupture include
severe back or abdominal pain, which may be persistent or intermittent
A patient has a nasogastric tube that has been placed to drain stomach contents by low intermittent suction. What is the nurse’s priority during this aspect of the patient’s care?
measure and record drainage
why measure and record drainage
This drainage should be measured and recorded because it is a significant indicator of GI function.
why not look for color change in NG output
The nurse should indeed monitor the color of the output, but fluid balance is normally the priority
Reglan use
promote gastic motility
Omeprazole and lansoprozole
PPI
Famotidine
H2 receptor antagonists
MRI
remove all metal containing objects
A patient who had surgery for a bowel obstruction has just returned to the post surgical unit from post anesthetic recovery. The nurse caring for this patient knows to immediately report what assessment finding to the physician?
rigidity of the abdomen
post op bowel surgery, why not be worries about decreased breath sounds
The location of the subcostal incision will likely cause the patient to take shallow breaths to prevent pain, which may result in decreased breath sounds.
why should we not be worried about pain in a post op bowel obstruction patient
Acute pain is an expected assessment finding following surgery
why should we not be worried about drainage of bile colored fluid onto the abdominal dressing for a post op bowel obstruction patient
Bile may continue to drain from the drainage tract after surgery, which will require frequent changes of the abdominal dressing
pros to a capsule endoscopy
noninvasive
do we still need prep for capsule endoscopy
yes
A patient is recovering in the hospital following gastrectomy. The nurse notes that the patient has become increasingly difficult to engage and has had several angry outbursts at various staff members in recent days. The nurse’s attempts at therapeutic dialogue have been rebuffed. What is the nurse’s most appropriate action?
make appropriate referrals to service that provide psychosocial support
A patient seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education?
small frequent meals
laxative long or short term use
avoid long term
what commonly occur with nitro
headache and dizziness
Complications of PTCA may include
bleeding at the insertion site, abrupt closure of the artery, arterial thrombosis, and perforation of the artery
what are important strategies for managing three major CV risk factors (hyperlipidemia, hypertension, diabetes)
Dietary modifications, exercise, weight loss, and careful monitoring
The physical therapist notifies the nurse that a patient with coronary artery disease (CAD) experiences a much greater-than-average increase in heart rate during physical therapy. The nurse recognizes that an increase in heart rate in a patient with CAD may result in what?
myocardial ischemia
what natural body process with decrease myocardial perfusion
increase in HR (coronary arteries are perfused during diastole)
Cardiac catheterization is usually used
to assess coronary artery patency to determine if revascularization procedures are necessary.
The triage nurse in the ED assesses a 66-year-old male patient who presents to the ED with complaints of midsternal chest pain that has lasted for the last 5 hours. If the patient’s symptoms are due to an MI, what will have happened to the myocardium?
It may have developed an increased area of infarction during the time without treatment.
