Neuro
A patient with Parkinson's Disease is experiencing weight loss due to difficulty chewing and swallowing. Which meal option below is the best for this patient?
A. Scrambled eggs with a side of cottage cheese
B. Grilled cheese with apple slices
C. Baked chicken with bacon slices
D. Tacos with refried beans
The answer is A. The patient should have a diet of soft foods that are easy to swallow and chew due to dysphagia that can occur with PD. The patient and family should be taught interventions to help prevent aspiration pneumonia because of the dysphagia concern.
The patient asks you as the nurse what the distinguishing difference is between osteoarthritis and rheumatoid arthritis. Your response indicates:
A. Inflammation
B. Only rheumatoid arthritis is painful
C. Only osteoarthritis affects the joints
D. They are both part of "getting old"
A. Inflammation
RA is chronic inflammation within the joints. OA is a degenerative disease affecting the joints.
You walk into your patient's room to assess the patient following an abdominal surgery. You immediately notice that the surgical site has opened and bowel is protruding from the site. What is this known as?
A. Dehiscence
B. Evisceration
C. Prolapse
D. Contusion
B. Evisceration
You are reviewing DVT prophylaxis with a student nurse who is following you. Which of the following, if stated as an intervention, would you correct?
A. Anticoagulation
B. Deep tissue massage to lower calves
C. Application of SCDs
D. Encouragement of early ambulation
Answer is B.
Your patient was admitted with influenza. What type of precautions should they be placed in?
A. Contact only
B. Place in negative airflow room
C. Standard precautions only
D. Droplet precautions
D. Droplet
Influenza patients should be placed in droplet precautions. If the patient is frequently coughing and sneezing, contact should also be used.
You are caring for a patient in the acute phase post-hemorrhagic stroke. As the nurse, you know your priority nursing interventions should pertain to which nursing concern?
A. Cerebral tissue perfusion
B. Impaired skin integrity
C. Activity intolerance
D. Ineffective coping
The answer is A. Cerebral tissue perfusion.
A trauma patient is brought to the ED. Upon initial assessment, all but what would indicate a possible hip fracture?
A. Pain in the affected extremity
B. External rotation of the extremity
C. Affected leg is shorter
D. Affected leg is longer
D. Affected leg is longer
The affected leg would be shorter with a hip fracture, not longer.
You are preparing your patient for surgery, which is in four hours. The patient asks for ice chips. What is your response?
A. "I cannot give you any ice chips because you need to be NPO for eight hours."
B. "I can give you a small cup of ice chips up until two hours prior to surgery"
C. "I can give you as much ice chips as you want to distract you from surgery."
D. "I can give you a small sip of water only, because four hours prior to surgery, you can no longer have clear liquids.
Answer is B. Clear liquids are allowable --- CHECK WITH YOUR SURGEON! ;) --- up to two hours before surgery. No solid foods should be give for 8 hours prior.
Your patient has been diagnosed with anemia. As the nurse, you know which two lab findings were reviewed for this diagnosis?
A. Hemoglobin and hematocrit
B. Creatinine and hemoglobin
C. Hematocrit and GFR
D. Creatinine and BUN
A. Hemoglobin and hematocrit
What would creatinine, BUN, and creatinine be used to monitor/diagnose?
You are reviewing the H&P of a patient and note rhinitis on the chart. When reviewing the patient's medications, which medication do you correlate with this diagnosis?
A. Fluticasone
B. Doxycycline
C. Tylenol
D. Allopurinol
A. Fluticasone
Nasal inhalation - corticosteroid.
You are providing pre-proceedure education to a client prior to having a lumbar punction. The client asks you why they must lie flat for six hours post-procedure. You explain:
A. Because of the anesthesia given during the procedure
B. To prevent cerebral spinal fluid leakage and spinal headache
C. To increase circulation to the lower extremeties
D. To decrease the risk of a pulmonary embolism
B. To prevent cerebral spinal fluid leakage and spinal headache
You patient asks you what lifestyle changes they could make to help alleviate their osteoarthritis. You include which of the following in your education:
A. Weight loss
B. Avoid exercise
C. Sleep on their stomach
D. Get a cat
A. Weight loss
What other lifestyle changes can help?
During report from the PACU nurse, they indicate that the patient lost 500 mL of blood. Which of the following vital signs would you expect?
A. Blood pressure 124/82
B. Respiratory rate 14
C. SpO2 95%
D. Heart rate 112
Answer is D.
Blood loss will cause tachycardia and hypotension. SpO2 may also drop.
As the nurse, you recognize that the connection between anemia and renal failure is what?
A. Loss of erythropoietin
B. Loss of fibrinogen
C. Loss of sodium
D. Loss of blood in urine
A. loss of erythropoietin
You walk into your patient's room and notice they are extremely short of breath. Which position should you place them in?
A. Low Fowler's
B. Supine
C. Sitting upright
D. Trendelenburg
C. Sitting upright
High Fowler's; tripod position
The nurse recognizes that this is a classic sign of bacterial meningitis:
A. Babinski reflex
B. Posturing
C. Nuchal rigidity
D. Tachycardia
Answer is C.
You are receiving report on a patient, post-op total hip replacement. As the nurse, you know all of the following are important post-op interventions for this patient EXCEPT:
A. Place abductor pillow between legs
B. Encourage use of incentive spirometer hourly
C. Allow patient to ambulate before sensation returns
D. Pain management
Answer is C.
Until the nerve block wears off and the patient has sensation return to lower extremities, the patient should not ambulate. Dangling can occur with two staff.
In the PACU, you are caring for a post-operative patient who becomes very short of breath, tachycardia, and complains of sudden, intense chest pain. What complication do you suspect?
A. Hypokalemia
B. Hyponatremia
C. Chest tube dislodged
D. Pulmonary emboli
A patient is admitted to the inpatient floor. Your initial vitals: Temp 101 F; heart rate 106; SpO2 87%; BP 115/78; RR 20; Pain 8/10. What is your priority intervention?
A. Apply O2 at 2L NC
B. Administer hydromorphone, 2 mg IV
C. Administer acetaminophen 650 mg PO
D. Initiate a fluid bolus IV
A. Apply O2
Review SpO2 ranges!
You are teaching your client pursed-lip breathing. You understand that use of the technique ensures what?
A. Retain CO2
B. Decrease O2 excretion
C. Excrete CO2
D. Reduce anxiety
C. Excrete CO2
Your patient is alert and orientated following a diagnosis of a subdural hematoma. What is your priority nursing intervention?
A. Place in prone position
B. Perform hourly neuro assessments
C. Provide ice chips
D. Reposition every two hours
B. Perform hourly neuro assessments
You are caring for a patient with a greenstick fracture. What age group would they be in?
A. Older adult
B. Middle age
C. Pediatric
D. Early 20s
Answer is C.
Greenstick fractures occur most often during infancy and childhood when bones are soft.
The nurse has just reassessed the condition of a postoperative client who was admitted 1 hour ago to the surgical unit. The nurse plans to monitor which parameter most carefully during the next hour?
A. Urine output of 20ml/hour
B. Temperature of 37.6 C
C. Blood pressure of 114/70
D. Serous drainage on the surgical dressing
A. Urine output
Urine output should be maintained at a minimum of 30mL/hour for an adult. An output of less than that for each of 2 consecutive hours should be reported to the health care provider.
One of your friend's mom's states that her teenage daughter is experiencing heavy menstrual bleeding monthly and is taking her in for a check-up. As a nurse, you expect that the provider will suggest what dietary changes?
A. Increase calcium intake
B. Decrease sodium intake
C. Ferrous sulfate supplement
D. Iodized salt
Answer is C
RBC count has decreased - need iron to boost it!
Your patient who is acute respiratory failure is no longer orientated to time or place. This is a sign of what symptom of respiratory failure?
A. Hypoxia
B. Anxiety
C. Fatigue
D. delirium
A. Hypoxia = confusion!
Why?