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VN 22 Med Surg 1 > VN 22 Mid Term > Flashcards

VN 22 Mid Term Flashcards

1
Q

What is a characteristic of atherosclerosis?

-Fatty deposits in the lumen of arteries
-Emboli in the veins
-Cholesterol plugs in the lumen of veins
-Blood clots in the arteries

A

Fatty deposits in the lumen of arteries

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2
Q

What is an appropriate nursing action when evaluating a client with coronary artery disease?

-Assess the skin of the client.
-Assess the characteristics of chest pain.
-Assess for any kind of drug abuse.
-Assess the client’s mental and emotional status.

A

Assess the characteristics of chest pain.

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3
Q

When assessing a client with a deep vein thrombosis, what would be most important to
assess for?

-Capillary refill of extremity
-Mottled coloring of leg and foot
-Leg pain and swollen calf
-Chest pain and dyspnea

A

Chest pain and dyspnea

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4
Q

What finding indicates a possible deep vein thrombosis?

-Pain in the calf
-Inability to sit up
-Negative Homan’s sign
-Pain in the toes

A

Pain in the calf

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5
Q

What is the definition of Arteriosclerosis?

-Arteriosclerosis is a loss of elasticity, or hardening of the arteries, that happens as we
age.
-Atherosclerosis is a loss of elasticity, or hardening of the arteries, that happens as we
age.
-Atherosclerosis is a formation of clots in the inner lining of the arteries.
-Arteriosclerosis is a formation of clots in the inner lining of the arteries.

A

Arteriosclerosis is a loss of elasticity, or hardening of the arteries, that happens as we
age

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6
Q

Which of the following medications would the nurse expect the physician to order for a
client with hypothyroidism?

-Propylthiouracil
-Propranolol
-Methimazole
-Levothyroxine

A

Levothyroxine

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7
Q

A client has just been diagnosed with prehypertension. What would the nurse instruct this
client to do to restore his blood pressure below hypertensive levels?

-Avoid salt substitutes
-Decrease sodium intake
-Increase fluid intake
-Increase iodine intake

A

Decrease sodium intake

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8
Q

A nurse is caring for a client who walks into the clinic and is exhibiting symptoms of
tachypnea and circumoral parasthesia. What should be the nurse’s first course of action?

-Turn off the mechanical ventilator
-Determine and correct the cause of tachypnea
-Initiate CPR
-Check for a DNR status

A

Determine and correct the cause of tachypnea

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9
Q

What effect should a nurse carefully monitor for in a client who has been using non-narcotic
analgesics daily over an extended period?

-Hypothyroidism
-Cardiac disorders
-Gastrointestinal bleeding
-Urinary tract infection

A

Gastrointestinal bleeding

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10
Q

A client is found to be unresponsive and hypoglycemic with a blood sugar of 30mg/dL. What
would the nurse expect the provider to order first?

-Order a urinalysis for the presence of sugar and acetone.
-Order 50% glucose IV to be given immediately.
-Administer orange juice
-Order 1000 mL D5W at 50mL/hr.

A

Order 50% glucose IV to be given immediately.

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11
Q

A nurse is collecting data from a client who has diabetic ketoacidosis and ketones in the
urine. The nurse should expect which of the following findings? Select all that apply

-Hunger
-Abdominal pain
-Fruity odor of breath
-Weight gain
-Kussmaul respirations

A

Hunger, Abdominal pain, Fruity odor of breath, and Kussmaul respiration

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12
Q

Which food or beverage items listed below are good sources of Potassium? Select all that
apply

-Orange juice
-Cantaloupe
-Yogurt
-Bananas
-Apples

A

Orange juice, Cantaloupe, Yogurt, and Banana

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13
Q

A client with type 1 diabetes is to receive a short-acting insulin and an intermediate-acting
insulin subcutaneously before breakfast. The nurse would administer the insulin at which site
as the preferred site?

-Anterior deltoid
-Upper abdomen
-Dorsal gluteal
-Vasts lateralus

A

Upper abdomen

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14
Q

A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse
expects that this test will determine what?

-The concentration of a substance in plasma
-The client’s digoxin level
-The functioning of endocrine glands
-Details about the size of the organ and its location

A

The functioning of endocrine glands

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15
Q

A nurse is collecting data from a client who recently began taking levothyroxine to treat
hypothyroidism. Which of the following findings should indicate to the nurse that the client
might need a decrease in dosage of this medication?

-Slow speech
-Bradycardia
-Hand tremors
-Pallor

A

Hand tremors

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16
Q

Hypertension places a client at risk for heart disease and heart failure. The nurse knows that
which complication is also at risk?

-Potential for liver cirrhosis and liver failure
-Potential for blindness and Retinopathy
-Risk for hypernatremia
-Secondary hypertension

A

Potential for blindness and Retinopathy

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17
Q

A client has been taking Milk of magnesium (magnesium hydroxide) for many days because of
gastric discomfort. The nurse knows the client has hypermagnesemia because of which
symptoms?

-Bradycardia and hypotension
-Shivering and hypertension
-Tachycardia and muscle cramping
-Hyperventilation and Insomnia

A

Bradycardia and hypotension

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18
Q

A nurse is reviewing the medication administration record of a client who has acute adrenal
insufficiency (Addison’s Disease) and hyperkalemia. Which of the following prescriptions
should the nurse expect to be ordered? Select all that apply?

-IV fluids with 0.9% NS sodium chloride
-Florine sodium succinate (Dexamethasone)
-Sodium polystyrene sulfonate (Kayexalalate)
-Spironolactone (Aldactone)
-Regular insulin

A

-IV fluids with 0.9% NS sodium chloride
-Florine sodium succinate (Dexamethasone)
-Sodium polystyrene sulfonate (Kayexalalate)

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19
Q

A nurse suspects a client is experiencing hypercalcemia. The lab results return and show the
calcium level is 12mg/dL. What signs lead the nurse to suspect the client is experiencing
hyperalcemia? Select all that apply

-Constipation
-Weight gain
-Pathologic fractures
-Deep bone pain
-Decreased memory & attention span (Change in mentation)

A

-Constipation
-Pathological fractures
-Deep bone pain
-Decreased memory & attention span (Change in mentation)

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20
Q

What is a normal Calcium level?

-1-4
-9-11
-5-8
-15-20

A

9-11

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21
Q

A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes,
decreased urine output, fever and a rough tongue. Serum sodium level is above 149 mEq/L
Should the nurse start salt tablets when caring for this client?

-Yes, along with the hypotonic IV fluid.
-No, start with 0.9% Normal Saline IV fluid.
-No, sodium intake should be restricted.
-Yes, this will correct the sodium deficit.

A

No, sodium intake should be restricted.

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22
Q

You are caring for a new client on your unit who is third-spacing fluid. You know to assess for
what type of edema?

-Pitting
-Bulging
-Generalized
-Dependent

A

Generalized

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23
Q

Your client has a diagnosis of hypervolemia. What would be an important intervention that a
nurse should initiate?

-Give medications that promote fluid retention.
-Teach client behaviors that decrease urination.
-Assess for dehydration.
-Limit sodium and water intake.

A

Limit sodium and water intake.

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24
Q

The Cardiac Nurse Clinician is teaching a group of clients with heart failure about self-
management of their disease. What dietary advice should the Nurse Clinician give to clients
with severe heart failure until edema resolves?

-Encourage increased intake of canned soups.
-Avoid the intake of fresh fruit and fruit juices.
-Encourage increased intake of vegetable flavored crackers.
-Avoid the intake of processed and commercially prepared foods.

A

Avoid the intake of processed and commercially prepared foods.

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25
Q

A nurse is correct in identifying which nursing considerations when administering an ACE
Inhibitor (Captopril) to a client? Select all that apply

-Client’s with diabetes taking an ACE Inhibitor should monitor closely for hypoglycemia
-ACE Inhibitors can have an interaction with the herbal supplement St. John’s Wort
-Generic names for ACE Inhibitors end in the suffix PRIL
-ACE Inhibitors may cause dizziness and a dry cough
-Generic names for ACE Inhibitors end in the suffix daPINE

A

-Client’s with diabetes taking an ACE Inhibitor should monitor closely for
hypoglycemia
-ACE Inhibitors can have an interaction with the herbal supplement St. John’s
-Generic names for ACE Inhibitors end in the suffix PRIL
-ACE Inhibitors may cause dizziness and a dry cough

26
Q

A nurse is assisting with teaching a client who has a new diagnosis of severe peripheral
arterial disease (PAD). Which of the following instructions should the nurse include?

-Wear tightly-fitted insulated socks with shoes when going outside
-Apply a heating pad to both legs for comfort
-Place both legs in a dependent position while sleeping
-Elevate both legs above the level of the heart

A

Place both legs in a dependent position while sleeping

27
Q

The nurse is educating a client with hypertension on a new prescription of eplerenone. What
nutritional recommendations would the nurse include in the teaching for this medication?

-Consume green leafy vegetables including spinach and kale
-Peanut butter and prune sandwiches
-Dried beans, peas and lentils are a good source of calcium
-Avoid potatoes and tomato soup

A

Avoid potatoes and tomato soup

28
Q

Which of the following nursing diagnoses would be most appropriate for the client with
Hypothyroidism?

-Altered thought process r/t increased neurologic function
-Altered growth & development r/t increased Growth Hormone production
-Fluid volume deficit r/t polyuria
-Hypothermia r/t decreased metabolic rate

A

Hypothermia r/t decreased metabolic rate

29
Q

What client education should be given to a client who was newly diagnosed with venous
insufficiency?

-Hot morning showers are recommended
-Wearing sandals during the summer is recommended
-Elevate the feet to promote venous circulation
-Avoid leg exercises or ROM

A

Elevate the feet to promote venous circulation

30
Q

A nurse is assisting with a community education program on recommended lifestyle changes
to prevent angina and myocardial infarction. Which of the following changes should the
nurse recommend be made first?

-Diet modifications
-Stopping smoking, vaping or any nicotine products
-Relaxation exercises
-Taking Omega-3 supplements

A

Stopping smoking, vaping or any nicotine products

31
Q

A client who was on IV Prednisone (Solumedrol) is now being discharged from the hospital
with a new prescription for oral dexamethasone. The provider’s order advises to gradually
taper the doses down. What complication might occur if the client stops taking the
prednisone abruptly?

-Stevens-Johnson syndrome
-Acromegaly
-Addisonian crisis
-Cushing’s syndrome

A

Addisonian crisis

32
Q

A client has been diagnosed with hyperthyroidism. Which of the following medications would
the nurse anticipate the provider to order for this client? Select all that apply

-Methamazole
-Synthroid
-Propranolol
-Adderall
-Levothyroxine

A

-Methamazole
-Prpranolol

33
Q

A nurse is collecting data from a client who has hyperKalemia. The nurse should identify
which conditions as being associated with this electrolyte imbalance?

-Heart failure
-Thyroidectomy
-Cushing’s syndrome
-Diabetic Ketoacidosis

A

Diabetic Ketoacidosis

34
Q

Which of the following specific drugs may contribute to malignant hypertension? Select all
that apply

-Acetaminophen
-Oral contraceptives
-Cocaine
-Amphetamines
-MAOIs

A

-Oral contraceptive
-Cocaine
-Amphetamines
-MAOIs

35
Q

A nurse is caring for a client who has nasogastric tube attached to low intermittent suction.
The nurse should monitor for which of the following electrolyte imbalance?

-Hyperkalemia
-Hypercalcemia
-Hypermagnesemia
-Hypokalemia

A

-Hypokalemia

36
Q

A nurse is caring for a client with a serum calcium level of 8.0mg/dL. The nurse performs
the Chvostek and Trousseau assessment and determines that both of these are positive.
What condition does the nurse suspect this client has?

-Hypernatremia
-Hypocalcemia
-Hypermagnesemia
-Hyperemesis gravidarum

A

-Hypocalcemia

37
Q

A nurse should assess for which of the following clinical manifestations in the client with
Cushing’s syndrome?

-Unexplained weight gain, energy loss and cold intolerance
-Water retention, moon faced, hirsutism and purple striae
-Tetany, irritability, dry skin and seizures
-Hypertension, nausea and vomiting

A

-Water retention, moon faced, hirsutism and purple striae

38
Q

What is the most common cause of an Ml?

-Arterioclerosis
-Coronary Thrombosis
-Stroke
-Venous Stasis

A

-Coronary Thrombosis

39
Q

What signs and symptoms should a nurse know that clients with suspected right-sided heart
failure may experience?

-Increased cardiac output
-Increased urine output
-Gradual, unexplained weight gain
-Sudden unexplained weight loss

A

-Gradual, unexplained weight gain

40
Q

What should nursing students be taught is the reason for heart failure?

-The heart cannot pump sufficient blood to meet the body’s metabolic needs.
-The heart is pumping too fast to adequately meet the body’s metabolic needs.
-The heart is fibrillating.
-The heart is pumping too slow to disseminate nutrients to the body.

A

-The heart cannot pump sufficient blood to meet the body’s metabolic needs

41
Q

The nurse is providing information about foot care to a client with diabetes. Which of the
following would the nurse include?

-“Wear well-fitting comfortable rubber shoes.”
-“Use a razor to remove corns or calluses.”
-“Be sure to apply a moisturizer to feet daily.”
-“Wash your feet in hot water every day.”

A

-“Be sure to apply a moisturizer to feet daily.”

42
Q

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic
complications. Which suggestion would be most important?

-Take the antidiabetic drugs regularly.
-Maintaining blood glucose levels within normal limits.
-Drink plenty of fluids, juices and smoothies.
-Eat a high-fiber, high-calorie diet.

A

-Maintaining blood glucose levels within normal limits.

43
Q

A nurse is reinforcing discharge instructions with a client who has diabetic ketoacidosis.
Which of the following information should the nurse include about PREVENTING DKA?
Select all that apply

-Notify the provider when blood glucose is 200mg/dL
-Report ketones in the urine after 24 hours of illness
-Administer insulin as prescribed when ill
-Monitor blood glucose closely when ill
-Drink 2L of fluids daily

A

-Report ketones in the urine after 24 hours of illness
-Administer insulin as prescribed when ill
-Monitor blood glucose closely when ill
-Drink 2L of fluids daily

44
Q

When administering insulin to a client with type I diabetes, which would be most important
for the nurse to keep in mind for insulin administration? (Select all that apply)

-Type of insulin administered
-Amount of air to withdraw from the insulin vial
-Size of the filter needle to use
-Duration of the insulin
-Accuracy of the dosage

A

-Type of insulin administered
-Duration of the insulin
-Accuracy of the dosage

45
Q

the following clients, the one who is at the greatest risk for developing fluid volume
deficit is a(an)?

-82 year old woman with heart failure
-23 year old man exercising vigorously
-71 year old man unconscious and on tube feeding
-34 year old woman on diuretic therapy

A

71 year old man unconscious and on tube feeding

46
Q

A nurse is reviewing the manifestations of hyperthyroidism with a client. Which of the
following findings should the nurse include? Select all that apply

-Anorexia
-Constipation
-Weight loss
-Heat intolerance
-Bradycardia

A

-Weight loss
-Heat intolerance

47
Q

A client is to begin taking metformin after being diagnosed with Type II diabetes. How does
metformin lower blood glucose levels?

-By lowering glucose production in the liver
-By increasing insulin release from the pancreas
-It increases the amount of glucose the body absorbs from the foods you eat
-It decreases the body’s sensitivity to insulin

A

-By lowering glucose production in the liver

48
Q

A nurse is contributing to the plan of care for a client who has just been diagnosed with an
aneurysm. What advice should the nurse provide to this client?

-Avoid straining during bowel movements and coughing.
-Minimize all bowel movements
-Wear wool socks and mittens during cold weather.
-Avoid situations that contribute to ischemic episodes.

A

Avoid straining during bowel movements and coughing.

49
Q

What nursing intervention should a student nurse perform to ensure that the client does not
suffer any injury due to a client recently diagnosed with hypertension?

-Monitor postural changes and measure orthostatic BP.
-Monitor the client’s BP every 5 minutes.
-Assess the client’s Intake & output
-Monitor the client’s positioning when sleeping.

A

-Monitor postural changes and measure orthostatic BP.

50
Q

What type of fluid is used to replace circulating blood?

-Hypotonic solutions
-Colloid solutions
-Crystalloid solutions
-Hypertonic solutions

A

-Colloid solution

51
Q

A nurse is discussing heart failure to a local community group. What would the nurse explain
is the major cause of right-sided heart failure?

-Left-sided heart failure
-Renal failure
-Pulmonary hypotension
-Arterial insufficiency

A

-Left-sided heart failure

52
Q

You are caring for a client that has been admitted with a possible clotting disorder. The client
is complaining of excessive bleeding and bruising without cause. You know that you should
take extra care to check for signs of bruising or bleeding in what condition?

-Hypomagnesemia
-Hypocalcemia
-Dehydration
-Hypokalemia

A

-Hypocalcemia

53
Q

A nurse is collecting data from a client who is suspected of having an endocrine disorder and
is scheduled for diagnostic testing that involves the use of a contrast medium. The nurse
would inform the physician if the client stated which of the following?

-“I have an allergy to iodine.”
-“I take a multivitamin every day.”
-“My father had diabetes when he got older.”
-“Years ago, I took a dexamethasone for my asthma.”

A

“I have an allergy to iodine.”

54
Q

You are caring for a client who is NPO and is going into surgery. What solution is
administered to maintain fluid balance when a client is unable to eat or drink temporarily?

-Colloid solution
-Isotonic solution
-Hypotonic solution
-Hypertonic solution

A

Isotonic solution

55
Q

When assessing your client, you note a blood pressure (BP) of 205/115. The client has had
BP’s within normal limits up until this time. The client complains of a sudden onset severe
headache. The nurse recognizes this as probable Malignant Hypertension. What would be
the nurse’s first action?

-Wait 45 minutes and reassess the vital signs.
-Give the prescribed thrombolytic.
-Notify the physician immediately.
-Call a code blue and begin CPR

A

Notify the physician immediately

56
Q

What should a nurse ask a client with heart failure to assess for nocturnal dyspnea?

-Asking the client if they have an Advanced Directive
-Asking how many pillows the client normally uses for sleep
-Asking about the client’s diet
-Asking the client about recent bruising or bleeding

A

Asking how many pillows the client normally uses for sleep

57
Q

Why would it be important for a nurse to closely monitor an older adult receiving a cardiac
glycoside for cardiac disorders?

-Older adults are at increased risk for cardiac arrests.
-Older adults are at increased risk for digoxin toxicity.
-Older adults are at increased risk for asthma.
-Older adults are at increased risk for hyperthyroidism.

A

-Older adults are at increased risk for digoxin toxicity.

58
Q

What is an appropriate nursing action when assessing a client at risk for a deep vein
thrombosis?

-Examine the extremities and assess skin color, capillary refill time, and tissue integrity.
-Examine the extremities for skin lesions.
-Examine the client’s mental and emotional status.
-Examine for pain around the shoulder and neck region.

A

-Examine the extremities and assess skin color, capillary refill time, and tissue integrity.

59
Q

A provider has ordered IV fluids of normal saline to be hung at 100mL/hr. You know that this
is what type of IV solution?

-Hypertonic
-Crystalloid
-Colloid
-Hypotonic

A

Crystalloid

60
Q

What condition is the most common fluid imbalance in older adults?

-Fluid volume excess
-Dehydration
-Hypervolemia
-Hypovolemia

A

-Dehydration

61
Q

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the
nurse expect to administer intravenously?

-Lente
-NPH
-Lispro
-Regular

A

-Regular

VN 22 Med Surg 1 (14 decks)

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