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Option C is better than Option B; endotracheal intubation will be difficult because the inflamed epiglottis will not permit the insertion of a laryngoscope. Hypothyroidism causes a decrease in thyroid hormones, which in turn causes decreased metabolism.

Options A, Band D are all consistent with decreased metabolism. Option C is a symptom of increased metabolism found in hyperthyroidism.

Use condoms B. Monogamous relationship C. Abstinence D. Practice Safe Sex The correct answer is B. Pick the conservative answer. Remember the Board of Nursing is composed of older women with traditional values who do not approve of promiscuity implied in options A and D. Telling the patient to abstain from sex Option C is not an acceptable response from the nurse.

Infection is a priority for all types of burns. Airway is a priority only for burns to the face and neck. Pain is a second priority for 1st and 2nd degree burns. Fluid and electrolyte balance is a second priority for 3rd and 4th degree burns [no pain because nerve endings are damaged]. The thyroid gland is symmetrical, non-tender, and palpable only if the patient has goiter. The palpable mass on the neck is the thyroid cartilage.

It is present in both males and females but is larger in males; it develops during puberty What food is most appropriate for a toddler? Toddlers need a high-carb diet to sustain their active play lifestyle.

Toddlers are also at risk for aspiration, therefore eliminate foods that are choking hazards options A and B. Milk is not the best food for toddlers because of its low IRON content; Milk is the primary cause of Iron-deficiency Anemia in children. No, no, no Do not justify a wrong answer. What would the nurse include in the teaching plan for a paraplegic client?

A paraplegic patient has lower extremity paralysis paralyzed bladder and bowel. Monoplegia -- 1 limb paralysis Hemiplegia -- Right or Left side paralysis Paraplegia - Lower extremity paralysis note: To increase environmental awareness during aggression pupillary constriction: Atopic Dermatitis eczema and foul-smelling odor [recall: Anti-hypertensives are not given to patients with CHF or cardiogenic shock Drug will cause a further decrease in heart rate -7 Death f Rx for Myasthenia Gravis: For the management of hypertension, the doctor prescribes Inderal 40 mg P.

What is the appropriate nursing action? A patient with COPD has decreased respiration. Excitability - Neurons are affected by changes in the environment 2. Conductivity - Neurons transmit wave of excitations 3. Permanent cells - Once neurons are destroyed, they are not capable of regeneration. Majority of brain tumors arise from neuroglia fTypes: Ammonia 2. Bilirubin 3. Carbon monoxide and Lead 4. The initial sign of Parkinson's disease: Hereditary f Etiology: Insulin f Treatment: The correct answer is D.

Option A is a characteristic of stroke.

Option C is a characteristic of Dementia? What type of environment is appropriate for a client with Alzheimer's? To promote the patient's safety and security, the patient needs to be in a familiar environment. A client with Alzheimer's disease has short-term memory loss, but has intact long-term memories. Therefore allowing the client to reminisce about the past reinforces the client's self-esteem. Options A is incorrect because the client is not disoriented.

Option B is incorrect because it dismisses the client's concerns. Option C is incorrect because with short-term memory loss, the client cannot talk about recent events. M f Characterized by remission and exacerbation f Common among women 15 to 35 y.

Because of decreased heat sensitivity, heat application can cause burns. Baclofen [Liorisal] and Dantrolene Sodium [Dantrium] -can be used to treat hiccups, which is caused by irritation of the phrenic nerve. Bronchospasm and Wheezing, so always check breath sounds 1 hour after administration. Provide high fiber diet fTo treat UTI: Baclofen is a muscle relaxant used to treat spastic movement in multiple sclerosis, spinal cord injury, amyotrophic lateral sclerosis Lou Gehrig's Disease and trigeminal neuralgia.

I' f Largest part of the brain f Composed of 2 hemispheres Left and Right joined by the copus callosum f Functions: A change in the level of consciousness is the earliest sign of increased ICP. Option C is incorrect; increased ICP causes bradycardia, not tachycardia.

Describe a conscious client: Aware B. Coherent C. Awake D. Alert The correct answer is C. Consciousness describes a patient's level of wakefulness. The terms aware, coherent and alert Options A, B and D are used when describing a patient's orientation to person, place and time. The 4 levels of consciousness: Flaccid posture is lost muscle tone, not found in increased ICP found in poliomyelitis.

Restlessness B. Agitation C. Tachycardia D. Bradycardia The correct answer is D. Options A, Band C are early signs. The brain is the most sensitive organ to hypoxia, causing restlessness and agitation. Tachycardia is a compensatory mechanism to increase O2 in the brain.

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When there are two opposite options Options C and D , one of them is definitely correct, so eliminate the other options Options A and B. Ambubag or Mechanical Ventilator -Note: Suctioning performed for only 10 to 15 seconds; apply suction only while removing the suction catheter -When suctioning an endotracheal tube, insert the suction cath all the way until resistance is felt, to ensure complete removal of secretions "Position Semi-Fowler's -Elevate head of bed 30 to 45Q with neck in neutral position unless contraindicated to promote venous drainage.

Bisacodyl [Dulcolax]. Dextromethorphan [Robitussin] 0Note: Phenergan [Plasil]. Acoustic neuromas produce symptoms of progressive nerve deafness, tinnitus, and vertigo due to pressure and eventual destruction of: a. CN5 c. CN8 d. The ossicles CN8, the acoustic nerve or vestibulocochlear nerve, is the most commonly affected CN in acoustic neuroma although as the tumor progresses CN5 and CN7 can be affected.

Signs and symptoms of increasing intracranial pressure may include all of the following except: a. However, as ICP continues to rise, vital signs may vary considerably. Mr Snyder is scheduled for surgery in the morning, and you are surprised to find out that there is no order for an enema. You assess the situation and conclude that the reason for this is: a. Snyder has had some mental changes due to the tumor and would find an enema terribly traumatic b. Straining to evacuate the enema might increase the intracranial pressure c.

Snyder had been on clear liquids and then was NPO for several days, so an enema is not necessary d. An oversight and you call the physician to obtain the order Any activity that increases ICP could possibly cause brain herniation. Straining to expel an enema is one example of how the increased ICP can be further aggravated.

Postoperatively Mr. Snyder needs vigilant nursing care including all of the following except: a. Keeping his head flat b. Helping him avoid straining at stool, vomiting, or coughing d.

Providing a caring, supportive atmosphere for him and his family Postoperatively clients who have undergone craniotomy usually have their heads elevated to decrease local edema and also decrease ICP. Potential postintracranial surgery problems include all but which of the following? Increased ICP may result from hemorrhage or edema. CSF leakage may result in meningitis. Seizures are another postoperative concern. Hogan, a year-old woman, is admitted to your unit for cholecystectomy. You are responsible for teaching Mrs.

Hogan deep breathing and coughing exercises. Why are these exercises especially important for Mrs. However, the risk of pulmonary problems is somewhat increased in clients with biliary tract surgery because of their high abdominal incisions.

Option C assumes the stereotype of the person with gallbladder disease — fair, fat and fory — which is not necessarily the case. Splinting the incision with the hands or a pillow is very helpful in controlling the pain during coughing. On the morning of Mrs. Your responsibility at this point is: a. This is not an unusual finding A WBC count of 15, probably indicates acute cholecystitis, especially considering Mrs.

Hogan is scheduled for surgery 2 days later and is to be given atropine 0. Which nursing actions follow the giving of the preop medication? The family may also be involved earlier but certainly should have that time immediately after the medication is given and before it takes full effect to be with their loved ones. Good planning of nursing care can facilitate this. Hogan is transported to the recovery room following her cholecystectomy.

As you continue to check her vital signs you note a continuing trend in Mrs. Your most appropriate nursing action is to: a. Hogan from the lab b. Your most appropriate action is to report your findings quickly and accurately and to continue to monitor Mrs. Hogan carefully. Hogan returns to your clinical unit following discharge from the recovery room. Her vital signs are stable and her family is with her. Postoperative leg exercises should be inititated: a.

Hogan will not be ambulated early d. The family can be extremely helpful in encouraging the client to do them, in supporting the incision, etc. An oropharyngeal airway may: a. Not be used in a conscious patient. Cause airway obstruction. Prevent a patient from biting and occluding an ET tube.

Be inserted "upside down" into the mouth opening and then rotated into the proper orientation as it is advanced into the mouth. All of the above. An oropharyngeal airway should be used in an unconscious patient. In a conscious or semiconscious patient its use may cause laryngospasm or vomiting.

An oropharyngeal airway that is too long may push the epiglottis into a position that obstructs the airway. It is often use with an ETT to prevent biting and occlusion.

It is usually inserted upside down and then rotated into the correct orientation as it approaches full insertion. Endotracheal intubation: a. Can be attempted for up to 2 minutes before you need to stop and ventilate the patient. Reduces the risk of aspiration of gastric contents. Should be performed with the neck flexed forward making the chin touch the chest. Should be performed after a patient is found to be not breathing and two breaths have been given but before checking for a pulse.

Letter A is wrong because an attempt should not last no longer than 30 seconds. Unless injury is suspected the neck should be slightly flexed and the head extended.. After securing an airway and successfully ventilating the patient with two breaths you should then check for a pulse. If there is no pulse begin chest compressions. When giving bag-valve mask ventilations: a. Rapid and forceful ventilations are desirable so that adequate ventilation will be assured b.

Effective ventilations can always be given by one person. Cricoid pressure may prevent gastric inflation during ventilations. Tidal volumes will always be larger than when giving mouth to pocket mask ventilations.

Cricoid pressure may prevent gastric inflation during ventilations and may also prevent regurgitation by compressing the esophagus. Letter A may cause gastric insufflation thus increasing the risk for regurgitation and aspiration. With adults breaths should be delivered slowly and steadily over 2 seconds. Effective ventilation using bag-valve mask usually requires at least two well trained rescuers. A frequent problem with bag-valve mask ventilations is the inability to provide adequate tidal volumes.

If breath sounds are only heard on the right side after intubation: a.

Edited Carl Balita Question and Answers

Extubate, ventilate for 30 seconds then try again. The patient probably only has one lung, the right.

You have intubated the stomach. Pull the tube back and listen again. Most likely you have a right main stem bronchus intubation. Pulling the tube back a few centimeters may be all you need to do. An esophageal obturator airway EOA : a. Can be inserted by any person trained in ACLS. Requires visualization of the trachea before insertion.

Never causes regurgitation. Should not be used with a conscious person, pediatric patients, or patients who have swallowed caustic substances. EOA insertion should only be attempted by persons highly proficient in their use.

Vomiting and aspiration are possible complications of insertion and removal of an EOA.

Pentagon NLE Review Notes

During an acute myocardial infarct MI : a. A patient may have a normal appearing ECG. What term should you use in documenting this finding?

Which of the following response of a year-old patient with acute appendicitis is an alarming sign? Which of the orders should the nurse question?

Limit dietary protein b. Provide a diet high in carbohydrates c. Limit Sodium NA intake d. Provide a diet high in Potassium rich food. In discussing transmission the nurse knows that the highest concentration of the HIV virus in infected patients is in the:.

Edited Carl Balita Question and Answers

In teaching HIV in high school students, what is the appropriate health practice that the nurse should emphasize? Wash with antibacterial soap immediately after intercourse.

Use a latex condom and water soluble during intercourse c. After oral sex, use anti-bacterial mouth wash to destroy the HIV virus d. Abstain from intercourse if the female partner is having her menstrual period. Using silence b. Passive Friendliness c. Using open-ended questions d. Giving information. In a geriatric unit, you have noticed that one patient seemed to change his behavior.

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Being talkative b. Sleeplessness c. Complains of getting tired easily d. Change in appetite. What is the effective nursing action in order to prevent disorientation? Secure the side rails up all the time b. Do routine rounds c. Leave a night light d. Orient the patient every night before he or she sleeps. What is the proper order in the physical assessment when it comes to examination of the abdomen?

Auscultation, Inspection, Percussion, Palpation b. Inspection, Auscultation, Percussion, Palpation c. Palpation, Percussion, Inspection, Auscultation d. Inspection, Percussion, Palpation, Auscultation. In assessing the cranial nerve function, a nurse finds out that a patient has a difficulty in determining the different scents when the eyes is closed. Which of the following cranial nerve had a problem? Monday, April 15, Bradycardia The correct answer is D.

Which of the following points is correct. It is usually inserted upside down and then rotated into the correct orientation as it approaches full insertion.

You are speaking to an elderly group of diabetics in the OPD about eye health and the importance of visits to the ophthalmologist.

The nurse planning with him for his discharge should educate him as to the purpose and actions of his new medication. She consults you for guidance in produces Hcg?

Hogan from the lab b. All of the following findings in the family history of your pediatric patient is considered to be an assessment clue to genetic abnormalities except:

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