Medsurg 1 Brunner and Suddarth Final Exam new material guide

Medsurg 1- Brunner and Suddarth Final Exam new material guide The nurse cares for clients with obesity and understands that causes are multifactorial. What factors contribute to the development of obesity? Select all that apply. A. Behavior B. Environment C. Physiology D. Genetics Which of the following situations would require the nurse to use critical thinking and decision making skills in providing genetics related nursing care? A. Providing a blended family with children of different ages education related to growth and development B. Providing fertility counseling to a young family with a two-year-old child with cystic fibrosis C. Providing family counseling to a same-sex couple that just adopted a five-year-old with attention deficit hyper activity disorder ADHD D. Providing a single parent of a four-year-old child education related to lead poisoning The case manager is working with an 84-year-old patient newly admitted to a rehabilitation facility. When developing a care plan for this older adult, which factors should the nurse identify as positive attributes that benefit coping in this age group? Select all that apply. A. Decreased risk taking B. Effective adaptation skills C. Avoiding participation in untested roles D. Increased life experience E. Resiliency during change Falls, which are a major health problem in the elderly population, occur from multifactorial causes. When implementing a comprehensive plan to reduce the incidence of falls on a geriatric unit, what risk factors should nurses identify? Select all that apply. A. Medication effects B. Overdependence on assistive devices C. Poor lighting D. Sensory impairment E. Ineffective use of coping strategies A diabetic patient calls the clinic complaining of having a "flu bug." The nurse tells him to take his regular dose of insulin. What else should the nurse tell the patient? A. "Make sure to stick to your normal diet." B. "Try to eat small amounts of carbs, if possible." C. "Ensure that you check your blood glucose every hour." D. "For now, check your urine for ketones every 8 hours." A patient is brought to the emergency department by the paramedics. The patient is a type 2 diabetic and is experiencing HHS. The nurse should identify what components of HHS? Select all that apply. A. Leukocytosis B. Glycosuria C. Dehydration D. Hypernatremia E. Hyperglycemia The occupational health nurse is assessing new employees at a company. What would be important to assess in employees with a potential occupational respiratory exposure to a toxin? Select all that apply. A) Time frame of exposure B) Type of respiratory protection used C) Immunization status D) Breath sounds E) Intensity of exposure The nurse is caring for a patient who has been in a motor vehicle accident and the care team suspects that the patient has developed pleurisy. Which of the nurse's assessment findings would best corroborate this diagnosis? A) The patient is experiencing painless hemoptysis. B) The patient's arterial blood gases (ABGs) are normal, but he demonstrates increased work of breathing. C) The patient's oxygen saturation level is below 88%, but he denies shortness of breath. D) The patient's pain intensifies when he coughs or takes a deep breath. A patient is brought to the ED by ambulance after a motor vehicle accident in which the patient received blunt trauma to the chest. The patient is in acute respiratory failure, is intubated, and is transferred to the ICU. What parameters of care should the nurse monitor most closely? Select all that apply. A) Coping B) Level of consciousness C) Oral intake D) Arterial blood gases E) vital signs The nurse is planning the care of a patient with HF. The nurse should identify what overall goals of this patient's care? A.Improve functional status B. Prevent endocarditis. C. Extend survival. D. Limit physical activity. E. Relieve patient symptoms. The critical care nurse is caring for a patient who is in cardiogenic shock. What assessments must the nurse perform on this patient? Select all that apply. A. Platelet level B. Fluid status C. Cardiac rhythm D. Action of medications E. Sputum volume The patient has just returned to the floor after balloon valvuloplasty of the aortic valve and the nurse is planning appropriate assessments. The nurse should know that complications following this procedure include what? Select all that apply. A. Emboli B. Mitral valve damage C. Ventricular dysrhythmia D. Atrialseptal defect E. Plaque formation Most individuals who have mitral valve prolapse never have any symptoms, although this is not the case for every patient. What symptoms might a patient have with mitral valve prolapse? Select all that apply. A. Anxiety B. Fatigue C. Shoulder pain D. Tachypnea E. Palpitations The prevention of VTE is an important part of the nursing care of highrisk patients. When providing patient teaching for these highrisk patients, the nurse should advise lifestyle changes, including which of the following? Select all that apply. A. High protein diet B. Weight loss C. Regular exercise D. Smoking cessation E. Calcium and vitamin D supplementation The nurse has performed a thorough nursing assessment of the care of a patient with chronic leg ulcers. The nurse's assessment should include which of the following components? Select all that apply. A. Location and type of pain B. Apical heart rate C. Bilateral comparison of peripheral pulses D. Comparison of temperature in the patient's legs E. Identification of mobility limitations the hormonal effects of stress, including norepinephrine release. Release of this substance would have what effect on the patients gastrointestinal function? Select all that apply. A. Decreased motility B. Increased sphincter tone C. Increased enzyme release D. Inhibition of secretions E. Increased peristalsis An inpatient has returned to the medical unit after a barium enema. When assessing the patients subsequent bowel patterns and stools, what finding should the nurse report to the physician? A. Large, wide stools B. Milky white stools C. Three stools during an 8-hour period of time D. Streaks of blood present in the stool A nurse is performing an abdominal assessment of an older adult patient. When collecting and analyzing data, the nurse should be cognizant of what age-related change in gastrointestinal structure and function? A. Increased gastric motility B. Decreased gastric pH C. Increased gag reflex D. Decreased mucus secretion A patients sigmoidoscopy has been successfully completed and the patient is preparing to return home. Which of the following teaching points should the nurse include in the patients discharge education? A. The patient should drink at least 2 liters of fluid in the next 12 hours. B. The patient can resume a normal routine immediately. C. The patient should expect fecal urgency for several hours. D. The patient can expect some scant rectal bleeding A nurse is creating a care plan for a patient who is receiving parenteral nutrition. The patient's care plan should include nursing actions relevant to what potential complications? Select all that apply. A. Dumping syndrome B. Clotted or displaced catheter C. Pneumothorax D. Hyperglycemia E. Line sepsis A nurse is participating in a patient's care conference and the team is deciding between parenteral nutrition (PN) and a total nutritional admixture (TNA). What advantages are associated with providing TNA rather than PN? A. TNA can be mixed by a certified registered nurse. B. TNA can be administered over 8 hours, while PN requires 24-hour administration. C. TNA is less costly than PN. D. TNA does not require the use of a micron filter. A nurse is preparing to discharge a patient home on parenteral nutrition. What should an effective home care teaching program address? Select all that apply. A. Preparing the patient to troubleshoot for problems B. Teaching the patient and family strict aseptic technique C. Teaching the patient and family how to set up the infusion D. Teaching the patient to flush the line with sterile water E. Teaching the patient when it is safe to leave the access site open to air A patient who suffered a stroke had an NG tube inserted to facilitate feeding shortly after admission. The patient has since become comatose and the patient's family asks the nurse why the physician is recommending the removal of the patient's NG tube and the insertion of a gastrostomy tube. What is the nurse's best response? A. It eliminates the risk for infection. B. Feeds can be infused at a faster rate. C. Regurgitation and aspiration are less likely. D. It allows caregivers to provide personal hygiene more easily.GT in comatose patients A patient's NG tube has become clogged after the nurse instilled a medication that was insufficiently crushed. The nurse has attempted to aspirate with a large-bore syringe, with no success. What should the nurse do next? A. Withdraw the NG tube 3 to 5 cm and reattempt aspiration. B. Attach a syringe filled with warm water and attempt an in-and-out motion of instilling and aspirating. C. Withdraw the NG tube slightly and attempt to dislodge by flicking the tube with the fingers. D. Remove the NG tube promptly and obtain an order for reinsertion from the primary care provider. A nurse cares for an obese client who wants more information about naltrexone/bupropion to help with weight loss. Which medical conditions does the nurse recognize as contraindications to this medication? Select all that apply. A. Uncontrolled hypertension B. History of alcohol abuse C. History of bulimia D. Epilepsy A nurse cares for a client with obesity who is scheduled to undergo vagal blocking therapy. When teaching the client about the procedure or device, which statements will the nurse include? Select all that apply. A. "It is a pacemaker-type device that is implanted under your skin." B. "A pre-programed pulsating signal is delivered." C. "Recharge the device two times per week." The nurse is admitting a client with traumatic injuries who also has class III obesity. When planning this client's care, the nurse should address the client's heightened risk of what nursing diagnoses related to obesity? Select all that apply. A. Impaired skin integrity B. Impaired gas exchange A nurse is caring for a patient in the late stages of esophageal cancer. The nurse should plan to prevent or address what characteristics of this stage of the disease? Select all that apply. A. Perforation into the mediastinum B. Development of an esophageal lesion C. Erosion into the great vessels D. Painful swallowing E. Obstruction of the esophagus A staff educator is reviewing the causes of gastroesophageal reflux disease (GERD) with new staff nurses. What area of the GI tract should the educator identify as the cause of reduced pressure associated with GERD? A. Pyloric sphincter B. Lower esophageal sphincter C. Hypopharyngeal sphincter D. Upper esophageal sphincter A nurse is performing health education with a patient who has a history of frequent, serious dental caries. When planning educational interventions, the nurse should identify a risk for what nursing diagnosis? A. Ineffective Tissue Perfusion B. Impaired Skin Integrity C. Aspiration D. Imbalanced Nutrition: Less Than Body Requirements