When is the preop phase?

Begins with the decision to proceed with surgery and ends with OR bed

What is the difference between cardioversion and defibrillation?

The timing of the delivery of the electrical current.

What is the cardiac bundle in the correct order?

SA node, AV node, bundle of His, purkinje fibers

Select All: Acute pancreatitis interventions:

Encourage cough and deep breathing, IV pain medications, NPO

How to prevent drug-induced hepatitis, most important medication education?

Follow instructions on the labels for OTC meds (take as directed)

Belching, reflux, dysphagia, vomiting

For a patient with chronic constipation, what should we recommend?

Increased fluids and fiber every day

Select All: What are the causes of dysrhythmias?

Stress, alcohol, caffeine, smoking, exercising, obesity, Infection, electrolyte imbalance, sleep apnea, hypertension

What is important to educate on status post MI?

To recognize cardiac s/s, diet, exercise, monitoring, and life changes

What is included in Hepatitis B prevention? (Select All)

Immunizations (vaccines), Standard precautions

If a patient with skin a graft that is blue, what is the priority action?

Notify the surgeon or health care provider

What is important for a pt and family to understand regarding a cardiac event?

Be able to recognize symptoms and respond appropriately

Select All: What is important diuretic (furosemide) education?

Increase water intake, Get up slowly from sitting or standing, Increase potassium in diet

With decreased cardiac output, what should the nurse prioritize in assessing for?

Reduced LOC and decreased oxygen saturation

What is the best way to prevent post-op blood clots?

Early ambulation as often as possible

Patient with PAD teaching plan?

Keep extremities in neutral or dependent position (DANGLE)

If a patient has a large abdomen, jaundice, and malaise, what question is important to ask?

How many drinks of alcohol per day/week?

A patient has an upper GI bleed due to gastritis and has been bleeding. What s/s should we assess for?

Tachycardia, tachypnea, hypotension

How would you explain a peptic ulcer?

It is an erosion of the stomach lining

What is the best way to prevent esophageal cancer?

Early detection and having hx of GERD

What is the sequence of bowel assessments for a nurse, in order?

Inspection, auscultation, palpation

The nurse is educating the client about their of first-degree AV block. The nurse should educate on what?

Regular visits with the doctors/ECGs

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MS2: Midterm Review

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Questions 159

Answers

1
When is the preop phase?
After surgery
Begins with the decision to proceed with surgery and ends with OR bed
At home
During surgery
2
What is the best nursing diagnosis for Raynaud's?
Ineffective tissue perfusion
Impaired body temperature
Ineffective breathing pattern
Impaired mobility
3
What is normal aging process for the hepatic function?
Poor nutrition
Decrease in liver size
Cysts
Increase in liver size
4
What is the difference between cardioversion and defibrillation?
The timing of the delivery of the electrical current.
P wave
T wave
The QRS wave
5
Med is running 265 ml for 2 hrs. Order is to infuse 85/ml. How much will you inform the next nurse is left?
95 ml
40 ml
20 ml
600 ml
6
What is the cardiac bundle in the correct order?
AV node, bundle of His, SA node, purkinje fibers
AV node, SA node, bundle of His, purkinje fibers
AV node, SA node
SA node, AV node, bundle of His, purkinje fibers
7
Orthostatic hypotension patients are at increased risk for what?
Falls
Diarrhea
High cholesterol
Hypertension
8
Select All: Acute pancreatitis interventions:
Encourage cough and deep breathing
IV pain medications
NPO
Bland diet
9
Why is it important to always report bowel changes?
Blood in stool
Sepsis
Indicator of colon cancer
Weight loss
10
91-year-old women lives alone. What should the nurse be aware of when providing information to this client?
Home environment
Independence
Needing a walker
What resources are available
11
Excess abdominal fat puts patients at increased risk for cardiovascular disease
True
False
12
After auscultation in a patient’s abdomen and hearing only 2 sounds in 2 mins, what is this considered?
Hyperactive bowel sounds
Hypoactive bowel sounds
Constant
Absent
13
Select All: In the PACU after general anesthesia, as the nurse, our main concerns are:
RR
BP
LOC
Pain level
14
How to prevent drug-induced hepatitis, most important medication education?
Do not take medications at bedtime
Avoid alcohol
Follow instructions on the labels for OTC meds (take as directed)
Drink more water
15
If a patient has a heart block, what do they need?
ECG
Medications
Pacemaker
Water
16
Hiatal hernia s/s:
Dizziness and abdominal pain
Fever
Diarrhea and vomiting
Belching, reflux, dysphagia, vomiting
17
For a patient with chronic constipation, what should we recommend?
Increased fluids and fiber every day
Increase protein in diet
Decrease exercise
Take more naps
18
Low BP and weak/rapid pulse can indicate what?
Hypovolemic shock
Dementia
A-Fib
Stroke
19
Patient with a new pacer, what do you assess for?
Blood pressure
Temperature
HR and Rhythm
Rhythm
20
If you have a patient on TPN, what is the priority action for patients with blurry vision and increased thirst?
Check vital signs
Assess bowel sounds
Draw labs
Check blood sugars (glucose)
21
Select All: What are the causes of dysrhythmias?
Stress, alcohol, caffeine, smoking, exercising, obesity
Infection, electrolyte imbalance, sleep apnea, hypertension
Good sleep hygiene
Healthy diet
22
What is important to educate on status post MI?
ECG monitoring
Diet
Regular visits
To recognize cardiac s/s, diet, exercise, monitoring, and life changes
23
What is included in Hepatitis B prevention? (Select All)
Avoid smoking
Immunizations (vaccines)
Standard precautions
Avoid sexual contact
24
If a patient with skin a graft that is blue, what is the priority action?
Skin assessment
Use antibiotic ointment
Notify the surgeon or health care provider
Check vital signs
25
A patient with Atrial Fibrillation is at increased risk for stroke
True
False
26
Patient dx with hernia, what is the best education will help with regurgitation and GERD?
Lay down after meals
Eat small meals
Eat 3 large meals a day
Avoid spicy foods
27
Heart disease contributes to increased cardiac output
False
True
28
What to do to help with esophageal reflux disease?
Eat spicy foods
Drink plenty of water
Avoid carbonated drinks
Increase salt in diet
29
Peptic ulcer disease and presented in severe distress what assessment finding would the nurse to suspect perforation?
Constipation
Diarrhea
Soft abdomen
Rigid board-like abdomen
30
What is important for a pt and family to understand regarding a cardiac event?
Be able to recognize symptoms and respond appropriately
They are doing to die
Drink more water
That it can be treated at home
31
Always ask patients about herbal remedies or supplements they may be taking
True
False
32
Select All: What is important diuretic (furosemide) education?
Increase water intake
Eat small meals throughout the day
Get up slowly from sitting or standing
Increase potassium in diet
33
The nurse's main priority when prepping for surgery is making sure the consent is signed.
True
False
34
With decreased cardiac output, what should the nurse prioritize in assessing for?
Reduced LOC and decreased oxygen saturation
Temperature
Blood pressure
HR and Blood pressure
35
What is the best way to prevent post-op blood clots?
Rest
Healthy diet
Increased water intake
Early ambulation as often as possible
36
Patient with PAD teaching plan?
Keep extremities in neutral or dependent position (DANGLE)
Compression stockings
Elevate the legs
Increase fluid intake
37
If a patient has a large abdomen, jaundice, and malaise, what question is important to ask?
How much water do you drink?
How many drinks of alcohol per day/week?
How much fat do you consume in your diet?
How much caffeine do you drink?
38
IF A PT HAS A RIGID-LIKE ABDOMEN THAT COULD INDICATE WHAT?
GERD
Gastritis
Perforated ulcer
Blood clot
39
A patient has an upper GI bleed due to gastritis and has been bleeding. What s/s should we assess for?
Hypotension and nausea
Tachycardia, tachypnea, hypotension
Hypertension and tachycardia
Bradycardia and hypertension
40
Order is to give 50 ml, 60 ml, 25 ml of diff meds every hour. What is the total amount of ml infused in 12 hours?
1620 ml
1720 ml
135 ml
700 ml
41
What is an important dietary restriction recommendation with a patient who has ascites?
Decrease sugar intake
Reduce fluids
Sodium restriction
Increase salt in diet
42
(FILL IN THE BLANK) V-fib strip, what is the priority action?
Call the Doctor
Check vital signs
Initiate CPR, call a code.
Check pulse
43
What does the lab test troponin check for?
SOB
Chest pain
MI (heart attack)
Stroke
44
Second Intension refers to healing of an open wound, by laying down new tissue and healing on it's own.
True
False
45
High LDL and Low HDL=
Hypertension
Indicator of CAD
Stroke
MI
46
If a patient has a behavior/cognitive change when they have cirrhosis what could cause this?
Hepatic encephalopathy
Obesity
Low blood pressure
Poor fluid intake
47
What is the most important barium enema education?
Exercise
Hydration
Rest
Low salt diet
48
How would you explain a peptic ulcer?
When the stomach lining thins out
It is an erosion of the stomach lining
Build of acid reflux
A hole in stomach
49
What is the best way to prevent esophageal cancer?
GERD
Dysphagia
EGD
Early detection and having hx of GERD
50
What is the sequence of bowel assessments for a nurse, in order?
Inspection, auscultation, percussion, palpation
Inspection, auscultation, palpation
Palpation, percussion, inspection
Inspection, auscultation, percussion
51
The nurse is educating the client about their of first-degree AV block. The nurse should educate on what?
Healthy diet
Regular visits with the doctors/ECGs
Drinking more fluids
Increase exercise
52
If standing someone for the 1st time after surgery, let them sit for a few min, then stand for 2 min before ambulating.
False
True
53
HIV reproduction education:
Have sex frequently
Don't have children
Breastfeed
Do not breastfeed
54
Select all: What is considered in a Nutrition Assessment?
Clinical exam findings (lab)
Dietary data
BMI
Coping strategies
55
What does a low HR contribute to?
Hypertension
Bradycardia
Decrease in cardiac output
Increase in cardiac output
56
For a patient with advanced cirrhosis, what do we need to assess for 1st?
Abdominal girth
Variceal bleeding
Weight
LOC
57
What is important education for varicose veins?
Important to walk for 30 minutes each day to promote circulation.
ECG
Compression hose
Regular visits
58
What is an oral cancer characteristic in the early stage?
Painless sore with raised edges
Bleeding
Painful sore
Bad breath
59
What is the primary pacemaker for myocardium?
Sinoatrial node (SA node)
AV node
Bundle of His
Conduction
60
What is the pumping action of the heart?
Ventricles
Pulse
Myocardium
Atrium
61
HIV; CD4 count, how many cells?
284
200
184
900
62
What is a nursing diagnosis for Achalasia (difficulty swallowing/dysphagia)?
Imbalance of electrolytes
Altered mental status
Risk for injury
Risk for aspiration/impaired nutrition
63
Select All: What are risk factors for a peptic ulcer?
Alcohol
Smoking
NSAIDs
H. Pylori
64
If a patient has an audible S3, who is most likely at high risk?
CHF patient
Elderly
Infant
Men
65
What is important to know for angina pain?
Chest pain with activity and goes away with rest
comes and goes
Chest pain at rest
go the ER
66
Select All: What are examples of modifiable RF?
DM2
Diet
Hypertension
Obesity
67
When to start health nutrition habits?
Newborn
Adolescents (teen years)
Toddler
Elderly
68
What is the best position for a patient undergoing a colonoscopy?
Lay on the right side
Lay on left side with knees tucked into chest
Lay on the left side with legs straight
Prone
69
What is a sign of lower GI bleed (large intestine)?
Yellow stool
Black tarry stool
Bright red (frank) blood in stool
Vomiting
70
How to count the pulse on a ECG strip?
Subtract the squares
Count many accelerations there are
Multiply the squares by 100
# of big squares between the R & R, divide by 300. Don't count the 1st one.
71
Select All: What are electrolyte examples?
Chloride
Potassium
Sodium
Glucose
72
Select all: Why would a patient need a nutrition assessment?
Lost 20 pounds in the last 5 months
They can't afford glasses
Depression
Widow
73
If a patient is on narcotics or drugs, their pain tolerance will be affected
True
False
74
Select All: Following surgery, we need to watch for what?
Bleeding/hemorrhage
Pneumonia
Atelectasis
Hypertension
75
Select All: What causes gastritis?
Alcohol use
Having children
NSAIDs (ibuprofen/aspirin)
Old age
76
If a patient has a new stoma 2 days post-op and is beefy red with scant bleeding, what do you do?
Wipe it clean
Administer antibiotics
Document the findings as this is a normal finding
Call a code
77
Select All: What are things that can interfere with wound healing?
Poor diet, hypertension, hyperlipidemia
Diabetes, Stress, Nutritional deficient, Alcohol abuse, Cushing disease
Smoking
Diabetes and stress
78
What is the primary goal for a patient with Atrial-fibrillation in regards to provider tx?
Prevent Stroke
Control the BP
Healthy diet
Control the v rate and prevent stroke
79
A patient presents with GI bleed and are experiencing hematemesis, hematuria, and hematochezia, what do we do 1st?
Notify the doctor
Call a code
Give medications
Check vital signs
80
What is a nursing diagnosis for orthostatic hypotension?
High risk for falls related to orthostatic hypotension
Risk for low blood counts
Impaired mental status
Impaired LOC related to orthostatic hypotension
81
If you notice an abnormal rhythm on a tele-strip while at the nurses station, what do you do 1st?
Give the medication
Check vitals
Assess the pt and check leads
Call a code
82
Order is 50 ml to be infused over 30 min, how many ml in 1 hr?
100 ml
25 ml
50 ml
200 ml
83
When is the best time to educate a patient that will be undergoing a surgical procedure?
Pre-op period
Intra-op period
Post-op period
At home
84
If urine output is 20 ml/hr, what should you do 1st?
Straight cath
Nothing, document it
Vital signs
Notify the doctor
85
What does a BNP lab level test for?
CKD
Low sodium
Low Potassium
Heart failure
86
Why do we assess and ask questions?
To see if the patient is having a good day
We are curious
It is easy to do
It is the best care to determine the diagnosis/cause
87
If a patient is diabetic and having surgery, what will we check diligently during surgery?
Blood sugars
Temperature
Pulse
Blood pressure
88
What does the QRS complex represent?
Ventricular repolarization
Ventricular depolarization
P wave
Portal Hypertension
89
Important use of oral airway note:
Do not remove oral airway device until evidence of gag reflex returns
Wait 48 hours to remove it
Remove it right away
Wait 24 hours to remove it
90
What is the most important post-op consideration with a patient who recently had an EGD?
Monitor LOC
Need to be NPO until gag reflex returns
Check vital signs every 2 hours
Exercise
91
Order for amoxicillin 50 mg every 8 hours, on hand 125/5ml, how many ml will you give with each dose?
6 ml
4 ml
2 ml
1 ml
92
What is Intermittent claudication?
Poor blood flow in legs, PAD pain that goes away with rest.
Edema in the legs
Pain in the legs that goes away with exercise
Pain in just one leg
93
IV potassium of 1% g with 600 ml to be infused over 4 hrs. What's the infusion rate?
100 ml/hr
50 ml/hr
25 ml/hr
150 ml/hr
94
For a patient who is being treated with lactulose due to hepatitis encephalopathy, what is important for their bowels?
Constipation
Hyperactive bowel sounds
Make sure they have 2-3 soft stools per day
Watery stool
95
Constipation after 1 day is not normal
False
True
96
What is important for atrial fibrillation?
Control BP
Control ventricular heart rate
Regulate oxygen levels
Monitor LOC
97
A client with cholecystitis is scheduled to have cholecystectomy why is this method performed by surgeons?
Need to be NPO
Invasive
Long procedure
Fewer risks than open
98
Coronary care unit, v-fib, what is the 1st action?
Defibrillation
Initiate cardiopulmonary resuscitation (CPR).
Call a code
Vital signs
99
What type of an aneurysm is the worst?
Fusiform
Leg
Saccular
Abdominal
100
A high or low BMI leads to what?
Mortality (death)
High blood sugar
Tremor
Decreased LOC
101
Primary wound healing=occurs when a clean laceration/surgical incision is closed w/ sutures, steri strips or adhesive
False
True
102
What is INR therapuetic level?
1-3
3-4
2-4
2-3
103
When is the post-operative phase?
Before surgery
Begins w/ admission of pt to PACU and ends with F/U eval at home/clinic
During surgery
Begins when the pt is transferred to the OR bed and ends with admin to PACU
104
What is the best discharge teaching for venous insufficiency?
Elevate legs
Exercise
Reduce sodium intake
How to put on TEDs correctly and wear them daily
105
If a patient has had PUD and perforated ulcer that is left untreated, what can happen?
Vomiting
Diarrhea
Perionitis
GI bleed
106
12 lead ECG and prepping the skin for a client with a lot of chest hair, what should you do?
Do it over the hair
Dump water on them
Clip/shave the chest hair
Call the doctor
107
Regarding venous insufficiency (PVD), what is the most important intervention?
TED/compression hose that are worn properly
Elevate legs
Exercise
Increase water intake
108
If a patient has PUD and we do an EGD, what are we testing for?
Giardia
Cancer
C-diff
H. Pylori
109
What is the priority nursing action after patient has had neck dissection surgery for oropharyngeal caner?
Maintain patent airway
Give analgesics
Early ambulation
NPO
110
Patient is about to undergo a procedure in the endoscopy department to evaluate colon polyps. What procedure is this?
EGD
Cholecystectomy
Colonoscopy
Transplant
111
If a patient states their duodenal pain goes away after eating, what would you suspect this is?
Hiatal hernia
Abdominal cancer
Duodenal ulcer
GERD
112
Select All: What do we need to know/assess for a patient with leg ulcers?
Location and pain
Comparision of pulses
Comparison of temperature
Mobility limitations
113
Barrett’s esophagus diagnosis education:
NPO
Drink plenty of fluids
Eat small meals
Be sure to have regular endoscopic surveillance/screenings
114
Post cardiac surgery, what is important to watch for?
Pulse
Bleeding/hematoma at the site
Diarrhea
Vomiting
115
Who is high risk for HIV?
LGTB youth
Men
Women
Elderly
116
Ventricular Depolarization=
P wave
T wave
Bundle of His
QRS
117
Why is the prognosis not good for oral cancer?
Often detected too late
It is detected too soon
Slow growing
It is aggressive
118
Order for 500 ml to infuse over 90 minutes, how many ml/hr?
333 ml/hr
5 ml/hr
555 ml/hr
10 ml/hr
119
Select All: What are the contributing factors for obesity?
Genetics/family history
Activity level
Endocrine/diabetes
Coping strategies
120
Patient is pulseless with v-tach, what do you do 1st?
Call the HCP
Find help
Initiate CPR, chest compressions, and defibrillation.
Check the MAR
121
You have a client with liver failure, he has an increased risk for bleeding. What factor contributes to this?
Low platelet count
Increase in Vitamin K production
Inability of the liver to use Vitamin K
Low INR
122
It is important to always check the ______ for bleeding with a hospitalized post-op patient.
Wound site
Mouth
Eyes
Anus
123
Select All: How to treat PUD?
Exercise
Sucralfate (carafate)
Antibiotics
PPI
124
What can propranolol cause?
Chest pain
Bronchoconstriction and wheezing
Wheezing
SOB
125
What is/are a possible side effect for Nitro?
Abdominal pain
dizziness
Throbbing headache and dizziness
Vomiting
126
Major symptoms of chronic pancreatitis?
Recurrent attacks and severe abdominal/back pain
Vomiting
Leg pain
Fever
127
What is stroke volume?
Amount of blood flow
Amount of blood ejected with each heart beat
Volume of blood in the body
How many strokes someone has had
128
Who explains and discusses the informed consent with the patient?
Nurse
Receptionist
Doctor/Surgeon
Radiologist
129
Tertiary Intention (third intention), what is it?
Completion of the healing
Delayed primary closure, healing from inside out
Open wound
Healing process
130
Why do we start with an Ultrasound?
More radiation
Fast
Easy to do
Safe and poses no health risks
131
What is the most important for assessing bowel sounds?
Auscultating bowel sounds in all 4 quadrants
Palpation
Inspection
Percussion in all 4 bowel sounds
132
Select All: Nurse is evaluating a patient's diagnosis of arterial insufficiency. What does good blood flow depend on?
Efficiency of heart as a pump
Patency and responsiveness of the blood vessels
Normal vital signs
Adequacy of circulating blood volume
133
What is the arterial plaque made of?
Protein
Fat
Trypsin
Lipids and fibrous tissue
134
What is the best CAD treatment?
Medications
Quit smoking (smoking cessation) and diet therapy
Increase water
More exercise
135
If a patient is having a procedure that will result in blood loss, what will we check prior to surgery?
Blood type
Vital signs
LOC
Blood pressure
136
Dx of acute myocardial infarction, sinus bradycardia 6 to 8 PVCs/min. What is the pattern?
Flatline
Wide, distorted QRS complex
No P wave
Short QRS
137
What is the term for a patient with tremors/flapping in their hands due to hepatic encephalopathy?
Cirrhosis
Achalasia
Asterixis
GERD
138
A patient with a 3rd-degree heart block, what do they need long term?
Defibrillation
CPR
Pacemaker--fewer QRS complexes than P waves.
Blood thinner
139
Select All: What are the digestive enzymes located in the pancreas?
Trypsin
Lipase
Protein
Amylase
140
Patient with sudden onset calf pain, warmth and redness, what possible dx do we need to notify the Dr of?
Cellulitis
DVT (blood clot)
MI
Stroke
141
Patient with a hx of bariatric surgery after lunch has symptoms, vertigo, palpitations, diarrhea, nausea. What is this?
Vertigo
Hypotension
Dumping syndrome
GERD
142
What is the priority nursing action post ECHO?
Fall prevention
Vaccines
Vital signs
Check gag reflex
143
What is the #1 cause of liver failure?
Diabetes
Poor diet
Alcohol
Smoking
144
Atrial Fibrillation means what?
No T wave happening
Long QRS
No P wave happening
P wave
145
What should a stoma look like?
Pink, moist, beefy red
Black
White
Blue
146
If you have a patient with dark tarry stool, where is it likely coming from?
Large intestine
Hemorrhoids
Small intestine
Upper GI tract
147
Select All: If a patient's BMI is greater than 40, what is the patient high risk for post-op?
Confusion
DVT
GI upset
Pneumonia
148
The pacemaker of the heart is the SA node
False
True
149
ECG strip that shows ventricular tachycardia, what do we assess 1st?
Blood pressure
Weight
Pulse
LOC
150
What does the P wave represent?
Depolarization of the ventricles
T wave
Depolarization of the atria
QRS
151
HIV targets what cells?
All of them
Esinophils
Lymphocytes
CD4+
152
Angina pain during exercise, what is happening?
Exercise decreases heart oxygen demand
SOB
Palpitations
Exercise increases heart oxygen demand
153
What is the best oral contraceptive intervention?
Take prior to sexual intercourse
early ambulation/exercise is needed due to high risk for DVTs
Compression hose
Take every other day
154
When is the intraoperative phase?
Begins when patient decides to do surgery
After surgery
Begins when the pt is transferred to the OR bed and ends with admin to PACU
Before surgery
155
Select All: What are modifiable RF for high cholesterol?
Alcohol
Stress
Smoking
Exercise/diet
156
What is important to have the patient do in preadmission prior to a procedure?
Have a BM
Sign a consent
Call their family
Take a shower
157
What helps aid the healing process?
Pain management
Staying in bed
Exercise
Therapy
158
Select All-HIV s/s:
Fever
Nonproductive cough
Blurry vision
Fatigue
159
How would you explain omeprazole's action to a patient?
It coats the stomach
It reduces nausea and vomiting
It reduces the stomach acid
Take only PRN

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