The document contains 24 multiple choice questions about medical surgical nursing. The questions cover topics like appropriate nursing interventions, nursing diagnoses, physiological responses to surgery, medication administration, diet recommendations, and quality improvement processes. The questions test understanding of concepts important for medical surgical nursing practice.
The research design refers to the overall strategy that you choose to integrate the different components of the study in a coherent and logical way, thereby, ensuring you will effectively address the research problem; it constitutes the blueprint for the collection, measurement, and analysis of data.
Case Study, Chapter 34, Management of Patients With Hematologic Neop.docxdrennanmicah
Case Study, Chapter 34, Management of Patients With Hematologic Neoplasms
1. John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen, and Vicodin. (Learning Objective 5)
a. What nursing management should the nurse provide the patient?
Explain the indication and action of the various medications ordered to treat the patient’s symptoms.
2. Susan Clare, age 38, is admitted to the medical oncology unit with acute myeloid leukemia (AML). She has many areas of ecchymosis and petechiae on her skin, as well as generalized pallor. She states she has lost 15 pounds in the last 2 months, and often has a low-grade fever. On physical assessment, you find her liver and spleen to be enlarged on palpation. (Learning Objective 3)
a. What laboratory results would you anticipate due to her ecchymosis and petechia?
Why would it be important to inspect her gums and teeth?
a. Why is her liver enlarged?
Case Study, Chapter 37, Management of Patients With HIV Infection and AIDS
1. The nurse is planning to provide education on HIV infection transmission and prevention strategies at a local senior center. (Learning Objectives 1 and 4)
a. What should the nurse include in the session considering the needs of the older population?
2. Sallie Jefferies, 28-year-old patient, is at the obstetric clinic for a pregnancy visit. The physician informs the patient that her HIV screen test is positive. The patient has no evidence of AIDS. The nurse provides patient education regarding what HIV is and what the clinical management entails. (Learning Objective 5)
a. What clinical management is recommended for the patient during the pregnancy to help decrease the risk of transmitting HIV to the unborn child?
The patient asks the nurse how zidovudine (Retrovir) will help her unborn child from getting HIV. How should the nurse respond?
What explanation about Retrovir should the nurse provide?
The patient asks the nurse if it will be safe to breast-feed her infant after the delivery. The nurse should provide what explanation?
a. The patient asks the nurse what testing schedule for the HIV antibody is needed after her baby is born. How should the nurse respond?
Case Study, Chapter 31, Assessment and Management of Patients With Hypertension
1. Joan Smith, 55 years of age, is a female patient who presents to the intensive care unit with the diagnosis of intracranial hemorrhage. The patient stopped taking her antihypertensives suddenly because of the cost of .
10Running Head Modulo 2 Plan de Cuidado- (cuidado holístSantosConleyha
10
Running Head: Modulo 2 Plan de Cuidado- (cuidado holístico)
Situación Hipotética
A 55-year-old woman admitted 2 days ago to the Intensive Care Unit. The admission diagnoses are: vomiting, seizures, and probable aspiration. She has a prior history of hypertension, COPD, and myocardial infarction with angioplasty performed six months ago.
Family members report that the client uses the following routine medications: Toprol 50mg 1 tab. daily, Lipitor 20 mg 1 tab. daily, Aspirin 81 mg 1ab. Daily, Plavix 75 mg 1 tab. daily; He smokes a daily pack of cigarettes since he was 30 years old. They also report that the patient drinks alcohol continuously; "In the last 3 days I have found her drunk in the house" said the woman's nephew.
The patient is 5'11'' and weighs approximately 180 pounds. Upon arrival at the emergency room she presents vital signs of: T-37°C, P-150/min., R-28/min. and B/P-193/124 mmHg. She is observed with recurrent vomiting and severe episodes of seizures, respiratory distress, and severe anxiety. Dr. Díaz orders ABG's which result in: pH-7.30, PaCO 2 -50 mmHg, PO 2 -81 mmHg and NaHCO 3 -23 mEq/L, Sat. 85%. The client is sedated with Propofol 5mL, for oroendotracheal intubation and transferred to the ICU area. Blood pressure after intubation medication decreased to 80/52 mmHg. She is restricted to patient per intubation protocol. Laboratory samples show elevated liver enzymes, elevated cholesterol and triglycerides, and normal CBC.
Introduction:
Aspiration pneumonia is caused by aspiration of oropharyngeal contents into the airways, leading to abscess lesions due to bacterial infection in the lower lung lobes. It generally occurs in patients with frequent seizures and loss of mental status, with impaired swallowing of food or loss of the gag reflex (Aspiration pneumonia, n.d.). In this work we will carry out the care plan and the nursing progress notes of a 55-year-old female patient admitted to the Intensive Care Unit with respiratory distress probably caused by pneumonia due to aspiration of her own vomit, leading her to a state of acute respiratory acidosis with adequate bicarbonate compensation by the kidney.
Care Plan:
Estimado
Diagnóstico de Enfermería
Expected results
Nursing Interventions
Evaluatión
domains
Needs
maladaptive behaviors
Focal Stimulus
Interventions
Scientific Rational
subjective data
Objective data
Domain 3: Elimination
Need 1: Breathe normally
The patient reports shortness of breath and that he is anxious
The patient is observed with labored breathing with RF at 28/min with abnormal arterial pH.
respiratory distress
(00030 Impaired gas exchange r/c ventilation-perfusion imbalance m/p shortness of breath, hypoxemia, and abnormal arterial pH.
The patient will recover her adequate ventilation after treatment, in a period of approximately 48 hours.
Domain 1: Security/ protection.
Need 1: Have no aspiration risks
Family me ...
10Running Head Modulo 2 Plan de Cuidado- (cuidado holístBenitoSumpter862
10
Running Head: Modulo 2 Plan de Cuidado- (cuidado holístico)
Situación Hipotética
A 55-year-old woman admitted 2 days ago to the Intensive Care Unit. The admission diagnoses are: vomiting, seizures, and probable aspiration. She has a prior history of hypertension, COPD, and myocardial infarction with angioplasty performed six months ago.
Family members report that the client uses the following routine medications: Toprol 50mg 1 tab. daily, Lipitor 20 mg 1 tab. daily, Aspirin 81 mg 1ab. Daily, Plavix 75 mg 1 tab. daily; He smokes a daily pack of cigarettes since he was 30 years old. They also report that the patient drinks alcohol continuously; "In the last 3 days I have found her drunk in the house" said the woman's nephew.
The patient is 5'11'' and weighs approximately 180 pounds. Upon arrival at the emergency room she presents vital signs of: T-37°C, P-150/min., R-28/min. and B/P-193/124 mmHg. She is observed with recurrent vomiting and severe episodes of seizures, respiratory distress, and severe anxiety. Dr. Díaz orders ABG's which result in: pH-7.30, PaCO 2 -50 mmHg, PO 2 -81 mmHg and NaHCO 3 -23 mEq/L, Sat. 85%. The client is sedated with Propofol 5mL, for oroendotracheal intubation and transferred to the ICU area. Blood pressure after intubation medication decreased to 80/52 mmHg. She is restricted to patient per intubation protocol. Laboratory samples show elevated liver enzymes, elevated cholesterol and triglycerides, and normal CBC.
Introduction:
Aspiration pneumonia is caused by aspiration of oropharyngeal contents into the airways, leading to abscess lesions due to bacterial infection in the lower lung lobes. It generally occurs in patients with frequent seizures and loss of mental status, with impaired swallowing of food or loss of the gag reflex (Aspiration pneumonia, n.d.). In this work we will carry out the care plan and the nursing progress notes of a 55-year-old female patient admitted to the Intensive Care Unit with respiratory distress probably caused by pneumonia due to aspiration of her own vomit, leading her to a state of acute respiratory acidosis with adequate bicarbonate compensation by the kidney.
Care Plan:
Estimado
Diagnóstico de Enfermería
Expected results
Nursing Interventions
Evaluatión
domains
Needs
maladaptive behaviors
Focal Stimulus
Interventions
Scientific Rational
subjective data
Objective data
Domain 3: Elimination
Need 1: Breathe normally
The patient reports shortness of breath and that he is anxious
The patient is observed with labored breathing with RF at 28/min with abnormal arterial pH.
respiratory distress
(00030 Impaired gas exchange r/c ventilation-perfusion imbalance m/p shortness of breath, hypoxemia, and abnormal arterial pH.
The patient will recover her adequate ventilation after treatment, in a period of approximately 48 hours.
Domain 1: Security/ protection.
Need 1: Have no aspiration risks
Family me ...
The research design refers to the overall strategy that you choose to integrate the different components of the study in a coherent and logical way, thereby, ensuring you will effectively address the research problem; it constitutes the blueprint for the collection, measurement, and analysis of data.
Case Study, Chapter 34, Management of Patients With Hematologic Neop.docxdrennanmicah
Case Study, Chapter 34, Management of Patients With Hematologic Neoplasms
1. John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen, and Vicodin. (Learning Objective 5)
a. What nursing management should the nurse provide the patient?
Explain the indication and action of the various medications ordered to treat the patient’s symptoms.
2. Susan Clare, age 38, is admitted to the medical oncology unit with acute myeloid leukemia (AML). She has many areas of ecchymosis and petechiae on her skin, as well as generalized pallor. She states she has lost 15 pounds in the last 2 months, and often has a low-grade fever. On physical assessment, you find her liver and spleen to be enlarged on palpation. (Learning Objective 3)
a. What laboratory results would you anticipate due to her ecchymosis and petechia?
Why would it be important to inspect her gums and teeth?
a. Why is her liver enlarged?
Case Study, Chapter 37, Management of Patients With HIV Infection and AIDS
1. The nurse is planning to provide education on HIV infection transmission and prevention strategies at a local senior center. (Learning Objectives 1 and 4)
a. What should the nurse include in the session considering the needs of the older population?
2. Sallie Jefferies, 28-year-old patient, is at the obstetric clinic for a pregnancy visit. The physician informs the patient that her HIV screen test is positive. The patient has no evidence of AIDS. The nurse provides patient education regarding what HIV is and what the clinical management entails. (Learning Objective 5)
a. What clinical management is recommended for the patient during the pregnancy to help decrease the risk of transmitting HIV to the unborn child?
The patient asks the nurse how zidovudine (Retrovir) will help her unborn child from getting HIV. How should the nurse respond?
What explanation about Retrovir should the nurse provide?
The patient asks the nurse if it will be safe to breast-feed her infant after the delivery. The nurse should provide what explanation?
a. The patient asks the nurse what testing schedule for the HIV antibody is needed after her baby is born. How should the nurse respond?
Case Study, Chapter 31, Assessment and Management of Patients With Hypertension
1. Joan Smith, 55 years of age, is a female patient who presents to the intensive care unit with the diagnosis of intracranial hemorrhage. The patient stopped taking her antihypertensives suddenly because of the cost of .
10Running Head Modulo 2 Plan de Cuidado- (cuidado holístSantosConleyha
10
Running Head: Modulo 2 Plan de Cuidado- (cuidado holístico)
Situación Hipotética
A 55-year-old woman admitted 2 days ago to the Intensive Care Unit. The admission diagnoses are: vomiting, seizures, and probable aspiration. She has a prior history of hypertension, COPD, and myocardial infarction with angioplasty performed six months ago.
Family members report that the client uses the following routine medications: Toprol 50mg 1 tab. daily, Lipitor 20 mg 1 tab. daily, Aspirin 81 mg 1ab. Daily, Plavix 75 mg 1 tab. daily; He smokes a daily pack of cigarettes since he was 30 years old. They also report that the patient drinks alcohol continuously; "In the last 3 days I have found her drunk in the house" said the woman's nephew.
The patient is 5'11'' and weighs approximately 180 pounds. Upon arrival at the emergency room she presents vital signs of: T-37°C, P-150/min., R-28/min. and B/P-193/124 mmHg. She is observed with recurrent vomiting and severe episodes of seizures, respiratory distress, and severe anxiety. Dr. Díaz orders ABG's which result in: pH-7.30, PaCO 2 -50 mmHg, PO 2 -81 mmHg and NaHCO 3 -23 mEq/L, Sat. 85%. The client is sedated with Propofol 5mL, for oroendotracheal intubation and transferred to the ICU area. Blood pressure after intubation medication decreased to 80/52 mmHg. She is restricted to patient per intubation protocol. Laboratory samples show elevated liver enzymes, elevated cholesterol and triglycerides, and normal CBC.
Introduction:
Aspiration pneumonia is caused by aspiration of oropharyngeal contents into the airways, leading to abscess lesions due to bacterial infection in the lower lung lobes. It generally occurs in patients with frequent seizures and loss of mental status, with impaired swallowing of food or loss of the gag reflex (Aspiration pneumonia, n.d.). In this work we will carry out the care plan and the nursing progress notes of a 55-year-old female patient admitted to the Intensive Care Unit with respiratory distress probably caused by pneumonia due to aspiration of her own vomit, leading her to a state of acute respiratory acidosis with adequate bicarbonate compensation by the kidney.
Care Plan:
Estimado
Diagnóstico de Enfermería
Expected results
Nursing Interventions
Evaluatión
domains
Needs
maladaptive behaviors
Focal Stimulus
Interventions
Scientific Rational
subjective data
Objective data
Domain 3: Elimination
Need 1: Breathe normally
The patient reports shortness of breath and that he is anxious
The patient is observed with labored breathing with RF at 28/min with abnormal arterial pH.
respiratory distress
(00030 Impaired gas exchange r/c ventilation-perfusion imbalance m/p shortness of breath, hypoxemia, and abnormal arterial pH.
The patient will recover her adequate ventilation after treatment, in a period of approximately 48 hours.
Domain 1: Security/ protection.
Need 1: Have no aspiration risks
Family me ...
10Running Head Modulo 2 Plan de Cuidado- (cuidado holístBenitoSumpter862
10
Running Head: Modulo 2 Plan de Cuidado- (cuidado holístico)
Situación Hipotética
A 55-year-old woman admitted 2 days ago to the Intensive Care Unit. The admission diagnoses are: vomiting, seizures, and probable aspiration. She has a prior history of hypertension, COPD, and myocardial infarction with angioplasty performed six months ago.
Family members report that the client uses the following routine medications: Toprol 50mg 1 tab. daily, Lipitor 20 mg 1 tab. daily, Aspirin 81 mg 1ab. Daily, Plavix 75 mg 1 tab. daily; He smokes a daily pack of cigarettes since he was 30 years old. They also report that the patient drinks alcohol continuously; "In the last 3 days I have found her drunk in the house" said the woman's nephew.
The patient is 5'11'' and weighs approximately 180 pounds. Upon arrival at the emergency room she presents vital signs of: T-37°C, P-150/min., R-28/min. and B/P-193/124 mmHg. She is observed with recurrent vomiting and severe episodes of seizures, respiratory distress, and severe anxiety. Dr. Díaz orders ABG's which result in: pH-7.30, PaCO 2 -50 mmHg, PO 2 -81 mmHg and NaHCO 3 -23 mEq/L, Sat. 85%. The client is sedated with Propofol 5mL, for oroendotracheal intubation and transferred to the ICU area. Blood pressure after intubation medication decreased to 80/52 mmHg. She is restricted to patient per intubation protocol. Laboratory samples show elevated liver enzymes, elevated cholesterol and triglycerides, and normal CBC.
Introduction:
Aspiration pneumonia is caused by aspiration of oropharyngeal contents into the airways, leading to abscess lesions due to bacterial infection in the lower lung lobes. It generally occurs in patients with frequent seizures and loss of mental status, with impaired swallowing of food or loss of the gag reflex (Aspiration pneumonia, n.d.). In this work we will carry out the care plan and the nursing progress notes of a 55-year-old female patient admitted to the Intensive Care Unit with respiratory distress probably caused by pneumonia due to aspiration of her own vomit, leading her to a state of acute respiratory acidosis with adequate bicarbonate compensation by the kidney.
Care Plan:
Estimado
Diagnóstico de Enfermería
Expected results
Nursing Interventions
Evaluatión
domains
Needs
maladaptive behaviors
Focal Stimulus
Interventions
Scientific Rational
subjective data
Objective data
Domain 3: Elimination
Need 1: Breathe normally
The patient reports shortness of breath and that he is anxious
The patient is observed with labored breathing with RF at 28/min with abnormal arterial pH.
respiratory distress
(00030 Impaired gas exchange r/c ventilation-perfusion imbalance m/p shortness of breath, hypoxemia, and abnormal arterial pH.
The patient will recover her adequate ventilation after treatment, in a period of approximately 48 hours.
Domain 1: Security/ protection.
Need 1: Have no aspiration risks
Family me ...
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
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the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Medical surgical exam.docx
1. Medical Surgical Nursing
1. The main goal of treatment for acute glomerulonephritis is to:
encourage activity.
encourage high protein intake.
maintain fluid balance.
teach intermittent urinary catheterization.
2. Nursing diagnoses mostly differ from medical diagnoses, in that they are:
dependent upon medical diagnoses for the direction of appropriate interventions.
primarily concerned with caring, while medical diagnoses are primarily concerned with curing.
primarily concerned with human response, while medical diagnoses are primarily concerned with
pathology.
primarily concerned with psychosocial parameters, while medical diagnoses are primarily
concerned with physiologic parameters.
3. A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical
unit and, after one and a half hours, now reports severe incisional pain. The patient's blood pressure is
170/90 mm Hg, pulse is 108 beats/min, temperature is 99o
F (37.2o
C), and respirations are 30
breaths/min. The patient's skin is pale, and the surgical dressing is dry and intact. The most appropriate
nursing intervention is to:
medicate the patient for pain.
place the patient in a high Fowler position and administer oxygen.
place the patient in a reverse Trendelenburg position and open the IV line.
report the findings to the provider.
4. To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin), patients taking
the drug are instructed to:
avoid crowds and obtain an annual influenza vaccination.
drink at least 2 L of fluids daily, including 8 to 10 glasses of water.
2. eat a potassium-rich, low sodium diet.
practice good dental hygiene and report gum swelling or bleeding.
5. The most common, preventable complication of abdominal surgery is:
atelectasis.
fluid and electrolyte imbalance.
thrombophlebitis.
urinary retention.
6. A 78-year-old patient is scheduled for transition to home after treatment for heart disease. The
patient's spouse, who has chronic obstructive pulmonary disease, plans to care for the patient at home.
The spouse says that their grown children, who live nearby, will help. The best approach to discharge
planning is to:
arrange nursing home placement for the couple.
consult the spouse's healthcare provider about the spouse's ability to care for the patient.
contact the children to ascertain their commitment to help.
discuss community resources with the spouse and offer to make referrals.
7. During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical
nurse notes the development of slurred speech and disorientation to time and place. The nurse's initial
action is to:
continue the hourly neurologic assessments.
inform the neurosurgeon of the patient's status.
prepare the patient for emergency surgery.
recheck the patient's neurologic status in 15 minutes.
8. For the evaluation feedback process to be effective, the medical-surgical nurse who is a manager:
3. conducts weekly meetings with staff members.
considers staff members' interests and abilities when delegating tasks.
informs staff members regularly of how well they are performing their jobs.
provides goals for staff members to meet.
9. An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus
aureus. The patient was alert and oriented on admission, but is now having visual hallucinations and can
follow only simple directions. The medical-surgical nurse recognizes that the changes in the patient's
mental status are related to:
a fluid and electrolyte imbalance.
a stimulating environment.
sensory deprivation.
sundowning.
10. To prepare a patient on the unit for a bronchoscopic procedure, the medical-surgical nurse
administers the IV sedative. The nurse then instructs the licensed practical/vocational nurse to:
educate the patient about the pending procedure.
give the patient small sips of water only.
measure the patient's blood pressure and pulse readings.
take the patient to the bathroom one more time.
11. Which physiological response is often associated with surgery-related stress?
Bronchial constriction.
Decreased cortisol levels.
Peripheral vasodilation.
Sodium and water retention.
4. 12. Which statement by a patient with diabetes mellitus indicates an understanding of the medication
insulin glargine (Lantus)?
"Lantus causes weight loss."
"Lantus is used only at night."
"The duration of Lantus is six hours."
"There is no peak time for Lantus."
13. Which action occurs primarily during the evaluation phase of the nursing process?
Data collection.
Decision-making and judgment.
Priority-setting and expected outcomes.
Reassessment and audit.
14. Which action best describes a sentinel event alert?
Documenting the breakdown in communication during a shift report.
Indicating that a community or institution is unsafe.
Recording the harm done when a medication error occurs.
Signaling the need for immediate investigation and response.
15. Which is primarily a developmental task of middle age?
Learning and acquiring new skills and information.
Rediscovering or developing satisfaction in one's relationship with a significant other.
Relying strongly upon spiritual beliefs.
Risk taking and its perceived consequences.
5. 16. The medical-surgical nurse, who is caring for a patient with a new diagnosis of cancer, observes the
patient becoming angry with the physicians and nursing staff. The best approach to diffuse the
emotionally charged discussion is to:
allow the patient and family members time to be alone.
arrange time for the patient to speak with another patient with cancer.
direct the discussion and validation of emotion, without false reassurance.
request a consultation from a social worker on the oncology unit.
17. It is hospital policy to assess and record a patient's pulse before administering digoxin (Lanoxin). By
auditing the nursing records to determine the frequency of compliance with this policy, the quality
assessment and improvement committee is conducting:
a process analysis.
a quality analysis.
a system analysis.
an outcome analysis.
19. The nursing diagnosis for a patient with a myocardial infarction is activity intolerance. The plan of
care includes the patient outcome criterion of:
agreeing to discontinue smoking.
ambulating 50 feet without experiencing dyspnea.
experiencing no dyspnea on exertion.
tolerating activity well.
20. Which statement by a patient demonstrates an accurate understanding about herbal supplements?
"Herbs may interact with prescribed medications but not other herbs."
"Most herbs have been tested and found to be safe and therapeutic."
"The Food and Drug Administration regulates herbs and allows advertising."
6. "There is no standardization among the manufacturers of herbs in this country."
21. For a patient with Crohn's disease, the medical-surgical nurse recommends a diet that is:
high in fiber, and low in protein and calories.
high in potassium.
low in fiber, and high in protein and calories.
low in potassium.
22. When examining a patient who is paralyzed below the T4 level, the medical-surgical nurse expects to
find:
flaccidity of the upper extremities.
hyperreflexia and spasticity of the upper extremities.
impaired diaphragmatic function requiring ventilator support.
independent use of upper extremities and efficient cough.
23. After completing a thorough neurological and physical assessment of a patient who is admitted for a
suspected stroke, the medical-surgical nurse anticipates the next step in the immediate care of this
patient to include:
administering tissue plasminogen activator.
obtaining a computed tomography scan of the head without contrast.
obtaining a neurosurgical consultation.
preparing for carotid Doppler ultrasonography.
24. The first step in applying the quality improvement process to an activity in a clinical setting is to:
assemble a team to review and revise the activity.
collect data to measure the status of the activity.
select an activity for improvement.