Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
31Activity
0 of .
Results for:
No results containing your search query
P. 1
Silvestri Comp Exam Edi#57F

Silvestri Comp Exam Edi#57F

Ratings: (0)|Views: 8,738 |Likes:
Published by Linda Kuglarz

More info:

Published by: Linda Kuglarz on Oct 14, 2008
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as RTF, PDF, TXT or read online from Scribd
See more
See less

05/09/2014

pdf

text

original

 
Silvestri, 3/e, ISBN 1-1460-0052-6Unit XV (edited file)—"Comprehensive Test10/14/08, Page 1 of 46, 0 Figure(s), 0 Table(s), 0 Box(es)
UNIT XXComprehensive TestFYI: Q52 has a Figure.QUESTIONS
1. Before administering an intermittent tube feeding through a nasogastric tube, the nurse checksfor gastric residual. The nurse understands that the rationale for checking gastric residual beforeadministering the tube feeding is to:1. Confirm proper nasogastric tube placement.2. Observe the digestion of formula.3. Check fluid and electrolyte status.4. Evaluate absorption of the last feeding.Answer: 4Rationale: All the stomach contents are aspirated and measured before administering a tubefeeding. This procedure measures the gastric residual. The gastric residual is checked toconfirm whether undigested formula from a previous feeding remains, and thereby evaluates theabsorption of the last feeding. It is important to check the gastric residual before administrationof a tube feeding. A full stomach could result in overdistention, thus predisposing the client toregurgitation and possible aspiration.Test-Taking Strategy: Note that the issue of the question is the purpose of checking residual.Focusing on this issue should direct you to option 4. Review this procedure if you had difficultywith this question.Level of Cognitive Ability: ComprehensionClient Needs: Physiological IntegrityIntegrated Process: Nursing Process/Data CollectionContent Area: Adult Health/GastrointestinalReference: deWit, S. (2005).
 Fundamental concepts and skills for nursing.
Philadelphia: W.B.Saunders, p. 481.2. A client is complaining of gas pains following surgery and requests medication. The nurseselects which medication from the PRN medication list to give to the client?1. Magnesium hydroxide (milk of magnesia, MOM)2. Droperidol (Inapsine)3. Acetaminophen (Tylenol)4. Simethicone (Mylicon)Answer: 4Rationale: Simethicone is an antiflatulent used in the relief of pain cause by excessive gas in thegastrointestinal tract. Magnesium hydroxide is an antacid and laxative. Droperidol is used totreat postoperative nausea and vomiting. Acetaminophen is a non-narcotic analgesic.Test-Taking Strategy: Use the process of elimination and note the key words,
 gas pains
.Recalling the classifications of the medications in the options will direct you to option 4. If this
 
Silvestri, 3/e, ISBN 1-1460-0052-6Unit XV (edited file)—"Comprehensive Test10/14/08, Page 2 of 46, 0 Figure(s), 0 Table(s), 0 Box(es)
question was difficult, review this medication.Level of Cognitive Ability: ApplicationClient Needs: Physiological IntegrityIntegrated Process: Nursing Process/ImplementationContent Area: PharmacologyReference: Hodgson, B., & Kizior, R. (2005).
Saunders nursing drug handbook 2005
.Philadelphia: W.B. Saunders, p. 970.3. A client is admitted to the hospital with a diagnosis of major depression. The nurse collectsdata on the client and determines that a major concern is the client’s altered nutrition related to poor nutritional intake. The most appropriate nursing intervention related to this concern is:1. Explain to the client the importance of a good nutritional intake.2. Weigh the client three times per week, before breakfast.3. Report the nutritional concern to the psychiatrist and obtain a nutritional consult as soon as possible.4. Consult with the nutritionist, offer the client several small, frequent meals daily, and schedule brief nursing interactions with the client during these times.Answer: 4Rationale: Change in appetite is one of the major symptoms of depression. Offering the clientseveral small, frequent meals and the nurse’s presence at that time to support, encourage, or  perhaps even feed the client is the most appropriate intervention. The client is experiencing poor concentration and will not understand the importance of an adequate nutritional intake.Weighing the client does not address how to increase nutritional intake. Reporting the nutritional problems to the psychiatrist is to some degree correct, but doesn’t address how one mightincrease food intake.Test-Taking Strategy: Use the process of elimination and focus on the issue, the poor nutritionalintake. Option 4 is the only option that addresses the altered nutrition concretely and designs amethod in which the client will feasibly increase the nutritional intake. Review care of the clientwith depression if you had difficulty with this question.Level of Cognitive Ability: ApplicationClient Needs: Physiological IntegrityIntegrated Process: Nursing Process/ImplementationContent Area: Mental HealthReference: Morrison-Valfre, M. (2005).
 Foundations of mental health care
(3rd ed.). St. Louis:Mosby, p. 215.4. A client received 20 units of NPH insulin subcutaneously at 8 a.m. The nurse should check the client for a hypoglycemic reaction at:1. 10 a.m.2. 11 a.m.3. 5 p.m.4. 11 p.m.Answer: 3Rationale: NPH is an intermediate-acting insulin. Its onset of action is 1 to 2 hours, it peaks in6 to 14 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur 
 
Silvestri, 3/e, ISBN 1-1460-0052-6Unit XV (edited file)—"Comprehensive Test10/14/08, Page 3 of 46, 0 Figure(s), 0 Table(s), 0 Box(es)
during peak time.Test-Taking Strategy: Knowledge regarding the onset, peak, and duration of action for NPHinsulin is required to answer this question. Recalling that peak action is between 6 and 14 hourswill direct you to option 3. Review the characteristics of NPH insulin if you had difficulty withthis question.Level of Cognitive Ability: ApplicationClient Needs: Physiological IntegrityIntegrated Process: Nursing Process/ImplementationContent Area: PharmacologyReference: Linton, A., & Maebius, N. (2003).
 Introduction to medical-surgical nursing 
(3rded.). Philadelphia: W.B. Saunders, p. 908.5. A nurse assists in developing a plan of care for a client with hyperparathyroidism receivingcalcitonin (Calcimar). Which outcome has the highest priority regarding this medication?1. Absence of side effects2. Reaching normal serum calcium levels3. Relief of pain4. Verbalization of appropriate medication knowledgeAnswer: 2Rationale: Hypercalcemia can occur in clients with hyperparathyroidism and calcitonin is usedto lower plasma calcium level. The highest priority outcome in this client situation would be areduction in serum calcium level. Option 3 is unrelated to this medication. Although options 1and 4 are expected outcomes, they are not the priority.Test-Taking Strategy: Use the process of elimination. Noting the client diagnosis will assist indirecting you to option 2. Additionally, note the relation between the name of the medication andthe word “calcium” in option 2. Review this medication if you had difficulty with this question.Level of Cognitive Ability: AnalysisClient Needs: Physiological IntegrityIntegrated Process: Nursing Process/EvaluationContent Area: Adult Health/EndocrineReference: Skidmore-Roth, L. (2005).
Mosby’s drug guide for nurses
(6th ed.). St. Louis:Mosby, p. 125. 6. A nursing instructor asks a nursing student about the cause of hemophilia. The studentresponds by telling the instructor that:1. Hemophilia is a Y-linked hereditary disorder.2. Males inherit hemophilia from their fathers.3. Females inherit hemophilia from their mothers.4. Hemophilia A results from deficiency of factor VIII.Answer: 4Rationale: Males inherit hemophilia from their mothers and females inherit the carrier statusfrom their fathers. Some females who are carriers have an increased tendency to bleed and,although it is rare, females can have hemophilia if their fathers have the disorder and their mothers are carriers of the genetic disorder. Hemophilia is inherited in a recessive manner via agenetic defect on the X chromosome. Hemophilia A results from a deficiency of factor VIII.

Activity (31)

You've already reviewed this. Edit your review.
MelG0502 liked this
1 thousand reads
1 hundred reads
tavito916 liked this
Zachari Jules liked this
Manol Manal liked this
Akunna Tagbo liked this
Trisha Jokerst liked this
Manol Manal liked this

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->