*NURSING > QUESTIONS & ANSWERS > Adult Health Final Exam- Cumulative Questions & Answers (All)

Adult Health Final Exam- Cumulative Questions & Answers

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1. Pt arrives from PACU. Arousable and oriented but drifts off to sleep. VSS w/ RR =14. Which is most appropriate nursing response? A. Continue w/ heat to toe assessment B. Call MD and ask PCA shou... ld be discontinued C. Continue to stimulate the patient to keep him awake. D. Encourage patient to drink some liquids. 2. RN removes urinary catheter. 12 hrs later voids 50 mL. Performs bladder scan that shows 400 mL of urine. Calls MD, what is an expected following order? A. Administer 500cc NS over 30 minutes B. Intermittent urinary catheterization C. Send urine culture D. Administer furosemide 20 mg IVP Ans: B. Intermittent urinary catheterization. That is standard of care not reinserting the Foley. Post void residue >100mL is abnormal, if no urine in bladder scan=dehydration therefore give fluid bolus (500cc NS over 30min). Lasix given to improve urine output. 3. Patient receiving morphine sulfate IV complains of feeling “itchy.” No rash on exam. Which of the following meds would be most helpful? A. Ondansteron 4 mg IV B. Heparin 5000 units SQ C. Benadryl 50 mg PO D. Docusate Sodium 100 mg PO Ans: C. Benadryl for complaints of itchiness but no rash with opioid/narcotic medications. 4. Patient POD1 lumbar fusion. 6AM hemovac drained for 500 mL. At 8AM drained for 250 mL. What is RN’s best response? A. Continue to monitor drainage Qhr B. Do nothing, this is expected C. VS and call MD to report findings D. Enter order to check Hgb and Hct Ans: C. For most drains, should not have to empty more than 4 hours, no actual threshold for each type of draining apparatus, most likely cause = bleeding need to consider this → chest tubes it is 100 mL per hour for threshold, but want much less. 5. POD2 for anterior-posterior lumbar fusion. On morning assessmentRN finds pt has no N but abd is distended with hypoactive bowel sounds and no flatus. RN should: A. Call MD and ask about NG tube placement B. Keep pt NPO and encourage ambulation C. Check medication record for stool softener D. Encourage patient to take oral fluids to stimulate peristalsis 6. Which of following is unexpected order POD1 following anterior posterior lumbar fusion? A. Ibuprofen 800 mg PO B. PCA dilaudid .12 Q6min with 1.2 mg Qhr C. Foley catheter to monitor u/o D. TLSO brace for ambulation 7. Pt hx of spondylolisthesis in lumbar spine admitted for pain control. Which finding is most cause for concerning? A. Pain 8 out of 10 B. Numbness in buttocks and thighs C. Complaint of dysuria D. Episode of urinary incontinence 1 Final Exam-Cumulative Questions & Answers Ans: D. For saddle anesthesia numbness in buttocks, thighs and groin area. If buttocks and thigh then sciatica. Pain 8 out of 10 is expected not concerning. 8. Pt POD1 following anterior cervical fusion C3 to C4 complains of dysphagia. Which is RN best response? A. Ask MD to order speech and swallow consult B. Reassure patient this is expected and will improve over time (expected finding) C. Check gag reflex D. Check MAR for order for dexamethasone Ans: B. Reassure the patient that dysphagia is expected and it will improve over time. Speech and swallow study if concern for choking and aspiration. For stroke, common to have problems with swallowing they get a speech and swallow study right after. Evaluate carefully when giving medications, if they have trouble, would most likely crush them and put them in applesauce, then would do speech and swallow consult; expect everyone to have problems swallowing initially after this particular surgery. 9. Patient w/ RA complains of muscle and joint stiffness that is worse in the morning. What medication does the RN expect to administer to the patient? A. Gabapentin B. Prednisone C. Oxycodone D. Cyclobenzaprine Ans: B. Prednisone for RA complaints of muscle and joint stiffness. Gabapentin for neuropathic pain and seizures. Oxycodone is an opioid. Cyclobenzaprine is a muscle relaxant, good for low back pain and muscle spasms. Gabapentin, cyclobenzaprine, lorazepam are CNS depressants. 10. Pt admitted with CP and rule out MI. What is most important for dx MI A. Elevated myoglobin and T wave inversion B. Elevated CPK-MB and tented T waves C. Elevated troponins and ST elevation D. Elevated WBCs and PVCs on EKG Ans: C. Elevated troponin, CPK-MB and ST elevation for diagnosis of MI. T wave inversion tells about ischemia. Myoglobin increases after muscle damage expected for MI but not diagnostic. Tented T waves seen with hyperkalemia. Elevated WBCs also seen in MI d/t to inflammation but not specific. Most common complications following an MI-cardiac arrhythmias (AF, PVC, V tach) and HF. [Show More]

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