PAPASA AKO SA MS PRAMIS PDF

Summary

This document appears to be a set of questions related to medical conditions and treatments. The questions cover topics such as hypocalcemia, whooping cough, and ABG results.

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PART I mg/dL. Which condition most likely caused this serum phosphorus level? 1. Calcium plays a major role in making our bones and teeth stronger. A client who was diagnosed with...

PART I mg/dL. Which condition most likely caused this serum phosphorus level? 1. Calcium plays a major role in making our bones and teeth stronger. A client who was diagnosed with a. Alcoholism hypocalcemia is assessed by the on-going nurse. b. Renal insufficiency During the assessment, the nurse noted a facial c. Hypoparathyroidism muscle spasm after he tapped the client's facial d. Tumour lysis syndrome nerves. This response called: 6. A nurse caring for a client with severe malnutrition a. Positive Trousseau's sign reviews the laboratory results and notes a magnesium b. Positive Chvostek's sign level of 1.0 mg/dL. Which electrocardiographic change c. Positive Brudzinski's sign would the nurse d. Positive Kernig's sign expect not included based on the magnesium level? (select all that apply) 2. Situation: Charles, an 8 year old boy, one of several siblings, is kept home by his mother a. Prominent U waves because he has a temp of 100.2 & a history of b. Prolonged PR interval hacking cough for 2 weeks. A definite whoop c. Depressed ST segment has been heard & doctor made diagnosis of d. Widened ORS complexes whooping cough. Nurse is to instruct the mother in proper care of this patient. This 7. A nurse caring for a client with hypocalcemia young boy should be: would expect to note which of the following changes on the electrocardiogram? a. Kept in warm, dry room b. Placed in a sunny room a. Widened T wave c. Kept in a room with a temperature of 60F b. Prominent U wave d. Allowed free run of the house c. Prolonged QT Interval 3. Interpret the ABG result- PH- 7.39, PaCO2- 60, 8. Phosphorus is a critical constituent of the body HC03- 30 tissues and is very essential in the formation of adenosine triphosphate (ATP) and in the maintenance a. Fully compensated respiratory acidosis of acid-base balance. Imbalances happen due to a b. Fully uncompensated respiratory alkalosis variety of factors. According to some research, which c. Fully compensated metabolic Alkalosis vitamin has a direct link towards changes in the d. Fully compensated metabolic acidosis phosphorus level? 4. A nurse caring for a group of clients reviews the a. Vitamin B1 electrolyte laboratory results and notes a sodium level b. Vitamin B6 of 130 mEq/L on one client's laboratory report. The c. Vitamin D nurse understands that which client is at highest risk d. Vitamin K for the development of a sodium value at this level? 9. A nurse who works in an oncology clinic is a. The client with renal failure assessing a patient who has arrived for a 2-month b. The client who is taking diuretics follow-up appointment following chemotherapy. The c. The client with hyperaldosteronism nurse notes that the patient's skin appears yellow. d. The client who is taking corticosteroid Which blood tests should be done to further explore this clinical sign? 5. A nurse reviews a client's laboratory report and notes that the client's serum phosphorus level is 2.0 a. Liver function tests (LFTs) b. Complete blood count (CBC) results have come back positive. As a result, the c. Platelet count patient is requesting a bilateral mastectomy. This d. Blood urea nitrogen and creatinine surgery is an example of what type of oncologic surgery? 10. Sodium plays an important role in water reabsorption, thus, promoting a control on the a. Salvage surgery vascular volume in general. A nurse has been b. Palliative surgery providing care to a client diagnosed with c. Prophylactic surgery hyponatremia. Which of the following manifestations d. Reconstructive surgery is consistent and would be expected during the assessment? 14. The nurse is caring for a patient who is to begin receiving external radiation for a malignant a. Elevated body temperature tumour of the neck. While providing patient b. Swollen dry tongue education, what potential adverse effects should the c. Decrease BP nurse discuss with the patient? d. Increase urine sodium a. Impaired nutritional status 11. A nursing student needs to administer potassium b. Cognitive changes chloride intravenously as prescribed to a client with c. Diarrhoea hypokalemia. The nursing instructor determines that d. Alopecia the student is unprepared for this procedure if the student states that which of the following is part of 15. A patient on the oncology unit is receiving the plan for preparation and administration of the carmustine, a chemotherapy agent, and the nurse is potassium? aware that a significant side effect of this medication is thrombocytopenia. Which a. Obtaining a controlled IV infusion pump symptom should the nurse assess for in b. Monitoring urine output during patients at risk for thrombocytopenia? administration c. Diluting in appropriate amount of normal a. Interrupted sleep pattern saline b. Hot flashes d. Preparing the medication for bolus c. Epistaxis (nose bleed) administration d. Increased weight 12. A nurse is caring for a client with acute congestive 16. Which of the following statement best heart failure who is receiving high doses of a diuretic. describes secretion? On assessment, the nurse notes that the client has flat neck veins, generalised muscle weakness, and a. The movement of solutes from the glomerulus diminished deep tendon reflexes. The nurse suspects into the proximal tubule hyponatremia. What additional signs would the nurse b. The movement of solutes from the proximal expect to note in this client if hyponatremia were tubule into the blood present? c. The movement of solutes from the blood into the tubule a. Dry skin d. The movement of solutes from the tubule into b. Decreased urinary output the ureter c. Hyperactive bowel sound 17. Situation: Bobby, 3 years old, from a family of 4 13. The nurse is caring for a 39-year-old woman older siblings, a mother & a father, was with a family history of breast cancer. She requested a admitted to the hospital w/temperature of 101 breast tumour marking test and the F, a sore throat of 4 days duration, w/ difficulty swallowing, & a moderate cervical adenitis. A diagnosis of pharyngeal diphtheria was made. 21. A male client with a cerebellar brain tumour is The best means for providing complete bed admitted to an acute care facility. The nurse rest for the child include: formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the a. feeding the patient nurse add to complete the nursing diagnosis b. giving sedation Statement? c. providing quiet diversion d. giving complete physical care a. Related to visual field deficits b. Related to difficulty swallowing 18. The nurse is orienting a new nurse to the c. Related to impaired balance oncology unit. When reviewing the safe d. Related to psychomotor seizures administration of antineoplastic agents, what action should the nurse emphasise? 22. A female client with cancer is scheduled for radiation therapy. The nurse knows that a. Adjust the dose to the patient's present radiation at any treatment site may cause a symptoms. certain adverse effects. Therefore, the nurse b. Wash hands with an alcohol-based cleanser should prepare the client to expect: following administration. c. Use gloves and a lab coat when preparing the a. hair loss. medication. b. Stomatitis. d. Dispose of the antineoplastic wastes in the c. Fatigue. hazardous waste receptacle. d. vomiting. 19. A nurse is creating a plan of care for an 23. A male client undergoes a laryngectomy to oncology patient and one of the identified treat laryngeal cancer. When teaching the client how nursing diagnoses is risk for infection related to care for the neck stoma, the nurse should include to myelosuppression. What intervention which instruction? addresses the leading cause of infection- related death in oncology patients? a. "Keep the stoma uncovered." b. "Keep the stoma dry." a. Encourage several small meals daily. c. "Have a family member perform stoma care b. Provide skin care to maintain skin integrity. initially until you get used to the procedure." c. Assist the patient with hygiene, as needed. d. "Keep the stoma moist." d. Assess the integrity of the patient's oral mucosa regularly. 24. A female client is receiving chemotherapy to treat breast cancer. Which assessment 20. For a female client with newly diagnosed finding indicates a fluid and electrolyte cancer, the nurse formulates a nursing imbalance induced by chemotherapy? diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which a. Urine output of 400 ml in 8 hours expected outcome would be appropriate for b. Serum potassium level of 3.6 mEq/L this client? c. Blood pressure of 120/64 to 130/72 mm Hg d. Dry oral mucous membranes and cracked lips a. "Client verbalises feelings of anxiety." b. "Client doesn't guess at the prognosis." 24. A client, age 41, visits the gynaecologist. After c. "Clients use any effective method to reduce examining her, the physician suspects cervical cancer. tension." The nurse reviews the client's history for risk factors d. "Client stops seeking information." for this disease. Which history finding is a risk factor b. BUN increases for cervical cancer? c. Urinary output less than 400ml/24h d. Creatinine started to normalized a. Onset of sporadic sexual activity at age 17 b. Spontaneous abortion at age 19 Situation: Acute Renal Failure is a reversible clinical c. Pregnancy complicated with eclampsia at age syndrome whereby there is sudden and pronounced 27 loss of kidney function. The question below pertains d. Human papillomavirus infection at age 32 to Renal Failure both in Acute and Chronic Stages. 25. A 35 years old client has been receiving 2. A client is admitted to the hospital with a diagnosis chemotherapy to treat cancer. Which of early-stage chronic renal failure. Which of the assessment finding suggests that the client following should the nurse expect to note on client has developed stomatitis (inflammation of the assessment? mouth)? a. Anuria. a. White, cottage cheese-like patches on the b. Polyuria. tongue c. Oliguria. b. Yellow tooth discoloration d. Polydipsia. c. Red, open sores on the oral mucosa d. Rust-coloured sputum 3. The client newly diagnosed with chronic renal failure recently has begun hemodialysis. Knowing that 26. A nurse should suspect meningitis if a patient the client is at risk for disequilibrium syndrome, the exhibited characteristic position which would be: nurse assesses the client during dialysis for: a. knees pulled up a. Hypertension, tachycardia, and fever. b. joints of hands flexed b. Hypotension, bradycardia, and hypothermia. c. backward arching of the spine c. Restlessness, irritability, and generalised d. head pulled forward onto the chest weakness. d. Headache, deteriorating level of 27. All of the following are part of the nurse's role consciousness, and twitching. in infection control except: 4. Assessing the laboratory findings, which result a. recognizing the signs and symptoms of would the nurse most likely expect to find in a client infection with chronic renal failure? b. collecting specimens of drainage from infected wound sites a. BUN 10 to 30 mg/dl, potassium 4.0 mEq/L, c. deciding upon the appropriate to be creatinine 0.5 to 1.5 mg/dl antibiotic to be administered to the client b. Decreased serum calcium, blood pH 7.2, d. supporting the client's body defense potassium 6.5 mEq/L mechanisms c. BUN 15 mg/dl, increased serum calcium, creatinine l.0 mg/dl —--------------------------------------------------------------------- d. BUN 35 to 40 mg/dl, potassium 3.5 mEq/L, pH PART II 7.35, decreased serum calcium 1. During the diuretic phase of acute renal failure 5. A client with chronic kidney disease (CKD) is about which of the following should be most expected? to begin hemodialysis therapy. The client asks the nurse about the frequency and scheduling of a. There is an increase in urine output from 1 to hemodialysis treatments. The nurse's response is 3 litres/ day. based on an understanding that which represents the b. Are you taking your blood pressure typical schedule? medication? c. How much activity are you getting in a day? a. 5 hours of treatment 2 days per week d. Have you noticed any swelling at the dialysis b. 2 hours of treatment 6 days per week sites c. 3 to 4 hours of treatment 3 days per week d. 2 to 3 hours of treatment 5 days per week 9. When caring for a patient during the oliguric phase of acute kidney injury, what would be an appropriate 6. A client with chronic renal failure has an internal nursing intervention? venous access site for hemodialysis on her left forearm. What action will the nurse take to protect a. Weigh patient three times weekly this access site? b. Increase dietary sodium and potassium c. Provide a low-protein, high-carbohydrate diet a. Irrigate with heparin and NS q8 hrs d. Restrict fluids according to the previous day's b. Apply warm moist packs to the area after fluid loss hemodialysis c. Do not use the left arm to take blood Situation: Romeo, age 78, is admitted to the hospital pressure readings. with the diagnosis of benign prostatic hyperplasia d. Keep the arm elevated above the level of the (BPH). He is scheduled for a transurethral resection of heart. the prostate (TURP). 7. You are teaching the patient with chronic kidney 10. It would be inappropriate to include which of the disease about what symptoms to report to the doctor following points in the preoperative teaching? when outside of the hospital. Which statement, if made by the patient, indicates correct understanding? a. TURP is the most common operation for BPH. b. Explain the purpose and function of a a. "I should call my doctor if my stomach starts two-way irrigation system. feeling sick or my breath smells funny like c. Expect bloody urine, which will clear as pea" healing takes place. b. "Muscle weakness and abdominal cramps are d. He will be pain free. a sign of worsening condition and I should report this to my doctor" 11. As part of the preoperative teaching, the nurse c. "My doctor wants me to call him if I feel a should tell the client 7 that after surgery: vibrating or buzzing sensation over my dialysis gram” a. Urinary control may be permanently lost to d. "I should call immediately if I see swelling at some degree my dialysis port" b. Urinary drainage will be dependent on a urethral catheter for 24 hours 8. The patient with hemodialysis for ESRD arrives to c. Frequency and burning on urination will last the clinic c/o DOE and fatigue. The vitals are as while the cystostomy tube is in place follows: BP 154/89 HR 78 RR 18 T 95.5 Spo2 90%. d. His ability to perform sexually will be Upon auscultation crackles are noted in bases of permanently impaired lungs. The patient also states that he has been experiencing muscle aches. What is the first question 12. The transurethral resection of the prostate is the nurse should ask? performed on a client with BPH. Following surgery, nursing care should include: a. Have you been following your dietary restrictions? a. Changing the abdominal dressing b. Maintaining patency of the cystostomy tube c. Maintaining patency of a three-way Foley 17. Clinical assessment of fluid volume deficit would catheter for cystoclysis be confirmed if the nurses identify which of the d. Observing for haemorrhage and wound following? infection a. 1 lb weight loss 13. In the early postoperative period following a b. Engorged neck vein transurethral surgery, the most common complication c. Dry mucous membrane the nurse should observe for is: d. Full bounding pulse a. Sepsis 18. The client who has a diagnosis of fluid volume b. Haemorrhage deficit was told to monitor his BUN and Creatinine. c. Leakage around the catheter Which of the following is an expected result of the d. Urinary retention with overflow patient’s BUN and Creatinine level? 14. Twenty-four hours after TURP surgery, the client a. The BUN will decrease and the creatinine will tells the nurse he has lower abdominal discomfort. increase The nurse notes that the catheter drainage has b. The BUN will increase and creatinine will stopped. The nurse’s initial action should be to: decrease c. Both the BUN and creatinine will increase a. Irrigate the catheter with saline d. Both the BUN and creatinine will decrease b. Milk the catheter tubing c. Remove the catheter 19. Which of the following nursing diagnoses might d. Notify the physician apply to a patient with fluid volume deficit? 15. The nurse would know that a post-TURP client a. Altered urinary elimination understood his discharge teaching when he says “I b. Decreased cardiac output should be worried if my urine output is decreased” c. Increased Cardiac output d. Impaired physical mobility a. Get out of bed into a chair for several hours daily b. Call the physician if my urinary stream 20. Which one of the following medications could decreases potentially exacerbate the problem of patients with c. Attempt to void every 3 hours when I’m FVD? awake d. Avoid vigorous exercise for 6 months after a. Synthroid surgery b. Digoxin c. Lasix 16. This type of fluid imbalance occurs when the loss d. Insulin of ECF volume exceeds the intake of fluids and when the water and electrolytes are lost in the same proportion? a. Fluid Volume Excess b. Fluid Volume Deficit c. Rehydration d. None of the above —--------------------------------------------------------------------- A) Psychosocial stress PART III B) Hypersensitivity to an immunization C) Menarche 1. A 50-year-old man diagnosed with leukemia will D) Streptococcal infection begin chemotherapy. What would the nurse do to combat the most common adverse effects of Ans: D Feedback: Post Infectious causes of post chemotherapy? infectious glomerular disease are group A beta-hemolytic streptococcal infection of the throat A) Administer an antiemetic. that precedes the onset of glomerulonephritis by 2 to B) Administer an antimetabolite. 3 weeks. Menarche, stress, and hypersensitivity are C) Administer a tumor antibiotic. not typical causes D) Administer an anticoagulant. 5. The nurse is caring for a patient who underwent Ans: A Feedback: Antiemetics are used to treat nausea percutaneous lithotripsy earlier in the day. What and vomiting, the most common adverse effects of instruction should the nurse give the patient? chemotherapy. Antihistamines and certain steroids are also used to treat nausea and vomiting. A) Limit oral fluid intake for 1 to 2 days. Antimetabolites and tumor antibiotics are classes of B) Report the presence of fine, sand like particles chemotherapeutic medications. Anticoagulants slow through the nephrostomy tube. blood clotting time, thereby helping to prevent C) Notify the physician about cloudy or foul-smelling thrombi and emboli urine. D) Report any pink-tinged urine within 24 hours after 3. The nurse is caring for a patient with a history of the procedure. systemic lupus erythematosus who has been recently diagnosed with end-stage kidney disease (ESKD). The Ans: C Feedback: The patient should report the patient has an elevated phosphorus level and has presence of foul-smelling or cloudy urine since this is been prescribed calcium acetate to bind the suggestive of a UTI. Unless contraindicated, the phosphorus. The nurse should teach the patient to patient should be instructed to drink large quantities take the prescribed phosphorus-binding medication at of fluid each day to flush the kidneys. Sand like debris what time? is normal due to residual stone products. Hematuria is common after lithotripsy A) Only when needed B) Daily at bedtime 6. The clinic nurse is preparing a plan of care for a C) First thing in the morning patient with a history of stress incontinence. What D) With each meal role will the nurse have in implementing a behavioral therapy approach? Ans: D Feedback: Both calcium carbonate and calcium acetate are medications that bind with the phosphate A) Provide medication teaching related to and assist in excreting the phosphate from the body, pseudoephedrine sulfate. in turn lowering the phosphate levels. B) Teach the patient to perform pelvic floor muscle Phosphate-binding medications must be administered exercises. with food to be effective. C) Prepare the patient for an anterior vaginal repair procedure. 4. A 15-year-old is admitted to the renal unit with a D) Provide information on periurethral bulking. diagnosis of post infectious glomerular disease. The nurse should recognize that this form of kidney Ans: B Feedback: Pelvic floor muscle exercises disease may have been precipitated by what event? (sometimes called Kegel exercises) represent the cornerstone of behavioral intervention for addressing symptoms of stress, urge, and mixed incontinence. None of the other listed interventions has a behavioral approach. 7. The nurse is assessing the patient for the presence of Chvostek’s sign. What electrolytes imbalance would a positive Chvostek’s sign indicate? A) Hypermagnesemia B) Hyponatremia C) Hypocalcemia D) Hyperkalemia Ans: C 8. A patient with a longstanding diagnosis of generalised anxiety disorder presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause of which acid base imbalance? A) Respiratory acidosis B) Respiratory alkalosis C) Increased PaCO2 D) CNS disturbances Ans: B Rationale: The most common cause of acute respiratory alkalosis is hyperventilation. Extreme anxiety can lead to hyperventilation. Acute respiratory acidosis occurs in emergency situations, such as pulmonary edema, and is exhibited by hypoventilation and decreased PaCO2. CNS disturbances are found in extreme hyponatremia and fluid overload An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do? A) Periodically apply ice to the area. B) Keep the area cleanly shaven. C) Apply petroleum jelly to the affected area. D) Avoid using soap on the treatment area. Ans: D Feedback: Care to the affected area must focus on preventing further skin irritation, drying, and damage. Soaps, petroleum ointment, and shaving the area could worsen the erythema. Ice is also contraindicated

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