Exam 3 Flashcards
1
Q
Antiobesity medications work by inhibiting GI absorption of fat and altering central brain receptors to enhance _________ or reduce cravings.
A
satiety
2
Q
Lifestyle modification is aimed at weight loss and _______________.
A
maintenance
3
Q
T/F: The average weight loss following bariatric surgery is 35% to 50% of previous body weight over 2 to 3 years.
A
FALSE- 30% to 40% of excess body weight
4
Q
Causes of obesity are complex and multifactorial and include __________, environmental, physiologic, and genetic factors.
A
behavioral
5
Q
T/F: Patients with dumping syndrome after gastric surgery, should consume at least 16 ounces of fluid with each meal.
A
False- drink water in betweem
6
Q
T/F: Traditionally, the term morbid obesity applies to adults whose body mass index (BMI) exceeds 30 kg/m2.
A
False- 35-40
7
Q
A greater risk for obesity is assessed by a waist circumference that is greater than how many inches for women and > 40 inches for men?. __________________
A
35
8
Q
T/F: Obesity is associated with a 6- to 20-year decrease in life expectancy.
A
True
9
Q
T/F: After bowel sounds have returned and oral intake is resumed following bariatric surgery, six small feedings consisting of a total of 600 to 800 calories per day should be consumed.
A
True
10
Q
Following bariatric surgery, disruption at the surgical site may cause leakage of gastric contents into the peritoneal cavity, causing ______________ and possible sepsis.
A
infection
11
Q
T/F: When fluid intake decreases, specific gravity increases.
A
True
12
Q
T/F: Urea is an abnormal constituent of urine.
A
False- Urea is a waste product that is excreted by the kidneys when you urinate. The urine urea nitrogen test determines how much urea is in the urine to assess the amount of protein breakdown. The test can help determine how well the kidneys are functioning and whether your intake of protein is too high or low.
13
Q
Dull, continuous pain that is located over the suprapubic area is most likely pain involving the ____________.
A
bladder
14
Q
Bladder _______________ is a noninvasive method of measuring urine volume in the bladder that can be performed by the nurse at the bedside.
A
ultrasonography
15
Q
T/F: The angling of the ureterovesical junction is the primary factor preventing backward movement of urine from the bladder toward the kidney.
A
True
16
Q
Regulation of sodium volume excretion depends on _____________, a hormone synthesized and released from the adrenal cortex.
A
aldosterone
17
Q
T/F: The medulla contains the nephrons, the structural and functional units of the kidney responsible for urine formation.
A
False- The glomerulus and convoluted tubules of the nephron are located in the cortex of the kidney, while the collecting ducts are located in the pyramids of the kidney’s medulla.
18
Q
T/F: The glomerular filtration rate decreases at a yearly decline of about 1 mL/min after age 40.
A
True
19
Q
Enclosed in an epithelial structure called Bowman capsule, the _____________ is a unique network of capillaries that form that part of the nephron through which filtration occurs.
A
glomerulus
20
Q
The normal adult bladder capacity is _______ to ________ mL of urine.
A
400 to 500
21
Q
A nurse is caring for a client who is in the diuresis phase of AKI. The nurse should closely monitor the client for what complication during this phase?
A
dehydration
22
Q
The nurse has identified the nursing diagnosis of “Risk for Infection” in a client who undergoes peritoneal dialysis. What nursing action best addresses this risk?
A
maintain aseptic technique when administering dialysate
23
Q
A nurse is aware of the high incidence and prevalence of fluid volume deficit among older adults. What related health education should the nurse provide to an older adult?
A
“remember to drink frequently even if you don’t feel thirsty”
24
Q
The nurse is planning client teaching for a client with ESKD who is scheduled for the creation of a fistula. The nurse should teach the client what information about the fistula?
A
a vein and an artery in your arm will be surgically attached
25
A 24-hour urine collection is scheduled to start at 0100. When should the nurse start the procedure?
after discarding the 0100 specimen
26
What is the normal adult bladder capacity?
300 to 500 mL
27
The nurse is caring for a client postoperative day 4 following a kidney transplant. When assessing for potential signs and symptoms of rejection, what assessment should the nurse prioritize? Assessment of
the quantity of the client's urine output
28
A client with a history of progressively worsening fatigue is undergoing a comprehensive assessment which includes test of renal function relating to erythropoiesis. When assessing the oxygen transport ability of the blood, the nurse should prioritize the review of what blood value?
hemoglobin
29
Diagnostic testing of an adult client reveals renal glycosuria. The nurse should recognize the need for the client to be assessed for what health problem?
diabetes mellitus
30
The nurse notes a weight gain of 3 pounds (1.4 kg) over the past 48 hours. What nursing diagnosis is suggested by this assessment finding?
excess fluid volume
31
After a sleeve gastrectomy, a 42-year-old male patient returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a patient controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the postoperative plan of care?
Support the surgical incision during patient coughing and turning in bed.
32
After a sleeve gastrectomy, a 42-year-old male patient returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a patient controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the postoperative plan of care?
Support the surgical incision during patient coughing and turning in bed.
33
After the nurse teaches a patient about the recommended amounts of foods from animal and plant sources, which menu selections indicates that the initial instructions about diet have been understood?
3 oz of roasted pork, a cup of broccoli, and a cup of carrot sticks
34
Which statement by the nurse is most likely to help a morbidly obese 22-year-old man in losing weight on a 1000 calorie / day diet?
You are likely to notice changes in how you feel with just a few weeks of diet and exercise.
35
A few months after bariatric surgery, a 56-year-old man tells the nurse, my skin is hanging in folds. I think I need cosmetic surgery. Which response by the nurse is most appropriate?
Cosmetic surgery is a possibility once your weight has stabilized.
36
When teaching the patient about testing to diagnose metabolic syndrome, which topic would the nurse include?
Fasting bood glucose test
37
The nurse is coaching a community group for individuals who are overweight. Which participant behavior is an example of the best exercise plan for weight loss?
Walking for 40 minutes, six or seven days a week.
38
Which assessment action will help the nurse determine if an obese patient has metabolic syndrome?
Check the patients blood pressure.
39
Which adult will the nurse plan to teach about risks associated with obesity?
Man with a 42" waist and 44" hips
40
The nurse will be teaching self-management to patients after gastric bypass surgery. Which information will the nurse plan to include?
Drink fluids between meals but not with meals.
41
Which nursing action is appropriate when coaching obese adults enrolled in a behavior modification program?
Asking about situations that tend to increase appetite.
42
Visible, painless _____________ is the most common symptom of bladder cancer.
hematuria- or blood in the urine
43
A UTI of the renal pelvis, tubules, and interstitial tissue of one or both kidneys is known as __________________.
pyelonephritis- AKA kidney infection
44
A _________________ is a form of continent urinary diversion that involves the transplantation of the ureters into the sigmoid colon.
Ureterosigmoidostomy- AKA you pee out your butt
45
T/F: Functional incontinence is the involuntary loss of urine through an intact urethra as a result of sneezing, coughing, or changing position.
FALSE- this would be considered stress incontinence
| functional incontinence is untimely urination d/t physical obstacles, or problems in thinking/ reaching a toilet
46
The most common route of lower UTIs is _______________, a process whereby bacteria (often from fecal contamination) colonize the periurethral area and enter the bladder.
transurethral
47
T/F: A flaccid bladder, caused by a lower motor neuron lesion which commonly results from trauma, is the more common type of neurogenic bladder.
False- neurogenic bladder is when a person lacks bladder control d/t spinal cord or nerve problems
A flaccid bladder is when bladder muscles don't fully contract
48
T/F: Cancer of the bladder is more common after age 55 and smoking increases the risk by 50%.
TRUE
49
________________ is the inability of the bladder to empty completely.
urinary retention
50
T/F: About 80% of all kidney stones are calcium based.
True- others can be cystine, uric acid, or struvite
51
T/F: Factors that contribute to urinary tract infections (UTIs) include bacterial invasion of the urinary tract, urethrovesical reflux, and shorter urethra in women.
TRUE
52
T/F: Compartment syndrome---the most serious complication of casting and splinting---occurs when increased pressure within a confined space compromises blood flow.
TRUE
53
T/F: A nurse should instruct a patient in a cast, splint, or brace to refrain from performing exercises until it has been removed.
FALSE- can do passive exercise or specific weight bearing as indicated by physician
54
A principle of effective traction is that it must be ______________ to reduce and immobilize fractures.
continuous
55
________or orthoses are custom-fitted to various parts of the body and are used to provide support, control movement, and prevent additional injury.
Braces
56
Patients usually begin ___________ one day following joint replacement surgery.
ambulation
57
T/F: Nursing assessment of the patient following orthopedic surgery includes neurovascular status and tissue perfusion.
True
58
Following the application of an immobilization device, the nurse should assess the affected extremity using the "6 Ps": pain, poikilothermia, _______, pulselessness, _______, and paralysis as a guideline.
pallor and paresthesias
59
To prevent dislocation of a hip prosthesis, a wedge pillow should be placed between the legs to prevent ____________ beyond the midline of the body.
adduction- think of adding to the midline
60
T/F: Nursing care of a patient in skeletal traction requires inspection of the pin site at least every 24 hours for signs of inflammation and evidence of infection.
FALSE q8hr
61
T/F: Traction is used as a short term intervention until other modalities are possible.
True
62
A client is undergoing diagnostic testing for a suspected urinary obstruction. The nurse should know that incomplete emptying of the bladder due to bladder outlet obstruction can cause what?
Hydronephrosis
63
The nurse on a urology unit is working with a client who has been diagnosed with oxalate renal calculi. When planning this client's health education, what nutritional guidelines should the nurse provide?
Restrict protein intake as prescribed
64
A client with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The client weighs 60 kg. The nurse is monitoring the client's urine output hourly and notifies the health care provider when the hourly output is less than what?
30 mL
65
Physician orders morphine sulfate 0.05 mg/kg IVP now. The patient weighs 176 lbs. The vial is labeled 4mg/2mL. How many mL will you draw up and administer?
2mL
66
A female client has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this client?
Drink liberal amounts of fluids
67
A nurse who provides care in a long-term care facility is aware of the high incidence and prevalence of urinary tract infections among older adults. What action has the greatest potential to prevent UTIs in this population?
Limit the use of indwelling urinary catheters
68
A client has just returned to the floor following a transurethral resection of the prostate. A triple-lumen indwelling urinary catheter has been inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens?
Continuous inflow and outflow of irrigation solution
69
The nurse is teaching a health class about UTIs to a group of older adults. What characteristic of UTIs should the nurse cite?
The prevalence of UTIs in older men approaches that of women in the same age group
70
A nurse is caring for a female client whose urinary retention has not responded to conservative treatment. When educating this client about self-catheterization, the nurse should encourage what practice?
Using clean technique at home to catheterize
71
A nurse is teaching a 53-year-old man about prostate cancer, given the fact that he has a family history of the disease. What information should the nurse provide to best facilitate the early identification of prostate cancer?
Have a digital rectal examination and prostate-specific antigen (PSA) test done as recommended
72
A nurse is providing an educational event to a local men's group about prostate cancer. The nurse should cite an increased risk of prostate cancer in what ethnic group?
african americans
73
The _________ ______ organism is responsible for the chickenpox infection.
varicella zoster
74
A nurse should wear a facemask within 3 to 6 feet of a hospitalized patient receiving _________ precautions for an infection.
droplet
75
A _____________ is a painless lesion at the site of primary syphilis infection which usually resolves spontaneously within 3 to 12 weeks.
chancre
76
T/F: Currently, there is no treatment for West Nile virus infection.
TRUE
77
Although the incubation period for chickenpox is about 21 days, it is during the _____ days before the rash develops that the newly infected host is capable of transmitting the virus to other susceptible contacts.
2
78
T/F: Vancomycin-resistant Enterococcus (VRE) is the most frequently isolated source of health care--associated infections in the United States.
False
| C. diff and MRSA are the most common
79
T/F: The first tier of isolation guidelines, called standard precautions, is designed for the care of all patients in the hospital and is the primary strategy for preventing health care--associated infections.
TRUE
80
T/F: The three usual modes of transmission for the human immunodeficiency virus are sexual, percutaneous, and perinatal.
True
81
T/F: Penicillin G benzathine is the medication of choice for early syphilis or early latent syphilis of less than 1 year's duration.
True
82
Calicivirus, also referred to as ___________, is the most common cause of foodborne illness and gastroenteritis in the United States.
norovirus
83
Low back pain that radiates down the leg suggests the presence of nerve root involvement known as _____________.
sciatica
84
The most prevalent bone disease in the world is __________________.
osteoporosis
85
T/F: Nursing interventions for a patient undergoing foot surgery include a neurovascular assessment every 1 to 2 hours for the first 24 hours.
True
86
T/F: Symptoms of plantar fasciitis include acute heel pain experienced in the morning upon arising.
True
87
T/F: Osteoporosis frequently results in compression fractures of the spine, fractures of the neck or intertrochanteric region of the femur, and Colles fractures of the wrist.
True
88
T/F: The nurse should recommend short periods of bed rest, in a prone position, for patients experiencing back pain resulting from a compression fracture.
False-
| "Bed rest for a short time, followed by limited activity while your bones heal."
89
________________ are administered on arising in the morning with a full glass of water on an empty stomach, and the patient must stay upright for 30 to 60 minutes.
bisphosphonates
90
T/F: Osteosarcoma is the most common, and most often fatal, primary malignant bone tumor.
True
91
The most common causative organism of osteomyelitis is ________________
staphylococcus aureus
92
Is the following statement true or false?
A carrier is a person who provides living conditions to support a microorganism
FALSE
93
When a disease infects a host a portal of entry is needed for an organism to gain access. What has been identified as the usual portal of entry for tuberculosis?
Respiratory system
94
Is the following statement true or false?
Droplet precautions include wearing a face mask, but the door may remain open; transmission is limited to close contact.
TRUE
95
What is the best rationale for health care providers receiving the influenza vaccination on a yearly basis? To:
decrease risk of transmission to vulnerable clients
96
What is colonization?
Describes microorganisms present without host interference or interaction
97
A ____________ is a person who carries an organism without apparent signs and symptoms and is able to transmit an infection to others
carrier
98
An adult client in the ICU has a central venous catheter in place. Over the past 24 hours, the client has developed signs and symptoms that are suggestive of a central line associated bloodstream infection (CLABSI). What aspect of the client's care may have increased susceptibility to CLABSI?
The client's central line was placed in the femoral vein
99
The physician orders ondansetron 0.15 mg/kg IVP to be given 15 minutes before chemotherapy. The patient weighs 118.8 lbs. How many milligrams will the patient receive? (Round to the nearest whole number)
8mg
100
A client has a concentration of S. aureus located on his skin. The client is not showing signs of an increased temperature, redness, or pain at the site. The nurse is aware that this is a sign of a microorganism at which of the following stages?
colonization
101
During a health education session, a participant asks the nurse how a vaccine can protect from future exposures to diseases against which she is vaccinated. What would be the nurse's best response? The vaccine
causes an antibody response in the body
102
An immunosuppressed client is receiving chemotherapy treatment at home. What infection-control measure should the nurse recommend to the family?
Maintain cleanliness in the home, but recognize that the home does not need to be sterile.
103
Which of the following positions would be most comfortable for a client with a ruptured disc at L5–S1 right?
Supine with legs flexed
104
A patient who suffered a traumatic below the knee amputation is withdrawn, does not look at the leg, and asks to be left alone. An appropriate nursing diagnosis for the patient includes
disturbed body image.
105
A client with severe peripheral artery disease and ischemic foot ulcers is very upset with the physician’s recommendation that she have an above-the-knee amputation. She tells the nurse, “If they want to cut my leg off they should just shoot me instead.” The appropriate response to this client’s statement is,
"Tell me how you feel this will impact your life."
106
The nurse determines that teaching regarding diet for a client with osteoporosis has been successful when the client selects, as having the highest amount of calcium, the meal of
3 ounces of salmon on white bread, carrot sticks and a cup of skim milk.
107
Which of the following is not a complication seen in patients who experience fractures?
Pain
108
A nurse develops a care plan for a patient following a below the knee amputation (BKA). The nursing diagnosis selected is Disturbed body image related the effects of loss of a body part. Which of the following outcomes is most definitive for this nursing diagnosis?
The patient will reach maximum rehabilitation potential using a prosthesis three months after surgery.
109
Buck's extension traction is applied to an older patient following a hip fracture.The nurse explains to the client that this type of traction is:
skin traction applied over the skin and soft tissues.
110
The nurse is preparing a client to use the continuous passive motion (CPM) machine for the first time after total knee arthroplasty. Which is the most important action?
Explain the benefit of CPM exercises.
111
A client has primary osteoarthritis of the left knee. Which assessment finding is considered the most common clinical symptom?
pain upon joint movement.
112
When taking a client history during assessment of the musculoskeletal system, the nurse identifies an increased risk of bone loss for the client who reports:
that a parent became much shorter with aging.
113
The nurse observes a client doing all these activities after having a hip replacement surgery. Which client action requires that the nurse intervene immediately? The client:
leans over to pull shoes and socks on.
114
A client with severe osteoarthritis has just had a total knee replacement . Which of the following assessment findings would indicate possible nerve damage?
Numbness
115
A nurse is teaching dietary measures to reduce the risk of osteoporosis. Increasing intake of which food would be most helpful to minimize this risk?
3/4 cup almonds
116
A patient sustained a fracture and a cast is applied. Prior to being discharged from the emergency room the nurse should teach the patient/family about proper cast care. The Teaching Plan should include the following information.
Call the healthcare provider if pain increases despite elevation, ice and pain medication
117
The second day after admission the client with a fractured pelvis develops chest pain, tachypnea, and tachycardia. The nurse determines these symptoms are related to fat embolism when additional assessment findings reveal:
petechiae noted on the upper chest.
118
A patient is admitted to the hospital after sustaining a femur fracture. The nurse suspects the patient is experiencing Fat Embolism Syndrome when the assessment findings reveal which of the following clinical manifestations?
Chest pain and dyspnea
119
On the first postoperative day, a client with a left below-the-knee amputation complains of left foot pain. The first action by the nurse should be:
administer ordered analgesics.
120
The client who had a right above the knee amputation 3 days ago needs further teaching when stating:
“My right leg hurts less when elevated on a pillow.”
121
The clinical manifestations of Compartment Syndrome may include increasing pressure in the compartment, paralysis, pallor, pulselessness, and which of the following manifestations?
Numbness and tingling in the extremity
122
When positioning the patient after a total hip replacement, it is important that the nurse maintains the affected extremity in
extension and abduction.
123
The three most common biopsy methods used to obtain a tissue sample for histologic analysis of possible malignant cells are: excisional, _____________, and needle methods.
incisional
124
Individuals use complementary approaches to prevent and treat cancer, although there are no data to support ___________________.
efficacy
125
T/F: Pain and fatigue are the two most common side effects of chemotherapy.
FALSE
126
A cluster of symptoms referred to as ___________________ syndrome may occur during the neutrophil recovery phase in both allogeneic and autologous transplants.
engraftment
127
T.F: Patients with seed implants typically aren't able to return home; radiation exposure to others is probable.
FALSE- they can return home just have to follow certain precautions
128
T/F: Genetic mutations may lead to abnormalities in cell signaling transduction processes that can in turn lead to cancer development.
True
129
T/F: Prophylactic cancer vaccines have been proven to prevent prostrate, breast, and lung cancers.
False
130
A complete diagnostic evaluation of a cancerous tumor includes pathology analysis, which is used to identify the __________ and grade of a tumor.
stage
131
T/F: Passive smoke (i.e., secondhand smoke) has been linked to lung cancer; nonsmokers who live with a smoker have about a 20% to 30% greater risk of developing lung cancer.
True
132
The leading causes of cancer death in the United States, for men, are lung, prostate, and _____________.
colorectal
133
The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?
Smoking cessation
134
The patient is to receive one unit (350 ml) packed red blood cells (PRBC) over 2.5 hours. After infusing for 20 minutes the patient develops a rash and the infusion is stopped. How many milliliters of this transfusion did the patient receive? __mL (Round your answer to nearest whole number)
42
135
Which type of surgery is being done when lesions that are removed are likely to develop into cancer?
Prophylactic
136
A nurse provides care on a bone marrow transplant unit and is preparing a female client for hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the client's family and friends?
"Do not visit if you've had a recent infection.”
137
The nurse is caring for a client has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The client states that he would like to die at home, but the team believes that the client's care needs are unable to be met in a home environment. What might the nurse suggest as an alternative?
Discuss a referral for hospice care
138
Is the following statement true or false?
Malignant tumors spread by way of blood and lymph channels to other areas of the body
True
139
Which specific agents or factors are associated with the etiology of cancer?
Dietary and genetic factors
Hormonal and chemical agents
Viruses
All of the above
All
140
While a client is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action?
Stopping the administration of the drug immediately
141
An adult client with leukemia will soon begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?
Administer an antiemetic
142
What nursing action best demonstrates primary cancer prevention?
Teaching clients to wear sunscreen
143
T/F: When caring for patients with low vision or blindness, it is important to encourage and support independence as much as possible.
True
144
____________ are ocular medications that result in relaxation of the ciliary muscle and cause the pupil to dilate.
mydriatics
| "D" for dilate
145
T/F: Cranial nerves II, V, and VI control eye movement and pupil size.
FALSE
| 3, 4, and 6 do
146
T/F: Age-related macular degeneration accounts for 54% of all blindness in older adults in the United States.
True
147
The lens of the eye enables focusing for near and distance vision through _____________, the process by which the lens of the eye adjusts the focal length to focus a clear image on the retina.
accommodation
148
____________, is called the "silent thief" due to patients being unaware of the condition until there is significant vision loss.
glaucoma
149
Those who have excellent distance vision but blurry near vision are farsighted and said to have the diagnosis of ____________.
hyperopia
150
T/F:
A person is considered legally blind whose best corrected visual acuity does not exceed 20/200 in the better eye or whose widest visual field diameter is 20 degrees or less.
True
151
T/F: A cataract causes a central opacity in the lens that results in painless, blurry vision.
True
152
Chronic bilateral inflammation of the eyelid margins is a common inflammatory eye disorder known as _________________.
Blepharitis
153
A client reports her right ear drum has been punctured many times as a child. The nurse assesses the client for signs of difficulty with:
Sound transmission
154
When preparing a client with glaucoma for discharge, which information by the nurse is most appropriate?
Correct use of eyedrops
155
What information should be included in the nursing plan for a patient who needs to administer antibiotic ear drops?
Avoid touching the tip of the dropper bottle to the ear.
156
Presbyopia occurs in older individuals because
the lens becomes inflexible.
157
While teaching the use of a hearing aid the nurse encourages the client to initially use the aid
in a quiet controlled environment to experiment with tone and volume.
158
The daughter of an elderly patient diagnosed with dry macular degeneration asks the nurse to explain this disorder. The nurse's best response includes:
atrophy and degeneration of the retina.
159
To prevent macular degeneration the nurse teaches the client to eat lutein which is found in:
Spinach and kale.
160
A client has an acute attack of Meniere's disease. The nurse should anticipate which of these clinical manifestations?
Vertigo, hearing impairment and tinnitus.
161
During assessment of hearing the nurse would expect to find:
Pearl-grey tympanic membrane.
162
A client is admitted with a diagnosis of increased intraocular pressure. This condition is most often caused by:
Increased aqueous humor
