MedSurg
Which of the following clients has indications of orthostatic hypotension? A client whose blood pressure is:
A) 118/68 when standing and 110/72 when lying down
B) 140/80, HR 82 bpm when sitting and 136/76, HR 98 bpm when standing
C) 126/72 lying down and 133/80 when sitting, and reports shortness of breath
D) 146/88 when lying down and 130/78 when standing, and reports feeling dizzy
The answer is....
D) 146/88 when lying down and 130/78 when standing, and reports feeling dizzy
Rationale:
Orthostatic hypotension is a drop of 10 mm Hg or more in blood pressure upon moving to a standing position, with complaints of feeling dizzy and/or faint.
Which action demonstrates a break in sterile technique?
A) Remaining 1 foot away from nonsterile areas
B) Placing sterile items on the sterile field
C) Avoiding the border of the sterile drape
D) Reaching 1 foot over the sterile field
The answer is...
D) Reaching 1 foot over the sterile field
Rationale:
Reaching over the sterile field while wearing sterile garb breaks sterile technique. While observing sterile technique, healthcare workers should remain 1 foot away from nonsterile areas while wearing sterile garb, place sterile items needed for the procedure on the sterile drape, and avoid coming in contact with the 1-inch border of the sterile drape.
Which of the following is the best method for performing a physical examination on a toddler
A) From head to toe
B) Distally to proximally
C) From abdomen to toes, the to head
D) From least to most intrusive
The answer is...
D) From least to most intrusive
Rationale: When examining a toddler or any small child, the best way to perform the exam is from least to most intrusive.
What was the first Pixar movie ever created?
A) Toy Story
B) The Incredibles
C) Up
D) Meet the Robinsons
A) Toy Story
Which city is often referred to as the birthplace of jazz?
A) Kansas City
B) Chicago
C) San Diego
D) New Orleans
D) New Orleans
The nurse is caring for a client diagnosed with right middle lobe pneumonia. The nurse should perform which intervention to mobilize secretions?
A) Administer antibiotics as ordered
B) Limit fluids to iv fluids only
C) Place the client in a prone position to increase alveolar expansion
D) Assist client to use incentive spirometer hourly.
The rationale is...
D) Assist client to use incentive spirometer hourly
Rationale: Helping clients deep breeze or use the incentive spirometer promotes maximum lung expansion, mobilizes secretions, and encourages cough. .
Which action should the nurse take when preparing patient-controlled analgesia for a postoperative patient?
A) Caution the patient to limit the number of times he presses the dosing button.
B) Ask another nurse to double-check the setup before patient use.
C) Instruct the patient to administer a dose only when experiencing pain.
D) Provide clear, simple instructions for dosing if the patient is cognitively impaired.
The answer is...
B) Ask another nurse to double-check the setup before patient use.
Rationale: As a safeguard to reduce the risk for dosing errors, the nurse should request another nurse to double-check the setup before patient use.
Immunization of children with Haemophilus influenzae type B (Hib) vaccine decreases the incidence of which of the following conditions?
1. Bronchiolitis
2. Laryngotracheobronchitis (LTB)
3. Epiglottitis
4. Pneumonia
The answer is...
C) Epiglottitis
Rationale: Epiglottitis is a bacterial infection of the epiglottis primarily caused by Hib. Administration of the vaccine has decreased the incidence of epiglottitis.
What animal did Peter Pan feed Captain Hook's hand to?
A) Shark
B) Crocodile
C) Whale
D) Alligator
B) Crocodile
Who is often referred to as the "Queen of Rock"?
A) Miley Cyrus
B) Janet Jackson
C) Tina Turner
D) Freddy Mercury
C) Tina Turner
The nurse is caring for a client in the short procedure unit (SPU) following a bronchoscopy using moderate (conscious) sedation. Prior to discharging the client, the nurse verifies that the client has achieved which priority outcome?
A) Verbalizes symptoms of late complications
B) Demonstrates an intact gag reflex
C) Remains afebrile for up to 2 postop days
D) Reports being thirsty and asks for oral fluids
The answer is...
B) Demonstrates an intact gag reflex
Rationale: An intact gag reflex indicates sedation has lost it's effects and the client is able to swallow. The ability to swallow proceeds consumption of oral intake and coincides with the return of the cough and gag reflex.
The nurse administers codeine sulfate 30 mg orally to a patient who underwent craniotomy 3 days ago for a brain tumor. How soon after administration should the nurse reassess the patient's pain?
A) Immediately
B) In 10 minutes
C) In 15 minutes
D) In 60 minutes
The answer is...
D) In 60 minutes
Rationale: Codeine administered by the oral route reaches peak concentration in 60 minutes; therefore, the nurse should reassess the patient's pain 60 minutes after administration.
The nurse receives a call from the mother whose child has a foreign body in the eye. The object is clearly visible and not embedded. When the mother asks for the most effective way to get it out, the nurse should give which response?
A) Irrigate the eye with natural tears.
B) Irrigate the eye with running tap water.
C) Let the object just "work its way out" of the eye.
D) Touch the object gently with a cotton swab, and lift it out.
The answer is...
D) Touch the object gently with a cotton swab, and lift it out.
Rationale: The most effective method that would cause the least amount of trauma would be to lift the foreign body from the eye. It should not be allowed to remain and "work its way out." Irrigating the eye may cause the foreign body to move and cause trauma in another area of the eye.
Mike and Sully joined which FRAT in Monsters University?
A) Eta Hiss Hiss
B) Sigma Kappa
C) Oozma Kappa
D) Roar Omega Roar
C) Oozma Kappa
What is the stage name for the artist whose real name is Peter Gene Hernandez?
A) Post Malone
B) Bruno Mars
C) Prince
D) The Weeknd
B) Bruno Mars
When teaching a client scheduled for a bedside thoracentesis, what would the nurse explain is the primary purpose for this procedure?
A) It is used to obtain pleural tissue for evaluation
B) It is used to determine the stage of a lung tumor
C) It is used to withdraw fluid from the pleural space
D) It is used to directly examine the pleural space
The rationale is...
C) It is used to withdraw fluid from the pleural space
Rationale: Thoracentesis is used to withdraw fluid or air from the plural space for diagnoses or therapeutic purposes. Although it may be used to help determine the stage of cancer, this is not the primary purpose in this case, he goes there is no specific reference to cancer in the question.
The nurse assesses clients' breath sounds. Which one requires immediate medical attention? A client who has:
A) Crackles
B) Rhonchi
C) Stridor
D) Wheezes
The answer is...
C) Stridor
Rationale: Stridor is a sign of respiratory distress, possibly airway obstruction. Crackles, rhonchi, and wheezes indicate respiratory illness and are potentially serious but do not necessarily indicate respiratory distress that requires immediate medical attention.
Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?
A) Peaches
B) Cottage cheese
C) Popsicle
D) Lima beans
The answer is...
C) Popsicle
Rationale: Hydration is important in the client with sickle cell disease to prevent thrombus formation. Popsicles, gelatin, juice, and pudding have high fluid content as well.
What was the name of Walt Disney's first cartoon character?
A) Donald Duck
B) Mickey Mouse
C) Pluto
D) Oswald the Lucky Rabbit
D) Oswald the Lucky Rabbit
Which classic song can be used to perform CPR?
A) Shake it Off
B) Stayin' Alive
C) Thrift Shop
D) Juju on dat beat
B) Stayin' Alive
Which arterial blood gas (ABG) report would the nurse expect in a client with advanced COPD?
A) pH 7.55, PaCO2 30mmHg, PaO2 80mmHG, HCO3 -24 mEq/L
B) pH 7.40, PaCO2 40mmHg, PaO2 94mmHG, HCO3 -22 mEq/L
C) pH 7.38, PaCO2 45mmHg, PaO2 88mmHG, HCO3 -24 mEq/L
D) pH 7.30, PaCO2 60mmHg, PaO2 70mmHG, HCO3 -30 mEq/L
The answer is...
D) pH 7.30, PaCO2 60mmHg, PaO2 70mmHG, HCO3 -30 mEq/L
Rationale: During the later stages of chronic obstructive pulmonary disease (COPD), Arterial blood gas (ABG) findings indicate low pH (less than 7.35) elevated PCO2 (greater than 45 mmHg), Low PO2 (less than 80 mmHg), and elevated HC03 (greater than 26 mEq/L).
Which of the following clients is experiencing an abnormal change in vital signs? A client whose (select all that apply):
A) Blood pressure (BP) was 132/80 mm Hg sitting and is 120/60 mm Hg upon standing
B) Rectal temperature is 97.9°F in the morning and 99.2°F in the evening
C) Heart rate was 76 before eating and is 60 after eating
D) Respiratory rate was 14 when standing and is 22 after walking
The answer is...
A) Blood pressure (BP) was 132/80 mm Hg sitting and is 120/60 mm Hg upon standing
C) Heart rate was 76 before eating and is 60 after eating
Rationale: The BP change is abnormal; a BP change greater than 10 mm Hg may indicate postural hypotension. The change in heart rate is abnormal; heart rate usually increases slightly after eating rather than decreasing.
The nurse is assigned to care for a child who is scheduled for an appendectomy. Which prescriptions does the nurse anticipate to be prescribed? (Select all that apply.)
A) Administer a Fleet enema.
B) Initiate an intravenous line.
C) Maintain nothing-by-mouth status.
D) Administer intravenous antibiotics.
E) Administer preoperative medications.
F) Place a heating pad on the abdomen to decrease pain.
The answers are...
B) Initiate an intravenous line.
C) Maintain nothing-by-mouth status.
D) Administer intravenous antibiotics.
E) Administer preoperative medications.
Rationale: During the preoperative period, enemas or laxatives should not be administered. In addition, heat should not be applied to the abdomen. Any of these interventions can cause the rupture of the appendix and resultant peritonitis. Intravenous fluids would be started, and the child should receive nothing by mouth while awaiting surgery. Antibiotics are usually administered because of the risk of perforation. Preoperative medications are administered as prescribed.
What is Flynn Rider's real name in Tangled?
A) Shawn Carter
B) Christopher Breaux
C) Eugene Fitzherbert
D) Armando Christian Pérez
C) Eugene Fitzherbert
What year did Elvis Presley die?
A) 1977
B) 1978
C) 1990
D) 1994
A) 1977