Top Posters
Since Sunday
5
o
5
4
m
4
b
4
x
4
a
4
l
4
t
4
S
4
m
3
s
3
A free membership is required to access uploaded content. Login or Register.

Free med surg EXAM 4

Uploaded: 2 years ago
Contributor: bio_man
Category: Medicine
Type: Solutions
Rating: N/A
Helpful
Unhelpful
Filename:   EXAM 4.docx (46.75 kB)
Page Count: 3
Credit Cost: 1
Views: 121
Last Download: N/A
Transcript
User Christine Ellen Behm Course (2015 Fall, Term C) NU 216-KEN/W/1: Adult Health I Test Exam 4 Started 12/2/15 3:46 PM Submitted 12/2/15 4:17 PM Status Completed Attempt Score 150 out of 150 points   Time Elapsed 31 minutes out of 1 hour and 15 minutes Instructions You will have 75 minutes to complete this exam. The exam is worth 170 points total. Please make sure you read the question carefully and in its entirety. This exam contains questions that are multiple choice, select all that apply, True/False, matching, and math dosage calculations. For multiple choice questions choose the best response to each question. For all that apply questions choose all that apply. Results Displayed All Answers, Submitted Answers, Correct Answers, Incorrectly Answered Questions Question 1 3.75 out of 3.75 points The most frequently used diagnostic test for persons with GERD is: Selected Answer:   Upper endoscopy (EGD) Answers:   Upper endoscopy (EGD) Barium swallow study 24 hour pH testing Biopsy the gastric mucosa Question 2 3.75 out of 3.75 points   With a prolonged episode of vomiting, the patient could be at risk for the development of what problem?    Selected Answer:    Acid-base disturbances Answers:    Acid-base disturbances  Intractable diarrhea  Esophageal tears  Hypoventilation Question 3 3.75 out of 3.75 points The nurse is presenting a class on urinary tract infections.  Which of the following should be included in the presentation? (select all that apply) Selected Answers:   Males and females over the age of 65 of equally prone to UTIs   Women of menopausal age have an increased risk of UTIs   E. Coli is the most common cause of bacterial UTIs Answers:   Males and females over the age of 65 of equally prone to UTIs   Women of menopausal age have an increased risk of UTIs   E. Coli is the most common cause of bacterial UTIs the urethra is sterile Question 4 3.75 out of 3.75 points What dietary information is it helpful to record when treating diarrhea in children?   Selected Answer:   Measure the fluid intake, including popsicles and ice chips   Answers:  Measure the percentage of additional high fiber in the diet.     Measure the fluid intake, including popsicles and ice chips   Weigh the client daily   Record hours of sleep Question 5 3.75 out of 3.75 points What is the most common cause of pyelonephritis? Selected Answer:   urinary retention Answers:   urinary retention renal calculi delayed voiding recurrent UTIs Question 6 3.75 out of 3.75 points The nurse is teaching a client diagnosed with a urinary tract infection. An intervention that needs to be followed by the client includes:    Selected Answer:    Avoid tight-fitting pants or clothing Answers:    Avoid tight-fitting pants or clothing  Drink 5- 6 glasses of water per day   Type of soap when bathing has no significance in this area.  Voiding pattern in the course of the day has no significance with this problem Question 7 3.75 out of 3.75 points When treating a nauseated patient with antiemetics, it is essential that the nurse understand what principle?     Selected Answer:   Patient safety is a concern, as drowsiness is a frequent side effect Answers:  There are no known side effects of antiemetics Sports drinks replace the essential ingredients lost by dehydration Antiemetics decrease the risk of aspiration     Patient safety is a concern, as drowsiness is a frequent side effect Question 8 3.75 out of 3.75 points Mrs. James has been given a drug for treatment of nausea and vomiting. She is now complaining of dry mouth, constipation, and a rapid heart rate. What drug would cause these side effects?     Selected Answer:   Prochlorperazine (Compazine)   Answers: Loperamide (Imodium, Kaopectate)     Prochlorperazine (Compazine)   Peppermint   Diphenoxylate (Lomotil) Question 9 3.75 out of 3.75 points What is the purpose for the insertion of a Sengstaken-Blakemore tube inserted into the esophagus to treat esophageal varices? Selected Answer:   Apply pressure to the area affected by the esophageal varices Answers: Removal of blood from the stomach Decrease the risk of aspiration of blood related to the bleeding esophageal varices   Apply pressure to the area affected by the esophageal varices Irrigate the stomach with cool saline Question 10 3.75 out of 3.75 points A patient is scheduled to have gastric bypass surgery.  The physician has ordered Cefazolin 1 gm per 100 ml 0.9 sterile normal saline  to be given IV piggyback 30 minutes pre-op. What is the rate the nurse needs to administer the Cefazolin? Selected Answer:  200 Correct Answer:  200 Answer range +/- 0 (200.0 - 200.0) Question 11 3.75 out of 3.75 points Gastroesophageal reflux disease (GERD) weakens the lower esophageal sphincter, predisposing older persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse should assign the highest priority to which of the following interventions? Selected Answer:   Eat small, frequent meals, and remain in an upright position for at least 30 minutes after eating Answers:  Decrease daily intake of vegetables and water, and ambulate frequently.  Drink coffee diluted with milk at each meal, and remain in an upright position for 30 minutes.   Eat small, frequent meals, and remain in an upright position for at least 30 minutes after eating  Avoid over-the-counter drugs that have antacids in them Question 12 3.75 out of 3.75 points A client comes to the primary care provider's office with the complaints of urinating all the time, pain on urination, small amounts of urine being passed when voiding, and a foul smell to the urine. A urine specimen has been sent for analysis. Based on the signs and symptoms expressed by the client, which of the following health problems would be anticipated? Selected Answer:    Urinary tract infection   Answers:  Acute renal failure  Renal stone    Urinary tract infection   Chronic renal failure Question 13 3.75 out of 3.75 points Which of these agents is a major contributing factor in the promotion of peptic ulcer disorder?     Selected Answer:   Helicobacter pylori infection Answers: Candida albicans   Staphylococcus infection   Streptococcus infection     Helicobacter pylori infection Question 14 3.75 out of 3.75 points The nurse is reviewing the preoperative orders of a client with a colon tumor who is scheduled for colon resection and notes that the physician has prescribed Neomycin for the client. The nurse determines that this medication has been prescribed primarily:   Selected Answer:   To decrease the bacteria in the bowel Answers: To prevent immune dysfunction To prevent surgical infection   To decrease the bacteria in the bowel Because the client is allergic to penicillin Question 15 3.75 out of 3.75 points The nurse is performing discharge teaching for a patient admitted with pyelonephritis. The patient asks the nurse, "What is pyelonephritis?" Based on the nurse's knowledge , the best response would be? Selected Answer:   inflammation of the kidney and renal pelvis Answers: inflammation of the bladder infection of the lower urinary tract   inflammation of the kidney and renal pelvis distention of the bladder Question 16 3.75 out of 3.75 points The patient needs to collect a timed 24 hour urine specimen from 10 am Monday to 10 am Tuesday.  What are the corrcet instruction for collecting the specimen? Selected Answer: Void at 10am Monday morning and discard the urine.  After that, begin collecting all the urine in the container provided keeping it on ice.  At 10 am on Tuesday collect a specimen and add that to the container. Answers: Void at 10am Monday morning and discard the urine.  After that, begin collecting all the urine in the container provided keeping it on ice.  At 10 am on Tuesday collect a specimen and add that to the container. Begin the urine collection with the voided urine at 10am on Tuesday morning.  Keep the urine collected in a specimen container placed on ice and end the specimen collection at 10 am Tuesday morning. Begin the urine collection with the voided urine at 10am on Tuesday morning.  Keep the urine collected in a specimen container placed on ice. At 10 am on Tuesday morning void and discard the specimen marking the end of the specimen collection. Begin the 24 hour specimen collection at 10 am on Monday morning at ending at the same time (10am) on Tuesday morning. Discard both specimens collecting all the urine during the 24 hour period between. Question 17 3.75 out of 3.75 points The nurse instrcuts a client with pyelonephritis to drink 2.5 to 3L of fluid per day.  The nurse understands the rationale for this self care intervention as: Selected Answer:   to prevent the stasis of urine Answers: to prevent the reflux of urine   to prevent the stasis of urine to decrease the stress on the bladder to decrease residual urine Question 18 3.75 out of 3.75 points The nurse is assessing the colostomy of a client who has had an abdominal perineal resection for a bowel tumor. Which of the following assessment findings indicates that the colostomy is beginning to function?   Selected Answer:   Passage of flatus Answers: Absent bowel sounds   Passage of flatus Client's ability to tolerate food Bloody drainage from the colostomy Question 19 3.75 out of 3.75 points A 52 year old woman is admitted to the emergency department. Her B/P is 115/70, pulse 20, and respirations 22.  She has been treated for alcoholism, esophageal varices, hiatial hernia and peptic ulcers for the past 5 years.  She was brought to the hospital where she has vomitted bright red blood.  What signs and symptoms indicate to the RN that the blood vomitted originated from esophageal varices? Selected Answer:   Anorexia, hememesis, chronic cough Answers:   Anorexia, hememesis, chronic cough Midepigastric pain and a feeling of fullness in her stomach Difficulty swallowing and hypertension Pain in the right upper quadrant afer eating Question 20 3.75 out of 3.75 points What are the correct instructions the nurse should give a female client for collecting a clean catch urine specimen? Selected Answer: Separate the labia , clean from front to back using the three wipes impregnated with the cleaning solution. Begin to void into the toliet, then stop. Finally continue to void into the sterile specimen container. Answers: Retract the foreskin, cleanse from front to back using the wipes impregnated with the cleaning solution, and then start to void in the toilet.  Stop, and lastly continue to void into the sterile specimen container.  Separate the labia, clean from back to front using three wipes impregnated with the cleaning solution. Start to void inthe toilet. Stop and lastly continue to void into the sterile specimen container.  Separate the labia , clean from front to back using the three wipes impregnated with the cleaning solution. Begin to void into the toliet, then stop. Finally continue to void into the sterile specimen container. Retract the foreskin, clean with soap and water. Begin to void into the toilet. Stop, then lastly continue to void into the sterile specimen container. Question 21 3.75 out of 3.75 points A 62 year old patient has a history of peptic ulcer disease.  In the past he has been hospitalized for episodes of bleeding and is currently being admitted to the hospital for an evaluation.  The dotor has ordered Cimetidine (Tagament).  What is the rationale for the adminstration of Cimetidine(Tagament)? Selected Answer:   The medication will reduce the secretion of stomach acid by blocking the action of histamine Answers: The medication will coat the gastric mucosa and protect the membranes from excessive stomach acids The medication will increase the sensitivity of H2 receptors in the stomach The medication will reduce the amount of stomach acid produced by blocking proton pumps in the stomach   The medication will reduce the secretion of stomach acid by blocking the action of histamine Question 22 3.75 out of 3.75 points A post-op laminectomy patient has been unable to void for the past 6 hours.  The order is to insert a Foley catheter if patient is unble to void.  What is the greatest concern for the nurse? Selected Answer:   Maintaining strict aseptic technique Answers: Obtaining a bladder scan to assess the need for a Foley catheter   Maintaining strict aseptic technique Notifying the doctor Ambulating the client to promote the urge to urinate Question 23 3.75 out of 3.75 points The  nurse is giving a presentaiton on urinary tract infections(UTI). Which of the following should the nurse include in the presentation? Selected Answer:   both males and females are equally prone to UTIs after the age of 65 Answers: pyelonephritis is the most common infection the urinary tract below the urethre is sterile males are mpre prone to UTIs than females   both males and females are equally prone to UTIs after the age of 65 Question 24 3.75 out of 3.75 points  Mr. Howard has been diagnosed with constipation after surgery. What drug should the nurse have prepared to administer?   Selected Answer:   Docusate sodium (Colace)   Answers:  Promethazine (Phenergan) Loperamide (Imodium) Prochlorperazine (Compazine)     Docusate sodium (Colace)   Question 25 3.75 out of 3.75 points What is one of the major precipitating factors in the development of irritable bowel syndrome (IBS)?   Selected Answer:   Stress Answers:   Peptic ulcers  GERD (gastroesophageal reflux disease)   Helicobacter pylori   Stress Question 26 3.75 out of 3.75 points A 6 year old boy has been newly diagnosed with celiac disease.  Which statement by the child indicates to the nurse that the child is following the correct diet?   " I ate chicken and vegetables my mom made for dinner." Answers: "I had a hot dog and french fries for lunch."   " I ate chicken and vegetables my mom made for dinner." "My favorite meal is macaroni and cheese." "I ate chicken soup and crackers for dinner." Question 27 3.75 out of 3.75 points The nurse administers which of the following prescribed medications to a client wiht recurrent UTIs casued by E. Coli? Selected Answer:   Sulfamethoxazole and Trimethaprim (Bactrim DS) Answers: Cranberry supplements Bethanechol chloride (Urecholine)   Sulfamethoxazole and Trimethaprim (Bactrim DS) Cephelaxin (Keflex) Question 28 3.75 out of 3.75 points A patient is admitted to the hospital with severe left flank pain related to kidney stones.  The first priority of the nurse in the management of the patient is: Selected Answer:   Administer opioid pain medications Answers: Strain all urine Obtain a set of vital signs Place the patient on NPO status pending surgery   Administer opioid pain medications Question 29 3.75 out of 3.75 points A patient is ordered a clear liquid diet. Which of the following foods should the nurse discourage? Selected Answer:   Skim Milk Answers: Apple Juice   Skim Milk Beef Broth Tea Question 30 3.75 out of 3.75 points You begin your shift at 0700.  A patient is scheduled to have a colon resection at 0900.  They have been NPO since midnight. 0.9% Normal saline with 20meq of Kcl have been infusing at a continuous rate of 100cc/hr. The patient weighs 260lbs.  Gentamicin 1.7 mg/kg IV has been ordered to be administered over 90 minutes one hour before the patient's scheduled gastric resection. What is the dose of Gentamycin the nurse will administer? Selected Answer:  200.6 Correct Answer:  200.9 Answer range +/- 1.1 (199.8 - 202.0) Question 31 3.75 out of 3.75 points A patient has a history of gastroesophageal reflux disease. Recenlty, he  has been experiencing frequent episodes of "heartburn" and complains he has had regurgitation of sour tasting fluid.  Which interventions will help alleviate his symptoms?  (select all the apply)   Elimininate caffiene, peppermint, and chocolate from the diet   Elevate the head of bed   Eat 4-5 small meals a day Answers: Elevate the lower extremities when in bed   Elimininate caffiene, peppermint, and chocolate from the diet   Elevate the head of bed Drink more fluids with meals   Eat 4-5 small meals a day Question 32 3.75 out of 3.75 points The nurse is caring for a patient preparing to undergo a colonoscopy. She should be prepared to give what drug?   Selected Answer:   Carthartic Answers:  Laxative  Diuretic   Antihypertensive    Carthartic Question 33 3.75 out of 3.75 points The nurse is caring for a patient recenlty diagnosed with inflammatory bowel diease. Which dietary choice indicates that the patient understands how she can prevent an acute excaberbation of her IBD? Selected Answer:   Refined cereals Answers: Apple Celery Hard cheeses   Refined cereals Question 34 3.75 out of 3.75 points The nurse is collecting a nursing history from a client admitted with acute pyelonephritis. Which of the following questions should the nurse ask? Selected Answer:   " Do you have pain when urinating?" Answers: "Have you noticed any blood in your urine?" "Have you experienced any decrease in your urinary output?" " Do you find you are experiencing dribbling at the end of urinating?"   " Do you have pain when urinating?" Question 35 3.75 out of 3.75 points A 54 year old patient with a history of alcohol abuse is being admitted because of bleeding esophageal varices. A Sengtaken-blakemore tube is inserted in order to stop the bleeding. After the tube is inserted the patient has difficulty breathing and a pulse ox of 88%.  Based on this assessment data, what is the FIRST action the nurse should take? Selected Answer:   Deflate the esophageal balloon Answers: Withdraw the tube Auscultate lungs sounds   Deflate the esophageal balloon Position the patient in a High-Fowler's position and administer 2L of oxygen immediately Question 36 3.75 out of 3.75 points The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching related to colorectal cancer is necessary if the client identifies which of the following as an associated risk factor? Selected Answer:   Family history of colorectal cancer Answers:  Age younger than 50 years History of colorectal  polyps   Family history of colorectal cancer Chronic inflammatory  bowel disease Question 37 3.75 out of 3.75 points A graduate nurse (GN) indicates a correct understanding of nasogastric tube feedings by the statement: "The most serious complication of a nasogastric method of delivery is..." Selected Answer:   Aspiration Answers: Diarrhea   Aspiration Nausea Weight gain Question 38 3.75 out of 3.75 points A patient was admitted two days ago diagnosed with a small bowel obstruction.  She has a a nasogastric tube connected to low intermittent suction in place with brown drainage observed in the suction cannister.  Which of the following nursing interventions will help to relieve discomfort in the nostril where the NG tube has been inserted? Selected Answer:   Secure the tube to the patient's gown allowing enough room for the patient to turn his head from side to side avoiding pressure on the nares Answers: Lubricate the NG tube with sterile water soluble lubricant Administer a PRN pain medication via the NG tube and flush with  20 cc's of water Lubricate the tube with vaseline   Secure the tube to the patient's gown allowing enough room for the patient to turn his head from side to side avoiding pressure on the nares Question 39 3.75 out of 3.75 points In order to decrease the risk of aspiration from a continuous nasogastric tube feeding, the RN should......... Selected Answer:   Elevate the head of the bed between 30 and 45 degress Answers: Keep the patient laying on his or her left side Flush the tube with 60ml water every four hours Clamp the tube when the patient is sleeping   Elevate the head of the bed between 30 and 45 degress Question 40 3.75 out of 3.75 points A patient is suspected to have a UTI.  Which lab tests are appropriate inthe diagnosis? Selected Answer:   Urinalysis for culture and sensitivity Answers: 24 hour urine collection Blood cultures   Urinalysis for culture and sensitivity post void residual

Related Downloads
Explore
Post your homework questions and get free online help from our incredible volunteers
  985 People Browsing
Your Opinion
What's your favorite funny biology word?
Votes: 156