GI, GERD, PUD
The answers are A, B, D. These are signs and symptoms seen with GERD. Melena is seen with gastrointestinal bleeding as in peptic ulcer disease. Smooth, red tongue is seen with vitamin B12 deficiency, and Murphy's Signs is seen with cholecystitis.
The answer is E. All of these conditions can cause cirrhosis.
Which of the following organs is not directly
involved in the compensatory mechanisms for
shock?
A. Kidney
B. Pancreas
C. Heart
D. Liver
B. Pancreas
The organs involved in the compensatory
mechanism process for shock include: heart, brain,
liver, blood vessels, kidney, and adrenal glands. The
pancreas is not directly related to the compensatory
process.
The answer is B. These are the classic characteristics of a 2nd degree (partial-thickness) burn.
A client is assessing a client who has an exacerbation of herpes zoster. Which of the following manifestations of the clients skin should the nurse expect?
1. Confluent honey colored crusted lesions
2. large tender nodule on a hair follicule
3. Unilateral localized nodule skin lesions
4. Fluid filled vesicular rash in the genital region
3. Unilateral localized nodule skin lesions.
This is herpes zoster or shingles. Remember it follows the nerve root (dermatone)
Honey colored lesions are impetigo.
The answer is A. Options B is a proton-pump Inhibitors (PPIs) and it decreases stomach acid and helps the esophagus heal. Option C is a type of prokinetic drug and prevents delayed gastric emptying by improving pressure in lower esophageal sphincter and it improves peristalsis of the GI tract. Option D is a histamine receptor blocker and it blocks histamine. When histamine is released it causes the parietal cells to release HCL but this response will be blocked so gastric acid secretion will be decreased. Option A is a drug used in gallbladder disease.
The answer are B, C, and E. Portal Hypertension is where the portal vein becomes narrow due to scar tissue in the liver, which is restricting the flow of blood to the liver. Therefore, pressure becomes increased in the portal vein and affects the organs connected via the vein to the liver. The patient may experience ascites, enlarged spleen "splenomegaly", and esophageal varices etc.
Which of the following interventions is most
important for hypovolemic shock?
A. Fluid administration
B. Inotrope administration
C. Removal of obstruction
D. Epinephrine administration
A. Fluid administration
The most important intervention for hypovolemic shock is
administration of isotonic crystalloid fluids to restore
circulating volume. If unresponsive, the healthcare
provider could begin inotrope therapy. However, fluid
replacement should always come first.
The answer is C. Due to the location of the burns (face and neck), the patient is at major risk for respiratory issues due to damage to the upper airways and the risk of an inhalation injury.
A nurse is caring for a client who has regular occupational exposure to sunlight and presents for evaluation of several skin lesions. Which of the following should alert the nurse to the possibility of basal cell carcinoma?
1. Pearly papule 0.5 cm wide with raised indistinct borders on shoulder
2. Several flat pigmented circumscribed areas of various sizes over bridge of nose
3. A raised circumscribed lesion on the face with yellow white purulent material
4. Irregularly shaped brown lesion with light blue areas on back
1. Pearly papule 0.5 cm wide with raised indistinct borders on shoulder
#2 is freckles, #3 is acne and #4 is malignant melanoma
The answer is A. The patient signs and symptoms describe a duodenal ulcer. Gastric ulcer tend to not cause pain in the middle of the night and epigastric pain in worst with food.
The answers are A, D, E, and F. Esophageal varices are dilated vessels that are connected from the throat to the stomach. They can become enlarged due to portal hypertension in cirrhosis and can rupture (this is a medical emergency). The patient should avoid activities that could rupture these vessels, such as excessive cough, vomiting, drinking alcohol, and constipation (straining increases thoracic pressure.)
A 3-year-old girl had a near-drowning incident when she fell into a wading pool. Which intervention would be of the highest priority?
a) Inserting a nasogastric tube to decompress stomach
b) Assuring the child stays still during an X-ray
c) Suctioning the upper airway to ensure airway patency
d) Covering the child with warming blankets
c) Suctioning the upper airway to ensure airway patency
Airway interventions must be initated immediatedly due to potentially devastating effects on childs brain
The answers are A, B, D, E, and F. These are all signs of a possible inhalation injury. Bright red lips and tachycardia are present in carbon monoxide poisoning as well.
A nurse discovers scabies when assessing a client who has just been transferred to the medical-surgical unit from the day surgery unit. To prevent scabies infection in other clients, the nurse should:
a) wash hands, apply a pediculicide to the client’s scalp, and remove any observable mites.
b) isolate the client’s bed linens until the client is no longer infectious.
c) notify the nurse in the day surgery unit of a potential scabies outbreak.
d) place the client on enteric precautions.
B. To prevent the spread of scabies in other hospitalized clients, the nurse should isolate the client’s bed linens until the client is no longer infectious — usually 24 hours after treatment begins. Other required precautions include using good hand-washing technique and wearing gloves when applying the pediculicide and during all contact with the client. Although the nurse should notify the nurse in the day surgery unit of the client’s condition, a scabies epidemic is unlikely because scabies is spread through skin or sexual contact. This client does not require enteric precautions because the mites are not found on feces.
The answer is A. This statement is false. H2 blockers block histamine which causes the PARTIETAL (not chief) cells to decrease the secretion of hydrochloric acid.
The answer is A. Murphy’s Sign can occur with cholecystitis. This occurs when the patient is placed in the supine position and the examiner palpates under the ribs on the right upper side of the abdomen. The examiner will have the patient breathe out and then take a deep breath in. The examiner will simultaneously (while the patient is breathing in) palpate on this area under the ribs at the midclavicular line (hence the location of the gallbladder). It is a POSITIVE Murphy’s Sign when the patient stops breathing in during palpation due to pain.
When a poison has been ingested the parents should be instructed to do the following first:
1. Induce vomiting
2. Call poison control
3. administer an emetic
4. get to an emergency facility
2. Call poison control
not all poisons should be vomited. poison control will provide the most accurate information and next steps
The answer is A and B. This phase starts from the onset of the burn and ends with the restoration of capillary permeability. Wound closure, and nutrition would be during the acute phase, and would continue into the rehabilitative phase. Psychosocial would be in the rehab phase.
1. The nurse is caring for a child with tinea pedis. Which of the following assessment findings would the
nurse expect to note?
a. Red scaling rash on soles and between toes
b. Patches of scaling in the scalp with central hair loss
c. Inflamed boggy mass filled with pustules
d. Erythema, scaling, maceration in the inguinal creases and inner thighs
a. Red scaling rash on soles and between toes
Rationale: Tinea pedis is a fungal infection of the feet that manifests as pink-to--red scales and usually
causes itching, stinging, or burning sensations. Patches of scaling in the scalp with central hair loss are
usually associated with tinea capitis. Inflamed boggy mass filled with pustules usually are characteristic
of folliculitis. Erythema, scaling, maceration in the inguinal creases and inner thighs describes a fungal
infection, tinea cruris
The answers are: A, E, F, and G. All these medications can be used to treat an h. pylori infection that is causing a peptic ulcer.
The answers are C, D, E, F, and G. Option A and B are not associated with cholecystitis, but a POSITIVE Murphy’s Sign is.
The nurse is receiving a pediatric patient in shock who was just involved in an accident and has lost a large amount of blood. The patient should be assessed for which type of shock first?
Septic shock
Distributive shock
Cardiogenic shock
Hypovolemic shock
Hypovolemic shock
This patient should be first assessed for hypovolemic shock because this is characterized by an overall decrease in circulating blood or fluid volume.
The answer is D. Think about the increase in the capillary permeability that happens with severe burns, which causes the plasma to leave the intravascular system and enter the interstitial tissue: Low sodium..why: sodium leaves with the plasma to the interstitial tissue and drops the levels in the blood; High potassium...why? damaged cells lysis and leak potassium which increases the leave in the blood; high glucose...why? stress response leads the liver to release glycogen and this increases levels; high hematocrit...why? when the plasma leaves the intravascular system (the fluid) it causes the blood to become more concentrated so hematocrit increases (this will decrease when the patient's fluid is replaced).
4. The nurse is caring for a child with a skin disorder. The child presented with papules that progressed to
vesicles with a honey-colored exudate. What treatment would the nurse expect to be ordered to treat
this disorder? Select all that apply.
a. Topical mupirocin ointment
b. Warm compresses after washing with soap and water several times a day
c. Cool compresses to assist in removing crusts on vesicles
d. Oral cephalexin
e. Regular hygiene measures
Rationale: The condition described is impetigo. Options A, C, & D are treatments used. Warm compresses
would cause increased blood flow to the area resulting in increased itching and discomfort. Since
impetigo is contagious, regular hygiene measures would not be adequate. Contact precautions should be
used