MedSurg
The medical-surgical nurse performs a dressing change on a patient with a history of insulin-dependent diabetes. The patient questions why the wound is not healing. How should the nurse respond?
A) "Are you eating enough carbohydrates in your diet?"
B) "Have you limited your exercise because of the wound?"
C) "How much sleep are you getting at night?"
D) "How often do you check your blood sugar levels at home?"
D) "How often do you check your blood sugar levels at home?"
Which statement by a patient demonstrates an accurate understanding about herbal supplements?
A) "Herbs may interact with prescribed medications but not other herbs."
B) "Most herbs have been tested and found to be safe and therapeutic."
C) "The Food and Drug Administration regulates herbs and allows advertising."
D) "There is no standardization among the manufacturers of herbs in this country."
D) "There is no standardization among the manufacturers of herbs in this country."
A patient tells you her last menstrual period was September 10th, 2014. According to the Nagele's rule when is her expected due date?
June 17, 2015
A topical corticosteroid is prescribed by the pediatrician for a child with contact dermatitis (eczema). Which instruction would the nurse give the parent about applying the cream?
A) Apply the cream over the entire body.
B) Apply a thick layer of cream to affected areas only.
C)Avoid cleansing the area before application of the cream.
D) Apply a thin layer of cream and rub it into the area thoroughly.
D) Apply a thin layer of cream and rub it into the area thoroughly
The Dr orders 800mg of ibuprofen for a patient experiencing reoccurring migraines. The pharmacy has 200mg/tablet in stock. How many tablets should the nurse provide?
4 tablets
BONUS (100 pts): What patient education would you include for high doses of ibuprofen?
For a patient with Crohn disease, the medical-surgical nurse recommends a diet that is:
A) high in fiber, and low in protein and calories.
B) high in potassium.
C) low in fiber, and high in protein and calories.
D) low in potassium
C) low in fiber, and high in protein and calories. (AKA Low-residue Diet)
Which statement by a patient with diabetes indicates an understanding of the medication insulin glargine injection (Lantus)?
A) "Lantus causes weight loss."
B) "Lantus is used only at night."
C) "The duration of Lantus is six hours."
D) "There is no peak time for Lantus.
D) "There is no peak time for Lantus.
During an assessment of a pregnant patient (who is 20 weeks pregnant) she tells you the following information regarding her pregnancy outcomes: She currently has 3 children (ages: 3, 8, 19), all of them were born at 39 and 40 weeks gestation, she has been pregnant 5 times (including this pregnancy). How would you document her GTPAL?
G: 5, T: 3, P: 0, A: 1, L: 3
A 10-year-old child with hemophilia A has slipped on the ice and bumped the knee. The nurse would prepare to administer which prescription?
A) Injection of factor X
B) Intravenous infusion of iron
C) Intravenous infusion of factor VIII
D) Intramuscular injection of iron using the Z-track method
C) Intravenous infusion of factor VIII
Patient presents to the ED with mild pain on the right lateral side of the abdomen. The patient states they have already taken 1g of Tylenol before coming in. The Dr orders 500mg/tablet of acetaminophen prn pain level between 4-7. How many tablets can the nurse administer for this hospital visit?
6 tablets
BONUS (100pts): What is the daily limit of acetaminophen and the antidote for acetaminophen toxicity.
To prepare a patient on the unit for a bronchoscopic procedure, the medical-surgical nurse administers an IV sedative. The nurse then instructs the licensed practical nurse to:
A) educate the patient about the procedure.
B) give the patient small sips of water only.
C) measure the patient's blood pressure and heart rate.
D) take the patient to the bathroom one more time.
C) measure the patient's blood pressure and heart rate.
To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin), patients taking the drug are instructed to:
A) avoid crowds and obtain an annual influenza vaccination.
B) drink at least 2 L of fluids daily, including 8 to 10 glasses of water.
C) eat a potassium-rich, low-sodium diet.
D) practice good dental hygiene and report gum swelling or bleeding.
D) practice good dental hygiene and report gum swelling or bleeding.
A patient with HIV is 6 weeks pregnant. What would you educate the patient about?
A) Practice safe but total abstinence from sexual intercourse during the pregnancy is recommended
B) HIV can not be passed to the fetus
C) How breast feeding will help the newborn after birth
D) HIV is only passed through blood
A) Practice safe but total abstinence from sexual intercourse during the pregnancy is recommended
The nurse is monitoring a 3-year-old child for signs and symptoms of increased intracranial pressure (ICP) after a craniotomy. The nurse would plan to monitor for which early sign or symptom of increased ICP?
A) Vomiting
B) Bulging anterior fontanel
C) Increased head circumference
D) C/O frontal headache
The nurse is setting up the Alaris pump for a patients routine antibiotics of 500mg/800mL of Ceftriaxone. Dr. orders for this med to run over 8 hours. What should the nurse set the rate of the pump to?
100 mL/hr
BONUS (100pts): What medication should the nurse have on hand if a patient who is allergic to PCN is taking Ceftriaxone for the first time?
A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical unit and, after 90 minutes, now reports severe incisional pain. Vital signs are listed. The patient's skin is pale, and the surgical dressing is dry and intact. The most appropriate nursing intervention is to:
VS: BP = 170/90, P = 108, T = 99, RR = 30
A) medicate the patient for pain.
B) place the patient in a high Fowler position and administer oxygen.
C) place the patient in a reverse Trendelenburg position and open the IV line.
D) report the findings to the provider.
A) medicate the patient for pain
A patient is taking a potassium-depleting diuretic and digoxin. The nurse expects that a low potassium level (hypokalemia) could have what effect on digoxin?
A) Increases serum digoxin sensitivity level
B) Decreases serum digoxin sensitivity level
C) No effect on serum digoxin sensitivity level
D) Causes a low-average serum digoxin sensitivity level
A) Increases serum digoxin sensitivity level
The L&D triage nurse notices late decelerations on the EFM monitor. Priority interventions include...
1) Turn to left side (or any position that relieves pressure)
2) Administer O2
3) IV hydration
4) Prepare for possible Cesarean/Emergent delivery
The 6 y/o child who has type 1 DM called the clinic nurse to report the child has been sick and has a positive urine test for ketones. The nurse should respond to the parents to take what action?
A) Hold the next dose of insulin
B) Come to the clinic immediately
C) Encourage the child to drink more fluids
D) Double the dose of insulin
C) Encourage the child to drink more fluids
The ICU nurse is preparing to hang 1g of Lasix in a 1L bag of NS over 4 hours for a CHF patient. The gtts/mL on the infusion set 20. Find the drops per minute.
83 gtts/min
BONUS (100pts): What is the generic name of Lasix and how does it help treat CHF?
When examining a patient who is paralyzed below the T4 level, the medical-surgical nurse expects to find:
A) flaccidity of the upper extremities.
B) hyperreflexia and spasticity of the upper extremities.
C) impaired diaphragmatic function requiring ventilator support.
D) independent use of upper extremities and efficient cough.
D) independent use of upper extremities and efficient cough.
A patient with COPD has severe acute bronchospasm. The nurse anticipates that the health care provider will prescribe which medication?
A) Zafirlukast
B) Epinephrine
C) Dexamethasone
D) Beclomethasone
B) Epinephrine
The postpartum nurse is educating a mother who gave birth to a preterm girl 3 hours ago. When talking about respiratory distress syndrome in the neonate, what are the signs & symptoms?
What interventions will the nurse implement if respiratory distress syndrome were to occur?
Nasal flaring, Expiratory grunts, Cyanosis, Tachypnea, Retractions of chest wall
Monitor HR. If >60 bpm, start compressions and ambu bag. If >/= 100 bpm, apply ambu bag
Which interventions should the nurse include when caring for a child with hepatitis? Select all that apply.
A) Providing a low-fat, well-balanced diet
B) Teaching the child effective hand washing techniques
C) Scheduling playtime in the playroom with other children
D) Notifying the primary health care provider (PHCP) if jaundice is present
E) Instructing the parents to avoid administering medications unless prescribed
F) Arranging for indefinite homeschooling because the child will not be able to return to school
A) Provide a low-fat, well-balanced diet
B) Teaching the child effective hand washing techniques
E) Instructing the parents to avoid administering medications unless prescribed
Sulfisoxazole 1 g orally twice daily, is prescribed for an adolescent with a UTI. The med label reads 500mg tablets. The nurse has determined that the dosage prescribed is safe. The nurse administers how many tablets per dose to the adolescent?
2 tablets
BONUS (100 pts): What is the drug class of sulfisoxazole? Can pregnant women take this same med for a UTI?