Kaplan QBank Flashcards
What is the purpose of OCD for the pt?
To avoid or alleviate increasing levels of anxiety
COntrol and relieve tension and axiety
What is a Weber test?
Simple screening test for hearing loss
What is the purpose of the cuff on a tracheostomy tube?
To decrease the chance of aspiration into the trachea
What is the purpose of the cuff on a tracheostomy tube?
To decrease the chance of aspiration into the trachea
What are the functions of the cerebellum?
Maintain balance, msk coordination, precise movements of hands, legs, arms.
For pts with RA, should they engage in passive or active exercises? like….
Active (low impact - yoga, swimming)
What age is a child who can walk steps alternating feet, bend over easily without falling, stand on one foot breifly and jum horizontally?
3 yrs
What are the electrolyte imbalances associated with Cushings?
HyperK
Hypernatremia
Why is a PSA test done?
To screen for prostate cancer
When do these reflexes disappear?
Babinksi:
Moro:
Tonic neck:
Grasp: (palmer and plantar)
12m/1yr
3-4 m
3-4m
Palmer by 3m
Plantar by 8m
What is the age difference in population between pts with gastric vs duodenal ulcers?
Gastric =. middle aged / older adults
Duodenal = younger pts 20-50 yrs
When do pts with duodenal ulcers experience pain?
After meals (midmorning/midafteroon)
Ages for Tdap
2, 4, 6 months
Age for MMR
12-15m and 4-6 yrs
Age for rotovirus vax (3 dose)
2, 4, 6 months
Age for varicella vax
12-15 m
4-6 yrs
Seratonin toxicity s/s
Fever
Abnormal eye movement
hallucinations
diarrhea
loss of coordination
What are the parameters that a pt on heparin should have their dose changes and you should notify the HCP?
aPTT <50 seconds
aPTT>100 seconds
What is the relationship between digoxin and potassium levels?
Hypokalemia can increase digoxin toxicity
What is the purpose of an electromyography (EMG)?
Electrodes are attached to the muscles and the test measures muscle response and electrical activity. The test takes 30-60 mins
With hypoparathyroidism, what happens to calcium levels? What about phosphorous levels?
They fall (hypocalcemia)
Hyperposphotemia
What does “failure to thrive” mean for newborns?
Weight gain is significantly below other children the same age.
Phenelzine is what type of drug?
MAOI
What type of med is Buspirone?
anti-anxiety
What type of med is Prochlorperazine?
Anti-emetic
After a minor head injury, what is NOT an expected side effect and should be reported to the HCP immediately? (6)
Vomiting
Blurred vision
Drainage from ear/nose
Weakness
Slurred speech
Worsening HA
At what age is immitative behavior most seen?
Preschoolers
How is a myelogram performed?
What’s its purpose?
Contrast medium is injected into the spinal fluid in the subarachnoid space through a lumbar spinal puncture.
It identified tumors, cycsts, herniated vertebral disks that protrude into the spinal canal
How should a pt with a cane walk UP stairs?
Step with strong leg
Bring weak leg and cane
How should a pt with a cane walk DOWN stairs?
Weak leg goes down first
What lab value will be monitored in a pt taking allopurinol?
CBC to monitor WBC because the drug depresses the bone marrow.
Which two drugs when used together can lead to hyponatremia in OAs?
Citalopram and Hydrochlorothiazide
In a pt with hyponatremia what will be monitored with fluids (advised)?
Restrict fluids to 800-1000ml because you want to increase the sodium in their blood
On streptomycin, what are s/s of aminoglycoside toxicity? (2)
Ototoxicity and nephrotoxicity
If a client with an NG tube vomits what nursing action in best?
Irrigate the NG tube with 20ml of NS
Common adverse effects of metformin
N/V
Diarrhea
Common adverse effects of metformin
N/V
Diarrhea
What are the interventions that should be initiated prior to a scheduled exercise stress test in a pt with chest tightness?
- Pt ed
- Ensure NPO for 4 hrs prior
- 12 lead EKG immediately prior to test (and during and after)
Is yellow exudate from the site of a circumcision normal? What should be done about it?
yes
Do not remove the exudate – the circumcision site should be cleaned with warm water.
What are the first s/s of hypocalcemia seen in a pt who had a thyroidectomy?
Tinglishing in the lips and fingertips
Muscle flacidity = hypo or hypercalcemia?
Hyper
When a pt is having a delusion (ex: someone is trying to hurt me) as a result of their schizophrenia, What should you help the pt focus on? What should you avoid?
Focus on: feelings that the delusions generate
Avoid: arguing about the content of the delusion. Avoid dwelling on it.
By 18m how many words should a child speak?
6-20
What is the tx of choice for a pt diagnosed with CHB who is symptomatic?
Pacemaker
A pt is pacing and continuously wringing their hangs and the pt voice becomes louder and angrier. What should the nurse do?
De-escalate by assisting the pt to express feelings of anger/frustration. Also, remove threatening components of the environment.
Avoid: disagreeing / threatening
What is one of the most common symptoms of Hep A in children?
Anorexia (symptoms of flu: fever, malaise, lethargy)
What are the symptoms of hep A in children 6 yrs + ?
Asymmtomatic often
Normal serum albumin. What can it be a good objective indicator of?
3.5 - 5.5
proetin intake
For the manic phase of bipolar, what should you do with the pt?
Redirect the pt (to safe behaviors) and reduce stimuli
How should a parent check the bathwater before their child goes in? Water should be no warmer than_____F.
Check with elbow not hands
Water should be no warmer than 120F
When doing a routine exam on a toddler, what are best practices of the care provider?
- Toddler removes clothing one item at a time as necessary for exam
- Introduce equipment for the exam and explain whats going to happen. Let the child hold the equipment
- praise the toddler and proovide positive feedback for cooperating during the exam.
The root of GAD is
conflict between expressing unacceptable impulses and the need to hold social approval
What electrolyte imbalance occurs in OAs?
Hyponatremia
Hypoglycemia is a BG lower than _____-
70
What is Azotemia?
Classic s/s of AKI
Buildup of nitrogenous products in the bloodstream.
Hallmarks: increased BUN and Cr
AKI s/s
Azotemia
Pruritis
Nausea / Vomiting
Hyperkalemia
During crisis management how many ppl should be in charge?
1 - Autocratic or directive leadership is appropriate
What does sodium polystyrene sulfonate treat?
Hyperkalemia
The nurse prepares to complete a health history with a client in a community clinic. Which action will the nurse take first?
Provide physical and psychological comfort –then the health assessment can go as smoothly as possible
When obtaining a urine sample, what type of technique should be used?
Aseptic
What is the initial tx for when a DVT occurs?
Bed rest w/affected leg elevated to decrease interstitial swelling and promote venous return from the leg
Which is achieved first: bowel or bladder control?
Bowel
At what age does voluntary control of anal and urethral sphincters typically occur?
18-24 m
What should the lighting in a room be for a pt with alcohol withdrawal?
Well lit
What is the first s/s of a perforated duodenal ulcer?
Sudden sharp mid-epigastric pain –> board-like abd
When are verbal orders acceptable?
For emergency situations not routine medication adjustments
At what age do colonoscopies begin? How often are they done?
Start at 45 yrs
q 10 yrs
Central venous pressure measures what?
Right atruim pressure
Should you share at change of shift any new HCP perscriptions?
Yes
When assessing a pt before a cardiac cath, which assessment is MOST critical for the nurse to perform?
Allergy to shellfish or iodine
Pts who recieved what vaccine might have a false-positive on a TST?
Pts who got a BCG vaccine (this vax prevents the development of TB)
How long does it take for a plaster cast to dry?
24-72 hrs
For a pt in isolation, what items should be marked as biohazardous when being removed from the room?
lab specimens
Discarded syringes
Prior to providing wound therapy to a pt with a negative pressure wound tx, what action should the nurse take prior to initiating therapy?
Check serum protein levels
- protein is essential for wound healing and if their protein level is low, wound healing will be impaired and the negative pressure wound therapy may not be helpful
When should toddlers be told that their parent is pregnant?
Not until shortly prior to the birth because they have little perception of time
Where is the safest spot in the car for the infant car seat?
Back, middle
How much alcohol a day is recommended for adult females?
One serving a day
Is coffee a recognized risk factor for HTN?
No
What does aging do to pain tolderance?
Lowers pain tolderance because of diminished adaptive capacity
What is the diet for a pt with severe liver disease?
Low Protein
High carb
- reduces the risks of ammonia build up that occurs from the breakdown of proteins
Which vaccines are safe to give in pregnancy?
Tetanus
Hep B
Influenza
(any inactivated ones)
A pt requires a paracentesis. Which is most important for the nurse to place at the pt bedside prior to the procedure?
A. tape measure
B. Emesis basin
C. BP cuff
D. Scale
C. BP Cuff
You must continuously measure the BP to assess for the development of shock from the removal of fluid
Don’t use “its normal to…” – why?
Because this is a closed response and doesn’t allow pts to further verbalize their concerns
When should an infant urinate after a circumcision?
6-8 hrs
When should the meconium stool be passed by?
12-24 hrs
When prepping a pt for a radioactive iodine uptake test, what should the pt not have prior to the test?
Restrict foods/medicines containing iodine for one week prior to the study. Dietary intake of iodine can affect the results of lab tests used to diagnose thyroid dysfunction.
What factors affect sleep apnea (3)
Obesity
Short neck
Smoking
When administering an IV vesicant for chemo, where is the correct spot for the IV?
Forearm (it doesn’t involve a moveable joint)
What should the diet of a pt with pancreatitis look like?
Low fat
High protein
Moderate carbs
Is Potassium affected by prednisone?
Yes - Hypokalemia can occur
What does a spacer do for asthma meds?
Improves the amount of medication recieved
Visual changes for color perception happen with glaucoma or cataracts?
What about artificial lights having rainbows around them?
Cataracts
Glaucoma
Which actions prevent VAP?
Elevate HOB to 30-45
Perform daily spontaneous breathing trials
Drain condensation from the vent tubing
(you don’t need to wear a mask during suctioning)
Pulmonary artery occlusion pressure in elevated- what is normal levels? What med is given to treat this and why?
Normal: 4-12 mmhg
Furosemide for diuresis because an elevated PAOP indicated fluid overload
What intervention can reduce the risk of cardiac dysrrhythmias occuring during a blood transfusion?
Blood warmer
What medication should be included as a core measure in stroke care when discharging a pt?
Statins
______ med is an anticholinergic used in end of life care to reduce the production of secretions
Scopolamine
For clients with confusion and disoridentation risks, what is most important to implement to resolve this issue?
Monitoring noise levels during the night
List 3 common symptoms of acute leukemia
Petechiae
Orthostatic Hypotension (d/t anemia)
Joint Pain
If a pt hasn’t pooped in 4 days and you know there is a ball of hard feces in the rectum, what med should be given?
Oil retention enema to soften the stool
A pt who got IV morphine 20 mins ago now has dyspnea and bilateral rales. Which med should the nurse plan to administer next?
Atropine SL
- the anticholinergic effects can reduce secretions and the dyspnea should improve and the rales should dissipate
Should a client with a DVT ambulate?
No
What type of dysrrhythmia is non concerning and typically occurs in the first few hrs after an MI?
PVCs
Is diziness after a pacemaker insertion a concern?
Yes - could indicate that the pacemaker isn’t functioning properly
How freq is BG monitoring done on a pt admitted and being treated for DKA?
Usually hourly
What is the purpose of a TEE?
To rule out thrombus in the heart
What type of med can be used to treat urinary retention in a pt with BPH?
Alpha adrenergic antagonists like Alfuzosin
What type of med is Tolterodine?
Muscarinic receptor antagonist for overactive bladder contractions - treats urinary incontinence and overactive bladder
What type of med is Amitriptyline?
Tryclilic antidepressant that can be used to reduce overactive bladder contractions
How frequently are CPR compressions done (rate)?
How freq should rescuers change positions?
100bpm
q2 min
Cushings triad
What is this indicitive of?
bradycardia
Irregular resps
Widened pulse pressure
Increased ICP
Meniere disease is characterized by….
severe dizziness and vertigo - can’t walk straight –> fall risk
What type of med is Alendronate?
How long does it need to be taken for?
Biphosphante to treat poor bone density
At least 3 yrs, then you do another bone density test and it might be continued or d/c
Can NAP accompany / assist the transfer of pts from PACU?
Yes
Pt says there is a change in their central vision- it is now blurry / distorted. What do you suspect?
Macular degeneration
Pt says there is a change in their vision- it is now cloudy. What do you suspect?
Cataracts
Pt says there is a change in their vision- they now have poor peripheral vision. What do you suspect?
Glaucoma
Pt says there is a change in their vision- they have a sudden loss of partial / complete vision in one eye. What do you suspect?
Detached retina
What is the purpose of a TIPS procedure?
Shunts blood away from esophageal varices for pts with liver dysfunction
s/s glaucoma (4)
Cloudy, blurry vision
Artificial lights appear to have rainbows around them
Decreased peripheral vision
HA
What ECG change is Torsades de pointes associated with?
Prolonged QT interval
Administration of nasal drops instruction
Sit with the neck flexed backwards for 5 mins after instilling the drops
Which factor is most likely to cause accidental injuries in school age children?
Peer pressure and risk-taking behavior
Pt is hypernatremic. Which type of fluids will they be given?
5% dextrose solution (it’s a sodium free solution) – LR and NS have Na+
What type of fluid drainage is most common in the immediate post op period?
What aout 1-2 days later?
Sanguineous
Serosanguineous
The nurse works in a psychiatric facility that applies behavioral therapy. Which group of clients benefits most from this method?
Children in general
Precaution type: RSV
Contact
The _______ is the best referral because this person works in collaboration with other departments and community agencies to take care of the client’s multiple needs.
case manager
When a client with a blood transfusion shows s/s of overload should you stop or slow the transfusion?
Slow
The nurse provides care for a client who exhibits a sacral pressure injury. The foam dressing was changed 13 hours ago. No drainage is noted on the dressing. Which action should the nurse take next?
Document that the dressing is intact.
Unless the dressing is soiled or there are other abnormalities, wound healing should not be disrupted for a period as short as 2 days but no longer than 7 days, depending on client status and institutional protocols.
Foam dressings are left intact on chronic wounds for 48 hours unless otherwise indicated.
The nurse inserts a nasogastric (NG) tube into a client and notes resistance when trying to advance the tube. Which action does the nurse take next?
Rotate the NG tube while in the nare
The NG tube may be against the wall of the nasal passage. Rotating the NG tube moves it off the wall and may allow the nurse to continue to advance the tube. This is the priority nursing action given the situation.
The nurse provides care for a client experiencing a fever who also reports bone pain, redness, and swelling. The client asks the nurse which treatment will likely be prescribed by the health care provider (HCP). Which response from the nurse is the most accurate?
“Antibiotics will be prescribed for several weeks, which you can take at home.”
The client with acute osteomyelitis will be prescribed antibiotics. These medications can be started in an acute care facility and continued at home after discharge.
zidovudine: type of drug?
ADR
Anti-retroviral for HIV
Anemia (look for low HgB)
