Med Surg

MEDSURG 2 NUR 265/ DETAILED ANSWER KEY NEURO-SHOCK & BURNS - QUESTIONS AND ANSWERS

• A client who takes rifampin tells the nurse, "My urine looks orange." Which action would the nurse take? - check liver enzymes • A client with biliary cirrhosis receives serum albumin therapy. Which action will the nurse take to evaluate the client's response to therapy? - Weight daily • Rationale • The increased osmotic effect of therapy increases the intravascular volume and urinary output; weight loss reflects fluid loss. The vital signs will not change drastically; freque...

The patient should be able to administer them using safe technique. Pain is not expected after cataract surgery and opioids will not be needed. Coughing and deep breathing exercises are not needed because a general anesthetic agent is not used. There is no bed rest restriction after cataract surgery. In reviewing a 55-year-old patient's medical record, the nurse notes that the last eye examination revealed an intraocular pressure of 28 mm Hg. The nurse will plan to assess a. visual ...

The accumulation of fluids in the pleural space is called: a. Pleural effusion b. Hemothorax c. Hydrothorax d. Pyothorax a. Pleural effusion 2. Nurse Kim is caring for a client with a pneumothorax and who has had a chest tube inserted notes continuous gentle bubbling in the suction control chamber. What action is appropriate? a. Do nothing, because this is an expected finding. b. Immediately clamp the chest tube and notify the physician. c. Check for an air leak because the bubbling s...

To assess the client for signs of protein malnutrition, what action should the nurse take? Note the texture of the client's hair. -Dull, dry, sparse hair may be an indication of nutritional deficiencies, protein deficiency. Nurse observes sputum in a tissue left at the bedside. The sputum is thick and purulent. What assessment should the nurse perform? Auscultate breath sounds bilaterally Nurse observes pt. is confused. Upon admission, pt. was oriented to person, place, and time. Nurse ...

Blood Gas Adult Child Blood Gas 7.35-7.45 same PC02 35-45 same Po2 80-100 same HCO3- 21-28 same Pink Puffer sign of? barrel chest is indicative of emphysema and is caused by use of accessory muscles to breathe. The person works harder to breathe, but he amount of 02 taken in is adequate to oxygenate the tissues. Blue bloater sign of? Insufficient oxygenation occurs with chronic bronchitis and leads to generalized cyanosis and often right sided heart failure Signs of inadequate arter...

Propranolol (Inderal), a -adrenergic blocker that inhibits sympathetic nervous system activity, is prescribed for a patient who has extreme anxiety about public speaking. The nurse monitors the patient for a. dry mouth. c. constipation. b. bradycardia. d. urinary retention. ANS: B Inhibition of the fight-or-flight response leads to a decreased heart rate. Dry mouth, constipation, and urinary retention are associated with peripheral nervous system blockade. 5. To assess the funct...

4. When examining a homebound patient, the home health nurse notes a musky, sour body odor. Based on this assessment, the most appropriate nursing action is to a. teach the patient to apply a moisturizing body lotion daily. b. ask about use of over-the-counter (OTC) skin medications. c. ask the health care provider about a prescription for a topical antifungal. d. schedule nursing assistive personnel to help with bathing several times weekly. ANS: D The skin odor indicates that the p...

The nurse understands that a major function of the kidneys is to remove potentially toxic waste products from the blood. Which function is inaccurate? Regulate blood pressure through the conservation of fluids. The nurse is providing care for a patient admitted for a suspected kidney infection. Which area of the body does the nurse expect the patient to identify as a source of pain? Bilateral flanks A patient's urinalysis results are WBCs 100+/bpf; RBC 4/bpf; bacteria, moderate amount; ...

During the relative refractory period of an action potential, a larger than normal stimulus is needed to cause another action potential. This is due to the fact that ________. the voltage gated potassium ion channels remain open long enough to hyper-polarize the axon membrane Which will occur when an excitatory post synaptic (EPSP) is being generated on the dendritic membrane? A single single type of channel will open, permitting simultaneous flow of sodium and potassium Which is not t...