Diagnostic: Endoscopic retrograde cholangiopancreatography (ERCP) - Nursing considerations

NPO 8 hrs prior; Check for gag reflex post, Keep NPO 8 hrs prior; Pancreatitis most common complication

What is a Surgical Curette?

resembles a spoon evacuator allowing for scraping motion.

The assessment step of the nursing process involves

Getting information about the resident and reviewing it

Which of the following actions by the MA demonstrates the correct use of surgical asepsis?

replacing sterile items that may have become contaminated

Why is Diagnostic Imaging important?

Determines abnormalities for Doctors to treat their patient

The order in which the nursing process is approached is:

assessment, diagnosis, planning, implementation, evaluation.

Nursing diagnosis includes:

Statement of client health status

Name a screening test used during pregnancy

Ultrasound, Nuchal translucency, Serum screening, AFP

What diagnostic test would you expect to be ordered for a Chronic Renal Failure patient?

GFR (Glomerular Filtration Rate)

What departments are in Diagnostic Imaging?

Radiology, CathLab, Interventional Radiology, CT/MRI, Radiology, Ultrasound and Nuclear Medicine, Ultrasound, Nuclear Medicine

Which nursing interventions can promote nutrition for the client with nausea?

offering small, frequent helpings of dry, bland foods

Nursing care following cardiac catheterization

Assess insertion site for hematoma

What can an amniocentesis test detect?

spina bifida, lung development, Down's syndrome

The nursing care plan is:

a written guideline for implementation and evaluation

Diagnostic: Esophagogastroduodensocopy (EGD) Nursing Interventions

NPO for 8 hrs prior; Keep NPO until gag reflex returns post

What is a surgical scrub?

removes microorganisms more effectively

Nursing Dx-altered nutrition, less than body requirements R/T anorexia, n/v. Best intervention:

Allow the child to eat any food desired and tolerated.

What can be diagnosed from a blood test in pregnancy?

Gestational diabetes, STDs (Syphillis), HIV

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CH 21-25

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Questions 84

Answers

1
Which procedure does not require surgical asepsis?
central line dressing change
surgical procedures
inserting a foley catheter
administering tube feedings
2
Which of the following requires the use of surgical asepsis?
Taking a patient's blood pressure
Insertion of sutures
Application of a bandage
Processing a PAP smear specimen
3
Diagnostic: Endoscopic retrograde cholangiopancreatography (ERCP) - Nursing considerations
NPO 8 hrs prior; Check for gag reflex post
Keep NPO 4 hrs prior: Appendicitis most common complication
Keep NPO 8 hrs prior; Pancreatitis most common complication
NPO 8-12 hrs prior; Peritonitis most common complication
4
Nursing care of the patient with varicose veins includes all of the following except:
Avoiding exercise
Avoiding prolonged standing
Wearing support hose
Losing weight
5
When establishing the chain of asepsis the instruments, surgical drapes, and gloved hands must
It doesn't matter
Always be sterile
Never be sterile
Only sort of sterile
6
Characteristics of asepsis EXCEPT...
sterile field
absence of miroorganisms
sterile equipment
basic hand hygene
7
What is a Surgical Curette?
resembles a spoon evacuator allowing for scraping motion.
Used to break away root remnants the tooth
dentist who has specialized in surgeries of the head
8
Diagnostic test measuring oxygen concentration & saturation of the blood
Serum enzymes
O2 Sat
ABG's
CKMB
9
The assessment step of the nursing process involves
Identifying health problems and resident needs
Getting information about the resident and reviewing it
Setting goals and creating a care plan
Decide if goals were met
10
A correct physical assessment starts with:
Cardiac assessment
Lung assessment
Gastrointestinal assessment
Neurological assessment
11
Which diagnostic test is used to determine bone density?
X-ray
Ultrasound
MRI
CT scan
12
Which of the following actions by the MA demonstrates the correct use of surgical asepsis?
close the exam door after setting up the sterile field
replacing sterile items that may have become contaminated
pouring liquids onto the sterile field from 20 inches above
opening sterile items with scrubbed hands
13
Why is Diagnostic Imaging important?
Imaging is just an additional way to make money
It isn't, it's actually very dangerous
Determines abnormalities for Doctors to treat their patient
It helps to heal the patient
14
The order in which the nursing process is approached is:
diagnosis, evaluation, assessment, implementation, planning.
assessment, diagnosis, planning, implementation, evaluation.
evaluation, diagnosis, planning, implementation, assessment.
planning, assessment, implementation, diagnosis, evaluation.
15
Functional assessment in the patient with problems in the vascular system includes
Asking about family hx of cardiovascular disease
Inspecting the skin for color/lesions
Performing the Allen Test
Asking about constant fatigue
16
Which is not a type of surgical gloving?
Assisted
Mechanical
Open
Closed
17
Nursing diagnosis includes:
Description of disease
Description of injury
Description of illness
Statement of client health status
18
What type of diagnostic test are used to diagnose Lupus?
Skin Biopsy
Kidney Biopsy
Physical examination of joints
Patch Test
19
Diagnostic: Percutaneous transhepatic (PTC)
NPO 4 hrs before test
NPO 8 - 12 hrs before test
NPO 1 - 4 hrs before test
NPO 8 hrs before test
20
Enteral nutrition is preferred over parenteral nutrition.
True
False
21
What is the goal of surgical asepsis?
the use of utility gloves
eliminate infection
all of the above
eliminate contamination
22
Assessing nutritional status is not a nursing function.
false
true
23
Which of these surgical instruments would require gas sterilization?
electrocautery handle
arthroscope
Metzenbaum scissors
fenestrated drape
24
Name a screening test used during pregnancy
Ultrasound
Nuchal translucency
Serum screening
AFP
25
What diagnostic test would you expect to be ordered for a Chronic Renal Failure patient?
Colonoscopy
GFR (Glomerular Filtration Rate)
Prothrombin
Mammogram
26
What departments are in Diagnostic Imaging?
Radiology, CathLab, Interventional Radiology
CT/MRI, Radiology, Ultrasound and Nuclear Medicine
Ultrasound
Nuclear Medicine
27
Which nursing interventions can promote nutrition for the client with nausea?
providing high-calorie, high-fat food and beverages
back massage
offering small, frequent helpings of dry, bland foods
administering ibuprofen as ordered
28
Which type of Diagnostic imaging are NONINVASIVE
Blood testing
CT-Scan
X-ray
MRI
29
What is NOT an example of a diagnostic test used for hypertension?
Eye exam
ECG
Taking temperature
Blood pressure measurement
30
Nursing care following cardiac catheterization
Elevate affected extremity
Assess insertion site for hematoma
Ambulate patient
Raise HOB to 45 degrees
31
The PIPP is an appropriate pain assessment tool for;
Infants
Premature infants
Cognitively impaired older adults
Children ages 2 to 8 years
32
Which of the following is prenatal diagnostic test for Down Syndrome?
alpha-fetaprotein (AFP)
chorionic villus sampling (CVS)
amniocentesis
percutaneous umbilical cord sampling (PUBS)
33
physical exam, any laboratory findings, and imaging studies
subjective
objective
assessment
plan
34
What can an amniocentesis test detect?
spina bifida
cystic fibrosis
lung development
Down's syndrome
35
Adequate nutrition is necessary for which of the following?
To maintain gastrointestinal tract integrity
All of the above
Reduce the incidence of sepsis
Reduce the length of hospitalisation
36
The nursing care plan is:
a documentation of client care
a written guideline for implementation and evaluation
a projection of potential alteration of client's behaviour
a tool to set goals and project outcomes
37
Nursing action for the pt with this EKG would be
Prepare for pacemaker insertion
Administer nitroglycerin
Initiate CPR
Apply oxygen
38
Based on Maslow’s hierarchy of needs, which nursing diagnosis should have the highest priority?
Risk for Aspiration
Disturbed Sensory Perception
Self-care Deficit
Impaired Physical Mobility
39
Diagnostic: Upper GI Series - ?
No Contrast used
Contrast used
40
What is asepsis?
Pathogens are present
Idk
Pathogens are absent
Pathogens are multipliying
41
Diagnostic: Esophagogastroduodensocopy (EGD) Nursing Interventions
NPO 4 hrs prior; Keep NPO until pt has BM post
NPO 8 - 12 hrs prior; Diet as tolerated post
NPO for 8 hrs prior; Keep NPO until gag reflex returns post
NPO 12 hrs prior; Clears only for 4 hrs post
42
Each of the following is a method of sterilization to achieve surgical asepsis except
gas processing.
dry heat.
microwaving.
steam under pressure.
43
What is a surgical scrub?
hand washing is enough
removes the oil in your hands
a top with monkeys on it
removes microorganisms more effectively
44
you are only allowed to do ONE diagnostic test for pulmonary embolism, which would you pick?
Xray
ECG
D-dimer
CT
45
Which is an example of a nursing diagnosis?
Diabetes mellitus
Impaired skin integrity
Pneumonia
Congestive heart failure
46
Nursing Dx-altered nutrition, less than body requirements R/T anorexia, n/v. Best intervention:
Restrict food brought form fast food restaurants.
Encourage a variety of large portions of food at every meal.
Allow the child to eat any food desired and tolerated.
Recommended eating the food as sibling eat at home.
47
Which assessment finding might indicate that a patient is experiencing pain?
Oxygen saturation 95%
Temperature 100.6°F
Blood pressure 160/82 mm Hg
Heart rate 80 beats/min
48
A place that can preform special diagnostic tests such as blood or urine test.
Optical center
Hospice
Laboritories
Doctor
49
Which diagnosis does a positive Barlow’s test confirm?
Club Foot
Hip Dysplasia
Heart Valve Defects
Spina Bifida
50
What can be diagnosed from a blood test in pregnancy?
Gestational diabetes
Ketones
STDs (Syphillis)
HIV
51
Diagnostic test with direct visualization of the bladder and urethra is:
Renal/bladder ultrasound
Cystoscopy
CT scan
Urinary catheterization
52
Which of the following is not included in the assessment of your patient
Observations of the nurse you are relieving
Observations of appearance and behavior
Measurements of physiologic function
Subjective report
53
Which of these technologies are NOT used for diagnostic imaging
X-ray
CT Scan
A camera
MRI
54
Parenteral nutrition refers to what?
IV nutrition
Supplementing feeds
Tube feeding
Force feeding
55
Which diagnostic test should be completed first for a pt. admitted to the ED with chest pain?
Troponin Level
CXR
ECG
CT Scan
56
Which diagnostic test would be used first to evaluate a client with upper GI bleeding?
Arteriography
Endoscopy
Hemoglobin and Hematocrit levels
Upper GI Series
57
What is the purpose of medical asepsis and surgical asepsis?
to increase the risk of the surgery
to increase the risk of the pt health
to decreasing the risk of infection
to decrease the risk of a tumor
58
Surgical asepsis procedures _____________ the presence of all microorganisms in the OR.
Remove
Reduce
Control
Eliminate
59
Diagnostic Assessments...
need to be reliable, valid, and sensitive and useful
are useful for planning differentiated instruction
All of the above
assess student's reading performance, strategies, and skills
60
A diagnostic assessment is
A post-test
A form of pre-assessment
project
An end of the term assessment
61
Name a diagnostic test
Cordocentesis testing
Amniocentesis testing
AFP testing
Chronic villus sampling
62
An EEG is a diagnostic test that measures?
electrical activity in the brain
congenital abnormalities
blood flow to the brain
CSF pressure
63
Nurse JV is performing wound care. Which of the following practices violates surgical asepsis?
Holding sterile objects above the waist
Pouring solution onto a sterile field cloth
Knowing a 1″ edge around the sterile field is contaminated
Opening the outermost flap of a package away from the body
64
Which manifestations can be caused by inadequate nutrition? SATA
Dry or brittle hair.
General weakness or impaired coordination.
Poor wound healing.
Lack of subcutaneous fat.
65
What is the first step when performing a physical assessment of the cardiovascular system?
Percussion
Auscultation
Inspection
Palpation
66
Assessment in Nursing process includes:
Utilization of systematic & ongoing process
Collecting data
Categorizing of data
recording of data
67
Diagnostic: Colonoscopy - Nursing Education
a signed permit is not necessary
one cleansing enema is necessary for preparation
light meals should be eaten for 3 days before the procedure
sedation will be used during the procedure
68
Asepsis means:
Being free of disease-producing microbes.
The process of destroying pathogens
Infection acquired after admission to a health care agency.
Clean technique.
69
What diagnostic test would confirm the diagnoses of GERD?
Lower GI series
Barium enema
Colonoscopy
Barium Swallow
70
Percussion is used during a physical exam to assess;
tissue texture
tissue turgor
tissue consistency
tissue density
71
During the assessment phase of the nursing process, the nurse
establishes a nursing diagnosis for the nursing care plan.
develops a care plan to meet the patient’s nursing needs.
gathers, organizes, & documents data in a logical database.
begins to formulate plans for providing nursing intervention
72
Which of the following is an example of surgical asepsis?
Donning personal protective equipment
Routine cleaning of equipment/surface
Handwashing
Sterile field
73
Nursing that views our mental, physical, emotional, and social aspects as interconnected
Patient-Centered
Attentive
Spiritual
Holistic
74
What is the first step in asepsis?
using PPE
sterilize instruments
cleanliness
explain the procedure to the patient
75
What is Diagnostic Imaging ?
A microscope
technology used to get medical images of inside the body
X-ray
A camera
76
The evaluation step of the nursing process involves
Identifying the health problems and resident needs
Deciding if goals were met
Setting goals and creating a care plan
Putting the care plan into action
77
The implementation step of the nursing process involves
Deciding if goals were met
Identifying the health problems and resident needs
Putting the care plan into action
Setting goals and creating a care plan
78
The diagnosis step of the nursing process involves
Putting the care plan into action
Getting information about the resident and reviewing it
Deciding if goals were met
Identifying health problems and resident needs
79
The purpose of obtaining a nursing history is to
Focus on objective physical data specific to the patient
Identify actual and potential nursing diagnoses
Minimize the time required to establish a nursing diagnosis
Assist the physician to establish a medical diagnosis
80
What is the Gold Standard diagnostic test for gonorrhea and chlamydia?
Urine NAAT
Pelvic Ultrasound
Vagina/Penile swab and culture
History
81
What diagnostic test is most commonly used to positively diagnose RSV?
Chest radiograph
Stool Sample
Blood test
Nasal-pharyngeal washings
82
A head to toe assessment at the beginning of a shift is considered a/an:
Focused assessment
Initial assessment
Special needs assessment
Ongoing assessment
83
Diagnostic: Lower GI series- ?
Contrast
No Contrast
84
An electroencephalogram (EEG) is a diagnostic test that measures
electrical activity in the brain
congenital abnormalities
blood flow to the brain
cerebrospinal fluid pressure

CH 21-25 Flashcards | StudBud