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Nursing Theory Exam 1 Review Flashcards | StudBud
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Nursing Theory Exam 1 Review
Nursing Theory Exam 1 Review
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1
82y/o F pt presents to ED c/o abd cramps, weakness, and diarrhea for 2-4wks. What kind of diarrhea is she experiencing?
Acute
Chronic
Persistent
Malabsorptive
2
55y/o male pt has CT scan of the abd w/ contrast. Results were + for diverticulitis. What symptoms do you expect?
N/V
Hypoactive bowel sounds in two quadrants.
Bouts of constipation w/ hard narrow stool that's difficult to pass
LLQ pain "spasms"
Afebrile
3
When should the nurse intervene when a pt has signs and symptoms of post-op nausea?
After giving the next dose of pain medications
At the pt's first repost of nausea
After calling to verify with anesthesia when the last antiemetic was given
Wait until the pt actually vomits
4
Your pt is admitted w/ chronic constipation. After many unsuccessful interventions the HCP orders what osmotic laxative?
Bisacodyl
Polyethylene glycol and electrolytes
Docusate
Magnesium hydroxide
5
A 65 y/o pt is being tx for
hypervolemia
from fluid overload. What are the clinical manifestations expected in this pt?
Hypotension
Crackles
Bradycardia
Hypertension
Decreased urine output
Bounding heart rate
6
A pt is admitted w/ CHF. What would you expect to find during your admission assessment?
Bradycardia and pitting edema in the lower extremities
Increased BP and crackles throughout the lungs
Decreased JVD
Dry mucous membranes
7
You have a 20 y/o pt w/ symptoms of sudden onset epigastric pain, N/V. What is your next priority while getting a hx?
Ask about cancer history
Obtain PQRST history of pain
Color, amount, consistency of emesis
Ask about last food/liquid/medications ingested
8
A patient who is allergic to latex might also have an allergy to bananas
True
False
9
Can 3rd space fluid shifts lead to hypovolemia?
False
True
10
The most characteristic manifestation of hypocalcemia & hypomagnesemia is:
Tetany
Constipation
Lack of coordination
Anorexia and nausea
11
Droplet precautions include wearing a face mask, but the door can stay open. Transmission is limited to close contact
True
False
12
Your pt has Peptic Ulcer Dz. You know the most common site is:
Jejunum
Duodenum
Pylorus
Gastric fundus
13
The circulating nurse is
responsible
for monitoring the surgical team.
False
True
14
Pt w/ PMH of RF w/ weakness & abd cramps. Labs: Na= 139, K+ 6.1, Cl=101, Mg=1.7, Ca=102. What is going ON?!
Hypokalemia
Hyperkalemia
Hypernatremia
Hypermagnesemia
15
After change of shift report, which pt should you assess first?
Serum phos of 4.8 who has multiple soft tissue calcium-phos precipitates
Serum Na+ of 150 who has a dry mouth & is asking for water
Serum magnesium of 1.1 who has tremors and hyperactive DTR
Serum K+ of 5.2 who is complaining of abdominal cramping
16
During administration of a hypertonic IV solution, the mechanism involved in equalizing the fluid concentration is:
Active transport
Diffusion
Facilitated diffusion
Osmosis
17
You walk into your pt w/ a PEG tube's rm to find them supine. Their spO2 is 89% on RA & the pt is coughing. You should:
Check tube placement
Check for working suction
Sit the patient up at least 30 degrees
Call the provider-- the patient is CODING!!
18
Which pt is at risk for experiencing a FVD? The patient:
All of these
Who has been vomiting & have diarrhea for 2 days?
With continuous NG suction?
With an abdominal wound vac at intermittent suction?
None of these
19
What can we do for the previous patient?
Administer Kayexalate (1st)
Ambulate the patient to alleviate the pain
Put them on cardiac monitoring
Administer Ca++ and/or IV insulin & D50 (if needed)
20
What interprofessional care would we anticipate for our pt??
Administer any PRN antipyretics
Anticipate IVF therapy to replace her K+
To address her hyperkalemia, anticipate potassium supplementation
Daily I&Os and a daily wt
Assess her BMP
21
A pt arrives for dialysis & is unresponsive to questions & has decreased DTR. They have taken Maalox. What do you do?
Teach the patient about magnesium-containing antacids
Notfy the patient's health care provider
Review the last Magnesium level on the patient's chart
Obtain an order to draw a K+ level
22
What conditions might lead to the development of hypovolemia?
Nausea/Vomiting
Gastric Suction
Constipation
Burns
Excess IV fluids
Blood loss
23
What is the most important thing to remember when your patient is on the operating table?
The floor is not an appropriate place for patients
They are strapped in for the ride
The patient should stay on the table
Empty choice
24
What are some of the 1st s/s your pt is going into septic shock from peritonitis?
Depends on their insurance.
Hypotension
Clammy (diaphoretic)
Tachycardia
25
What is colonization?
Microorganisms present without host interference or interaction
The infected host displays a decline in wellness caused by the infection
Indicates host interaction with the organism
None of these
26
What are some red flags about our pt??
She hasn't been taking her potassium supplementation
She recently has a "stomach flu" (gastritis) with V/D
She's taking her furosemide that promotes fluid loss AND K+
She's just so adorable! She brought the unit cookies!
27
What additional dx test is indicated and why??
An EGG
An EGD
An EEG
An EKG
28
Newly dx pt w/ IBS requires further teaching when they state which of the following?
"If I'm constipated, I'm not having a flare up of IBS"
"I should keep a food diary for 1-2 wks to correlate food w/ my symptoms"
"I need to make sure I get at least 8hrs of uninterrupted sleep."
"I need to make an appointment with my therapist"
29
You are caring for a pt dx w/ hypovolemic hyponatremia. Which IVF should you anticipate?
3% NS (always)
D5W
D5 1/2 NS
0.9% NS
30
You provide D/C instructions to a pt dx with ESRD. You explain the pt is @ risk for hypernatremia. You report what CM?
Weight gain of 3 lb in 1 day
Nausea for one day
Single episode of diarrhea
Feeling of euphoria
31
What is the possible pathophysiologic cause of our pt's muscle weakness and dizziness??
Their K+ level of 5.1
Their K+ level of 3.0
32
CDC: responsible for monitoring endemic & epidemic dz, recommend strategies, & guidelines to reduce risk of dz to pts
True
False
33
You are caring for a pt after an EGD. What is your priority assessment upon their return to your unit?
Thorough abdominal assessment
Ask if pt is passing gas
Check gag reflex
Obtain VS
34
A 55 y/o male pt has returned to your unit post colonoscopy. What
symptom
would you report to the GI doc on call?
Abdominal cramping
Passing a lot of gas
Rectal bleeding
Sleepiness and forgetfulness
35
A carrier is a person who provides living conditions to support a microorganism.
True
False
36
Voluntary & written
informed consent
from the pt is necessary before non-emergent sx can be performed solely to protect:
The hospital from anti-kickback allegations
The family members in a wrongful death lawsuit
The surgeon from claims of unauthorized operation or battery
The patient from unsanctioned surgery
37
The most common site for diverticulitis is the ileum?
True
False
38
The primary nursing goal in the immediate postop period is maintenance of pulmonary fxn and prevention of laryngospasm
False
True
39
An older woman is admitted to the Med Surg unit w/ GI bleeding. Clinical manifestations would include:
JVD
Weight loss
Increased central venous pressure
Full bounding pulse
40
What are some interventions for the previous pt?
Add KCl supplements
Decrease loop diuretics
Push K+ as fast as you can!
Monitor I&Os, labs, and ask if N/V/D
Add protein to their diet
Give KCl IV or PO
41
What
other
symptoms is our pt having that are related to
hypokalemia
?
K+ levels don't affect peristalsis
Constipation
Abdominal distention
42
A 77y/o pt prescribed furosemide 40mg PO for tx of CHF. You teach the pt to observe what signs of K+ imbalance?
Confusion, agitation, muscle twitching
Increased BP and HR, constipation
General muscle weakness, constipation, weak thready pulse
Muscle twitches, diarrhea, increased GI motility
43
You have an A/O older adult pt w/ a hx of dehydration. What instruction should you give this pt r/t fluid intake?
"If you feel confused, you need more to drink"
Drink more fluids in the late evening hours"
"More fluids are needed if you feel thirsty"
"Increase fluids if your mouth feels dry"
44
What organ the surgeon mistakenly take out?
Brains!!!!!
Liver
Spleen
Gallbladder
45
A pt is receiving IVF post-op following cardiac sx. What assessment should focus on which post-op complication?
Fluid volume deficit
Liver failure
Fluid volume excess
Seizure activity
46
A pt w/ fluid overload has been taking a diuretic for 2 days & now experiences changes. Which change shows it's working?
0800 FSBS decreases from 142 to 110
Respiratory rate decreases from 20 to 16
HR decreases from 80 to 72
Weight loss of six pounds
47
A pt w/ an NG c/o muscle weakness & leg cramps. PVCs noted. Labs: Na 142, K+ 2.9, Cl 101, Mg 1.9, Ca 9.3. What?!
Hypokalemia
Hyperkalemia
48
The nurse is preparing to administer a premedication of morphine. Which action should be taken
first
?
Have the family present
Ensure the preoperative shave is completed
Make sure the patient is covered with a warm blankie
Have the patient void
49
Through which route are inhaled general anesthetics primarily eliminated?
Lungs
Skin
Liver
Kidneys
50
Which one of the listed intraoperative complications are the
most severe
and why?
Anaphylaxis
Hypothermia
Anesthesia awareness
Malignant hyperthermia
N/V
Hypoxia
51
What are the major differences between hypovolemia and third-space fluid shift?
In 3rd spacing fluid loss cannot be detected by a decrease in patient wt
In 3rd spacing interstitial fluid is forced into the intravascular space.
In hypovolemia fluid is forced into the intravascular space
In hypovolemia fluid loss can be detected by an increase in patient weight
52
Which of the following occurs during the inflammatory stage of wound healing?
Blood clot forms
Fibroblasts leave the wound
Tensile strength increases
Granulation tissue forms
53
What medication classification
must
be assessed during pre-op period d/t an electrolyte imbalance risk during sx?
Insulin
Corticosteroids
Diuretics
Phenothiazines
54
What are some additional signs and symptoms we should assess for our dear pt?
Urine output
Capillary refill
Yes.
The most right answer would be...
Obtain a weight
Evaluate skin turgor
