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NUR 198 Final Reveiw Flashcards | StudBud
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NUR 198 Final Reveiw
NUR 198 Final Reveiw
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1
Which patient is priority?
Stable angina with chest pain
Aneurysm with sudden back pain
Raynaud's with numbness in fingers
Asthma pt with 95% O2 sats
2
Thyroidectomy: 104°F, HR 144, BP 184/108—expect?
Beta blocker + cooling blanket
Benadryl
Epinephrine
Aspirin
3
BP 118/60—how to document?
Stage 1 HTN
Elevated BP
BP WNL
Hypotensive
4
Taking metformin—what extra lab to monitor?
Lipids
CBC
Urine blood
Kidney function
5
How to check if iron supplements are working?
WBC and platelets
Electrolytes and BUN
APTT & PT
Hgb and Hct
6
The pt has suffered a myocardial infarction, the elevation of which laboratory value supports this finding?
Troponin
Amylase
Glucose
Ammonia
7
Why take antibiotics before dental surgery with valve disorder?
Prevent incision infection
Prevent heart infection
Prevent fever
Prevent pneumonia
8
What’s expected with a posterior pituitary tumor?
High BP
Increased urine output
Fluid overload
Low sodium
9
After AAA repair, which finding is urgent?
Urine output 60 ml/hr
Pain level 5
Increased abdominal girth
Temp 98.9 °F
10
Iron-deficiency anemia—what helps iron absorption?
Citrus Fruits
Yogurt
Green veggies
Vitamin D
11
Apical pulse 54 for digoxin—what to do?
Give atropine
Count for 1 full min
Give med
Hold med
12
What is a hypertensive emergency?
Very high BP episode
Heart pumping poorly
A small stroke
Fast heart rate
13
How do oral diabetes meds work in type 2 DM?
Works like insulin
Replaces insuline
Stimulates pancreas
Used with ketoacidosis
14
Aortic regurgitation—what shows care was effective?
Discharged home with palliative care
Quit gardening
Resumed daily & social activities
Needed help with ADL's
15
Which BP patient is the priority?
150/60 and anxious
170/80 with a mild headache
140/70 with a nosebleed
180/120 with no symptoms
16
Buerger disease—what lifestyle change is key?
Quit smoking
Low-fat diet
Stress reduction
avoid caffeine
17
Potassium 6.4 mEq/L—what symptom is likely?
Strong pulse
High BP
Constipation
Slow, irregular HR
18
12-year-old in 5th height percentile—what’s likely prescribed?
Wait until age 18
Growth hormone
Leg-lengthening surgery
Test adrenal gland
19
Type 1 DM marathon runner—what to teach?
Avoid exercise
Carry emergency glucose
Time with insulin peak
Carb up before running
20
Hemophilia + pain—what action?
Teach signs of bleeding
Give opioids, avoid IM injections if possible
Refer for support
Desmopressin
21
Best test to monitor diabetes control?
Fasting BG
Random BG
Glucose tolerance
Hgb A1C
22
What do gonadocorticoids affect?
Estrogen balance
Glucose production
Sodium retention
Libido
23
Frequent hyperglycemia—what might be cause?
Swapping cookies for bread
Exercise increase
Diet isn't filling
Busy job
24
Hemolytic anemia cause?
Malformed RBC's
Immature RBC's
RBC destruction
Low B12
25
Post radial cardiac cath—activity level?
Flat bedrest 4 hrs
Up as tolerated
Chair after 4 hrs
Bedrest with HOB elevated
26
What to do when a Holter monitor event happens?
Notify Dr
Call 911
Press event button
Take radial pulse
27
Venous stasis ulcers—what to do?
keep legs elevated on a pillow
Encourage fluids
Bedrest with bathroom privledges only
Encourage ambulation and compression devices
28
Ongoing hypoglycemia in type 1 DM—best monitoring?
Before meals
Continuous monitoring
Check urine ketones
Every 3 hours
29
Patient has speech issues, headaches—what test besides CT?
Growth hormone
ADH
ACTH
TSH
30
Therapeutic INR for warfarin?
3.0-4.0
2.0-3.0
1.0-2.0
4.0-5.0
31
Hypoglycemia—what does pancreas do?
Inhibits insulin
Decreases insulin
Moves glucose
Releases glucagon
32
Athlete’s heart rate—what is expected?
Orthostatic hypotension
Bradycardia
Tachycardia
Hypotension
33
Before giving atenolol, HR is 55 bpm—what now?
Give 1/2 dose
Recheck in 8 hrs
Notify DR
Give med
34
Warm, swollen arm with tenderness—likely cause?
BP cuff
IV therapy
Bug bite
Tight clothing
35
Which patient should be seen first?
Lasix pt with increased urine output
Metoprolol pt BP 126/74
Atenolol pt BP 188/114
Spironolactone pt, K+ 4.8
36
Mitral valve prolapse—what shows poor understanding?
I'll quit drinking coffee
I'll eat a well balanced diet
I can still practice yoga
I must avoid any activity
37
What to do for red, swollen calf with fever?
Measure both calves
Use compression
Massage calf
Apply ice
38
Which med should be reported before cardiac surgery?
Metformin
Furosemide
Asprin
Carvedilol
39
Iron-deficiency anemia—what to teach?
Cluster activities
Report nausea/constipation
Stop when feeling better
Take with meals
40
Water deprivation test—what confirms diabetes insipidus?
Stable weight
Weight loss + dilute urine
High specific gravity
No voiding
41
Stage 1 Hodgkin disease—where are swollen lymph nodes?
In neck only
On both sides of diaphragm
All over body
above and below diaphragm
42
Venous blood flow issue—what leg signs?
Pallor
Cyanosis
Greenish skin
Brown skin, turns blue when dependent
43
AAA patient—what activity shows understanding?
Restarting marathon training
Returning to stocking job
Using a motorized scooter to get around
Walking 20 mins every other day
44
Post-cardiac cath via femoral—what should nurse do?
Apply light dressing
Encourage fluids
Walk in 2 hrs
Bend knees 30°
45
Why use insulin before surgery in type 2 DM?
BG must be kept low
Insulin prevents infection
Surgery raises BG through stress
Insulin always needed after surgery
46
Chronic venous insufficiency—what skin change?
Leathery, brown skin
Weak pedal pulse
No pedal pulse
Pale skin
47
What causes pernicious anemia?
Low kidney hormones
Low B12 intake
Low iron intake
No intrinsic factor
48
Pericarditis patient has low BP, confusion—what next?
Prepare for a pericardiocentesis
Myectomy
Start Labetalol drip
Start antibiotics
49
Chest pressure “like someone standing on me”—first action?
Order ECG
Check pt's vitals
Give Nitro
Notify Dr
50
Highest heart failure (HF) risk group?
Hispanic female
Asian male
White male
Black female
51
HR 102, PR 0.16, QRS 0.06—what’s rhythm?
Atrial flutter
Sinus Tach
A-fib
Normal sinus
52
Folic acid anemia—what to ask?
Do you smoke
Alcohol use
Take any herbals
Consume a vegan diet
53
Digoxin toxicity—watch for which rhythm?
Atrial flutter
Ventricular fibrillation
Ventricular tachycardia
Atrial fibrillation
54
CLL patient has bruising, gum bleeding, back pain—cause?
DIC
Thrombocytopenia
Sickle cell crisis
Pancytopenia
55
New HTN patient says meds are too expensive—what to do?
Refer to support group
Refer for financial assistance
Give samples
Watch BP closely
56
Hypothyroid patient is cold, confused— Number one concern?
Cardiac failure
Myxedema coma
Respiratory failure
Thyroid storm
57
Before haning blood What action should the nurse take?
Monitor for hypothermia
Administer antihistamines
Stay with the pt for at least 5 mins
Obtain VS
58
Main factor in cardiovascular disease?
Drug use
Lifestyle
Culture
Genetics
59
P wave on ECG shows what?
Atrial repolarization
Atrial depolarization
Ventricular depolarization
Ventricular repolarization
60
A patient is prescribed to receive two units of packed red blood cells (PRBCs). What action should the nurse take?
Monitor for Hypothermia
Give antihistamine
Stay with the pt for the 1st 5 mins
Assess Vital Signs
61
3rd-degree block HR 45—what’s pacing heart?
SA node
Aortic valve
AV node
Ventricles
62
After a transesophageal echocardiogram. Which action should the nurse take?
Force 1000ml of fluid/hr
Hold fluids for 2 hrs after procedure
Keep NPO until gag reflex returns
Encourage fluids
63
GH deficiency—what should the nurse do?
Offer emotional support
Monitor cholesterol
Teach weight loss strategies
Watch for stroke signs
64
Suppression test—how to explain?
Inject stimulant
Use epinephrine
Low cortisol = failure
Give seroid to suppress cortisol
65
Diet advice for atherosclerosis?
Eat more potassium
Choose low-fat foods
Cut carbs
Eat more cholesterol
66
What to avoid when taking glyburide?
Skipping meals
Alcohol
Contrast dye
Birth control
67
Hgb <6—what symptoms?
Jaundice, bone pain
Mild palpitations
Fatigue, dyspnea, tachycardia
Petechiae, restlessness
68
Cushing syndrome—what to monitor?
Encourage fluids
Check for bronze skin
Watch for low BP when standing up
Give insulin
69
K level 4.6 before Lasix—what should the nurse do?
Give the medicine
Wait till after the next blood draw
Hold the med
Call the Dr
70
Which valve patient risks fluid overload?
27 y/o male on atenolol
68 y/o female on digoxin
18 y/o female on warfarin
44 y/o male on amoxicillin
71
Post-MI: when can patient resume sex?
In 1-2 months
Immediately as long as they have nitro available
No sex-life after an MI
In 1-2 weeks
72
DVT prevention—what’s best practice?
Combination of heparin and compression
Daily low molecular weight heparin
Compression while in bed
Thigh-high stockings
73
Which patient is at highest risk for developing heart failure (HF)
A Hispanic female
A Black female
An Asian male
A White Male
74
Chest pain 4/10—how to give nitroglycerin?
1 tab every 2 mins
1 tab every 5 mins, up to 3 times
1-3 tabs every 3 mins
2 tabs every 3 hrs
75
PVCs—what symptom to monitor?
🔘 Headache 🔘 Disorientation ✅ Dizziness 🔘 Tingling
Tingling of fingers
Disorientation
Dizziness
Headache
76
Lymph node infection—what to do first?
Apply ice
Keep arm below level of the heart
Intubate
Start antibiotics
77
Multiple myeloma—what lab to monitor?
Potassium
Magnesium
Sodium
Calcium
78
Polycythemia vera—expected treatment?
Heat/cold
Splenectomy
Therapeutic phlebotomy
Vitamin B12 injections
79
Hyperosmolar hyperglycemia—priority care?
Rehydrate
Check for illness
Monitor BG
Assess age changes
80
Aortic regurgitation—what meds are expected?
Oxygen & inotropes
Fluids & volume expanders
Diuretics & vasodilators
Antihypertensives & anticoagulants
81
Telemetry shows asystole—first action?
Start CPR
Call the DR
Document rhythm
Prepare adenosine
82
Diabetic diet teaching for multicultural group—what to include?
Snacks
Culturally sensitive food options
Sugar free foods are okay
Standard diabetic diet
83
HR 120 bpm pt is symptomatic —what is the best nursing intervention?
Document the finding
Have pt cough
Recheck HR in 15 min
Turn the patient
84
Pacemaker in right chest—what statement is correct?
Back to gym tomorrow
Move arm freely
Resume activity normal
Report increased pain or redness
85
What lab finding is expected in COPD with hypoxia?
Secondary polycythemia
Polycythemia Vera
CLL
DIC
86
Pink, frothy sputum—what to do?
Encourage fluids
Notify Dr
Encourage ambulation
Document finding
87
Post-hypophysectomy—what should be reported?
Pain 5/10
Urine specific gravity 1.20
800 mL urine in 3 hrs
Hgb 13.2
88
Ventricular fibrillation—what’s the emergency action?
Start Compressions
Intubation
Cadioversion
Defibrillation
89
Who’s at highest risk for dialysis?
Asian with type 1 and stable BG
Older adult with type 2 & HTN
African American with controlled BG
Non-Hispanic type 1
90
Pericarditis—what type of med is expected?
Beta blocker
Anti-inflammatory
Calcium channel blocker
Antihypertensive
91
Mitral stenosis—what is most concerning?
Right hand weakness
Coughing up blood
Murmur
Palpitations
92
Peripheral neuropathy in DM—what to teach?
Use lotion all over feet
Wear loose shoes
Soak in hot water
Check feet daily
93
An S3 heart sound may mean what?
Fluid overload
Liver failure
Asthma
Crohn's disease
94
HTN urgency—when should follow-up be?
Within a few days
Within a week
In the next month
Within 24 hrs
95
Secondary hypertension from adrenal tumor—treatment?
Treat cause
Hormone replacement
Remove kidney and adrenal glands
High-dose BP meds
96
Best care after transsphenoidal pituitary surgery?
Irrigate nose
Use stool softeners
Encourage coughing
Change packing daily
97
CML patient—what should the nurse monitor?
Tarry stools
Urine output
Vitals every shift
Lung sounds
98
Taking digoxin—what finding needs HCP call?
80 mL urine in an hour
Ankle pain
Blurred vision
Slightly elevated BP
99
ITP patient—what should be avoided?
Church
Gardening
Flu vaccine
Electric razor
100
The nurse is caring for a patient with pernicious anemia. Which deficiency is this patient experiencing?
Vitamin B12
Vitamin D
Vitamin K
Vitamin C
101
New admission with crackles—what lab is most concerning?
BUN high
Na normal
BNP elevated
TSH low
102
Giving enoxaparin (Lovenox)—what’s the correct action?
Inject at a 10 ° angle
Use iodine to clean injection site
Leave air bubble in syringe
Give in the gluteal muscle
103
SA and AV node damaged—bundle of His takes over. HR?
10-20 bpm
80-100 bpm
40-60 bpm
20-35 bpm
104
Early sign of AAA?
Pulsating abdominal mass
Nausea and feeling of fullness
Sudden back pain
Vomiting
105
Most obvious sign of adrenal insufficiency?
Dehydration only
Tachycardia
High BP
Bronze skin
106
What’s expected after thyroid needle biopsy?
Pain 2/10
02 sat of 90%
Trouble swallowing
Moderate bleeding
107
Severe HTN, palpitations, sweating—what to ask?
Do you have a headache?
What's your normal BP?
Are you feeling anxious?
When is the last time you've been to the Dr
108
Which telemetry patient needs attention first?
Asymptomatic PAC's
HR 55, sinus brady
A-fib with shortness of breath
HR 108, sinus tach
109
Atherosclerosis can be defined as?
Hardening of the arteries
Narrowing of the arteries
Flaccid arteries
Protrusion of the arteries
110
Which patient needs to be seen first?
Sudden confusion
Elevated BNP
Sodium 137
Urine output 50 mL/hr
111
Pink, frothy sputum—indicates what?
Pneumonia
Liver failure
Heart failure
H-pylori
112
Aplastic anemia—what does bone marrow look like?
Thin and bloody
Red and gelatinous
Pale and fatty
Pink and watery
113
What increases risk for PACs?
A flutter + hiccups
Tachycardia + video games
Alcohol + scary movies
Smoking + digoxin
114
Type 1 DM education—what shows poor understanding?
Family history
Risk of ketoacidosis
Weight loss will reduce insulin need
Viral trigger
115
Addison’s discharge teaching—what’s most important?
Eat balanced meals
Increase steroids with stress
Exercise daily
Check BG levels
116
Syndrome of inappropriate antidiuretic hormone—what condition may cause it?
Diabetes inipidus
Congestive heart failure
Lung cancer
Kidney failure
117
Who’s at highest risk for HTN?
51 y/o female truck driver with no family hx
40 y/o man with family hx of HTN
43 y/o mom who drinks a beer every weekend
31 y/o female smoker with no family hx of HTN
118
Sickle cell crisis—priority assessment?
Urine output
Skin temp
Last BM
Neuro status
119
Diabetes insipidus—what shows treatment worked?
Normal urine specific gravity
Ketones gone
K+ up
Blood glucose down
120
What hormone affects glucose?
TSH
PTH
Cortisol
Aldosterone
121
V-fib patient—what lab value expected?
Ca 9.1
Na 140
Mg 1.7
K+ 6.8
122
Shallow to deep breathing, then apnea—what is this?
Kussmaul breathing
Orthopnea
Cheyne-stokes respirations
Exertional dyspnea
123
Older adult lacks energy—best nurse reply?
Maybe diabetes
GH increases with age
Metabolic rate slows with age
Low PTH causes fatigue
124
Aortic stenosis patient has severe dyspnea. First action?
Raise HOB
Take vitals
Give Nitro
Place O2 on
125
When to check for hypoglycemia after regular insulin?
30 min
12 hrs
4 hrs
2 hrs
126
Which valve patient is the priority?
Myocarditis with a temp of 99.1 ° F
Post-op valve surgery with pain a 9/10
Awaiting an echo for aortic regurgitation
Endocarditis on IV antibiotics
127
BP still high after 6 months of meds—what to ask?
How much do you drink?
What's your pharmacy?
Are you taking your meds?
How much do you sleep?
128
DASH diet—what shows poor understanding?
Had a hamburger and fries
Uses 1 tsp canola oil to prepare food
Ate beans 4 x's this week
Ate fish for dinner
129
Post-op bedrest patient suddenly has dyspnea & fear—what's your first action?
Give narcotics
Call the Dr
Auscultate lungs
Check vitals
130
Heart failure lung sounds-what to expect?
Rub
Stridor
Crackles
Rhonchi
131
Why stop warfarin before surgery?
Increases risks of bleeding
Causes high BP
Causes nausea
Interacts with anesthesia
132
Pancreas endocrine function—what does it secrete?
Lipase
Glucogon
Amylase
Bile
133
Which lab value needs attention?
Platelets 200k
Hgb 13.4
RBC 2.4 million
WBC 4,500
134
What causes type 1 diabetes?
Pancreas makes no insulin
Tissues resist insulin
Reversed with diet/exercise
Insulin helps digestion
135
Thrombocytopenia—what to give?
Fresh frozen plasma
Albumin
Platelets
RBC's
136
Clotting disorder from low factors—what to give?
Cryoprecipitates
Albumin
Fresh frozen plasma
Platelets
137
Common finding with chronic venous disease?
Spider veins
Ankle swelling
Hard nodules
Purple lesions
138
Endocrine system exam—what to include?
Palpate thyroid
Check height, weight, and VS
Look for facial buffalo hump
Check abdomen for pancreas
139
PVCs—what lifestyle change is most important?
Avoid caffeine & alcohol
Cut back exercise
Eat low-fat diet
Watch for weight gain
140
Adrenal crisis—most likely trigger?
Job loss
Slow paced walking daily
Fatty diet
Too much Tylenol
141
Low molecular weight heparin-what labs to monitor?
Heparin antifactor Xa
Platelets
Troponins
Hgb & Hct
142
Post bone marrow biopsy, BP drops—first action?
Check CBC
Check biopsy site
Review meds
Ask about dizziness
143
24-hour urine test—what’s incorrect?
Keep first morning sample
Test ends with last void
Collect after each void
Restart if missed
144
Patient says no-salt diet will fix hypertension. Response?
I will just take more of my diuretic
Salt causes most hypertension
Salt incrases BP
BP may still be high without salt
145
Post-MVA, chest hit steering wheel—what is most concerning?
Pain on expiration
S3 heart sound
Crackles
Jugular vein distension
146
INR 2× normal on warfarin—bleeding? Give what?
Adenosine
Atropine
Lidocaine
Vitamin K
147
Post-cardiac cath—leg cool & dusky. What now?
apply warm compress
Elevate the leg
Document the findings
Notify the DR
148
BP is 120/80 mm Hg—what should the nurse do?
Recommend Salt-free diet
Document as normal
Call the DR
Give IV fluids
149
After lymphangiography, why is urine blue?
Diet contains too much artificial dyes
Means results are abnormal
Dye used causes blue urine for up to 2 days
Notify DR
150
Post-thyroidectomy: numb mouth & twitching—give what?
Calcium gluconate
Sodium bicarbonate
Iodine
Potassium chloride
151
Endocrine hormone regulation—how does it work?
Glands grouped
Each respond to multiple stimuli
All work independently
Negative feedback
152
Nailbed angle >180°, feels spongy. What is it?
Severe clubbing
COPD
Normal nails
Mild clubbing
153
Hyperthyroidism symptoms?
Tremors & nervousness
Psychosis & Mania
Confusion & vision changes
Depression
154
Suspected thyroid masses—what test is likely the first to be done?
Ultrasound
Radioactive iodine test
Thyroid scan
PET scan
155
Dark stool in leukemia—what now?
Collect a stool specimen
Notify Dr
Document finding
Ask if this is normal for them