Professional Documents
Culture Documents
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What is the typical temp elevation in Low grade, usually below 102, but can go
croup? up to 104.
Are ATBs helpful for croup? For epiglottits? For croup, no. Epiglottitis, yes
What should never be done to a child with Never put anything in the child's mouth, ie,
epiglottitis? a tongue blade can lead to obstruction
What are the typical signs and symptoms Barking cough, inspiratory stridor, labored
of croup? resp. pattern
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What 3 signs tell you that the child has
Muffled voice, drooling, increased fever
epiglottitis instead of croup?
When is croup bad enough to be evaluated When retractions, and high pitched stridor
by a doc? are present
The most freq. cause of lead poisoning is... Ingestion of lead-based paint chips
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The type of cell that is most common and
Immature WBC
problematic in leukemia is ____
What causes lymph gland enlargement in All those small immature WBC clog the
leukemia? lymph system
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RN's priority in tx a child with newly
Dec. risk of infection
diagnosed leukemia is...
Why do some kids with leukemia have joint The immature WBCs infiltrate the joint and
pain? cause inflammation
Why is a child with leukemia at risk for The immature WBCs infiltrate the brain and
neuro sx due to ICP cause inflammation
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What does ANC mean? Absolute Neutrophil Count
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At what age should the infant be fed
Not before 12 months
cows/goats milk?
Youngsters develop food preferences by.. Observing significant ppl in their environ
What dietary strategy is most appropriate Wholesome snacks, bc they are often too
for the industrious school-age child? busy too eat
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Girls in adolescence need more calories
False, boys need more cals
than adolescent boys T/F?
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Temporary increase in vascular & lymph
If mastitis is caused by an organism , what
supply to the breast in preparation for milk
causes breast engorgement
production
Does breast engorgement interfere with Yes, the infant has a difficult time latching
nursing? on
The mother with mastitis should stop False. The mother must keep breast
breast feeding (T/F)? feeding. (Offer unaffected breast first).
For breast engorgement, the non- No, that would increase milk production and would
breastfeeding mother should be told to make the problem worse (warm compresses or a
express milk (T/F) warm shower to let milk "leak" is okay - Ice is best
What is the best tx for breast Breast feeding - it will balance supply and
engorgement? demand
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Inflammation / infection of the mastoid
What is mastoiditis?
process
What unusual post-op complication can Facial nerve paralysis d/t accidental
result from mastoidectomy? damage during surgery
What should you do to assess for facial Have the patient smile and wrinkle
nerve paralysis post-mastoidectomy? forehead
Should the nurse change the post- No, reinforce it. Physician changes first
mastoidectomy dressing? post-op dressing
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What is a major nursing diagnosis post-
Safety
mastoidectomy ? PG 92
What safety measures should be followed Side rails up x4, ambulate only with
with Meniere's? assistance
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What disease often follows Bell's palsy - facial paralysis, will go away in
labyrinthectomy? a few month
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What visual S&S will the pt with meningitis
Photophobia (over-sensitivity to light)
have?
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The client with meningitis can develop ___ Seizures
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To develop and maintain the corpus luteum
What is the major function of the luteal
which produces progesterone to maintain
phase of the ovarian cycle?
pregnancy until placenta is est.
What occurs during the follicular phase of It accomplishes maturation of the graafian
the ovarian cycle? follicle which results in ovulation
The long term tx of migraine focuses Assessing things that bring on stress and
upon... then planning to avoid them
What are the processes occurring in Reflex constriction then dilation of cerebral
migraines? arteries
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Where is the pain of migraines most likely
Temporal, supraorbital
located?
MS affects men more than women (T/F) False, affects women more than men
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What is the 1st sign of MS? Blurred or double vision
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Diarrhea (Hint: the D's go together,
Dantrium causes (constipation/ diarrhea)
Dantrium and Diarrhea)
What major sense is affected most in MS Tactile (touch) - they burn themselves
(besides vision)? easily
MG affects men more than women (T/F) False, affects women more than men
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What neurotransmitter is problematic in
Acetycholine
MG?
What will the facial appearance of a patient Mask-like with a snarling smile (called a
with MG look like? myasthenic smile)
If a patient has MG, what will be the results The patient will show a dramatic sudden
of the Tensilon Test? increase in muscle strength
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What is the most important thing to
They must be given EXACTLY ON TIME; at
remember about giving Mestinon and other
home, they might need to set an alarm
anticholinesterases?
Do you give anticholinesterases with or With food, about 1/2 hour ac; giving ac
without food? helps strengthen muscles of swallowing
Name the two types of crises that a MG pt Cholinergic (too much Mestinon);
can have Myasthenic (not enough Mestinon)
What words will the client use to describe Crushing, heavy, squeezing, radiating to
the pain of an MI? left arm, neck, jaw, shoulder
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Death d/t MI occurs within ___ hour of
1
symptom onset in 50% of all patients
What is the reason for giving post MI To prevent platelets from forming clots in
patients ASA? the coronary arteries
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Do people without cell damage have No, troponin is only present when
troponin in their blood? myocardial cells are damaged
How soon after cell damage does troponin As soon as 3 hours (can remain elevated
increase? for 7 days)
Will the client with an MI need 100% O2 for No, just moderate flow (42% or 3-6L for
their entire stay in the hospital? first 48h)
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Vegetables highest in Na are ___ Canned veggies
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As a rule, processed meats and cheeses
Very high
are ___ in Na
When an NG tube is being used for The stomach is being emptied of its
decompression what is happening? contents by suction
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How long do you irrigate an NG with iced Until the irrigating solution comes back out
tap water when the stomach is bleeding? clear
Why are salem sump tubes best suited for Because they have vents that prevent
safe gastric suctioning? damage to the gastric mucosa
Before you put anything down the NG you You must check the see if the NG
must do what? placement is in the stomach
How do you determine how far to put an Measure from the tip of the nose to the
NG tube in? back of the ear then to the xiphoid process
In what position should the client be during HOB must be elevated 30 degrees (semi-
a continuous NG tube feeding? fowler's would be acceptable)
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No, it is not a specific disease, it is a group
Is nephrotic syndrome a disease?
of S&S that can result from many diseases
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Is scrotal edema common in nephrosis? Yes
Name the 3 sub-scales in the Glasgow Best eye opening (E), Best verbal response
coma scale (GCS) (V), and best motor response (M)
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False, non-walking infants normally have a positive
It is always pathologic if a Babinski is
Babinski, walking infants, toddlers, and all other people
negative (T/F) should normally have a negative Babinski
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A system that defines actions with respect
Ethics
to their being judged right or wrong
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If the client perceives that the nurse
How could a nurse be convicted of
intends to do a procedure without consent
assault?
or justification
If a nurse uses restraints to keep a client, who is a False, you can detain/restrain a person
danger to himself, in bed, the nurse is likely to be against their will if they are: 1) a threat to
convicted of false imprisonment (T/F) self; 2) a threat to others
In order to legally sign as a witness to informed consent, False. You are only witnessing that the
the nurse must have been present when the physician patient was the one who signed the
and client discussed the procedure (T/F) consent
Can a patient legally sign an informed No. The patient would be considered to be
consent after they have received the under the influence of a mind-altering drug.
premedication analgesic for a procedure? The consent would be invalid
Name 3 groups of ppl who cannot give Minor, unconscious client (even under
legal consent influence of CNS drugs), mentally ill
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Anxiety-producing thoughts are called
Obsessions
____
Should you allow an OCD person to Yes, give them time to do their ritual and
perform their compulsive behavior? try to set a limit and redirect
What should you do if an obsessive- Get them started earlier - for ex. if they wash their hands
complusive person is always late due to for 1/2 hour before meals and are always late for
their rituals? breakfast, just get them started 1/2 hour earlier
What are the two typer of oral Progestin only & combination progesterone
contraceptives? and estrogen
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How many days of the menstrual cycle do You take it on days 5-24, but not on days
you take the combo pill? 24-28 and 1-4 (8 days off)
If a woman forgets to take the pill one day, Take it as soon as she remembers it, and
what should she do? take next pill at regular time.
What if a woman forgets to take the pill for Take 2 pills a day for 2 days in a row and
two days in a row? What should she do? then resume normal schedule
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Osteoarthritis is most commonly caused by
True
the wear and tear of life (T/F)
Are rest periods and ROM exercises Yes, rest is probably the most effective
appropriate in the care of osteoarthritis? thing they can do.
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Osteoarthritis is more common in females
False, it occurs in equal frequency
(T/F)
What should the client avoid post- Coughing, sneezing, blowing nose,
stapedectomy? swimming, showers, flying
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What warning should you give the client
Get up slowly
about getting up after stapedectomy?
What should the client expect regarding An initial decrease with the benefits of
hearing post-stapedectomy? surgery noticeable in 6 weeks
What should the client do if he must Open his mouth, this de-pressurizes the
sneeze? middle ear
What will be the results of the Rinne test in Bone conduction will be better than air
otosclerosis? conduction
If the client complains of dec. hearing after It is normal d/t edema. The hearing will
stapedectomy what would you say? start to improve within 6 weeks
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What 2 drugs are commonly given post- Codeine/Demerol for pain, Dramamine for
stapedectomy dizziness
What is the #1 reasons why MD's remove Remove before they transform into
ovarian cysts? malignant
What does torsion of an ovarian cyst Twisting of cyst with interruption of its blood
mean? supply
What is the big danger from torsion? Necrosis and rupture of ovary
What affect do oral contraceptives have on They cause it to stop growing and
ovarian cysts? decrease in size
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Compare signs of non-ruptured ovarian Non-ruptured= low back pain, dull pelvic pain, abnormal
uterine bleeding esp. with mensturation
cysts with the signs of a ruptured ovarian
cyst Ruptured: acute pain, abd distention, and abd rigidity
When does it occur in pregnancy? 2-3 weeks before birth for primipara
What is the most common positive effect of After it occurs the woman can breathe
lightening? much easier
Name the 2 earliest signs that a woman is Low back pain and show (blood-tinged
likely in labor mucous plug has passed)
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What is the meaning of cervical
The cervix thins
effacement?
The 3rd stage of the L&D lasts... Less than one hour
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What occurs during the 4th stage of L&D? Recovery
When does 4th stage of L&D end? 2 hours after expulsion of the placenta
When are urine pregnancy tests positive? At the time of the first missed period
Pregnancy tests test for the presence of HCG (human chorionic gonadotropin
what hormone? hormone)
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What is Hegar's sign? Uterine softening
Which week can mother first feel the fetus 16th-20th week, (the end of the 4th month
move? into the 5th month)
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Which trimester is N&V most common? First
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Which trimester is constipation most
Third
common?
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When O2 is administered, it must be ... Humidified
What drugs can cause a Parkinson-like Haldol, major tranquilizers - drugs that end
syndrome? in "-azine"
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What type of gait is seen in Parkinson's? Shuffling slow gait
What vitamin should patients on Levodopa B6, pyridoxine - Vitamin B6 reduces the
avoid? effectiveness of levodopa
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The tremors of Parkinson's will get better
Better, they tremor more when not
or worse when they purposefully move or
performing an action
perform a task?
The client on a PCA pump is less likely to True, b/c the comfortable pt moves around more
have post-op complications than the client and is less likely to get thrombophlebitis,
w/o a PCA pump (T/F)? pulmonary embolus, fatigue, ileus and pneumonia
Clients with COPD are not good candidates True, d/t the effects of narcotics on central
for PCA pumps (T/F)? respiratory control
Name the 3 most common uses of PCA Post-op pain, cancer pain, sickle-cell crisis
techniques pain
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Which patients should be forbidden to Those with oxygen in the room, confused,
smoke? Smoke alone? sleepy, drugged patients
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The comfort range of temperature is ... 68-74
Bed side rails should be up for the Elderly clients, unconscious, babies, young
following individuals... children, restless, confused
The S&S of sensory overload and sensory Fear, panic, depression, inability to
deprivation are... concentrate, restlessness, agitation
If a family member asks to have the side Remember that you are responsible for the
rails down while they are in the room you client's safety - not his family, it might be
should... unwise to permit this
What common household solution is used Vinegar. Nits are the eggs of lice that
to remove nits? adhere to the hair shaft
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Where are head lice most commonly At the back of the head and behind the
found? ears
After tx how long do you have to inspect for Inspect for 2 weeks to be sure that they are
lice? all gone
What is the typical of the lesions of Foul-smelling, blisters break easily, seen in
pemphigus the elderly, cause is unknown
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What is the typical skin care of pemphigus? Cool, wet dressings
What are the top 3 nursing interventions in Oral care, protection from infection,
pemphigus? encouraging high fluid intake
An acute or chronic disease of adults, characterized by occurrence of successive crops of bullae that
appear suddenly on apparently normal skin and disappear, leaving pigmented spots. It may be attended by
Define pemphigus itching and burning and constitutional disturbance. The disease if untreated is usually fatal. A characteristic
finding is a positive Nikolsky sign: When pressure is applied tangential to the surface of affected skin, the
outer layer of epidermis will detach from the lower layer (probably autoimmune)
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How long does one episode /course of PD
Could be 10 hours
last?
Before PD it is important the client be... Weighed, to assess water loss or gain
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What force is used to introduce the
Gravity only, no pumps
dialysate into the peritoneum
How often do you measure vital signs Q15min during the first cycle and qhour
during PD? thereafter
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If the client absorbs too much of the
Increased BP (circulatory overload)
dialysate the client will experience...
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Why isn't Vitamin B-12 (extrinsic factor)
Bc these patients lack intrinsic factor
absorbed in pernicious anemia?
Is it okay to give B-12 orally to a client with No, it will never be absorbed d/t a lack of
pernicious anemia? intrinsic factor
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When the child realizes that number, weight,
What is conservation? In what stage does
volume remain the same even when outward
it develop?
appearances change; Concrete Operational
What is the classic symptom of Placenta Painless 3rd trimester bleeding (hint:
Previa? Painless Placenta Previa)
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What is meant when the physician/nurse use Total or complete: placenta covers whole cervical opening
the terms total (complete) or partial Partial or incomplete: placenta covers only part of the
(incomplete) in reference to placenta previa? cervical opening
If a surgeon delays doing a C-section for Immaturity of the fetus (they will want the
placenta previa it is d/t: (reason for delay) child to mature)
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Pneumonia is an ____ in the ____ __ ____ Infection, alveoli of lungs
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What organ will be enlarged in The spleen, bc it is destroying the
polycythemia vera? excessive RBCs
D/t enlarged destruction of RBCs seen in Uric acid levels will be high (remember- uric acid levels
polycythemia vera what blood level will be are always high when cells are being destroyed as in
increased? hemolysis, chemotherapy or radiation therapy)
What drug is most commonly used in Myleran (this is usually used for bone
polycythemia vera? marrow cancer)
Will the typical post-op client have lung Lung-yes; bowel sounds- no; Low grade
sounds? Bowel sounds? Increased temp? temp- yes
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Unless contraindicated the pt should be out
24h
of bed no later than ___ hours post-op
The best way to prevent thrombophlebitis False, ambulation /exercise are the best
is TED hose (T/F) way
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Dec HOB (but not flat); cover with sterile
What do you do, in order, for evisceration? gauze moistened with sterile saline, call
MD
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In gestational diabetes the client
Increase (polydipsia)
experiences a (dec/inc) in thirst
Gestational diabetes is ass w/ what OB Prev. large baby (over 9lb.), unexplained
history? stillbirth, miscarriage, congenital anomalies
3 hr glucose tolerance test A blood sample will be collected when you arrive. This is your fasting blood
glucose value. It provides a baseline for comparing other glucose values.
What test confirms the diagnoses of You will be asked to drink a sweet liquid containing a measured amount of glucose. It is best to drink the
liquid quickly. For the standard glucose tolerance test, you will drink 75 grams or 100 grams.
gestational diabetes? Blood samples will be collected at timed intervals of 1, 2, and sometimes 3 hours after you drink the
glucose. Blood samples may also be taken as soon as 30 minutes to more than 3 hours after you drink the
glucose.
How often should a woman visit the doctor Twice a month, then once per week in the
prenatally if diabetes is present? 3rd trimester
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Is severe carbs restriction required in
No, it could lead to ketosis
gestational diabetes?
When is insulin used in tx of gestational When dietary control does not keep the
diabetes? blood sugar within normal limits
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Why is hypoglycemia such a dangerous
Brain cells die w/t glucose, brain damage
problem?
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When pre-eclampsia gets worse the deep
tendon reflexes will be (hypo/hyper)- Hyper-reflexia
reflexia
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Premature rupture of membranes (PROM)
is a ____ break in the amniotic sac ___ the Spontaneous, before, onset
____ of the contractions
How would you tell if the woman with Maternal fever, fetal tachy, foul smelling
PROM had an infection? discharge
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If labor does not begin within ___ hours
24
after PROM, labor will likely be induced
If PROM occurs after viability but before 36 Hospitalize, watch for infection, try to gain
weeks, what is the typical management? time for the infant to mature
If the nurse uses self-disclosure it should Short, quickly re-focused back on the
be ____ and the conversation should be... patient
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During what phase should the nurse
Pre-interaction phase
examine his/her own feelings
What are the steps of the nurse/patient Pre-interaction phase, orientation phase,
therapeutic relationship? working phase, termination phase
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What force causes pulmonary edema in Increased hydrostatic pressure in the
left ventricular failure? pulmonary capillaries
Can letting IVs run in too fast cause Yes, in the client with poor cardiovascular
pulmonary edema? function
What are the 4 classic signs of pulmonary Dyspnea on exertion, paroxysmal nocturnal
edema? dyspnea, orthopnea, coughing
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Is O2 given in pulmonary edema? Yes
Why is morphine given to clients with To dec apprehension and dec preload, this
pulmonary edema? rests the heart
If your client suddenly goes into pulmonary Elevate the HOB, then increase oxygen,
edema what would you do first? then call MD
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What genetic disorder can lead to
Sickle cell anemia
pulmonary embolus?
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It is low-dose Heparin used for anticoagulation in
What is lovenox? POST-OP THROMBOPHLEBITIS PREVENTION
NOT USED FOR PULMONARY EMBOLUS
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Name the S&S that pyelonephritis and Frequency, urgency, burning, cloudy, foul
cystitis have in common? smelling urine
What medical intervention is necessary in IV ATBs for 1-2 weeks, must get urine
pyelonephritis? culture 2 weeks after ATBs therapy over
Will the client with pyelonephritis have daily Yes, as would any client with a kidney
weight? problem
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Where is the pyloric sphincter? At the distal (duodenal) end of stomach
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What do you see during and after feeding? Peristaltic waves from L to R
Of sealed internal, unsealed internal, and Sealed internal then unsealed internal, external
external radiation tx, which is MOST radiation tx is of no danger to the RN unless
dangerous for the nurse? the RN is in the radiation tx room during the tx
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Should prego nurses care for a patient
Never (Lawsuit time!)
receiving sealed internal radiotherapy?
What skin products should the pt receiving No ointments with metals like zinc oxide, no
external radiotherapy AVOID? talcum powder
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Immediately after rape, a woman who is False, calmness and a composed attitude are S&S
calm and composed is adjusting well of Rape Trauma syndrome (calm person is just as
(T/F)? disorganized as the crying and upset lady)
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What drug is often used to prevent Kits approved by FDA: Preven of Plan B
pregnancy after rape? (less N&V)
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What will you find when you assess the Weak/absent pulse, cool, pale, loss of hair,
legs of these patients? shiny thin skin
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Give three stages of ARF Oliguric, diuretic, recovery
What is the BIG danger in ARF? Hyperkalemia and it's effect on the heart
What are the dietary modifications for the Increased carbs, decreased protein, dec.
oliguric phase of ARF? sodium, dec. potassium, dec. water
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In the oliguric phase, blood volume is ___,
High, high, high
sodium is ____, and potassium is ____
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Surfactant prevents the ____ of the alveoli Collapse
What other test is used to confirm fetal Amniotic fluid is analyzed for presence of
lung maturity? PG
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PEEP (positive end expiratory pressure) and CPAP
Severe cases of Respiratory Distress (continuous positive airway pressure), to keep the
Syndrome requires ventilation with ____ alveoli open while on the ventilator. High frequency jet
ventilation is sometimes used.
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As in most inflammatory disorders, the
Elevated; leukocytosis
WBC count is ___. This is called ____
What type of chair should be used for A chair with a high seat, armrests, and one
rheumatoid arthritis clients? in which the knees are lower than hips
Rheumatoid arthritis attacks the ___, ___, Joint, muscles, tendons, ligaments, blood
____, ___, and ____. vessels
Where are the nodules of rheumatoid The nodes of rheumatoid arthritis are subcutaneous
arthritis found in contrast to the Heberdens nodules usually on the elbows (ventral forearm);
nodes of osteoarthritis? Herberden's nodes of osteroarthritis are on the fingers
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Which joints of the fingers are most
The proximal interphalangeal joint (PIP)
effected by rheumatoid arthritis?
CHF CHF
Scoliosis is MOST common in the ____ Thoracic and lumbar (2nd and 3rd section/
and ____ sections of the spinal column 5 sections)
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With which other two spine deformities is Lordosis (swayback)
scoliosis associated? Kyphosis (humpback)
What is the difference between structural Structural - you are born with it
and functional scoliosis? Functional - you get from bad posture
Name 4 exercises used to treat mild Heel lifts; sit ups; hyperextension of the
scoliosis? spine; breathing exercises
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What type of cast is used post-op? Risser cast
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What group of people get cast syndrome? ANYONE in a body cast
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What are the #1 and #2 causes of sickle
Hypoxia, dehydration
cell crisis?
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Sickle-cell anemia symptoms do not
appear before the age of ___ months d/t 6; fetal hemoglobin
the precense of ____ ____
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When does spinal shock occur? Immediately or within 2 hours of injury
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The patient with spinal cord injury will have
Spastic
(flaccid/spastic) muscles
What are the vital sign changes seen in Sweating, HA, N&V, gooseflesh, and
autonomic dysreflexia? severe HYPERtension
Should the client drink after a spinal tap? Yes, encourage fluids to replace CSF
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Do need an informed consent for a spinal
Yes
tap?
In what position should the client be during Lateral decubitus (on their side) position
a spinal tap? and knees to chest
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Which hand should hold the suction
catheter? Which should hold the The dominant, the non-dominant hang
connecting tube?
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When its needs to be, for ex. moist lung
How often should the client's airway be
sounds, tachy, restlessness (hypoxia),
suctioned?
ineffective cough
Do you assess for suicide potential Yes, in fact whenever a patient makes a statement about
wishing or wanting to die or kill self you must ALWAYS
whenever a pt makes any statement about AND FIRST assess suicide potential - stop everything
wanting to die or kill self? and assess for suicide patient (except CPR, of course)
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Adolescents are (low/high) risk for suicide High
The pt who has a definite plan is (low/high) Moderate to high, depends upon feasibility
risk for suicide and ease of plan
The goal of action while the suicidal patient Another person on the scene (this
is still on the phone is to get ___ person immediately decreases risk). Remember:
___ the ____. ppl who are alone are always at high risk
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Search personal belongings for drugs and alcohol,
remove any sharp objects, remove any device for
What are the 4 classic suicide precautions? hanging or strangling; must be on constant one-to-one
observation (NEVER out of sight)
Syphilis first infects the ___ ____ Mucous membranes (mouth, vulvar)
What is the lesion like in primary syphilis? The chancre (pronounced shanker)
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Late syphilis attacks which 3 body organs? Liver, heart, brain
TENS electrodes stimulate (large/small) Large - this is the basis of the gate control
diameter fibers theory
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TENS electrodes are placed onto the... Skin
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Describe the position the client should Upright with arms and shoulders elevated,
assume during a thoracentesis? slightly leaning forward
SSKI should be given with ___ ___ to dec. Fruit juices; bitter taste (SSKI - super
the ___ ____ saturated solution of potassium iodide)
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Give another name for thyroid storm Thyrotoxicosis, thyroid crisis
What is the second thing a nurse does Call MD, can pack in ice or use
when thyroid crisis occurs? hypothermia blanket
What are the side effects of thyroid Tachy, palpitations and other signs seen in
replacement drugs? hyperthyroidism
Why is Lugols solution given pre-op To dec. the vascularity of the gland and
thyroidectomy minimize blood loss
After thyroidectomy you check for wound Slipping your hand under the neck and
hemorrhage by... shoulders
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*Why do you assess the post-op Bc during surgery the surgeon may have
thyroidectomy pt voice for hoarseness nicked the recurrent laryngeal nerve (this
periodically? nerve is tested on state boards)
When is hypocalcemia most likely to occur The 2nd and 3rd post-op day- bc it takes
after thyroidectomy? Why? awhile for the level to drop
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Tremors/ tingling
What is the earliest sign of hypocalcemia?
(muscles weakness/ numbness)
TPN can be safely infused via a peripheral It can, but only for a very short period - 48
IV line (T/F) to 72 hours maximum
It is okay however to slow the rate down if False, never slow the rate down - it could
the client leaves the unit (T/F) cause hypoglycemia
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What tests must the nurse perform q6h
#1 accu check, #2 urine glucose/acetone
when a patient is on TPN?
Be certain to shake a lipid emulsion before False, never shake it, shaking damages
administration (T/F) the molecules
1) Esophageal atrasia - EA
What are the 3 most common tracheo- 2) Tracheo-esophageal fistula - TEF
esophageal malformations? 3) Tracheo-esophageal fistula with esophageal atresia -
TEF w/ EA
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Name - a blind end esophagus: the
Simple esophageal atresia
trachea is connected to the lungs
What are the 2 major reasons for To keep the airway patent, and to keep the
performing trach care? stoma site clean (decrease infection)
Both hands must be kept sterile throughout False, only the dominant hand remains
the entire trach care procedure (T/F) sterile
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When trach suctioning and care is
performed by the client at home, sterile False, clean technique is adequate
technique must be followed (T/F)
Is surgery done for trigeminal neuraglia? Yes, nerve avulsion (destroying the nerve)
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What organism causes pulmonary TB? Mycobacterium tuberculosis
When should a Mantoux test be read? 48-72 hours after test injection
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How often and when during the day should
Isonizad, Rifampin, and Ethambutol be Every day, all together
given?
Which test is most diagnostic for TB? Sputum for acid-fast bacilli
What does the sputum look like in TB? Purulent (pus) or hemoptysis (blood)
Bed rest UC
Women mostly UC
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One-layer ulceration's with edema of bowel UC
Bloody diarrhea UC
Young adults UC
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Terminal-distal-small intestine Crohn's
Adults, up to 4o Crohn's
Diarrhea Crohn's
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The purpose of an upper GI series is to
Ulcerations
detect ____
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If your client is 4 years old or younger,
No
should you take an oral temp?
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In the normal adult, which is longer,
Expiration
inspiration or expiration
Is the client NPO for a voiding cystogram? No, just clear liquid breakfast
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Sutures in general are removed by the ___
7th
day
To remove tape always pull (toward/away) Toward (this way you don't put pressure/
from the wound pull on the suture line)
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When swabbing an incision you should
start at the incision or 1 inch away from the Start at the incision and move outward
incision?
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If you are the nurse starting the IV on the
client with Abruptio Placenta, what gauge 18 gauge - to give blood if necessary
needle should you use?
How often should you measure the vital q5-15min for bleeding and maternal VS -
signs, vaginal bleeding, fetal heart rate continuous fetal monitoring, deliver at
during Abruptio Placenta? earliest sign of fetal distress
Should vomiting be induced after ingestion No - not for gas or any other petroleum
of gasoline? products
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An elderly client is a (high/low) risk for
High - d/t poor eyesight
accidental poisoning?
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What side effects is MOST important in
health teaching in accutane It can cause birth defects
administration?
What instructions do you give a client Take it on an empty stomach and avoid the
taking tetracycline? sunlight (photosensitivity)
The AIDS virus invades helper ___ ____ T-lymphocytes (CD4 cells)
AIDS is transmitted through what four Blood, sexual contact, breast feeding,
routes? across placenta in utero
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True, but not transmitted by all - only
HIV is present in all body fluids (T/F)
blood, semen, and breast milk
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A delayed onset of AIDS for as long as
What does the physician hope to achieve
possible. (Usually can delay onset for 10-
with these drugs?
15 years)
What lab findings are present in AIDS? Decreased RBC, WBC, platelets
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If the AIDS pt has leukopenia (dec. WBC) a
Protective isolation
they will be on ___ ____
W/o leukopenia the AIDS pt will be on ___ Standard precautions or blood and body
precautions fluid precautions
When the AIDS pt has a low platelet count, Bleeding precautions: No IM's, no rectal
what is indicated? temps, etc.
Are all articles used by AIDS pts double No - only those contaminated with
bagged? secretions
Can AIDS pt leave the floor? Yes, unless WBC very low
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Not usually - however if there is severe azotemia then it
Is dietary protein limited in AGN? may be restricted -- azotemia means nitrogenous
wastes in the blood - increased creatinine, BUN
What is the most important intervention in Bedrest - they can walk if hematuria,
treating AGN? edema, and hypertension are gone
What is the common dietary restriction for Moderate sodium restriction. Fluid
AGN? restriction is #2 if edema is severe.
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It becomes clogged with antigen-antibody
What happens to the kidney in AGN? complexes which then cause inflammation
and loss of function
What are the first signs of AGN? Puffiness of face, dark urine
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How do you prevent flexion contracture of Remind the patient to straighten their knee
the knee after BKA? constantly while standing
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Can an aneurysm result from an infection?
Yes, yes
From syphilis?
The pain of the two is very similar; the way to tell the
How do you tell if the client has angina or difference is if nitroglycerine and rest relieve the pain, its
an MI? angina. If nitroglycerine and rest do not relieve the pain,
it's probably an MI.
How many minutes should lapse between 5 minutes, remember you can take up to 3
the nitroglycerine pills you take? tablets 5 minutes apart. If no relief, call MD.
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By what route do you take nitroglycerine? Sublingual
What precaution must the nurse take when Wear gloves - nurse may get a dose of the
administering topical nitroglycerine paste? medicine
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What is found over the body of the client
Lanugo- soft downy hair
with anorexia nervosa?
What is the top priority in the care of the Intake of enough food to keep them alive,
client with anorexia nervosa? have them gain weight
When is APGAR scoring performed on At one minute and again at 5 minutes after
infants? birth
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A 0 on the APGAR is ____ (bad/good) Bad, the baby is stillborn
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To score the max of 2 pts on
neuromuscular reflex irritability the infant Cry
must ___
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What is the 1st sign of appendicitis? Right upper quadrant pain
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Before the client with suspected
No pain meds, NO enemas or laxatives, no
appendicitis sees the physician what
food
should be avoided?
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When the body does not receive enough
Protein and fats
carbs it burns ___ and ___
Vitamins and minerals provide energy for False- they are necessary for a body's
the body (T/F)? chemical reactions
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An individual is overweight if they are ___%
10%
above the ideal weight
How should the temp of the water be Dropping water on inside surface of your
tested if no thermometer is available? forearms
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When cleansing an infant's eye, cleanse
No, inner to outer
from outer to inner canthus?
Should you retract the foreskin of a 5 week No, not until foreskin retracts naturally and
old male, uncircumcised infant to cleanse without resistance - then it should be
the area? retracted, cleansed, and replaced
What solution is commonly used for care of 70% alcohol to promote drying (trend is
the umbilical cord? toward soap & water)
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In addition to the facial paralysis, the sense
Taste
of ___ is also affected
Give 3 eye interventions for the client with Dark glasses, artificial tears, cover eye at
Bell's Palsy night
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Will the man with BPH have enuresis, Enuresis (unable to control pee) - no,
nocturia, or hematuria? nocturia - yes, and hematuria - maybe
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Should you take a rectal temp after
No rectal temps, yes stool softeners
prostatectomy? Give stool softeners?
You should call the MD after TURP when Bright thick blood, persistent clots,
you see ___ thick ____ , ___ clots, and persistent urine on dressing (don't call MD
___ urine drainage on the dressing for transitory clots and urine on dressing)
If you see an increase in the blood content Pull carefully on the catheter to apply local
of urine coming out of the catheter, you pressure on the prostate with the Foley
would first ____ balloon
What exercises should the post- Perineal exercises, start and stop stream of
prostectomy patient do upon discharge? urine, bc dribbling is a common but temp.
Why? problem post-op
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Is it okay to routinely irrigate indwelling
No
catheters?
What agents are best for catheter care? Soap and water
What is the most effective way to dec. UTI Keep the drainage system closed, do not
with catheters? disconnect junctions of the tubing
Give 3 appropriate indications for bladder Urinary retention, to check for residual, to
catheterization? monitor hourly output
What are the top 2 diagnoses for a client #1 - Potential for infection; Potential
with a catheter? Which is #1? impairment of urethral tissue integrity
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The difference between the systolic and
What is the pulse pressure?
the diastolic BP
If you deflate a cuff TOO SLOWLY, the High, venous congestion makes the arterial
reading will be too high or low? Why? pressure higher (increases resistance)
What does a type and cross match Whether the client's blood and donor blood
indicate? are compatible
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What should the nurse measure before
Vital signs
starting a transfusion?
What happens when blood is administered The cells clump together and don't flow
with dextrose IVs? well
If a transfusion reaction occurs what First, stop the blood flow and start running
should the nurse do first? the saline
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What are the 3 types of transfusion
Allergic, hemolytic, febrile
reactions that can occur?
What are the S&S of a febrile transfusion Low back pain, HA - same as hemolytic
reaction? Increasing temp, confusion, hemoptysis
What are the S&S of an allergic reaction to Hives (uticaria), wheezing, pruritus, joint
a transfusion? pain (arthralgia)
What does blood typing mean? Check for surface antigen on the RBC
When does typing and cross matching Whenever a client is to get a blood product.
need to be done? It is only good for 24 hours
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Within 30 minutes of the beginning of the
When is a febrile reaction likely to occur?
transfusion
What is the difference between whole Packed cells don't have nearly as much
blood and packed cells? plasma or volume as whole blood does
What would you do if the client had an Call the MD because blood is often held
increasing temp and was to get blood? with an elevated temperature
What is the routine for vital sign Once before admin and q15min x2 after admin has
measurements with a transfusion? begun, then q hour x1 after transfusion has stopped
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What gauge needle is used with a blood
Large gauge, 18 gauge
transfusion?
What other things are appropriate to do Call MD, get a blood sample, get urine
after a reaction? sample, monitor vitals, send blood to lab
Can blood be given immediately after No, it has to be warmed first for only about
removal from refrigeration? 20-30min
How does the mother break the suction of She inserts her little finger into the side of
the breast feeding infant? the infants mouth
Assuming no mastitis, on which side should Begin nursing on the side that the baby
breast feeding begin? finished on the last feeding
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How long can breast milk be frozen? 6 months
What should you tell a breast feeding Milk should come in by postpartum day 3.
mother about her milk supply when she Breastfeed q2-3 hours to est. good milk
goes home from the hospital? supply
Should not use OCP during first 6 weeks after birth bc the
Can a woman on oral contraceptives hormones may dec. milk supply. Estrogen is not
breastfeed? recommended. Non-hormonal methods are recommended.
Remember breastfeeding is an unreliable contraceptive
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Upon walking the pt with Buerger's
Intermittent Claudication
experiences ____
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A third-degree burn is wet or dry? Dry
Of first, second, and third degree burns Third degree burns, nerve damage has
which has less pain? Why? occurred
For what purpose do you use the rule of To estimate the percentage of body
nines? surface burned; is NOT used for children
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The shock phase lasts for the first ___ to
24-48 hours
___ hours after a burn
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If the nurse accidently runs the IVs at the
shock phase rate during diuretic phase the Pulmonary edema
pt will experience ___ ____
It is a stress GI ulcer, you get these with any severe physical stress. Tagament,
Zantac, Pepcid, (any H2 receptor antagonist), Protonix Prilosec
What is Curlings ulcer? Why is it a problem
-Acute peptic ulcer of the duodenum resulting as a complication from severe burns
in a burn patients? What drug prevents it? when reduced plasma volume leads to ischemia and cell necrosis (sloughing) of the
gastric mucosa
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The cause of cancer is known (T/F) False
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What drug should NOT be given to the
ASA - aspirin
patient with chemo thrombocytopenia?
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Can scalp tourniquets prevent chemo
In some cases, yes
alopecia?
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What is the #1 tx of CD during pregnancy? Rest
Why are anticoags (hep only) given to To prevent thrombophlebitis d/t venous
women with CD of pregnancy? congestion, usually in legs
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How long must the woman with CD of
At least one week
pregnancy be on bed rest after delivery?
What nutrients should be supplied in the Iron, folic acid, prevent anemia (anemia
diet of this woman? always makes the heart work more)
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From where should the nurse provide care
The head of the bed
to the client with cesium implant?
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Should the nurse provide perineal care for
No, risk of radiation hazard
the client an implant?
Should you use a heat lamp or hair dryer NO- heat lamp and hair dryer
or fan to help dry a cast? YES- fan
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Anxiety and stress leading to
What causes cast syndrome?
sympathoadrenal shut-down of the bowel
Traction is used to ___ a fracture, relieve Reduce and immobilize; muscle spasm;
___ ____ and prevent de-____ deformities
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Cranial tongs, Thomas splints with Peason
Name 3 types of skeletal traction
attachments, 90 - 90
To insure that Bryant's traction is working Off the bed enough to slip a hand between
the child's hip/sacrum should be ____ the sacrum and the bed
Is surgery done immediately upon No, they usually wait until it interferes with
diagnosis of cataract? activities of daily living
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What three most common visual defects Cloudiness, diplopia (double vision),
occur with cataract? photophobia (sensitivity to light)
When the client asks about the use of If an intraocular lense is implanted they will NOT need
glasses. If no lense is implanted, then contacts will be
glasses or contacts after surgery what fitted 3m post-op, temporary thick glasses given
would you say? immediately but will get a diff prescription in 2-3m
What positions are to be avoided after Lying face down. Also, do not lie on
cataract surgery? operative side for a month
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What positions are okay after cataract
Do not lie on operative side; DO lie on back
surgery?
Should you use talcum powder with a post- No, may cause sneezing; also should avoid
op cataract client? pepper
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The stools of a client with celiacs disease
Large, greasy, foul-smelling
are ___, ____, and ___ ____
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What grains are allowed in a gluten-free
Rice and corn
diet?
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How often should central line dressings be
QOD - every other day
changed?
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Obesity increases risk of CVA (T/F) True
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How often should the CVA pt be turned
Q2H
and repositioned?
ROM exercises should occur every 2 hours False - every 4 hours or 3 times a day is
(T/F) enough
To prevent urinary incontinence, the CVA False - remember incontinence will never
pt should be catheterized (T/F) be allowed as a reason for catheterization
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If the client has right homonymous
hemianopsia, the food on the ___ side of Right
the tray may be ignored
Should a CVA pt have all 4 side rails up at Side rails yes. Restraints no - unless they
all times? Should they be restricted? are a danger to self or others
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The loss of the ability to perform
purposeful, skilled acts, ie, brushing teeth, Apraxia
is called ____
The infant fears __ most when hospitalized Separation from love object
The school-aged child perceives the cause External, she knows that illness is not a
of illness to be external or internal? result of bad behavior
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The adolescent who is hospitalized fears
Peers, independence
separation from ___ and loss of ___
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Milk is (high/low) in cholesterol Low
Is cholesterol a triglyceride? No
What are the 2 common objective signs of Fever (hyperpyrexia), drainage from the
otitis media? ear
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What commonly happens secondary to
Perforation of the ear drum
otitis media?
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When is the cleft palate repaired? Between 1-5 years of age
In how many surgeries is cleft palate 2 surgeries - one at 12 -18m, the last at 4-
repaired? 5y
Why is final repair of the palate delayed Earlier surgery would interfere with tooth
until 4-5 years? development
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Is the infant restrained before repair? No, just after repair
What is the purpose of a Logan bow? To prevent stress on the suture line
What will be used to feed the infant after A dropper/syringe with rubber top to
cleft lip repair? discourage sucking
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What must the mother do after feeding the
Rinse the infant's/child's mouth with water
baby who has had cleft lip/palate repair?
What is meant by the term "double-barrel" A procedure where the colon is cut and
colostomy? both ends are brought out onto the abd
A fresh new stoma is ___, ___, and ____ Large, red, and noisy
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What behavior on the part of the client is
the BEST indicator that they have accepted When they do their own stoma care
their stoma?
By what day post-op should the client By the 3rd and 4th day. They should be
begin to take care of their own stoma? looking at it and asking questions by day 2
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Define descending colostomy
characteristics Formed s tool, ty pic al s tool odor, s tool does n't irritate unles s diarrhea, predic table 2-3 times per day empty ing, lowes t ris k
for F&E imbalanc es , c ontinent, do irrigate
When CO fails, name 3 ways the heart will Ventricular hypertrophy, dilate and heart
try to compensate rate will increase
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How often should anti-embolism hose be
Daily
removed? (TED)
Should clients with CHF have a foley Yes, on diuretics and fluid balance is
catheter? important
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You should tell the client with CHF to
immediately report to the doctor if he gains 3 pounds
___ lb in one week
Name the 4 most common toxic effects of Anorexia, N&V - very common, yellow
dig vision, arrhythmia
Hearing aids make sounds more distinct False- they only amplify - make it louder,
and clear (T/F) they do not clarify
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Can you use alcohol on the ear mold of a
No, it will dry and crack
hearing aid?
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What is gynecomastia?
Female-ty pe breas ts
What is hirsutism?
Hair where y ou don't want it
Is CF hereditary? Yes
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What glands are affected in CF? Exocrine glands
What are the top 2 nursing diagnoses for a Dec airway clearance; alteration in nutrition
client with CF? or alteration in absorption
What is the typical diet for the CF client? High cal, high protein, modified fat
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The child with a diagnosis of CF probably Meconium ileus - bowel obstruction d/t the
had a hx of ___ ___ at birth thickness of the stool
Why is the child with CF receiving They are enzymes which aid absorption of
pancreas/ viokase/ pancreatin? nutrients
What would you do if the clients urine was Record it in the notes, no need to call the
pink-tinged after cystoscopy? MD
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Is a signed consent required for
Yes
cystoscopy?
What vital sign changes are most ominous A fall in BP and increase in pulse -
after cystoscopy? increasing hemorrhage
Pacing can be a warning sign of potential True, as it any other form of increased
violence (T/F) motor activity
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What are you going to do and ask if there
After IDing yourself what do you say next?
are any questions
When a client is overtly and actively violent, True, once enough trained personnel are
they are given a chance to calm down present the client is told that if they don't
themselves before being subdued (T/F) control themselves they will be controlled by us
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False, in fact defense mechanisms are
Defense mechanism are always unhealthy
often and most always healthy bc they
(T/F)
reduce anxiety
When a pt hates someone but then Reaction formation - you form the opposite reaction, ie,
expresses the opposite emotion, it is called you love a person and that makes you anxious so you
____ form the opposite reaction and you ignore them
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What is the most important thing to do
immediately when retinal detachment is Bedrest
suspected?
Vitreous (c lear gel) pulls hard enough to tear the retina in one or more plac es . Fluid may pas s through a retinal tear, lifting
the retina off the bac k of the ey e
Does the client always need surgery for No, lasers can be used, as can freezing
retinal detachment? probes
Can the client return to work after retinal Not for 3 weeks - and may not be able to
surgery? go back to active jobs 6-8w after that
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What are the 2 non-surgical tx done for Laser photo coagulation cryosurgery -
retinal detachment? freezing
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What age can infant follow an object with
2m
its head?
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The signs of lithium toxicity are ___
(muscle symptom), ___, (abd sign), and Tremor, N&V
thirst
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Dig is a cardiac ___, used to ___ the
Glycoside, increase
contraction of cardiac muscle
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Ectopic pregnancy is (usually/almost
Almost never
never) carried to term
The most common med-surg tx for ectopic Surgical removal of fetus and some
pregnancy is ___ surrounding tissue
What is ECT?
The us e of elec tric al s hoc k c urrent deliv ered to the brain to induc e a s eiz ure that treats depres s ion
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How long will a client's memory be
2-3 weeks
impaired after ECT?
The convulsion (seizure) that the electrical False, it used to be, but it isn't any more
current produced is violent (T/F) with the use of muscle relaxants
When are there activity restrictions after an ONLY when sedatives are used, and then
EEG? it's only necessary to keep side rails up
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What instructions are MOST important to
Try not to move
give a client during an EEG?
How much sleep should the client get the 4-5 hours - unless it is a sleep deprivation
night before an EEG? EEG
What will excessively fatty stool be like? Large, pale, foul-smelling, greasy
What does occult blood in feces mean? Bleeding somewhere in the GI tract
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Are fats a normal constituent of feces? Yes, but it should be WDL
What flow rates of O2 are appropriate for Low flow - <2.5L/min; NEVER exceed 2.5L
the client with emphysema? in COPD
If a client with emphysema has a severe Sitting upright with arms folded on the over
dyspneic episode what position is best? bed table
In emphysema, the alveoli are over- ___ Enlarged, ventilated so that air is trapped in
and under-____ alveoli
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The development of emphysema is most
Smoking
ass. with a history of ___
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Another name for low growth hormone
Pituitary dwarfis m
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After menopause, endometriosis (dec/inc) Dec.
What advice is best for women with Do not postpone pregnancy, may not be
endometriosis who want to have kids? able to have children
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Epiglottitis most commonly occurs in
1-8y
children from age ___ to ____
How will the child with epiglottitis breathe? Leaned forward with flaring nostrils
If a child is suspected having epiglottitis NO, never put any instrument in the child's
should you put a tongue depressor in their mouth unless you are prepared to do an
mouth look? immediate intubation
Would you do a throat culture? NO, never put anything in their mouth
If epiglottitis is suspected, what should the To take the child to the ER as soon as
parents be told? possible
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What is recommended for prevention of All children 2 months and over should
epiglottitis? receive an H. Influenza B vaccine
Does client need to have the side rails up Yes, until sedative effects of valium have
after EGD? worn off (meds in vein)
When can an EGD client begin to eat after When gag reflex returns (knocked out with
the test? lidocaine)
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What drug is given to anesthetize the
Lidocaine- a local anesthetic
pharynx?
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Name the most common side effect of
Diuresis
carbonic anhydrase inhibitors
What do mydriatics do for the eye? Dilate the pupil (My"D"riatic - "D" for dilate)
What is the most common use for To cause cycloplegia (dilation), allowing
anticholinergics in the eye? eye exam
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Placed on lower inner eye lid, then have
How should eye ointments be given?
client close eyes
How should eye drops be given? Place drops into the lower conjunctival sac
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Veggies are (low/high) in fiber High
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How long is the incubation period of genital
3-7 days (about the same for gonorrhea)
herpes?
When is C-section delivery indicated if the If the vesicles are present, then C-section
mother is infected with herpes? is indicated
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