Med/Surg Exam 1

Last updated over 2 years ago

68 questions

1

Library

Med/Surg Exam 1

Last updated over 2 years ago

68 questions

1

What are the implications of IV therapy? _______ 

1

_______ Have most of the plasma removed and only contains 285-300ml.

1

_______ Is a mixture of clotting agents, treats blood clotting disorders, and diluted with NS with an infusion time of 4-6hrs.

1

_______ Is separated from blood cells within 8hrs after collection and is frozen.

1

_______ the infusion, elevated head, provide O2 and call provider when the patient is experiencing_______ 

1

_______ IV and elevate arm when patient shows S/S of _______ 

1

Place patient on L side in Trendelenburg position, CALL FOR HELP, provide O2, and stay with patient when patient has S/S of _______ 

1

When administering _______ you must ask for _______ allergy and wean client before D/C to avoid a _______ in _______ 

1

What labs need to be monitored while a patient is receiving TPN?

1

What must be sent to the lab after an incompatibility reaction occur? _______ 

1

_______ _______ _______ _______ _______ _______ Are the methods of transmission

1

_______ do NOT elevate WBC

1

Mucous membranes, GI/GU Tract, Respiratory Tract, Broken Skin, and Blood are_______ 

1

A patient with severe sepsis has a lactic acid _______ than 2 and must receive _______  and _______ within  1 hour of discovery.

1

Pain should be less than _______ on pain scale.

1

_______ is usually poorly localized and manifests as nausea, vomiting, and hypotension.

1

_______ Is usually treated with _______ 

1

_______ _______ _______ _______ are the theories of pain

1

Always _______ patches before putting them in _______ 

1

Monitor for _______ _______ and _______  when administering an opioid

1

_______  may increase risk for serotonin syndrome when taking_______ 

1

Can a nurse push the button on a PCA for the patient _______  

1

A client must wait _______ before palliative sedation begins after consenting to process.

1

Decreased metabolism, fluid overload, delayed wound healing and formation of blood clots are complications found in _______ people.

1

_______ Patients may experience F&E imbalance, delayed wound healing, and infections after surgery.

1

_______ May cause altered respiratory functions, nutritional status, and impaired liver function complications.

1

_______ dysfunction may cause delayed drug metabolism leading to drug toxicity, disrupted clotting mechanisms which causes _______ _______ _______ 

1

_______ dysfunction may cause F&E imbalance, fluid overload, delayed excretion causing drug toxicity, and dysrhythmias.

1

_______ is responsible for educating the patient about the procedure including the risks and benefits.

1

Diazepam, Atropine, and Zofran are _______ 

1

A "Time Out" must identify the right _______ _______ _______ 

1

Hx of chemo, tobacco use, and insufficient vitamin c and protein are risk factor for _______ 

1

When can a patient go home after ambulatory surgery?

What are the implications of IV therapy? _______ 

What type of IV solution is Hypotonic?

0.45% Normal Saline

10% Dextrose in Water

1 unit of whole blood

0.9% Normal Saline

What is the definition and an example of Hypertonic solution?

Pulls fluid from cells and interstitial tissues into vascular space. Ex: 3% Saline

Shifts body fluids out of blood vessels and into cells and interstitial space. Ex: 3% Saline

Maintains normal cell size. Ex: 0.9% Normal saline

What are 0.9% NS, D5W, and Lactated Ringers

Hypotonic Solutions

Hypertonic Solutions

Isotonic Solutions

Fluids

How many mL are in Whole Blood?

100

500

475

250

_______ Have most of the plasma removed and only contains 285-300ml.

What blood products are WBC, Improves ability to fight infection, and must be transfused in 48hrs of collection?

Granulocytes

Cryoprecipitate

Albumin

Albumin:

Pulls 3rd spaced fluid by decreasing colloidal osmotic pressure.

Must be hung at least 4ft higher than the heart.

Is a Plasma protein, must be hung at least 3ft higher than the heart, infused within 30-60 minutes.

_______ Is a mixture of clotting agents, treats blood clotting disorders, and diluted with NS with an infusion time of 4-6hrs.

_______ Is separated from blood cells within 8hrs after collection and is frozen.

What tubing is used to transfuse blood and blood products?

Y Tubing

Piggyback

Primary Tubing 

What Type of Cath is placed 3-6in above or below the armpit?

Midline

PICC Line

CVC

____ Is used to provide TPN, monitor central venous pressure, admin irritating medications, and used only when peripheral veins have collapsed.

PICC

Midline

CVC

IV

When is IV tubing replaced

q24h

Its a one time use only

q72-96h

q72hrs

DIAGNOISE S/S: Elevated BP, SOB, Bounding Pulse, anxiety

Infiltration

Circulatory overload

Pulmonary embolism

S/S: Redness, warmth and discomfort along vein.

Infiltration

Phlebitis

Thrombus formation

S/S: Sudden chest pain, SOB, anxiety, rapid heart rate, DROP in BP.

Circulatory overload

Pulmonary embolism

Air embolism

_______ the infusion, elevated head, provide O2 and call provider when the patient is experiencing_______ 

_______ IV and elevate arm when patient shows S/S of _______ 

Place patient on L side in Trendelenburg position, CALL FOR HELP, provide O2, and stay with patient when patient has S/S of _______ 

When administering _______ you must ask for _______ allergy and wean client before D/C to avoid a _______ in _______ 

What labs need to be monitored while a patient is receiving TPN?

S/S: Hypotension, tachycardia, back pain, flushing, and DIB.

Circulatory Overload

Septic reaction

Incompatibility reaction

What do you do when a febrile reaction to a blood transfusion occurs?

Slow IV and infuse normal saline in piggyback

Stop infusion and infuse normal saline.

Stop infusion and give the client an icepack.

Reduce rate of infusion, elevate head, call provider, and admin diuretic for this reaction?

Septic reaction

Moderate Chilling

Circulatory overload

What must be sent to the lab after an incompatibility reaction occur? _______ 

_______ _______ _______ _______ _______ _______ Are the methods of transmission

_______ do NOT elevate WBC

Mucous membranes, GI/GU Tract, Respiratory Tract, Broken Skin, and Blood are_______ 

Select the patient with SEPSIS

Patient with HR of 98bpm and WBC 13,000 cells/mm3

Patient with RR 27rpm and temp of 95.5F

Patient with PaCO2 28mmHg and HR 80bpm

Patient with temp of 100.3F and HR of 98bpm

A patient with severe sepsis has a lactic acid _______ than 2 and must receive _______  and _______ within  1 hour of discovery.

TB, Measles, Chickenpox require what precautions

Contact

Airborne

Droplet

Meningitis and Pneumonia require what precaution?

Contact

Droplet

Airborne

After a culture is taken, when will the initial results be ready?

2 days

48-72 hours

7 days

5 days

Pain should be less than _______ on pain scale.

_______ is usually poorly localized and manifests as nausea, vomiting, and hypotension.

_______ Is usually treated with _______ 

This phase of is the impulse transmission during which the brain experiences pain at a conscious level.

Transduction

Transmission

Perception

Modulation

_______ _______ _______ _______ are the theories of pain

Tier 1 of pain includes

Opioid for moderate or severe pain +/- non opioid and adjuvant

Opioid for mild pain +/- non opioid and adjuvant

non opioid +/- adjuvant

Always _______ patches before putting them in _______ 

Monitor for _______ _______ and _______  when administering an opioid

Analgesic Adjuvants:

Must be titrated down before stopping and increase fall risk

all the above

are Anticonvulsants

are Carbamazepine, Gabapentin, and Pregabalin

_______  may increase risk for serotonin syndrome when taking_______ 

Prednisone:

must be titrated when stopping.

Decreases Potassium and increases glucose. 

Causes sleep apnea.

Causes weightloss

Can a nurse push the button on a PCA for the patient _______  

A client must wait _______ before palliative sedation begins after consenting to process.

This procedure destroys the medial branch sensory nerve that protrudes between the spinal joints.

Cordotomy

Rhizotomy

When should the nurse reassess a patient's pain level after administering pain medications?

10 minutes

15 minutes

30 minutes

1 hour

When does a reaction to blood transfusion occur?

10 minutes

1 hour

5-15 minutes

After transfusion is complete.

Decreased metabolism, fluid overload, delayed wound healing and formation of blood clots are complications found in _______ people.

_______ Patients may experience F&E imbalance, delayed wound healing, and infections after surgery.

_______ May cause altered respiratory functions, nutritional status, and impaired liver function complications.

_______ dysfunction may cause delayed drug metabolism leading to drug toxicity, disrupted clotting mechanisms which causes _______ _______ _______ 

_______ dysfunction may cause F&E imbalance, fluid overload, delayed excretion causing drug toxicity, and dysrhythmias.

_______ is responsible for educating the patient about the procedure including the risks and benefits.

How long should a patient be NPO before a procedure?

2-4 hours 

8-10hrs or after midnight

it does not matter

after 3am

Diazepam, Atropine, and Zofran are _______ 

A "Time Out" must identify the right _______ _______ _______ 

Propofol:

is a spinal anesthetic 

decrease oral secretions

provides "twilight" sedation

What are the S/S of malignant hyperthermia

Jaw muscle rigidity, bradycardia, hypertension

Potassium elevation, diaphoresis, tachycardia

dry skin, PaCO2 elevation, Potassium elevation

A patient recovering from anesthesia is able to move 2 extremities, breathe freely, has a BP =/- 50mmHg, is aroused with verbal stimuli and is 94% on room air. What is the Aldrete score?

4

3

5

6

This intention heals within 8-10 days.

Tertiary

Secondary

Primary

Secondary intention is:

Widely sutured

sutured together

not sutured together

S/S of infection

pink and warm to touch

red and hot to touch

Hx of chemo, tobacco use, and insufficient vitamin c and protein are risk factor for _______ 

Distended abdomen, pain, vomiting and absent bowel sounds are:

normal after abdominal surgery

S/S of appendicitis

S/S of paralytic ileus

When can a patient go home after ambulatory surgery?

What type of IV solution is Hypotonic?

0.45% Normal Saline

10% Dextrose in Water

1 unit of whole blood

0.9% Normal Saline

What is the definition and an example of Hypertonic solution?

Pulls fluid from cells and interstitial tissues into vascular space. Ex: 3% Saline

Shifts body fluids out of blood vessels and into cells and interstitial space. Ex: 3% Saline

Maintains normal cell size. Ex: 0.9% Normal saline

What are 0.9% NS, D5W, and Lactated Ringers

Hypotonic Solutions

Hypertonic Solutions

Isotonic Solutions

Fluids

How many mL are in Whole Blood?

100

500

475

250

What blood products are WBC, Improves ability to fight infection, and must be transfused in 48hrs of collection?

Granulocytes

Cryoprecipitate

Albumin

Albumin:

Pulls 3rd spaced fluid by decreasing colloidal osmotic pressure.

Must be hung at least 4ft higher than the heart.

Is a Plasma protein, must be hung at least 3ft higher than the heart, infused within 30-60 minutes.

What tubing is used to transfuse blood and blood products?

Y Tubing

Piggyback

Primary Tubing 

What Type of Cath is placed 3-6in above or below the armpit?

Midline

PICC Line

CVC

____ Is used to provide TPN, monitor central venous pressure, admin irritating medications, and used only when peripheral veins have collapsed.

PICC

Midline

CVC

IV

When is IV tubing replaced

q24h

Its a one time use only

q72-96h

q72hrs

DIAGNOISE S/S: Elevated BP, SOB, Bounding Pulse, anxiety

Infiltration

Circulatory overload

Pulmonary embolism

S/S: Redness, warmth and discomfort along vein.

Infiltration

Phlebitis

Thrombus formation

S/S: Sudden chest pain, SOB, anxiety, rapid heart rate, DROP in BP.

Circulatory overload

Pulmonary embolism

Air embolism

S/S: Hypotension, tachycardia, back pain, flushing, and DIB.

Circulatory Overload

Septic reaction

Incompatibility reaction

What do you do when a febrile reaction to a blood transfusion occurs?

Slow IV and infuse normal saline in piggyback

Stop infusion and infuse normal saline.

Stop infusion and give the client an icepack.

Reduce rate of infusion, elevate head, call provider, and admin diuretic for this reaction?

Septic reaction

Moderate Chilling

Circulatory overload

Select the patient with SEPSIS

Patient with HR of 98bpm and WBC 13,000 cells/mm3

Patient with RR 27rpm and temp of 95.5F

Patient with PaCO2 28mmHg and HR 80bpm

Patient with temp of 100.3F and HR of 98bpm

TB, Measles, Chickenpox require what precautions

Contact

Airborne

Droplet

Meningitis and Pneumonia require what precaution?

Contact

Droplet

Airborne

After a culture is taken, when will the initial results be ready?

2 days

48-72 hours

7 days

5 days

This phase of is the impulse transmission during which the brain experiences pain at a conscious level.

Transduction

Transmission

Perception

Modulation

Tier 1 of pain includes

Opioid for moderate or severe pain +/- non opioid and adjuvant

Opioid for mild pain +/- non opioid and adjuvant

non opioid +/- adjuvant

Analgesic Adjuvants:

Must be titrated down before stopping and increase fall risk

all the above

are Anticonvulsants

are Carbamazepine, Gabapentin, and Pregabalin

Prednisone:

must be titrated when stopping.

Decreases Potassium and increases glucose. 

Causes sleep apnea.

Causes weightloss

This procedure destroys the medial branch sensory nerve that protrudes between the spinal joints.

Cordotomy

Rhizotomy

When should the nurse reassess a patient's pain level after administering pain medications?

10 minutes

15 minutes

30 minutes

1 hour

When does a reaction to blood transfusion occur?

10 minutes

1 hour

5-15 minutes

After transfusion is complete.

How long should a patient be NPO before a procedure?

2-4 hours 

8-10hrs or after midnight

it does not matter

after 3am

Propofol:

is a spinal anesthetic 

decrease oral secretions

provides "twilight" sedation

What are the S/S of malignant hyperthermia

Jaw muscle rigidity, bradycardia, hypertension

Potassium elevation, diaphoresis, tachycardia

dry skin, PaCO2 elevation, Potassium elevation

A patient recovering from anesthesia is able to move 2 extremities, breathe freely, has a BP =/- 50mmHg, is aroused with verbal stimuli and is 94% on room air. What is the Aldrete score?

4

3

5

6

This intention heals within 8-10 days.

Tertiary

Secondary

Primary

Secondary intention is: 

Widely sutured

sutured together

not sutured together

S/S of infection

pink and warm to touch

red and hot to touch

Distended abdomen, pain, vomiting and absent bowel sounds are:

normal after abdominal surgery

S/S of appendicitis

S/S of paralytic ileus