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In what document would you find the client's rights?
Patient's Bill of Rights
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Where is the info. for the standards of nursing practice found?
The Nurse Practice Act
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If your client is at risk for fluid volume overload, what assessment is going to provide you the most accurate info?
daily weight
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What kind of diet should a pt. w/ an elevated temp. (hyperthermic) be on?
regular diet w/ high-protein/calories
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What is the best way to determine whether a pt. who does not speak English understand discharge instructions?
getting the pt. to return demonstration
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Your pt. has a wound that is not healing, what kind of food do they need in their diet?
protein
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A pt. is getting a continuous tube feeding, what position should they be in?
semi-fowler’s (HOB elevated at a 45-degree angle)
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What is the most important thing to do to reduce transmission of organism from pt. to pt.?
hand washing
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What is a clear-liquid diet?
- consists entirely of liquids (foods fluid at room temp.)
- ex: bouillon/broth, carbonated beverages, coffee/tea, apple/grape/cranberry juice, gelatin/popsicles, sugar/honey/hard candy
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What is a full-liquid diet?
all clear liquids plus: milk/milk drinks & liquid supplements, puddings/custards & desserts, all vegetable & fruit juices, refined/strained cereals, eggs in custard, butter/margarine/cream
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What kind of questions are used in an effective communication?
open-ended questions--questions that encourages longer & more thorough answers. (ex: tell me about your usual sleep pattern vs. do you sleep well?)
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What kinds of things block effective communication besides closed-ended questions?
verbal barriers like offering empty reassurances—“everything will be OK”
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When you're assessing a pt. what is the 1st step always?
observation/inspection
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The following statement appears on pt's plan of care, “the client will__________” in a given time frame. The statement is an ex. of a?
client outcome
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What term would you use to document the fact that your pt. is breathing 36/min?
tachypnea--condition in which breaths are abnormally rapid, more than 20/min.)
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What are the s/s of an infection?
elevated temp., red/flushed skin, elevated WBC's & presence of pus
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What is the name of the document that a pt. can have signed prior to the event when they can't make decisions for themselves?
advance directive: durable power of attorney for healthcare
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Where is the best place to assess the pulse in an adult?
carotid artery
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Where is the best place to assess the pulse in a child?
brachial artery
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A pt. who has a fecal impaction, can have what kind of stool?
watery
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The pt's description of pain is subjective or objective?
subjective--consists of the client’s opinions/feelings about what is happening)
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What does the objective data consist of?
anything that you (as the examiner) elicits
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What is a vesicle?
a circumscribed, elevated, palpable mass containing serous fluid
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What is a papule?
an elevated, palpable, solid mass (pus filled) w/ a circumscribed border
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What is a macule?
a flat, nonpalpable skin color change--ex: freckle
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What are the characteristics of psoriasis?
erythematous, silvery, scaling plaques on scalp, elbows, chin & trunk, pitted & discolored nails
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A pt. has a burn injury over 60% of their body & has a hoarse voice. What is that a sign of?
compromised airway
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A pt. w/ herpes zoster comes in to the hospital. What kind of room do they need?
private room
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What is herpes zoster?
continuation/extension of a previous chickenpox (varicella) infection
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What are the stages of pressure ulcers?
- stage 1: area of non-blanching erythema (redness)
- stage 2: partial thickness skin loss
- stage 3: full thickness, with subcutaneous damage
- stage 4: full thickness, extensive destruction to muscle bone/other structures
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Which vitamins enhance wound healing?
vitamins A, C, & D
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What is the normal urine output per hr?
30 mL/hr
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What type of arthritis is it when uric acid crystals are deposited in the joints?
gout
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What kind of diet should a pt. w/ gout have?
low-purine diet
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What are the diff kinds of fx?
open (compound): ?
closed: ?
complete: ?
incomplete: ?
comminuted: ?
greenstick: ?
displaced: ?
oblique: ?
spiral: ?
impacted: ?
transverse: ?
colle’s fx: ?
pott’s fx: ?
- open (compound): through the skin
- closed: not through the skin
- complete: through the bone
- incomplete: not through the bone
- comminuted: multiple sm. pcs.
- greenstick: bent, common in children
- displaced: out of alignment
- oblique: at an angle
- spiral: twisted, associated w/ abuse
- impacted: 1 end enters other end
- transverse: straight across
- colle’s fx: most common wrist fx
- pott’s fx: most common ankle fx
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What is the best way to prevent osteoporosis?
(1 g of) calcium & vitamin D supplements; weight bearing exercises
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When teaching a pt. to walk w/ a cane, what should you instruct them to do?
the cane should be held on the strong side (& adjusted to the appropriate height)
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How should you turn a pt. who just had a laminectomy (back surgery)?
log roll turn
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If a pt. had hip surgery, when they start ambulating & sitting down, what kind of chairs do we want them to sit it?
elevated chairs to promote minimal bending at the hip
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How would you instruct a pt. using a walker?
by moving the walker ahead about 1 foot & having the pt. walk up to the walker
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A pt. is taking spironolactone (Aldactone), a potassium sparing diuretic for HTN. Their lab report shows that their potassium level is 6. What do you do?
hold meds until potassium levels become normal (normal serum potassium levels are 3.5 to 5.0 mEq/L)
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After surgery, you notice that your pt’s calf looks red & painful. A Homan's sign is performed & turns out positive. What do you do?
notify MD
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What electrolyte needs to be monitored for a pt. taking furosemide (Lasix)?
potassium
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Your pt. is very anxious & the MD suspects the pt. has hyperventilation. To confirm his dx, he asked to have an arterial blood gas drawn. The result shows: pH 7.55, paCO2 27, HCO3, paO2 90. What do we have?
respiratory alkolosis
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Your pt. has pyelonephritis, would you increase/decrease fluids?
increase fluid intake to 2-3 L/day
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What kind of juice should you instruct your pt. to drink for their UTI (urinary tract infection)?
cranberry juice to acidify the urine b/c bacteria does not grow in an acidic environment
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What kind of dietary restriction would a pt. w/ chronic renal failure have?
high-carbs, high-fat, low-protein, no sodium
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Is urinary incontinence part of normal aging?
no
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Can urinary incontinence be tx? If so, how?
yes, through bladder training
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Your pt. has gone for a TURP (transurethral resection of the prostate). He has a 3-way foley in place w/ continuous irrigation. If the catheter becomes kinked/blocked, what s/s would the pt. have?
bladder spasms & the urge to void
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A pt. comes into the ED c/o being tired, peeing just a little bit, their urine is coca-cola colored & had a recent upper respiratory infection. What condition do you suspect the pt. has?
acute glomerulonephritis (AGN)
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What is the normal level for the specific gravity of urine?
1.003-1.030
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What is the normal pH level of urine?
4.5-8.0
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What medication might the MD order for UTI (urinary tract infection) pain?
phenazopyridine hydrochloride (Pyridium)
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What is the working unit of the kidney called?
nephron
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Your pt. w/ chronic renal failure is undergoing hemodialysis, what electrolyte is the pt. going to lose?
fluid, sodium, potassium
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To prevent the recurrence of cystitis, the MD might want the pt. to go on what kind of diet?
acid-ash diet
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What kinds of foods are included in an acid-ash diet?
cranberry juice & meat
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Your pt. has acute cholelithiasis, one of the stones has made it to the hepatic ducts of the biliary tree causing spasms. What color is the pt's stool going to be?
clay-colored
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What color is the pt's urine going to be w/ cholelithiasis?
tea-colored
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A pt. who is going to undergo a GI surgery, why might the MD prescribe a prophylactic antibiotic?
to reduce bacterial count
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What kind of disease is c-diff?
bacteria in the colon (result of long-term antibiotic use)
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What drug is given for c-diff?
metronidazole (Flagyl)
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A pt. has acute pancreatitis, why don't we give morphine?
morphine stimulates the contraction of the sphincter of odi
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A pt. had a liver biopsy, after the procedure, how do you position the pt.?
right (sim's/lateral/lying) side to tamponade the bleeding
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How is hepatitis A transmitted?
oral-fecal route
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How is hepatitis B transmitted?
through blood
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How is hepatitis C transmitted?
through blood also
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If a pt. were deficient in vitamin K, what does that lead to?
bleeding gums, bruises, big ecchymotic areas, purpura
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A pt. who has gone a total gastrectomy may have probs. w/ what?
dumping syndrome
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A pt. w/ dumping syndrome looks like?
pale, cold, diaphoretic
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nursing interventions for a pt. w/ dumping syndrome:
- *lay down while eating
- *no liquids while eating
- *avoid big meals (small frequent meals only)
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What lab would be elevated for a pt. who has acute pancreatitis?
AST & ALT, lipase, amylase
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A pt. w/ ulcerative colitis had an ileostomy, 1st day post-op his stoma is dark-red looking, is this normal?
yes
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2-3 days post-op, what should a stoma look like?
pink
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You're instructed to give a pt. an enema, how far do you insert it?
3-4 in.
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What are some risk factors for peptic ulcers?
alcohol abuse, NSAID abuse, aspirin, stress, smoking
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What is the causative organism for peptic ulcers?
H. pylori
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What vitamin deficiency might you find in a pt. who had a subtotal gastrectomy?
B 12
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Vitamin B 12 deficiency can lead to what?
pernicious anemia
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How long are B 12 supplements taken?
for life
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What kind of drug is docusate (Colace)?
stool softener
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