QUIZ 6

Question 1

Bronchitis

Answer 1

Inflammation of the bronchial tubes.
Bronchitis may result from viral or respiratory infections (producing fever).
This upper airway infection may
1. Increase in breathing rate (tachypnea),
2. Difficulty breathing at rest, and chest tightness due to mucus accumulation in the bronchial tubes;
3. Productive cough with thick, yellow mucus.
4 bronchitis does not usually display rales or rhonchi or experience severely impaired gas exchange/altered pulse oximetry.

Question 2

Pneumonia”

Answer 2

Severe lung inflammation causes the alveoli to fill with mucus, fluid, and debris.
Eventually, these changes lead to impaired gas exchange, resulting in hypoxia.
Manifestations include
1. Fever due to infection
2. Productive cough with yellow sputum (from mucus-filled alveoli)
3. Rapid breathing (tachypnea)
4. Chest tightness
5. Shortness of breath (dyspnea) due to impaired gas exchange
6. Abnormal breath sounds (rales and rhonchi due to accumulation of mucus, fluid and debris in the lungs)

Question 3

Diaphragmatic breathing

Answer 3

chronic respiratory conditions like COPD and asthma

Question 4

Drug Diversion

Answer 4

the abuse, illegal distribution, or use of prescription medications for purposes not intended by the prescribing health care provider.

Question 5

Findings that support drug diversion include the following:

Answer 5

Disposing of or wasting controlled substances without a witness
and disposing of or wasting controlled substances without another nurse as a cosigner within the automated dispensing system.

Additionally, frequent bathroom breaks at work are an additional symptom associated with drug diversion, as the employee may be using controlled substances in the bathroom.

Question 6

Behavioral Impairment”

Answer 6

Substance use disorder (SUD) can be behavioral or physical.

EX : leaving work before the end of the shift and frequent absences

Question 7

The nurse manager develops a unit specific policy to address substance use disorder (SUD) in the clinical setting. What should be included in the SUD policy?

Answer 7

1. The maintenance of confidentiality.
2. A process for auditing medication records.
3. The use of a fitness for duty evaluation tool.
4. A procedure to report suspected impairment.

Question 8

The nurse manager notices a staff nurse appears to be impaired while on duty. Which action should the nurse manager implement?

Answer 8

1. Remove the nurse from the unit.
2. Inform the nurse that a drug screening is required.
3. Evaluate the nurse’s need for emergency treatment.

Question 9

Seborrheic Dermatitis”

Answer 9

Rash behind the ears and at the nape of the neck.

Seborrheic dermatitis rash is diffusely present on the scalp, including behind the ears and at the nape of the neck. This condition is rarely itchy, but lesions are typically greasy and scaly, and sores are uncommon.

With seborrheic dermatitis, the client has a potential association with the history of tree nut allergy. Seborrheic dermatitis occurs in response to immune reactions or allergies, so it could be precipitated by the response to an allergen (tree nut allergy)

Question 10

Gout

Answer 10

very painful condition in which high levels of uric acid in the blood create uric acid crystals that lodge in the joints (most commonly, the great toe)

Question 11

symptoms of gout

Answer 11

1. Severe pain, tenderness, and redness of joints.
2. Pain occurs suddenly, more commonly at night..

Question 12

Treatment for acute gout attacks

Answer 12

non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain

Question 13

teaching the client about prevention of future gout attacks,

Answer 13

Dietary changes (low purine foods), exercise, and limiting alcohol intake are important. Preventative medication may also be used to prevent gout attacks.

Question 14

Allopurinol

Answer 14

gout to help reduce the amount of uric acid the body manufactures.
Due to the drowsiness that occurs with allopurinol, taking at night is also advisable. Allopurinol has a high risk of the side effect of Stevens-Johnson syndrome (SJS). It can begin with a rash, blisters, and peeling of the skin then become fatal. Any rash should be reported immediately.

Question 15

Colchicine

Answer 15

An anti-inflammatory medication that is very effective in reducing gout pain in clients.
Avoid intake of grapefruit while taking colchicine since it can cause the medication to build up in the body and cause rhabdomyolysis.
Colchicine should be taken every two hours until the gout pain is relieved.

Question 16

Probenecid

Answer 16

for clients with gout to help the kidneys rid the body of uric acid. Therefore, the client should be taught to increase water intake to at least 64 ounces daily.

Question 17

Preterm labor

Answer 17

refers to a labor that begins too early–between 20 and 37 weeks of pregnancy. Preterm labor is characterized by cervical changes (dilation or effacement). Preterm labor is the number one cause of neonatal mortality, because immature organs have not developed enough, leading to complications.

Question 18

Risk factors OF Preterm labor

Answer 18

1 A distended uterus from large babies
2 or too much amniotic fluid;
3 disorders like diabetes mellitus,
4 eclampsia,
5 heart disease,
6 anemia;
7 infection
; 8 placental abruption
;9 and stress..

Question 19

signs and symptoms of preterm labor,

Answer 19

1. Rupture of membranes at 20-37 weeks,
2. Low back pain,
3. Pelvic pressure,
4. Contractions occurring every 10 minutes or less.

Question 20

Interventions for preterm labor

Answer 20

1. Activity restriction
2. Tocolytics
3. Antibiotics
4. Steroids to enhance fetal lung maturity

Question 21

Neonatal Hypoglycemia”

Answer 21

Premature neonates are at increased risk for hypoglycemia after birth because they have lower glycogen stores and deplete them more quickly.
Additionally, a maternal diagnosis of GDM is also a risk factor for neonatal hypoglycemia because the neonate’s glucose supply via the umbilical cord is immediately interrupted while neonatal insulin levels are still elevated, resulting in hypoglycemia.
FHR tracings that are indicative of perinatal stress increase the risk of hyperinsulinism and resultant hypoglycemia in the neonatal period because anaerobic metabolism is used to maintain blood glucose concentrations.

Question 22

“RDS” neonatal respiratory distress syndrome

Answer 22

Preterm birth increases the risk for neonatal RDS due to insufficient surfactant in the lungs.
Maternal GDM is associated with fetal hyperglycemia and hyperinsulinemia, which disrupts normal surfactant synthesis and function, leading to surfactant inadequacy and clinical RDS in neonates.
Fetal distress during labor and childbirth is also a risk factor for neonatal RDS, as perinatal asphyxia decreases the synthesis and release of surfactant. The fetal lie and station are not favorable for a vaginal birth which can also increase the risk for neonatal RDS due to an inability to absorb fluid in the lungs before birth.

Question 23

autonomic dysreflexia (AD)

Answer 23

a spinal cord injury, when a noxious stimulus occurs below the level of spinal cord injury, the parasympathetic response is blocked at the level of spinal cord injury. As a result, nasal congestion and flushing and diaphoresis are present above the injury and bradycardia occurs. Below the level of injury, vasoconstriction occurs, leading to hypertension.

Question 24

Hyperthyroidism

Answer 24

An endocrine condition that causes increased levels of thyroid hormones.
This condition results in manifestations that are caused by increased metabolism and sympathetic nervous system (SNS) stimulation.

Hyperthyroidism results from high T3 and T4 and promotes high/hyper energy. Graves disease is the primary cause of hyperthyroidism. Manifestations include hypertension (high blood pressure), exophthalmos (“grape eyes”), heat intolerance, weight loss and goiter.

Question 25

Hypothyroidism”

Answer 25

Hypothyroidism causes low and slow responses in the body because of low T3 and T4. Manifestations of hypothyroidism may include weight gain, brittle nails, and constipation (slowed GI tract).

Question 26

thyroid storm

Answer 26

thyrotoxic crisis is a potentially life-threatening complication of hyperthyroidism manifested by tachycardia, fever, dehydration, heart failure, and coma occurring in the client with untreated or inadequately treated hyperthyroidism, especially during a time of emotional stress.

Question 27

cretinism

Answer 27

it is a congenital form of hypothyroidism that occurs in a child with a poorly functioning or absent thyroid gland.

Question 28

myxedema coma

Answer 28

result of severe hypothyroidism.

Question 29

Propranolol

Answer 29

A beta-adrenergic blocker, is administered to control signs and symptoms of excessive stimulation of the sympathetic nervous system, such as tachycardia, palpitations, excessive sweating, tremors, and nervousness.
The client should not take the dose of propranolol if the heart rate is less than 60 beats/min

Question 30

Propylthiouracil (PTU)

Answer 30

An antithyroid drug, treats hyperthyroidism by blocking the production of thyroid hormones and peripheral conversion of T4 to the more active T3.

Propylthiouracil may be taken with or without food, but it must be taken consistently with or without food for all doses because food affects serum blood levels.

Propylthiouracil should be taken around the clock, every 8 hours. Taking the medication at 0800, 1200, and 1600 would be spacing the frequency to every 4 hours during the day, with a gap of 16 hours through the evening and night, leading to fluctuations in blood levels.

Question 31

seizure

Answer 31

uncontrolled electrical brain discharges.

Question 32

Common causes of seizures

Answer 32

Anything that can cause swelling or hypoxia inside the brain, including infection, fever, and even withdrawal from drugs and alcohol. Many pediatric clients experience at least one seizure during childhood; however, some individuals experience recurrent seizures requiring ongoing therapeutic management.

Question 33

status epilepticus

Answer 33

The diagnosis of recurrent seizures.
his condition involves either a seizure that lasts longer than 5 minutes or more than one seizure within a 5-minute period of time. Status epilepticus is a medical emergency. Signs and symptoms may include an aura, loss of consciousness, a postictal period, and amnesia to the event.

Question 34

Generalized Seizure”

Answer 34

A generalized seizure involves abnormal electrical activity in both hemispheres of the brain. Because these electrical impulses discharge randomly throughout the brain, a generalized seizure may produce: amnesia to the event, an aura (strange smell, taste, or sensation), loss of consciousness, a postictal state, and jerky, rhythmic muscle spasms.

Question 35

Simple Focal Seizure”

Answer 35

A simple focal seizure is classified as such because seizure activity occurs in a specific portion of the brain, and since the electrical activity is confined to the cerebral cortex, findings are more limited. Clients may still experience an aura or rhythmic muscle spasms.

Question 36

HIV

Answer 36

a viral infection that progressively destroys white blood cells known as CD4 lymphocytes. It is transmitted through exchange of bodily fluids. If left untreated, it can develop into AIDS (acquired immunodeficiency syndrome).

Question 37

decisions about delegation and assignments

Answer 37

1. the right person,
2. the right task,
3. the right circumstances,
4. the right directions and communication,
5. the right supervision and evaluation.

Question 38

Asthma Exacerbation”

Answer 38

An asthma exacerbation can indicate signs and symptoms of sinus tachycardia, hyperglycemia, and low levels of oxygen (SpO2 90% on RA). The body’s response to airway constriction, including the stress response, can cause sinus tachycardia and hyperglycemia. Lower levels of oxygen are likely the result of airway constriction.

Question 39

“Theophylline Toxicity”

Answer 39

Theophylline toxicity has several signs and symptoms including seizure activity (becoming unconscious with jerking arms and legs), sinus tachycardia 142 beats per minute, hypokalemia (K+ of 3.0), hyperglycemia (242 mg/dL), and decreased oxygenation (SpO2 90% on RA). These symptoms should be reported immediately, and emergency medical help indicated. Theophylline can result in arrhythmia and death if medical attention is not received.

Question 40

Theophylline

Answer 40

type of bronchodilator known as a xanthines and is used to treat asthma or other respiratory conditions to relieve airway constriction and promote oxygenation. The nurse recognizes that theophylline has a very narrow therapeutic index of 10-20 mcg/mL, and blood tests are required to ensure that the blood level is within a therapeutic range. Theophylline toxicity occurs with blood levels >20 mcg/mL. The nurse recognizes that symptoms of theophylline toxicity may include insomnia, restlessness, nausea, vomiting, hypotension, tachycardia, tachypnea, hypokalemia, hyperglycemia, arrhythmia, and seizures. The nurse should report any findings of potential theophylline toxicity immediately to the health care provider.

Question 41

the antidote for heparin overdose.

Answer 41

. Protamine sulfate 20 mg IV, repeat x 1 every 2 hours

Question 42

About theophylline.

Answer 42

1. Caffeinated foods and beverages can increase side effects and the risk of theophylline toxicity.
2. Theophylline blood levels should be checked at least yearly, and more should be checked if the client has symptoms or known blood level fluctuations.
   3 Chocolate and cocoa have theophylline in each and can increase levels if intake is not limited.
   4 Decreases in theophylline levels have been reported with increased charbroiled beef intake.
   5 take theophylline on an empty stomach with a full glass of water around an hour before eating or 2 hours after eating so that the medication can be absorbed more quickly.

Question 43

colostomy

Answer 43

Defined as a diversion of the colon’s effluent and it may be temporary or permanent.

Question 44

types of colostomies

Answer 44

1. Ascending
2. Descending
3. Transverse
4. Sigmoid.

Question 45

17 g polyethylene glycol

Answer 45

used to treat constipation in clients

Question 46

Triggers for Seizures”

Answer 46

emotional stress,
a 3-day fast,
and lack of sleep.

Question 47

“Ictal Phase”

Answer 47

Stiffening with jerky extremity movement. client first experiences the increased electrical activity; this electrical activity in the brain results in abnormal movement.

Question 48

Post-Ictal Phase

Answer 48

drowsiness, fatigue, and headache; clients experience fatigue after the burst of electrical activity in the brain that occurs during the ictal phase.