Testing for TB –
Correct Answer -- A Mantoux skin test is the most accurate and valuable screening tool available for TB. A positive result means only
... [Show More] that the client has been exposed to TB; it does not meant that the client has active TB.
Testing for TB continue –
Correct Answer -- A sputum culture for acid fast bacillus (AFB) is used to confirm the diagnosis of pulmonary TB after a screening test and chest x-ray come back positive.
Teaching instructions for the use of a cane:
- Correct Answer -(1) The cane is moved forward about 12 inches.
(2) Then, the weak leg is moved even with the cane.
(3) Finally, the strong leg is brought forward and ahead of the cane and weak leg.
- Cane is held on stronger side.
- The gripper of the cane should be level with the trochanter of the femur.
Meningococcal vaccine
- Correct Answer -- Recommended that this vaccine be given to children who are 11 through 12 years of age and then given a booster dose at age 16.
When should the single dose of Herpes zoster vaccine be given?
- Correct Answer -- To adults 60 years or older whether or not they report a previous episode of herpes zoster.
Rotavirus should be given at what age?
- Correct Answer -- During the child's first year of life.
Alendronate (Fosamax)
- Correct Answer -- This medication is used to prevent and treat postmenopausal osteoporosis and Paget's Disease.
- Alendronate-taken in morning on an empty stomach.
- The patient must be instructed to wait at least 30 minutes after taking Alendronate before eating, drinking, or taking other medications.
What to expect with a patient having a chest tube?
- Correct Answer -- Continuous gentle bubbling in the suction control chamber.
- Crepitus (with a pneumothorax, this will persist for several hours depending)
- Oscillations-tidaling in the water seal chamber upon respiration are expected.
What is a potential complication of a thyroidectomy?
- Correct Answer -- Hypocalcemia: numbness and tingling in the hands, soles of the feet and around the lips.
What is Chvostek's sign? And how is it done?
- Correct Answer -Tap on the pt's face at a point just anterior to the ear and just below the zygomatic bone. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggestive of neuromuscular excitability caused by hypocalcemia.
Brudzinski's sign
- Correct Answer -- Is an indication of meningeal irritation, which may be positive in patient's with meningitis.
- To perform this, the client needs to be supine. The nurse: -places one hand behind patient's head.
-places the other hand on the client's chest.
Brudzinski's sign continue
- Correct Answer --raises the clients head (with the hand behind the head) while the hand on the chest restrains the clients and prevents the client from rising. Flexion of the clients lower extremities constitutes a positive sign.
Kernig's sign
- Correct Answer -- Is an indication of meningeal irritation. The maneuver is usually performed with the client supine with hips and knees in flexion. Extension of the knees is attempted and the inability to extend the clients knee beyond 135 degrees w/out causing pain constitutes a positive test.
Babinski sign
- Correct Answer -- This is used to test for brain damage or upper motor neuron damage. It is considered positive if the toes flare up upon stroking the plantar aspect of the foot.
Cataract surgery discharge instructions
- Correct Answer -- Do not lift anything heavier than 10lbs for at least one week
- Sleep on your back or unaffected side to lessen the pressure.
- Need to report any pain, decrease in vision or increase in discharge in the eye.
Cataract continue
- Correct Answer -- It is normal to feel itching and mild discomfort after surgery, but the pt should be instructed not to rub or place pressure on the eye.
Exposure or possible exposure to anthrax –
Correct Answer -- Administer an antibiotic prophylaxis to all pt's newly exposed
**Those exposed to anthrax do not require decontamination and are not considered contagious**
Botulism treatment - Correct Answer -- Give an antitoxin
Why would lidocaine (Xylocaine) be given to someone following cardiac arrest? - Correct Answer -- Lidocaine is an antiarrhythmic med that is commonly used to restore a regular heartbeat in a client who has arrhythmia. This effect is produced by delaying abnormal nerve pulses to the heart and reducing irritability of the heart tissue.
Factors that can trigger an exacerbation of SLE? - Correct Answer -- Infection (especially a strep or viral infection. This can be a major stressor and can trigger an exacerbation)
- Pregnancy (due to hormonal changes. The pt should be advised of the risks and must be monitored closely for effects on the renal and cardiovascular system if she decides to get pregnant)
- Sunlight (Exposure to sunlight and artificial UV light is the leading cause of SLE exacerbation manifestations, especially the characteristic skin manifestations of lesions and butterfly rash)
What diagnostic test would help the nurse monitor and evaluate the effectiveness of the aspirin medication for an Rhematoid arthritis patient? - Correct Answer -- Erythrocyte sedimentation rate (ESR)
** RA is a chronic inflammatory disease. ESR is useful in detecting and monitoring tissue inflammation in clients with RA.**
Antinuclear antibody (ANA) - Correct Answer -- ANAs are frequently present in pts who have systemic lupus erythematosus and other autoimmune disorders such as RA and scleroderma.
Rheumatoid factor (RF) diagnostic test - Correct Answer -This is helpful in diagnosing RA, but the levels do not always correlate with the severity of the disease activity.
Cheyne-Stokes Respirations - Correct Answer -- Is characterized by a rhythmic increase (to the point of hyperventilation) and decrease (to the point of apnea) in the rate and depth of respirations.
- It is commonly seen in pts who are unconscious, comatose or moribund (approaching death).
Cryoprecipitate - Correct Answer -- Clients with hemophilia (deficiency of clotting factor), are given cryoprecipitate to replace the deficient factor as a prophylactic measure before any invasive procedure, surgery or when actively bleeding.
Cryoprecipitate continue - Correct Answer -- Cryoprecipitate provides therapeutic amounts of Facto 8, Factor 13, von Willebrand factor and fibrinogen. These concentrates are made with recombinant DNA technology and are the treatment of choice with hemophilic A and von Willebrands disease.
Cisplatin (Platinol) - Correct Answer -- Treatment for cancer.
- If a client has reported fatigue it is important to check the patients most recent CBC. The client I likely to be anemic as a result of myelosuppression (bone marrow suppression) from the chem.
Cisplatin continue - Correct Answer -The pt may require tx for the anemia (transfusion, medications) and further chemo may be need to be delayed until the blood counts are higher.
Jerking movements of the extremities - Correct Answer -- Such as ataxia, may be seen with many neurologic conditions affecting the clients ability to produce a smooth movement.
Ataxia - Correct Answer -Jerky movements of the extremities
Spasm of the extremities - Correct Answer -- Involuntary spasms may be found with such conditions as cerebral palsy, trauma, cerebral infection and certain degenerative disorders.
Peripheral neuropathy - Correct Answer -- Is a neurological disorder resulting from damage to the peripheral nerves. It may be caused by diseases of the nerves, systemic illness or a side-effect from chemo.
Peripheral neuropathy continue - Correct Answer -If sensory nerve is damaged, the client is likely to experience pain, numbness, tingling, burning or a loss of feeling in the extremities.
RAST testing - Correct Answer -- Involves measuring the quantity of IgE present in the serum after exposure to specific antigens that are selected based on the pts symptom hx. An elevated IgE indicates a positive response to RAST testing and is seen in pts who have a hx of allergic manifestations, anaphylaxis and asthma. [Show Less]