Final Exam Flashcards
Most common treatments for peptic ulcers
proton pump inhibitor
2 antiboiotics
What do you need to make sure the patient is willing to do for treatment of H. Pylori
Finish the medication
If you have a renal patient which medicines should they not take
Maalox
What happens if you take to much Maalox
Diarrhea
What kind of med is carafat
Mucosal Barrier
Do you take carafat before or after you eat
Before
What comfort measures would you ask the AP to do for a patient that has a NG tube and is a GI bleeder with suctioning?
Provide oral hygiene
Is an out pouching of the intestine
Diverticulitis
What type of diet should you eat if you have divertiulitis
High Fiber
What should you avoid eating if you have divertiulitis
alcohol seeds nuts corn popcorn cucumbers tomatoes figs strawberries
cholecystecotomy
removal of the gall bladder
How are you going to care for a patient with gastroenteritis that has a excoriated perinium
wash with soap and water
put dry
baby wipes
What kinds of foods should a person with gall bladder pains avoid
Fatty Foods
After surgery a patient has shoulder pains what do you do for them?
have them ambulate
The difference between acute and chronic cystitis
Clay or light colored stools
Patient comes in the doctors office and has lost forty pounds since their last visit. what is the best thing for the nurse to do
ask if the weight lose was intentional
why did they lose the weight
are you having problems swallowing
If someone is having problems swallowing what is that a sign of
Cancer
What do you do after giving a NG tube feeding
Flush it
check for residual
listen to the lung sounds
When your watching what you eat what kind of things do you want to look at
portion control
calories
psychological reason why you are eating
are they stressed or depressed
When you are caring for a bariatric patient what is the most appropriate action when transferring them
make sure you have a enough staff on hand when you moving the paitent
What can you assign the AP to do with a bariatric patient who is in a normal hospital bed?
Check for pressure ulcers
how do you develop bacterial cystitis, UTI
E. Coli
not cleaning properly
estrogen levels low
not going to the bath room when you have to go
Postmenopausal patient has two UTI (cystitis) in a short amount of time. what do you tell this patient
Could be due to low estrogen
A patient with an indwelling catheter what are some reasons they my have the catheter
neurogenic bladder
incontinent
a patient comes from a nursing home that has had a lot of falls what is the first thing you a want to do
Get a urine sample and look for UTI
signs and symptoms for older patients with UTI’S
level of consciousness
confused
agitation
a female with urinary incontinents how would you help this patient and make her feel comfortable
ask about her lifestyle and find stratages that will work for her
a patient with a fungal urinary tract infection what should the nurse do
get a list of current meds
look at current medical HX
how would the nurse promote good nutrition when working with older adults
Dentures in
Glasses on
bed pan out of sight
what does the nurse tell the AP before going to feed the patient
make sure the urinal is removed make sure it is a nice quite environment to eat in warm food warm cold food cold sit pt up
risk factors for gastritis
NSAIDS Caffeine Alcohol Corticoid steroids H. Pylori
What do you tell the patient to do when on a toilet training program?
Hold it until next scheduled time to go
A calorie malnutrition in which fat and proteins are wasted
marasmus
lack of protein quality and quantity
kwashiorkor
combination of energy and protein malnutrition
Marasmus-kwashiorkor
Sodium range
135-145
Potassium range
3.5-5
Calcium rnage
9-10.5
Chloride range
98-106
Magnesium range
1.3-2.1
Phosphorus range
3-4.5
Positive Chvostek (face) and trousseau (hand) are signs of
Hypocalcemia
Which statements about the purpose of the immunity system are true? (select all that apply)
A. The immune system provides protection from and eliminates or destroys microorganisms
B. The immune system is able to identify non-self proteins and cells
C. The immune system removes foreign proteins and other substances
D. The immune system protects against allergic/anaphylactic reactions
E. The immune system is able to prevent healthy body cells from being destroyed.
A,B,C,E
Which factors may affect the function of the immune system? (select all that apply)
A. Nutritional Status B. Environmental conditions C. Drugs D. Family health history E. Age
A,B,C,E
The immune system is responsible for self tolerance. Which functions related to self tolerance are included the immune systems responsibilities? ( select all that apply)
A. Recognizing self versus non self
B. Be recognized by T-lymphocyte helper/inducer T cells
C. Recognize different proteins on cell membranes
D. Recognize self versus the inflammatory response
E. Identify non-self, which includes all invading cells and organisms
A,C,E
From where do most immune cells originate?
A. Thymus
B Spleen
C. Liver
D. Bone marrow
Bone Marrow
The patient’s wound has increased blood flow (hyperemia) and swelling. Which stage of inflammation does the nurse recognize?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Stage 1
The nurse is providing care for a patient whose wound is producing the substance commonly called “pus” as exudate. Which stage of inflammation does the nurse recognize?
Stage 2
Which cell interacts in the presence of an antigen to start antibody production? (select all that apply)
A. B-lymphocytes B. Macrophages C. Neutrophils D. T-helper/inducer cells E T suppressor cells
A. B-lymphocytes
B. Macrophages
D. T-helper/inducer cells
A patient who had an organ transplant 2 months ago is experiencing rejection of the organ. What type of rejection is this?
A. Acute
B. Hyperacute
C. Delayed
D. Chronic
Acute
Cancer cells that are abnormal, serve no useful function, migrate, large nucleus ot plasma ratio, anaplasia, loose adherence and are harmful to normal body tissue
Malignant Cancer Cells
Substances that change the activity of the cell’s genes so that the cell becomes a cancer cell are called?
Carcinogens
Is the most common cause of cancer spread?
Blood borne metasaisis
Is used to describe the anatomic extent of the cancer
TNM (tumor, Node, Metastasis)
Number one cancer causing death in both men and women?
Lung and bronchus
Which pathological description of a client’s tumor does the nurse interpret as being the “most malignant” or “high grade” cancer?
C. Undifferentiated: = 50% aneuploid
7 warning signs of cancer
Changes in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in the breast or else where Indigestion or difficulty swallowing Obvious change in mole or wart Nagging cough or hoarsness
The nurse learns that the most important function of the inflammation is which purpose?
Provide protection against invading organisms
Which medication should the nurse plan primary teaching?
Tylenol (Acetaminophen)
What recommendation is BEST to help prevent osteoarthritis?
Lose weight if needed
The white blood cell count with differential of a client undergoing preadmission testing before surgery indicates total count of 10,000 cells per cubic millimeter (mm^3) of blood. Which differential counts of percentages does the nurse report to the physician?
A. Eosinophils 220/mm^3
B. Monocytes 2000/mm^3
C. Segmented neutrophils 5700/mm^3
D. Lymphocytes 2100/mm^3
B. Monocytes 2000/mm^3
Also known as Humoral Immunity, involves antigen-antibody interactions to neutralize, eliminate or destroy foreign proteins?
(AMI) antibody-mediated immunity
A disease causing bacteria, protoza, fungus or virus is called?
Pathogen
Arthritis that is chronic, progressive,systemic inflammatory autoimmune disease process that affects primarily the synovial joints?
(RA) Rheumatoid Arthritis
The nurse is assessing an older patient and has a below normal fever 97. What is the BEST response?
A. Conclude the infection is not present
B. Monitor and continue to document any findings
C. Assess the client for more specific signs
D. Request blood cultures
Assess the client for more specific signs
Someone is diagnosed with osteoarthritis. What would be the first drug the nurse would tell them to use?
Tylenol
What is the absolute reason someone would NOT get a limb transplant?
If they have osteoporosis
After patient is released and goes to a long term care facility for rehab for a joint replacement. What action is important for the nurse to know?
A. Administer pain meds for transport
B. Answer last minute question by the family
C. Insure the family has directions to the facility
D. Provide a verbal hand off report to the facility
Provide a verbal hand off report to the facility
In a Rheumatoid arthritis facility which patient do you see first?
A. Jaw pain
B. Hot and swollen right wrist
C. Puffy area behind the knee
D. Joint deformities
Hot and swollen in the wrist
A patient with osteoarthritis’s is running a low grade fever. What is the best action by the Nurse?
A. Reassure patient problem will fade when the weather changes
B. Prepare to teach them about taking Tylenol
C. Inspect their hands and feet and toes
D. Assess the patient for subcutaneous nodules or bakers cyst.
Assess the patient for subcutaneous nodules or bakers cyst
A patient with rheumatoid arthritis is experiencing worsening physical status and are finding it difficult to maintain their role in the community. Stress is adding to their condition. As a visiting nurse what is the best thing for you to do?
A. Suggest to give up the role as an elder
B. See if they can call a meeting
C. Discuss their role duties
D. Assess their culture more
Asses their culture more
A client with stiff hands in the morning wants to finish their baby quilt. What are you going to use?
Wax
Where would you look for Heberdens nodes?
Distal ends for digits
Where would you look for Bouchards nodes
Proximal joint in digit
The difference between normal cells and benign cells. The teacher gives the correct description of benign tumors?
A. Benign tumors grow through invasion of other tissue
B. Benign tumors lost their contact inhibitions
C. Growing in the wrong place and wrong time is normal of benign tumors
D. The loss of characteristic are symptoms of anaplasia
Growing in the wrong place at the wrong time
What statement about carcinogenics is accurate?
A. Initiated cell will ALWAYS become clinical cancer
B. Normal hormones or proteins do not promote cancer growth
C. Tumor cells need their own blood supply
D. Cancer becomes a health problem once it is one centimeter larger
Tumor cells need their own blood supply
How is Metastasis most spread in the body?
Blood borne
A patient has very dry skin. What is the nurses BEST action?
Have the patient take a cool shower and apply lotion before drying off
If your transferring your patient into a chair and you notice her pressure relieving mattress has deep imprints. What would be the best thing for the nurse to do?
Get a different pressure relieving mattress
Assess their skin
Turn them every two hours
A patient has a pressure ulcer on their right ankle. What should the nurse do first?
Assess the ankle
The nurse is visiting a client at home and notices the patient is at risk for a pressure ulcer. What is the appropriate response to the caregiver?
Do not message the area and turn the patient every two hours
A patient is at risk for a pressure ulcer. What statement by the patient indicates that the patient understands how to decrease the risk of pressure ulcers?
I need to eat more protein
The nurse is assessing patients with wounds. Which patient is at risk for infection?
Someone who has a WBC count of 23000
The nurse is assessing a patient with a Braden Scale of 9.
What should the nurse include in the assessment?
How are you providing his care
The nurse is assessing a patient with peripheral vascular disease of an older patient. What action by the student nurse would cause the faculty to intervene?
Checking the corotoid arteries at the same time
If the patient has peripheral artery disease and the patient tells you “ i walk 5 blocks without plan”. What would the nurses next question be?
Could you walk 5 blocks two months ago
The patient has peripheral vascular disease is explaining the daily foot care routine to the nurse. What statement by the patient indicates there may be a barrier to foot care?
My hands shake when I do things that require coordination
A nurse is caring for someone with (DVT) Deep vein thrombosis. what assessment indicates priority outcome has been made?
O2 SAT is at 98%
A obese patient is in for follow up with a DVT. The patient has lost 20 pounds. What is the BEST action by the nurse?
Check to see if the anti embolism stocking still fit
The nurse is treating a patient with a non healing arterial leg ulcer. What is the BEST action by they nurse?
Call the wound nurse
Which statement by the patient indicate need for further teaching of care for peripheral arterial disease?
I can use a heating pad
Arthritis that is bilateral, an autoimmune disease, systemic and is caused by antibodies
Rheumatoid Arthritis
Characteristics of normal cells
Non traveling
Differentiated
Specific morpholog
Cardinal Signs of inflammation
redness swelling (edema) warmth pain loss of function
Is a progressive deterioration and loss of cartilage and bone in one or more joints
Osteoarthritis
Osteoarthritis is caused by
Aging and genetic fatctors
The nurse is caring fora client with chronic stasis ulcers. Which statement by the client indicates a need for further health teaching?
A. I will wear compression stockings at night
B. I will keep my affected leg above my heart
C. I will eat protein and vitamin C food to help heal the ulcer
D. I will change my dressing every 3 to 5 days as needed.
I will wear compression stockings at night
A chronic metabolic disease in which the bones that cause decreased density and possible fractures. it is known as “ silent disease/thief”
Osteoporosis
Osteoporosis is cause by a combination of:
genetic
lifestyle
environmental factors
Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly
pigmented skin may not have visible blanching; its color may differ from the surrounding area. Is what pressure ulcer stage?
Stage 1
Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without
slough. May also present as an intact or open/ruptured serum-filled blister. Is what stage pressure ulcer?
Stage 2
Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed.
Slough may be present but does not obscure the depth of tissue loss. May include undermining and
tunneling. Is what stage pressure ulcer?
Stage 3
Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some
parts of the wound bed. Often include undermining and tunneling. Is what stage pressure ulcer?
Stage 4
Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or
brown) and/or eschar (tan, brown or black) in the wound bed. Is what stage pressure ulcer?
Unstagable
