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MDC IV Final Exam Part 1 Flashcards | StudBud
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MDC IV Final Exam Part 1
MDC IV Final Exam Part 1
100 terms
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1
Patient education and prevention for autonomic dysreflexia.
Empty bladder every 2-4 hours.
Avoid constipation.
Avoid wearing tight shoes.
Avoid wearing tight clothing.
2
What are the clinical manifestations of meningitis?
Severe headache, flu-like symptoms, nuchal rigidity, fever, chills, rash
Severe headache, cough, muscle weakness
Tachypnea, cough, crackles in lung bases
Flu-like symptoms, numbness in extremities, gait imbalance
3
What are common symptoms during the ictal phase of a seizure (any type)?
Jerking of extremities
Incontinence
Vomiting
Sudden loss of muscle tone
4
How much does MAP drop in initial phase of shock?
5-10mmHg
10-15mmHg
0-5mmHg
20+mmHg
5
Anaphylactic shock is caused by an extreme hypersensitivity.
False
True
6
Interventions for flail chest include surgery and/or ventilator with PEEP.
True
False
7
There is no reason to put burn patients on PPIs or H2 blockers.
False
True
8
Taking medications the same time daily can help prevent myasthenia gravis.
True
False
9
Best treatment for anaphylactic shock.
Fluids
Diphenhydramine
NSAIDs
Epinephrine
10
A myoclonic seizure is a brief jerking of the extremities.
True
False
11
A chest tube is the first intervention for a tension pneumothorax.
False
True
12
Progressive Phase of Shock
MAP decreases by at least 20mmHg.
Vital organs- hypoxia
Non-vital organs- anoxia
MAP decreases by 15mmHg.
13
110kg, 43% BSA burned, and arrives to the hospital immediately after injury. How many mL fluids should patient receive?
8,600
189.2
37,840
18,920
14
Prevention of increased ICP.
Elevate the head of the bed.
Avoid Valsalva maneuvers.
Avoid clustering nursing procedures.
Keep environment quiet and room lighting low.
15
Interventions for rib fractures.
Return to contact sports in four weeks.
NSAIDs, Tylenol, or opioids for pain.
Splint chest.
Oxygen supplementation
16
Guilllain-Barre Syndrome most commonly occurs?
Once a year.
After an illness or some other immunocompromise.
At the core and spreads to the periphery.
On one side of the body.
17
Hypovolemic shock is caused by a lack of circulating volume.
False
True
18
Factors to assess prior to tPA administration.
Cannot be given if patient's INR is abnormal.
Blood pressure, antihypertensives may need to be administered first.
When the stroke began (must be given within 3-4.5 hours of stroke)
Weight
19
Both of patients legs, anterior right arm, and perineum are burned. What total BSA is burned?
31.5%
46%
41.5%
45%
20
A pressure alarm that is low OR high can signify there is a ventilator equipment malfunction.
True
False
21
Spinal shock is when the patient loses sensation and function 24 hours after injury.
True
False
22
3rd degree frostbite
Edema only
Small blisters with dark fluid
Muscle and bone envolvement
Large, milky, fluid-filled blisters
23
It is expected to have drainage on the dressing of a penrose drain.
True
False
24
Neurogenic shock is commonly caused by a spinal cord injury.
True
False
25
Symptoms of an ischemic stroke
Visual disturbances
Gradual onset of symptoms
Severe headache
Weakness of face and extremities
26
Acceptable labs for a pre-operative patient.
K+ 5.5, Hgb 15, Hct 45%
K+ 5.4, Hgb 9, Hct 20%
K+ 4.0, Hgb 9, Hct 45%
K+ 4.1, Hgb 15, Hct 45%
27
Neurogenic shock is the only shock where the patient will be bradycardic.
True
False
28
Nursing interventions post CVA.
Allow sufficient time for ADLS.
Rush patient when speaking.
Do as many of the patient's tasks for them as possible.
Place food on unaffected side during feedings.
29
4th degree frostbite:
Small blisters with dark fluid
Edema only
Muscle and bone envolvement
Large, milky, fluid-filled blisters
30
A hemorrhagic stroke is caused by a blood clot.
False
True
31
EEG patient education.
Arrive sleep deprived.
Drink caffeine and take stimulant medications prior.
Arrive with clean, dry hair.
Take sedative medications as scheduled prior.
32
Signs of infection after surgery: mental status changes, fever, redness and discharge at surgical site.
True
False
33
Assessment of rib fractures.
Respiratory effort
X-ray
TSH
Oxygen saturation
34
Treatments for increased ICP.
Diuretics such as mannitol
Craniotomy
Dehydrate the patient
Drain the extra CSF with a spinal tap
35
Having an AMBU bag near the HOB isn't always necessary for a ventilated patient.
True
False
36
Compensatory Phase of shock:
The body is attempting to compensate to return to baseline.
MAP drops by 10-15mmHg
MODS occurs.
MAP drops by 20mmHg
37
What intervention can be used for a patient with inhalation injury?
Normal room air.
Humidified air and controlled ventilation.
Dry O2 supplementation.
Air with essential oils.
38
A tonic-clonic seizure causes extremity stiffness, a loss of consciousness, and then jerking of the extremities.
False
True
39
A caregiver of an Alzheimer's patient states they are stressed and can't catch a break. What would help the burnout?
Leave the patient unattended for small increments to catch a break.
Respite Care
Teach caregivers to be aware of their own health and stress levels.
Drop the patient off at the ED.
40
Cherry red face and lips are a sign of carbon monoxide exposure.
True
False
41
How to assess for CSF leak.
Any clear fluid from the nose is CSF
Halo test
Use a glucometer to test for glucose
Any blood from the ears contains CSF
42
Frostbite interventions:
Wrap the area tightly with gauze.
Provide opioids for pain
Pad between the fingers and toes
Warm hands in water that is 104-108 degrees
43
Pulsus paradoxus is a common clinical manifestation of cardiogenic shock.
False
True
44
2nd degree frostbite:
Large, milky, fluid-filled blisters
Muscle and bone envolvement
Edema only
Small blisters with dark fluids
45
What PTT is therapeutic?
20
53
40
90
46
Eye opening to pain only, uses inappropriate words, and flexes to withdraw from pain. GCS?
12
9
3
15
47
Symptoms of ARDS.
Non-cardiac pulmonary edema.
White-out x-ray.
Decreased pulmonary compliance.
Hypoxemia with 100% O2 supplementation.
48
A living will and power of attorney are examples of advanced directives.
True
False
49
How to prevent VAP.
Take ventilator out of patient to clean it every two hours.
VAP isn't common, no prophylaxis needed.
Provide oral care Q2 hours or by facility policy.
Provide patient with antibiotics while on the ventilator.
50
A high pressure alarm signifies the ventilator is obstructed or patient is biting the tubing.
False
True
51
Patient teaching for hemianopsia.
Avoid ambulating without assistance.
Cover the affected eye.
Scan the room entirely before ambulation.
Place personal items on the affected side.
52
Who is at risk for PE?
Obese patients
Surgery patients
Patients who smoke
Patients on estrogen therapy
53
What are some patient teachings for Parkinson's Disease?
Take medications at the same time daily
Fall precautions
Monitor ability to safely swallow
Provide extra time to perform ADLS
54
Obstructive shock results from:
Cardiac tamponade
Tension pneumothorax
Pulmonary embolism
Constrictive pericarditis
55
Assessment findings for pulmonary embolism.
Shortness of breath
Chest pain
Crackles
Elevated d-dimer
56
Teachings for bleeding precautions.
Use an electric razor.
Floss daily.
Seek medical care for falls.
Use a firm toothbrush to remove plaque.
57
Patients with allergies to bananas and kiwi are at a higher risk of a latex allergy.
False
True
58
Symptoms of tension pneumothorax.
JVD
Dyspnea and unequal chest rise
Compression on the heart
Tracheal deviation
59
To assess central-brain and spinal cord pain response, perform a sternal rub.
False
True
60
A clonic seizure causes the muscle to contract and then relax.
True
False
61
Clinical manifestations of flail chest.
Fever
3+ broken ribs.
Epistaxis
Paradoxical chest movements.
62
Distributive shock: Fluid is distributed to interstitial spaces where it cannot perfuse organs.
False
True
63
Nursing interventions during the ictal phase of a seizure?
Restrain the patient to avoid injury.
Observe the time and length of the seizure.
Protect the patient from injury.
Use tongue blade to prevent the patient from biting tongue.
64
Centilator alarms: D.O.P.E.
Disarmed, Open, Pneumothorax, Equipment
Dislodged, Open, Pneumonia, Equipment
Dislodged, Obstructed, Pneumothorax, Equipment
Dislodged, Obstructed, Pneumonia, Equipment
65
Obstructive shock is a circulatory issue.
False
True
66
Anticoagulants and oxygen supplementation are used to treat PE.
True
False
67
Anticholinergics, corticosteroids, and immunosuppresives are commonly used to treat myasthenia gravis.
True
False
68
An ischemic stroke is caused by a brain bleed.
False
True
69
Patient's with frostbite are at an increased risk of developing compartment syndrome.
True
False
70
Cardiogenic shock is not a heart (pump) failure.
True
False
71
It is expected to have drainage on the dressing of a Hemovac or JP drain.
True
False
72
Distributive shock is an umbrella term for:
Anaphylactic shock
Neurogenic shock
Cardiogenic shock
Septic shock
73
Common abnormal labs for shock patients includes elevated lactic acid, hyperkalemia, hyponatremia, and acidosis.
True
False
74
The refractory phase of shock causes MODS and there is no return for the patient.
False
True
75
What is a complication of Dilantin (phenytoin)?
Tachycardia
Dry mucous membranes
Gingival hyperplasia
Hypertension
76
Septic shock is caused by an overwhelming infection.
True
False
77
Burn patients often encounter hyperkalemia and hyponatremia.
True
False
78
A tonic seizure is an abrupt increase in muscle tone causing stiffness.
False
True
79
Nursing interventions for a burn patient.
Monitor for fever/infection.
Secure airway.
Fluid resuscitation.
Manage pain.
80
A runaway minor who is not emancipated can give informed consent.
True
False
81
In a drowning incident, the aspiration of fluids washes out surfactant.
True
False
82
What questions should be ask during a seizure assessment?
Alcohol or illicit drug use
Presence of aura before seizure occurred
Prescription medications or herbal supplements
How many has the patient had, how long do they last, and any pattern
83
What is the most important thing to monitor in a patient that is in the post-ictal stage of a seizure?
Blood pressure.
Use of incentive spirometer.
CBC, CMP, BUN, and creatinine.
That the patient returns to their baseline.
84
What is a common symptom in the preictal phase of a seizure?
Cold intolerance
Hypotension
Aura
Headache
85
Factors that determine surgical positioning.
Surgical site
Type of anesthesia
Surgeons preference
Age, weight, and size of the patient
86
When a patient has a halo device, the nurse should adjust the pins to make sure they remain tight.
True
False
87
Safety measures to prevent drowning:
Don't swim alone.
Drink ETOH while in the water.
Anyone over 2 doesn't need supervision when swimming.
Test water depth before diving.
88
Common symptoms of shock.
Tachycardia
Increased urine output
Narrowing pulse pressure
Tachypnea
89
A patient with septic shock does not have an infection that needs antibiotics.
False
True
90
What INR is therapeutic with anticoagulants?
1.5
2.2
4.0
3.7
91
A pressure alarm that sounds low THEN high signifies a pneumothorax.
False
True
92
tPA can be administered for both hemorrhagic and ischemic strokes.
True
False
93
Nurses can obtain informed consent.
True
False
94
A low pressure alarm signifies the ventilator loss pressure or dislodged.
True
False
95
Eyes open spontaneously, confused, and moves to localized pain. GCS?
13
5
9
15
96
An atonic seizure is the sudden loss of muscle tone, lasting for seconds, with post-ictal confusion.
False
True
97
What medication is used to treat muscle spasms in multiple sclerosis?
Baclofen
Lisinopril
Ibuprofen
Oxycodone
98
Burn patients and shock patients are NOT at risk for acute kidney injury.
False
True
99
To assess peripher nerves outside of the CNS, use the pen to the fingernail method.
False
True
100
What are symptoms/signs of inhalation injury?
Hoarse, brassy cough
Soot in nares
Singed facial hair
Drooling
