sem 1 med surg final
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| when the nurse removes an NG tube that has been placed for 7 days, the pt develops nosebleeds. To control nosebleeds, the nurse should: | show 🗑
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| show | suction the pt's mouth before deflating the cuff
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| show | Assess the airway and breath sounds
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| Following assessment of a pt with pneumonia, whe nurse identifies a nursing dx of "ineffective airway clearance". Which info best supports this dx? | show 🗑
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| To promote airway clearance in a pt with pneumonia, the nurse instructs the pt to | show 🗑
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| show | positon pt with altered LOC laterally
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| show | immediately upon waking in the AM
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| In a pt with active TB, the disease can be transmitted to others until: | show 🗑
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| show | daily noontime meal with meds at the community center
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| show | Paradoxical chest wall movement
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| A patient with incision pain, poor cough effort and ronchi has a dx of "ineffective airway clearance" after a pneumonectomy - what is your first action to promote airway clearance? | show 🗑
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| A 68yo male w/ hx of COPD is admitted with cor pulmonale. What clinical manifestation is consistent with cor pulmonale? | show 🗑
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| A at is admitted w/ pneumonia and c/o sharp pain when taking a deep breath. What shoud the nurse do? | show 🗑
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| show | BP 90/46
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| show | 46 yo who is having dyspnea one hour after thoracentesis
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| show | client is laying in bed w/ head elevated a zero degrees, client is coughing up blood tinged secretions from tracheostomy, hemovac has 200ml of bloody drainiage, NG tube is disconnected from suction and clamped off
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| show | follow evidence-based national guidelines
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| To check if aromatherapy was effective on a pt after surgery: | show 🗑
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| show | do a focused resp assessment and ask questions that are specific to this exacerbation of resp distress
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| show | PAO2 40mm, O2sat=92%, PH 7.38, PaCO@ 82
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| show | supplemental O2 should be used when the pt exercises
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| show | Arrange for the pt's spouse to be present during teaching
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| show | instruct the pt to keep head elevated for 48 hours to minimize swelling
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| show | identification and avoidance of triggers is the best way to managed
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| The nurse will plan on administering the flu vaccine to: | show 🗑
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| A 76yo pt has influenza, what should the nurse report to the HCP? | show 🗑
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| The RN can delegate whoch to a UAP? | show 🗑
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| An 82yo pt w/ nosebleed has nasal packing. What assessment requires immediate action? | show 🗑
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| A pt w/ pneumonia has a fever of 101.2, nonproductive cough, 02 89%. He is very weak and needs assistance getting out of bed. Best nursing dx is: | show 🗑
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| show | WBC count 9000
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| show | direct observed therapy (DOT) will be needed if the medications have not been taken correctly
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| A pt is scheduled for a lobectomy for stage 1 non-small cell lung cancer, the pt says they would rather die than have radiation or the surgery. which is the most appropriate response by the nurse? | show 🗑
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| A newly diagnosed lung cancer patient says"I think I am going to die soon". THe best response by the nurse is: | show 🗑
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| Pt is admitted to the ER with a stab wound to his chest. Air can be heard entering the chest with each inspiration. To decrease the possibility of tension pneumothorax, the nurse should: | show 🗑
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| show | obtain vitals and O2 sat
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| show | position the pt sitting upright on the edge of the bed and leaning forward
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| All are orders for a pt with possible pneumonia and sepsis. Which is the priority? | show 🗑
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| show | one drug is to decrease the inflamation and the other is a bronchodilator
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| show | using a spacer with the MDI improves the inhalation of the medications
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| Which finding best indicates that acute asthma exacerbation is responding to bronchodilator therapy? | show 🗑
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| show | airway narrowing
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| Pt w/ an acute exacerbation of COPD has the following ABG's - PH 7.32, PaO2 55mmhg, PaCO2 55mmhg, SaO2 86%. the nurse recognizes this as evidence of | show 🗑
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| Pt is seen in the clinic with COPD. Which information given by the pt would help most in confirming a dx of chronic bronchitis? | show 🗑
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| A nurse teaches a pt w/ COPD how to do pursed lip breathing, explaining that this will assist respiration by: | show 🗑
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| Pt w/ COPD asks home health nurse about O2 use. The nurse should teach teh pt that long term O2 therapy: | show 🗑
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| show | sitting up at the bedside in a chair, leaning slightly forward
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| A 26 yo with CF has harsh lung changes and cor pulmonale. Expected outcome: | show 🗑
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| show | perform chest physiotherapy q4h to mobilize secretions
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| show | i will have an ice cream snack every day
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| Teaching is successful with homecare of an asthma pt when pt states: | show 🗑
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| The nurse is assessing a 36yo woman admitted for knee surgery. Which info obtained during the preoperative assessment should be communicated to the surgeon prior to surgery? | show 🗑
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| When the nurse is performing a physical examination of a pt who smokes and who is being admitted on the day of surgery, it is especially important to: | show 🗑
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| show | methods for effective C&DB
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| 10 mins after receiving the ordered preoperative opioid by IV injection the pt asks to get up and go to the bathroom. The most appropriate action by the nurse is to: | show 🗑
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| show | i will need to have cobalamin (b12) injections for the rest of my life
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| show | admitting, identifying and assessing the pt
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| show | keeps both hands above the operating table
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| show | having a hx of spinal and hip arthritis
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| show | a drug will be injected through the IV which will induce sleep
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| The nurse recognizes that the use of local anesthesia would be particularly beneficial to the pt if the pt" | show 🗑
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| show | weak chest wall movement
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| show | walking into the hallway outside the OR without hair covered
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| show | continue to monitor VS q 15 min.
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| There is a new nurse in the PACU. The charge nurse evaluates her orientation successfully when: | show 🗑
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| When a pt is transferred from the PACU to the unit, the first action by the RN on the unit should be to: | show 🗑
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| The NG tube is removed on the second postoperative day for a pt who had abdominal surgery. A clear liquid diet is ordered. Four hours later, the pt c/o of abdominal distension and sharp, cramping gas pain. The most appropriate nursing action is to: | show 🗑
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| in intervening to promote ambulation, C&DB and turning in a pt on the first postoperative day, which action by the nurse is most helpful? | show 🗑
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| show | Hgb 8.6
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| show | plan alternate periods of rest and activity
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| When talking about appropriate food choices to a person with Fe deficiency anemia who follows a low cholesterol diet, the nurse should encourage increased intake of: | show 🗑
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| A pt in a sickle cell crisis asks the nurse why sickling causes pain. the best response by the nurse is: | show 🗑
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| Which data, for a pt with thrombocytopenia, should be reported to the PCP? | show 🗑
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| All of these pts are waiting to be seen in the ER. Which has priority? | show 🗑
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| a 24yo pt who uses a diuretic for BP control is scheduled for abdominal surgery. Which information should be told to the surgeon prior to surgery? | show 🗑
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| show | include pt complaints of pain in the pre-op report
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| A 26yo pt with stage 2 Hodgkins Lymphoma asks the nurse, "how long do I have to live?" The nurse responds correctly with: | show 🗑
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| To relieve sx of a lower UTI for a pt on antibiotics, the nurse suggests phenazopyradine(pyridium) but cautions the pt that this med might: | show 🗑
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| show | recent fever or sore throat
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| show | obtain serum potassium levels
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| show | More protein will be allowed b/c of the removal of urea and creatinine
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| A male is hospitalized because of gross hematuria and severe colicky left flank pain that radiates to his left testicle. He has a hx of kidney stones. priority dx is: | show 🗑
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| show | determined hourly based on every ML of UOP
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| show | I will wash the catheter with soap and water before and after each catheterization
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| show | pain with urination
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| show | empty bladder every 3-4 hours during the day
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| show | left sided flank pain
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| A pt is admitted with severe crushing injury. Which lab level is the nurse most concerned with? | show 🗑
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| Acute renal failure pt has a gradual increase to 3400ml/day of UOP, BUN of 92 and serum creatinine of 4.2. the nurse should plan to | show 🗑
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| Which order will the nurse question for a pt with renal insufficiency scheduled for IVP? | show 🗑
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| Before administering Kayexalate to a pt with hyperkalema, assess: | show 🗑
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| show | serum phosphate
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| show | it is much less likely to clot
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| A pt with CKD is thinking about using continuous ambulatory peritoneal dialysis. The nurse informs the pt that | show 🗑
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| A client with CKD brought all her meds from home to the hospital so the nurse could look over them. Which of the following meds shows that the pt needs more teaching? | show 🗑
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| show | place the client on bedrest
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| show | Tell me more about what happened to your mother.
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| show | dorsiflexion and plantar flexion of feet, ankle circles and pressing the back of her knees to the bed while lying supine
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| A femal client a second recurrence of pyelonephritis. The nurse should expect the following labs: | show 🗑
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| The nurse is caring for a pt who has 20 second periods of deep and rapid breathing followed by...the nurse should document this finding as: | show 🗑
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| A nurse admits pt with AIDS who has cryptococcal meningitis. The pt tells her "if my heart or breathing stops, I dont want to be resuscitated" the nurse: | show 🗑
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| show | a 28 yo with aids related dementia who needs palliative care and pain management.
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| show | slows the tube feeding rate
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| Pt who is receiving continuous tub feeding through small bore silicone feeding tube has a CT scan ordered and will have to be placed in the flat position for the scan. The nurse: | show 🗑
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| show | provide skin care around the tube
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| show | support the incision while coughing to prevent dehiscence
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| The following are orders for a dehydrated pt. Which do you act on first? | show 🗑
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| show | breath sounds
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| Patient is prescribed Nexium for heartburn. the nurse explains that the drug: | show 🗑
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| show | NSAID use
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| A pt vomiting bright red blood is admitted to the ER. Which assessment should the nurse do first? | show 🗑
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| show | the medication will inhibit stress ulcers
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| A pt w/ and acute GI bleed has NS infusing at 500 ml/h. Which data is most important to communicate to the HCP? | show 🗑
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| show | place pt in a private room under contact isolation
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| show | assisting the client to ambulate to increase peristalsis
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| show | make the client NOPO to rest the bowel
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| show | they are experiencing bloody stools
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| show | teach the client about oral corticosteroids
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| A nursing hx is being taken on a 55yo scheduled for a colonoscopy. THe nurse should be concrned when the pt tells her: | show 🗑
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| show | document the findings
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| show | maintain adaquate nutrition
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| a 32yo w/ early alcohol chirrosis is dx via liver biopsy. Priority teaching is: | show 🗑
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| show | Monitor for SOB
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| show | muscle twitching and finger numbness
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| show | Deacrease in abdominal pain
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| A client has acute pancreatitis. What findin is priority? | show 🗑
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| Which is a lab finding suggestive of hepatitis | show 🗑
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| lab results for a pt w/ chirrosis have elevated ammonia levels. What diet should be ordered? | show 🗑
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| show | morphine for pain
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| show | the wound appearance and pt temp
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| A nursing student carinng for a dying pt asks the nurse how will we know when pt has died? | show 🗑
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| A pt near death has a decrease in all body system functions except a HR of 124 and RR of 28. Nurse explains to family that: | show 🗑
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| show | sat at the bedside and ask if there is anything the pt needs
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| show | it si acceptable and healthy to cry with the family
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| show | pallor and changes in sensation& mvt in the extremeties
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| show | not to alter intake of green leafys, dairy or meat because they are high in vit K
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| 72 yo. 5'2", 92lbs. Massive infection. Lab results hgb 10.2, albumin 2.0. Which info will be most useful when the nurse is determining nutritional status? | show 🗑
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| show | pressure ulcers
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| 22yo w/ anorexia nervosa. labs reveal hypokalemia and Fe deficency anemia. Priority dx is: | show 🗑
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| taking a health hx for an obese pt, info that is most helpful in determine pts success w/ wt loss is: | show 🗑
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| Pt who is consistentlyfollowin diet and ex program has been losing 1 lb per week, but has lost no weght in the last month. It is important for the nurse to ask: | show 🗑
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| nurse is developing a wt loss program for a 21yo obese pt. What stament is most likely to help pt adhere to the 800cal diet? | show 🗑
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| show | Suggest a reward (sugarless candy) when pt has been successful
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| show | that the pt has had occasional palpitations
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| Pt has fecal impaction resulting in bowel obstruction. Assessment consistent with a bowel obstruction is | show 🗑
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| show | Assessing the perineal drainage and incision.
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| 69yo pt has developed frequent watery stool after a 10 day course of antibx. Pt wil need: | show 🗑
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| Findongs of a biliary obstruction include: | show 🗑
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| show | turn off tube feeding. obtain O2 sat, chec residual volume, notify pts HCP
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| Pt dx with HIV 3years ago admitted w/ pneumocystis jiroveci. Pt now dx as having: | show 🗑
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| show | remind pt to retrun for testing to verify results
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| show | they will improve the clients immune function
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| Drug therapy is considered of an HIV pt with CD4 count of 400. Most important in determining drug therapy is: | show 🗑
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| When teaching a pt with HIV about antretroviral therapy, the nurse explains that these drugs: | show 🗑
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| show | viral load testing
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| show | prevention of transmission between sexual partners
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| The difference between a benign tumor and a malignant is that benign: | show 🗑
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| show | dietary fat and obesity promote cancer growth
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| A pt is scheduled for a needle biopsy of prostate. RN explains that a needle biopsy is done to: | show 🗑
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| show | administering prescribed antiemetic 1 hr before tx
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| show | to stop the infusion if swelling is observed at the site
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| a pt is receiving head and neck radiation & systemic chemo. there are lesions on oral mucosa and tongue, ropey saliva. The nurse teaches: | show 🗑
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| a pt w/ terminal liver cancer is cared for by family at home. Tells the nurse, "i have intense pain most of the time". Teachin regarding pain mgt is: | show 🗑
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| show | WBC 1700
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| Which action by a CNA who is pancytopenic indicates a need for the RN to intervene? | show 🗑
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| Pt screened for diabetes has a fasting plasma glucose level of 120. Rn will teach pt about: | show 🗑
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| Whan assessing a pt experiencing symptoms of DMII, pt reports following a reduced calorie diet. Pt has not lost weight and does not have record of glucose. Nurse will anticipate: | show 🗑
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| show | check glucose before, during and after swimming.
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| Diabetic is admitted with DKA. The HCP writes the following orders, which do you implement first? | show 🗑
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| Dx of HHNC for pt w/ type 2 brought to the ER in unresponsive state. The nurse will: | show 🗑
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| Patient with type I using Lantus and Humalog develops a sore throat, cough and fever. Pt reports a BS of 210. THe nurse: | show 🗑
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| show | obtain glucose with finger stick
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| show | insulin deficient metabolis of fat storage produces acidic ketones
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| show | have cheese and crackers
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| 3 mile a day runner was just dx w/ DM 1. What is the education: | show 🗑
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| show | noon glucose of 52
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| show | UOP is increased
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| show | serum sodium of 125
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| show | pt is lethargic and confused
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| show | the antithyroid medication takes several weeks to have an effect
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| during initial tx of thyroid replacement with synthroid, the most important assessment is: | show 🗑
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| in teaching a pt with a new dx of hypothyroidism: | show 🗑
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| show | drink 4000 ml of fluid
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| show | to use calcium supplementation to achieve normal levels
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| A cushing syndrome pt has an adrenalectomy. The highest priority initially is: | show 🗑
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| pt is on prednisone every other day for RA. Asks the nurse about taking the prednisone daily. The nurse says: | show 🗑
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| pt is on high doses of prednisone to control an acute exacerbation of systemic lupus. What teaching is most important? | show 🗑
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| show | monitor BP q4h
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| Which client has priority? | show 🗑
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| Pt experiencing hypercalcemic crisis. The nurse should question the order that states: | show 🗑
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| show | giving the pt insulin to treat acute hypokalemia
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| show | abdominal pain
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| show | polydipsia and polyuria
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