A nurse is caring for a client with frequent migraines.

  What foods should the nurse

reinforce to avoid when teaching about migraine prevention measures?

Foods containing tyramine, monosodium glutamate (MSG), nitrites or milk products

A nurse is assisting with care of a client with a pneumothorax.  The client has a chest
tube in place and the water seal chamber vigorous bubbling noted.  What steps should
the nurse take to troubleshoot the chest tube drainage system?
Suggested Adult Med Surg Learning Activity:  Chest Tubes

Continuous bubbling in the water seal chamber indicates an air leak.

Locate the source of the air leak by checking all connections and intervene accordingly by
tightening the connection or replacing the system.
If the tubing is separated, instruct client to exhale as much as possible and cough to remove
as much air from the pleural space.
If drainage system is compromised, immerse the end of the chest tube in sterile water to
restore water seal.
Notify charge nurse or provider.

A nurse is caring for a client with right-sided heart failure.  What are clinical
manifestations of right-sided heart failure the nurse should identify during client care? 
Select all that apply.
Fatigue
Liver tenderness
Ascites
Bibasilar crackles
Nausea
Dyspnea
Suggested Adult Med Surg Learning Activity:  Heart Failure

Identify three (3) priority nursing actions for wound evisceration.

Suggested Med-Surg Learning Activity: Dehiscence/Evisceration
 
1. Cover the wound with a sterile towel or dressing moistened with sterile saline
2. Place in low Fowler’s with hips and knees bent
3. Monitor for shock and notify provider immediately
(Do not attempt to reinsert organs)

If available, create custom exam and complete 5 Board Vitals questions using the
following content areas.   

PN Graduates 

 Med-Surg 
 Physiological Integrity - Reduction of Risk  

 Physiological Integrity - Physiological

Adaptation 

 Safety and Infection Control 

  
1. Osteoporosis is a chronic metabolic disease. Bone loss results in a decrease of bone
density and increases the risk of fractures. Risk factors include:
 Family history
 Current tobacco use
 Alcohol intake of more than three drinks per day
 Inactive or sedentary lifestyle
 Males over the age of 60
 Females who are postmenopausal
 Inadequate calcium and vitamin D intake
 Low body mass index
 History of bone fractures during adulthood
2. A client who is receiving mechanical ventilation can become anxious and resist the
ventilator, causing an increase in oxygen consumption. Vecuronium is a
neuromuscular blocking agent that is used to produce skeletal muscle paralysis prior
to endotracheal intubation and to also reduce resistance to mechanical ventilation.
Vecuronium is used to improve client/ventilator synchronization and to increase
oxygenation for a client who has acute respiratory distress syndrome (ARDS).
Vecuronium causes apnea due to paralysis of the skeletal muscles. The nurse
should never administer this medication to a client who is not receiving ventilator
support.