Acute Care Exam 2 Questions
with Accurate Answers
1.In teaching a patient with pyelonephritis about the disorder, the
nurse informs the patient that the organisms that cause pyelonephritis
most commonly reach the kidneys through
a.the bloodstream.
b.the lymphatic system.
c.a descending infection.
d.an ascending infection. correct answer d.an ascending infection.
3. A 50-year-old woman with a suspected brain tumor is scheduled for a
computed tomography (CT) scan with contrast media. The nurse
notifies the physician that the patient reported an allergy to shellfish.
Which response by the physician should the nurse question?
A. Infuse IV diphenhydramine prior to the procedure.
B. Administer lorazepam (Ativan) before the procedure.
C. Complete the CT scan without the use of contrast media.
D. Premedicate with hydrocortisone sodium succinate (Solu-Cortef).
correct answer C. Complete the CT scan without the use of contrast
media.
An individual with an allergy to shellfish is at an increased risk to
develop anaphylactic shock if contrast media is injected for a CT scan.
To prevent anaphylactic shock, the nurse should always confirm the
,patient's allergies before diagnostic procedures (e.g., CT scan with
contrast media). Appropriate interventions may include cancelling the
procedure, completing the procedure without contrast media, or
premedication with diphenhydramine or hydrocortisone. IV fluids may
be given to promote renal clearance of the contrast media and prevent
renal toxicity and acute kidney injury. The use of an antianxiety agent
such as lorazepam would not be effective in preventing an allergic
reaction to the contrast media.
3. The nurse provides nutritional counseling for a 45-year-old man with
nephrotic syndrome. The nurse determines that teaching has been
successful if the patient selects which breakfast menu?
A. Scrambled eggs, milk, yogurt, and sliced ham
B. Oatmeal, nondairy creamer, banana, and orange juice
C. Cottage cheese, peanut butter, white bread, and coffee
D. Waffle, bacon strips, tomato juice, and canned peaches correct
answer B. Oatmeal, nondairy creamer, banana, and orange juice
,Patients with nephrotic syndrome should follow a low-sodium (2 to 3
g/day), low- to moderate-protein (0.5 to 0.6 g/kg/day) diet. Ham, milk
products, peanut butter, and bacon are high in sodium. Eggs, milk
products, and peanut butter are high in protein.
A 22-year-old male is admitted to the emergency department with a
stab wound to the abdomen. The patient's vital signs are blood
pressure 82/56 mm Hg, pulse 132 beats/minute, respirations 28
breaths/minute, and temperature 97.9° F (36.6° C). Which fluid, if
ordered by the health care provider, should the nurse question?
A. 0.9% saline
B. 0.45% saline
C. Packed red blood cells
D. Lactated Ringer's solution correct answer B. 0.45% saline
IV administration of 0.45% saline is hypotonic and is used for
maintenance fluid replacement and dilutes the extracellular fluid.
Intravenous solutions used for volume expansion for hypovolemic
shock include lactated Ringer's solution and 0.9% saline. If hypovolemia
is due to blood loss, blood may be administered.
A 25-year-old patient with a group A streptococcal pharyngitis does not
want to take the antibiotics prescribed. What should the nurse tell the
patient to encourage the patient to take the medications and avoid
complications of the infection?
, 1) "The complications of this infection will affect the skin, hair, and
balance."
2) "You will not feel well if you do not take the medicine and get over
this infection."
3) "Without treatment, you could get rheumatic fever, which can lead
to rheumatic heart disease."
4) "You may not want to take the antibiotics for this infection, but you
will be sorry if you do not." correct answer 3) "Without treatment, you
could get rheumatic fever, which can lead to rheumatic heart disease."
A 46-year-old woman with a subclavian triple-lumen catheter is
transferred from a critical care unit after an extended stay for
respiratory failure. Which action is important for the nurse to take?
A. Change the injection cap after the administration of IV medications.
B. Use a 5-mL syringe to flush the catheter between medications and
after use.
C. During removal of the catheter, have the patient perform the
Valsalva maneuver.
D. If resistance is met when flushing, use the push-pause technique to
dislodge the clot. correct answer C. During removal of the catheter,
have the patient perform the Valsalva maneuver.
The nurse should withdraw the catheter while the patient performs the
Valsalva maneuver to prevent an air embolism. Injection caps should be
changed at regular intervals but not routinely after medications.
with Accurate Answers
1.In teaching a patient with pyelonephritis about the disorder, the
nurse informs the patient that the organisms that cause pyelonephritis
most commonly reach the kidneys through
a.the bloodstream.
b.the lymphatic system.
c.a descending infection.
d.an ascending infection. correct answer d.an ascending infection.
3. A 50-year-old woman with a suspected brain tumor is scheduled for a
computed tomography (CT) scan with contrast media. The nurse
notifies the physician that the patient reported an allergy to shellfish.
Which response by the physician should the nurse question?
A. Infuse IV diphenhydramine prior to the procedure.
B. Administer lorazepam (Ativan) before the procedure.
C. Complete the CT scan without the use of contrast media.
D. Premedicate with hydrocortisone sodium succinate (Solu-Cortef).
correct answer C. Complete the CT scan without the use of contrast
media.
An individual with an allergy to shellfish is at an increased risk to
develop anaphylactic shock if contrast media is injected for a CT scan.
To prevent anaphylactic shock, the nurse should always confirm the
,patient's allergies before diagnostic procedures (e.g., CT scan with
contrast media). Appropriate interventions may include cancelling the
procedure, completing the procedure without contrast media, or
premedication with diphenhydramine or hydrocortisone. IV fluids may
be given to promote renal clearance of the contrast media and prevent
renal toxicity and acute kidney injury. The use of an antianxiety agent
such as lorazepam would not be effective in preventing an allergic
reaction to the contrast media.
3. The nurse provides nutritional counseling for a 45-year-old man with
nephrotic syndrome. The nurse determines that teaching has been
successful if the patient selects which breakfast menu?
A. Scrambled eggs, milk, yogurt, and sliced ham
B. Oatmeal, nondairy creamer, banana, and orange juice
C. Cottage cheese, peanut butter, white bread, and coffee
D. Waffle, bacon strips, tomato juice, and canned peaches correct
answer B. Oatmeal, nondairy creamer, banana, and orange juice
,Patients with nephrotic syndrome should follow a low-sodium (2 to 3
g/day), low- to moderate-protein (0.5 to 0.6 g/kg/day) diet. Ham, milk
products, peanut butter, and bacon are high in sodium. Eggs, milk
products, and peanut butter are high in protein.
A 22-year-old male is admitted to the emergency department with a
stab wound to the abdomen. The patient's vital signs are blood
pressure 82/56 mm Hg, pulse 132 beats/minute, respirations 28
breaths/minute, and temperature 97.9° F (36.6° C). Which fluid, if
ordered by the health care provider, should the nurse question?
A. 0.9% saline
B. 0.45% saline
C. Packed red blood cells
D. Lactated Ringer's solution correct answer B. 0.45% saline
IV administration of 0.45% saline is hypotonic and is used for
maintenance fluid replacement and dilutes the extracellular fluid.
Intravenous solutions used for volume expansion for hypovolemic
shock include lactated Ringer's solution and 0.9% saline. If hypovolemia
is due to blood loss, blood may be administered.
A 25-year-old patient with a group A streptococcal pharyngitis does not
want to take the antibiotics prescribed. What should the nurse tell the
patient to encourage the patient to take the medications and avoid
complications of the infection?
, 1) "The complications of this infection will affect the skin, hair, and
balance."
2) "You will not feel well if you do not take the medicine and get over
this infection."
3) "Without treatment, you could get rheumatic fever, which can lead
to rheumatic heart disease."
4) "You may not want to take the antibiotics for this infection, but you
will be sorry if you do not." correct answer 3) "Without treatment, you
could get rheumatic fever, which can lead to rheumatic heart disease."
A 46-year-old woman with a subclavian triple-lumen catheter is
transferred from a critical care unit after an extended stay for
respiratory failure. Which action is important for the nurse to take?
A. Change the injection cap after the administration of IV medications.
B. Use a 5-mL syringe to flush the catheter between medications and
after use.
C. During removal of the catheter, have the patient perform the
Valsalva maneuver.
D. If resistance is met when flushing, use the push-pause technique to
dislodge the clot. correct answer C. During removal of the catheter,
have the patient perform the Valsalva maneuver.
The nurse should withdraw the catheter while the patient performs the
Valsalva maneuver to prevent an air embolism. Injection caps should be
changed at regular intervals but not routinely after medications.
