Final

A female patient is being discharged from the hospital today after being admitted the day prior for a urinary tract infection (UTI). The client demonstrates an understanding of ways to help prevent future UTIs when she states? Select all that apply:

I will take more bubble baths verses showers to better clean the peri area.

I will void and drink a glass of water after intercourse.

C. I will wipe from front to back after using the restroom.

D. I will wear tight fitted non-cotton undergarments such as panty hose.

I will void every 2-3 hours to help prevent UTIs.

A post op patient has just arrived to the medical surgical floor following a partial thyroidectomy. A few hours into the shift, your patient becomes tachycardic, agitated, hypertensive, and has an elevated temperature. What intervention would the nurse perform first in this situation?

A. Call the doctor and report suspected thyroid storm

B. Document and continue to monitor vitals

C. Ensure patient has a patent airway and adequate ventilation

D. Administer antithyroid medications as prescribed

A 90-year-old woman is admitted to the hospital after being found in her home on the floor complaining of severe pain in her pelvis. She states that she had been there for 2 hours before someone found her. X-ray findings showed a closed compound fracture of her left pelvis. Which of these assessment findings would the nurse recognize as needing immediate intervention?

B) Both feet are pale, with thready, equal pulses

C) Patient asks if the hospital has her will on file

D) Increased redness, ecchymosis, and heat on hip

A) Blood droplets in the client’s underwear

When teaching her patient with Addison’s disease about hydrocortisone, the nurse knows teaching is successful when the patient says which statements (select all that apply):

A) “My doctor may increase my dose during finals week”

C) “I need to notify my doctor if I gain more than 5 pounds in a week.”

D) “I should not abruptly stop taking this medication unless my doctor tells me to”

E) I can eat all the cake that I want to when taking this medication

F) I should avoid contact with sick people if possible

Which patient on the burn unit is at the greatest risk for developing a respiratory tract infection?

A. 60-year-old male with history of myocardial infarction and chronic obstructive pulmonary disease came in with a burn on the chest and neck

B. 40-year-old female with asthma and a history of bronchitis that came in for a burn from breathing in hot steam while cooking

C. A 70-year-old male who weighs 300 pounds came in for burn trauma to his lower extremities

D. A 22-year-old male who is in hypovolemic shock from full-thickness electrical burns with 400 ml of urine output within 24 hours

Mr. Mayors is a 43-year-old patient is in the Intensive Care Unit at the Veteran’s Hospital. He came into the emergency department 3 days ago for a head trauma from a motor vehicle accident. A ventriculostomy was placed for monitoring intracerebral pressure and drainage of cerebrospinal fluid as needed. Mr. Mayors started talking about currently being in the war as well as complaining of stiff neck and worsening head pain. Vital Signs are as follows: Intracranial pressure 20mmHg at rest Blood pressure 160/90 Heart rate 50 beats per minute Temperature 101 Fahrenheit Respirations 13 breaths per minute Which of following orders would the nurse expect the doctor to prescribe (select all that apply).

A. Perform a lumbar puncture

B. Administer IV ampicillin

C. Administer IV mannitol

D. Administer Normal Saline drip at 125/ml

E. Collect specimens for cultures

A nurse is given a group of patients at the beginning of her shift to take care of. Which patient should the nurse see first?

A. A patient who had a colectomy 22 hours ago and is complaining of 8/10 pain.

B. A patient with acute back pain who is receiving opioid therapy. Patient’s O2 sat is at 75%, nasal flaring is present, lips are tinged blue, and respirations are at 8 per minute.

C. A patient diagnosed with anxiety is feeling fearful and is screaming out for help. Patient is nauseous, has a heart rate of 118, is breathing rapidly, and her body is trembling.

D. A patient with a UTI is suspected of having urosepsis. Patient has already started fluid resuscitation, but patient still has an order to do blood cultures and start antibiotic therapy.

A nurse is taking care of a patient with an infected full thickness thermal burn. What interventions will the nurse start with this patient? Select all that apply.

At shift change the on-coming nurse is receiving report. Which of the following should the on-coming nurse be the MOST concerned about when giving care to a patient that suffered from electrical burns 18 hours ago?

A. Patient has no ECG monitor

B. Patient has had indwelling catheter removed

A patient presents to the emergency department as a result of a motor vehicle accident. The patient’s right lower extremity was crushed in the accident, resulting in extensive soft tissue damage and fractures to the tibia and fibula. The patient has been given intravenous opioid analgesics to control his pain, however the patient continues to have pain he describes as being “the worst pain he’s ever felt in his whole life” and rates the pain as a 10 on a 0 – 10 scale. The nurse suspects the patient may be experiencing compartment syndrome and expects to find which other symptoms associated with this condition? Select all that apply.

A. Bounding pedal pulse in the affected extremity

B. Numbness and tingling throughout the affected extremity

C. Pallor and coolness of the affected extremity

D. Inability to move the affected extremity

E. Diminished or absent pedal pulse

F. Erythema and inflammation of the affected extremity

You are working in a hospital on a med-surg unit and one of your assigned patients has been diagnosed with osteoporosis by his health care provider. The health care provider has prescribed the bisphosphonate medication alendronate (Fosamax) to help manage the patient’s condition. When administering this medication to the patient, the nurse makes sure to…

a.Give the medication with food, in order to reduce gastric irritation.

B. Administer the patient’s other medications first, to ensure the alendronate won’t interfere with the patient’s other medications.

C. Have the patient take the medication with a full glass of water, to ensure the medication completely clears the Esophagus.

D. Have the patient lie down for 30 minutes after administering the medication, to ensure the medication is adequately absorbed.

A patient is admitted to the burn unit with second- and third-degree burns covering the face, entire right arm, entire anterior trunk area, and perineal area. Using the rule of nines, what should the nurse calculate the extent of these burns as being?

A. 18%

B. 32.5%

C. 31.5%

D. 41.5%

A 70-year-old man is getting ready to be discharged home after a right hip replacement. Which statement(s) below by the patient indicates further teaching needs to be done?

A. I need an elevated toilet seat

B. I can cross my legs at my ankles only while sitting in a chair

C. I am able to sit in low chairs and flex my hip greater than 90 degrees if I feel no pain.

D. I should keep my hip in neutral, straight position, when sitting walking or lying

E. I need to notify the surgeon immediately if severe pain, deformity, or loss of function occurs

The nurse is assessing a client who is experiencing a tonic-clonic seizure. Which findings during the assessment suggest the seizure was in the Aural Phase? (Select all that apply).

A. Loss of consciousness

B. Bowel and bladder incontinence

C. Continuous muscle contractions

D. Extreme muscular rigidity lasting 5-15 sec

E. Pallor, flushing, or cyanosis

The nurse is educating a client about gout. The nurse discusses with the client the most common initial problem experienced with gout would be?

A. Inflammation of the wrists

B. Inflammation of the knees

C. Inflammation of the ankles

D. Inflammation of the great toe (podagra)

A 32-year-old woman who is in the first trimester of pregnancy is diagnosed with Grave’s disease. The nurse anticipates the doctor will provide which drug therapy?

A. Methimazole

B. Levothyroxine

C. Propylthiouracil

D. Tapazole

A patient is transferred to the medical-surgical floor after having a thyroidectomy. The nurse knows what interventions and postoperative care are necessary after a thyroidectomy:

A. Place the patient in a Semi-Fowler’s position and support the patient's head with pillows

B. Assess for signs of tingling in toes, fingers and around the mouth and muscular twitching

C. Place the patient in a High- Fowler’s position with flexion of the neck

D. Monitor vital signs and sodium levels

E. Assess the patient every 2 hours for 24 hours for signs of hemorrhage or tracheal compression

Which of the following patients is most likely to have the most difficult time recovering from a burn?

A. A 24 year old female who is malnourished.

B. A 36 year old male with a history of bipolar depression.

C. A 65 year old male with a history of alcoholism and heart disease.

D. A 50 year old woman with diabetes mellitus.

The nurse is caring for a patient with suspected diabetes insipidus. Which signs and symptoms would the nurse expect to see? (Select all that apply.)

A patient with a left sided stroke is having right sided hemiplegia. The nurse identifies a nursing diagnosis of “altered nutrition: less than body requirements related to inability to feed self. What is the most appropriate intervention to improve the client’s nutrition?

1. Move the tray throughout the meal to make sure they see the entire plate

2. Assist the client to eat with the left hand

3. Provide a liquid diet

4. Assist patient to an upright position and have a pureed diet ordered

The nurse is assigned to care for a patient with complete right-sided hemiparesis. Which characteristics are associated with this condition? Select all that apply

A. The patient is aphasic

B. The patient has weakness in the face and tongue

C. The patient has weakness on the right side of the body

D. The patient has lost the ability to move the right arm but is able to walk independently

E. The patient has complete bilateral paralysis of the arms and legs.

A patient suffered a spinal cord injury and was brought to the ER in neurogenic shock. How would you expect them to present? Select all that apply.

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