NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B

NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B) Leave the first rating STUDY PLAY Flashcards Learn Write Spell Test Match Created by mabbruzzi Questions and Notes Tags related to this set Nursing Increase The Risk Of Cancer Artery Blood Flow End Stage Kidney Disease 3/2/2021 NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B) Flashcards | Quizlet Terms in this set (90) Your Progress With Progress, you can start studying the terms you still need to master in one click. Not studied Study Still learning Study Mastered Study Get access to all your stats, your personal progress dashboard and smart study shortcuts with Quizlet Plus. Unlock Progress AMS16B-1 A nurse is providing dietary teaching to a patient who has celiac disease. Which of the following food choices should the nurse identify as an indication that the patient understands the teaching? A. Chocolate pudding B. Grilled chicken breast C. Macaroni and cheese D. Peanut butter and saltine crackers Answer: B A-Chocolate pudding contains wheat starch, which is a source of gluten and can cause an exacerbation of celiac disease. An alternative dessert choice is tapioca, which does not contain gluten. B-Clients who have celiac disease should avoid food that contains gluten. In a person who has celiac disease, gluten causes inflammation of the small intestine mucosa and can increase the risk of cancer. A grilled chicken breast does not contain gluten and is, therefore, a good food choice. C-Macaroni contains a wheat product, which is a source of gluten and can cause an exacerbation of celiac disease. Alternatives to wheat flour include rice flour and corn flour. D-Saltine crackers contain a wheat product, which is a source of gluten and can cause an exacerbation of celiac disease. The nurse should instruct the client to avoid products that contain wheat, barley, and rye. [AMS16B-1 - RN Adult Medical Surgical Nursing (10.0); p 3/2/2021 NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B) Flashcards | Quizlet AMS16B-2 A nurse is developing a teaching plan for a patient who has gout. Which of the following recommendations should the nurse include? A. Take a daily aspirin B. Decreased intake of purine meats C. Avoid milk products D. Take allopurinol for an acute attack Answer: B A-A client who has gout should avoid aspirin and diuretics as these medications are known to precipitate an attack that causes pain and inflammation in the joints. B-A client who has gout should follow a lowpurine diet and avoid foods, such as organ meats and shellfish, to prevent precipitating an attack that causes pain and inflammation in the joints. C-Clients who have gout should eat and drink foods—such as citrus fruits and juices, milk, and other dairy products—that increase the urinary pH. Increasing urinary pH decreases the risk of precipitating an attack that causes pain and inflammation in the joints. D-A client who experiences an acute attack of gout should take prescribed colchicine, indomethacin, or a corticosteroid. Allopurinol is used to lower uric acid after the initial manifestations of an acute attack have resolved. [AMS16B-2 - RN Adult Medical Surgical Nursing (10.0); p AMS16B-3 A nurse is assessing a client who has a comminuted fracture of the femur. Which of the following findings should the nurse identify as an early manifestation of a fat embolism? A. Dyspnea Answer: A A-Fat embolisms originate in the yellow bone marrow and travel through the vascular system, clogging small vessels. Dyspnea, along with tachypnea and a decreased arterial oxygen level, is an early manifestation of a fat embolism. B-During the later stages of the process, the client can develop a fever, often higher than 39.5º C (103º F). C-Petechiae, a red-brown measles-like rash, is 3/2/2021 NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B) Flashcards | Quizlet B. Fever C. Petechiae on the chest D. Fat globules in the urine usually the last manifestation of a fat embolism to occur. Petechiae can appear on the conjunctiva, hard palate, neck, chest, axilla, or anterior upper arms. D-Fat globules can be observed in some cases of fat embolism. The fat globules appear in the urine when the fat is filtered by the renal tubules and excreted. However, this is not an early manifestation. [AMS16B-3 - RN Adult Medical Surgical Nursing (10.0); p AMS16B-4 A nurse is caring for a patient who has cervical spinal cord injury sustained 1 month ago. Which of the following manifestations indicates that the client is experiencing autonomic dysreflexia (AD)? A. Temperature 38.8°C or 102°F B. Systolic blood pressure 70 mmHg C. Heart rate 52/min D. Respiratory rate 8/min Answer: C AD is an exaggerated response to stimuli in clients who have high level spinal injuries. Untreated, AD can result in stroke, organ damage, or death. Manifestations of AD include diaphoresis above the site of the spinal cord injury, but an elevated temperature is not a manifestation of AD. Systolic blood pressure 70 mm HgA client who has a spinal injury that involves cervical or high thoracic vertebrae can experience AD any time after the shock of the initial spinal injury. A hallmark manifestation of AD is a sudden, significant rise in systolic and diastolic pressures. Heart rate 52/minMYANSWERA client who is experiencing AD will exhibit multiple manifestations, including bradycardia, severe headache, and flushing. Respiratory rate 8/minAnxiety is a manifestation of AD. Therefore, the nurse should expect the client to exhibit tachypnea, rather than bradypnea. signs of autonomic dysreflexia include bradycardia, severe headache, and flushing 3/2/2021 NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B) Flashcards | Quizlet [AMS16B-4 - RN Adult Medical Surgical Nursing (10.0); p AMS16B-5 A nurse is caring for a client who has pancreatitis. The nurse should expect which of the following laboratory results to be below the expected reference range? A. Amylase B. Alkaline phosphate C. Bilirubin D. Calcium Answer: D An elevated amylase level is an expected finding in a client who has pancreatitis due to injured pancreatic cells. Alkaline phosphataseAn elevated alkaline phosphatase level is an expected finding in a client who has pancreatitis with biliary involvement. BilirubinAn elevated bilirubin level is an expected finding in a client who has pancreatitis with biliary involvement. CalciumMYANSWERA client who has pancreatitis is expected to have decreased calcium and magnesium levels due to fat necrosis. pancreatitis causes decreased calcium and magnesium levels due to fat necrosis [AMS16B-5 - RN Adult Medical Surgical Nursing (10.0); p AMS16B-6 A nurse is preparing to give amikacin 500 mg by intermittent IV bolus to a client. Available is amikacin 500 mg in dextrose 5% in water (D5W) 200 mL to infuse over 30 min. The nurse should set the IV pump to deliver how 400 mL/hr STEP 1: What is the unit of measurement the nurse should calculate? mL/hr TEP 2: What is the volume the nurse should infuse? 200 mL STEP 3: What is the total infusion time? 30 min STEP 4: Should the nurse convert the units of measurement? Yes (min ≠ hr) 60 min/30 min = 1 hr/X hrX = 0.5 hr STEP 5: Set up an equation and solve forX. Volume (mL)/Time (hr) = X mL/hr 200 mL/0.5 hr 3/2/2021 NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B) Flashcards | Quizlet many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) = X mL/hr X = 400 STEP 6: Round if necessary. STEP 7: Reassess to determine whether the amount to administer makes sense. If the prescription reads amikacin 500 mg in D5W 200 mL to infuse over 30 min, it makes sense to administer 400 mL/hr. The nurse should set the IV pump to deliver amikacin 500 mg in D5W 200 mL at 400 mL/hr. [AMS16B-6 - RN Adult Medical Surgical Nursing (10.0); p AMS16B-7 A nurse is providing teaching to a client who has a recent diagnosis of constipationpredominant irritable bowel syndrome. Which of the following instruction should the nurse include in the teaching? A. Take calcium antacid before meals and at bedtime B. Consume at least 30 g of fiber daily C. Take a stimulant laxative daily D. Consume no more than 1,000 mL of water per day Answer: B Calcium antacids are used to manage the manifestations of gastric reflux and dyspepsia, not constipation. Furthermore, the major adverse effect of calcium antacids is constipation. Consume at least 30 g of fiber daily.MY ANSWERIrritable bowel syndrome is a gastrointestinal disorder characterized by abdominal pain, bloating, and either constipation or diarrhea or a mixture of both. Consuming a diet high in dietary fiber helps produce bulky, soft stools and establish regular bowel patterns. Take a stimulant laxative daily.Stimulant laxatives are not for long-term use. The client should take a bulk-forming laxative with a full glass of water at mealtimes to help maintain bulky, soft stools. Consume no more than 1,000 mL of water per day.The nurse should instruct the client to drink at least 1,500 mL of fluid to promote normal bowel function and prevent constipation. 3/2/2021 NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B) Flashcards | Quizlet [AMS16B-7 - RN Adult Medical Surgical Nursing (10.0); p AMS16B-8 A nurse is teaching a client who has a cardiac dysrhythmia about the purpose of undergoing continuous telemetry monitoring. Which of the following statements by the client reflects an understanding of the teaching? A. "This measures how much blood my heart is pumping." B. "This identifies if I have a defective heart valve." C. "This identifies if the pacemaker cells of my heart are working properly." D. "This measures the blood circulating to my heart muscle." Answer: C Cardiac output, which is calculated by multiplying heart rate and stroke volume, measures the amount of blood ejected by the heart over 1 min. "This identifies if I have a defective heart valve."An echocardiogram, a non-invasive ultrasound procedure, evaluates heart valve function and structure. "This identifies if the pacemaker cells of my heart are working properly."MY ANSWERTelemetry detects the ability of cardiac cells to generate a spontaneous and repetitive electrical impulse through the heart muscle. "This measures the blood circulating to my heart muscle."Cardiac catheterization allows for the measurement of coronary artery blood flow. telemetry detects the ability of cardiac cells to generate a spontaneous and repetitive electrical impulse through the heart muscle [AMS16B-8 - RN Adult Medical Surgical Nursing (10.0); p AMS16B-9 A nurse is planning care for a client who has communityacquired pneumonia. Which of the following intervention should the nurse include in Answer: Monitor the patient for confusion. Pneumonia is an inflammatory process resulting in increased exudate and a thickening and narrowing of the airways, which causes hypoxia. The reduced oxygen level places the client at risk for confusion. Encourage the client to use an incentive spirometer every 8 hr.The nurse should 3/2/2021 NURS-272_Final (W9) - ATI (RN Adult Medical Surgical Online Practice 2016 B) Flashcards | Quizlet the plan of care? A. Monitor the client for confusion B. Encourage the client to use an incentive spirometer every 8 hr C. Instruct the client to drink 1 L of fluids daily D. Titrate the oxygen to maintain SaO2 level at 92% encourage the client to use an incentive spirometer every hour while awake to improve her ability to deep breathe and to prevent alveolar collapse. Instruct the client to drink 1 L of fluids daily.The nurse should instruct the client to drink at least 2 L of fluid daily to prevent dehydration and decrease the thickness of the secretions. Titrate the oxygen to maintain the SaO2 level at 92%.The nurse should titrate the oxygen to maintain an SaO2 level of at least 95% to prevent hypoxia.