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Med-Surg II > Final Exam > Flashcards

Final Exam Flashcards

1
Q

If there is a patient with a low immune system, what is the highest priority nursing intervention?

A

Hand washing

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2
Q

A patient has a wound their left calf with drainage. Why does the nurse tell the patient to monitor the drainage color?

A

Some drainage is normal but doesn’t mean the wound is infected. The color of the drainage can indicate this.

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3
Q

The nurse is assessing an older adult post-op patient to see if the incision/wound is infected. What would indicate an infection?

A

Confusion

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4
Q

What precautions would you take for an HIV patient?

A

Standard precautions

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5
Q

What should the nurse educate an HIV patient about?

A

Watching for opportunistic infections (infections on normal people not causing issues)

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6
Q

What are some nursing interventions for a patient with anemia?

A

Tell the patient to sit down with dyspnea from exercise.

Nurse should monitor HR and RR - both will be increased

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7
Q

What would a nurse assess on a patient will frequent bruising?

A

Assess for medication usage of NSAIDs

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8
Q

What are normal platelet counts?

A

150,000-450,000

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9
Q

A patient has a platelet count of 30,000. What would be a priority nursing intervention?

A

Risk for bleeding

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10
Q

How does a patient develop iron deficient anemia?

A

Lack of red meat consumption

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11
Q

What would you educate a patient about thrombocytopenia?

A

Teach patient to use a soft bristle toothbrush or electric shaver.

Avoid using aspirin

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12
Q

What will excessive catecholamines lead to?

A

Will lead to a sympathetic response

Fight or Flight

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13
Q

What can happen with too much thyroid hormone in the body?

A

It can cause a thyroid storm which can be life threatening

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14
Q

What causes acromegaly?

A

Excessive growth hormone - causes soft tissue changes but not bone changes

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15
Q

What nursing intervention would you do with a patient that has SIADH?

A

Hold fluids! Body is retaining fluid and causing the body to fake hyponatremia. Fluids could cause the patient to become hypervolemic.

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16
Q

Why is it important to wean off high doses of cortisone?

A

This allows the adrenal gland to start working on it’s own again

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17
Q

A patient is prescribed spironolactone. What should this patient know about this medication?

A

It’s potassium sparing so it is important to avoid green leafy foods and salt substitutes containing potassium. This could cause hyperkalemia.

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18
Q

What should a diet look like for a patient with hyperthyroidism?

A

Increased carbohydrates, protein, and calories

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19
Q

What would be a quick fix for a patient experiencing hypoglycemia?

A

4 oz of juice and a form of carbohydrates

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20
Q

A patient comes in and states a 15 year hx of DM. What should the nurse assess first?

A

Check the feet!

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21
Q

A patient with DM has become visually impaired and would like to have pre-filled syringes. What should you tell the patient?

A

They can be stored for up to 3 wees and stored upright.

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22
Q

What are some signs of ketoacidosis?

A

Fruity breath, kussmals respirations

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23
Q

A patient with asthma cannot take deep breathes and there aren’t any wheezes. As the nurse, what should you do?

A

Check O2 sat

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24
Q

There are four asthma patients on the unit. As the nurse, who has the highest priority for assessment or interventions?

A

Assess the patient with the high HR first

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25
Q

What should you educate the patient about when being prescribed an inhaled corticosteroid?

A

Rinse the mouth after use.

Not used for fast relief - used for long term treatment

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26
Q

What can the nurse do for a patient that has pneumonia?

A

Increase fluid intake to at least 2 L a day

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27
Q

A patient was recently prescribed a nicotine patch to stop smoking. What should you warn the patient about?

A

Don’t smoke while having the patch on - could cause a heart attack

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28
Q

What intervention can you do for a patient that is dizzy?

A

Have the patient sit up slowly and take their BP

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29
Q

You are assessing a patient in an outpatient clinical setting with left-sided heart failure. What would you expect to see or hear?

A

Crackles in the lungs
Winded easily
Poor exercise tolerance

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30
Q

What should you check for in a patient with right-sided HF?

A

Check for edema

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31
Q

A patient, who just had a valve replacement, asks the nurse why he has to take anti-coagulants?

A

The valve is synthetic and can cause blood to clot easier. This will help prevent the clots.

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32
Q

What would be the ideal position for a patient with heart failure?

A

Sitting up, with pillows under the arms

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33
Q

The patient is prescribed lovastatin but the nurse notices elevated liver enzymes on the lab results. What should the nurse do?

A

Hold the medication

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34
Q

Education for a patient with HTN

A

Patient will need to take the meds forever even when the patient feels better.

Diet and exercise change (low sodium diet)

35
Q

What would nurse be looking for on a patient with venous ulcer?

A

Brownish spots on the legs

36
Q

A client found she has a lump in her breast and becomes tearful while scheduling her mammogram. As the nurse, what should you say?

A

It may be benign unless there is a relative that has had cancer in the past.

Explore her feelings and reassure her.

37
Q

A patient with endometriosis just got married and wants to have children but believes she is infertile because of the endometriosis. As the nurse, what should you explain?

A

Having endometriosis doesn’t always mean/cause infertility.

38
Q

A 20-year old female believes she has endometriosis. What would be some indications of this?

A

Pain with intercourse

Pain while on her period

39
Q

A patient was prescribed Finasteride 4 weeks ago and states that he hasn’t seen a reduction in his symptoms. What should the nurse tell him?

A

It can sometimes takes months for results to be seen.

40
Q

A patient with BPH has been having difficulty urinating. What should you explain to hiim?

A

Since his prostate is enlarged, it is providing extra pressure on the urethra causing the difficulty urinating.

41
Q

The nurse is assessing a lesion on a smooth indurated area on a patient. What should be the first priority intervention?

A

Don gloves

42
Q

A patient dx with genital herpes simplex states that she hasn’t had sex in over a year since she was dx and wonders how she had another outbreak. What should the nurse say?

A

This disease is treatable but it is not cureable.

43
Q

What precautions should you follow with a patient who has syphilis?

A

Don gloves when touching the skin.

44
Q

A female patient developed PID from gonorrhea and wants to know what cause her sterility?

A

Could be from scarring in fallopian tubes or from being untreated for a long period of time.

45
Q

What disease process has the potential of causing an ectopic pregnancy?

A

PID

46
Q

What would be included in a plan of care for a patient with bacterial meningitis?

A 
Monitor for tachycardia
Provide emesis basin
Administer antipiuretic medications
Skin assessment
Elevate the head of the bed d/t increased risk for ICP
47
Q

What is the biggest difference between MS and ALS?

A

ALS effects the respiratory muscles where MS does not

ALS can also kill you

48
Q

What is Cushing’s disease?

A

Excess secretion of cortisol from the adrenal cortex caused by problem in adrenal cortex (probably anterior pituitary gland) or hypothalamus

Increase in total body fat

49
Q

Patient had a subtotal thyroidectomy. What should the nurse monitor for?

A

Hypocalcemia which can be checked with trousseau and chvosteks signs

50
Q

A patient is receiving IV insulin for hyperglycemia. What should the nurse monitor during this therapy?`

A

Potassium levels because insulin drives K into the cells

51
Q

While assessing her patient, the nurse suspects that patient is experiencing respiratory acidosis. What kind of patients are most at risk for this?

A

Hypoventilating
COPD
Asthma
Opioids (Increased CO2, Decreased O2)

52
Q

A patient with metabolic alkalosis is being discharged. What should the nurse teach them before they leave?

A

Taking antacids could increase the risk of metabolic alkalosis

53
Q

A COPD patient has a cough and low grade temp. What other info would be useful for the nurse to have?

A

Sputum color - has it changed? Could indicate if it is viral or not urgent

54
Q

A patient with severe arthritis pain has been having frequent asthma attacks. What should the nurse assess for?

A

Determine what medications the patient is taking

NSAIDs could trigger asthma attacks

55
Q

For a patient with lung disease, what symptoms would tell the nurse to intervene?

A

Check breathing or resp rate
Check HR
Look for edema
Fatigued accessory muscles

56
Q

A patient states that they are afraid of the getting the flu. What should the nurse tell them?

A

Get a flu shot

57
Q

The nurse is prepping a patient for a cardiac catheterization procedure. Before the procedure, what should the nurse verify?

A

Allergies - allergy to iodine or shellfish could cause a reaction because it is in the contrast dye being used for the procedure

58
Q

A patient was newly diagnosed with HTN, what foods should he avoid?

A

Avoid high sodium foods such as canned foods

59
Q

True of False: Once warfarin is started, heparin can be stopped.

A

False - warfarin takes a few days for it to reach therapeutic levels. It is important for the patient to stay on the heparin which reaches therapeutic levels faster until the warfarin is at the necessary level

60
Q

What’s the difference between angina and MI?

A

Angina can be relieved by stress and nitroglycerin

61
Q

Patient with chest pain had lab tests done. What should the nurse look for when the labs come back?

A

Troponin 1 - could indicate cardiac damage

62
Q

A nurse is educating a patient about his glaucoma and things to avoid doing that would increase IOP. What should she tell the patient?

A

Don’t bend over
Don’t wear tight shirts or ties
Don’t strain during a BM

63
Q

If a patient has macular degeneration, what would be the best position for the tv in his room?

A

To the side

64
Q

What medication increases a patient’s risk for developing hearing loss?

A

Gentamyacin (antibiotics)

65
Q

A patient with a ruptured ear drum wants to know what to do now?

A

Ear drum will heal on its own

66
Q

What is Meniere’ disease?

A

Inner ear disorder that causes dizziness, vertigo, tinnitus

67
Q

If a patient with Meniere’s disease is experiencing a lot of vertigo, what should the nurse tell the patient?

A

Stand up slowly, don’t bend over, ask for help

Vertigo may cause severe nausea and imbalance. Hearing loss may become permanent.

68
Q

Patient has frequent migraines and was prescribed beta blockers to help manage them. What should the nurse educate the patient to monitor for?

A

Monitor pulse

69
Q

Tonic-Clonic Seizure

A

Lasts 1-2 minutes but not more than 5

Alteration in vision, smell, or emotional feeilng

70
Q

Tonic Phase

A

Stiffening of muscles, loss of consciousness cessation of breathing dilated pupils, and development of cyanosis.

71
Q

Clonic Phase

A

Rhythmic jerking of extremities, irregular respirations, biting of cheek or tongue, bladder/bowel incontinence

72
Q

Postictal Phase

A

May last for several hours, unconsciousness may last for 30 minutes

May not have memory of what happened jut before the seizure

73
Q

Partial or Focal/Local Seizure

A

Seizure activity begins in one cerebral hemisphere

74
Q

Complex Partial Seizure

A

Have associated automatisms, LOC for several minutes, amnesia may occur immediately prior to and after the seizure

75
Q

Simple Partial Seizure

A

Consciousness is maintained throughout, activity may consist of unusual sensations, a sense of deja vu, autonomic abnormalities (change in HR)

76
Q

Unclassified or Idiopathic Seizures

A

Don’t fit into other categories

These types account for 50% of all seizure activities and occur for no known reason

77
Q

What instructions would you give to a patient who is prescribed phenytoin?

A 
Don't drive until 6 months seizure free
Wear a medical alert bracelet
Keep a seizure frequency diary
Avoid triggers
Take medicine as prescribed
78
Q

As the nurse what could you do to prevent respiratory complications in patient with Parkinson’s?

A

Elevate the head of the bed 30 degrees or more to prevent aspirations

79
Q

A physician ordered an antibiotic and a sputum culture. What would the nurse do first?

A

Hold the antibiotic until the culture results came back

80
Q

Daughter has Alzheimer’s and wants to knew if a new medication is going to make the dementia better?

A

Medication can only slow the progression of the disease, not cure

81
Q

A patient with Alzheimers is being discharged. What are some safety things the nurse should go over with the patient?

A

Bracelet
Geri-chair
Distractions
Door locks

82
Q

What are some signs and symptoms of early onset MS?

A

Headaches, mild memory loss, fatigue is first symptoms, sensitivity to temp, stiffness in extremities, flexor spasms especially at night, DTR, positive babinski’s sign, absent abdominal reflexes

83
Q

What is Guillian-Barre?

A

D/O causing demyelination and axonal degeneration resulting in acute, ascending and progressive neuropathy, characterized by weakness, hyporeflexia

Med-Surg II (2 decks)

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