Mosby's Comprehensive Review Practice Exam 2

Question 1

How do you know when a patients death is imminent ?

Answer 1

there skin may become mottled. - As death approaches, the skin becomes cool, clammy, and mottled due to diminished circulation.

Question 2

What is a first- line medication a patient will likely receive when experiencing unstable angina?

Answer 2

Nitroglycerine (Nitrolingual) - Nitrates are first-line therapy for treatment of acute anginal symptoms. They will dilate peripheral blood vessels and coronary arteries, increasing blood flow to the heart.

Question 3

What is the purpose of CABG surgery?

Answer 3

To provide a new circuit for blood flow to get to the heart muscle - The construction of new conduits beyond the coronary obstruction restores blood flow to the myocardium.

Question 4

what nursing care to anticipate 3 days postsurgery for a cabg?

Answer 4

Care for two surgical sites - CABG requires a graft from another site, most often the saphenous vein, internal mammary artery, or radial artery; thus, there would be a chest and a graft site.

Question 5

What is the most important reason for client documentation?

Answer 5

To facilitate communication concerning the client - The primary purpose of documentation is to communicate client information among care providers. Documentation is communication that reflects the client’s health and well-being, the care provided, the effect of care, and the continuity of care. All health care providers need ongoing access to client information to provide safe and effective care and treatment.

Question 6

When care is provided through an agency, who owns and has access to the health record?

Answer 6

The agency owns the health record, but the client has legal access to the information according to agency policies. - When care is provided by an agency, the actual record belongs to that agency. With very few exceptions, clients have right of access to their own records. Agencies generally have policies about what to do if clients ask for their charts.

Question 7

What is the most important reason alcohol-dependent people need to be monitored carefully while withdrawing from alcohol?

Answer 7

Cardiac failure - Alcohol withdrawal delirium, or delirium tremens (DTs), may lead to death caused by hyperthermia, peripheral vascular collapse, and cardiac failure.

Question 8

What test should be ordered to confirm the level of jaundice?

Answer 8

Serum billirubin - Bilirubin metabolism abnormalities with cirrhosis are responsible for the deposit of yellow pigment in the skin (jaundice).

Question 9

What tests are done for liver enzymes?

Answer 9

alkaline phosphate and alanine aminotransferase (ALT)

Question 10

What kind of diet should a patient with cirrhosis be on?

Answer 10

A low protein diet, as protein is converted to ammonia.

Question 11

What OTC medication can trigger asthma attacks?

Answer 11

aspirin can trigger asthma attacks in 20% of adults.

Question 12

What is the therapeutic action of long-acting beta2-agonist as well as steroids in an inhaler.

Answer 12

They provide bronchodilation and reduced airway inflammation - The long-acting beta2-agonist provides bronchodilation for up to 12 hours. The inhaled steroid decreases inflammation. Combining the two medications provides a convenient dosing regimen for the client

Question 13

What should the practical nurse teach a patient about the first thing they should do when experiencing a serious acute episode of shortness of breath?

Answer 13

Use his “rescue inhaler” and wait for about 10 minutes to assess if it restores normal breathing - Short-acting bronchodilators (also known as “rescue” medications) provide temporary relief of bronchospasm and should help restore normal breathing within 10 to 15 minutes. Another puff may be taken if optimum breathing does not resume.

Question 14

When providing postoperative care to a patient with ruptured aortic aneurysm what would be of concern to the nurse?

Answer 14

Urinary output of less than 30 mL per hour - An adult’s urinary output should be a minimum of 30 mL per hour. Urinary output below this level may indicate inadequate perfusion of the kidneys, or urinary retention

Question 15

Care of a Pleur-evac chest drainage system includes what?

Answer 15

taping the connection between the chest and the drainage system - Taping connections prevents accidental disconnection

Question 16

What is the purpose of the type and cross-match test?

Answer 16

to determine the compatibility of patients blood with the donor

Question 17

what would be the most appropriate initial action to determine whether a child has a fracture?

Answer 17

ask them to point to where it hurts - The initial practical nursing efforts are directed at calming the child. It is best not to touch children initially but to ask them to point to the painful area.

Question 18

What should be included in the instructions regarding care for a plaster of paris cast in the first 24 hrs?

Answer 18

Expose the cast to air until dry. - A plaster of Paris cast does not fully dry for up to 72 hours. Until then, it must be left exposed to the air to speed the drying process.

Question 19

what medication is known to help alleviate the symptoms of osteoarthritis?

Answer 19

Nonsteroidal anti-inflammatory drugs (NSAIDs) - NSAIDs have been shown to provide greater relief than acetaminophen (Tylenol) in clients with knee pain from osteoarthritis.

Question 20

what is the most important assessment who a women who is 22 weeks pregnant with her 5th child and is at her prenatal care app?

Answer 20

the patients blood pressure - Pregnancy-induced hypertension occurs after 20 weeks’ gestation, more frequently in high-risk pregnancies. It can result in pre-eclampsia and eclampsia, which are dangerous to the mother and the fetus.

Question 21

what is the recommended treatment for mild pre-eclampsia?

Answer 21

restricted activity at home - most women with mild pre-eclampsia may be managed at home with restricted activity and mild exercise.

Question 22

What are some questions to ask a patient related to pre-eclampsia?

Answer 22

“Do you have headaches or visual disturbances?” - these are signs of more severe pre-clampsia

Question 23

what initial action should be taken for a patient coming to a clinic specific to their HIV status

Answer 23

place pt in a room separate from infectious clients - the patient is at risk of infection and thus must have restricted contact with persons who have infections.

Question 24

Potential complications in children with HIV/AIDS

Answer 24

Weight loss and a decrease in growth are potential complications in children with HIV/AIDS. Weight loss may also be part of normal adolescence. The initial question for data collection should be to determine the reason for the weight loss. “ what has your appetite been like in the past two months?”

Question 25

How should a practical nurse best evaluate a patients tolerance of TPN

Answer 25

Laboratory values - Blood glucose, electrolytes, urea nitrogen, complete blood count, and hepatic enzyme studies are performed at routine intervals. Assessment of these values will assist the practical nurse in evaluating Mr. Ford’s tolerance of parenteral nutrition

Question 26

what is a characteristic of fraternal twins?

Answer 26

there are two placentas - Fraternal twins are two ova that have been fertilized by two sperm. They develop as two fetuses and will have two placentas.

Question 27

health canada recommends that all women of child-bearing years take folic acid supplement. What is the reason for this?

Answer 27

It helps prevent neural tube defects in the fetus, should the woman become pregnant. - Women should take it prior to becoming pregnant as it is necessary from the early stages, when the woman may not be aware she is pregnant.

Question 28

what is the most common precipitating cause of autonomic dysreflexia?

Answer 28

Distended bladder or rectum

Question 29

What should be included during teaching of nitroglycerine spray for angina ?

Answer 29

The spray should be taken before exercise or stressful physical activity. - Exercise creates cardiovascular demand. Administration of nitroglycerine prior to physical activity will increase blood flow to the heart, increasing tolerance for the activity.

Question 30

what is the purpose of a medical inquest?

Answer 30

To make recommendations to improve the health care system in the future - Inquests are held to provide recommendations that may be used to improve systems or practices in health care. They must answer how the person died and the manner of death.

Question 31

What should be the primary action of a nurse who is being verbally abused by a patient?

Answer 31

Implement safety strategies to protect herself. - The practical nurse must first protect herself from verbal abuse that may turn to physical abuse. Once safeguards are in place, she may address documentation, support, communication with colleagues, and methods to provide care to Mr. Dovgan.

Question 32

First aid treatment for a pt with epistaxis

Answer 32

Pinch both nostrils closed just below the nasal bone and hold for 10 to 15 minutes. - most effective method for stopping a nose bleed