Nurse State Exam Flashcards
1
Q
Post op Mastectomy position
A
90 degree flexion at the solider with 90 degrees flexion of the elbow with hand pointing across
2
Q
Post op Lymphoma?
A
Raise arm above level of heart when possible. Lets gravity help drain the fluid
3
Q
Effects of radiotherapy on skin
A
Mild erythema to ulceration skin can be red
4
Q
Management of burns
A
Maintain skin integrity such as hydrate the peripheral areas, use perscribed ointments
5
Q
Side effects of chemo
A
Fatigue, Nausea, hair loss, anaemia Infection
6
Q
When to start chemo post operatively
A
6-8 weeks
7
Q
When is the best time for breast exam
A
3-4 days after periods in menstrual cycle
8
Q
Most accurate way to diagnose Breast CA
A
Biopsy, mammogram
9
Q
Can Men get breast CA?
A
Yes
10
Q
How do pregnancy & breast feeding affect breast Ca risk ?
A
It reduced the risk of devloping Cancer
11
Q
Signs & symptoms of Type 1 Diabetes ?
A
Increased thirst (polydipsia)
Frequent urination (Polyuria)
Increased hunger (polyphagia)
Fatigue
Blurred Vision
12
Q
What Lab value states that pt is in hypoglycaemia state ?
A
<4mmol
13
Q
Hypoglycaemia sympthoms
A
Pallor
Sweating
Irritability
Hunger
Sleepiness
Lack of coordination
14
Q
Immediate treatment of hypoglycaemic patient that is awake
A
Quick acting carbohydrates (juice, jelly, glucose tablets). Retest 10 mins
15
Q
Immediate intervention for hypoglycaemic patient that is unconscious
A
Glucagon Injection
Retest after 10 mins
16
Q
Hyperglycaemic symptoms
A
Dry mouth
Increased thirst
Weakness
Headache
Blurry vision
Frequent urination
17
Q
Pt has flu & is not eating - give insulin ?
A
Monitor for hypoglycaemia, if low withhold insulin, encourage intake.
18
Q
What advice will you give diabetic patients about foot care ?
A
Inspect feet DAILY
Bathe feet in like warm water NEVER HOT
Moisturise feet but NOT between your toes
Never treat corn and calluses yourself
Clean, dry socks
19
Q
How long after S/C rapid acting insulin should the pt eat ?
A
5-10 mins
20
Q
How long after Rapid insulin should a patient eat ?
A
5-10 mins
21
Q
How long do the effects of Rapid Insulin lasts
A
1-2 hours
22
Q
Examples of rapid act insulin
A
Novo rapid, apidra solostar, Humalog
23
Q
When short acting insulin is injected how long does it take to work
A
15-20 mins
24
Q
How long does the effects of short insulin last ?
A
3-4 hrs
25
Examples of short acting insulin
Actarapid, Humulin R
26
Long acting insulin examples ?
Lantus, Protophane
27
Normal GFR range
Above 90
28
Normal HBA1C
<41 mmol
29
Pre diabetic HBA1C
>41
30
Diabetic HBA1C ?
>50
31
4 Stage of Shock
Initial
Compsentary
Progressive
Irreversible
32
Compensatory Signs & Symptoms
Tachycardia
Tachypenea
Increased BP
33
Earliest Sign of Shock
Cool clammy skin
Mental status changes
Delayed capillary refill <3
34
Septic shock Signs & Symptoms
Cool Clammy skin
Delayed Capillary refill
Mental status changes
High WBC (Over 10,000)
Temp HIGH or LOW
35
Neurogenic shock Signs & Symptoms
Low BP
Bradycardia <60 BPM
Skin that is warm/Pink & Dry
36
Priority Intervention for Neurogenic Shock
IV Normal Saline
Foley
Laxatives
Loose clothing
37
Hypovalemic Shock Signs & Sympthoms
Low BP
Tachycardia
Low CVP (<2)
Low Urinary output
38
Priority Interventions for Hypovalemic shock
Lower HOB
IV normal saline
IV norepiphrine/ Dopamine
MAP >65 MMHG
CVP 2-6
39
Cariogenic shock Signs & Symptoms
Severe LOW BP
Tachycardia
40
Medications for Cariogenic Shock
Dopamine & Digoxin
41
Anaphylactic Shock Intervention
EPI pen every 5-15 mins
Diphenhydramine
Albuterol
42
Risk Factors for type 2 Diabetes
Weight
Family History
Race or ethnicity
Age
PCOS
High blood pressure
43
2000ML in /1500 out in 24 hours is this ok ?
Yes
44
what alerts you need Rapid response
Urine output<30ML hr
45
Sign of Hypoxia in a pt
Confusion
Sweating
Hypotension
Cyanosis
Rapid R&R
46
when do you start CPR
Unconscious Not breathing
47
1 st Priority Spinal Injury
Immobilisation of head or neck
48
What if Patient is unconscious but breathing ?
Roll them into recovery position on their side. Tilt their head back slightly to keep airway open
49
Child - Pencil in ear Intervention ?
Sit up, Bring to docter/ED
50
Signs & Symptoms of pneumothorax
SOB
Tachycardia
Cyanosis
Fatigue
Cough
51
Purpose of wound drain
To drain Pus
52
5 rights of delegation
Right person
Right Task
Right environment
Right direction
Right Supervision
53
Pts Jewellery pre-op ?
Remove, Document, hand it over to family
54
why teach deep breathing pre op
Prevents Pneumonia & DVT
55
Fire On ward who to evacuate first
Mobile Patients
56
Which assessment finding would you report to the HCP with clients with Ulcerative Colitis?
Rebound tenderness
57
Correct way of cleaning a wound
From middle outwards
58
5 P
Pain
Pulse
Pallor
Parsethsia
Paralysis
59
Sympthoms of appendicitus
Poor appetite, Fever
Chills
60
postion leg Ulcer
Leg elevated
61
Women hasn't used PCA in the last 7 hours, you ?
Ask why, educate
62
Pt is restless, has hypertension & back pain with Blood transfusion?
Stop Transfusion
Inform Dr, Blood bank
63
RN should never delegate
New Admissions
Post Op
Unstable blood sugar
Suden Neuro change
64
Reason for shallow breathing after abdo Hysterectomy ?
DVT, Sepsis, Morphine & Pain
65
EN can not perform
IV push meds
Titrating meds
Blood Transfusions
66
Developed Pink frothy sputum & Dyspnea
PE/Edema
67
Tuberculosis Signs & Symptoms
Night sweats
Anorexia
Coughs & Blood tinged sputum
Dysnea & SOB
Fever & Chills
68
How to mobilise first time post op
Give slow support to abdomen & move slowly roll onto side prevent bleeding
69
Airborne precautions (MTV)
Measles
Tuberculosis
Varicella
70
Airborne precaution rules
PPE
N95 mask
Neg pressure room
Door closed
Transport with surgical mask
71
Women already has high dose Morphine what do you do
Provide non Pharmacological treatment
72
Droplet Precautions PPE Gear
Surgical Mask & Googles
Single room
73
Droplet precautions (PIMP)
P- pertussis
I- Influenza
M- Meningitis
P- pneumonia
74
Pre op checklist
Weight
NBM
OBS
Medical HX
Meds
Allergy
ECG
Chest Xray
75
TB Diagnostic tests
Intradermal TB skin Chest xray
Sputum culture 3 consecutive days
76
why nil by mouth ?
Reduce the risk of aspiration of stomach content during surgery
77
Positive Signs of pregnancy
Foetal heartbeat heard by a Doppler device at 10-12 weeks
Ultrasound visualisation of the foetus
Foetal movement (palpated by or observed by the HCP)
78
Best way to Increase awareness for breast self examination
Look at breast after shower
79
Pt had mastectomy + Radiation Reoccurrence ?
10 years, 3-15%
80
Uterine growth & Fundal height at 12 weeks ?
above the symphysis pubis
81
Uterine growth & Fundal height at 16 weeks
Galway between the symphysis pubis and umbilicus
82
Uterine growth & Fundal height 20 weeks ?
on the umbilicus
83
First Aid Action of burns
Cool the burn under luke warm water
Cover the burn cling wrap
84
Which layer of the skin is nerves in ?
Dermis
85
Meds to avoid during Pregnancy (NSAIK)
N-Naproxen (aspirin)
S-Salycic acid
A- Aspirin
I - Ibuprofen & Indomethacin
Ketorolac
86
Safe Vaccines for Pregnancy
Inactivated Influenza (flu shot)
Tdap
Diphtheria
Pertussis
87
Not safe vaccines
Varicella zoster (2 does 4-8 weeks, birth control 1 month to prevent pregnancy)
Rotovarius
Live inactivated Influenza
MMR (not get pregnant 1 month after vaccine)
88
Weight Gain Appropriate for pregnancy
(11-15kg)
18.25- 24.9 BMI
89
Signs & symptoms of anaemia.
Dyspnea
Pallor
Tachycardia
90
Benzodiapines risks for long term use ?
Can cause addiction & dependence
91
How fast does Benzodiapines work ?
Acts fast within Minutes
92
MOA Benzodiapines
Increases GABA which decreases Neuron Activity. Low HR, BP, RR
93
Take Benzo at night or day ?
Night
94
What to teach patients on Benzo
Avoid valerian root
Avoid heavy operation machines
95
Antidote fr Benzo
Flumazenil
96
Antidote for opiates
Naloxone
97
Barbituates last how long in the body ?
3-5 days
98
Droplet precaution diseases
Measles
Tuberculosis
Varicella
99
Airborne precaution diseases
Pertusis
Influenza
Meningitis
Pneumonia
100
PPE gear On
Gown
Mask
Google
Gloves
101
PPE gear Off
Gloves
Gown
Googles
Mask
102
Benefits of Busipirone?
Does not sedate
2-4 weeks to take effect
No withdrawal symptoms
103
3 common side effects SSRI ?
Weight Gain
Sexual Dysfunction
Insomnia
104
SSRI+ ST JOHNS WORT ALLOWED TO BE MIXED ?
NO
105
Maoi + Antidepressants allowed to be mixed ?
No
106
Amitryptiline Side effects
Anticholergenic effects
Cant pee
Cant see
Cant spit
Can shii
107
MAOI cannot eat
No fermented fruits, veges, meats, chocolates & cheese
108
Which OTC meds is not allowed with MAOI?
C- Calcium
A- Antacids
A- Acetomiphen
N- Nsaids
109
Buporian XL, XR, how to take meds ?
Never Chew
Crush
Cut
110
Signs & Symp serotonin syndrome
Sweaty + Hot fever
Rigid muscles
Agitation
111
SSRI Take in morning or Night ?
Morning
112
Creatinine Range
Over 1.3 = Bad Kidney
113
Urine ranges
30 ML Hour/ or less= Kidney distress
114
Contraintradiction to taking Lithium
Cant give when low in sodium (Hyponatremia) 135.
115
Pa02 normal ranges
80-100
116
C02 ranges
35-45
117
Leukopenia range
Below 5,000 WBC
118
Hypoexemic ranges
<60
119
Hypercapnic lab values
>50
120
Priority Intervention Hypercapnic ?
Bipap machine
121
Antidote for Warfarin?
Vitamin K
122
Antidote for Heparin?
Protomine Sulfate
123
Interventions priority for burns
IV Lactated Ringers
IV normal solution
Input & output
124
124
125
What is Audiotory Hallucinations
Hearing voices & sounds that are not there
125
What is Tactile Hallucanations?
Sensation of being touched
126
Best Intervention for Auditory Hallucinations ?
Headphones & Music
127
Positive symp of Schizo?
Tactile Hallucination
Auditory Hallucination
Loose associations
Neogilism
128
“This song is just for me” is an example of what delusion
delusion of reference
129
“I do not go online, that's how the FBI control you” is an example of what type of delusions ?
DELUSION OF CONTROL
130
“ I have a very Important meeting with the queen today” is an example of what type of delusion
Delusions of Grandeur
131
“The hospital food is trying to poison me” is an example of what type of delusion ?
Persecutory Delusions
132
Flight of Ideas Definition ?
Sentences that dont relate to situation
133
Akathasia means
Inability to sit still
134
Normal side effects for Haliperidol
Dystonic behaviours
135
Priority side effects NMS
High fever
Sweating
Tremours
Muscle rigidity
136
2nd gen Antiphycotics meds?
Respiradone
Colonzapine
137
Clozapine, respiradone side effects
Weight Gain
Hypesalivation
sedation
138
first Gen antiphycotics meds
Haliparedol
139
Major Adverse effects to clozapine & Respiradone
Sore throat
Fever
Flu like Sympthoms
140
Contraindications to medications like respiradone & Clonzapine
Do not give to patients with dementia
