med surg exam 6

Question 1

Know what causes a functional intestinal obstruction

Answer 1

• tumor, adhesions, incarcerated, strangulated hernias, volvulus
  -ABDOMINAL SURGERY

Question 2

What can the prolonged use of laxatives cause

Answer 2

• dependence, decrease of muscle tone, and sluggish

Question 3

Know the characteristics of stimulant laxatives

Answer 3

• acts directly on intestinal mucosa and alters water/ electrolytes

Question 4

What major issues can prolonged diarrhea cause

Answer 4

• dehydration, electrolyte imbalance, vitamin deficiency

Question 5

Know what Rovsing’s sign is

Answer 5

• appendicitis
• pain in the RLQ when palpating the LLQ

Question 6

What is the surgical procedure for colon cancer located in the lower third of the rectum

Answer 6

• abdominoperineal resection

Question 7

Know which clients are at higher risk for developing an anorectal abscess

Answer 7

• Common in patients with Crohn Disease

Question 8

What is an intussusception of the bowel

Answer 8

• telescoping of one part of the intestine into an adjacent part

Question 9

know the nursing intervention for a client with an enlarged abdomen on assessment

Answer 9

• the abdomen appears enlarged, the nurse
  measures it according to a set routine

Question 10

Know what to do for a patient returning from surgery who is shivering

Answer 10

• cover with a light blanket

Question 11

Know what to administer to a patient prior to a liver biopsy

Answer 11

• IV administration of Vitamin K to reduce the risk of bleeding

Question 12

Know what to administer to a patient to detoxify elevated ammonia

Answer 12

• Lactulose

Question 13

Know what lab to monitor when administering furosemide to a patient

Answer 13

• sodium

Question 14

Which medication can help dissolve gallstones

Answer 14

• Chenodeoxycholic acid (CDCA) ; chenodiol (chenix)
• Ursodeoxycholic acid (UCDA) ; ursodiol (actigall)

Question 15

What are the central nervous system effects in a patient with cirrhosis of the liver

Answer 15

• Disorientation, confusion, personality changes, and asterixis

Question 16

What lab study would indicate a patient may have a primary malignant liver tumor

Answer 16

• elevated alpha fetoprotein

Question 17

Know when to resume normal activity after a laparoscopic cholecystectomy

Answer 17

-within 1 week

Question 18

Know what to monitor for a client who has had colostomy surgery

Answer 18

• monitor fluid and electrolyte status
• volume of gastric secretions (poop bag)

Question 19

What is secreted by the adrenal medulla

Answer 19

• epinephrine

Question 20

Know what anabolic steroids are used for

Answer 20

• promote the development of muscle mass and other maculinizing characteristics

Question 21

What condition is Exophthalmos

Answer 21

• abnormal bulging or protrusion of the eyes

Question 22

How does the nurse palpate the thyroid gland

Answer 22

• the clients head tilted to the side, the examiner displaces the thyroid laterally with their fingers and palpate the thyroid as the client shallows
• GENTLY - repeated can cause large amounts of thyroid hormones

Question 23

What is the function of oxytocin in the body

Answer 23

• stimulates contraction of pregnant uterus and release of breast milk after childbirth

Question 24

Know which medication is given for hypothyroidism

Answer 24

• levothyroxine

Question 25

What precautions are used when caring for a patient who has been treated with radioactive iodine

Answer 25

- handle bodily fluids carefully

Question 26

Know which intervention is most important for dehydrated client with diabetes insipidus

Answer 26

- to diagnose use CT or MRI - need to measure urine output every 30 minutes

Question 27

Know patient teaching for lypressin nasal spray

Answer 27

- teach patient not to inhale spray

Question 28

What lab value would the nurse find for a client with SIADH

Answer 28

- Sodium- decrease osmolarity - Syndrome of inappropriate antidiarrheal hormone

Question 29

Know what diagnostic testing is the most reliable for confirming acromegaly

Answer 29

- glucose tolerance test- is the most reliable method of confirming acromegaly in combination with growth hormone - big head; over growth of tumor causes pressure leaving headache

Question 30

What are nursing priorities in caring for a client post hypophysectomy

Answer 30

-help the client cope with changes in physical appearance, pacing activities to accommodate the client's fatigue relieving discomfort from headaches, abdominal care and activities when the clients strength and endurance permit

Question 31

Know the teaching for a client hypophysectomy

Answer 31

- avoid drinking from a straw, sneezing, coughing, and bending over to prevent dislodging the graft that seals the operative area between the cranium and nose

Question 32

What are the signs and symptoms for diabetes insipidus

Answer 32

- polyuria, weight loss, thirst, weakness, dehydration

Question 33

What is type 2 diabetes

Answer 33

- non-insulin dependent - insulin resistance/ insufficient insulin production - more common in aging adults -being detected in obese children

Question 34

What can eliminate the need for medications for a client with type 2 diabetes

Answer 34

- diet weight loss: major component of treatment exercise

Question 35

What does fruity breathe indicate

Answer 35

- DKA, acetone

Question 36

How does exercise lower blood sugar

Answer 36

- exercise helps metabolize carbohydrates and control blood glucose level. gets glucose into cells w/o insulin

Question 37

Why is rotating injection sites important for clients taking insulin

Answer 37

-to prevent lipoatrophy, breakdown of subcutaneous fat the sit of repeated injections

Question 38

What is the immediate action for a diaphoretic client in a stuporous state who is diabetic

Answer 38

- check their blood sugars first - bedside glucometer test

Question 39

Why is pancreas transplantation not an option offered to all clients with type 1 diabetes

Answer 39

- type 1 can be managed with insulins and many exerts believe that the risks involved with immunosuppression outweigh the benefits that can be achieved with a pancreas transplant

Question 40

Which is the first actions taken in the management for a client with DKA

Answer 40

- being fluid replacement

Question 41

Which medication is a client with diabetes mellitus at greater risk for developing

Answer 41

- hypoglycemia, uti, skin and vaginal infection