Power Point Questions

Question 1

A patient with metabolic alkalosis has an SpO2 of 93% and a shift to the left in the oxygen-hemoglobin dissociation curve. Which action by the nurse is appropriate?

Answer 1

A. Administer supplemental oxygen because oxygen is not readily released to the tissues

Question 2

A patients ABG results include the following: pH:7.32, PaO2 84, PaCO2 49 and SaO2 84%. For what should the nurse assess the patient?

Answer 2

A: Tachypnea

tachypnea is a rapid respiratory rate and indicates respiratory distress

Question 3

The nurse would interpret an induration of 5mm resulting for TB skin testing as a positive finding in which pt?

Answer 3

A: A pt who is HIV infected

Question 4

What factors in J.B.’s history increase his risk for lung cancer?

Answer 4

A: Smoking exposure to chemicals on job site

Question 5

What are some risk factors for pneumonia?

Answer 5

Age, limited mobility, chronic heart failure

Question 6

A 56 yr old normally healthy pt at the clinic is dx with bacterial community-acquired pneumonia. Before treatment is prescribed, the nurse asks the pt about an allergy to:

Answer 6

A: Erythtomycin

Question 7

The nurse is caring for a patient with pneumonia. If pleural effusion is developing, the nurse would expect which finding?

Answer 7

A: Localized decreased breath sounds

R: symptoms of pleural effusion include: diminished breath sounds, decreased movement of the chest on the affected side, dullness to percussion, dyspnea, cough, and sharp and no radiating chest pain that is worse on inhalation

Question 8

What risk factors does S.C have for TB?

Answer 8

Homelessness, I-V drug use, resident of the shelter, poverty, HIV

Question 9

What diagnostic test would you expect the HCP to order for S.C. (TB)

Answer 9

TB skin test, IGRA, chest x-ray, sputum culture and sensitivity, sputum for AFB

Question 10

What treatment do you expect for S.B. (TB)

Answer 10

4 drug therapy, isoniazid, rifampin, pyrazinamide, and ethambutol

Question 11

What risk factors does D.F. have for the development of pulmonary embolism?

Answer 11

Obesity, orthopedic surgery, immobility, dehydration, heart failure

Question 12

What clinical manifestations of PE does D.F. demonstrate?

Answer 12

Chest pain, dyspnea, tachycardia, tachypnea, restlessness, crackles

Question 13

What diagnostic tests would you expect to teach D.F. about (PE)?

Answer 13

Serum D-dimmer levels, spiral CT scan, chest x-ray, ECG, troponin, b-natriuretic peptide. If cannot have contrast media for spiral CT scan, then V/Q scan

Question 14

What are the priority assessment for A.M. on his return from the OR (trache)?

Answer 14

Airway patency, lung sounds, need for suctioning, bleeding around newly formed trach, mechanical vent settings, neurological assessment

Question 15

What emergency equipment should be available at bedside for trache?

Answer 15

Need to have tracheostomy setup at beside as well as a second trach tube, forceps. Oburator should be available in case of decannulation. suction equipment

Question 16

24 hrs after a pt had a tracheostomy, the tube accidentally dislodged after a coughing episode. Which action should the nurse take first?

Answer 16

A: Grasp the retention sutures to spread the tracheostomy opening

Question 17

How will you assess prior to removing the tracheostomy?

Answer 17

A: Close the stoma with tape and apply an occlusive dressing. Close dressing if it gets soiled or wet. Stoma should close within 4-5 days

Question 18

A patient is receiving a drug that decreases afterload. To evaluate the patients repose to this drug, what is the most important for the nurse to assess?

Answer 18

Blood pressure

R: Afterload is affected by the size of the ventricle, wall tension, and arterial blood pressure

Question 19

A patient arrives at an urgent care center after experiencing unrelenting substernal and epigastric pain and pressure for about 12 hrs. The nurse reviews lab results with the understanding that at this point in times, a MI would by indicated by peak levels of:

Answer 19

A. Troponin

Troponin is the biomarkers of choice in the dx of MI
Troponin levels peak at 10-24 hrs

Question 20

A patient returns to the cardiac observation area following a cardiac catherization with coronary angiography. Which assessment would require immediate action by the nurse?

Answer 20

St-segment elevation develops on the ECG

ST elevation on ECG indicates myocardial ischemia or injury with partial or total occlusion of a coronary artery

Question 21

The nurse determines that the pt has stage 2 HTN is when a patients average BP is

Answer 21

Greater than or equal to 160/100

Question 22

While performing BP screening at a health fair, the nurse counsels which person as having the greatest risk for developing HTN?

Answer 22

A 56 yr old man whose father dies at age 62 from a stroke

Question 23

A pts BP is not responded consistently to rx drugs for HTN. The first cause of this lack of responsiveness the nurse should?

Answer 23

The patient not adhering to therapy

Question 24

The nurse takes BP at a health fair. The nurse identifies which person as most at risk for developing HTN?

Answer 24

A 52 yr old male who smokes and has a patent with HTN

Question 25

The nurse determines that which blood pressure would meet the criteria for a dx of stage 1 HTN

Answer 25

Stage one HTN is blood pressure if 140-159/90-99

Question 26

A patients bp has not responded to the prescribed drugs for HTN. Which of the following should the nurse assess first?

Answer 26

Patients adherence to drug therapy

Question 27

Two risk factors for CAD that increase the workload of the heart and increase Myocardial demand are:

Answer 27

HTN and cigarette smoking

Question 28

Which pt is most at risk for developing CAD?

Answer 28

A HTN pt who smoke cigerattes

Question 29

The nurse determines that teaching about implementing dietary changes to decrease the risk of CAD has been effective when the pt says:

Answer 29

Most of my fat intake should be from olive oil or the oils in nuts

Question 30

A patient is admitted to the coronary care unit following a cardiac arrest and successful cardiopulmonary resuscitation. When reviewing the HCP admission orders, which order should the nurse question?

Answer 30

tPA 100 mg IV infused over 3 hr

Question 31

The most significant factor in long-term survival of a pt with sudden cardiac death is:

Answer 31

Rapid institution of emergency services and procedures

Question 32

The nurse is caring for a pt who survived a sudden cardiac death. What should the nurse include in the discharge instructions?

Answer 32

“Your family members should learn to perform CPR and practice these skills regularly”

Question 33

A pt with a hx of CHF is hospitalized with severe dyspnea and a dry, hacking cough. Assessment findings include pitting edema in both ankles, BP 170/100, P: 92 and R: 28. Which statement, if made by the nurse, is most accurate:

Answer 33

“ The manifestations indicate impaired emptying of both the right and let ventricles, with decreased forward blood flow

Question 34

A pt with L sided HF is rx oxygen at 4 L/min nasal cannula, furosemide (Lasix), spironolactone (Aladctone), and enalapril (Vasotec). Which assessment should the nurse complete to best evaluate the pts response to these drugs?

Answer 34

Auscultate lung sounds

Question 35

The home care nurse visits a pt with CHF who is taking digoxin (Lanoxin) and furosemide (Lasix). The pt complains of nausea and vomiting. Which action os most appropriate for the nurse to take?

Answer 35

Notify the HCP immediately

Question 36

The nurse is caring for a patient with aortic stenosis. For what should the nurse assess the pt?

Answer 36

Systolic murmur

Question 37

A 19 yr old pt with rheumatic heart disease is admitted to the hospital with a recurrence of rheumatic fever. In planning care for the pt, which nursing dx should the nurse include?

Answer 37

Ineffective health management related to lack of knowledge about long-term prophylactic antibiotic therapy

Question 38

Following an aortic aneurysm repair, the pt suddenly develops severe pain in the R lower extremity. The right pedal pulse is decreased and the R foot is cool and pale. Which complication should the nurse suspect?

Answer 38

Embolization or graft occlusion

Question 39

A pt with PAD has marked peripheral neuropathy. An appropriate nursing dx for the pt is

Answer 39

Risk for injury related to decrease sensation

Question 40

The nurse teaches a pt with peripheral arterial disease. The nurse determines that further teaching is needed if the pt makes which statement?

Answer 40

I should cut back on my walks i’d it causes pain in my legs

Question 41

The nurse is caring got a patient who is admitted after a head injury. When would the nurse obtain most of the data related to this patients mental status?

Answer 41

During the nursing health history

Question 42

The nurse is caring for a patient who has a spinothalamic tract lesion. Which assessment finding would the nurse expect?

Answer 42

Loss of peripheral sensitivity to pain

Question 43

How should the nurse assess cranial nerves III, IV, and VI?

Answer 43

Test the pts eye movements

Question 44

The nurse is caring for a pt after a head injury. how should the nurse position the pt in the bed?

Answer 44

Side-lying with the head elevated 30 degrees

Question 45

A patient with a head injury has an arterial BP of 92/50 and ICP of 18. The nurse uses the assessments to calculate the CCP How should the nurse interpret the results?

Answer 45

The CPP is low, and the BP should be increased

Question 46

A pt with increased ICP is positioned in a lateral position with the HOB elevated 30 degrees. The nurse evaluates a need for lowering the HOB when the pt experiences:

Answer 46

Decreasing LOC

Question 47

As one of your clinical assignments, you are assisting an RN with a health screening at a health fair. Which individual is at greatest risk for experiencing a stroke?

Answer 47

A 52 yr old African American make with HTN who is 35 lbs overweight

Question 48

Interferon B-1b (Betaseron) has been prescribes with relapsing remitting MS. Which statement, if made by the pt, indicates that additional teaching is needed?

Answer 48

I will reduce my sodium intake to prevent edema

Question 49

Several years later you see MJ at your outpatient clinic with a cough and fever. It is obvious that his Parkinson’s disease has advanced. During your assessment of him, you would expect to find?

Answer 49

Drooling, stooped posture, tremors, and a propulsive gait

Question 50

An appropriate nursing dx for MJ at this stage of advanced Parkinson’s disease is:

Answer 50

Fish for aspiration related to impaired swallowing

Question 51

You are called to the patients room by he pr spouse when the pt experiences a seizure. Upon finding the pt in a clonic reaction, what do you think you should do first?

Answer 51

Tuen the patient to the side

Question 52

An older pt is admitted to the hospital with a urinary infection and possible bacterial sepsis. The family is concerned because the pt is confused and not able to carry on a conversation. Which statement by the nurse is most appropriate?

Answer 52

The mental changes are most likely caused by the infection and most often reversible

Question 53

A daughter of a pt with early familial AD asks how AD is different from forgetfulness. You describe early warning signs of AD, including:

Answer 53

Having no memory of preparing a meal and forgetting to serve of eat it

Question 54

DB is admitted to a long-term care facility. He has a nursing diagnosis of impaired memory related to effects of dementia. An appropriate nursing intervention for his is to

Answer 54

Maintain familiar routines of sleep, meals, drug administration, and activities

Question 55

A patient is just admitted to the hospital following a spinal cord injury at the level of T4. A priority of nursing care for the pt is monitoring for

Answer 55

Bradycardia with hypoxemia

Question 56

A young adult is hospitalized after an accident that resulted in a complete tan section of the spinal cord at the level of C7. The nurse informs the pr that after rehab, the level of function that is most likely to occur is the ability to

Answer 56

Drive a vehicle with hand controls

Question 57

During assessment of the pt with a spinal cord injury at the level of T2 at the rehab center, which finding would concern the nurse the most

Answer 57

Marked perspiration on the pts face and arms

Question 58

The nurse identifies that the patient with the greatest risk for UTI is

Answer 58

A 72 yr old woman hospitalized with a stroke who has a urinary catheter because of urinary incontinence