QT2

Question 1

RSV transmission precautions

Answer 1

transmission: direct contact with nasal droplets from a person who is infected

(this is common cause of bronchiolitis in which the bronchiole inflammation causes production of thick mucous that occludes the tubes and small bronchi)

**precaution: **standard and contact –>

good hand-washing

gloves and gown

Question 2

Mononucleosis

Answer 2

Agent: Epstein-Barr

Incubation: 4-6 weeks

Transmission: direct intimate contact

Question 3

Autonomic dysreflexia (hyperreflexia)

Answer 3

• generally occurs with injuries above T6 and after spinal shock
• commonly caused by visceral distention from a distended bladder or impacted rectum
• manifestations:
  
  • ​sudden onset, severe throbbing h/a (from rapid onset of HTN)
  • severe HTN and bradycardia
  • flushing above the level of injury
  • pale below the level of injury
  • nasal stuffiness
  • nausea
  • dilated pupils or blurred vision
  • sweating (especially forehead)
  • piloerection (goose bumps)
  • restlessness and a feeling of apprehension

Question 4

Congenital deformities detected at birth

Answer 4

Tetralogy of Fallot: pulmonary stenosis, ventricular septal defect, overriding aorta, hypertrophy of right ventricle

Talipes equinovarus: foot twisted out of normal position, clubfoot

Cleft lip and palate: midline fissure or opening into lip or palate

Question 5

recommended intake of calories for women and men

Answer 5

women: 1200 - 1500
men: 1500 - 1800

Question 6

iron recommendations

Answer 6

women 15mg/day (pregnancy 30mg/day)

men 10mg/day

Question 7

signs and symptoms of a hemolytic reaction

Answer 7

chills, headache, backache, dyspnea

hypotention, fever, low back pain

Question 8

anorexia nervosa and assertiveness skills classes

Answer 8

clients with eating disorders experience difficulty with self-identity and self-esteem, which inhibits their abilities to act assertively; some assertiveness techniques that are taught include giving and receiving criticism, giving and accepting compliments, accepting apologies, being able to say no, and setting limits on what they can realistically do rather than just doing what others want them to do

Question 9

anorexia nervosa and family therapy

Answer 9

addresses the aggressive behavior and angery feelings, as well as family boundary intrusion

Question 10

What does improving ventilation refer to?

Answer 10

to improve the quality of ventilation refers to levels of carbon dioxide and oxygen

Question 12

primary goal of a reminiscing group for geriatric clients

Answer 12

Provides an environment for social interaction and companionship.

review and share their life experiences with the group members

Question 13

Hypocalcemia

Answer 13

positive Trousseau’s sign is indicative of neuromuscular hyperreflexia

Question 14

hypercalcemia

Answer 14

1. Constipation.
2. Depressed reflexes.
3. Decreased muscle strength.

Question 15

When should sputum for C&S be collected?

Answer 15

morning

specimens should be obtained in the early morning because secretions develop during the night

Question 16

Which electrolyte must be maintained with Lithium? and why?

Answer 16

SODIUM

alkali metal salt acts like sodium ions in the body; excretion of lithium depends on normal sodium levels; sodium reduction causes marked lithium retention, leading to toxicity

Question 17

normal Hct

Answer 17

normal HCT (male 41 to 53%, female 36 to 46%)

Question 18

Normal Hgb

Answer 18

male 13.5 to 17.5 g/dL,

female 12 to 16 g/dL

Question 19

What labs are assessed for meningitis?

Answer 19

cloudy CSF, low Hgb/Hct, high WBC = bacterial

clear CSF, close to normal Hgb/Hct, WBC slightly elevated? = viral

Question 20

Miller-Abbott tube

Answer 20

provides for intestinal decompression; intestinal tube is often used for treatment of paralytic ileus

Removes fluid and gas from the small intestine.

Question 21

PKU test

Answer 21

After newborn is 24 hours old and before 7d, and may repeat test at 2 weeks of age for accuracy.

Done as close to discharge as possible.

Question 22

Promethazine hydrochloride (Phenergan)

Answer 22

used as an adjunct to analgesics but has no analgesic activity itself

Question 24

Buerger’s disease

Answer 24

intermittent claudication (pain with exercise)

digital sensitivity to cold

Question 25

What should I tell a pt starting estrogen?

Answer 25

nausea is common at breakfast time; will subside after weeks of medication use; take after eating to reduce incidence

w/ long-term use, tinnitus and visual changes may occur

Question 26

methenamine mandelate (Mandelamine)

Answer 26

Methenamine is used to prevent or control returning urinary tract infections caused by certain bacteria. It is not used to treat an active infection. Other antibiotics must be used first to treat and cure the infection. Methenamine is an antibiotic that stops the growth of bacteria in urine. This medication also contains an ingredient that helps to make the urine acidic. When the urine is acidic, methenamine turns into formaldehydeto kill the bacteria.

AVOID alkalinic foods and drinks like milk.

Cranberry juice good, makes it more acidic.

Question 28

What age should toilet training be taught?

Answer 28

20 months of age

• not able to physiologically control sphincters until 18 months of age
• by 24 months may be able to achieve daytime bladder control

Question 29

What is hematuria a sign of?

Answer 29

sign of cancer, infection, or trauma of urinary tract, glomerular disease, renal calculi, bleeding disorders

Question 30

Why does TURP patient have a continuous bladder irrigation (CBI)?

Answer 30

enables urine to keep flowing to prevent formation of clots that can lead to obstruction and spasm in the postoperative TURP client

Question 31

signs of hypoglycemia

Answer 31

Diaphoresis, confusion, tachycardia, restlessness, headache, weakness, irritability, apprehension, lack of muscle coordination

Question 32

When does person w/ gastric ulcer experience pain?

Answer 32

about 0.5 to 1 hour after a meal and rarely at night; is not helped by ingestion of food (makes worse)

Pt loses weight.

Question 33

When does person w/ duodenal ulcer experience pain?

Answer 33

1.5 to 3 hrs after a meal and during the night (often awakens pt) Pain relieved with food.

Pt will gain weight.

Question 34

where do I auscultate right middle lobe?

Answer 34

right anterior chest between the fourth and sixth intercostal spaces

Question 35

Ménière’s syndrome

Answer 35

characterized by tinnitus, unilateral sensorineural hearing loss, and vertigo

symptoms occur in attacks and last several days, leaving pt totall incapacitated during attack

SAFETY IMPORTANT!

Stand in front of pt so he/she doesn’t have to turn ahead, decreasing risk of vertigo attack

Question 36

Why is morphine given to pt in respiratory distress?

Answer 36

decrease anxiety

Question 37

MOST reliable client measure to evaluate the desired response of diuretic therapy?

Answer 37

Daily weights

Question 38

normal urine specific gravity

Answer 38

normal 1.010 to 1.030

Question 39

Delegation to LPN and NA

Answer 39

(1) stable patient with an expected outcome; assign to the LPN/LVN
(2) standard, unchanging procedure; assign to the nursing assistant
(4) RN need to perform all assessment skills

Question 40

When giving Narcan what is IMPORTANT for the nurse to consider?

Answer 40

Narcan is effective in treating respiratory changes caused by opiates

half-life of Narcan is short; may go back into respiratory depression; may need to be repeate

Question 41

How should a client diagnosed with paranoid schizophrenia be addressed?

Answer 41

needs reality testing from nurse, not questioning.

Do not question the client about his false ideas because it encourages patient to engage in further distortion of reality

Question 42

What does pt with Cushing’s syndrome look like?

Answer 42

thin extremities, round middle, brusing w/ petechiae

Question 43

The nurse cares for a client receiving haloperidol (Haldol). What major s/e should be assessed?

Answer 43

major side effects of haloperidol (Haldol) include hematologic problems, primarily blood dyscrasia and extrapyramidal symptoms (EPS)

Question 44

What is an expected finding of pulmonary edema?

Answer 44

expectorating pink-tinged mucus