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Med Surg > HESI > Flashcards

HESI Flashcards

1
Q

Which electrolyte should be closely monitored in just a few hours after treatment with Digibind?

a. ) Calcium
b. ) Potassium.
c. ) Magnesium.
d. ) Phosphate.

A

B - A precipitous drop in serum potassium may occur after treatment with Digibind.

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2
Q

Which manifestations are early indications of digitalis toxicity?

a. ) Hypertension and dizziness.
b. ) Anorexia, nausea, and vomiting.
c. ) Weight gain and fluid retention.
d. ) Blurred vision and halo vision.

A

B - Gastrointestinal (GI) symptoms are among the earliest symptoms of digitalis toxicity, along with confusion and fatigue. Additional manifestations include headache, hypotension, and cardiac dysrhythmias.

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3
Q

A client has been diagnosed with A fib. Name the procedure the client will undergo prior to cardioversion

A

TEE

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4
Q

Client with suspected PAD should undergo this test to confirm their diagnosis.

A

Ankle-brachial index test (ABI)

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5
Q

A client who experiences chest pain on excretion that is relieved by rest has this condition

A

Stable angina

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6
Q

A client with chest pain should have these labs drawn

A 
Troponin
Troponin high sensitivity
CK
CK-MB
BMP
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7
Q

Clients with a family Hx of colorectal cancer should consume what

A

Fiber

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8
Q

Clients with renal failure can double intake of this nutrient once they began dialysis

A

Protein

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9
Q

Client who takes digoxin to manage CHF should consume plenty of this electrolyte

A

Potassium

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10
Q

The nurse should teach clients with this disease to add salt to their foods and drink more fluids

A

Addison’s disease

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11
Q

A lack of this critical vitamin to bright up you day is also associated with hypocalcemia

A

Vitamin D

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12
Q

A client has a calcium level of 10.8 Name 2 Tx options for this client

A

Loop diuretics, Biphosphates, NS

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13
Q

A client’s parathyroid hormone regulates these two electrolytes so hopefully you are taking a vitamin D supplement

A

Calcium and phosphorus

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14
Q

A client is very dehydrated and is requesting a lot of ice water Name the electrolyte imbalance

A

Hypernatremia

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15
Q

A client presents with the clinical with peaked T wave and muscle cramps. These interventions can help correct this abnormality

A 
IV calcium Gluconate
Albuterol
Insulin
D50
Kayexalate
IVF
Loop diuretics
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16
Q

Name the category of IVF that should be avoided with client with increased ICP

A

Hypotonic

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17
Q

The client is admitted with complaints of 15 bloody diarrhea bowel movement and abdominal pain. Name the condition

A

Ulcerative colitis

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18
Q

This client is experiencing this life-threatening condition presents with decreased BP, increased HR, and decreased level of consciousness. Name this type of shock

A

Hypovolemic shock

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19
Q

These 3 modifiable risk factors along with obesity and genetic factors contribute to PUD

A

Caffeine, alcohol, smoking

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20
Q

Clients with exacerbation of Crohn’s disease and ulcerative colitis are most are risk for this ABG imbalance

A

Metabolic acidosis

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21
Q

A client reports RLQ pain. Name a diagnostic procedure and the potential diagnosis

A

CT and Appendicitis

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22
Q

A decrease in bone marrow function means you would expect these 3 low labs levels

A

Low WBC
Low RBC
Low platelet

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23
Q

The client is taking warfarin and knows this lab value is necessary to be drawn weekly

A

PT/INR

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24
Q

An unstable client with COPD may receive O2 with this device if a nasal cannula is not available

A

Venturi mask

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25
Q

Assessment findings for this disease are sudden SOB and chest pain however the x-ray is normal

A

PE

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26
Q

O2, hydrations and pain management are 3 priorities for this disease?

A

Sickle cell anemia

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27
Q

This vital sign is the most important one to monitor in a client with esophageal varices

A

Blood pressure

28
Q

The types of viral hepatitis are often caused by consuming contaminated drinking water

A

Hepatitis A & E

29
Q

Tachycardia, hypoxia, hypotension, increased HR, and elevated WBC indicate what?

A

Sepsis

30
Q

Bilateral joint inflammation is the main assessment finding for this autoimmune disease

A

RA

31
Q

Clients with lupus are at risk for this type of organ failure

A

Renal failure

32
Q

Interventions for Mag < 1.6

A

PO Mag

IV replacement

33
Q

Interventions for Phos < 2.5

A

Oral/IV Phos

Seizure precautions

34
Q

Interventions for Pos > 4.5

A

Phosphate binders - renal failure pt.
Loop diuretics
IV NS

35
Q

Interventions for Ca+ > 10.2

A

NS IV
Loop diuretics
IV Biphosphates
Calcitonin

36
Q

Interventions for Ca+ < 8.5

A

IV Calcium gluconate

PO Ca+

37
Q

Interventions for Mag > 2.2

A

IV NS

Loop diuretics

38
Q

Interventions for K+ > 5

A

Calcium gluconate
Insulin & Albuterol (push K+ back into cell)
D50W (giving to prevent glucose from dropping)
IVF (dilute & push K+ out)
Kayexalate
Loop diuretics

39
Q

Interventions for K+ < 3.5

A

IV, PO, NG admin of K+
Food high in K+
Bananas, raisins, oranges, avocados, potatoes, tomatoes, broccolioos

40
Q

Interventions for Cl- > 107

A

Admin Hypotonic IV (1/2 NS) &/or Na+bicarb infusion (increase excretion of Cl-)
Limit Na+ intake

41
Q

Interventions for Cl- < 97

A

Treat underlying cause
Admin ½ NS OR NS
Intake of Cl-

42
Q

Interventions for Na+ > 145

A

IVF replacement of ½ NS (Hypotonic) or D5W

Limit Na+

43
Q

Interventions for Na+ < 135

A

Free water restriction
Oral Na+ supplement if tolerable
Spironolactone (Pt. w/ cirrhosis)

44
Q

What causes fluid shift from osmotic pressure? Select all that apply.

a. ) Albumin
b. ) Hypertonic fluids
c. ) Hypotonic fluids
d. ) Mannitol
e. ) Isotonic fluids

A

A, B, C, D

45
Q

A client is experiencing symptoms of fluid volume excess. Which actions should the nurse take? Select all that apply.

a. ) Limit daily intake of fluid and sodium
b. ) Monitor daily weight
c. ) Eliminate sodium-containing IV fluids
d. ) Administer diuretics, as ordered
e. ) Offer oral fluids

A

A, B, C, D

46
Q

What conditions cause fluid volume excess? Select all that apply.

a. ) Cirrhosis
b. ) Diarrhea
c. ) Adrenal gland disorder
d. ) Hemorrhage
e. ) Heart failure

A

A, C, E

47
Q

Which lab values are impacted by fluid volume deficit? Select all that apply.

a. ) Hemoglobin and hematocrit
b. ) Urine specific gravity
c. ) Sodium
d. ) White blood cells
e. ) Serum osmolality

A

A, B, C, E

48
Q

Which fluid is considered hypertonic?

a. ) 1/2 NS
b. ) D5 1/2 NS
c. ) NS
d. ) D5W

A

B - D5 1/2 NS

49
Q

What is the normal lab value for Na+?

a. ) 135-145
b. ) 3.5-5
c. ) 8.9-10.1
d. ) 8-25

A

A - 135-145

50
Q

What is the normal value for K+?

a. ) 4.4-5.3
b. ) 1.5-2.5
c. ) 8.9-10.1
d. ) 3.5-5

A

D - 3.5-5

51
Q

BUN measures the function of which organ?

a. ) liver
b. ) eyes
c. ) kidneys
d. ) heart

A

C - Kidneys

52
Q

Muscle cramps, widened QRS complex, peak T wave, parasthesia are electrolyte imbalance?

a. ) hyponatremia
b. ) hypermagnesemia
c. ) hyperkalemia
d. ) hypocalcemia

A

C - hyperkalemia

53
Q

Confusion, N & V, HA, lethargy are signs of which electrolyte imbalance

a. ) hyponatremia
b. ) hypercalcemia
c. ) hypokalemia
d. ) hyperchloremia

A

A - hyponatremia

54
Q

Normal level is 1.6-2.6 mg/dL for which electrolyte?

a. ) potassium
b. ) chloride
c. ) magnesium
d. ) sodium

A

C -Mag

55
Q

Testing positive for Chvostek’s sign is an indicator of this electrolyte imbalance.

a. ) hypercalcemia
b. ) hypocalcemia
c. ) hypermagnesemia
d. ) hypomagnesemia

A

B - hypocalcemia

56
Q

Client has decreased deep tendon reflexes. Which electrolyte is suspected?

a. ) hypercalcemia
b. ) hypermagnesemia
c. ) hypomagnesemia
d. ) hypocalcemia

A

B - hypermagnesemia

57
Q

Which lab value is likely to be decreased in a client with chronic kidney disease?

a. ) Serum calcium.
b. ) Serum creatinine and BUN.
c. ) Serum potassium.
d. ) Serum phosphorous.

A

A - Serum calcium is decreased in CKD in response to an increase in serum phosphorous. Serum potassium levels are increased in CKD as the kidney loses the ability to remove potassium from the body. Clients with CKD should be assessed carefully for symptoms of hyperkalemia.

58
Q

Which assessment data indicates to the nurse that the desired outcome of the epoetin alfa (Epogen) has been achieved?

a. ) Conjunctival sac returns to a reddish-pink color.
b. ) Consumed 100% of diet.
c. ) No evidence of edema.
d. ) Normo-active bowel sounds.

A

A - This assessment finding reflects an improvement in the client’s anemia. Epogen stimulates the production of RBCs, resulting in an increase in hematocrit. It is used to treat the anemia common in clients with CKD.

59
Q

Which risk factors relate to the use of hemodialysis?
Select all that apply
a.) Ascites.
b.) Orthostatic hypotension.
c.) Bowel or bladder perforation.
d.) Non-compliance because treatments require more time.
e.) Hemorrhage.

A

B, E - Hypotension can occur in up to 50% of HD treatments.
The heparin required during HD increases the risk for excessive bleeding. All invasive procedures must be avoided for 4 to 6 hours after dialysis. Continually monitor the client for hemorrhage during and for at least 1 hour after dialysis.

60
Q

What is the maximum amount of weight that Judy should gain between each dialysis treatment?

a. ) 1.5 kg.
b. ) 2 kg.
c. ) 2.5 kg.
d. ) 3 kg.

A

A - The goal for hemodialysis clients is to keep their interdialytic (between dialysis treatments) weight gain under 1.5 kg.

61
Q

Which of these medications places pt. at increased risk for the development of DVT?

a. ) Antibiotics.
b. ) Analgesics.
c. ) Antiasthmatics.
d. ) Oral contraceptives.

A

D

62
Q

Pt. on heparin therapy starts bleeding profusely from incision site. Which action should the nurse initiate first?

a. ) Obtain a STAT APTT.
b. ) Stop the heparin infusion.
c. ) Assess vital signs.
d. ) Observe the surgical site for bleeding.

A

B - This will cause an immediate reduction in further anticoagulant effect, which should help stabilize Mrs. Buckley’s bleeding. Others are not the most important actions

63
Q

Which action should the nurse implement on the scheduled day of surgery for a client with type 1 diabetes mellitus (DM)?

a. ) Obtain a prescription for an adjusted dose of insulin.
b. ) Administer an oral anti-diabetic agent.
c. ) Give an insulin dose using parameters of a sliding scale.
d. ) Withhold insulin while the client is NPO.

A

A - Stressors, such as surgery, increase serum glucose levels. A client with type 1 DM who is NPO for scheduled surgery should receive a prescribed adjusted dose of insulin.

64
Q

A client is admitted to the emergency department after being lost for four days while hiking in a national forest. Upon review of the laboratory results, the nurse determines the client’s serum level for thyroid-stimulating hormone (TSH) is elevated. Which additional assessment should the nurse make?

a. ) Body mass index.
b. ) Skin elasticity and turgor.
c. ) Thought processes and speech.
d. ) Exposure to cold environmental temperatures.

A

D - TSH influences the amount of thyroxine secretion which increases the rate of metabolism to maintain body temperature near normal. Prolonged exposure to cold environmental temperatures stimulates the hypothalamus to secrete thyrotropin-releasing hormone, which increases anterior pituitary serum release of TSH.

65
Q

Which client should the nurse assess first?

a. ) A 27-year-old complaining of severe back pain.
b. ) A 63-year-old complaining of foot and ankle pain.
c. ) A 49-year-old with pancreatitis complaining of unrelenting abdominal pain.
d. ) A 55-year-old newly admitted client complaining of jaw pain and indigestion.

A

D- symptoms indicative of MI

66
Q

The PET (positron emission tomography) scan is commonly used with oncology clients to provide for which diagnostic information?

a. ) A description of inflammation, infection, and tumors.
b. ) Continuous visualization of intracranial neoplasms.
c. ) Imaging of tumors without exposure to radiation.
d. ) An image that describes metastatic sites of cancer.

A

A

Med Surg (22 decks)

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