Final Review Q's Flashcards
A patient with chronic back pain is seen in the pain clinic for follow-up. In order to evaluate whether the pain management is effective, which question is best for the nurse to ask?
a. “Can you describe the quality of your pain?”
b. “Has there been a change in the pain location?”
c. “How would you rate your pain on a 0 to 10 scale?”
d. “Does the pain keep you from doing things you enjoy?”
d. “Does the pain keep you from doing things you enjoy?”
The nurse assesses a postoperative patient who is receiving morphine through patient-controlled analgesia (PCA). Which information is most important to report to the health care provider?
a. The patient complains of nausea after eating.
b. The patient’s respiratory rate is 10 breaths/minute.
c. The patient has not had a bowel movement for 3 days.
d. The patient has a distended bladder and has not voided.
b. The patient’s respiratory rate is 10 breaths/minute.
A patient who is using a fentanyl (Duragesic) patch and immediate-release morphine for chronic cancer pain develops new-onset confusion, dizziness, and a decrease in respiratory rate. Which action should the nurse take first?
a. Remove the fentanyl patch.
b. Notify the health care provider.
c. Continue to monitor the patient’s status.
d.Give the prescribed PRN naloxone (Narcan)
a. Remove the fentanyl patch.
These medications are ordered for an 86-year-old patient with arthritis in both hips who is complaining of level 3 (0 to 10 scale) hip pain while ambulating. Which medication should the nurse use as initial therapy?
a. aspirin (Bayer) 650 mg orally
b. naproxen (Aleve) 200 mg orally
c. oxycodone (Roxicodone) 5 mg orally
d. acetaminophen (Tylenol) 650 mg orally
d. acetaminophen (Tylenol) 650 mg orally
Which effect should the nurse instruct a patient receiving NSAIDs to report?
a. Blurred vision
b. Nasal stuffiness
c. Urinary retention
d. Black or tarry stools
d. Black or tarry stools
The nurse is caring for a patient who suddenly experiences chest pain. What is the nurse’s first priority?
a. Call the rapid response team.
b. Ask the patient to rate and describe the pain.
c. Raise the head of the bed.
d. Administer pain relief medications.
b. Ask the patient to rate and describe the pain.
The nurse is completing a neurovascular assessment on the patient with a tibial fracture and a cast. The feet are pulseless, pale, and cool. The patient says they are numb. What should the nurse suspect is occurring?
a. Paresthesia
b. Pitting edema
c. Poor venous return
d. Compartment syndrome
d. Compartment syndrome
When counseling an older patient about ways to prevent fractures, which information will the nurse include?
a. Tack down scatter rugs in the home.
b. Most falls happen outside the home.
c. Buy shoes that provide good support and are comfortable to wear.
d. Range-of-motion exercises should be taught by a physical therapist.
c. Buy shoes that provide good support and are comfortable to wear.
The occupational health nurse is teaching a class on the risk factors for developing osteoarthritis (OA). Which is a modifiable risk factor for developing OA?
a. Being overweight
b. Increasing age
c. Previous joint damage
d. Genetic susceptibility
a. Being overweight
Which client goal is most important for a client diagnosed with OA?
a. Perform passive ROM
b. Maintain optimal functional ability
c. Client will walk 3 miles every day
d. Client will join a health club
b. Maintain optimal functional ability
A 55-year-old female arrives to the ER with a right leg fracture. An x-ray is performed and shows a closed tibia fracture. A closed reduction is performed and a cast is put in place. The patient is ordered Morphine 2 mg IV every 4-6 hours as needed for pain. The patient calls on the call light to tell you the pain medication is not working and that it even hurts to slightly stretch the leg. What is your response to this statement by the patient? Select all that apply:
a. Reassure the patient that this is normal after a bone fracture, and reposition the cast.
b. Re-adjust the cast to ensure it fits snugly against the fracture.
c. Perform neurovascular checks.
d. Elevate the leg above heart level.
e. Loosen and remove restrictive items.
f. Notify the physician.
c. Perform neurovascular checks.
e. Loosen and remove restrictive items.
f. Notify the physician.
Before the administration of preoperative medications, the nurse is preparing to witness the patient signing the operative consent form when the patient says, I do not really understand what the doctor said. Which action is best for the nurse to take?
A. Provide an explanation of the planned surgical procedure.
B. Notify the surgeon that the informed consent process is not complete.
C. Administer the prescribed preoperative antibiotics and withhold any ordered sedative medications.
D. Notify the operating room staff that the surgeon needs to give a more complete explanation of the procedure.
B. Notify the surgeon that the informed consent process is not complete.
The surgeon is responsible for explaining the surgery to the patient, and the nurse should wait until the surgeon has clarified the surgery before having the patient sign the consent form. The nurse should communicate directly with the surgeon about the consent form rather than asking other staff to pass on the message. It is not within the nurses legal scope of practice to explain the surgical procedure. No preoperative medications should be administered until the patient signs the consent form.
Ten minutes after receiving the ordered preoperative opioid by intravenous (IV) injection, the patient asks to get up to go to the bathroom to urinate. The most appropriate action by the nurse is to
A. assist the patient to the bathroom and stay with the patient to prevent falls.
B. offer a urinal or bedpan and position the patient in bed to promote voiding.
C. allow the patient up to the bathroom because the onset of the medication takes more than 10 minutes.
D. ask the patient to wait because catheterization is performed at the beginning of the surgical procedure.
B. offer a urinal or bedpan and position the patient in bed to promote voiding.
The patient will be at risk for a fall after receiving the opioid, so the best nursing action is to have the patient use a bedpan or urinal. Having the patient get up either with assistance or independently increases the risk for a fall. The patient will be uncomfortable and risk involuntary incontinence if the bladder is full during transport to the operating room.
A 36-year-old woman is admitted for an outpatient surgery. Which information obtained by the nurse during the preoperative assessment is most important to report to the anesthesiologist before surgery?
A. The patients lack of knowledge about postoperative pain control measures
B. The patients statement that her last menstrual period was 8 weeks previously
C. The patients history of a postoperative infection following a prior cholecystectomy
D. The patients concern that she will be unable to care for her children postoperatively
B. The patients statement that her last menstrual period was 8 weeks previously
This statement suggests that the patient may be pregnant, and pregnancy testing is needed before administration of anesthetic agents. Although the other data also may be communicated with the surgeon and anesthesiologist, they will affect postoperative care and do not indicate a need for further assessment before surgery.
Which term is documented for a client who experiences bone inflammation that is often caused by an infection?
A. Sepsis
B. Subluxation
C. Osteoporosis
D. Osteomyelitis
D. Osteomyelitis
The nurse is instructing a 65-year-old female client diagnosed with osteoporosis. The most important instruction regarding exercise would be to:
A. Exercise doing weight bearing activities.
B. Exercise to reduce weight.
C. Avoid exercise activities that increase the risk of fracture.
D. Exercise to strengthen muscles and thereby protect bones.
A. Exercise doing weight bearing activities.
A patient has a new order for magnetic resonance imaging (MRI) to evaluate for left femur osteomyelitis after a hip replacement surgery. Which information indicates that the nurse should consult with the health care provider before scheduling the MRI?
A. The patient has a pacemaker.
B. The patient is claustrophobic.
C. The patient wears a hearing aid.
D. The patient is allergic to shellfish.
A. The patient has a pacemaker.
A. Patients with permanent pacemakers cannot have MRI because of the force exerted by the magnetic field on metal objects. An open MRI will not cause claustrophobia. The patient will need to be instructed to remove the hearing aid before the MRI, but this does not require consultation with the health care provider. Because contrast medium will not be used, shellfish allergy is not a contraindication to MRI
