medsurg Flashcards
During a health fair, a 72 y/o male pt tells the nurse that he is experiencing shortness of breath. Auscultation reveals crackles and wheezing in both lungs. Suspecting that the pt might have chronic bronchitis, which classic symptom should the nurse expect this pt to have?
a. Racing pulse with exertion
b. Clubbing of the fingers
c. An increased chest diameter
d. Productive cough with grayish-white sputum
d. Productive cough with grayish-white sputum
The nurse working on a telemetry unit finds a pt unresponsive and in pulseless ventricular tachycardia (VT). The pt has an implanted automatic defibrillator. What action should the nurse implement?
a. Prepare the to for transcutaneous pacemaker
b. Shock the pt with 200 joules per hospital policy.
c. Use a magnet to deactivate the implanted pacemaker
d. Observe the monitor until the onset of ventricular fibrillation.
b. Shock the pt with 200 joules per hospital policy.
Rationale: The implanted defibrillator is malfunction and the pt needs to be externally shocked to restore effective cardiac rhythm.
A pt taking furosemide (Lasix), reports difficulty sleeping. What question is important for the nurse to ask?
a. What dose of medication are you taking?
b. Are you eating food rich in potassium?
c. Have you lost weight recently?
d. At what time do you take your medication?
d. At what time do you take your medication?
The nurse is providing dietary instructions to a 68 y/o pt who is at high risk for development of coronary heart disease (CHD). Which information should the nurse include?
a. Limit dietary selection of cholesterol to 300 mg per day.
b. Increase intake of soluble fiber to 10-25 mg a day.
c. Decrease plant stalls and sterols to less than 2 g/day.
d. Ensure saturated fat is less than 30% of total caloric intake.
b. Increase intake of soluble fiber to 10-25 mg a day.
Which intervention should the nurse implement for a female pt diagnosed with pelvic relaxation disorder?
a. Describe proper administration of vaginal suppositories.
b. Encourage the pt to perform Kegel’s 10 times a day.
c. Explain the importance of using condoms when having sexual intercourse.
d. Discuss the importance of keeping a diary of daily temperatures and menstrual cycle events.
b. Encourage the pt to perform Kegel’s 10 times a day.
Which postmenopausal pt’s complaint should the nurse refer to the healthcare provider?
a. Breasts feel lumpy when palpated
b. History of white nipple discharge
c. Episodes of vaginal bleeding
d. Excessive diaphoresis occurs at night
c. Episodes of vaginal bleeding
Rationale: Vaginal bleeding might indicate endometrial cancer
An elderly male pt comes to the geriatric clinic complaining of pain in his left calf. The nurse notices a reddened area on the calf of his right leg which is warm to the touch and suspects it might be thrombophlebitis. Which type of pain should further confirmation of this suspicion?
a. Pain in the calf awakening him from a sound sleep.
b. Calf pain on exertion which stops when standing in one place.
c. Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
d. Pain upon arising in the morning which is relieved after some stretching and exercise.
c. Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
rationale: Thrombophelbitis pain is relieved by rest and elevation of the extremity.
In assessing a pt diagnosed with primary hyperaldosteronism, the nurse suspects the laboratory test results to indicate a decreased serum level of which substance?
a. Sodium
b. Antidiuretic hormone
c. Potassium
d. Glucose
c. Potassium
rationale: Primary hyperaldosteronism exhibits a profound decline in potassium levels– hypertension is the most prominent and universal sign.
The nurse is assessing a pt’s lab values following administration of chemotherapy. Which lab value leads the nurse to suspect that the pt is experiencing tumor lysis syndrome (TLS)?
a. Serum PTT of 10 seconds
b. Serum calcium of 5 mg/dl
c. Oxygen saturation of 90%
d. Hemoglobin of 10 g/dl
b. Serum calcium of 5 mg/dl
A pt has been taking oral corticosteroids for the past 5 days because of seasonal allergies. Which assessment finding is of most concern to the nurse?
a. White blood count of 10,000 mm3.
b. Serum glucose of 115 mg/dl
c. Purulent sputum
d. Excessive hunger
c. Purulent sputum
rationale: steroids cause immunosuppression and purulent sputum is an indication of infection
A pt how has heart failure is admitted with a serum potassium level of 2.9 mEq/L. Which action is most important for the nurse to implement?
a. Give 20 mEq of potassium chloride
b. Initiate continuous cardiac monitoring
c. Arrange a consultation with the dietician
d. Teach about the side effect of diuretics
b. Initiate continuous cardiac monitoring
The nurse knows that lab values sometimes vary in the older pt. Which data should the nurse expect to find when reviewing lab values of an 80 y/o male?
a. Increase WBC, decreased RBC
b. Increased serum bilirubin, slightly increased liver enzymes
c. Increase protein in the urine, slighting increase serum glucose
d. Decreased serum sodium, an increased urine specific gravity
c. Increase protein in the urine, slighting increase serum glucose
A pt with death disease is on a continuous telemetry monitor and developed sinus bradycardia. In determining the possible causes of the bradycardia, the nurse assess the pt’s medication record. Which medication is most likely the cause of the bradycardia?
a. Propanolol (Inderal)
b. Captopril (Capoten)
c. Furosemide (Lasix)
d. Dobutamine (Dobutrex)
a. Propanolol (Inderal)
Which pt should the nurse recognize as most likely to experience sleep apnea?
a. Middle aged female who take diuretic nightly
b. Obese olde male pt with short, thick neck
c. Adolescent female with history of tonsillectomy
d. School-aged male with a history of hyperactivity disorder
b. Obese olde male pt with short, thick neck
Based on the analysis of the pt’s atrial fibrillation, the nurse should prepare the pt for which treatment protocol?
a. Diuretic therapy
b. Pacemaker implantation
c. Anticoagulation therapy
d. Cardiac catheterization
c. Anticoagulation therapy
