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NURSING BUNDLE SOLUTION 2022 A+ GRADE
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Chapter 50- Assessment and Management of Patients With Biliary Disorders Question With Correct Ans
Chapter 50- Assessment and Management of Patients With Biliary Disorders Questions With Correct Answers 2022 1. A nurse is assessing a patient who has ... [Show More] been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the patient's pain, the nurse should anticipate that it may radiate to what region? A) Left upper chest B) Inguinal region C) Neck or jaw D) Right shoulder - Correct Answer- Ans: D Feedback: The patient may have biliary colic with excruciating upper right abdominal pain that radiates to the back or right shoulder. Pain from cholecystitis does not typically radiate to the left upper chest, inguinal area, neck, or jaw. 2. A 55-year-old man has been newly diagnosed with acute pancreatitis and admitted to the acute medical unit. How should the nurse most likely explain the pathophysiology of this patient's health problem? A) "Toxins have accumulated and inflamed your pancreas." B) "Bacteria likely migrated from your intestines and became lodged in your pancreas." C) "A virus that was likely already present in your body has begun to attack your pancreatic cells." D) "The enzymes that your pancreas produces have damaged the pancreas itself." - Correct Answer- Ans: D Feedback: Although the mechanisms causing pancreatitis are unknown, pancreatitis is commonly described as the autodigestion of the pancreas. Less commonly, toxic substances and microorganisms are implicated as the cause of pancreatitis. 3. A patient's assessment and diagnostic testing are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment questions address likely etiologic factors? Select all that apply. A) "How many alcoholic drinks do you typically consume in a week?" B) "Have you ever been tested for diabetes?" C) "Have you ever been diagnosed with gallstones?" D) "Would you say that you eat a particularly high-fat diet?" E) "Does anyone in your family have cystic fibrosis?" - Correct Answer- Ans: A, C Feedback: Eighty percent of patients with acute pancreatitis have biliary tract disease such as gallstones or a history of long-term alcohol abuse. Diabetes, high-fat consumption, and cystic fibrosis are not noted etiologic factors. 4. A patient's abdominal ultrasound indicates cholelithiasis. When the nurse is reviewing the patient's laboratory studies, what finding is most closely associated with this diagnosis? A) Increased bilirubin B) Decreased serum cholesterol C) Increased blood urea nitrogen (BUN) D) Decreased serum alkaline phosphatase level - Correct Answer- Ans: A Feedback: If the flow of blood is impeded, bilirubin, a pigment derived from the breakdown of red blood cells, does not enter the intestines. As a result, bilirubin levels in the blood increase. Cholesterol, BUN, and alkaline phosphatase levels are not typically affected. 5. A nurse who provides care in a walk-in clinic assesses a wide range of individuals. The nurse should identify which of the following patients as having the highest risk for chronic pancreatitis? A) A 45-year-old obese woman with a high-fat diet B) An 18-year-old man who is a weekend binge drinker C) A 39-year-old man with chronic alcoholism D) A 51-year-old woman who smokes one-and-a-half packs of cigarettes per day - Correct Answer- Ans: C Feedback: Excessive and prolonged consumption of alcohol accounts for approximately 70% to 80% of all cases of chronic pancreatitis. 6. A 37-year-old male patient presents at the emergency department (ED) complaining of nausea and vomiting and severe abdominal pain. The patient's abdomen is rigid, and there is bruising to the patient's flank. The patient's wife states that he was on a drinking binge for the past 2 days. The ED nurse should assist in assessing the patient for what health problem? A) Severe pancreatitis with possible peritonitis B) Acute cholecystitis C) Chronic pancreatitis D) Acute appendicitis with possible perforation - Correct Answer- Ans: A Feedback: Severe abdominal pain is the major symptom of pancreatitis that causes the patient to seek medical care. Pain in pancreatitis is accompanied by nausea and vomiting that does not relieve the pain or nausea. Abdominal guarding is present and a rigid or board-like abdomen may be a sign of peritonitis. Ecchymosis (bruising) to the flank or around the umbilicus may indicate severe peritonitis. Pain generally occurs 24 to 48 hours after a heavy meal or alcohol ingestion. The link with alcohol intake makes pancreatitis a more likely possibility than appendicitis or cholecystitis. 7. A patient has been scheduled for an ultrasound of the gallbladder the following morning. What should the nurse do in preparation for this diagnostic study? A) Have the patient refrain from food and fluids after midnight. B) Administer the contrast agent orally 10 to 12 hours before the study. C) Administer the radioactive agent intravenously the evening before the study. D) Encourage the intake of 64 ounces of water 8 hours before the study. - Correct Answer- Ans: A Feedback: An ultrasound of the gallbladder is most accurate if the patient fasts overnight, so that the gallbladder is distended. Contrast and radioactive agents are not used when performing ultrasonography of the gallbladder, as an ultrasound is based on reflected sound waves. 8. A patient who had surgery for gallbladder disease has just returned to the postsurgical unit from postanesthetic recovery. The nurse caring for this patient knows to immediately report what assessment finding to the physician? A) Decreased breath sounds B) Drainage of bile-colored fluid onto the abdominal dressing C) Rigidity of the abdomen D) Acute pain with movement - Correct Answer- Ans: C Feedback: The location of the subcostal incision will likely cause the patient to take shallow breaths to prevent pain, which may result in decreased breath sounds. The nurse should remind patients to take deep breaths and cough to expand the lungs fully and prevent atelectasis. Acute pain is an expected assessment finding following surgery; analgesics should be administered for pain relief. Abdominal splinting or application of an abdominal binder may assist in reducing the pain. Bile may continue to drain from the drainage tract after surgery, which will require frequent changes of the abdominal dressing. Increased abdominal tenderness and rigidity should be reported immediately to the physician, as it may indicate bleeding from an inadvertent puncture or nicking of a major blood vessel during the surgical procedure. 9. A patient with chronic pancreatitis had a pancreaticojejunostomy created 3 months ago for relief of pain and to restore drainage of pancreatic secretions. The patient has come to the office for a routine postsurgical appointment. The patient is frustrated that the pain has not decreased. What is the most appropriate initial response by the nurse? A) "The majority of patients who have a pancreaticojejunostomy have their normal digestion restored but do not achieve pain relief." B) "Pain relief occurs by 6 months in most patients who undergo this procedure, but some people experience a recurrence of their pain." C) "Your physician will likely want to discuss the removal of your gallbladder to achieve pain relief." D) "You are probably not appropriately taking the medications for your pancreatitis and pain, so we will need to discuss your medication regimen in detail." - Correct Answer- Ans: B Feedback: Pain relief from a pancreaticojejunostomy often occurs by 6 months in more than 85% of the patients who undergo this procedure, but pain returns in a substantial number of patients as the disease progresses. This patient had surgery 3 months ago; the patient has 3 months before optimal benefits of the procedure may be experienced. There is no obvious indication for gallbladder removal and nonadherence is not the most likely factor underlying the pain. 10. A nurse is caring for a patient who has been scheduled for endoscopic retrograde cholangiopancreatography (ERCP) the following day. When providing anticipatory guidance for this patient, the nurse should describe what aspect of this diagnostic procedure? A) The need to protect the incision postprocedure B) The use of moderate sedation C) The need to infuse 50% dextrose during the procedure D) The use of general anesthesia - Correct Answer- Ans: B Feedback: Moderate sedation, not general anesthesia, is used during ERCP. D50 is not administered and the procedure does not involve the creation of an incision. 11. A patient has undergone a laparoscopic cholecystectomy and is being prepared for discharge home. When providing health education, the nurse should prioritize which of the following topics? A) Management of fluid balance in the home setting B) The need for blood glucose monitoring for the next week C) Signs and symptoms of intra-abdominal complications D) Appropriate use of prescribed pancreatic enzymes - Correct Answer- Ans: C Feedback: Because of the early discharge following laparoscopic cholecystectomy, the patient needs thorough education in the signs and symptoms of complications. Fluid balance is not typically a problem in the recovery period after laparoscopic cholecystectomy. There is no need for blood glucose monitoring or pancreatic enzymes. 12. A nurse is preparing a plan of care for a patient with pancreatic cysts that have necessitated drainage through the abdominal wall. What nursing diagnosis should the nurse prioritize? A) Disturbed Body Image B) Impaired Skin Integrity C) Nausea D) Risk for Deficient Fluid Volume - Correct Answer- Ans: B Feedback: While each of the diagnoses may be applicable to a patient with pancreatic drainage, the priority nursing diagnosis is Impaired Skin Integrity. The drainage is often perfuse and destructive to tissue because of the enzyme contents. Nursing measures must focus on steps to protect the skin near the drainage site from excoriation. The application of ointments or the use of a suction apparatus protects the skin from excoriation. 13. A home health nurse is caring for a patient discharged home after pancreatic surgery. The nurse documents the nursing diagnosis Risk for Imbalanced Nutrition: Less than Body Requirements on the care plan based on the potential complications that may occur after surgery. What are the most likely complications for the patient who has had pancreatic surgery? A) Proteinuria and hyperkalemia B) Hemorrhage and hypercalcemia C) Weight loss and hypoglycemia D) Malabsorption and hyperglycemia - Correct Answer- Ans: D Feedback: The nurse arrives at this diagnosis based on the complications of malabsorption and hyperglycemia. These complications often lead to the need for dietary modifications. Pancreatic enzyme replacement, a low-fat diet, and vitamin supplementation often are also required to meet the patient's nutritional needs and restrictions. Electrolyte imbalances often accompany pancreatic disorders and surgery, but the electrolyte levels are more often deficient than excessive. Hemorrhage is a complication related to surgery, but not specific to the nutritionally based nursing diagnosis. Weight loss is a common complication, but hypoglycemia is less likely. 14. A patient has had a laparoscopic cholecystectomy. The patient is now complaining of right shoulder pain. What should the nurse suggest to relieve the pain? A) Aspirin every 4 to 6 hours as ordered B) Application of heat 15 to 20 minutes each hour C) Application of an ice pack for no more than 15 minutes D) Application of liniment rub to affected area - Correct Answer- Ans: B Feedback: If pain occurs in the right shoulder or scapular area (from migration of the CO2 used to insufflate the abdominal cavity during the procedure), the nurse may recommend use of a heating pad for 15 to 20 minutes hourly, walking, and sitting up when in bed. Aspirin would constitute a risk for bleeding. 15. A patient returns to the floor after a laparoscopic cholecystectomy. The nurse should assess the patient for signs and symptoms of what serious potential complication of this surgery? A) Diabetic coma B) Decubitus ulcer C) Wound evisceration D) Bile duct injury - Correct Answer- Ans: D Feedback: The most serious complication after laparoscopic cholecystectomy is a bile duct injury. Patients do not face a risk of diabetic coma. A decubitus ulcer is unlikely because immobility is not expected. Evisceration is highly unlikely, due to the laparoscopic approach. 16. A patient has been treated in the hospital for an episode of acute pancreatitis. The patient has acknowledged the role that his alcohol use played in the development of his health problem, but has not expressed specific plans for lifestyle changes after discharge. What is the nurse's most appropriate response? A) Educate the patient about the link between alcohol use and pancreatitis. B) Ensure that the patient knows the importance of attending follow-up appointments. C) Refer the patient to social work or spiritual care. D) Encourage the patient to connect with a community-based support group. - Correct Answer- Ans: D Feedback: After the acute attack has subsided, some patients may be inclined to return to their previous drinking habits. The nurse provides specific information about resources and support groups that may be of assistance in avoiding alcohol in the future. Referral to Alcoholics Anonymous as appropriate or other support groups is essential. The patient already has an understanding of the effects of alcohol, and follow-up appointments will not necessarily result in lifestyle changes. Social work and spiritual care may or may not be beneficial. CONTINUES... [Show Less]
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Fundamentals: Chapter 19, Implementing Nursing Care Study Guide 2022
Fundamentals: Chapter 19, Implementing Nursing Care Study Guide 2022 Implementation - The fourth step of the nursing process,(formally begins after the ... [Show More] nurse develops a plan of care) the nurse initiates the interventions that are most likely to achieve the goals and expected outcomes needed to support or improve the client's health status. Nursing intervention - Is any treatment, based on clinical judgment and knowledge, that a nurse performs to enhance client outcomes. Ideally the interventions a nurse uses are evidenced based, providing the most current, up-to-date, and effective approaches for managing patient problems. Interventions include direct and indirect care aimed at individuals, families, and/or the community. Direct care (interventions) - Are treatments performed through interactions with patient's. Ex: Medication administration, insertion of an intravenous (IV) infusion, or counseling during a time of grief. Indirect care (interventions) - Are treatments performed away from the patient but on behalf of the patient or group of patient's. Ex: Actions for managing patient's environment (e.g. safety and infection control), documentation, and interdisciplinary collaboration. Critical Thinking in Implementation - Critical thinking is necessary to consider the complexity of interventions, including the number of alternatives approaches and the amount of time available to act. Before implementing a planned intervention, use critical thinking to confirm whether the intervention is correct and still appropriate for the patient's clinical situation. Identify the factors that should be considered when making decisions about implementation - a. Review the set of all possible interventions for the patient's problem b. Review all of the possible consequences associated with each possible nursing action c. Determine the probability of all possible consequences d. Make a judgment of the value of that consequence to the patient Standard nursing interventions - Many patients have common health care problems; thus standardized interventions for these health problems make it quicker and easier for nurses to intervene. ->Nurse/Physician initiated standardized interventions- Clinical guidelines or protocols, Preprinted (standing) orders, and Nursing Interventions Classification (NIC) interventions. ->Professional level- The American Nurses Association (ANA) defines standards of professional nursing practice, which include standards for the implementation step of the nursing process. Clinical practice guideline - Or protocol is a document that guides decisions and interventions for specific health care problems or conditions. (or protocol) Is a systematically developed set of statements that helps nurses, physicians, and other health care providers make decisions about appropriate health care for specific clinical situations. Standing orders - Is a preprinted document containing orders for the conduct of routine therapies, monitoring guidelines, and/or diagnostic procedures for patients with identified clinical problems. Nursing Interventions Classification (NIC) interventions - Offer a level of standardization to enhance communication of nursing care across settings and to compare outcomes What are the five preparatory activites for implementation of safe and effective nursing care. - 1. Reassessing the patient 2. Reviewing & Revising the existing nurse care plan 3. Organizing resources and care delivery 4. Anticipating and preventing complications 5. Implementation nursing interventions 1. "Reassessing the patient" - Reassessing the patient is a continuous process that occurs each time you interact with a patient; you collect new data, identify a new patient need, and modify the care plan 2. " Reviewing & Revising the existing nurse care plan" - If the patient's status has changed and the nursing diagnosis and related nursing interventions are no longer appropriate, modify the nursing care plan 3. "Organizing resources and care delivery" - Organizing resources and care delivery involves organization of equipment, skilled personnel, and the environment. This makes timely, efficient, skilled patient care possible. 4. "Anticipating and preventing complications" - Risks to patients come from both the illness and the treatments 5. "Implementation skills" - Implementation skills includes cognitive (application of critical thinking in the nursing process), interpersonal (trusting relationship, level of caring and communication) and psychomotor skills (integration of cognitive and motor activities). CONTINUES.... [Show Less]
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Health Care Delivery ATI Questions And Answers 2022
Health Care Delivery ATI Questions And Answers 2022 A nurse is caring for a client who reports that they have lost their job and do not have insurance.... [Show More] Which of the following social determinants of health is challenging for this client? - Answer- Economic stability A nurse is teaching about Medicaid to a client who is concerned about paying for health care. Which of the following statements should the nurse make? - Answer- "Your income will determine if you are eligible for Medicaid." A nurse is teaching a newly licensed nurse about The Joint Commission (TJC). Which of the following information should the nurse include? - Answer- TJC ensures organizations remain up-to-date with state guidelines. A nurse is hired to be a case manager in a facility. Which of the following services should the nurse expect to perform? - Answer- Facilitate transfer of clients to meet the required level of care. A nurse at a community health center is providing an in-service for a group of residents about the Healthy People program. Which of the following information should she include? - Answer- Initiatives to reduce health care disparities. Activities to improve social determinants of health. Improving access to health care. A nurse is teaching a class about the Hospital-Acquired Condition Reduction Program (HACRP). Which of the following information should the nurse include? - Answer- The HACRP links Medicare payments to health care quality. A nurse in a provider's office is speaking with a client who needs a refill for a prescription that has expired. The nurse should identify that which of the following team members can assist the client with the refill? - Answer- Advanced practice registered nurse (APRN) Physician Assistant (PA) Physician A nurse is discussing social determinants of health with a newly licensed nurse. The nurse should include that which of the following factors contribute to the neighborhood and built environment determinant category? - Answer- Access to foods that support healthy eating patterns. Crime and violence. Environment conditions. A nurse is teaching a newly licensed nurse about Medicare reimbursement. What should she include? - Answer- Reimbursement amounts will be adjusted for clients who contract HACs. CONTINUES..... [Show Less]
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Drexel NUR 550 Final Exam; Cumulative Review Questions With Correct Answers 2022
Drexel NUR 550 Final Exam; Cumulative Review Questions With Correct Answers 2022 Which of the following is NOT considered a risk factor for the developin... [Show More] g of melanoma? a). Light hair and eyes b). Female gender c). Severe sunburns in childhood d). 1-4 dysplasyic moles - Correct Answer- b). Female gender When using the otoscope to inspect the inside of the nose, which of the following structures is not visible? a). Inferior turbinate b). Middle turbinate c). Superior turbinate d). All of the above - Correct Answer- c). Superior turbinate When palpating the thyroid, which of the following is true? a). Flex the neck slightly backward b). Place the index fingers just above the cricoid cartilage c). The thyroid isthmus may not be palpable d). A bruit auscultated over the lateral lobe is expected - Correct Answer- b). Place the index fingers just above the cricoid cartilage During the palpation of a patient's thyroid gland you note a multinodular gland. Which of the following is the first on your list of differential diagnoses? a). Thyroid cancer b). Hashimoto's thyroiditis c). Grave's disease d). A metabolic process - Correct Answer- d). A metabolic process You are evaluating a 4 year-old male patient with ear pain. You note the patient has a temperature of 102.4F. While performing your exam, you note the patient is pulling at his left ear. What is our most likely differential diagnosis? a).Otitis externa b). Otitis media c). Tinnitus d). Ottorhea - Correct Answer- b). Otitis media You are using a Snellen chart to evaluate a patient's visual acuity, which of the following is true? Select all that apply: a). Have the patient stand back 20 ft. from the chart b). Have the patient use their hand to cover one eye c). You are evaluating cranial nerve II d). Evaluate visual acuity with both eyes open - Correct Answer- a). Have the patient stand back 20 ft. from the chart & c). You are evaluating cranial nerve II Within 48-72 hours after the birth, a neonate has bilateral copious purulent drainage from the eyes. You most likelu differential diagnosis is? a). Gonococcal conjunctivitis b). Allergic conjunctivitis c). Bacterial conjunctivitis d). Viral conjunctivitis - Correct Answer- a). Gonococcal conjunctivitis Which of the following are normal findings during the ophthalmoscope examination? Select all that apply: a). The physiologic cup is 70% of the optic disc b). the area of the macula is absent of blood vessels c). The optic rim is fuzzy in appearance d). The optic disc should be orange in appearance - Correct Answer- b). the area of the macula is absent of blood vessels & d). The optic disc should be orange in appearance You are beginning the examination of the skin on a 25-year-old teacher. You have previously elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly suspect that she has hypothyroidism. What is the expected moisture and texture of the skin of a patient with hypothyroidism? a). Dry and smooth b). Moist and rough c). Moist and smooth d). Dry and rough - Correct Answer- d). Dry and rough A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator for 3 weeks. You are completing your initial assessment and are evaluating her skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter, with damage to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pressure ulcer. What is the stage of this ulcer? a). Stage 3 b). Stage 1 c). Stage 2 d). Stage 4 - Correct Answer- a). Stage 3 A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis? a). Actinic keratosis b). Seborrheic keratosis c). Squamous cell carcinoma d). Basel cell carcinoma - Correct Answer- a). Actinic keratosis Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus erythematosus). She has noticed a raised, dark red rash on her legs. When you press on the rash, it doesn't blanch. What would you tell her regarding her rash? a). It is likely to be related to an exposure to a chemical. b). It should not cause any problems c). It is likely to be related to an allergic reaction d). It is likely to be related to her lupus - Correct Answer- d). It is likely to be related to her lupus Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his scapula. It has been there for about a year and is getting larger. He says his wife has been able to squeeze out a cheesy-textured substance on occasion. He worries this may be cancer. When gently pinched from the side, a prominent dimple forms in the middle of the mass. What is most likely? a). A malignant lesion b). An enlarged lymph node c). An actinic keratosis d). A sebaceous cyst - Correct Answer- d). A sebaceous cyst A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but not as severe. She does not know of any inciting factors. There has been no change in the frequency of her headaches. She usually takes an over-the-counter analgesic and this results in resolution of the headache. Based on this description, what is the most likely diagnosis of the type of headache? a). Cluster b). Tension c). Migraine d). Analgesic rebound - Correct Answer- c). Migraine Which of the following is a "red flag" regarding patients presenting with headache? a). Unilateral headache b). Pain over the sinuses c). Age over 50 d). Photophobia and phonophobia - Correct Answer- c). Age over 50 Very sensitive methods for detecting hearing loss include which of the following? a). The whisper test b). The tuning fork test c). Audiometric testing d). The finger rub test - Correct Answer- c). Audiometric testing A college student presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles bilaterally. What group of nodes is this? a). Occipital b). Tonsillar c). Submandibular d). Posterior cervical - Correct Answer- d). Posterior cervical A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular skin check-up. She has just returned from her annual dig site in Greece. She has fair skin and reddish-blonde hair. She has a family history of melanoma. She has many freckles scattered across her skin. From this description, which of the following is not a risk factor for melanoma in this patient? a). Hair color b). Actinic lentigines c). Heavy sun exposure d). Age - Correct Answer- d). Age Is the following statement true or false? When assessing the patient's thought content, it is important to always follow specific questions to keep the patient on task. a). True b). False - Correct Answer- b). False Which of the following is true about hallucinations? a). Experiences may or may not be recognized by the person as false. b). Hallucinations may be auditory, visual, olfactory, gustatory, tactile, or somatic. c). Do not include false perceptions associated with dreaming and falling asleep. d). All of the above. - Correct Answer- d). All of the above. Coordination of muscle movement requires that four areas of the nervous system function in an integrated way. Coordinating eye, head, and body movements applies to which area of the nervous system? a). Motor system b). Cerebellar system c). Vestibular system d). Sensory system - Correct Answer- c). Vestibular system Which of the following statements regarding reinforcement when assessing reflexes is true? a). Used when reflexes are symmetrically hyperactive b). Technique involves isometric contraction of other muscles c). Supports the unsteady patient d). All of the above - Correct Answer- b). Technique involves isometric contraction of other muscles A patient presents to you with shoulder pain after falling during an ice storm. On examination, he exhibits localized shoulder pain when you preform the "crossover test" (arm moved across the chest toward the opposite side while extended at the elbow). Which of the following is the most likely site of injury? a). Rotator cuff b). Bicipital tendon c). Glenohumeral joint d). Acromioclavicular joint - Correct Answer- d). Acromioclavicular joint A patient who presents to the clinic complaining of hand pain says she was told by a friend that it is most likely carpal tunnel syndrome. Upon assessing the patient, you note the following. Which finding would be suggestive of carpal tunnel syndrome? a). Hand pain when holding both hands in acute extension b). Numbness and tingling when tapping over the course of the radial nerve c). Symptoms related to compression are evident in all fingers d). None of the above - Correct Answer- d). None of the above ---- b). MEDIAL NERVE is correct c). FIRST THREE FINGERS is correct You are assessing a patient with joint pain and are trying to decide whether it is inflammatory or noninflammatory in nature. Which one of the following symptoms is consistent with an inflammatory process? a).Tenderness b).Ecchymosis c).Nodules d).Cool temperature - Correct Answer- a).Tenderness An 85-year-old retired housewife comes with her daughter to establish care. Her daughter is concerned because her mother has started to fall more. As part of her physical examination, you ask her to walk across the examination room. Which of the following is not part of the stance phase of gait? a). Heel strike b). Foot arched c). Push-off d). Mid-stance - Correct Answer- b). Foot arched A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a sudden onset of pain after lifting a set of boxes that were heavier than usual. He also states that he has numbness and tingling in the left leg. He wants to know if he needs to be off of work. What test should you perform to assess for a herniated disc? a). Phalen's test b). Straight-leg raise c). Leg-length test d). Tinel's test - Correct Answer- b). Straight-leg raise A high school soccer player "blew out his knee" when the opposing goalie's head and shoulder struck his flexed knee while the goalie was diving for the ball. All of the following structures were involved in some way in his injury, but which of the following is actually an extra-articular structure? a). Synovium b). Juxta-articular bone c). Joint capsule d). Tendons - Correct Answer- d). Tendons A 28-year-old book editor comes to your clinic, complaining of strange episodes. He states that about once a week for the last 3 months his left hand and arm will stiffen and then start jerking. He says that after a few seconds his whole left arm and then his left leg will also start to jerk. He denies any loss of consciousness or loss of bowel or bladder control. When the symptoms resolve, his arm and leg feel tired but otherwise he feels fine. His past medical history is significant for a cyst in his brain that was removed 6 months ago. He is married and has two children. His parents are both healthy. On examination you see a scar over the right side of his head but otherwise his neurologic examination is unremarkable. What type of seizure disorder is he most likely to have? a). Complex partial seizure b). Simple partial seizure (Jacksonian) c). Generalized tonic-clonic seizure d). Generalized absence seizure - Correct Answer- b). Simple partial seizure (Jacksonian) A 21-year-old engineering student comes to your office, complaining of leg and back pain and of tripping when he walks. He states this started 3 months ago with back and buttock pain but has since progressed to feeling weak in his left leg. He denies any bowel or bladder symptoms. He can think of no specific traumatic incidences but he was a defensive lineman in high school and junior college. His past medical history is unremarkable. He denies tobacco use or alcohol or drug abuse. His parents are both healthy. On examination he is tender over the lumbar spine and he has a positive straight-leg raise on the left. His Achilles tendon deep reflex is decreased on the left. While watching his gait you notice he has to pick his left foot up high in order not to trip. What abnormality of gait does he most likely have? a). Sensory ataxia b). Steppage gait c). Parkinsonian gait d). Spastic hemiparesis - Correct Answer- b). Steppage gait Steve has had a stroke and comes to you for follow-up today. On examination you find that he has increased muscle tone, some involuntary movements, an abnormal gait, and a slowness of response in movements. He most likely has involvement of which of the following? a). The corticospinal tract b). The cerebrum c). The basal ganglia d). The cerebellum - Correct Answer- c). The basal ganglia . CONTINUES..... [Show Less]
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Taylor Chapter 24 Vital Signs Prep U Questions And Answers 2022
Taylor Chapter 24 Vital Signs Prep U Questions And Answers 2022 Nurse T. has auscultated Mr. Weinstein's apical pulse while a colleague simultaneously ... [Show More] palpated his radial pulse. This assessment of Mr. Weinstein's apical/radial pulse indicates that the two values differ significantly, a finding that suggests which of the following health problems? - Answer- Peripheral vascular disease Explanation: A pulse deficit indicates that all of the heartbeats are not reaching the peripheral arteries or are too weak to be palpated, a finding that is congruent with peripheral vascular disease. It does not signal a lack of circulation to the heart muscle (coronary artery disease), a pulmonary embolism, or COPD. Which peripheral pulse site is generally used in emergency situations? - AnswerCarotid Explanation: The carotid artery is lightly palpated to obtain a pulse in emergency assessments, such as in a patient in shock or cardiac arrest. The brachial pulse site is used for infants who have had a cardiac arrest A nurse plans to measure the temperature of a client with mild diarrhea, but the client has just had hot soup. Which of the following actions should the nurse perform in order to obtain the accurate temperature of the client? - Answer- Wait for 15 to 20 minutes before measuring the oral temperature Explanation: The nurse should wait for 15 to 20 minutes and then measure the oral temperature of the client because hot and cold liquids cause slight variations in temperature. Giving the client a glassful of cold water to drink will not help because the thermometer will still show temperature variation and not the accurate body temperature. The rectal route is contraindicated in clients with diarrhea because it can cause mucosal tearing or perforation. Hence, the nurse should not lubricate the client's rectum or measure the rectal temperature. The axillary route is the least accurate and least reliable site because temperature may reflect the temperature of the water used during sponging. Friction used to dry the skin may also influence the temperature. The nursing student is selecting a blood pressure cuff prior to obtaining a patient's blood pressure. What cuff width is appropriate to obtain an accurate blood pressure reading? - Answer- 40% of the circumference of the limb to be used Explanation: The width of the cuff should be about 40% of the circumference of the limb to be used. A nurse is assessing the blood pressure of a client using the Korotkoff sound technique. The nurse notes that the phase I sound disappears for 2 seconds. What should the nurse document on the progress record? - Answer- There is an auscultatory gap Explanation: An auscultatory gap is a period during which sound disappears. An auscultatory gap can range as much as 40 mm Hg. A widening in the diameter of the artery takes place in the phase II of the Korotkoff sound technique. An adult diastolic pressure takes place in the phase IV of the Korotkoff sound technique. A nurse is taking the vital signs of a 9-year old child who is anxious about the procedures. Which nursing action would be appropriate when assessing this child? - Answer- Perform the blood pressure measurement last. CONTINUES..... [Show Less]
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