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NUR 198 Final Reveiw Flashcards | StudBud
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NUR 198 Final Reveiw
NUR 198 Final Reveiw
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1
Venous blood flow issue—what leg signs?
Cyanosis
Greenish skin
Pallor
Brown skin, turns blue when dependent
2
Hypothyroid patient is cold, confused— Number one concern?
Respiratory failure
Cardiac failure
Myxedema coma
Thyroid storm
3
Endocrine hormone regulation—how does it work?
Glands grouped
Each respond to multiple stimuli
Negative feedback
All work independently
4
Which patient is priority?
Stable angina with chest pain
Raynaud's with numbness in fingers
Asthma pt with 95% O2 sats
Aneurysm with sudden back pain
5
Dark stool in leukemia—what now?
Collect a stool specimen
Ask if this is normal for them
Document finding
Notify Dr
6
What do gonadocorticoids affect?
Libido
Estrogen balance
Glucose production
Sodium retention
7
Post radial cardiac cath—activity level?
Bedrest with HOB elevated
Chair after 4 hrs
Flat bedrest 4 hrs
Up as tolerated
8
How to check if iron supplements are working?
Electrolytes and BUN
APTT & PT
Hgb and Hct
WBC and platelets
9
Apical pulse 54 for digoxin—what to do?
Give med
Give atropine
Count for 1 full min
Hold med
10
A patient is prescribed to receive two units of packed red blood cells (PRBCs). What action should the nurse take?
Give antihistamine
Monitor for Hypothermia
Stay with the pt for the 1st 5 mins
Assess Vital Signs
11
Endocrine system exam—what to include?
Look for facial buffalo hump
Check height, weight, and VS
Check abdomen for pancreas
Palpate thyroid
12
Highest heart failure (HF) risk group?
Asian male
Black female
Hispanic female
White male
13
K level 4.6 before Lasix—what should the nurse do?
Hold the med
Wait till after the next blood draw
Call the Dr
Give the medicine
14
Chest pressure “like someone standing on me”—first action?
Notify Dr
Give Nitro
Check pt's vitals
Order ECG
15
GH deficiency—what should the nurse do?
Offer emotional support
Teach weight loss strategies
Monitor cholesterol
Watch for stroke signs
16
3rd-degree block HR 45—what’s pacing heart?
SA node
Aortic valve
Ventricles
AV node
17
BP 118/60—how to document?
Hypotensive
Stage 1 HTN
Elevated BP
BP WNL
18
Best care after transsphenoidal pituitary surgery?
Change packing daily
Irrigate nose
Use stool softeners
Encourage coughing
19
Iron-deficiency anemia—what to teach?
Report nausea/constipation
Cluster activities
Take with meals
Stop when feeling better
20
Diet advice for atherosclerosis?
Eat more cholesterol
Choose low-fat foods
Eat more potassium
Cut carbs
21
What increases risk for PACs?
Tachycardia + video games
Smoking + digoxin
A flutter + hiccups
Alcohol + scary movies
22
Aortic regurgitation—what meds are expected?
Diuretics & vasodilators
Oxygen & inotropes
Antihypertensives & anticoagulants
Fluids & volume expanders
23
Buerger disease—what lifestyle change is key?
Low-fat diet
Stress reduction
avoid caffeine
Quit smoking
24
Post-MI: when can patient resume sex?
In 1-2 months
In 1-2 weeks
No sex-life after an MI
Immediately as long as they have nitro available
25
Taking digoxin—what finding needs HCP call?
Slightly elevated BP
Ankle pain
Blurred vision
80 mL urine in an hour
26
After AAA repair, which finding is urgent?
Temp 98.9 °F
Increased abdominal girth
Urine output 60 ml/hr
Pain level 5
27
CML patient—what should the nurse monitor?
Urine output
Tarry stools
Lung sounds
Vitals every shift
28
BP is 120/80 mm Hg—what should the nurse do?
Call the DR
Document as normal
Give IV fluids
Recommend Salt-free diet
29
Diabetic diet teaching for multicultural group—what to include?
Culturally sensitive food options
Standard diabetic diet
Snacks
Sugar free foods are okay
30
DASH diet—what shows poor understanding?
Uses 1 tsp canola oil to prepare food
Ate fish for dinner
Ate beans 4 x's this week
Had a hamburger and fries
31
Hyperosmolar hyperglycemia—priority care?
Check for illness
Rehydrate
Monitor BG
Assess age changes
32
Warm, swollen arm with tenderness—likely cause?
Bug bite
BP cuff
Tight clothing
IV therapy
33
Pericarditis—what type of med is expected?
Calcium channel blocker
Antihypertensive
Anti-inflammatory
Beta blocker
34
Folic acid anemia—what to ask?
Alcohol use
Do you smoke
Consume a vegan diet
Take any herbals
35
Therapeutic INR for warfarin?
4.0-5.0
1.0-2.0
2.0-3.0
3.0-4.0
36
What to do when a Holter monitor event happens?
Notify Dr
Call 911
Take radial pulse
Press event button
37
Low molecular weight heparin-what labs to monitor?
Platelets
Heparin antifactor Xa
Troponins
Hgb & Hct
38
Aplastic anemia—what does bone marrow look like?
Pale and fatty
Pink and watery
Red and gelatinous
Thin and bloody
39
What hormone affects glucose?
Aldosterone
PTH
TSH
Cortisol
40
Syndrome of inappropriate antidiuretic hormone—what condition may cause it?
Congestive heart failure
Lung cancer
Diabetes inipidus
Kidney failure
41
CLL patient has bruising, gum bleeding, back pain—cause?
DIC
Sickle cell crisis
Thrombocytopenia
Pancytopenia
42
Post-op bedrest patient suddenly has dyspnea & fear—what's your first action?
Give narcotics
Call the Dr
Check vitals
Auscultate lungs
43
24-hour urine test—what’s incorrect?
Test ends with last void
Keep first morning sample
Restart if missed
Collect after each void
44
Polycythemia vera—expected treatment?
Vitamin B12 injections
Therapeutic phlebotomy
Heat/cold
Splenectomy
45
Severe HTN, palpitations, sweating—what to ask?
When is the last time you've been to the Dr
Are you feeling anxious?
What's your normal BP?
Do you have a headache?
46
Which patient is at highest risk for developing heart failure (HF)
A Hispanic female
A White Male
An Asian male
A Black female
47
Best test to monitor diabetes control?
Fasting BG
Hgb A1C
Glucose tolerance
Random BG
48
Stage 1 Hodgkin disease—where are swollen lymph nodes?
In neck only
On both sides of diaphragm
above and below diaphragm
All over body
49
Why use insulin before surgery in type 2 DM?
Insulin always needed after surgery
BG must be kept low
Surgery raises BG through stress
Insulin prevents infection
50
Hemophilia + pain—what action?
Desmopressin
Give opioids, avoid IM injections if possible
Teach signs of bleeding
Refer for support
51
Hemolytic anemia cause?
Malformed RBC's
Low B12
RBC destruction
Immature RBC's
52
Why take antibiotics before dental surgery with valve disorder?
Prevent heart infection
Prevent pneumonia
Prevent fever
Prevent incision infection
53
Sickle cell crisis—priority assessment?
Last BM
Skin temp
Neuro status
Urine output
54
Main factor in cardiovascular disease?
Drug use
Genetics
Lifestyle
Culture
55
Before haning blood What action should the nurse take?
Monitor for hypothermia
Obtain VS
Stay with the pt for at least 5 mins
Administer antihistamines
56
Cushing syndrome—what to monitor?
Check for bronze skin
Encourage fluids
Give insulin
Watch for low BP when standing up
57
Giving enoxaparin (Lovenox)—what’s the correct action?
Use iodine to clean injection site
Inject at a 10 ° angle
Give in the gluteal muscle
Leave air bubble in syringe
58
After a transesophageal echocardiogram. Which action should the nurse take?
Hold fluids for 2 hrs after procedure
Keep NPO until gag reflex returns
Force 1000ml of fluid/hr
Encourage fluids
59
What to avoid when taking glyburide?
Skipping meals
Alcohol
Birth control
Contrast dye
60
Secondary hypertension from adrenal tumor—treatment?
Treat cause
Remove kidney and adrenal glands
High-dose BP meds
Hormone replacement
61
Post-cardiac cath via femoral—what should nurse do?
Walk in 2 hrs
Encourage fluids
Bend knees 30°
Apply light dressing
62
Which lab value needs attention?
WBC 4,500
Hgb 13.4
Platelets 200k
RBC 2.4 million
63
BP still high after 6 months of meds—what to ask?
How much do you sleep?
Are you taking your meds?
What's your pharmacy?
How much do you drink?
64
What to do for red, swollen calf with fever?
Use compression
Apply ice
Measure both calves
Massage calf
65
Taking metformin—what extra lab to monitor?
Urine blood
Lipids
CBC
Kidney function
66
Who’s at highest risk for HTN?
51 y/o female truck driver with no family hx
43 y/o mom who drinks a beer every weekend
31 y/o female smoker with no family hx of HTN
40 y/o man with family hx of HTN
67
Athlete’s heart rate—what is expected?
Bradycardia
Tachycardia
Hypotension
Orthostatic hypotension
68
Mitral stenosis—what is most concerning?
Murmur
Right hand weakness
Coughing up blood
Palpitations
69
Ventricular fibrillation—what’s the emergency action?
Defibrillation
Cadioversion
Intubation
Start Compressions
70
New HTN patient says meds are too expensive—what to do?
Give samples
Refer to support group
Refer for financial assistance
Watch BP closely
71
Patient has speech issues, headaches—what test besides CT?
ACTH
Growth hormone
ADH
TSH
72
Potassium 6.4 mEq/L—what symptom is likely?
High BP
Strong pulse
Slow, irregular HR
Constipation
73
V-fib patient—what lab value expected?
K+ 6.8
Mg 1.7
Na 140
Ca 9.1
74
Chronic venous insufficiency—what skin change?
No pedal pulse
Leathery, brown skin
Pale skin
Weak pedal pulse
75
Aortic regurgitation—what shows care was effective?
Quit gardening
Resumed daily & social activities
Needed help with ADL's
Discharged home with palliative care
76
Type 1 DM marathon runner—what to teach?
Carb up before running
Avoid exercise
Time with insulin peak
Carry emergency glucose
77
Which patient needs to be seen first?
Sudden confusion
Urine output 50 mL/hr
Elevated BNP
Sodium 137
78
Post-MVA, chest hit steering wheel—what is most concerning?
Pain on expiration
Jugular vein distension
Crackles
S3 heart sound
79
How do oral diabetes meds work in type 2 DM?
Works like insulin
Replaces insuline
Stimulates pancreas
Used with ketoacidosis
80
Venous stasis ulcers—what to do?
Bedrest with bathroom privledges only
keep legs elevated on a pillow
Encourage ambulation and compression devices
Encourage fluids
81
AAA patient—what activity shows understanding?
Restarting marathon training
Using a motorized scooter to get around
Walking 20 mins every other day
Returning to stocking job
82
The nurse is caring for a patient with pernicious anemia. Which deficiency is this patient experiencing?
Vitamin K
Vitamin D
Vitamin B12
Vitamin C
83
Who’s at highest risk for dialysis?
Older adult with type 2 & HTN
African American with controlled BG
Asian with type 1 and stable BG
Non-Hispanic type 1
84
Frequent hyperglycemia—what might be cause?
Busy job
Exercise increase
Swapping cookies for bread
Diet isn't filling
85
DVT prevention—what’s best practice?
Compression while in bed
Combination of heparin and compression
Daily low molecular weight heparin
Thigh-high stockings
86
Pink, frothy sputum—what to do?
Notify Dr
Document finding
Encourage fluids
Encourage ambulation
87
PVCs—what lifestyle change is most important?
Cut back exercise
Watch for weight gain
Eat low-fat diet
Avoid caffeine & alcohol
88
Post-hypophysectomy—what should be reported?
Hgb 13.2
800 mL urine in 3 hrs
Urine specific gravity 1.20
Pain 5/10
89
What lab finding is expected in COPD with hypoxia?
CLL
Secondary polycythemia
Polycythemia Vera
DIC
90
Type 1 DM education—what shows poor understanding?
Risk of ketoacidosis
Viral trigger
Family history
Weight loss will reduce insulin need
91
Addison’s discharge teaching—what’s most important?
Eat balanced meals
Check BG levels
Increase steroids with stress
Exercise daily
92
PVCs—what symptom to monitor?
🔘 Headache 🔘 Disorientation ✅ Dizziness 🔘 Tingling
Tingling of fingers
Headache
Disorientation
Dizziness
93
An S3 heart sound may mean what?
Liver failure
Crohn's disease
Asthma
Fluid overload
94
Suspected thyroid masses—what test is likely the first to be done?
Radioactive iodine test
Thyroid scan
Ultrasound
PET scan
95
Which valve patient risks fluid overload?
68 y/o female on digoxin
44 y/o male on amoxicillin
27 y/o male on atenolol
18 y/o female on warfarin
96
What is a hypertensive emergency?
A small stroke
Fast heart rate
Heart pumping poorly
Very high BP episode
97
When to check for hypoglycemia after regular insulin?
12 hrs
2 hrs
30 min
4 hrs
98
Which patient should be seen first?
Spironolactone pt, K+ 4.8
Atenolol pt BP 188/114
Metoprolol pt BP 126/74
Lasix pt with increased urine output
99
ITP patient—what should be avoided?
Gardening
Electric razor
Church
Flu vaccine
100
Adrenal crisis—most likely trigger?
Job loss
Slow paced walking daily
Fatty diet
Too much Tylenol
101
Older adult lacks energy—best nurse reply?
Low PTH causes fatigue
Metabolic rate slows with age
Maybe diabetes
GH increases with age
102
Before giving atenolol, HR is 55 bpm—what now?
Recheck in 8 hrs
Give med
Notify DR
Give 1/2 dose
103
INR 2× normal on warfarin—bleeding? Give what?
Lidocaine
Adenosine
Vitamin K
Atropine
104
HR 102, PR 0.16, QRS 0.06—what’s rhythm?
Normal sinus
A-fib
Sinus Tach
Atrial flutter
105
Which BP patient is the priority?
170/80 with a mild headache
180/120 with no symptoms
140/70 with a nosebleed
150/60 and anxious
106
Which telemetry patient needs attention first?
HR 55, sinus brady
A-fib with shortness of breath
Asymptomatic PAC's
HR 108, sinus tach
107
Which valve patient is the priority?
Awaiting an echo for aortic regurgitation
Post-op valve surgery with pain a 9/10
Endocarditis on IV antibiotics
Myocarditis with a temp of 99.1 ° F
108
Atherosclerosis can be defined as?
Flaccid arteries
Narrowing of the arteries
Protrusion of the arteries
Hardening of the arteries
109
12-year-old in 5th height percentile—what’s likely prescribed?
Wait until age 18
Leg-lengthening surgery
Growth hormone
Test adrenal gland
110
Why stop warfarin before surgery?
Causes nausea
Causes high BP
Increases risks of bleeding
Interacts with anesthesia
111
P wave on ECG shows what?
Atrial depolarization
Ventricular depolarization
Atrial repolarization
Ventricular repolarization
112
Early sign of AAA?
Pulsating abdominal mass
Nausea and feeling of fullness
Sudden back pain
Vomiting
113
Clotting disorder from low factors—what to give?
Albumin
Fresh frozen plasma
Platelets
Cryoprecipitates
114
Suppression test—how to explain?
Use epinephrine
Low cortisol = failure
Inject stimulant
Give seroid to suppress cortisol
115
What’s expected with a posterior pituitary tumor?
Low sodium
High BP
Fluid overload
Increased urine output
116
Shallow to deep breathing, then apnea—what is this?
Cheyne-stokes respirations
Kussmaul breathing
Orthopnea
Exertional dyspnea
117
Pacemaker in right chest—what statement is correct?
Move arm freely
Report increased pain or redness
Back to gym tomorrow
Resume activity normal
118
Patient says no-salt diet will fix hypertension. Response?
BP may still be high without salt
I will just take more of my diuretic
Salt causes most hypertension
Salt incrases BP
119
Heart failure lung sounds-what to expect?
Rub
Stridor
Crackles
Rhonchi
120
Peripheral neuropathy in DM—what to teach?
Wear loose shoes
Check feet daily
Soak in hot water
Use lotion all over feet
121
Pancreas endocrine function—what does it secrete?
Amylase
Bile
Lipase
Glucogon
122
What causes type 1 diabetes?
Insulin helps digestion
Tissues resist insulin
Pancreas makes no insulin
Reversed with diet/exercise
123
What’s expected after thyroid needle biopsy?
Pain 2/10
Moderate bleeding
02 sat of 90%
Trouble swallowing
124
Diabetes insipidus—what shows treatment worked?
Blood glucose down
K+ up
Ketones gone
Normal urine specific gravity
125
Digoxin toxicity—watch for which rhythm?
Ventricular tachycardia
Atrial fibrillation
Ventricular fibrillation
Atrial flutter
126
Iron-deficiency anemia—what helps iron absorption?
Green veggies
Citrus Fruits
Vitamin D
Yogurt
127
HR 120 bpm pt is symptomatic —what is the best nursing intervention?
Document the finding
Have pt cough
Turn the patient
Recheck HR in 15 min
128
New admission with crackles—what lab is most concerning?
TSH low
BUN high
Na normal
BNP elevated
129
Which med should be reported before cardiac surgery?
Carvedilol
Metformin
Furosemide
Asprin
130
Ongoing hypoglycemia in type 1 DM—best monitoring?
Before meals
Check urine ketones
Every 3 hours
Continuous monitoring
131
Hypoglycemia—what does pancreas do?
Inhibits insulin
Releases glucagon
Decreases insulin
Moves glucose
132
Pink, frothy sputum—indicates what?
Pneumonia
H-pylori
Liver failure
Heart failure
133
Telemetry shows asystole—first action?
Call the DR
Document rhythm
Prepare adenosine
Start CPR
134
Post-cardiac cath—leg cool & dusky. What now?
Elevate the leg
apply warm compress
Document the findings
Notify the DR
135
Pericarditis patient has low BP, confusion—what next?
Myectomy
Start antibiotics
Start Labetalol drip
Prepare for a pericardiocentesis
136
Post-thyroidectomy: numb mouth & twitching—give what?
Calcium gluconate
Sodium bicarbonate
Iodine
Potassium chloride
137
Nailbed angle >180°, feels spongy. What is it?
Severe clubbing
COPD
Mild clubbing
Normal nails
138
Common finding with chronic venous disease?
Ankle swelling
Hard nodules
Spider veins
Purple lesions
139
HTN urgency—when should follow-up be?
Within a few days
Within a week
In the next month
Within 24 hrs
140
Mitral valve prolapse—what shows poor understanding?
I can still practice yoga
I must avoid any activity
I'll quit drinking coffee
I'll eat a well balanced diet
141
Multiple myeloma—what lab to monitor?
Sodium
Calcium
Potassium
Magnesium
142
After lymphangiography, why is urine blue?
Diet contains too much artificial dyes
Means results are abnormal
Dye used causes blue urine for up to 2 days
Notify DR
143
Lymph node infection—what to do first?
Apply ice
Start antibiotics
Keep arm below level of the heart
Intubate
144
Chest pain 4/10—how to give nitroglycerin?
1-3 tabs every 3 mins
2 tabs every 3 hrs
1 tab every 2 mins
1 tab every 5 mins, up to 3 times
145
The pt has suffered a myocardial infarction, the elevation of which laboratory value supports this finding?
Amylase
Troponin
Glucose
Ammonia
146
SA and AV node damaged—bundle of His takes over. HR?
40-60 bpm
10-20 bpm
20-35 bpm
80-100 bpm
147
Aortic stenosis patient has severe dyspnea. First action?
Raise HOB
Place O2 on
Take vitals
Give Nitro
148
Thyroidectomy: 104°F, HR 144, BP 184/108—expect?
Epinephrine
Aspirin
Beta blocker + cooling blanket
Benadryl
149
Thrombocytopenia—what to give?
RBC's
Fresh frozen plasma
Albumin
Platelets
150
Hgb <6—what symptoms?
Jaundice, bone pain
Mild palpitations
Petechiae, restlessness
Fatigue, dyspnea, tachycardia
151
Most obvious sign of adrenal insufficiency?
Tachycardia
Dehydration only
High BP
Bronze skin
152
Post bone marrow biopsy, BP drops—first action?
Check CBC
Review meds
Ask about dizziness
Check biopsy site
153
Water deprivation test—what confirms diabetes insipidus?
Weight loss + dilute urine
Stable weight
No voiding
High specific gravity
154
Hyperthyroidism symptoms?
Depression
Confusion & vision changes
Tremors & nervousness
Psychosis & Mania
155
What causes pernicious anemia?
Low B12 intake
Low kidney hormones
Low iron intake
No intrinsic factor