Show:
Endocrine
Respiratory
Musculoskeletal
Nervous System
Cardiovascular & Renal
100
When the thyroid gland does not produce enough thyroid hormone (due to illness, surgery, stress, obstruction, etc.), the pituitary gland detects this reduction in hormone and makes more TSH (releases/stimulates thyroid hormone production) to correct the problem. Blood test results of TSH > 5... What is condition is this?
What is hypothyroidism. In hyperthyroidism, there are high levels of thyroid hormone present, which results in an increased metabolism. The pituitary gland detects this excess and therefore reduces the amount of TSH, levels are therefore <1.
100
Differentiate the major characteristics of Ineffective Airway Clearance and Impaired Gas Exchange in clients.
What is (Ineffective Airway Clearance) - ineffective or absent cough, inability to move secretions, abnormal breath sounds, abnormal RR - rhythm - depth- (Impaired Gas Exchange) - excess or deficit in oxygenation and/or CO2 elimination at the alveolar-capillary membrane, causing confusion, somnolence, restlessness, irritability, inability to move secretions, hypercapnia, and hypoxia.
100
What disease is classified by a decrease in bone density, "brittle bones", due to a loss of calcium out of the bone or inadequate nutritional intake of calcium? Also define Osteomalacia and Paget's disease:
What is Osteoporosis. Osteomalacia is classified by a deficiency in Vitamin D, causing for a lack of calcium absorption in the body. It is referred to as "soft bones" due to bone demineralization. Paget's disease consists of excessive osteoblastic (re-formed bone) and osteoclastic (breakdown)activity creating structurally disorganized and weakened bones.
100
You walk in the room to help setup the client with his supper tray and you note that he begins having seizure activity. What are 3 important seizure management interventions that you will perform immediately?
What is turn the client to the side (if able), remove close objects, loosen clothing (especially around waist), maintain airway, suctioning prn, do not put anything in the client's mouth, do not restrain, ensure padded side rails are in proper position, oxygen therapy PRN, call for help from other staff, administer PRN medications (Lorazepam/Valium as ordered).
100
Name the ranges for normal BP, pre-hypertension, Stage 1 HTN, and Stage 2 HTN.
What is: Normal =/< 120/80 mmHg Pre-hypertension is between 121-139/80-89 mmHg Stage 1 is between 140-159/90-99 mmHg Stage 2 is >/= 160/100 mmHg HTN is diagnosed via at least 3 blood pressure readings over time that are >140/90
200
Name 4 manifestations or signs/symptoms noted in clients with Addison's disease.
What is bronze pigmentation of skin, changes in distribution of body hair, GI disturbances, weakness, hypoglycemia, postural hypotension, weight loss, fatigue, dehydration, in adrenal crisis there is vascular collapse (severe hypotension), and renal shut down (decrease in serum Na+ and increase in serum K+)
200
Explain how a typical client with Pneumonia will present, and also what diagnostics are performed to diagnose the condition.
What is (how client will present) - cough, yellow/green/rusty colored sputum, fever, chills, tachycardia/tachypnea, dyspnea, pleural pain, malaise, respiratory distress, diminished breath sounds- (diagnostics) - CXR, sputum sample for culture, ABGs, VS, assessment findings.
200
Please give an example of how spiral and impacted fractures can occur. What are applicable nursing interventions for a client with a fracture?
What is (spiral) from twisting or abusive type of injury; (impacted) from great force or pressure like a MVA. Nursing interventions include: splinting, elevate, check 6 P's, immobilize, prevent DVTs, cast/skin care, prevent infection.
200
You are working in the ER and a client presents with many manifestations of Meningitis. Diagnostic tests confirm this diagnosis and therefore the nurse would expect an order for which 3 possible medications for management of this condition? What are typical manifestations of Meningitis?
What is antibiotics, antiepileptics, and steriods. Manifestations of Meningitis include N/V, fever, HA, stiff neck/nuchal rigidity, light aversion, drowsiness, joint pain, fitting (convulsions), chills, tachycardia, muscle aches, AMS, ICP, nystagmus.
200
How does Urethritis and Cystitis occur?
What is poor hygiene, females wiping incorrectly after micturition, dehydration from inadequate fluid intake, not voiding after intercourse, STIs, perfumes/perineal deodorants or chemicals. Cystitis is the inflammation of the bladder caused by bacteria, fungi, parasites, irritation from chemicals or radiation... vs. Urethritis is caused by STIs, tissue changes in older adults, and low estrogen levels.
300
Diabetes Insipidus is a water metabolism problem caused by a deficiency of ADH. What are 2 important nursing interventions for a client with Diabetes Insipidus? What is SIADH then?
What is DO NOT DEPRIVE FLUIDS as there is a risk for severe dehydration, IVF, low salt diet (due to hypernatremia), medications to stimulate the production of antidiuretic hormone. Opposite disorder is SIADH: water intoxication problem due to water retention - results from excess ADH, causes severe FVE issues, severe hyponatremia, lethargy, mental status changes, tachycardia & HTN from serum FVE.
300
Your client with COPD is being discharged home from the hospital and you plan to give what 4 discharge instructions related to this disease process?
What is energy conservation, proper positioning to optimize breathing, oxygen therapy as ordered, community referrals, home oxygen and other respiratory equipment, not to exceed (on average) 3 liters/min oxygen as this can cause for apnea (or per MD orders), pulmonary rehabilitation, pharmacologic teaching on bronchodilators, short and long acting beta 2 agonists, cholinergic antagonists, anti-inflammatory agents, corticosteriods, and mucolytics.
300
Name 4 nursing assessment findings in the client with Osteomyelitis of the plantar surface of the left foot.
What is bone pain, fever, swelling at site, erythema to site and surrounding skin, heat, drainage at site, circulation impaired to tissue and bone, loss of function or ROM of foot/toes, increased WBC, increased ESR, bacteremia (causing sepsis).
300
What are 3 nursing diagnoses that are appropriate for clients diagnosed with either a Cataract or Glaucoma? Also, differentiate between these two medical problems:
What is risk for injury, disturbed sensory perception, social isolation, self-care deficit, deficient knowledge, disturbed body image, impaired home maintenance. Cataracts involve opacity of the lens which may develop as a result of aging, metabolic disorders, trauma, or heredity. Glaucoma involves increased IOP as a result of occular disease, and causes include aging, heredity, reinal vein occlusion, trauma, occular tumors, DM, HTN.
300
Describe what Nephrotic Syndrome is and potential complications of this disease:
What is... 1) Nephrotic syndrome is a condition of increased glomerular permeability that allows for larger molecules to pass through the membrane into the urine and then be excreted, causing for massive loss of protein, decreased serum albumin levels, edema formation, high serum lipid levels, fatis in urine, HTN, and increased coagulation. 2) Clients have risk for DVT/PE, CVA/MI from increased coagulation and increased lipid levels, FVE issues.
400
Name 5 classic manifestations of hypoglycemia, and 5 classic manifestations of hyperglycemia. What are long term complications of poor glucose control?
What is (hypoglycemia) - shaking, tachycardia, sweating, anxiety, dizziness, hunger, impaired vision, wekaness, fatigue, HA, irritability- (hyperglycemia) - 3 P's, dry skin, blurred vision, drowsiness, nausea. Long term complications of poor glucose control (elevated hgbA1C) include ARF, CRF, CAD, peripheral neuropathy, decrease in circulation, risk for infection, diabetic and retinopathy/blindness.
400
Clients with chronic bronchitis (blue bloater) have the following manifestations: color dusky to cyanotic, recurrent cough, hypoxia, hypercapnia, increased RR and dyspnea, and digital clubbing. Explain what process/patho causes for these symptoms:
What is chronic bronchitis is inflammation of bronchi and bronchioles related to chronic exposure to irritants (irritant causes inflammation, causes vasodilation and congestion, mucosal edema, and bronchospasm). There is an increase in number and size of mucous glands, the bronchial walls also thicken and therefore both changes impair airflow.
400
A client is taken to the OR to have an ORIF of the left hip following a fall and hip fracture. What are 3 potential medical complications that the nurse can help prevent post-operatively, and what are the 3 necessary hip precautions?
What is (complications) - DVT, bleeding, swelling, atelectasis/PN, skin breakdown, urinary retention, delayed union or infection at site- (hip precautions) - avoid hip adduction - bringing leg back into center, avoid internal rotation, avoid hip flexion greater than 90 degrees.
400
1) Describe the changes in dopamine and acetylcholine levels in the Parkinson's patient and why that is relevant- 2) Describe 3 nursing considerations that are appropriate for clients diagnosed with Parkinson's disease.
What is... 1) dopamine levels are low and acetylcholine levels are high in this disease process - causing for lack of normal movements - progresses over time. 2) Nursing considerations/interventions include: nutrition therarpy with high protein and calorie foods, monitor I&O and swallowing issues; pace activities, allow for extra time to respond, provide communication board as appropriate; monitor for emotional changes including depression, anxiety, and insomnia, and collaborate with the other disciplines to provide support/resources.
400
Describe what TURP stands for, what the procedure involves, and 3 nursing interventions for the client S/P TURP.
What is 1) Transurethral Resection of the Prostate- 2) involves resecting part of the prostate through a minimally invasive surgery- 3) CBI, IVF or encourage increase in oral fluids, pain control, bladder spasm medication, monitor I&O closely, monitor for infection and continued bleeding/clots.
500
Differentiate between the diagnosis of DKA and HHNS:
What is (DKA) - >300 blood glucose, ketones present - metabolic acidosis, hypokalemia initially and then hyperkalemia with acidosis- (HHNS) - >600 blood glucose, no ketones present / no acidosis, hypokalemia present. Increased BUN/creat and Na+ with both problems due to dehydration/hemoconcentration.
500
Your 20 year old male client has been classified in Step 4 on the Asthma Step System, which indicates he has severe and persistent symptoms (daily s/s, episodes severely affect activity and sleep, s/s present at night frequently). What is the appropriate pharmacologic treatment for this client?
What is... a medium dose ICS inhaler, a long-acting inhaler, also a short acting rescue inhaler for PRN use. Examples of ICS inhaler are Pulmicort and Asthmanex, an example of a long-acting inhaler is Serevent (Salmeterol), examples of short acting rescue inhalers are Proventil, Atrovent, Albuterol.
500
A female client has just undergone a below-knee amputation (BKA) on the right extremity due to complications of DM. Name 4 nursing interventions that are essential during the first few days post-operatively.
What is elevate stump for the first 24 hours only, prevent contracture of the joint above amputation, discuss phantom limb pain, analgesics per orders, evaluate healing and possible infection at site, prevent infection, dressing changes as ordered, compression dressing (amputation shrinker). Nursing implications include: prevent further loss of circulation, promote comfort, promote optimal level of mobility.
500
Clients who have Alzheimer's disease may be on a number of different medications to slow cognitive decline and reduce aggitation symptoms. GIve an example of each of the following medications: 1) Cholinesterase inhibitors 2) NMDA receptor antagonist 3) SSRI's 4) Anti-psychotic drugs Also, how is Alzheimer's disease diagnosed/confirmed medically?
What is 1) examples are Aricept and Exelon - slow cognitive decline, 2) example is Namenda - blocks excess glutamine, 3) examples are Paxil and Zoloft - treats chronic depression, 4) examples are Haldol and Risperdal - manages behavior problems. Only an autopsy can confirm tangled lesions and plaques. It is important to R/O other conditions that may cause AMS and confusion in elderly. CT, EEG, PET scans can all show changes consistent with Alzheimer's, and mini-mental assessment is useful in diagnosis.
500
A client presents to the ER complaining of CP unrelieved by 3 doses of nitroglycerin, and has lasted 40 minutes. Initial cardiac enzymes are negative. In 2 hours Myoglobin is elevated at 150 mcg/L, but the Troponin I, Troponin T, and CK-MB are all WNL. What conclusion does the nurse make from these lab results? And, what interventions would be appropriate for this client?
What is (conclusion) - Myoglobin rises within 2 hours follwoing myocardial injury, but it is not specific to myocardial damage, as it can relate to skeletal muscle damage. The other enzymes will rise after 3-6 hours post myocardial injury and a rise in those would indicate a positive MI - (interventions) - MONA interventions to stabilize the client, patient education, reassurance, etc.