ATI Proctored-Medical Surgical Exam Questions and Complete Solutions

ATI Proctored-Medical Surgical Exam Questions and Complete Solutions In extubating an Endtroacheal tube, what needs to be reported immedatiely? - Ans: stridor Why is stridor bad? - Ans: it means that there is an obstruction or edema in airway What is common in heart rate in a patient with low fluid volume (hypovolemia)? - Ans: usually greater than 110- to compensate for the low bp What is normal urine gravity? - Ans: 1.000 - 1.030 What is the role of positive pressure? - Ans: to promote lung expansion and stabilize chest Would you recommend exercise for a pt who has been discharged with heart failure? - Ans: yes How often should exercise be in heart failure pt? - Ans: regular routine Should you consume milk with iron supplements? - Ans: no- can cause gastric disturbance. Would you take iron with antacids? - Ans: no- causes gastric disturbances Would you tell the pt to lower red meat intake with iron deficiency? - Ans: no- increase iron rich foods What is a common side effect with iron pills? - Ans: constipation What would you tell them to eat with taking iron pills? - Ans: high fiber When does pain worsen with compartement syndrome? - Ans: when passive moving occurs. What does warmth under cast indicate? - Ans: infection Should pt decrease complex carbs for atherosceleoris? - Ans: no, increase them What carb should a client with atherosceloris decrease? - Ans: simple sugars Is MRSA airborne or contact? - Ans: contact What does phenyotoin do to hepatic enzymes (for seizures meds)? - Ans: it decreases effectiveness What should you tell the pt not to take with ciprofloxacin? - Ans: magnesium containg antacids Why wouldn't you take magnesium containing anatacids with cipro? - Ans: calcium can decrease absorption of med What is a common side effect of rifampin? - Ans: color of urine- Can you take ciproflaxcin with alcohol? - Ans: yes After a parathryoidectomy what would be the priority for the nurse? - Ans: to put trach tray by bedside in case of airway occlusion(AIRWAY) What meds increase osteoporosis? - Ans: fludrocortisone With enoxaparin, what is the priority as the med the nurse? - Ans: give dosage same time every day Is restlessness common in hyperthyroidism? - Ans: yes What would be urgent for hyperthyroidism? - Ans: high BP If a pt has a weird heart sound what would be first thing you do? - Ans: listen to it again but on the left side (least invasive) Why would gentamicin be withheld from a pt? - Ans: if creatine levels are too high What is normal creatine? - Ans: .6-1.2 What is one of the first vital signs of a hemorrhage? - Ans: increase heart rate What med would you give for a febrile reaction? - Ans: tylenol (reduces fever) How long does a drain stay in place for a radical mastectomy? - Ans: 1 to 3 week What drainage amount to get rid of drainage tube for mastectomy? - Ans: less than 25 What is first thing to ask if a pt reports dyspnea and SOB when administering O2? - Ans: if they have COPD Why would it be bad for you to put O2 on a COPD pt? - Ans: It can worsen hypercarbemia. What is someones HGB look like with leukemia (increase or decreased)? - Ans: decreased What would be a big sign that nephrosotomy tube has popped or been displaced? - Ans: back pain What is max amount of flexion for total hip replacement? - Ans: no more than 90 degrees Why would you place a pillow between a pt legs for hip athroplasy? - Ans: so the hips don't get dislocated What is a holter monitor used for? - Ans: detecting irregular heart rate and rhythms What is the role of a pacemaker? - Ans: regulate the heart rate What is a echocardiogram used for? - Ans: detecting valve dysfunction What do PPI do for gastric ulcers? - Ans: it suppresses gastric acid production What does high fowler's position accomplish? - Ans: increases lung expansion and improves ventilation What med would you d/c to before going in for allergy testing? - Ans: prednisone If a pt were to state that their vision went blurry before a car accident, what would you do first? - Ans: monitor neuro What would be first thing to do if bowel is protruding from stomach? - Ans: call for help What kind of skin for hypothyroidism? - Ans: dry scaly What does metformin do to glucose? - Ans: it decreases the amount of glucose produced in liver When should pt take metformin? - Ans: with or immediately following meals If you have hair loss on lower legs what could be problem? - Ans: Peripheral arterial disease (PAD) When does pain happen with PAD? - Ans: with resting How is pain relieved with PAD? - Ans: Dangling the feet After a thoracenteisis what should a nurse tell the pt? - Ans: to take deep breaths to help with lung expansion What would be an indication of osteomyelitis what lab? - Ans: increase sedimentation rate What is a blood problem that can occur with someone taking feverfew. - Ans: platelet aggregation What med does not go with feverfew? - Ans: naproxen- increases bleeding What is a normal SaO2 range? - Ans: above 90% What vital sign could drop with digoxin toxicity? - Ans: HR With a burn pt what do you do after securing airway and O2? - Ans: initiate IV fluids Why would you keep IV patent with someone that has seizures? - Ans: so you can give correction meds to stop it. Would you apply O2 or give epinephrine first with an anaphylactic reaction? - Ans: give O2 Why does kidney failure happen, what electrolyte? - Ans: it cant excrete properly, potassium What would be manifestation of chronic glomerulonephritis? - Ans: hyperkalemia How should a pt breath in when administering meter dosage inhaler? - Ans: slowly and deeply How long should pt hold breath after inhaling meter dosage inhaler? - Ans: 10 seconds after inhaling How often should you wait between puffs for inhaler? - Ans: at least one minute What should be first thing to do with a pt with a seizure? - Ans: call for help and turn them on their side. What 2 meds cause ringing in ears? - Ans: aminoglycocides and asprin (NSAIDS) What is the goal in erythropoietin therapy? - Ans: to increase levels of energy by increasing HCT What is needed sputum wise with a pt with TB? - Ans: samples are needed every 2 to 4 weeks until there are three negatives What is direct mode of transmission for C diff? - Ans: contact What electrolyte could be screwed up with long term mechanical vent? - Ans: sodium- hyponatremia If a stimulus is given to the ventricle a spike happens what should you document? - Ans: depolarization has occurred If a pt cant produce urine after surgery what is the first intervention? - Ans: bladder scan Why shouldn't you use moisturizing soaps to clean the skin in ureterostomy? - Ans: it decreases adherance to the skin How long would you avoid direct exposure to sunafter radiation therapy in those areas? - Ans: at least one year Why would you give lidocaine? - Ans: ventricular dysrhythmias Why would you defibrillate someone? - Ans: ventricaular tachycardia or Vfib Why would you perform synchronized cardiovert? - Ans: superventricular tachycardia What is aphasia? - Ans: lack of communication What is the first priority finding in pt with cerebrovascular accident? - Ans: dsyphagia, risk of apsirations What nut has a high amount of source of calcium? - Ans: almonds What should you increase with IRB? - Ans: fiber How much water to drink to promote normal bowel function in IRB? - Ans: 2L of water What should a client avoid with IRB? (What substance) - Ans: caffeine Why would decreasing weight be good for stress incontinence? - Ans: because it decreases abdominal pressure How often should a pt with risk for UTI urinate? - Ans: q2-4 Why should you increase asorbic acid for UTI's? - Ans: it decrease risk of UTI What vital sign increases with hypoxia? - Ans: heart rate What should be position for an A-line? - Ans: 60 degree HOB supine What should the nurse place around the flush solution of an a-line? - Ans: pressure bag What should you not give through an a-line? - Ans: antibiotics What should you use an a-line for? - Ans: monitoring BP and obtaining ABGs What increased electrolyte causes facial twitching? - Ans: potassium- hyperkalemia What is decreased peristalsis a manifestation of? - Ans: hypokalemia What glucose reading for DKA indicates an improvement? - Ans: reading less than 300 What nursing action helps with managing drainage of a laparotomy? - Ans: compressing the reservoir creates a vacuum that draws fluid out of the wound. Should people with venous insuffency exercise? - Ans: yes they should Should venous insuffenciy people avoid sitting and standing for long periods? - Ans: yes, they are at an increased risk for DVT Should you wear compression socks every day with venous insuffcency? - Ans: yes What is a key sign of lupus? - Ans: butterfly rash What can plasmapheresis cause? (what electrolyte imbalance) - Ans: hypocalcemia- monitor electrolyte levels What should you give if you cant find TPN immediately following the last bags is completion? - Ans: adminter dextrose 10% in NS until new bag arrives What side of the brain of stroke for anxiety? - Ans: left What side of brain stroke for aphasia? - Ans: left What side of the brain stroke for impulsive behavior? - Ans: right What side for feelings of guilt in a stroke? - Ans: left What should AIDS pt's take daily vital wise? - Ans: temp What temp for an AIDS pt of an infection? - Ans: greater than 100.0 Should you admin IV iron fast or slowly? - Ans: slowly Why should you monitor vital signs with iron? (what problem can occur to circulatory) - Ans: can progress to circulatory collapse with parenteral administration What med to treat iron toxicity? - Ans: deferoxamine (desferal) Should you use iron oral and parenteral at the same time? - Ans: no How far apart should you give anatacids and tetracyclines with iron? - Ans: at least two hours because of absorption What increases absoprotion for iron? - Ans: vitamin C Would you take caffeine with iron supplements? - Ans: no When should you take iron supps? (before or after meals and how long) - Ans: 1 hour before meals Can you dilute liquid iron? - Ans: yes How long does iron therapy last for? - Ans: 1 to 2 months Where is b12 produced? - Ans: in bone marrow Loss of leukocytes lead to what? - Ans: infection What dose b12 is necessary to convert? - Ans: folic acids What electrolyte could decrease due to an increase RBCs in relation to b12? - Ans: potassium- hypokalemia What electrolyte acts as a diuretic - Ans: magnesium Magnesium depresses neuromuscular stimulation, causing what? - Ans: muscle weakness and resp. depression When taking an liquid iron supplement what can happen to oral and what should you do to get rid of it? - Ans: it can stain teeth so rinse after med is taken. Chronic or high use of kava can cause what? - Ans: liver damage Why would a prego women take folic acid? - Ans: to prevent neural tube defects in the fetus Excess alcohol consumption can lead to poor dietary intake of this? - Ans: folic acid How would you infuse potassium to prevent vein irriation? - Ans: with a large bore needle What herbel med is used to treat frequency of migranes? - Ans: feverfew What herbel med should not be taken with warfarin? - Ans: gingko biloba If the urine output after surgery is less than------ in 2 hours, you should report to the physician. - Ans: less than 30 How often after surgery should you do deep breathing? - Ans: q1 What would provide as a splint to an abdomninal incison? - Ans: pillow or folded blanket between legs How often should you reposition post op pt? - Ans: q2 How often to assist with spirometer post op? - Ans: q2 When will the pt remain on NPO after surgery? - Ans: until gag reflex has been assessed What would you irrigate NG suction tubes with? - Ans: normal saline How do you prevent thromboembolisms from occurring? - Ans: compression devices What med type helps prevent thromboembolism? - Ans: antiplatelets Would you place a pillow under the knees post op? - Ans: no because it decreases venous return If somone is hypotensive or in shock what do you do with legs and the head? - Ans: elevate legs, lower the head of bed When is pain relief given post op? - Ans: given after assessing recovery status If you see increases of drainage post op what may it be a sign of? - Ans: hemorrhage When would sutures or staples be removed post op? - Ans: 5- 10 days after What would be the diet for wound healing post op? (3 things) - Ans: increase calories, protein, and vitamin C If a client is unresponsive, how would they be positioned? - Ans: turn them on their side for reduced risk of aspiration How much urine does a adult produce a day? - Ans: 1500 to 2000mL An increase in what electrolyte decreases urination? - Ans: sodium What color does urine turn with phenazopyrdine? - Ans: orange or red What color does urine turn with amitriptyline? - Ans: green blue What color does urine turn with levodopa? - Ans: dark What allergy contraindicates contrast medium? - Ans: shellfish and iodine What is a renal scan used for? - Ans: viewing renal blood flow and anatomy without using contrast What does a urodynamic testing do? - Ans: test for bladder muscle function Less than 30mL of urine output in how many hours is a concern? - Ans: 2 hours. How should pt take phenazopyrdaine? - Ans: with food What may happen to skin with phenazopyrdine? - Ans: skin may turn yellow If an indwelling cath is in and the pt feels that their bladder is full and needs to urinate, what is the probable complication? - Ans: that the cath is kinked or clogged If a nurse needs a 24 hr urine sample how would they collect it? - Ans: they would discard the first voiding and collect for the following 24 hours If a pt is on a urine schedule and needs to go what should the nurse tell them? - Ans: that holding it in would be good until next schedule How often should pt themselves shift weight? - Ans: q15 What side should you position crutches when risking from chair? - Ans: on the unaffected side. For hot or cold items how often should you remove application? - Ans: usually 15 to 30 minutes of once applied What does the Valsalva maneuver do? - Ans: it increases the workload of the heart but not peripheral formation Does increasing fluid intake help or hurt reducing the risk of thrombus formation? - Ans: it decreases risk, it increases the MAP Does increasing fluids help with constipation? - Ans: yes How often should the nurse assess the skin under pressure device? - Ans: q8 Should the pt advance the weaker leg or the stronger leg first? (crutches) - Ans: the weaker leg followed by stronger How many points should be on the ground at all times to support stability with a cane? - Ans: 2 What side should the cane be on? - Ans: the effected side What side of heart failure would you get pulmonary edema and HTN? - Ans: left sided What degree of hBNP indicated no heart failure? - Ans: less than 100 Greater than what hBNP indicates mild heart failure? - Ans: more than 300 What heart failure are jugular veins distended? - Ans: right sided ACE inhibitors can cause what, orally? - Ans: angioedema What is angioedema? - Ans: swelling of the tongue and throat What electrolyte can increase with ACE inhibitors? - Ans: potassium How should you take the pulse for a client on dig - Ans: apical How long should you count pulse before giving dig? - Ans: 1 min How should digoxin be taken? - Ans: at the same time each day What levels should be checked for dig(2)? - Ans: potassium and dig What is a common side effect of vasodilators other than hypotension? - Ans: headaches What should be status for pt about to get a VAD? - Ans: NPO What is a ventricular assist device (VAD)? - Ans: assist the heart that is too weak to pump. Who is a primary candidate for VAD? - Ans: heart transplant people and those who have end stage heart failure but cant do transplant What amount of weight is a problem in 24h or in one week? - Ans: 2 pounds or 5 in a week What is orthopnea? - Ans: SOB when supine What color is sputum with someone with pulmonary edema? - Ans: pinky frothy What would be evidence in labs that heparin induced thrombocytopenia has occurred? - Ans: low platelet At what platelet count should the nurse stop heparin? - Ans: less than 100,000 What is reversal agent of warfarin? - Ans: vitamin K Does oral contraceptives decrease effects of heparin? - Ans: yes they decrease effects What food should you avoid with heparin? - Ans: dark green leafy veggies What is therapeutic PT levels for someone on blood thinner? - Ans: 18 to 24 seconds (1.5 to 2) What is theraputeic INR levels for someone on blood thinner? - Ans: 2 to 3 What is more accurate PT or INR? - Ans: PT Avoid what medication while on heparin? - Ans: NSAIDS How long does it take for theraupitc effects of warfarin to kick in? - Ans: 3 to 5 days How long do the effects of anticoagulatents last for after usage? - Ans: up to 5 days Should you take asprin with or without food? - Ans: with When injecting subq enoxaparin do you keep the air bubble in the syringe why or why not? - Ans: you keep it in- it seals off the drug and its measured dose What is atropine used for? - Ans: reverse effects of bradycardia What is protamine used for? - Ans: reverse effects of heparin What is calcium gluconate used to treat? - Ans: magnesium sulfate toxicity How long should a nurse hold direct pressure on enoxaparin? - Ans: 10 to 30 minutes or until it stops bleeding What can throw up look like in asprin therapy? - Ans: coffee ground emesis An adverse reaction of aspirin therapy, how does stool look? - Ans: dark and tarry What can happen during a tonic clonic seizure? - Ans: the patient can stop breathing and is at risk for cyanosis. How long does a tonic seizure last? - Ans: 30 seconds What med decreases absorption of phenytoin (a seizure med)? - Ans: warfarin What surgery can take place if meds don't help with partial seizures? - Ans: vagal nerve stimulation (pacemaker for the brain) What does phenytoin cause in the oral cavity? - Ans: overgrowth and bleeding of the gums (gingival hyperplasia) Would little or too much stimulation cause a seizure to some? - Ans: too much Can caffeine cause a seizure and why? - Ans: it can because it stimulates too much in the brain If you feel an aura coming with a vagal nerve simulator what should you do? - Ans: put magnet over the implant What kind of insulin is lispro? - Ans: rapid acting How long is onset for rapid acting insulin? - Ans: 15 to 30 minutes How long does rapid acting insulin last? - Ans: 3 to 6 What kind of insulin is short acting? - Ans: regular What is onset for short acting insulin? - Ans: .5 to 1 hour What is the duration of short acting insulin? - Ans: 6 to 10 hours How long does NPH last? - Ans: 16 to 24 How long does it take for nph to kick in? - Ans: 1 to 2 hr What kind of insulin is NPH? - Ans: intermediate What is a long acting insulin? - Ans: glargine What is onset for long acting insulin? - Ans: 70 minutes What is duration of long acting insulin? - Ans: 24 hours. What method for giving iron parenterally? - Ans: Z track method Large doses of folic acid may mask what? - Ans: a vitamin b12 deficancy How long does it take for an improvement in blood cell counts and problems with anemia take when blood is given? - Ans: immediately If a gastrectomy has happened how often would b12 be given to a pt? - Ans: monthly Can a pt with a gastrectomy use a nasal spray everyday? - Ans: yes What deformity is caused by anemia? - Ans: spoon-shaped fingernails Where is decreased skin integrity found? (what type of pt?) - Ans: in dehydrated pt's, excessively moist patients, immobile patients How often should someone taking erthypoietin get hgb and hct monitored? - Ans: twice weekly What is a common side effect of giving IV antibiotics in high dosages? - Ans: hepatoxicity What are two signs of hepatoxicity - Ans: lethargy and jaundice How should antibiotics like doxycycline be taken? (when with meals) - Ans: with meals If penicillin is given in the same IV as aminoglycosides what happens? - Ans: it inactivates aminoglycocides What is a common side effect of administering aminoglycides? - Ans: ototoxicity What can diarrhea indicate with tetracyclines? - Ans: a suprainfection What drink should be avoided with tetracyclines? - Ans: milk When should you take a tetracycline? (what time of day) - Ans: in the morning to prevent lessen the risk of ulceration When should a blood sample of gentamicin be taken? - Ans: 30 minutes after after dosage is completely given What could be adverse effect of streptomycin? - Ans: paresthesia (numbness and tingling/Pins and needles) What antibiotic is used in surgeries for the normal flora of the intestines? - Ans: neomycin Do respirations increase or decrease with hypovolemia? - Ans: increase What o2 mask delivers the highest amount of O2? - Ans: nonrebreather Should you use a nonrebreather with a pt with high risks of aspirations or airway obstructions? - Ans: no What kind of symptom comes with oxygen toxicity? - Ans: nonproductive cough If a pt gets oxygen toxicity, do they hyper or hypo ventilate? - Ans: hypoventilate What is expected refrence range for PaO2? - Ans: 80-100 What may be prescribed to help with oxygen induced toxicity (2)? - Ans: CPAP or BiPaP PEEP (Something that has positive pressure) What does low pressure alarms indicated? - Ans: disconnection or cuff leak What is high pressure alarms indicated? - Ans: excess secretions What disorder to set off high pressure alarm? - Ans: pneumothorax or bronchospasm What does positive pressure do? - Ans: allows preset pressure to deliver during spontaneous ventilation to help decrease the work of breathing for the patient What is an early sign of hypoxemia? - Ans: pale skin What is late signs of hypoxemia? - Ans: bradycardia and hypotension How often should the nurse assess breath sounds on a vented pt? - Ans: q1 to 2 What type of mask to deliver precise amount of O2? - Ans: venturi mask If a pt has diabetes type 1, what is impaired(2)? - Ans: circulation and immune system If organs become exposed when tissue protrudes through the skin, what should you put on them? - Ans: sterile dressing soaked with sterile normal saline What position is best for abdominal incision complication? - Ans: supine and hips and knees bent Should a nurse massage a bony prominence and why or why not? - Ans: no because it can traumatize deep tissue With a burns do they become hypothermic or hyperthermic? - Ans: hypothermic What type of burn is sunburn? - Ans: superficial thickness burn What can be a cause of superficial partial thickness burns? - Ans: a flame What can a deep partial thickness burn result from? - Ans: hot grease What can a full thickness burn result from? - Ans: hot tar Does HCT increase or decrease with burn? - Ans: there is an initial increase due to hemo-concentration Why would hyperkalemia occur with a burn victim? - Ans: leakage of fluid from intracellular space Why would hyponatremia happen in a burn victim? - Ans: sodium resides in interstial spaces Why shouldn't a nurse use subq for burn victims? - Ans: because it might not absorb well because of skin isn't intact What is best route for admin meds to burn pt? - Ans: IV Why would you increase protein for a burn? - Ans: it promotes wound healing Should calories increase or decrease after burn? (if so by how much) - Ans: increase calories by double or triple If a pt is taking epinephrine what med class should they avoid? - Ans: MAOIs Would you want the pt to vomit during drug toxcitiy? - Ans: no- it increases the risk for aspiration What med would you give for drug OD? - Ans: activated charcoal; nalaxone (narcan) for opioids Why would you admin IV fluids to a drug toxicity pt? - Ans: helps dilute the toxic substances in the blood stream and promote eliminate from the body through the kidneys When would you use modified jaw thrust? - Ans: When the pt is unresponsive and has a neck injury Why would you head tilt and chin lift a pt? - Ans: if they are unresponsive (without suspicion of trauma) to maintain airway If a pt is in asystole what would you admin? - Ans: epinephrine Can you defibrillate a patient with asystole, why or why not? - Ans: No its not a shockable rhytmn What would you elevate in shock? - Ans: lower extremites Do respirations increase or decrease with hypovolemia? - Ans: increase, to compensate for the lack of pressure What o2 mask delivers the highest amount of O2? - Ans: nonrebreather If a pt gets oxygen toxicity what do they hyper or hyp ventilate? - Ans: hypoventilate What is expected refrence range for PaO2? - Ans: 90-100; 80-90 in patients with COPD How often should the nurse assess breath sounds on a vented pt? - Ans: q 1 to 2 hours What position is best for abdominal incision complication? - Ans: supine and hips and knees bent What can a deep partial thickness burn result from? - Ans: hot grease Does HR increase or decrease with renal calculi? - Ans: increase Would a pt have diaphoresis with a renal calculi (stones)? - Ans: yes Is oliguria present in renal calculi? - Ans: yes What is oliguria? - Ans: urine output less than 400mL in 24 hours or 30mL in 2 hours What mineral and electrolyte(2) would you would you limit with renal calculi? - Ans: protein and sodium What would you tell the pt to report with a renal calculi? - Ans: buring with urinating (because it's a sign of UTI) Would you increase or decrease fluids with renal calculi? - Ans: increase What can dehydration do to someone with renal calcui? - Ans: it can increase the risk for renal calculi formation What would you avoid intake (food-wise) for a calcium oxalate renal calculi? - Ans: spinach and iron rich foods What would you avoid intake food wise with a pt with a calcium or phosphate oxalate renal calculi? - Ans: dairy products What would you avoid intake food wise for a struvite renal calculi? - Ans: whole grains When would a pt strain urine for a renal calculi? - Ans: after lithotripsy How is proper placement of a hemodynamic monitor ensured? - Ans: xray How would a pt keep their leg after an angiography? - Ans: straight - it decreases risk for bleeding and hematoma in cath site What is an angiography? - Ans: medical technique involving contrast to see the blood vessels and organs of the body Would pt be NPO for angiography why or why not? - Ans: they would be NPO because they are at risk for aspiration during surgery What total cholesterol increases risk for heart disease? - Ans: more than 200mg If a cancer pt WBC drops below ____ youre going to put them in a private room with neutropenic precautions? - Ans: 1000 If a cancer pt that is neutropenic needs to transport, how would you transport? - Ans: with the patient wearing a mask What would you give to stimulate WBC production? - Ans: NEUpogen NEUlasta What is better for infection prevention for hand washing soap or alcohol based? - Ans: alcohol Would you use alcohol based on soiled hands? - Ans: no, hand washing is necessary With an airborne infection what type of pressure flow in pt room? - Ans: negative If a patient is on droplet precaution, are they isolated? - Ans: they can but they can be put in the same room with someone with the same illness If someone has contact do they get their own private room tell me why or why not? - Ans: they can but if someone has the same problem then they can be put with them What kind of airflow with pt with TB? - Ans: negative- airborne precaution How often should you monitored someones neurovascular status in a 24 hour period for a fracture? - Ans: every hour Would you put a pt on high protein diet with chronic kidney disease? - Ans: yes because it replaces the high rate of protein breakdown due to the stress from the illness. If someone is having heart failure what dietary restrictions would be in place(increase this and decrease that)? - Ans: increase potassium and decrease sodium What would be in urine for nephrotoxicity? - Ans: protein (proteinuria) If someone has a stroke what could you do for the affected extremity? - Ans: put it in a sling What is prioty assessment for pt with hypokalemia? - Ans: AIRWAY and cardiac function If PICC is in what should you tell the client about water? - Ans: not to immerse arm in water but cover the dressing site to avoid water exposure What would you do to ensure PICC is in place? - Ans: xray Osteoporosis: With taking alendronate when should you take it? - Ans: before meal in morning What would you want to give to a pt with pancreatitis (food wise)? - Ans: snacks high in calories How to reduce pancretis stimulation? - Ans: NPO For a patient undergoing a lumbar puncture, when should they void? - Ans: before the procedure What is normal RBC? - Ans: 4.7 and 6.1 What is normal WBC? - Ans: mmm3 What is a normal HGB for men? - Ans: 14-18 Normal HCT%? - Ans: 42-52% How should a patient be positioned for thoracentesis? - Ans: sitting upright with arms raised and supported on pillows Where is the liver located? - Ans: upper right quadrant, inferior to the diaphragm With Cushing's disease, what are you monitoring daily? - Ans: daily weights Is there hyper or hypovolemia in cushings? - Ans: hyper What fluids for fluid resuscitation in burn victims? - Ans: 0.9 NS or LR What is meningitis? - Ans: inflammation of the brain and spinal cord What kind of room should a pt with meningitis be in? - Ans: isolation- droplet for 24 hours of antibiotic therapy Does meningitis increase or decrease ICP? - Ans: increase For a chest tube what is the first chamber? - Ans: drainage collection What is the second chamber for in chest tube? - Ans: water seal What is third chamber for in chest tube? - Ans: suction control Is tidaling with movement expected in water chamber seal? - Ans: yes What should cuff pressure be for ET tube? - Ans: 20mm hg What mask for TB? - Ans: N95 What color tongue in vitamin b12 deficiency? - Ans: bright red What could increase while administering epoetin alfa? - Ans: increased blood pressure (increasing blood count) How often should you monitor HGB and HCT with epoertin Alfa? - Ans: twice weekly What position should the patient be in for a liver biopsy? - Ans: supine What color stools for cirrhosis? - Ans: clay colored What type of diuretic would you give for heart failure and pulmonary edema? - Ans: loop diuretics Would you give nitro for heart failure? - Ans: yes What is number one reason of vision loss in people? - Ans: age This causes loss of peripheral vision? - Ans: open angle glaucoma What elevated (intraocular pressure) IOP would cause open angle glaucoma? - Ans: >21 Is angle closure glaucoma rapid or slow increase (intraoccular pressure) IOP? - Ans: rapid What is common in the pupils for angle closure? - Ans: they aren't reactive Does open angle or angle closure cause severe pain? - Ans: angle closure What would you notify a doctor for with a pt taking cabmazepine (Tegretol) -3 things? - Ans: sore throat, fever, and bleeding If pt is taking vasopressin what would you notify the doctor for (2)? - Ans: headache and confusion What are the 5 P's for compartment syndrome? - Ans: Pain paralysis paresthesia pallor pulselessness What ABG reading would tell you what changes are with chronic kidney disease? - Ans: metabolic acidosis What heart sound would you hear with heart failure? - Ans: S3 What kind of bowel sounds for hypokalemia? - Ans: hypoactive bowel sounds What happens if too much magnesium is given what would you see happen to the body? - Ans: respiratory paralysis What would skin look like for an anaphylactic reaction? - Ans: flushing What aches with lyme disease? - Ans: joints What enzyme would indicate hepatitis C? - Ans: enzyme immunoassay (EIA) What would someone with a detached retina say that they are seeing? - Ans: curtain closed over my eye Should you take insulin even if you are unable to eat your regular diet? - Ans: yes What electrolyte would you want to decrease with cushings? - Ans: decreased sodium What is an adverse effect of amphoetericin B for a fungual infection? - Ans: increased BUN What is normal urine specific gravity? - Ans: 1.000 to 1.030 If a pt has a high urine specific gravity, what does it mean and what color is urine? - Ans: it means they are dehydrated and dark amber color urine, usually cloudy What can be done after kidney transplant? - Ans: hemodialysis If a pt is receving morphine via PCA pump what could happen to urine as a side effect? - Ans: urinary retention What are the symptoms in Cushing's traid? - Ans: bradycardia, abnormal decreased respirations, and systolic hypertension Would Diabetes Insipidus (DI) be increase or decrease urine specific gravity? - Ans: decrease What drug class can interfere with mepedrine? - Ans: MAOI because they can increase hypotension What is mepedrine? - Ans: a narcotic What leads would tell you of an MI? - Ans: V3 and V4 What should you tell a pt with crohns to do before a scheduled barium enema the day before? - Ans: to encourage plenty of fluids (bowel prep can casue dehydration and more fluids prevent from fecal impactment) If someone has an amputation what should you do post op to the amputated appendage? - Ans: elevate it for the first 24 hours If there is kinking in a vent tubing is it high or low pressure alarm? - Ans: high Why should a pt with knee amputation wash and dry stump daily? - Ans: to prevent infection Why is a skeletal traction good for a fracture? - Ans: reduce and immobilize the fracture What is best lab to monitor heparin therapy? - Ans: APTT What is APTT used to measure? - Ans: Clotting status when the client is receiving heparin What electrolyte would be hypo with throwing up , diarrhea and vomiting? - Ans: Hypokalemia If the pt has an NG tube in and has abdominal distention what should the Nurse do first? - Ans: Check the function of the suction equipment If a pt has cellulitis in the lower extremities should legs be elevated or relaxed? - Ans: Elevated Does iron deficiency anemia increase likelihood of infection in children? - Ans: Yes What med can interfere with Synthroid? - Ans: calcium pills What is a night cough an early predictor of what problem? - Ans: heart failure- left sided because of pulmonary edema If a pt has a hematoma after cardiac cath what should you do? - Ans: apply pressure to the site (to decrease chances of bleeding) What is the first manifestation of a fat emboli? - Ans: dyspnea What is usually last manifestation of fat emboli? - Ans: rash on chest If a pt is having a hemolytic reaction during a blood transfusion what kind of pain would the pt have? - Ans: lower back pain What does it mean if bubbling ceases in chest tube? - Ans: it means that the lungs are expanding Elevated bilirubin is a sign of what? - Ans: cirrhosis of the liver Is albumin increased or decreased in cirrhosis? - Ans: decreased What is an important thing to ask for a health history of a chemo pt that just started? - Ans: have you've been experiencing and nausea and vomiting (hypovolemia is the concern here) Is depression more common in hyper or hypothyroidism? - Ans: hypothyroidism How long does a person with a bilateral adrenalectomy have to take steroids for? - Ans: the rest of their life. With atropine medications what could be a side effect orally? - Ans: it will dry out the mouth What is visous lidocaine good for with the mouth? - Ans: to help heal the pain of stomatitis (sores). What is stomatitis? - Ans: painful swelling and sore in your mouth (can be seen in chemo pt'sas well as common cold/canker sores) What does prefix peri mean? - Ans: around What hep is received through sex? - Ans: Hep B What hepatitis is due to poor sanitation(2)? - Ans: A and E What ABG will someone be in with hyperventilation? - Ans: resp alkalosis What type of diabetic pt are oral antidiabetics only effective in? - Ans: type 2 If there is a lack of blood return on a IV cath for chemo what should the nurse do? - Ans: D/C treatment because it is most likely occluded. Lymphocytes help defend against what? - Ans: viruses especially Natural killers Neutrophils help defend during what? - Ans: bacterial infections Basophil elevation may occur because of? - Ans: allergic responses and neoplasm When does a pericardial friction rub happen? - Ans: usually occurs a week after MI Why does a pericardial friction rub happen? - Ans: due to inflammation of pericardial sac. When ALT and AST are elevated what is it a sign of? - Ans: chronic liver damage What is increased during kidney failure? - Ans: creatinine level What is most common reason for appendicitis? - Ans: appendix obstruction How does the nursing process go (this will help answer question on tests)? - Ans: assess, plan, intervention What is one of the most common metastasis spots? - Ans: the liver What should you tell the pt not to do after eating with a hietal hernia? - Ans: to lay down When someone has meineres disease and they start having a vertigo attack what would you tell them to do? - Ans: lie down or go into reclining position. How to reduce osteoporosis OTHER than meds? - Ans: weight bearing exercises. What should you increase fluids to with UTI? - Ans: 2500 If someone is recovering from a hemorrhagic cerebral vascular accident (CVA) what would be concerning if what starts happening? - Ans: they start having a worse headache(vasospasm) How often should you change tube feedings? - Ans: every 24 hours Sharing needles could lead to what hep(2)? - Ans: Hep C more commonly but possibly hep b What sided heart failure is associated with air hunger? - Ans: left side Prior to suctioning what should the nurse do? - Ans: give 100% O2 If pt is not tolerating (Positive-end expiratory pressure) PEEP because of an increase in H20 what would be vital sign to confirm this? - Ans: hypotension What kind of chest does a COPD pt have? - Ans: barrel What lab value will be low with graves disease? - Ans: TSH Excessive levels of thyroid could cause client to have what breathing problem? - Ans: dyspnea How long after postop to start back exercising with heart valve replacement? - Ans: 6 weeks Where would you hear an s4? - Ans: aortic stenosis What would you hear with mitral valve insuffiency while ausclating? - Ans: crackles in lungs due to back-flow What bacteria are UTI's usually associated with? - Ans: E coli What would be order to answering questions? - Ans: ABCDES (S for safety) then Pain then Education Test questions try to trick you- when should you call the provider? - Ans: Think about it this way. If a patient is struggling to breath, will leaving the room to call the provider be the FIRST thing you should do? Probably not. There are immediate needs the patient has that YOU can address prior to calling the provider. What fracture do you see fat embolism associated with? - Ans: long bone How long does antibiotic treatment for osteomyletisis last? - Ans: 3 months albumin normal range - Ans: 3.5-5 g/dL INR Normal range - Ans: 0.8-1.1 Bilirubin normal range - Ans: 0.3-1.0 mg/dL Ammonia normal range - Ans: 10-45 mcg/dL ALT Normal range - Ans: 7-56 U/L AST Normal range - Ans: 10-40 U/L