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Quiz to prepare for the med surg final exam.

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MED SURG

Pregunta 1 de 54

1

You have been caring for a 58-year-old male who underwent a radical neck dissection. He is being transferred from the PACU to a step-down unit. You are giving handover to the nurse from the step-down unit. What is the main purpose of your report?

Selecciona una de las siguientes respuestas posibles:

  • To anticipate patient needs and potential problems

  • To make the patient and family more comfortable, knowing that someone cares

  • To make sure that all post-op orders will be followed on the new unit

  • To help the new nurse make sure that s/he has a good understanding of the patient's tubes and drains

Explicación

Pregunta 2 de 54

1

Which of the following statements is true regarding delayed awakening?

Selecciona una de las siguientes respuestas posibles:

  • It is a form of delirium that requires swift intervention.

  • It is a medical emergency.

  • It may occur in patients with renal insufficiency.

  • It is always accompanied by other symptoms, such as hypoxemia, hypoventilation, and low BP.

Explicación

Pregunta 3 de 54

1

Select all appropriate nursing interventions directed at preventing pulmonary complications post-operatively.

Selecciona una o más de las siguientes respuestas posibles:

  • Encourage deep breathing and coughing

  • Place the patient in a supine position

  • Encourage early ambulation

  • Manage pain effectively

  • Teach the patient how to use an incentive spirometer

Explicación

Pregunta 4 de 54

1

You are caring for a 72-year-old female who underwent a hysterectomy, salpingo-oopherectomy, and bilateral LND. She is post-op day 2. You received handover this morning and the night nurse told you that the patient has had a low urine output. During your assessment, you notice that her extremities are cold, her BP is low, her HR is high, and she seems restless. You suspect that the patient may be experiencing...

Selecciona una de las siguientes respuestas posibles:

  • hypovolemic shock

  • hemorrhage

  • orthostatic hypotension

  • emergent delirium

Explicación

Pregunta 5 de 54

1

Of the following nursing interventions, which is the most important to prevent cardiac complications?

Selecciona una de las siguientes respuestas posibles:

  • Encouraging leg exercises while in bed

  • Frequent turning and re-positioning (e.g. q2h)

  • Administering anticoagulants (e.g. heparin)

  • Encouraging early ambulation

Explicación

Pregunta 6 de 54

1

What is the minimum amount of urine output we want patients to have?

Selecciona una de las siguientes respuestas posibles:

  • 30cc/h

  • 60cc/h

  • 100cc/h

  • 10cc/h

Explicación

Pregunta 7 de 54

1

Select all correct characteristics of pain.

Selecciona una o más de las siguientes respuestas posibles:

  • multidimensional

  • always caused by identifiable tissue damage

  • subjective

  • objective

  • over-reported

  • the most common cause of disability among working-age adults in Canada

Explicación

Pregunta 8 de 54

1

In Canada, nurses routinely administer the smallest prescribed dose of analgesics when a range of doses is prescribed.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 9 de 54

1

The manifestations of acute pain reflect the ________ nervous system activation, whereas chronic pain manifests as predominantly ________ changes.

Selecciona una de las siguientes respuestas posibles:

  • sympathetic; behavioural

  • parasympathetic; behavioural

  • sympathetic; affective

  • central; lifestyle

Explicación

Pregunta 10 de 54

1

The intensity of acute postoperative pain is a significant predictor of the presence and severity of persistent postoperative pain.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 11 de 54

1

What does the acronym PQRST stand for with regard to assessing pain?

Selecciona una de las siguientes respuestas posibles:

  • provokes; quality; radiates; severity; time

  • provokes; quantity; region; severity; time

  • persistence; quality; radiates; severity; time

  • provokes; quality; region; severity; threshold

Explicación

Pregunta 12 de 54

1

A patient's self report of pain is very unreliable; it is the responsibility of the nurse and other healthcare providers to corroborate self reporting with other data.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 13 de 54

1

What is one of the most important the first signs that a patient may be developing a tolerance to a certain analgesic?

Selecciona una de las siguientes respuestas posibles:

  • The patient begins to experience regular end-of-dose failure

  • The patient's self-report does not change (i.e. pre-dose 9/10, post-dose still 9/10)

  • The patient starts to exhibit signs of withdrawal

  • The family says that the patient needs to get a higher dose

Explicación

Pregunta 14 de 54

1

You are caring for an 82-year-old female who is recovering from a hip replacement. The patient is experiencing acute pain in addition to her chronic pain. The daughter asks you, "Why aren't the doctors giving her naproxen? I use it all the time and it works for me." What is the best response to the daughter's question?

Selecciona una de las siguientes respuestas posibles:

  • "Naproxen is a type of drug called a nonsteroidal anti-inflammatory drug and it isn't given to elderly patients because of the risk of it causing a bleed in the digestive system."

  • "Naproxen is an old class of drug that isn't prescribed much anymore."

  • "Naproxen is too weak of a drug and it wouldn't do anything to help your mother's pain."

  • "You should ask the physician when she comes by."

Explicación

Pregunta 15 de 54

1

Which of the following is the best definition of "failure to rescue"?

Selecciona una de las siguientes respuestas posibles:

  • Preventable injury to or death of a patient that resulted from our inability to detect, recognize, and prevent acute deterioration

  • The failure of the healthcare team to detect and recognize deterioration

  • The failure of nurses to regularly observe the patient (e.g. monitoring of vital signs is not prioritized)

  • Death that occurs after a patient develops a complication before admission to hospital

Explicación

Pregunta 16 de 54

1

Which of the following is the most common cause of coronary artery disease (CAD)?

Selecciona una de las siguientes respuestas posibles:

  • Atherosclerosis

  • Previous myocardial infarction

  • Familial history of CAD

  • Smoking

Explicación

Pregunta 17 de 54

1

Select all modifiable risk factors from the following list.

Selecciona una o más de las siguientes respuestas posibles:

  • physical inactivity

  • obesity

  • hypertension

  • serum lipid levels

  • tobacco use

  • genetics

  • age

  • sex

Explicación

Pregunta 18 de 54

1

You enter a patient's room at the start of your shift. The patient says, "Nurse, I have a funny feeling in my chest and I feel like I might throw up." What is the best course of action?

Selecciona una de las siguientes respuestas posibles:

  • Begin a focused assessment based on your suspicion of myocardial infarction

  • Bring the patient a bucket in case he throws up and encourage the patient to drink lots of fluids

  • Check the patient's list of prescribed medications to rule out these symptoms as side effects

  • Call the Rapid Response Team because this patient is having a heart attack

Explicación

Pregunta 19 de 54

1

Stable angina can progress to unstable angina.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 20 de 54

1

Pain at rest is unusual for patients with chronic stable angina.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 21 de 54

1

What is the cause of insufficient oxygen supply in patients with chronic stable angina?

Selecciona una de las siguientes respuestas posibles:

  • Artherosclerosis

  • Myocardial myopathy

  • Hypocalcemia

  • Hypovolemia

Explicación

Pregunta 22 de 54

1

What is the most common reported symptom of chronic stable angina?

Selecciona una de las siguientes respuestas posibles:

  • Heaviness in the chest

  • Sharp pain in the chest

  • Radiating pain down the right arm

  • Nausea and vomiting

Explicación

Pregunta 23 de 54

1

A patient reports feeling pressure, burning, and crushing sensation in their chest. You notice that their forehead is dotted with sweat. What might this patient be experiencing?

Selecciona una de las siguientes respuestas posibles:

  • myocardial infarction

  • an episode of stable angina

  • heartburn

  • an episode of unstable angina

Explicación

Pregunta 24 de 54

1

A patient reports feeling episodes of heaviness in their chest that last 3-5 minutes. The pain goes away when they sit down and rest and feels similarly to heartburn. What is this patient most likely experiencing?

Selecciona una de las siguientes respuestas posibles:

  • Stable angina

  • Unstable angina

  • Myocardial infarction

  • Gastro-esophageal reflux disease

Explicación

Pregunta 25 de 54

1

Which form of atypical chronic stable angina is asymptomatic and is associated with diabetes mellitus?

Selecciona una de las siguientes respuestas posibles:

  • Silent ischemia

  • Nocturnal angina

  • Angina decubitus

  • Prinzmetal's angina

Explicación

Pregunta 26 de 54

1

Which form of atypical chronic stable angina occurs only while lying down and is relieved by standing or sitting?

Selecciona una de las siguientes respuestas posibles:

  • Silent ischemia

  • Nocturnal angina

  • Angina decubitus

  • Prinzmetal's angina

Explicación

Pregunta 27 de 54

1

The etiology of acute coronary syndrome is the deterioration of a once stable plaque that stimulates platelet aggregation and local vasoconstriction with thrombus formation. Which of the following result(s) in partial occlusion of the coronary arteries?

Selecciona una o más de las siguientes respuestas posibles:

  • unstable angina

  • non-ST segment elevation myocardial infarction

  • ST segment elevation myocardial infarction

Explicación

Pregunta 28 de 54

1

You are caring for a patient who has unstable angina. The patient's son asks you, "Why did my dad have a heart attack?" Which of the following is the best response?

Selecciona una de las siguientes respuestas posibles:

  • "Unstable angina is not a heart attack. It is a condition that leads to a narrowing of the arteries that deliver oxygen-rich blood to the heart. It is important that your father seek medical attention if his chest pain gets worse and is accompanied by other new symptoms."

  • "Your father had a heart attack because he has a history of coronary artery disease in his family."

  • "Certain risk factors, such as abdominal obesity, smoking, and high cholesterol, can lead to problems, such as a heart attack. It will be very important for your father to make alterations to his lifestyle."

  • "You should ask the physician."

Explicación

Pregunta 29 de 54

1

What is the first line of treatment for patients with a confirmed MI?

Selecciona una de las siguientes respuestas posibles:

  • Percutaneous coronary intervention (PCI)

  • Fibrinolytic therapy

  • Morphine

  • Oxygen delivered via non-rebreather mask

Explicación

Pregunta 30 de 54

1

_______ is the term for a state of decreased partial pressure of oxygen in arterial blood, whereas ________ is the term for a state of increased partial pressure of carbon dioxide in arterial blood.

Selecciona una de las siguientes respuestas posibles:

  • hypoxemia; hypercapnia

  • hypercapnia; hypoxemia

Explicación

Pregunta 31 de 54

1

Pneumonia, pulmonary edema, and ventilator-induced lung injury are all common causes of...

Selecciona una de las siguientes respuestas posibles:

  • hypoxemia

  • hypercapnia

  • myocardial infarct

  • shock

Explicación

Pregunta 32 de 54

1

COPD, drug overdoses with CNS depressants, and trauma to the spinal cord are all common causes of...

Selecciona una de las siguientes respuestas posibles:

  • hypoxemia

  • hypercapnia

  • hypertension

  • the progression of stable angina to unstable angina

Explicación

Pregunta 33 de 54

1

A patient reports having morning headaches, feeling disoriented, and generalized weakness. You note that the patient exhibits dyspnea and shallow respirations. You suspect that this client is exhibiting signs of....

Selecciona una de las siguientes respuestas posibles:

  • hypoxemia

  • hypercapnia

  • unstable angina

  • hemorrhage

Explicación

Pregunta 34 de 54

1

A patient reports feeling agitated. She is unable to speak without pausing and has a prolonged expiration. You suspect that she is exhibiting signs of...

Selecciona una de las siguientes respuestas posibles:

  • hypoxemia

  • hypercapnia

  • stable angina

  • COPD

Explicación

Pregunta 35 de 54

1

Your patient is tachycardic, tachypnic, and has a decreased O2 saturation. You note an audible stridor and nasal flaring. You suspect that this patient...

Selecciona una de las siguientes respuestas posibles:

  • has an airway obstruction

  • is hypoxemic

  • is experiencing an inflammatory response

  • has overdosed

Explicación

Pregunta 36 de 54

1

Select all of the subjective forms of data from the following:

Selecciona una o más de las siguientes respuestas posibles:

  • psychosocial assessment

  • past health history

  • medications

  • allergies

  • system review

  • physical examination

  • laboratory results (e.g. blood work)

  • diagnostic testing

Explicación

Pregunta 37 de 54

1

While performing preoperative teaching, a patient asks when she needs to stop drinking water before the surgery. Based on the most recent practice guidelines, the nurse tells the patient that:

Selecciona una de las siguientes respuestas posibles:

  • she must be NPO after breakfast

  • she need to be NPO after midnight

  • she can drink clear fluids up to 2 hours before surgery

  • she can drink clear fluids up until she is moved to the OR

Explicación

Pregunta 38 de 54

1

Choose the term that matches this description: "a minimally depressed level of consciousness with maintenance of the patient's protective airway reflexes."

Selecciona una de las siguientes respuestas posibles:

  • Procedural sedation

  • General anesthesia

  • Local anesthesia

  • Epidural

Explicación

Pregunta 39 de 54

1

Choose the term that best matches the following description: "The technique of choice for surgical procedures requiring significant skeletal muscle relaxation, control of respirations, or long procedures."

Selecciona una de las siguientes respuestas posibles:

  • General anesthesia

  • Local anesthesia

  • Procedural sedation

  • Spinal block

Explicación

Pregunta 40 de 54

1

Choose the term that best matches the following description: "Injection of anesthetic into the CSF below L2."

Selecciona una de las siguientes respuestas posibles:

  • Spinal block

  • Epidural block

  • General anesthesia

  • Procedural sedation

Explicación

Pregunta 41 de 54

1

How much blood is in the average human body?

Selecciona una de las siguientes respuestas posibles:

  • 5-6 L

  • 10 L

  • 2-3 L

  • 4-5 L

Explicación

Pregunta 42 de 54

1

The three main components of blood are plasma, erythrocytes, and the buffy coat. Plasma makes up __% of the blood, whereas erythrocytes make up __% of blood. The remainder is the buffy coat.

Selecciona una de las siguientes respuestas posibles:

  • 55; 45

  • 45; 55

  • 20; 70

  • 90; 8

Explicación

Pregunta 43 de 54

1

Health Canada is responsible for regulating blood donation, whereas it is the responsibility of the Canadian Blood Services and Hema-Quebec to actually screen donations.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 44 de 54

1

How much whole blood is collected per donation?

Selecciona una de las siguientes respuestas posibles:

  • 300 mL

  • 500 mL

  • 250 mL

  • 800 mL

Explicación

Pregunta 45 de 54

1

__ is known as the "universal donor" of RBCs, whereas __ is known as the "universal recipient" of RBCs.

Selecciona una de las siguientes respuestas posibles:

  • O; AB

  • AB; O

  • A; B

  • O; B

Explicación

Pregunta 46 de 54

1

Bob's blood type is O. Maria is type B. In theory, can Bob donate blood to Maria?

Selecciona una de las siguientes respuestas posibles:

  • Yes.

  • No, however, Maria could in theory donate blood to Bob.

Explicación

Pregunta 47 de 54

1

Peter's blood type is AB. Susan's blood type is B. In theory, could Peter donate plasma to Susan?

Selecciona una de las siguientes respuestas posibles:

  • Yes.

  • No, however, Susan could donate plasma to Peter.

Explicación

Pregunta 48 de 54

1

You are caring for a patient who has thrombocytopenia. You suspect that this patient may be ordered a transfusion of which of the following?

Selecciona una de las siguientes respuestas posibles:

  • Fresh Frozen Plasma

  • Platelets

  • Albumin

  • Cryoprecipitate

Explicación

Pregunta 49 de 54

1

You are caring for a patient who needs treatment for a massive bleed, who also has a low fibrinogen concentration. You suspect that this patient may be ordered a transfusion of which of the following?

Selecciona una de las siguientes respuestas posibles:

  • Fresh Frozen Plasma

  • Platelets

  • Cryoprecipitate

  • Albumin

Explicación

Pregunta 50 de 54

1

Can an RN independently obtain informed consent prior to a procedure or surgery?

Selecciona una de las siguientes respuestas posibles:

  • No, however, it is the nurse's responsibility to ensure that consent has been given.

  • No. It is not the nurse's responsibility to deal with consent.

  • Yes, an RN can obtain informed consent from a patient.

  • Yes, an RN can obtain informed consent from a patient so long as there is another nurse who can sign the form as a witness.

Explicación

Pregunta 51 de 54

1

When administering blood products, the nurse knows that s/he can only use _____ to administer, as other solutions will cause hemolysis.

Selecciona una de las siguientes respuestas posibles:

  • normal saline

  • ringer's lactate

  • D5W

  • 2/3 + 1/3 with 20 KCl

Explicación

Pregunta 52 de 54

1

Blood products should be administered over a period of ___ if tolerated. The maximum infusion time for a blood product is ___.

Selecciona una de las siguientes respuestas posibles:

  • 2 hours; 4 hours

  • 30 minutes; 1 hour

  • 4 hours; 6 hours

  • 1 hour; 2 hours

Explicación

Pregunta 53 de 54

1

Select all common signs of a transfusion reaction:

Selecciona una o más de las siguientes respuestas posibles:

  • fever

  • urticaria

  • decreased LOC

  • dyspnea

  • hypotension

  • hypertension

Explicación

Pregunta 54 de 54

1

You are administering a blood product to your patient. 15 minutes after the start of the infusion, the patient reports nausea. You notice he is experiencing dyspnea, urticaria, and a fever. You suspect he is having a transfusion reaction. What should you do first?

Selecciona una de las siguientes respuestas posibles:

  • Stop the transfusion.

  • Document your findings.

  • Recheck patient ID and blood product tags.

  • Notify the MD and the blood bank.

Explicación

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