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Med-Surg I > Final Exam > Flashcards

Final Exam Flashcards

1
Q

As a new nurse, what is the main priority?

A

Patient safety

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2
Q

If a patient’s BP drops from 140 to 80, as the nurse, what should you do?

A

Call the RRT team

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3
Q

What demonstrates patient autonomy?

A

Asking the patient if they have any questions prior to them signing consent

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4
Q

If your patient is part of the LGBTQ community, what would do as the nurse?

A

Don’t make assumptions!

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5
Q

If a patient had surgery two days ago but the doctor on-call is not who performed the surgery, and the patient is complaining of pain, as the nurse what would you first tell the doctor?

A

If the patient is allergic to any medications

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6
Q

Who can participate in quality improvement projects?

A

Everyone

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7
Q

If you move to a new city or state and are looking for a new physician or hospital to visit, what should you look for?

A

Accreditation

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8
Q

There is an older patient in the hospital for surgery. What would you include in your post-op assessment?

A

Any change in behavior

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9
Q

If you have a pre-op patient, as the nurse what is the most important thing to relay to the surgical team?

A

If the patient is taking any herbs or supplements

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10
Q

There are four people that need to be discharged on your floor. Who will require the most care after discharge?

A

Older adult patient with memory loss

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11
Q

Labs come back for a pre-op patient. What levels should the OR team be notified about specifically?

A

Potassium 2.9

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12
Q

Patient is experiencing pain after surgery and coughing even after pain meds have been administered, as the nurse, what should you tell the patient to do?

A

Splint the abdomen

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13
Q

A patient has an abdominal drain placed. What would be identified as recovery goals being met?

A

No redness around the area

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14
Q 
A patient has been given sedatives prior to being taken to the OR room, but now the patient has to use the restroom. What would you do?
A. Assist them to the restroom
B. Tell them it is okay for them to go
C. Insert a Foley catheter
D. Give them a bedpan or urinal to use
A

D. Give bedpan or urinal

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15
Q

Your patient is in pre-op and you notice they have dry, brittle hair and nails, and poor skin turgor, what should you do?

A

Make sure the surgeon writes for a dietary consult after the surgery

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16
Q

Your patient is getting very anxious before their surgery, what is the best thing for the nurse to do?

A

Ask them to describe their feelings

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17
Q

You’ve been instructed to administer IV antibiotics to your pre-op patient but the patient stops you and asks if you can wait until closer to the surgery. What would you tell the patient?

A

Explain the rationale behind giving the antibiotics now versus later

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18
Q

A patient signed consent for MIS. As the nurse, what should you remind the surgeon?

A

That the patient only signed for MIS, nothing more

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19
Q

You walk into a room and noticed a frayed electrical cord. What do you do?

A

Get a new one

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20
Q

In the OR room, the surgeon puts on sterile gloves but then drops his hands below his waist, what should you tell the surgeon?

A

He just broke sterile field

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21
Q

When someone is receiving IV anesthesia, what post-anesthesia care is the best?

A

Hook them up to a monitor and monitor pulse ox

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22
Q

When bringing an older patient in the OR room, what action by the nurse is the most important for the patient?

A

Allowing them to keep their hearing aids on until the last minute

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23
Q

A circulating nurse needs to provide emotional support to her patient. What would be the best action?

A

Remain with the patient

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24
Q

You are the nurse in the PACU and have four patients to tend to. Who is the priority patient?
A. Blood pressure of 120/84
B. Pulse 58
C. Resp = 6

A

C. Respirations = 6

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25
Q

Patient’s O2 levels drop from 98 to 95. What should you do?

A

Assess for other signs of oxygenation

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26
Q

A patient is 10 hours post-op and is wearing anti-embolism stockings. The patient is complaining about them being too hot and itchy and wants you to take them off. What should you do?

A

Tell the patient that they are on to help prevent blood clots in the legs and they need to stay on for a few more hours

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27
Q

A patient just received spinal anesthesia. When you raised the head of the bed, the patient’s BP dropped. What should you do?

A

Lower the head of the bed

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28
Q

What is a priority PACU post-op assessment for patients?

A

Airway

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29
Q

Peripheral Arterial Disease (PAD)

A

Results from atherosclerosis that usually occurs in the arteries of the lower extremities and is characterized by inadequate flow of blood

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30
Q

How you help relieve leg pain in a patient who has PAD?

A

Place legs at rest in a dependent position but not above the heart

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31
Q

A nurse is collecting data from a client who has chronic PAD. Which of the following should the nurse expect to see?
A. Edema around the ankles and feet
B. Ulceration around the medial malleoli
C. Scaling eczema of the lower legs with stasis dermatitis
D. Pallor on elevation of the limbs and rubor when limbs are dependent

A

D. Pallor on elevation of the limbs and rubor when limbs are dependent

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32
Q

Sodium Levels

A

136 - 145

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33
Q

Potassium Levels

A

3.5 - 5.0

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34
Q

Calcium Levels

A

9.0 - 10.5

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35
Q

Magnesium Levels

A

1.3 - 2.1

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36
Q

Phosphorus Levels

A

3.5 - 4.5

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37
Q

Chloride Levels

A

98 - 106

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38
Q

ROME

A

Respiratory
Opposite
Metabolic
Equal

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39
Q

pH Range

A

7.35 - 7.45

Alkalosis >7.45
Acidosis <7.35

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40
Q

PaCO2 Range

A

45 - 35

Alkalosis <35
Acidosis >45

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41
Q

HCO3- Range

A

22 - 26

Alkalosis >26
Acidosis <22

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42
Q

Respiratory vs. Metabolic Factors

A

PaCO2 deals with respiratory

HCO3- deals with metabolic

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43
Q

What does it mean if ROME values are all within normal limits?

A

Homeostasis

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44
Q

Causes of Respiratory Acidosis

A 
Respiratory depression from poisons
Anesthetics 
Trauma
Neurological diseases
Inadequate chest expansion d/t muscle weakness
Obesity
Airway obstruction
Asthma
Some cancers
Pulmonary edema
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45
Q

Causes of Respiratory Alkalosis

A 
Hyperventilation d/t fear
Anxiety
Intracerebral trauma
Excessive mechanical ventilation
Hypoxemia from asphyxiation
Shock
Pneumonia
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46
Q

Causes of Metabolic Acidosis

A 
Diabetic ketoacidosis
Starvation
Heavy exercise
Fever
Hypoxia
Intoxication with ethanol or salicylates
Kidney failure
Liver failure
Dehydration
Diarrhea
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47
Q

Causes of Metabolic Alkalosis

A 
TPN
NG tube suctioning
Prolonged vomiting
Laxative abuse
Diuretics
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48
Q

Ileostomy

A

A surgical opening into the ileum to drain stool

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49
Q

Colostomy

A

A surgical opening into the large intestine to drain stool

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50
Q

Describe a stoma that is ischemic

A

Bluish/purple in color

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51
Q

GERD

A

Gastric content and enzyme leakage back up into the esophagus.

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52
Q

Risk Factors of GERD

A 
Obesity
Older adults
Sleep apnea
NG tube
Excessive ingestion of fatty foods, chocolate, or caffeine
Pregnancy
NSAIDs 
Stress
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53
Q

Antacids

A

Neutralize excess acidi

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54
Q

Types of Antacids

A

Mylanta
Maalox
Gaviscon

55
Q

Histamine2 Receptor Antagonists

A

Reduce the secretion of acid

56
Q

Types of H2 Receptors Antagonists

A

Zantac
Pepcid
Axid

57
Q

Proton Pump Inhibitors (PPIs)

A

Protonix - pantoprazole
Prilosec - omeprazole
Nexium - esomeprazole
Prevacid - lansoprazole

58
Q

Is it better to have a pill form or liquid form of antacids?

A

Liquid - it will coat the lining of the esophagus

59
Q

Peptic Ulcer

A

An erosion of the mucosal lining of the stomach or duodenum

60
Q

Causes of Peptic Ulcer Disease

A 
H. pylori
NSAIDs
Corticosteroids
Stress
Alcohol
61
Q

Most common treatment of Peptic Ulcers

A

2 antibiotics and a PPI

62
Q

Gastritis

A

Inflammation of the stomach

63
Q

Risk Factors of Gastritis

A 
H. pylori
E. coli
Family hx
Prolonged use of NSAIDs
Caffeine
Stress
64
Q

Chronic vs. Acute Gastritis

A

Chronic gastritis is indicated by light, clay colored stools

65
Q

Carafate

A

Mucosal barrier

66
Q

Cholecystitis

A

Inflammation of the gallbladder

67
Q

Cholelithiasis

A

Presence of stones in the gall bladder

68
Q

Osteoporosis

A

Common chronic metabolic bone disorder resulting in low bone density

Occurs when the rate of bone resorption exceeds the rate of bone formation resulting in fragile bone tissue and subsequent fractures

69
Q

Osteoarthritis (OA)

A

Cartilage destruction with bone spur growth at joint ends; degenerative

Localized inflammatory response

Occurs usually in people who are overweight

70
Q

Symptoms of OA

A

Pain with activity that improves with rest

Heberden’s and Bouchard’s nodes

71
Q

Rheumatoid Arthritis (RA)

A

Synovial membrane inflammation resulting in cartilage destruction and bone erosion; inflammatory

Can affect all joints

Occurs usually in people who are underweight

Can involve the lungs, heart, skin, and extra-articular

72
Q

Symptoms of RA

A

Swelling, redness, warmth, pain at rest or after immobility (morning stiffness)

Swan neck and boutonniere deformities of hands

73
Q

Medications to Help Treat OA

A

Tylenol and NSAIDs

74
Q

Risk Factors for RA

A 
Female gender (3:1)
Age 20 - 50 
Genetic predisposition
Epstein-Barr virus
Stress
75
Q

Non-Medication Treatment Options for RA

A

Morning stiffness - hot shower
Pain in hands/fingers - heated paraffin wax
Edema/swelling - ice

76
Q

TNM

A

Tumor - Node - Metastasis

X = unable to evaluate
0 = no evidence of...
is = in situ = hasn't spread from original location
1-4 = size, extent, spread, number, etc.
77
Q

Responsibilities for Informed Consent

A

Provider obtains it
Patient give it
Nurse witnesses it

78
Q

A patient with a drain and dressing is being discharged. What is the priority message to remind the patient of?

A

Hand hygiene when working with the drain or dressing change to prevent infection

79
Q

An older adult just come back from surgery. The family is concerned that he is taking longer to wake up than they figured. As the nurse, what would you tell them?

A

Older adults often take a longer amount of time to wake up from the anesthesia because it takes longer to process through their body

80
Q

A nurse answers a call light in the post-op unit and the patient states that there is blood gushing from my incision. What should the nurse do?

A

Hand hygiene and put on gloves

81
Q

A newly licensed nurse is changing the dressing around a Penrose drain. What action by the new nurse would need an intervention from the RN in charge?

A

Securing the safety pin to the sheets - would be considered a restraint

82
Q

What is the most important function of inflammation and immunity?

A

To provide protection

83
Q

A nurse is trying to prevent infection in an older adult. What would be the first thing they should do?

A

Assess vaccination records

84
Q

Someone is newly dx with osteoarthritis. As the nurse, what medication should you educate the patient about?

A

Tylenol

85
Q

A nurse is working in the orthopedic clinic today. What would be a contraindication of joint replacement?

A

Severe osteoporosis

86
Q

During peri-op , what should the nurse do as wound infection prevention?

A

Administer antibiotics

87
Q

A patient is being discharged to a short term rehab facility. What is the nurse’s number one priority?

A

Provide verbal hand-off to the facility

88
Q

A nurse is working in a RA clinic and there are four patients. Which patient would you see first?

A

Patient with red, hot, and swollen wrists

89
Q

A nurse identifies poor body image in a patient. After education, what would be a good indication that the education worked?

A

Patient went to a book club

90
Q

Your patient has RA and has red, hot joints. What would be a non-medication treatment option that you could tell them about?

A

Ice

91
Q

A patient comes in self-diagnosed with osteoarthritis. The patient has a low-grade fever and pain in the back of her knees. What should the nurse assess for?

A

Assess for baker’s cysts which could indicate RA

92
Q

A patient has RA in her hands but wants to finish knitting a baby blanket. What would you suggest the patient to do?

A

Dip hands in heated paraffin wax

93
Q

What are Heberden’s nodules?

A

Enlarged areas on the distal ends of the digits

94
Q

What are Bouchard’s nodules?

A

Enlarged areas on the proximal area of the digits

95
Q

What is one fact that is always true about cancer?

A

The tumor cell needs to develop own source of blood

96
Q

Most common form of metastasis?

A

Bloodborne

97
Q

If you are caring for a patient with peptic ulcer pain, what should you do?

A

Notify PCP immediately - could be perforation

98
Q

If a patient is educated about H. pylori, what is the main concern when a patient is given an antibiotic?

A

Are they going to follow the drug regimen completely?

99
Q

You walk into a room and see your patient on the floor vomiting blood. What is the first thing you would do?

A

Put on gloves

100
Q

You have a patient with an NG tube inserted. What is comfort measure that you could delegate to a UAP?

A

Oral care

101
Q

A patient has a newly placed ileostomy and has some concerns about going to prom. What would be the best action by the nurse?

A

See the ostomy nurse about dresses and different bags that the patient could wear

102
Q

A patient with diverticulitis would eat what kind of diet?

A

Low fat, no seeds

Baked fish, carrots, juice

103
Q

After teaching a patient about Humira, what would indicate that the patient needs additional teaching?

A

If they stated they should take it with breakfast

104
Q

A patient had their gall bladder removed. What would indicate the patient understood the teaching about gall bladder removal?

A

Decrease fatty foods in their diet

105
Q

Patient is experiencing pain the shoulder blades after laparoscopic surgery. What do they need to do?

A

Ambulate

106
Q

Patient needs to stick to a low-fat diet. What foods would indicate the patient understands?

A

Roast chicken breast, baked potatoes with chives, and OJ

107
Q

A patient with a PCA button wakes up in pain. What should you tell them?

A

Push the button

108
Q

Which patient is the most at risk for bacterial cystitis?

A

Female patient not taking estrogen

109
Q

A nurse has a post-menopausal patient that has experienced 2 UTIs in the last six months. What would the nurse tell the patient?

A

Low estrogen can cause an increased risk for UTIs

110
Q

True or False: Infection is always accompanied by inflammation.

A

False; Inflammation can occur without infection

111
Q

Five Cardinal Manifestations of Inflammation

A 
Warmth
Redness
Swelling
Pain
Decreased function
112
Q

Serosanguineous Exudate

A

Blood-tinged amber fluid consisting of serum and red blood cells

113
Q

Suspected Deep Tissue Injury

A

Intact skin appears purple or maroon

Blood-filled blisters may be present

114
Q

Stage I Pressure Ulcer

A

Intact skin; area, usually over a bony prominence, is red and does not blanch with external pressure

115
Q

Stage II Pressure Ulcer

A

Skin is not intact
Partial-thickness skin loss of the epidermis or dermis
Ulcer is superficial and may be characterized as an abrasion, a blister (open or fluid-filled), or a shallow crater
Bruising is not present

116
Q

Stage III Pressure Ulcer

A

Skin loss is full thickness
SC tissues may be damaged or necrotic
Damaged extends down to but not through the underlying fascia; bone, tendon, and muscle are not exposed
Undermining and tunneling may or may not be present

117
Q

Stage IV Pressure Ulcer

A

Skin loss is full thickness with exposed or palpable muscle, tendon, or bone
Often includes undermining or tunneling
Sinus tracts may develop
Slough and eschar are often present on at least part of the wound

118
Q

Unstageable Pressure Ulcer

A

Skin loss is full-thickness and the base is completely covered with slough or eschar obscuring the true depth of the wound

119
Q

What causes cholecystitis?

A

Fatty diet, high cholesterol

Affects American Indians and Mexicans the most

120
Q

What are some signs and symptoms of cholecystits?

A

Pain in the right abdomen that radiates to the upper right shoulder

121
Q

Who are the most likely people to have pain in their gallbladder?

A

Female
Forty
Fat
Fertile

122
Q

Cholecystectomy

A

Removal of the gallbladder

123
Q

After they remove the gallbladder laparoscopically, do they usually still have gallbladder pain afterwards?

A

No, they will just have post op pain

124
Q

If they cannot get it done laparoscopically, what is another way they can remove the gallbladder?

A

Cholecystectomy

125
Q

If someone went for a doctor’s visit and they lost 40 or 60 pounds from their last visit. What would the nurse ask them?

A

If the weight loss was intentional

126
Q

Which type of malnutrition lacks calories?

A

Marasmus

127
Q

Which type of malnutrition lacks protein?

A

Kwashiorkor

128
Q

If a nurse is giving an NG bolus tube feeding every 4 hours, what would the nurse do before and after each feeding.

A

Before: check placement of the tube before feeding

After: Auscultate lung sounds

129
Q

If a patient is transferred to the bariatric clinic after they had bypass surgery and they start saying, “I did not know it would be this hard to live like this…”, what is the best for the nurse to do?

A

The nurse should find out if they have a support system at home.

Assess their coping skills.

Get them into a support group.

130
Q

If you delegate feeding to a CNA, what directions should you give them?

A 
Nice, quite, relaxed atmosphere
Hot food - hot
Cold food - cold
Urinals/bedpans off the bedside table
Patient should have glasses, dentures, utensils, and hearing aids
131
Q

If you are giving someone Maalox, what is the most important teaching the nurse should do with the patient?

A

Notify the provider if you have diarrhea

132
Q

What intervention would be helpful for an incontinent patient?

A

Bladder training program

133
Q

How should the nurse react if the patient is embarrassed to be incontinent?

A

The nurse should strategize with the patient about their lifestyle, use of pads, Kegel exercises, and a bladder program

Med-Surg I (7 decks)

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