661 Final Exam Kahoot! Questions and Answers

661 Final Exam Kahoot! Questions and Answers Nurse on med-surg unit caring for group clients. Should notify rapid response team for which of following clients? A. Pressure injury of R heel whose BS is 300 mg/dL B. Reports R. calf pain and SOB C. Has blood on a pressure following cardiac cath D. Dark red coloration of L toes and absent pedal pulse B. Reports R. calf pain and SOB Concern for PE - Pulmonary embolism calf pain -- DVT #1 sign PE = SOB also ABCs -- SOB = #1 Order B, D, A, C Client receiving opioid analgesic. Which of following is adverse reaction? A. Urinary retention B. Tachycardia C. Hypertension D. Diarrhea A. Urinary retention Concern for brady, hypo, constipation Which adventitious breath sound is commonly hear on expiration? A. Rhonchi B. Stridor C. Wheezing D. Crackles C. Wheezing If adventitious breath sound is heard, have the patient A. Cough B. Take deep breath C. Exhale D. Hold breath A. Cough 1st thing in morning or if havent moved in a while things can settle have cough and see if secretions are released or if BS still heard. Diabetes Insipidus occurs because of: A. Decrease in insulin secretion B. Increase in secretion of ACTH C. Decrease production of thyroid hormone D. Decrease production of ADH D. Decrease production of ADH Why is a T-tube placed after an open cholecystectomy? A. Prevent inflammation cystic duct B. Prevent inflammation hepatic duct C. Prevent inflammation common bile duct D. Prevent infection C. Prevent inflammation common bile duct RN reviewing labs of a pt Dx with infective endocarditis. Which study confirms dx? A. CBC B. Positive blood culture C. Serum cardiac enzyme D. Immuno-suppressant assay B. Positive blood culture Endocarditis = bacterial infect Want to culture to identify type of bacteria for specific Abx Tx A pt w/ aortic regurgitation is admitted to the hospital. Which assess finding indicates L ventricular failure? A. Dyspnea, orthopnea, PND B. Distended jugular veins, pedal edema, nausea C. Distended jugular veins, splenomegaly, edema D. Nausea, pedal edema A. Dyspnea, orthopnea, PND Aortic regurgitation and L ventricular failure -- back up in lungs -- resp Sx rest option = R side A pt returned from a percutaneous balloon angioplasty. Which intervention should the nurse implement? A. Assess chest tube drainage B. Keep patients affected leg straight C. Monitor for splinter hemorrhages D. Monitor for pericardial friction rub B. Keep patients affected leg straight angioplasty usually through femoral artery Keep leg straight for hours to help clotting Sand bags pedal pulses if injected dye -- will feel warm and will need to void Pt recovering from MI develops chest pain (CP) 3 days later when taking deep breath and is relieved by leaning forward. Next action? A. Assess feet for pedal edema B. Palpate radial pulses bilaterally C. Auscultate for pericardial friction rub D. Check heart monitor for dysrhythmias C. Auscultate for pericardial friction rub Pain w/ deep breath + relieved by leaning forward = Concern for pericarditis Pericarditis -- would hear pericardial friction rub Unstable Angina: A. Occurs during rest and/or unrelieved by rest B. Diagnosed by 12 lead EKG and relieved by sublingual nitro C. Causes troponin levels to be elevated D. Is not a reason to admit someone to the hospital A. Occurs during rest and/or unrelieved by rest Unstable at rest, not relieved by nitro Stable is relieved at rest and by nitro Likely will not cause troponin levels to be elevtated Client just admitted following surgical evacuation of a subdural hematoma. Which of the following is a priority assess A. GCS B. Cranial nerve function C. O2 sat D. Pupillary response C. O2 sat ABCs first, then Neuro asses Client who had SCI reports severe headache and is sweating profusely. VS include BP 220/110 HR 54. Which action should be taken first? A. Examine skin for irritation or pressure B. Sit client upright in bed C. Check urinary cath for blockage D. Administer antihypertensive medications C. Check urinary cath for blockage Autonomic dysreflexia = high HR and low BP Check for the stimulation -- wrinkled sheet, blockage, urine, etc client on telemetry HR is 46. Nurse notifies provider and expects which of the following prescriptions? A. Defibrillation B. Pacemaker insertion C. Synchronized cardioversion D. IV lidocaine B. Pacemaker insertion Pacing = Tx for low HR Cardioversion = Tx for abnormal rhythm Nurse presenting in a community education program on recommended lifestyle changes to prevent angina and MI. Which of following recommended changes should be implemented first? A. Diet modification B. Relaxation exercises C. Smoking cessation D. Taking omega 3 capsules C. Smoking cessation Smoking causes vasoconstriction = #1 concern 2nd = diet modification Patient scheduled to receive a CT scan with IV contrast. Which pre-assess test is most important? A. Liver enzymes B. Troponin C. Renal function D. CBC C. Renal function IV contrast effects BUN and Cr Pt has Fluid volume deficit. When evaluating urinalysis, what should RN anticipate? A. Fluctuating urine specific gravity B. Fixed urine specific gravity C. Decreased urine specific gravity D. Increased urine specific gravity D. Increased urine specific gravity USG depends on hydration status Dehydrated = increased UPG -- concentrated urine Overhydrated = decreased UPG -- diluted urine Which assess data reported by patient is most consistent with a lower UTI? A. Poor UO B. Bilateral flank pain C. Burning on urination D. Nausea and vomiting C. Burning on urination Patient with T2DM returns for a f/u visit 6 month after diagnosis. Which lab test would be best indicator for BS control? A. fasting BG B. Glycosylated hemoglobin level C. Urine dipstick for glucose D. Oral glucose tolerance test B. Glycosylated hemoglobin level Glycosylated hemoglobin level = A1C A1C level helps distinguish how consistently blood sugar is regulated/how well Pt manages A1C is looking at 3 month time period T1DM patient explains to RN they want to return to jogging. Nurse will plan to teach patient to: A. Check glucose level before and after jogging B. Delay eating breakfast until after jogging C. Increase morning dose regular insulin D. Time morning insulin inject so peak occurs while jogging A. Check glucose level before and after jogging RN is explaining the Dx of pernicious anemia to a pt. Which of the following would the RN teach about the disease? A. It is related to dietary restriction B. It is caused by a deficiency in intrinsic factor C. Risk for dehydration is increased D. There is no Tx for this disease B. It is caused by a deficiency in intrinsic factor Which information obtained by RN caring for a pt w/ thrombocytopenia should be communicated to the HCP ACAP? A. Platelet count is 140,000 B. Patient is difficult to arouse C. Purpura on the oral mucosa D. There are large bruises on the patient's back B. Patient is difficult to arouse Low platelets, purpura, and large bruises on back would be expected findings decreased LOC -- concern for cerebral hemorrhage Which problem reported by a patient with hemophilia is most important for the nurse to communicate to provider? A. Melena in stool B. Leg bruises C. Skin abrasions D. Bleeding gums A. Melena in stool Expect to see bleeding gums and bruises, maybe abrasions Melena = concern for GI bleed Nurse is teaching client who will have an X-ray of kidneys, ureters, and bladder (KUB). Which of following statements should nurse include in the teaching? A. "You will receive contrast dye during the procedure" B. " An enema is necessary before the procedure" C. "You will need to lie in a prone position during the procedure" D. "The procedure determines whether you have a kidney stone" D. "The procedure determines whether you have a kidney stone" Nurse is teaching a client who has CKD and is to begin hemodialysis. Which of following information should nurse include in teaching? A. Hemodialysis restores kidney function B. Hemodialysis replaces hormonal function of the renal system C. Hemodialysis allows an unrestricted diet D. Hemodialysis returns a balance to blood electrolytes D. Hemodialysis returns a balance to blood electrolytes Does NOT restore kidney function Nurse is preparing to administer pRBCs to a client who has a Hgb of 8. Which of the following actions should the nurse plan to take during the first 15 min of transfusion? A. Obtain consent from client for the transfusion B. Assess for an acute hemolytic reaction C. Explain the transfusion procedure to the client D. Obtain the blood culture specimens to send to the lab B. Assess for an acute hemolytic reaction Can occur within just 10cc of blood admin Consent and explanation is before blood is ordered Blood culture specimens would only happen after high suspicion of reaction Nurse is completing discharge teaching with a client who has a permanent pacemaker. which of the following statement by the client indicates understanding of the teaching? A. "I will notify the airport screeners about my pacemaker" B. "I will expect to have occasional hiccups" C. "I will have to disconnect my garage door opener" D. "I will not use a microwave" A. "I will notify the airport screeners about my pacemaker" Don't have travel restrictions, but should notify airport security before going through machine Hiccups not expected. If they happen it could mean pacemaker has moved into wrong position What should the RN include in care plan for a patient with bacterial meningitis? A. Monitor for bradycardia and HTN B. Keep HOB flat C. Monitor for fever and administer antipyretic medication D. Monitor for fever and administer Abx D. Monitor for fever and administer Abx Abx = #1 for bacterial. If meningitis suspected start Abx BEFORE distinguishing b/w bacterial and viral. then d/c if viral If viral meningitis -- monitor for fever and administer antipyretics Client reports stiff neck and headache. What is priority intervention? A. Administer Abx B. Decrease bright light and stimulation C. Initiate IV access D. Implement droplet precautions D. Implement droplet precautions Stiff neck + headache -- think meningitis 1st thing = implement precautions before any other interventions Nurse is caring for client with increased ICP. All of the following will decrease ICP except: A. Suction the ET tube only when needed B. Administer stool softener C. Elevate client's head on 2 pillows D. Decrease the noise level in the client's room C. Elevate client's head on 2 pillows 2 pillows would cause neck to be hyper-flexed -- increased HOB 30-45 degrees but NOT w/ pillows Always: suction only as really needed, stool softener, and decrease stim Analyzing an EKG the RN notes 4 small boxes from beginning of P wave to the beginning of R wave. The PR interval is: A. 0.12 sec B. 0.16 sec C. 0.2 sec D. 0.24 sec B. 0.16 sec 1 large box = 0.2 sec 1 sm box = 0.04 -- 4 sm. box = 0.16 sec Patient with pancreatitis is admitted to the MICU. Which nursing intervention is most appropriate? A. Providing generous servings at mealtimes B. Providing patient with plenty of fluids C. Limiting IV fluid intake according to the HCP order D. Reserving a site for a PICC line D. Reserving a site for a PICC line Acute pancreatitis == ABSOLUTE NPO Will have IVF but NOTHING through GI tract Reserving site for PICC line -- likely TPN RN is administering Cephulac (Lactulose) to decrease ammonia in a pt with encephalopathy. What is an adverse effect? A. Vomiting B. Tinnitus C. Watery diarrhea D. Asterixis C. Watery diarrhea Purpose is to increase soft bowel movements, but watery diarrhea is not a good effect at risk hypovolemia, hypokalemia, etc. -- need to report to HCP Asterixis is part of encephalopathy After a thyroidectomy, which IVF would alleviate tingling and muscle twitching symptoms? A. Calcium gluconate B. Potassium chloride C. Normal saline D. Lactated ringers A. Calcium gluconate Thyroidectomy -- concern for parathyroid damage/removal -- risk for hypocalcemia paresthesia = hypocalcemia Sx -- Tx with calcium replacement Pt Dx with esophageal varices are at risk for hemorrhagic shok. Which is a sign of potential hypovolemia? A. polyuria B. Bradycardia C. Hypotension D. Warm, moist skin C. Hypotension Pt with CVA has dysphagia. Which intervention during eating will allow for safe swallowing? A. Instruct pt to lie in bed while eating B. Offer liquids frequently and in large quantities C. Help pt sit upright when eating and feed slowly D. Allow optimum physical activity before meals to expedite digestion C. Help pt sit upright when eating and feed slowly Pt with meningitis has a Hx of seizures. Which activity should the RN do while the pt is actively seizing? A. Place a cooling blanket beneath the patient B. Provide O2 or anticonvulsants, whichever is available C. Turn patient to side during seizure and do not restrain movements D. Suction pts mouth and pharynx C. Turn patient to side during seizure and do not restrain movements