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COMP FINAL
COMP FINAL
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1
Pt with hx of tobacco use presents with white, thick, firmly attached lesions on tongue & oral mucosa. Nurse suspects:
Leukemia
Basal cell carcinoma
Thrush
Leukoplakia
2
Nurse teaching female menopausal pt about osteoporosis, which statement by pt would require further education?
"Menopause puts me at higher risk due to decrease in Estrogen"
"I will continue to avoid smoking as that can put me at risk"
"I will avoid weight bearing exercise during menopause to reduce fractures"
"I will supplement with Calcium and Vitamin D"
3
Testing a pt neurological assessment using Glasgow Coma scale, the nurse knows it measures these 3 categories:
Eye opening, verbal, motor
Pain, LOC, range of motion
Pain response, Balance, Motor response
vision, verbal, positioning
4
If Calcium is elevated.....
Phosphorus supplements can be given to reduce
Phosphorus should be avoided as it could cause further increase
5
Nurse caring for pt w/ hx of Malignant Hyperthermia who just had surgery with general anesthesia. Nurse will watch for:
decrease temperature, flaccid muscles
hypotension, decreased LOC
s/s of bleeding: pallor, fatigue, tachy
muscle rigidity, tachycardia
6
This type of stroke accounts for aprox 80% of all strokes:
Ischemic stroke
Hemorrhagic stroke
7
Hyperthyroid results in elevated TSH (thyroid stimulating hormone)
False
True
8
This pediatric disease is due to inadequate motility resuliting in mechanical obstruction of intestines
Celiac Disease
Hirschprung Disease
Intussusception
Pediatric Peritonitis
9
Pt with small cell lung cancer develops urinary retention and very low sodium levels. Oncologic emergency suspected:
Superior Vena Cava Syndrome
Sepsis
SIADH
Tumor Lysis syndrome
10
Which of the following is considered an
Extreme emergency
regarding aspiration of foreign body?
Lower airway
Upper airway
11
Pt taking Coumadin for congestive heart failure. Nurse understands ____is the reversal if pt is having hemorrhaging:
Platelets
Narcan
Protamine Sulfate
Vitamin K
12
Second course of chemo started during remission with intent to cure:
Induction chemo
Maintenance chemo
Re-induction chemo
Consolidation chemo
13
Post hip replacement, pt should practice rotating hip inward & outward to prevent stiffness starting 3 days post-op
True
False
14
This dysrythmia is emergency charactererized by electrical chaos resulting in death whtin 3-5 min if not corrected:
Premature Atrial Contraction
Ventricular Fibrillation
Atrial Fibrillation
Sinus Tachycardia
15
Regarding cluster headaches, what area would the nurse expect the patient to complain of the pain?
posterior head/occipital
in and around eye
temple region
forehead & cheekbones
16
What of the following is NOT TRUE statement about Sickle Cell Disease?
"Sickle cell episodes are triggered by dehydration or low oxygen perfusion"
"Sickle cell crisis can be very painful for the patient"
"sickle cell is due to 40% of Hgb is abnormal" (Hgb S)
"Sickle cell occurs most often in caucasians"
17
Type III immune complex can trigger autoimmune conditions such as Systemic Lupus Erythematosus. Some s/s associated?:
bullseye rash, flu like symptoms, joint pain
"butteryfly" rash, arthritis, kidney dysfunction
urate cyrstal deposit in joints causing pain & inflammation
18
Pt with chronic arterial disease is experiencing intermittent claudication. Appropriate interventions include all BUT:
Avoid nicotine, caffeine
Continue BP & cholesterol medications as ordered
Avoid exercising to prevent pain
Keep extremities warm
19
This viral form of hepatitis is usually spready by fecal matter and does not lead to chronic infection:
Hepatitis A
Hepatitis B
Toxic hepatitis
Hepatitis C
20
Gastric ulcers symptoms flare with food?
False
True
21
Nurse rounds on pt taking opiod meds post surgical to manage pain. Pt has RR of 7, O2 sat of 85, not arousable to voice:
Nurse will give Benadryl due to allergic reaction to opiod
Nurse will prepare to give Narcan (Naloxalone)
Nurse will prepare to give antidote of Flumazenil (romazicon)
22
Nurse caring for pt with polycythemia vera; The nurse would expect all of these findings EXCEPT:
Risk of clotting
Risk of bleeding
Elevated RBC count
Hypertension
23
Nurse making care plan for pt that has intestinal obstruction with NG tube could include all of the following EXCEPT:
Provide frequent oral care
IV fluid & electrolyte replacement
Check NG tube placement after each feeding
Irrigate NG Tube q 4hrs
24
Pt with liver disease asks " why do I need my esophogus scoped if the problem is in my liver?" Nurse response:
They will go through throat to abdomen to drain excess fluid (ascites)
Liver disease can cause enlarged veins in esophogus that could bleed
You have increased risk of stomach cancer with liver disease
The doctor examines the liver by going down throat with scope to see
25
34yr old female in clinic where provider suspects anemia. What lab value would indicate this is correct?
WBC 9,000
Albumin 3.6 g/dL
Hematocrit 43%
Hemoglobin 9.5%
26
Teaching for pt with cystic fibrosis should include all of the following instructions EXCEPT:
Increase calories including high protein & moderate fat
Avoid cough suppressants
Take pancreatic enzymes with meals
Avoid salty snacks
27
Pt with inoperable brain tumor asks for clarification on Gamma knife as treatment for her tumor. Nurse best response:
I don't know what it is, you should research online
high dose cobalt radiation to target tumor tissue
An electrical scalpel with precision tip for cutting out tumor
It is a slang term for combination chemo & radiation therapy
28
All of the following would be indicators of Leukemia EXCEPT:
blood clotting
very elevated WBC count
bruising, petichiae
decreased Hgb & Hct
29
Chronic kidney disease could lead to all of the following EXCEPT:
Low vitamin D leading to low calcium
chronic anemia
hypokalemia
poor blood pressure regulation
30
Hodgkin's lymphoma is one of the most curable types of cancer
True
False
31
Nurse caring for 12hr post-op knee replacement patient expects to see what med order to prevent DVT?
Warfarin (Coumadin) 1mg po for 7 days
Lovenox (enoxparain) sq injection daily for 10 days
Onansteron (Zofran) 8mg PO for 7 days
Furosemide (Lasix) 20mg po qam for 10 days
32
Pt in ED ruling out acute pancreatitis, the nurse would expect to see which lab order for diagnosis?
Albumin level
Amylase
Alkaline Phosphatase
Ammonia
33
Diabetes Insipidus is characterized by all of the following EXCEPT:
very dilute urine (low specific gravity)
Elevated levels of ADH
excessive urine output
Hyposecretion of ADH
34
Nurse teaching pt on Aplastic Anemia. Which statement by pt would require further teaching?
"I am at an increased risk of bleeding & bruising"
"I will be cautious to avoid infection"
"I will begin IM b12 injections for treatment"
"I will likely require blood transfusions for treatment"
35
Pt diagnosed with Left side heart failure. Nurse would expect to see all of the following findings EXCEPT:
Dyspnea with exertion
enlarged liver & spleen
Crackles in lung sounds
Cyanosis
36
Nurse educating asthma patient on Fluticasone (Flovent) inhaler. Which teaching would be INCORRECT?
This may take a couple of weeks to start working
Rinse mouth after use to prevent thrush
This is a bronchodilator to open airways in acute asthma attack
This should be taken daily as preventative treatment
37
Pt presents with SOB, low 02 sat, fatigue, crackles/wheezing in lungs. This lab value would determine CHF vs respiratory
Elevated BUN
Elevated BNP level
Elevated LDH levels
Elevated Troponin level
38
This autoimmune disease characterized by decrease ACH, muscle weakness, eyelid dropping, dysphagia, rapid onset fatigue:
Bell's Palsy
Myasthenia Gravis
Guillan-Barre Syndrome
Cerebral Palsy
39
Which lab value would indicate poor renal function?
WBC 9,000
Potassium 2.9
Creatinine 1.9
BUN 13
40
5yr old with firm, lobulated mass on left side midline abdomen and additional mild hypertension. MD might suspect___?
Pediatric Hodgkins Lymphoma
Wilms Tumor
Stage 3 stomach cancer
41
In testing a pt for deep tendon reflex the nurse notes that they are slightly exaggerated. She would document this as a
3
4
2
0
42
Nurse caring for pt post-thyroidectomy should include all of these in her care plan EXCEPT:
Assess and manage pain
throat care: soft foods, humid air, ice chips
Prepare for possible elevated calcium levels
Position pt in sem fowlers position supporting neck
43
Nurse is teaching pt on cast care. Which of the following statements by the pt requires further teaching?
"I will use a small stick to reach into cast to scratch my leg if needed"
" I will not bear weight on my cast for 48hrs"
"I will not get my cast wet"
"I will elevate move joints above & below cast daily"
44
4 types of Hypersensitivity reactions; Rash from latex allergy would be an example of:
Type I: Rapid
Type II Cytotoxic
Type IV: Delayed
Type III: Immune