QT4

Question 1

What is necessary to implement a behavior modification plan successfully?

Answer 1

Confirm that all staff members understand and comply with the treatment plan

all staff members need to be included in program development, and time must be allowed for discussion of concerns from each nursing staff member; consistency and follow-through is important to prevent or diminish the level of manipulation by the staff or client during implementation of this program

Question 2

preoperative medication given before a cesarean section compared to general surgery

Answer 2

• decreased so that less narcotic crosses the placental barrier, causing respiratory depression in the infant
• dosages of sedatives and hypnotics will be similar

Question 3

How is consent for procedure obtained from divorced parents?

Answer 3

parent or legal guardian required to give informed consent prior to surgical procedure

Question 4

Prochlorperazine maleate (Compazine)

Answer 4

antipsychotic for schizophrenia

Compazine should be considered incompatible in a syringe with all other medications

Question 5

butorphanol (Stadol)

Answer 5

Pain medication

Question 6

What is important teaching for a pt postgastrectomy surgery?

Answer 6

measures to prevent dumping syndrome,

• lying down for 30 minutes after meals,
• drinking fluids between meals (not with meal)
• reducing intake of carbohydrates
• avoid sugar, salt, milk, and highly spiced foods
• Avoid eating large meals that are high in simple sugars and liquids
• Eat small meals with no fluids
• Eat high-protein, high-fat, low-carb diet

Question 7

What influences use of restraints for an agitated/aggressive patient?

Answer 7

• restraints/seclusion policies set forth by the institution
• patient’s competence (must get written permission from the patient for restraints; if patient has been judged incompetent, permission is obtained from the legal guardian)
• patient’s nursing care plan (must first try less restrictive means to control patient before using restraints)

**the need for restraints is based on patient’s behavioral status and condition, not the patient’s voluntary/involuntary status

Question 8

What is in Oxycodone terephthalate (Percodan) that is contraindicated for persons with bleeding disorder?

Answer 8

aspirin

Question 9

What are the s/e of terbutaline (Brethine)?

Answer 9

maternal side effects include:

• tachycardia,
• nervousness,
• tremors,
• headache, and
• possible pulmonary edema;

fetal side effects include tachycardia and hypoglycemia;

Brethine is usually preferred over ritodrine (Yutopar) because it has minimal effects on blood pressure

Question 10

Transmission precautions for Hep A

Answer 10

Contact precautions

contact precautions required for diapered or incontinent clients

Need private room

Question 11

Administration of haloperidol decanoate (Haldol D)

Answer 11

2 inch 21 gauge needle

Give deep IM in a large muscle mass

very irritating to subcutaneous tissue

Question 12

What is drug of choice for PVCs?

Answer 12

lidocaine is the drug of choice for frequent premature ventricular contractions (PVC) occurring in excess of 6 to 10 per minute; for coupled PVCs or for a consecutive series of PVCs that may result in ventricular tachycardia

Question 13

What is Isoproterenol (Isuprel) given for?

Answer 13

Lidocaine hydrochloride (Xylocaine) IV

lidocaine is the drug of choice for frequent premature ventricular contractions (PVC) occurring in excess of 6 to 10 per minute; for coupled PVCs or for a consecutive series of PVCs that may result in ventricular tachycardia

Question 14

The nurse’s INITIAL priority when managing a physically assaultive client?

Answer 14

most important priority in the nursing management of an assaultive client is to maintain milieu safety by restoring the client’s self-control; a quick assessment of situation, psychological intervention, chemical intervention, and possibly physical control are important when managing the physically assaultive client

**Clearing the immediate area of other clients to prevent harm is not realistic if situation escalates quickly.

Question 15

When a pt is experiencing EPS, what medication is given?

Answer 15

antiparkisonian drug

Biperiden (Akineton)

Question 16

hypernaetremia

Answer 16

Sticky mucous membranes; decreased urinary output; and firm, rubbery tissues

restlessness, weakness, coma, tachycardia, flushed skin, oliguria, fever

Answer 17

Headache, apprehension, and lethargy

muscle twitching, convulsions, diarrhea, fingerprinting of skin

Question 18

most effective way of deep breathing and coughing

Answer 18

“Take three deep breaths, hold your incision, and then cough.”

This dilates airway and expands lung surface area.

Question 19

how many words can a 12mo speak?

Answer 19

3-5 in addition to mama and dada

Question 20

at what age can infant pull self up?

Answer 20

8 months (and can say a few words)

Question 21

gemfibrozil (Lopid)

Answer 21

lipid-lowering agent

used with patients with high serum triglyceride levels

side effects include: abdominal pain, cholelithiasis (gall stones)

take 30 minutes before breakfast and supper

check liver function before admin

Question 22

ranitidine hydrochloride (Zantac)

Answer 22

Treats and prevents heartburn with acid indigestion. Also treats stomach ulcers, gastroesophageal reflux disease (GERD), and conditions that cause your stomach to make too much acid

best results when taking once a day, at night.

not affected by food.

Question 23

side effect of haloperidol (Haldol)

Answer 23

includes galactorrhea (excessive or spontaneous flow of milk), lactation, gynecomastia (excessive growth of male mammary glands)

Question 24

When should antiembolism stockings be worn?

Answer 24

the entire time that client is in the hospital; should be removed for baths and replaced after the skin is dry, and before the client gets out of bed

stockings should be worn during the day and when client is nonambulatory

Question 25

Pts with multiple sclerosis (MS) have decreased perception of _________?

Answer 25

pain

Need less pain medications.

Question 26

diet teaching for an older client with acute gout

Answer 26

should be on low-purine diet, should avoid red and organ meats, shellfish, oily fish with bones

Question 27

How long does coumadin last in system?

Answer 27

duration of Coumadin 2 to 5 days, client at risk for a repeat CVA if not taken for 2 days because medication ran out

Question 28

NANDA for right-sided hemiparesis

Answer 28

Alteration in communication related to decrease in thought processes

Question 29

What cranial nerve is facial?

Answer 29

VII

Question 30

positive response to fluoxetine HCl (Prozac)

Answer 30

This medicine is an SSRI that treats depression, obsessive-compulsive disorder (OCD), and other disorders.

fluoxetine HC (Prozac) is an “energizing” antidepressant; as client begins to demonstrate a positive response, he has an increased energy level, is able to participate more in milieu

Question 31

Four reactions to blood transfusion and the S/S

Answer 31

(1) febrile reaction;

• symptoms include fever, chills, nausea, headache;
• treatment is to stop blood and administer aspirin

(2) hemolytic reaction; most dangerous type of transfusion reaction,

• symptoms include nausea, vomiting, pain in lower back, hematuria;
• treatment is to stop blood, obtain urine specimen, and maintain blood volume and renal perfusion

(3) allergic reaction;

• symptoms include urticaria, pruritus, fever;
• treatment is to stop blood, give Benadryl, and administer oxygen

(4) circulatory overload;

• neck vein distention
• treatment is to stop blood, position in an upright position, and administer oxygen

Question 32

What may precipitate a mid–life crisis?

Answer 32

The client starts to measure life accomplishments against goals.

Question 33

What type of pt is MOST at risk for developing herpes zoster?

Answer 33

clients with compromised immune system at risk for reactivation of the varicella zoster virus

Question 34

myxedema

Answer 34

there is a slowing of all body functions, (b/c no metabolism?)

hypotenstion

bradycardia

hypothermia

hyponaetremia

hypoglycemia

generalized edema

respiratory failure

coma

Question 35

post renal transplant and visitors

Answer 35

Remind family and friends that there is restricted visiting for at least 72 hours postoperatively.

Question 36

esophageal speech following a total laryngectomy

Answer 36

The client swallows air and then eructates it while forming words with his mouth.

Question 37

one of the first signs of an increase in the intracranial pressure in infants

Answer 37

High-pitched cry.

Question 38

patient has become very hard of hearing may exhibit?

Answer 38

suspicious of strangers results from interference with communication

Question 39

client has pulled out the nasogastric tube and is picking at the bed covers. The client’s BP is 150/90 and pulse is 90.

Indicates what?

Answer 39

decreased oxygen levels

Answer 41

Ewald tube is a large, orogastric tube designed for rapid lavage; insertion often causes gagging and vomiting, suction equipment must be immediately available to reduce the risk of aspiration

Have suction equipment at bedside.

Question 42

what happens to blood glucose during illness?

Answer 42

increases, so insulin should still be given though not eating

Question 43

signs of narcotic withdrawal

Answer 43

very much like the symptoms of the flu

Runny nose, yawning, fever, muscle and joint pain, diarrhea

Question 44

signs of barbiturate withdrawal

Answer 44

Nausea and vomiting, tachycardia, coarse tremors, seizures

Question 45

signs of amphetamine withdrawal

Answer 45

Depression, disturbed sleep, restlessness, disorientation

Question 46

sign of cocaine withdrawal

Answer 46

Severe cravings, depression, fatigue, hypersomnia

Question 47

MOST important initial goal for the pt dx of rape trauma syndrome, acute phase?

Answer 47

nurse’s initial priority to encourage client to begin dealing with what happened by verbalizing her feelings and gaining some acceptance and