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VATI Medical-Surgical test bank Complete Solution guide. All Questions and answers. Latest Version, Rated A+

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What natural supplement/homeopathic remedy is used to help heal burns and wounds? - ✔✔Aloe vera What is lavage? - ✔✔Washing out of a body cavity, such as a colon or stomach with water or a ... medicated solution What is a peritoneal lavage? - ✔✔a diagnostic test in which a catheter is inserted into peritoneal cavity and fluid is aspirated with a syringe. It is most commonly performed to assess for bleeding in abd cavity in clients who have experienced blunt trauma. What are catecholamines? - ✔✔adrenal hormones: dopamine, norepinephrine, epinephrine that help with fight or flight reactions Bag holding formula and other feeding equipment for intermittent enteral feedings should be discarded how often? - ✔✔Every 6 hours to prevent bacterial contamination What are the S/S of addison's disease? - ✔✔-Muscle or joint pain -N/V -abd pain -Postural hypotension -Fatigue -Salt craving -Weight loss Postural hypotension and salt craving may occur with what disease? - ✔✔Addison's disease Skin pigmentation is a specific feature of what disease? - ✔✔Addison's disease. Caused by increased production of melanin Adverse effect of echinacea? - ✔✔Anaphylaxis, specifically in people with asthma What is St. John's wort used for and what is its adverse effect? - ✔✔Depression *Precipitates serotonergic crisis with SSRIs *Precipitates HTNsive crisis with digoxin What is echinacea used for? - ✔✔Colds and flu (boosts immune system) What is Kava used for and what is its adverse effect? - ✔✔Anxiety reduction, insomnia Can cause severe liver damage What herbal supplements increase risk of bleeding? - ✔✔-Garlic -Ginseng -Ginger -Feverfew -Ginkgo biloba What are some complications of untreated growth hormone deficiency? - ✔✔-Delayed sexual development -Short stature -Delayed epiphyseal closure -Stunted bone age -Premature aging What is the primary focus of group therapy? - ✔✔Personal feelings that affect behavior. Group setting allows for feedback that may enhance discovery of how feelings and situations can drive behavior A nurse is caring for a client with reduced mobility who has RA. To help hip flexion deformities associated with RA; the nurse should help the client assume which of the following positions in bed several times a day? - ✔✔Prone. It will help keep the hips and knees in an extended position The nurse is providing care for a client who was admitted with an exacerbation of chronic obstructive pulmonary disease (COPD). On assessment the nurse finds the client to be pale, short of breath, and their lung sounds reveal rhonchi. What is the best initial action by the nurse? - ✔✔Encourage the client to take several deep breaths and perform diaphragmatic coughing. The deep breaths will loosen secretions and coughing deeply will allow these secretions to be expectorated A charge nurse is planning a staff education session to discuss the meds used during the care of a client experiencing GI bleeding. What med should the charge nurse include in discussion? - ✔✔Vasopressin (manmade ADH). It is a vasopressor that can constrict the arterioles and reduce inflow to portal vein What is protamine sulfate used for? - ✔✔Antidote to heparin for clients experiencing a severe bleeding episode What should be done with unused portion of formula used in intermittent enteral feedings? - ✔✔Refrigerated (up to 24 hrs) to prevent bacterial contamination How long should the nurse elevate the HOB for a client after an intermitting feeding? - ✔✔30-60 minutes Intermittent feedings are administered how often and for how long? - ✔✔4-6x times/day in equal portions 30-45 min. What material is used for deep granulation of a pressure ulcer? - ✔✔Impregnated gauze and alginate to promote packing of the tissue Pressure wounds with minimal to moderate exudates can be dressed with what? - ✔✔Thin hydrocolloid What is the granulation phase of the healing process (of pressure ulcers)? - ✔✔Initial repair of new tissues are formed to facilitate remodeling of the affected area What is the leading type of healthcare-associated infection? - ✔✔Pneumonia Encephalitis occurs most frequently d/t what? - ✔✔Viruses (e.g. herpes simplex I and II, varicella zoster (chickenpox and shingles); measles, mumps, and rubella How long should a nurse hold direct pressure on puncture sites after administering alteplase? - ✔✔30 min. or until oozing of blood stops Pramipexole has what adverse effect? - ✔✔Hallucinations. It is used for parkinson's to stimulate brain's DA receptors to decrease tremors and rigidity associated with disease In what trimester do uterine pain and significant bleeding occur? - ✔✔Plot twist! They're never normal and should not occur in any trimester In what trimester will a woman experience frequent urination? - ✔✔3rd trimester In what trimester will a woman feel the first fetal movements? - ✔✔2nd trimester In what trimester will a woman feel a renewed sense of energy? - ✔✔2nd trimester In what trimester will a woman develop breast tenderness? - ✔✔1st trimester How does STI risk affect boys relative to girls? - ✔✔Women are biologically more receptive than men to infection by sexually transmitted organisms. E.g. girls will get them more readily In most circumstances, when there is a med error, the initial appropriate response will be to? - ✔✔Contact the primary care provider, so that an appropriate order can be given to counteract the med What is a gastric lavage? - ✔✔flushing out the contents or excess fluid from stomach What is the purpose of leucovorin? - ✔✔Folic acid derivative that is used to protect healthy cells from the cytoxic affects of methotrexate A nurse is preparing to initiate IV therapy on a client. What solution is the best choice for preparing the client's skin at the insertion site? - ✔✔Chlorhexadine What is murophobia? - ✔✔Fear of mice What is acrophobia? - ✔✔fear of heights What is mysophobia? - ✔✔fear of dirt and germs How does immobility affect urinary output? - ✔✔Urinary output decreases resulting in urinary stasis, renal stones, urinary retention, and UTIs What is Trousseau's sign? - ✔✔Inflating a BP above systolic pressure that elicits wrist and hand flexion (carpal spasm), indicating hypocalcemia because of nerve excitability What are the manifestations of autonomic dysreflexia? - ✔✔-Bradycardia -Severe HA -Flushing -HTN -Tachypnea What is glossitis and what causes it? - ✔✔Smooth red tongue indicates pernicious anemia What supplement treats nausea caused by vertigo? - ✔✔Ginger root What supplement decreases the risk and severity of symptoms of migraines? - ✔✔Feverfew *It also increases risk of bleeding by decreasing platelet aggregation What supplement treats joint pain by reducing inflammation and promotes the body's ability to make cartilage and synovial fluid? - ✔✔Glucosamine What is cardiogenic shock? - ✔✔Occurs when the heart is damaged (large portion of left ventricle dies) after an MI and is unable to supply sufficient blood to the body, resulting in hypotension What electrolyte changes occur with pancreatitis? - ✔✔Decreased calcium and magnesium levels d/t fat breakdown What is the major adverse effect of calcium antacids? - ✔✔Constipation A nurse is assessing a client who has a diagnosis of RA. What nonpharmacological intervention should the nurse suggest to the client to reduce pain? - ✔✔Alternate application of heat and cold to affected joints. Cold can relieve joint swelling and heat can decrease joint stiffness and pain What supplement interferes with the effectiveness of levothyroxine? - ✔✔Calcium-can serve as an antacid. Should not be taken within 4 hours of levothyroxine administration What is urography? - ✔✔Imaging of the renal drainage or collecting system (kidneys, ureter, and bladder) What is lactulose used for? - ✔✔Lactulose works by stimulating the production of excess stools to rid the body of excess ammonia from cirrhosis. These excessive stools can result in hypokalemia and dehydration. How do opioids affect urine output? - ✔✔Cause urinary retention, so decreases it A nurse is providing discharge instructions to a client following an upper GI series with barium contrast. What teaching should the nurse provide? - ✔✔Increase fluid intake to facilitate removal of barium used during the test A nurse should avoid what type of dressing for a pressure ulcer? - ✔✔Wet-to-dry gauze dressing because they interrupt viable, healing tissues when removed What is a common adverse effect of epoetin alfa? - ✔✔HTN and can lead to hypertensive encephalopathy Expected Hct range for females? - ✔✔37-47% What is the expected range for magnesium? - ✔✔1.3-2.1 mEq/L What is the normal aPTT value for a client on heparin? - ✔✔45-80 seconds (normal is 30-40 seconds) What normal bicarbonate (HCO3) range? - ✔✔22-26 mEq/L What is the expected Hct range for males? - ✔✔42-53% Hypernatremia causes what S/S? - ✔✔Weakness, dry lips, and muscle twitching What route is epinephrine given for anaphylaxis? - ✔✔IM injection into anterolateral aspect of thigh A nurse is planning care for a client who has anorexia and nausea d/t cancer treatment. What intervention should the nurse perform? - ✔✔Limit drinking fluids with food. Drinking leads to early satiety and bloating which results in the client consuming fewer calories What is sallow skin? - ✔✔Yellow or brown tone to skin (especially face) that is losing its natural complexion A nurse should expect what S/S with opioid withdrawal? - ✔✔Muscle aches Insomnia Diarrhea Pupillary dilation *occurs within 6-8 hours of the last dose of opioid Foul, fatty, frothy stools are a manifestation of what disease? - ✔✔Celiac disease. This is steatorrhea How often should antiembolitic stockings be removed? - ✔✔Once per shift to inspect the skin and check circulation A nurse is caring for a client who is undergoing conservative treatment for deep-vein thrombosis. The client asks the nurse what will happen to the clot. What should the nurse say? - ✔✔Your body has a process called fibrinolysis that will eventually dissolve/break down the clot over time Client should ingest adequate intake of what when on epoetin alpha? - ✔✔Iron, folic acid, and Vit B12 Incontinence is a manifestation of what? - ✔✔Anaphylactic reaction What is clonidine (Catapres) used for? - ✔✔Hypertension, ADHD (and opioid withdrawal) What are normal lead levels in children? - ✔✔<10 mcg/dl What is exstrophy of the bladder and what should the nurse do? - ✔✔Bladder disorder in which it is exposed externally and must be surgically repaired b/c it did not develop properly in abd during embryo *Place a protective non-adherent plastic film, such as saran wrap, to maintain moistness and prevent infection What is insensible fluid loss? - ✔✔The amount of fluid lost that is not easily measured on a daily basis from the lungs, skin, respiratory tract, and water excreted in the feces How is a hydatidiform mole characterized? - ✔✔Dark brown vaginal bleeding during 2nd trimester. NO abd pain What is an implantable cardioverter defibrillator (ICD) used for? - ✔✔V-fib and V-tach A nurse is assisting a physician who is removing a client's central line. What instruction should the nurse give as the physician removes the catheter? - ✔✔Take a deep breath and hold it. This will increase the intrathoracic pressure, reducing occurrence of air embolus What condition is likely to lead to a high platelet count and increased risk of blood clots? - ✔✔Splenectomy. Spleen is a reservoir for platelets. A splenectomy may release a bunch into the bloodstream What is the pathophys for myasthenia gravis? - ✔✔Chronic autoimmune neuromuscular disease characterized by weakness of the skeletal muscles of the body. In this disorder, the body produces autoantibodies that block, alter, or destroy acetylcholine receptors at the NMJ. This prevents muscular contraction (spec. of eye/eyelid movement, facial expression, chewing, talking, and swallowing). Muscle weakness increases during periods of activity and improves during rest When is melena seen? - ✔✔=dark, tarry stools Associated with bleeding in the upper GI tract When is steatorrhea seen? - ✔✔=foul-smelling, fatty stools that result from malabsorption of dietary fats Seen in cystic fibrosis, chronic pancreatitis, and celiac disease What are the S/S of irritable bowel syndrome? - ✔✔-abd pain -diarrhea -constipation -feelings of incomplete evacuation -Bloating -Flatulence What finding on a newborn assessment should be reported to the healthcare provider? - ✔✔Sacral dimple. It may be caused by spina bifida occulta or a dermal sinus tract What is the normal respiratory rate in a newborn? - ✔✔30-60 breaths/minute At what point during gestation does the fundus become even with the umbilicus? - ✔✔22nd week of gestation What is a complication of an IUD? - ✔✔Increased risk for an ectopic pregnancy S/S: abrupt, sharp unilateral lower quadrant pain that can occur with or without bleeding Which type of hepatitis does not have a vaccine? - ✔✔Hep C What injury is concerning for child abuse? - ✔✔Humerus fracture, retinal hemorrhages Infants allergic to what foods typically outgrow them? - ✔✔Soy, cow's milk, eggs What is a biophysical profile? - ✔✔Test used to assess mother and baby at high-risk. It involves an ultrasound to visualize characteristics of fetus and observe fetal responses to stimuli (combines ultrasound and nonstress test) What is cullen's sign? - ✔✔ecchymosis and superficial edema at the umbilicus due to pancreatic necrosis and bleeding in severe pancreatitis What is turner's sign? - ✔✔Bleeding into flank => hemorrhagic pancreatitis What is murphy's sign? - ✔✔Pain with deep inspiration when the gallbladder is palpated. Indicates acute cholecystitis Hypersensitivity to yeast is a contraindication for what vaccine? - ✔✔Hep B vaccine Family history of seizures DOES NOT prevent administration of what? - ✔✔DTaP vaccine (only if serious allergic reaction to previous dose or encephalopathy) When are live virus vaccines contraindicated in relation to pregnancy? - ✔✔One month before and during pregnancy Where is the safest location to assess the carotid artery? - ✔✔Lower half of the artery at the level of the cricoid cartilage. Palpating it too high on the neck could stimulate carotid sinus, which could cause a HR drop What complication is most likely to occur following cardioversion? - ✔✔Stroke. Clot may have formed in atria that can embolize to brain. SO, you need to give anticoagulants before cardioversion for a-fib A client is developing a care plan for a client with hypocalcemia. The client's serum calcium level is below 8.5 mg/dL. What nursing diagnosis is appropriate? - ✔✔Risk for injury. D/t laryngospasm, dysrhythmia, and seizures. Other hypocalcemia S/S include tetany and paresthesias What is pertussis? - ✔✔A highly contagious bacterial infection - it causes whooping cough, and vomiting that can last 6 weeks , and runny nose, sneezing, congestion, and mild fever What is is an adverse effect of Atomoxetine (Strattera)? - ✔✔Liver damage. Monitor for jaundice, upper abd tenderness, darkening of urine, and elevated liver enzymes How does glomerular filtration rate affect potassium excretion? - ✔✔As glomerular filtration rate decreases, the excretion of potassium decreases What is the magnesium level range for a client with preeclampsia? - ✔✔4-7 mEq/L What is an early sign of relapse in psychosis? - ✔✔Difficulty sleeping What is a greenstick fracture? - ✔✔type of fracture where the bone bends and splits, causing a crack or incomplete break; common in children How do beta blocker prescriptions change with scheduled surgery? - ✔✔They don't change in clients who take them regularly. Client should continue to take beta blocker to reduce risk of adverse cardiac events during surgery What is malpractice? - ✔✔professional negligence (failed to uphold standard of care) Pregnant women should not receive what types of immunizations? - ✔✔LIVE attenuated (weak) viruses. So do not take live viruses like MMR, varicella, or influenza by nasal spray (influenza by shot is okay) Can children with tympanostomy tubes swim in lakes or oceans? - ✔✔Yes, but parents need to put earplugs in to prevent contaminated water from entering the holes in the eardrums How do corticosteroids affect WBCs? - ✔✔Increase WBC count (specifically neutrophils) because it stimulates RELEASE of WBCs from bone marrow Acne, hirsutism and easy bruising are some manifestations of what disease? - ✔✔Cushing's syndrome How does Cushing's disease affect client activity? - ✔✔Causes lethargy and depression Who should not be allowed to visit a client with a radioactive implant? - ✔✔Children What is borborygmi? - ✔✔stomach growling; a rumbling or gurgling noise made by the movement of fluid and gas in the intestines Where is the best place to initiate IV therapy on an elderly client? - ✔✔Dorsal surface of nondominant hand. These veins are relatively large and easy to puncture compared to other veins in the arm What is the initial treatment for a STEMI? - ✔✔MONA -Morphine -O2 -Nitroglycerin -Aspirin Varicella vaccine is contraindicated with what? - ✔✔Pregnancy A history of guillain-barre's syndrome is contraindicated with what vaccine? - ✔✔Influenze vaccine An allergy to eggs is contraindicated with what vaccine? - ✔✔Influenza immunization When and how often should females have mammograms (breast exams)? - ✔✔Annual mammograms starting at age 40 When and how often should colonoscopies be performed? - ✔✔Start at age 50 and then every 10 years thereafter How often should males and females have a fecal occult test done? - ✔✔Every year What is Palivizumab (Synagis)? - ✔✔Drug for severe RSV infections. Only for most at-risk children How long are kids contagious with RSV? - ✔✔3-8 days What are Pirbuterol and salmeterol? - ✔✔Adrenergic stimulants used for asthma What are methylxanthines? - ✔✔Asthma meds that prevent nocturnal asthma by producing bronchodilation (by relaxing bronchial smooth muscle) E.g. Theophylline, Aminophylline Eating what at bedtime can help you sleep better? - ✔✔Cheese or drinking milk b/c dietary L-tryptophan found in these foods can help induce sleep What are the S/S of lead toxicity? - ✔✔Aggression, sleep difficulties, changes in appetite, irritability, and HA What is the S3 heart sound? - ✔✔Ventricular gallop that occurs in a short, low frequency sound with a cadence similar to the word "Kentucky" What is the S4 heart sound? - ✔✔An extra heart sound occurring immediately before the normal "lub-dub". It is caused by the atria contracting forcefully in an effort to overcome an abnormally stiff or hypertrophic ventricle Risperidone (Risperdal) causes what adverse effect? - ✔✔Metabolic syndrome=set of 5 symptoms revolving around unhealthy weight gain: increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels *So eat low-calorie snacks to prevent weight gain What are indications of a blood transfusion? - ✔✔-Hemorrhage causing 30% total blood volume loss -Sickle cell disease that causes severe anemia -Hgb 6g/dL or less What is chlordiazepoxide (Librium)? - ✔✔long acting benzodiazepine used for alcohol withdrawal and anxiety What is Acamprosate (Campral)? - ✔✔Drug used to help clients with alcohol withdrawal (restores disrupted neural pathways to address anxiety, restlessness, and insomnia) What three meds are used to treat opioid withdrawal? - ✔✔-Buprenorphine, a partial opioid agonist -Methadone, an opioid agonist -Clonidine, an alpha-2 adrenergic agonist What is buprenorphine? - ✔✔- Opiod "partial" agonist-partial activation, but not enough to experience "high" or euphoria -Also acts indirectly as an opiod antagonist, blocking effects of other opiods A nurse is caring for a client who has a pneumothorax and a closed-chest drainage system. What finding is an indication of lung re-expansion? - ✔✔Bubbling in the water seal chamber has ceased What is homonymous hemianopsia? - ✔✔loss of half of the field of view on the same side in both eyes. will turn head to see entire visual field. A nurse is providing discharge instructions to a client who has a partial-thickness burn of the hand. How often should she teach dressings should be changed? - ✔✔12-24 hours to allow for wound inspection *Wrap fingers individually to allow for functional use of hand while healing occurs *Perform ROM exercises for each finger to promote function of injured hand What is a hematoma? - ✔✔a solid swelling of clotted blood within the tissues A nurse is providing teaching to a client who has angina and a new prescription for sublingual nitroglycerin. What teaching instruction should the nurse include? - ✔✔Store the med in its original dark glass container. It is inactivated by heat, light, and moisture. How long does it take for sublingual nitroglycerin to kick in? - ✔✔1-3 minutes What is a major cause of death following a kidney transplant? - ✔✔Cardiovascular disease How does dopamine affect the heart? - ✔✔Useful in cardiogenic shock because it produces inotropic effects, thereby improving cardiac output. It also raises BP by causing vasoconstriction of the blood vessels A nurse is assessing a client with Cushing's disease. What findings should be expected? - ✔✔-Muscle atrophy (from decreased nitrogen and mineral loss) -thin skin -Bruising and striae from fragile blood vessels -HTN (from fluid overload When is a noncoring needle used? - ✔✔When accessing an implanted port What is compensatory shock? - ✔✔First stage of shock. Decreased MAP, decreased BP, decreased cardiac output, but nothing is in the emergency zone, yet. Sympathetic nervous system compensates for decreases SO TACHYCARDIA. *hypoactive bowel sounds because blood shunts to vital organs A nurse is administering meperidine IM in the right deltoid of a client. The nurse aspirates and pulls back blood in the syringe. What action should the nurse take? - ✔✔-Dispose of the med and get a new dose -Do not continue with injection. You are likely in a blood vessel which would mean putting the med in the wrong route (IV) What is an early manifestation of a fat embolism? - ✔✔Dyspnea. Fat embolisms originate in the yellow bone marrow and travel through the vascular system, clogging small vessels -Tachypnea is another early sign How does hypercalcemia affect deep tendon reflexes? - ✔✔Decreases deep tendon reflexes How does the liver interact with albumin? - ✔✔Liver manufactures albumin. Liver disease will cause albumin levels to decrease How does liver interact with prothrombin time? - ✔✔Liver cells produce prothrombin. Liver disease will prolong prothrombin time because it cannot create this clotting factor How does the liver interact with ammonia? - ✔✔Liver converts ammonia to urea. Liver disease will cause ammonia levels to rise b/c liver is not adequately doing its job What does low back pain, hypotension, tachycardia, and apprehension indicate? - ✔✔Hemolytic transfusion reaction from infusion of incompatible blood products A nurse is caring for a client who has amyotrophic lateral sclerosis (AlS) and is being admitted to the hospital with pneumonia. What assessment finding is the nurse's priority? - ✔✔Increased respiratory secretions b/c put client at risk for aspiration pneumonia d/t respiratory muscle weakness caused by ALS How does Cushing's disease affect electrolytes? - ✔✔-Hyperglycemia -Hypernatremia -Hypokalemia -Hypocalcemia What is Cushing's disease? - ✔✔Disease of adrenal gland where is produces too much hydrocortisone *Cushing's adds cushion through weight gain (such as buffalo hump, rounded face-moon face, stretch marks) What are the symptoms of Lyme disease? - ✔✔headache, backache, chills, and fatigue. 3 stages... Stage 1: JOINT AND MUSCLE PAIN Stage 3: S/S become chronic, adding memory problems and fatigue What is ranitidine (zantac)? - ✔✔H2 blocker (gastritis/ulcers) used to prevent [Show More]

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