Which are symptoms of early dumping syndrome? (SATA)

Tachycardia, Occurs 30 min after eating, Syncope, Desire to lie down

Which conditions pose a high risk for development of compartment syndrome? (SATA)

Massive infiltration of IV fluid into forearm, Severe burns to the upper extremities, Multiple insect bites to lower legs

A patient develops an active Upper GI bleed, which are the priority actions the nurse takes? (SATA)

Start large-bore IV line & prepare normal saline, Monitor hematocrit and hemoglobin, Provide Oxygen; prepare for NG tube insertion

A patient experiencing gout will most likely seek medical attention for which reason?

Severe pain in the joint of the great toe.

Which interventions prevent or minimize risk factors in patients at risk for aspiration? (SATA)

Providing liquids w/ a thickening agent & feed in small bites, Position patient in 90 degree upright position, Keep suctioning equipment nearby

Which are recommended prevention strategies for oral cancer? (SATA)

Minimize sun exposure, Avoid use of tanning beds, Stop using tobacco and decrease alcohol intake

What are the potential adverse effects of alendronate (Fosamax)? (SATA)

Difficulty swallowing, Esophagitis, Esophageal or gastric ulcers

What information should you include when teaching the patient about antibiotic therapy for osteomyelitis?

The infected wound may be irrigated w/ one or more antibiotic solutions

Which signs/symptoms represent the priority concepts for musculoskeletal trauma?

Patient reports decreased ROM & pain in leg that is unrelieved by meds

Which dietary suggestions would you suggest to reduce the risk of colorectal cancer? (SATA)

High fiber, High in brassica vegetables, Low fat, Low refined carbs

What is the current barrier to using MRI to diagnose and evaluate osteoporosis?

It is expensive & third parties don't recognize the value to reimburse cost

Which assessment technique will be best to assess a patient's report of paraesthesia in their lower extremities?

Ask pt to identify sharp/dull sensation by using a paper clip & cotton ball

Which abnormal lab findings accompany fat embolism syndrome? (SATA)

Decreased serum calcium levels, Decreased RBC and PLT counts; Increased serum level of lipids, Increased erythrocyte sedimentation rate, Decreased PaO2 level (<60)

How do you assess motor function in a patient w/ severe pain in the right wrist after falling off a step stool?

Ask the patient to move fingers

When assessing a pt w/ a salivary gland tumor, which requests may determine if the tumor's affected the facial nerve?

"Raise your eyebrows", "Puff out your cheeks", "Wrinkle your nose"

Which info do you include when teaching about health promotion & maintenance to prevent gastritis? (SATA)

"If you stop smoking, there's less chance that you will develop gastritis.", "To prevent gastritis, alcohol should be avoided.", "Yoga has been found to be effective in preventing gastritis."

Which interventions can be used to prevent/manage infections in Pts who have undergone total joint replacement? (SATA)

Wash hands thoroughly when caring for patients, Monitor incision q4hrs for the first 24hrs and ever 8-12 hrs thereafter, Culture drainage if a change is observed

Which assessment technique for a probable fractured tibia-fibula is incorrect?

Push on leg to elicit pain response

Which statement would cause the most concern from a patient taking hydroxychloroquine for RA?

"I think I must need new glasses. Lately, my vision is really blurry."

Which are examples of primary stomatitis? (SATA)

Traumatic ulcers, Aphthous stomatitis, Herpes simplex stomatitis

Which position is therapeutic & comfortable for patient w/ acute lower back pain from a herniated disc?

Semi-Fowler's position with a pillow under the knees to keep them flexed

The nurse is teaching a patient about what structures will be removed during a radical neck dissection. What's included?

Internal jugular vein, Sternocleidomastoid muscle, Excision of cervical lymph nodes on affected side, Cranial nerve XI

Which strategies does the nurse expect to implement in the management of dumping syndrome? (SATA)

Eliminate liquids ingested with meals, Administer acarbose to decrease carbohydrate absorption, Provide more frequent smaller meals, Increase protein and fat in the diet

Which factor indicates the largest risk factor for stomach cancer in a patient with PUD?

History of infection w/ H. pylori

What is the cause of late dumping syndrome?

Release of an excessive amount of insulin

Which patient has the most risk factors associated with osteoporosis?

Female, white, menopausal, thin, lean, immobilized

When teaching a patient about pernicious anemia, which statement should be included?

"Pernicious anemia results from a deficiency of Vitamin B12."

What kind of stool should a patient expect after a descending colon colostomy?

Similar to stool expelled from the rectum

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AH Exam 3 Review GI Cancers and MSK

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Answers

1
Which are symptoms of early dumping syndrome? (SATA)
Tachycardia
Occurs 30 min after eating
Syncope
Desire to lie down
2
While assessing a patient w/ an oral tumor they develop stridor. Which functional assessment is least important now?
Quality of respirations
Ability to speak
Pain rating
Gag reflex
3
What is an early indicator of fat embolism?
Severe respiratory distress
Significantly increased pulse rate
Petechial rash over the neck
Change in mental status
4
Which body system side effects are affected most by long-term salicylate and NSAID therapy?
CNS
Cardiovascular
GI
Skin
5
Which conditions pose a high risk for development of compartment syndrome? (SATA)
Massive infiltration of IV fluid into forearm
Severe burns to the upper extremities
Multiple insect bites to lower legs
Bivalve cast on the lower leg
6
A patient develops an active Upper GI bleed, which are the priority actions the nurse takes? (SATA)
Start large-bore IV line & prepare normal saline
Monitor hematocrit and hemoglobin
Provide Oxygen; prepare for NG tube insertion
Monitor serum electrolytes
7
A patient experiencing gout will most likely seek medical attention for which reason?
Severe pain in the joint of the great toe.
Presence of hard irregular tophi in the outer ear
Dry, red, scaly rash with butterfly pattern on face
Trouble passing urine because of uric acid formation
8
Which interventions prevent or minimize risk factors in patients at risk for aspiration? (SATA)
Providing liquids w/ a thickening agent & feed in small bites
Keep head of bed elevated for 5 mina after eating
Position patient in 90 degree upright position
Keep suctioning equipment nearby
9
What is the priority concept related to changes that occur during the ischemia-edema cycle?
Perfusion
Mobility
Comfort
Tissue integrity
10
Which are recommended prevention strategies for oral cancer? (SATA)
Minimize sun exposure
Avoid use of tanning beds
Stop using tobacco and decrease alcohol intake
Avoid intake of fatty foods
11
What are the potential adverse effects of alendronate (Fosamax)? (SATA)
Difficulty swallowing, Esophagitis
Drowsiness
Esophageal or gastric ulcers
Constipation
12
What information should you include when teaching the patient about antibiotic therapy for osteomyelitis?
Patients usually remain hospitalized to complete the full course
The infected wound may be irrigated w/ one or more antibiotic solutions
Chronic osteomyelitis may require 1 month of antibiotic therapy
Single-agent therapy is the most effective for acute infections
13
What is your priority nursing intervention when caring for a patient with a radical neck dissection?
Enhance the patient's ability to communicate
Manage the patient's pain
Maintain fluid and electrolyte balance
Maintain the patient's airway
14
You are caring for a patient that vomited coffee-ground emesis. Where do you suspect the patient is bleeding?
Small intestine
Upper GI system
Colon
Rectum
15
What is the most common area of involvement of RA in the spine?
Sacral spine
Thoracic spine
Lumbar spine
Cervical spine
16
Which signs/symptoms represent the priority concepts for musculoskeletal trauma?
Patient describes discomfort in knee & hip joints, worse in the morning
Patient unable to get adequate Ca & vit D because of lactose intolerance
Patient notes mild shortness of breath & palpitations with minor exertion.
Patient reports decreased ROM & pain in leg that is unrelieved by meds
17
Which dietary suggestions would you suggest to reduce the risk of colorectal cancer? (SATA)
High fiber
High in brassica vegetables
Low fat
Low refined carbs
18
What is the current barrier to using MRI to diagnose and evaluate osteoporosis?
It is expensive & third parties don't recognize the value to reimburse cost
Radiation exposure is excessive for the purpose of annual screening
Many HCPs are not aware of the value of this procedure
Many facilities do not have the specialized equipment to perform this test
19
Which assessment technique will be best to assess a patient's report of paraesthesia in their lower extremities?
Ask pt to identify sharp/dull sensation by using a paper clip & cotton ball
Use reflex hammer to test for deep tendon patellar or Achilles reflexes
Use doppler to locate the pedal, dorsalis pedis, or popliteal pulses
Ask the patient to walk across the room, & observe gait & balance
20
What musculoskeletal health problem is often associated with rheumatoid arthritis?
Paget's disease
Osteoporosis
Lyme disease
Marfan syndrome
21
Which abnormal lab findings accompany fat embolism syndrome? (SATA)
Decreased serum calcium levels
Decreased RBC and PLT counts; Increased serum level of lipids
Increased erythrocyte sedimentation rate
Decreased PaO2 level (<60)
22
Which NG tubes can be connected to low continuous suction?
Anderson
Salem sump
Levin
Carney
23
A patient at risk for vertebral compression fracture should avoid which activity?
Climbing stairs
Walking
Swimming
Jogging
24
Which is the definitive diagnostic for esophageal cancer?
EGD
Esophageal ultrasound (EUS)
PET scan
Barium swallow study
25
How do you assess motor function in a patient w/ severe pain in the right wrist after falling off a step stool?
Ask the patient to flex and extend the elbow
Instruct the patient to rotate the wrist
Ask the patient to move fingers
Perform passive range of motion for the wrist
26
What type of fracture is a pt w/ osteoporosis who suddenly fell b/c it felt like her "leg gave way" most likely to have?
Impacted
Colles'
Compound
Pathologic
27
When assessing a pt w/ a salivary gland tumor, which requests may determine if the tumor's affected the facial nerve?
"Raise your eyebrows"
"Puff out your cheeks"
"Turn your head back & forth"
"Wrinkle your nose"
28
Which type of NSAID is less likely to cause mucosal damage to the stomach?
Acetaminophen
Ibuprofen
Aspirin
Celecoxib
29
Which oral cavity tumor appears as a raised scab, primarily on lips, & evolves to an ulcer w/ a raised pearly border?
Kaposi's sarcoma
Leukoplakia
Erythroplakia
Basal cell carcinoma
30
What diagnostic test is the gold standard for gastritis?
Upper GI series
EGD with biopsy
Cholangiogram
CT scan
31
Which test is definitive for the diagnosis of colorectal cancer?
Colonoscopy with biopsy
Barium swallow
Fecal occult blood test (FOBT)
Carcinoembryonic antigen (CEA)
32
Which exercise is most directly related to mobility when preventing and managing osteoporosis?
Abdominal muscle tightening
Focused deep-breathing exercise
Pectoral muscle tightening
Range-of-motion exercise
33
Which info do you include when teaching about health promotion & maintenance to prevent gastritis? (SATA)
"If you stop smoking, there's less chance that you will develop gastritis."
"To prevent gastritis, alcohol should be avoided."
"Yoga has been found to be effective in preventing gastritis."
"To prevent gastritis, you should limit your intake of salt."
34
Which interventions can be used to prevent/manage infections in Pts who have undergone total joint replacement? (SATA)
Wash hands thoroughly when caring for patients
Monitor incision q4hrs for the first 24hrs and ever 8-12 hrs thereafter
Encourage early ambulation along with leg exercises
Culture drainage if a change is observed
35
If a patient is prescribed raloxifene (Evista) which patient health factor should be mentioned to the prescriber?
Patient has a family history of osteoporosis
Patient has had recurrent VTE
Patient has had previous episodes of hypoglycemia
Patient has a history of iron deficiency anemia
36
Which assessment technique for a probable fractured tibia-fibula is incorrect?
Instruct the patient to wiggle the toes
Push on leg to elicit pain response
Inspect fracture site for swelling or deformity
Assess bilateral dorsalis pedis pulse
37
An older adult patient is admitted w/ an upper GI bleed. Which finding does the nurse expect to assess in the patient?
Increased blood pressure
Decreased pulse
Increased hemoglobin and hematocrit
Dizziness
38
Which statement would cause the most concern from a patient taking hydroxychloroquine for RA?
"I think I must need new glasses. Lately, my vision is really blurry."
"I seem to have a mild stomach discomfort when I take this medication."
"Could you give me a Tylenol or something mild? I have some muscle pain."
"I get kind of light-headed. I suppose I should stand up a little slower."
39
Which are examples of primary stomatitis? (SATA)
Chemotherapy-induced stomatitis
Traumatic ulcers
Aphthous stomatitis
Herpes simplex stomatitis
40
Which position is therapeutic & comfortable for patient w/ acute lower back pain from a herniated disc?
Modified Sims' position with upper arm and leg supported by pillows
Semi-Fowler's position with a pillow under the knees to keep them flexed
Orthopneic position; sit w/ trunk slightly forward arms supported on pillow
Supine position with arms and legs in a correct anatomical position
41
The nurse is teaching a patient about what structures will be removed during a radical neck dissection. What's included?
Internal jugular vein
Sternocleidomastoid muscle
Excision of cervical lymph nodes on affected side
Cranial nerve XI
42
Which assessment findings indicate early rheumatoid arthritis?
Joint deformities
Weight loss
Subcutaneous nodules
Joint inflammation
43
A Pt was prescribed the combo drug of probenecid & colchicine for gout treatment. How's the effectiveness evaluated?
Monitor serum uric acid level
Assess mobility of affected joints
Review compliance with a low-purine diet
Check results of urinalysis
44
Which strategies does the nurse expect to implement in the management of dumping syndrome? (SATA)
Eliminate liquids ingested with meals
Administer acarbose to decrease carbohydrate absorption
Provide more frequent smaller meals
Increase protein and fat in the diet
45
Which factor indicates the largest risk factor for stomach cancer in a patient with PUD?
History of gastritis
History of GERD for 6 weeks
History of hiatal hernia
History of infection w/ H. pylori
46
What is the cause of late dumping syndrome?
Shift of fluids into the gut leading to abdominal distention
Release of an excessive amount of insulin
Rapid entry of high-protein foods into jejunum
Rapid emptying of food into the small intestine
47
Which patient has the most risk factors associated with osteoporosis?
Adult who usually exercises and has moderate alcohol intake
Female, white, menopausal, thin, lean, immobilized
Older adult with vitamin B12 deficiency, insufficient exposure to sunlight
Male over 50 years, European heritage
48
What is the most common cause of back and cervical pain?
arthritis
disc herniation & degeneration
pulled muscle
osteoporosis
49
Disc herniation or degeneration in the lumbar region of the spine can lead to foot drop or loss of function.
False
True
50
When teaching a patient about pernicious anemia, which statement should be included?
"All patents with GI bleeding will eventually develop pernicious anemia."
"Patients w/ pernicious anemia are not able to digest fats."
"Pernicious anemia results from a deficiency of Vitamin B12."
"Oral iron supplements are an effective treatment for pernicious anemia."
51
What kind of stool should a patient expect after a descending colon colostomy?
Thick and paste-like
Watery
Similar to stool expelled from the rectum
Thin and gelatin-like
52
Which member of the health care team is responsible for teaching the patient about proper use of the cane?
Occupational therapist
Orthopedic surgeon
Physical therapist
Home health adie
53
A patient in traction reports severe pain from a muscle spasm. What is your priority action?
Remove some of the traction weights
Assess patient body alignment
Give patient a prn pain medication
Notify health care provider
54
Which are pathologic changes associated with acute gastritis? (SATA)
Increased cell production in superficial epithelium of stomach lining
Severe mucosal damage and ruptured vessels
Vascular congestion; edema
Acute inflammatory cell infiltration
55
Which operative procedure includes excision of a segment of the mandible with the oral lesion & radical neck dissection?
Glossectomy
Oropharyngeal resection
Commando procedure
Mandibulectomy
56
Which condition can develop after hip fracture with prolonged immobility?
Osteomyelitis
Pulmonary embolism
Neuroma
Internal derangement
57
Which statement represents the most typical reason for a patient with osteoarthritis to seek medical care at a clinic?
"I have a family hx of OA, & wondered what I can do to prevent it."
"I am having a lot of joint pain, and I'm frequently taking pain meds."
"I think that being overweight is putting too much stress on my joints."
"My third finger joint seems to be tilting inward toward my index finger."
58
Which key points must be included in preoperative teaching for a patient scheduled for lumbar surgery? (SATA)
Immediately report any numbness & tingling
Expectations for turning and moving in bed
Limitations for home activities
Restricted to bedrest for at least 48hrs
59
What admitting assessment would you find in the chart of a 40 yr-old Pt w/ acute osteomyelitis of the left lower leg?
Temp greater than 101oF, swelling, tenderness, erythema, warmth of area
Shortening of the extremity with pain during weight bearing or palpation
Ulceration resulting in sinus tract formations, localized pain, & drainage
Aching pain, poorly described, deep & worsened by pressure & weight bearing
60
Which factors may be associated with osteoporosis? (SATA)
Muscle cramps
Fracture
Urinary or renal stones
Sedentary lifestyle
61
What is the best lab test to detect early rheumatoid arthritis?
Anti-cyclic citrullinated peptide
Complete blood cell count
Rheumatoid factor
Erythrocyte sedementation rate
62
After colostomy surgery, which intervention does the nurse employ?
Watch for the colostomy to start functioning on day 1
Make a hole in the pouch for gas to escape
Cover the stoma with a dry, sterile dressing
Apply a pouch system as soon as possible
63
How do you prevent infection of an open fracture?
Culture the wound and obtain an order for antibiotics
Place the patient on neutropenic precautions and perform hand hygiene
Use aseptic technique for dressing changes and wound irrigations
Place the patient in contact isolation and wear sterile gloves
64
Which order do you question for a patient admitted for 24-hr observation of a leg fracture with a cast?
Provide regular diet as tolerated
Perform neurovascular assessments q8hrs
Elevate lower leg above the level of the heart
Apply ice pack for 24hrs
65
Which question best identifies causative factors of a history of acute back pain?
"Are you having trouble walking or maintaining your balance?"
"Do you have a family history of neurologic disorders?"
"Have you had a recent fall or accident or lifted a heavy object?"
"Are you having pain that radiates down the back of your leg?"
66
Which treatment modalities might the nurse expect for a Pt undergoing non-surgical management of chronic joint pain?
Weight control
Thermal modalities
Limit foods & liquids with Calcium
Exercise balanced with rest
67
Which intervention applies to nursing care of an elderly patient w/ HF & hypovolemia r/t an intestinal obstruction?
Provide frequent mouth care with lemon-glycerin swabs
Offer a small glass of water
Assess for crackles in lungs
Offer ice chips to suck on before surgery
68
Which of the following are early signs of gastric cancer? (SATA)
Nausea and vomiting
Iron deficiency anemia
Feeling of fullness
Epigastric, back, or retrosternal pain
69
If a patient w/ RA is to undergo general anesthesia for a hip replacement, which is imperative for the surgeon to know?
Patient fears that the procedure will cause complications because of the RA
Patient has a previous history of joint surgery on the affected side
Patient has cervical spine disease and not had any recent spinal x-rays
Patient has been taking vitamin C & NSAIDs for years
70
Which lunch tray contains the most nutritional elements required for healthy bones?
Processed lunch meat on whole-grain bread, apple juice, chips & salsa
Pasta with red tomato sauce, garlic toast, seltzer water & ice cream
Green leafy vegetable salad with cheese wedges and low-fat milk
Fruit salad, iced tea, and a whole grain muffin with butter & jam
71
Compared to acute osteomyelitis, which characteristic is more associated with chronic osteomyelitis?
Erythema
Sinus tract formation
Swelling
Fever
72
What type of fracture would a bleeding lower leg with bone fragments protruding from the skin most likely be?
Impacted
Displaced
Pathologic
Open
73
What nursing care does a patient with an NG tube require? (SATA)
Confirm placement by x-ray if it is repositioned
Educate patient that feelings of nausea are due to tube placement
Monitor contents and irrigate w/ 30mL of NS as ordered
Keep patient in semi-fowler's position
74
Which foods should someone with a family hx of stomach cancer avoid?
Large & heavy meals
Pickled & processed foods
Foods that cause reflux
Heavily spiced foods
75
Although the etiology of RA is considered to be unknown, it is considered to be what kind of disorder?
Trauma disorder
Autoimmune disease
Genetic disorder
Disease associated with aging
76
Which is a key feature in advanced gastric cancer?
Indigestion
Feeling of fullness
Progressive weight loss
Epigastric, back, or retrosternal pain
77
If a pt is experiencing s/s of hypovolemia & compartment syndrome which complication will management of care focus on?
Myoglobinuric renal failure
Ischemic heart rate
Respiratory failure
Acute liver failure
78
Following a total joint arthroplasty, which patients have higher risk of VTE? (SATA)
Older patient who has trouble with mobility at baseline
Patient with a previous history of VTE related to job as a truck driver
Thin patient who needs medication for hyperthyroidism
Patient with a history of OA pain that is treated w/ acetaminophen
79
Which sign/symptom below is associated with chronic gastritis?
Gastric hemorrhage
Dyspepsia
Hematemesis
Pernicious anemia
80
What are the most common signs of colorectal cancer? (SATA)
Change in stool consistency
Anemia
Rectal bleeding
Abdominal cramping
81
A pt presents w/ sudden epigastric pain, nausea & vomiting. "Pain is the worst heartburn ever." What do you suspect?
H. Pylori infection
Peritonitis
Acute gastritis
Duodenal ulcer

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