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