MED SURG II - EXAM #2 - COMBINED

The nurse is caring for a client with recurrent hemoptysis who has undergone a bronchoscopy. Immediately following the procedure, the nurse should complete which action?

 The nurse is developing a plan of care for a client with pulmonary embolism (PE). Which client problem does the nurse establish as the priority?

The nurse is assessing a client with possible pulmonary embolism (PE). For which symptoms consistent with PE will the nurse assess? select all that apply. (3)

A nurse is caring for four clients on intravenous heparin therapy. Which laboratory value possibly indicates that a serious side effect has occurred?

A nurse is assisting the health care provider who is intubating a client. The provider has been attempting to intubate for 40 seconds. What action by the nurse takes priority?

The client is admitted to the medical unit diagnosed with a PE. Which intervention should the nurse implement?

A client is hospitalized with a second episode of pulmonary embolism (PE). Recent genetic testing reveals the client has an alteration in the gene CYP2C19. What action by the nurse is best?

The nurse is caring for a client who is scheduled for a bronchoscopy. The nurse understands that it is important to provide the required information and appropriate explanations for any diagnostic procedure to a client with a respiratory disorder in a way that

The nurse is preparing to educate the client on how to perform incentive spirometry. Which concepts should the nurse include?

Which ventilator mode provides a combination of mechanically assisted breaths and spontaneous breaths?

Arterial blood gases should be obtained how often after initiating continuous mechanical ventilation

The nurse assesses a patient for a possible pulmonary embolism. The nurse looks for the most frequent sign of:

What are the possible complications in a patient with pulmonary embolism?

What finding would indicate a decrease in pressure with mechanical ventilation?

A client diagnosed with impaired gas exchange. While performing a physical assessment of the client, which data is the nurse likely to find, keeping in mind the client's diagnosis?

A patient has been hospitalized in the ICU for a near drowning event. The patient's respiratory function has been deteriorating over the last 24 hours. The physician suspects acute respiratory distress syndrome. A STAT chest x-ray is ordered. What finding on the chest x-ray is indicative of ARDS?*

Who performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for how long?

The bilevel positive airway pressure (bi-PAP) ventilatior offers independent control of inspiratory and expiratory pressures while providing pressure support ventilation. It delivers two levels of positive airway pressure provided via a nasal or oral mask, nasal pillow, or mouthpiece with a tight seal and portable ventilator.

for a patient to be safely weaned from a ventilator the minute ventilation should be

The endotracheal tube cuff pressure should be checked every

Which of the following are goals of chest physiotherapy (CPT)

A nurse assess arterial blood gas results for a patient in acute respiratory distress syndrome (ARDS). Which values indicate respiratory acidosis

A nurse assess arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder?

After a bronchoscopy the nurse should assess for

The cuff pressure for endotracheal tubes should be maintained between

Hypoxia usually leads to hypoxemia, a decrease in oxygen supply to the tissues

For a patient to be safely weaned from a ventilator, the tidal volume should be

Cirrhosis results in shunting of portal system blood into collateral blood vessels in the GI tract. The most common sites are the esophagus, lower rectum, and stomach.

A patient is mechanically ventilated with an oral endotracheal tube in place. The nurse observes that the cuff pressure is 25 mm Hg. The nurse is aware of what complications can be caused by this pressure. (Select all that apply.) (3)

For a patient to be weaned from a ventilator, the vital capacity should be between

Decreased oxygen supply to the tissues is termed

The nurse hears the patient’s ventilator alarm sound and attempts to find the cause. What is the priority action of the nurse when the cause of the alarm is not able to be determined?

Mr. Brown, a 25-year-old man with a drug overdose, has been maintained on a volume-cycled ventilator for 3 weeks. Which of the following indicates the patient is experiencing hypoxia and hypoxemia

Positive Pressure Ventilators inflate the lungs by exerting pressure on the airway, pushing air in, and forcing the alveoli to expand during inspiration

What does the nurse recognize as an optimal PaO2 range for the patient weaning from oxygen?

Mr. Brown, a 25-year-old man with a drug overdose, has been maintained on a volume-cycled ventilator for 3 weeks. What is the priority nursing assessment indicated for this patient

A patient is diagnosed with mild obstructive sleep apnea after having a sleep study performed. What treatment modality will be the most effective for this patient?

The nurse is using an in-line suction kit to suction a patient who is intubated and on a mechanical ventilator. What benefits does in-line suction have for the patient? (Select all that apply.)

A decrease in the arterial oxygen tension in the blood

Mr. Brown, a 25-year-old man with a drug overdose, has been maintained on a volume-cycled ventilator for 3 weeks. Before weaning, what should his ventilatory capacity be? Select all that apply

A patient has been receiving 100% oxygen therapy by way of a nonrebreather mask for several days. Now the patient reports tingling in the fingers and shortness of breath, is extremely restless, and describes a pain beneath the breastbone. What condition should the nurse suspect?

The nurse auscultates crackles in a patient with a respiratory disorder. What condition does the nurse recognize that these symptoms are indicative of?

A nurse caring for a patient with a pulmonary embolism understands that high ventilation–perfusion ratio may exist. What does this mean for the patient?

A nurse understands that a safe but low level of oxygen saturation provides for adequate tissue saturation while allowing no reserve for situations that threaten ventilation. What is a safe but low oxygen saturation level for a patient?

The nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation?

The nurse is educating the patient in the use of a mini-nebulizer. What should the nurse encourage the patient to do? (Select all that apply.)

The nurse is educating a patient with COPD about the technique for performing pursed lip breathing. What does the nurse inform the patient is the importance of using this technique?

What finding by the nurse may indicate that the patient has chronic hypoxia?

Gas exchange between the lungs and blood, and between the blood and tissues is called

Which of the following causes low compliance or distensibility of the lungs (6)

The nurse is admitting a patient with chronic obstructive pulmonary disorder (COPD). The decrease of what substance in the blood gas analysis would indicate to the nurse that the patient is experiencing hypoxemia?

A patient in the ICU has been orally intubated and on mechanical ventilation for 2 weeks after having a severe stroke. What action does the nurse anticipate the healthcare provider will take now that the patient has been intubated for this length of time?

Which of the following are major signs and symptoms of respiratory disease (4)

A patient with Hepatitis is extremely confused. The patient is diagnosed with Hepatic Encephalopathy. What lab result would correlate with this mental status change?

TRUE or FALSE: A patient with Hepatitis A is contagious about 2 weeks before signs and symptoms appear and 1-3 weeks after the symptoms appear.

The symbol used to identify the partial pressure of oxygen is PaO2

The movement of air in and out of the airways is referred to as

Which of the following is NOT a common source of transmission for Hepatitis A? Select all that apply:

A mechanically ventilated client is receiving a combination of atracurium and the opioid analgesic morphine. The nurse monitors the client for which potential complication?

Which of the following are complications the nurse should be aware may occur during a bronchoscopy?

Which condition is NOT a known cause of cirrhosis?

A patient is diagnosed with Hepatitis A. The patient asks how a person can become infected with this condition. You know the most common route of transmission is?

What is the MOST common transmission route of Hepatitis C?

A 45 year old male has cirrhosis. The patient reports concern about the development of enlarged breast tissue. You explain to the patient that this is happening because?

A. The liver cells are removing too much estrogen from the body which ca

Which of the following is NOT a role of the liver?

Select all the types of viral Hepatitis that have preventive vaccines available in the United States?

You're caring for a 45-year-old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. As a nurse, you know the two most common causes of acute pancreatitis are:

A client is on intravenous heparin to treat a pulmonary embolism. The clients most recent partial thromboplastin time (PTT) was 25 seconds. What order should the nurse anticipate?

You’re providing an in-service on viral hepatitis to a group of healthcare workers. You are teaching them about the types of viral hepatitis that can turn into chronic infections. Which types are known to cause ACUTE infections ONLY? Select all that apply:

A nurse is caring for a client with pulmonary edema whose respiratory status is declining. Chronologically arrange the nursing interventions to prioritize care. All options must be used. 

In acid-base balance, the normal plasma PCO2 and bicarbonate levels are disturbed. Match the changes in this parameter with the disorders in the given choices: Increased plasma bicarbonate (HCO3-)

If a client continues to hypoventilate, the nurse will continually assess for a complication of:

Pink, frothy sputum may be an indication of 

Conditions associated with decreased compliance include

The nurse is caring for a patient who experiences frequent generalized tonic-clonic seizures associated with periods of apnea. The nurse must be alert for which acid-base imbalance?

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices ?

A male adult patient hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?

The respiratory system regulates acid-base balance by:

In chronic liver dysfunction clients have problems with insufficient vitamin intake. Which may occur as a result of vitamin C deficiency? 

The assistive personnel (AP) reports to the nurse that a patient seems very anxious, and vital sign measurement included a respiratory rate of 38 breaths/min. Which acid-base imbalance should the nurse suspect?

Which visualizes the pancreas via endoscopy

Ruptured Esophageal Varices are the most common single cause of death in patients with cirrhosis

When the nurse is caring for a patient with acute pancreatitis, what intervention can be provided in order to prevent atelectasis and prevent pooling of respiratory secretions?

Liver Function Tests do not reveal abnormal results until ____ of the liver is damaged

Which visualizes the biliary structure

Which type of hepatitis is mosly caused by contaminated needles shared by drug users.

Which visualizes the liver and pancreas

The endocrine secretions of the pancreas are

A patient who had a recent myocardial infarction was brought to the emergency department with bleeding esophageal varices and is presently receiving fluid resuscitation. What first-line pharmacologic therapy does the nurse anticipate administering to control the bleeding from the varices?

A major cause of morbidity and mortality in patients with acute pancreatitis is pancreatic necrosis

The most common reasion for liver transplantation is exposure to

Which identifies small tumors and facilitates fine needle aspiration biopsy

The patient admitted with acute pancreatitis has passed the acute stage and is now able to tolerate solid foods. What type of diet will increase caloric intake without stimulating pancreatic enzymes beyond the ability of the pancreas to respond?

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor?

A patient is scheduled for a diagnostic paracentesis, but when coagulation studies are reviewed, the nurse observes results outside of normal parameters. How does the nurse anticipate the healthcare provider will proceed with the paracentesis?

What intervention does the nurse anticipate providing for the patient with ascites that will help correct the decrease in effective arterial blood volume that leads to sodium retention?

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder?

A patient with acute pancreatitis puts the call bell on to tell the nurse about an increase in pain. The nurse observes the patient guarding; the abdomen is board like and no bowel sounds are detected. What is the major concern for this patient?

What is a major concern for the nurse when caring for a patient with chronic pancreatitis?

A patient is suspected to have pancreatic carcinoma and is having diagnostic testing to determine insulin deficiency. What would the nurse determine is an indicator for insulin deficiency in this patient? (Select all that apply.)

The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler position. What is the nurse’s priority assessment of this patient?

The nurse is administering lactulose to decrease the ammonia level in a patient who has hepatic encephalopathy. What should the nurse carefully monitor for that may indicate a medication overdose?

The nurse should assess for an important early indicator of acute pancreatitis. What prolonged and elevated level would the nurse determine is an early indicator?

A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. What vitamin deficiency does the nurse suspect the patient may be experiencing?

The nurse is educating a patient who has been treated for hepatic encephalopathy about dietary restrictions to prevent ammonia accumulation. What should the nurse include in the teaching?

The nurse is caring for a patient with ascites as a result of hepatic dysfunction. What intervention can the nurse provide to determine if the ascites is increasing? (Select all that apply.)

The nurse is caring for a patient with ascites due to cirrhosis of the liver. What position does the nurse recognize will activate the renin–angiotensin–aldosterone and sympathetic nervous system and decrease responsiveness to diuretic therapy?