Featured

Story Time About the Dog and His Owner.

"You must give everything to make your life as beautiful as the dreams that dance in your imagination"-Roman Payne.
My handsome big dog dedicated to his owner.Runs errand for the owner.
The dog is asked to go into the house and bring kola nut(this could be anything for
entertainment)

It is a bedtime story about a dog and his owner.The owner surprisingly had visitors that they were not expecting .So the owner started a song like this.

My handsome big dog go into the house in the living room and get me some kola nut, so that we can give to these uninvited visitors.I did not invite them and I am sure that you did not invite them.So come on big boy go into the house and get me some kola nut so that we can give to these strangers.Hopefully the kola nut will force them to tell us why they are here.

So the dog went into the house and got the kola nut.The uninvited strangers ate the kola nut.After eating the Kola nut (coca cola) they confessed that they are interested in buying the piece of land in their backyard so that they could be their neighbor.Sometimes a kind gesture can lead to meeting pretty nice people.The dog owner told them that she owns the land but the land is not for sale.So they left back to where they came from.The big dog and his owner live happily there after .The End.

Featured

My Honor As A Nurse.

On my honor as a Registered Nurse.


I will provide compassionate excellent Nursing care.

I will do my best now and tomorrow.
Be a good leader,not a follower.
I must Move Nursing Agenda Forward.
I must do my Best all the time.
I promise to update and obtain required CE every two years.
Advance my knowledge,education,and experiences.
I will be Knowledgeable not Knowledge Deficit.
Team player,work effectively with my colleagues and other ancillary.
Clock or sign in on time.
Clock or Sign out on time. Have all my equipment such as Stethoscope,Pen and Pencils.
I must Reason,and be Reasonable.
Perform my assigned role effectively and efficiently. Follow Hospital policies and Regulations.
Comply with JCAHO Standards of Care and Regulations.
Carry out Doctors Orders on Time.
Troubleshoot and be Supportive of my Colleagues. Know and Understand Patient Bill of Rights.
Respect Patient and Families. “The very First Requirements in a Hospital is that, it should do the sick no harm “Florence Nightingale .
Give medications by mouth and intravenously as ordered. Advocate for my Patients.
And provide TLC.
Must not Abuse Patients Physically, Emotionally or Sexually.
Promote Health and Prevent Diseases.
“I attribute my Success to this -I never gave or took any excuse”- Florence Nightingale .
Nursing Assessment.

Comprehensive Questions and Answers.

(401)What is the antidote for coumadin?.

(A) Protamine sulfate.

(B) Vitamin K.

(C )Narcan.

(D )Streptokinase.

Ccorrect answer B.

Rationale: Inhibits blood clotting by interfering with hepatic synthesis of Vitamin clotting factors. Vitamins K helps with the clotting. Antidote for heparin is Protamine sulfate. Antidote for opioids is Narcan.

(402) Laboratory test to test the actions of heparin are?

(A) Sedimentation rate.

(B) WBC,and CBC.

(C) Partial Thromboplastin time or PTT.

D Coag and ABG.

Correct answer C.Rationale : PT and PTT test is for heparin while PT test is for Coumadin.

(403)When it comes to patient education just because you teach it doesn’t mean that compliance will follow?

A True

B False

Correct answer A.

You have to educate and allow patient to return demonstration of what was taught because some patients are noncompliance no matter what.There should be a follow up teaching after discharge to minimize frequent flyers.

(404)Is pain subject or objective?.

(A )Pain is Subjective and objective. Objective is your findings example grimacing,vital sign high blood pressure. Subjective because it is what the patient said about pain his or pain level.

(B) It is what it is.

(C) It is hoax.Some of these patients come to the hospital to get high.

(D) He is sleeping that means that he is no in pain.

Correct answer A.

Rationale:Pain is always rated as patient said.It is not the amount of physical injury sustained by the patient but rather by complex determined factors such as medical history, psychological history, culture, age, sex,and beliefs. Some patient you can see it ,for example grimacing, moaning, increase in blood pressure and some you cannot see it.Follow the doctor orders.

(405)Free nerve endings in the skin, tissues and organs called Nociceptors located in the afferent fibers are known as?.

(A) Peptide.

(B) Receptor sites.

(C)Psychological dependence.

(D )Pain pathway.

Correct answer D.

(406)What is Opiate receptor?

(A)receptors that act in a highly selective manner with opiate drugs thus improving the potency of the drugs.

B Opiate has different receptor sites.

(C) Endogenous peptides.

(D) All of the above.

Correct answer A.

(407)It is a requirement that patients have nasal Swabs for MRSA collected within 24hours of admission.

(A )True.

(B) False.

Correct answer A

(408)The nurse plans care for a 45years old female admitted 2days ago for treatment of newly diagnosed bipolar disorder. The physician admitting orders included to give Lithium po Bid.Before administration of morning dose lithium, the nurse should?.

(A) Check to see if patient blood has been drawn that morning for a lithium level.

(B )Check the potassium levels.

(C) C02 level in the blood.

(D ) None of the above. Correct answer A.

(409)A male patient with obsessive compulsive disorder is often late for therapy sessions because of his need to shower for one hour each morning. In order to get the patient to therapy on time the nurse should take which of the following actions.

(A) Warn him to be ready on time.

(B) Cover for the patient.

(C) Awaken him early and allow him to shower for one hour.

(D) None of the above is correct.

Correct answer C.

(410)What are Opiate receptors?.

(A)Opiate receptors are found at the pre and post synaptic sites of the ascending pain transmission system in the dorsal horn of the spinal cord, the brainstem, thalamus and the cortex. Three Opiate receptors are Mu,delta and kappa. Each receptors play different roles.

(B ) All medications receptors.

(C )All of the above.

(D) None of the above is correct.

Correct answer A.

(411)The doctor placed patient on Coumadin (Warfarin).How will the prothrombin test result be expressed?.

(A) PT.

(B ) PTT.

(C )Coag.

(D)INR(international normalized ratio)

Correct answer D.

Rationale: Prothrombin time test is for Coumadin and is expressedas INR. PT and PTT is the test for heparin.

CHRONIC KIDNEY DISEASE. Questions and answers.

The kidneys are known as two heart-shaped organs. Each of this kidney is approximately the size of human fist.They are located on the back of the body, on each side of the spine, just below the rib cage.The main functions of the kidneys is to remove waste and water from the body.And they also produce essential hormones including vitamin D,renin,and erythropoietin. Also each of this kidney contains approximately one million function units called nephrons.The nephrons which is made up of two major parts, functions is to form urine and remove waste substances from the bloodstream. The glomerulus filters the blood, removing waste products while keeping proteins and blood cells in the bloodstream. As the functions of the kidney reduce. The kidney will have difficulty to balance fluids concentration in the body. Edema and Hypertension develops because the body cannot remove salts and fluids from bloodstream.

(1)All of the following are the functions of healthy kidney except?.

(A) produce parathyroid hormone.

(B )Removal of water and waste products from the body.

( C )Production of vitamin D.

(D)Produce erythropoietin.

Correct answer A.

Rationale:

The function of the kidney is not to produce parathyroid hormone. The parathyroid gland produces parathyroid hormone.

(2)KDIGO workgroup recommends restrictions of sodium for adults with chronic kidney disease is?.

(A)Less than 4gram.

(B)Less than 1gram.

(C)Less than 2gram.

(D)Greater than 5grams.

Correct answer C.

(3)What is the targeted blood pressure recommended for CKD patients?.

(A)120/80.

(B )130/80.

(C) 150/90.

(D)117/70.

Correct answer B.

(4)Anemia is associated with all of the following except?.

(A )Excess exercise and activity.

(B )Decreased in the quality of life.

(C )Feeling of tiredness .

(D) Dizziness.

Correct answer A.

Rationale: Low hemoglobin levels will make you to feel tired, lightheaded but not excessive activity because you cannot do what you want to do.

(5)The nurse on assessment of a 76years old man with chronic kidney disease will expect?.

(A)Renal response to sodium intake decreased. Blood urea nitrogen levels decreased by 10%.Kidney atrophy and increase in size.

(B ) Kidney disease is a hoax.

( C) Patient will not need dialysis.

(D) B and C.

Correct answer A.

Comprehensive Questions and answers in Nursing for nurses.

(381)What would put you at risk for contracting AIDS, Hepatitis B and C?.

(A )Exposure to sharing bathroom.

(B) Living in the same house with same patient.

(C) knowledge deficit.

(D )Exposure to blood and body fluids.

Correct answer D.

True or false

(382)In dry surrounding skin you should choose a dressing that keeps the ulcer bed moist while the surrounding intact(periulcer) skin dry.

A True.

B False

Correct answer True .

(383)All of the following is correct except?.

(A )Avoid overpacking wound.

Overpacking may increase pressure and cause additional tissue damage.

(C )Eliminate wound dead space by loosely filling all cavities with dressing material. Prevent abscess formation.

(D) Only losers change wound dressing.

Correct answer D.

(384)All of the following statement are correct except?.

(A )Pressure ulcer requires dressings to maintain physiological integrity.

(B)An ideal dressing should protect the wound, be biocompatible and provides hydration.

C It must be very dry.

D The cardinal rule is to keep the ulcer tissue moist and the surrounding intact skin remain dry and intact.

Correct answer C.

(385)What is Trousseau ‘a sign?

(A)It is carpopedal spasm known as spasmodic contractions of the hand and feet muscles triggered in about three minutes after blood pressure level went 20mmHg higher above patient systolic pressure .

(B )It is the hyperloop.

(C )Hyperrritability of the facial nerve manifested by facial spasms.

(D )Stress and irritability.

Correct answer A.

(386)What is the appropriate PH analysis

(A)PH less than <7.35 is acidosis .

PH greater than >7.45 is alkalosis.

If the PH is acidosis the disorder will be respiratory acidosis. Also if the PC02 indicates acidosis call it respiratory acidosis.

If the HC03 = 12 it is acidosis.

HCO3 less than < 22- acidosis.

If HC03 is greater than >26 it is alkalosis.

PH >7.45 – alkalosis.

When the PH indicates alkalosis call the disorder respiratory alkalosis.

Metabolic acidosis if the HCO3 indicates acidosis.

PH = 7.49 ,PCO2 = 30,HCO3 =normal (24).

(B)It is what it is.

(C)None of the above is correct.

(D)B and C are correct.

Correct answer A .

(386)PH >7.45 will be an indication for what?

A Respiratory acidosis

B Metabolic acidosis.

C Respiratory alkalosis.

D Metabolic alkalosis.

Correct answer C.

Rationale: When the PH indicates alkalosis call the disorder respiratory alkalosis .

PH <7.35 is acidosis.

PH >7.45 is alkalosis.

Normal PH is 7.35 to 7.45.Metabolic alkalosis in which PH is elevated. Metabolic acidosis is usually a buildup of acid in the body. The kidney is diseased and cannot function well to filter out the blood. Kidney is not getting rid of the acid or the body is producing too much acid.In metabolic acidosis the blood bicarbonate is 12 to 22mEq.The normal blood bicarbonate is 22 to 29.Symptoms include fatigue, confusion, headache, upset stomach.Treatment keep blood bicarbonate above 22mEq/L.

Normal bicarbonate is 22 to 29mEq/L.Take calcium citrate or calcium carbonate as ordered by your doctor.

Normal ABG Values and range.

Pao2 90mmHg 80-100mmHg .

Sa02 93 – 100%.

Paco2 40mmHg 35 – 45mmHg.

HC03 24mmHg 22 to 26.

(387)What is ABG?.

A arterial blood gas.

B artery bad and gases.

C Abdominal blood gas.

D B and C.

Correct answer A.

(388)What is the normal PH range?.

(A) 7.35 to 7.45.

(B )7.25 to 7.45.

(C )7.30 to 7.46.

(D) 7.29 to 7.46.

Correct answer A.

(389) A newly diagnosed patient with Alzheimer disease is admitted to the hospital. The nurse first action will be to?.

(A) Introduce patient to his roommate.

(B )Give patient toothpaste and toothbrush.

(C )Give the patient finger food.

(D) Assess the patient’s level of orientation during the admission process.

Correct answer D.

(390)A 33years old female comes to the recovery room following a tympanoplasty of the right ear.The nurse should?.

(A) Position the patient flat in bed with affected ear up.

(B )Position patient supine in bed with affected ear lateral.

(C )Position patient on the left side with affected ear downward.

(D )Allow patient to choose comfortable position.

Correct answer A.

Rationale: Flat in bed for 12 hours with affected ear up prevent disgorgement of graft.

(391) If a new born fail to pass meconium within 24hours after birth. It will indicate to the nurse that?

( A) celiac disease.

(B) Chickenpox.

(C) Abdominal wall infection.

(D) Hirschsprung’s disease.

Correct answer D.

Rationale:If a newborn fails to pass meconium. It is a strong indicator for hirschsprung’s disease.

(392)A mother of a 2years and 3months old daughter is concern about her child umbilical hernia.What will be the nurse most appropriate statement?

(A)You might want to ask your pediatrician.

(B ) Hold on I am new.Let me ask my charge nurse.

(C )Definitely I think that surgery is the best option.

(D)As she gets older the defect will become smaller and will be close by the time that your daughter starts school.

Correct answer D.

Rationale: Umbilical hernia usually closes spontaneously by the age of 3years to 4 years old.

(393) A 68years old woman diagnosed with Alzheimer disease is being discharged. The nurse teaches her daughter how to care for her mother at home. Which statement if made by her daughter will be an indication that she understands how to care for her mother at home?.

(A) I will just let her do her own thing.

(B) I thought that God is perfect and he made this stupid mistake.

(C ) It is important to establish a routine for daily activities.

(D ) None of the above.

Correct answer C.

Rationale:Consistent environment and routine helps with memory.

Alzheimer disease (senile dementia)chronic, progressive degenerative disease resulting in cerebral atrophy. Signs and symptoms are changes in memory, confusion, disorientation, change in personality. Most common after the age of 65years. Nursing Responsibilities: Reorient as needed, speak slowly. Clocks and calendars in the room.Bed in low position with side rail up.

(394)The nurse is assisting an elderly client’s family to cope with the stress of caring for the client at home. The nurse knows that when client has dementia. Which of the following is most likely to increase the family’s stress?.

(A )The client wandering.

(B)The client poor appetite.

(C )The client’s inability to recognize and communicate with the family.

( D) None of the above.

Correct answer C.

(395)The nurse prepares an adult client for instillation of ear drops. The nurse should use which of the following methods to administer the ear drops?.

(A )Warm the solution. Drop the medication along the side of the ear canal.

(B) Let patient drop.

(C ) None of the above.

(D)All of the above.

Correct answer A.

Rationale: prevents acoustic nerve reflex and dizziness. This method will not damage the tympanic membrane.

(396) A 42years old woman is admitted to the hospital for surgical repair of a retinal tear of the right eye.While waiting for surgery which of the following nursing interventions should receive the highest priority?.

(A )Place patch on the right eye.Position him on the right side,and increase sensory stimuli.

(B) Patch is not needed. Only facemask.

(C) patient should be sitting in upright position.

(D) Let him decide.

Correct answer A.

(397)A 52years man is admitted to the hospital for treatment of severe diverticulitis. Because he has not responded well to medical treatment .Surgical treatment with a colostomy is scheduled. The nurse plan to teach the patient ostomy self care.Which of the following will the nurse recognize to have the greatest influence on the success of the teaching?.

(A )Patient acceptance of the colostomy and the ability to manage it well at home.

(B)The vow not to look at the bag or touch it.

(C )Patient vomited each time that colostomy is mentioned.

(D )All of the above.

Correct answer A.

Rationale: Provide proper education on how to manage the colostomy. Clean stoma and surrounding skin with moisten cloth. Do no use soap or cleanser because it will cause problem and keep barrier from sticking.

(398)The nurse performs discharge teaching with a woman who has been treated for a duodenal ulcer. The patient is to continue taking ranitidine (Zantac)and aluminum hydroxide ( Amphojel) at home. The patient asks the nurse what she should do if she experience epigastric discomfort between meals. Which of the following suggestion,if provided by the nurse should be most appropriate?.

(A) Take additional Amphojel.OTC antacid,take 4 to 6 tablets a day as ordered by your doctor.

(B) Call your doctor.

(C)Good back to emergency room.

( D ) It is going to go away.

Correct answer A.

(399)A client is diagnosed with bipolar disorder and is manic physic with combative behavior. An initial nursing priority is to?.

(A ) Adminster and monitor sedative and mood stability medication.

(B )Do not allow patient to escape.

(C )All of the above.

(D) None of the above.

Correct answer A.

(400) A young adult client describes her fears about taking the elevator to the 15th floor of her office building. She states feeling anxious, dizzy her heart races and she is short of breath.This information gained during the nursing assessment reveals that the client is probably experiencing?.

(A )Hallucination.

(B )Phobic disorder.

(C) Delusions.

(D )All of the above.

Correct answer B.

TUBERCULOSIS.QUESTIONS AND ANSWERS.

Tuberculosis is a serious infectious bacteria disease that will affect mostly the lungs. Tuberculosis is easily spread when an infected person sneezes or coughs.Patient with TB are placed on airborne Isolation that is in negative pressure room with anteroom room attached.( In hospital as inpatient)It can be treated with a six months course with medications given and taken properly.

SYMPTOMS ARE:

Blood tinged sputum.

Night sweats.

Weight loss.

Fever.

(1)Mrs Miranda Sanchez is 39years old female came to the health clinic to be screened for tuberculosis. The tuberculosis mantoux test came back positive.But her chest Xray and sputum culture came back negative. Isniazid(INH)and pyridoxine(Vitamin B6) are prescribed for mrs Sanchez. Mrs Sanchez asks the nurse what is the meaning of the results of her test.

(A )The result is negative since your Xray and sputum are negative.

(B )The results means that more test are needed.

(C )Mrs Sanchez has been infected with tuberculosis.

(D) All of the above.

Correct answer C.

(2)The nurse explains to mrs. Sanchez that pyridoxine is administered with INH in order to?

(A )Prevent INH associated neuritis.

(B )To prevent nausea and Vomiting.

(C )Prevent diarrhea, nausea and Vomiting.

(D) All of the above.

Correct answer A.

(3)Mrs Sanchez is told to bring her husband during her next visit to the healthcare clinic. In order to determine whether mr Sanchez has been infected with tuberculosis, the nurse injects him with purified protein derivative. (PPD)Which of the following skin reactions might be interpreted as positive tuberculosis test?.

(A )Redness without induration.

(B )Bump on both arms.

(C )Induration(5-10 millimeter of firm,swelling)

(D) All of the above.

Correct answer C.

(4)The nurse overhears mrs Sanchez talking to her husband about Tuberculosis. Which statement made by Mrs Sanchez shows that further teaching is needed.

(A) I will take my medication and remain in Isolation for six months.

(B) I must remain in Isolation for four weeks.

(C) All of the above.

(D) None of the above.

Correct answer B.

(5)A friend of Mrs Sanchez tells her that her children will probably get TB from her.Which of the following statement if made by the nurse is true.

( A)It is possible that the family could be infected but studies need to be done.

(B )Absolutely no questions ask.

(C) A & B.

(D) All of the above.

Correct answer A

CASE SCENARIO:HEPATITIS B.

QUESTIONS AND ANSWERS .

(1) Linda Godlove is 27years old female admitted to the hospital with a diagnosis of hepatitis B,Isolation precautions, lowfat diet,high in protein ,Carbohydrate and calories. Linda is placed on Contact Isolation. The nurse understands this because.

Answer

(A)Health team members can contract hepatitis B through contact with blood and body fluids of an infected individual.

(B) It is not necessary to use contact precautions because universal precautions in enough.

(C )Should be airborne Isolation.

(D) All of the above.

Correct answer A.

(2) The nurse provides dietary instructions to Mrs Linda.Which of the following meals if selected by Mrs Linda would indicate that she can identify foods appropriate to her?.

Answer

(A )Lean roasted beef, orange juice and cereal.

B Milk and Banana.

C Rice and yogurt.

D All of the above.

Correct answer A.

(3 )Miss Linda develops pruritus and she ask the nurse why is she itching so much?The nurse replies

Answer

(A ) Itching is normal. You don’t have to worry about it.

(B )The itching is caused by the accumulation of bile salts in your skin,that you are unable to excrete at this time.

(C)I think that the itching is because of dryness.

(D) None of the above.

Correct answer B.

(4) The nurse enters the following nursing diagnosis for Miss Linda.Alteration in comfort related to pruritus. Which of the following would be the most appropriate nursing intervention to include with this diagnosis?.

Answer

(A) There is no intervention. It will disappear.

(B )Apply calamine lotion onto affected areas .

(C) None of the above.

(D) All of the above.

Correct answer B.

(5) The nurse enters Miss Linda room to find her looking at herself in the mirror. Miss Linda Godlove turns to the nurse and shouts,I hate the way I look with yellow skin”and begins to cry .Which of the following statements if made by the nurse would be most therapeutic?.

Answer.

(A) I understand, it’s okay to be upset.I sorry I can’t help you.

(B) I know you’re upset but your skin will return to its normal color as you get well.

(C)It is a permanent damage to your skin.

(D) All of the above.

Correct answer B.

CASE SCENARIO (NURSING).WOUNDCARE QUESTIONS.

To measure your wounds you need measuring Tapes,Gloves, Cotton Swab,digital camera,and clock.

Have all your supplies ready because you do not want to be going back and forth for supplies.

Provide privacy.

Wash your hands and wear your glove.

Get the measuring tools ready.(Write patient initial ,date,time and your name and title).

Patient initial and room number is good enough for this situation,because we are trying

to protect the patient as much as we can.Please follow your Facility policies and procedures .

Position your patient properly for the camera.

Remember do not take a picture of your patient face or his/her tattoos.

Position the measuring tape correctly and take your picture.

Use the tape to measure length and width ,and the cotton swab to measure the

depth by sticking it into the wound to find the depth,undermining and tunneling.

Place the cotton swab on the measuring tape to get and document the depth of the wound.

L x W x D =Length x Width x Depth

If the wound is round find the diameter.

Is there a tunneling.

Check for undermining?

What did you see?

Do not alter what you saw.And do not use personal phone to take pictures.

Remember that the head is always 12oclock and the tail 6oclock.

Discard the measuring tapes with patient initial in patient’s room ,inside the trash can,

after tearing it.

Wash your hands before leaving patient room.

cotton swab


Measuring tape

Print the pictures ,write a brief description and place it in patient chart.

Thanks ,you have done well.

46TH CASE SCENARIO.(NURSING) WOUNDCARE.

Wound assessment is very important point in the preparation and treatment of wound. The entire person need to be assessed,life history, such as smoking,hypertension and diabetes.

And for pressure ulcer to be treated effectively, a team approach is required. This involves the patients, families,healthcare providers and caregivers.

Medical Diagnosis of

: Pressure ulcer is usually pressure areas.

Arterial is usually distal ,small in size,round in shape, the dept is usually shallow, smooth margins and surrounding tissues are pale.

Venous is above malleolus, size can be small or large.Burns,dermatitis, abcess,necrotizing fasciitis,and Diabetic ulcers is on pressure areas of the foot.

Nursing Diagnosis:

Impaired skin integrity related to non healing wound.

(1) Partial thickness wound can be classified as:

(A )Stage IV

(B )Stage 111.

(C )Stage 11.

(D)Wound covered with escher and some sloughs

Correct answer C.

The partial thickness wound involves loss of dermis.It presents itself filled blisters or as an open shallow ulcer that has no sloughs.

(2) Full thickness wound without exposed exposed bony areas, tendon,or slough should be classified as :

( A)Stage 11.

(B) Unstagable.

(C)Stage 1V.

(D)Stage 111

Correct answer D.

(3)What is most important factors in delayed of chronic wound healing is known as:

(A)Prolonged inflammation.

(B)High mitogenic activity.

(C) Face mask.

(D) All of the above.

Correct Answer A.

(4)The most common method of wound measurement includes

(A)Linear measurements.

(B) Fluid distribution.

(C) Surface Tracing.

( D)All of the above.

Correct Answer:A.

(5) What is pressure ulcer ?.

(A )Pressure ulcer is defined as a localized injury to the skin or underlying tissue usually are found over a bony prominence due to pressure .It can also be a combination of pressure and shear.

(B )All wounds are pressure ulcer.

(C )It is blanchable and nonblanchable.

(D )All of the above.

Correct answer A.

(6)What are the stages of pressure ulcer?.

(A)There are two stages of pressure ulcer.Stage 11 and stage IV.

(B )There are four stage Stage1,stage11,(partial thickness) stage111(Full thickness)stage IV (Full thickness tissue loss with exposed bone tendons and muscle),Unstagable, Suspected (Deep is unknown)Deep tissue injury.

C Depth unknown and full thickness.

D All of the above.

Correct answer B.

(7) Arterial insufficiency. What is it?.Who are more vulnerable?.

(8) Give examples of diabetic neuropathy.

(9) What is Venous insufficiency?.

(10)The major function of neutrophils in the wound is to:

(A) Destroy bacteria by the process of phagocytosis.

( B) No function.

(C) Manufacture of white blood cells.

( D)A and C.

Correct answer : A.

(11) Bedridden patient position should be changed. While in bed – – – and while in in a wheelchair – ——-.

(12) When do we remove foot pump or SCD?.

(A)Whenever a patient ask for its removal.

(B)The patient does not need it.

(C)As needed.

(D)During the patient’s initial skin assessment in your shift.

Correct answer D.

Plan for Skin integrity.

Wound care dressing, using the right type of dressing on the right wound. Wound care Consultation done.

Documentation. Accurate documentation of wound care wound location in the body, color,etiology of the wound.

Drainage Care.

Jackson pratt,

Hemovac,

T tube,

biliary drainage system,

and wound vac system.

Reposition of patient frequently for comfort and pressure redistribution every two hours while in bed and every one hour while in the wheelchair.

Nutrition consult, increase in protein intake unless it is contraindicated.

Hydration intravenously or by po.

Special Equipments to help manage care for the patient with the wound for example assistive devices such Accu care mattress.

Pain management.

Keep patient comfortable. Medicate as ordered by the doctor.

Assessment for signs and symptoms of infection. Checking for wound color, edema, temperature and wound drainage.

The goal is to possibly return wound to the baseline skin integrity .

QUESTIONS AND ANSWERS ON BURNS.

Mrs Maggy Cuban 59years female is brought to the hospital after she sustains burns when her oven blew up on her face.Her burns had second and third degree covering her face,neck,upper chest,upper arms,forearms and hands.So she is admitted to the burn unit.

45TH CASE SCENARIO NURSING (AIDS)

HIV is human immunodeficiency virus, and aids is acquired immunodeficiency syndrome. HIV causes aids if not treated. The most serious side effects of HIV is called aids.There is no cure for aids but there is treatment. HIV/AIDS affects the body ability to fight infections.

HIV signs and symptoms are flu like symptoms of sore throat, swollen glands, skin rashes, night sweats, nausea, vomiting and diarrhea, muscle weakness. If treatment is not given, the immune system weakens and it can lead to death. It can be transmitted through blood, vagina discharge and semen.

CASE SCENARIO BELOW.

Age / sex 36years Male.

Unit # QZ0000021

MR# Q0054322166

Location : 6th Floor.

Chief Complaint: Tired,Weakness and dry cough.

Attending Doctor : Dr. NOTIN, MEAN.

Admitting diagnosis: Pneumonitis Carni Pneumonia. Dry cough.

CODE STATUS Full code.

Allergy: NKDA.

Height 5ft 11inches.

Weight 137lbs.

(1) Mr Tony Parken is a 36 years old man, intravenous drug abuser,was diagnosed by the doctor with acquired immunodeficiency syndrome. (AIDS )in the past is admitted with a diagnosis of Pneumocystis Carni pneumonia. Universal precautions is required for every patient. What will be the most appropriate items for the nurse to have available.

(A) Mask and gloves.

(B) gloves, and gowns

( C) Masks,gloves, gowns and goggles.

(D)None of the above.

Correct answer : C.

(2 )For the nurse safety and to minimize the possibility of needle injury?.

(A) Leave the needle unsheathed, discard it into a puncture resistant container.

(B )Throw the needle in a special place.

(C) I saw experience nurses put it in the thrash.

(D) All of the above.

Correct answer A.

(3 )The charge is evaluating the care provided to Mr Tony by other health care workers. Which of the following actions should the nurse intervene?.

(A)The nursing assistant wearing only a mask and gloves while providing bedpan.

(B) There is nothing to intervene.

(C)The nursing assistant doing the right thing.

D All of the above.

Correct answer A.

(4 ) Since Mr Tony has been diagnosed, which of the signs and symptoms would the nurse most likely find that are consistent with Pneumonitis Carni pneumonia?

(A) Nonproductive cough.

(B)Productive cough.

(C )No coughing.

(D) Dry cough.

Correct answer:

Dry cough.

(4) The doctor orders antibiotics for Mr Tony. Mr Tony is to receive trimethoprim- Sulfamethoxazole ( Septra) IV four times a day. He weighs 70kg(154lbs ) The package inserts state that 10mg/day in four divided doses a day is the recommended dose. How many mg should the nurse administer in each dose.

(A)10mg/day ÷4 =2.5 ×70=175mg.

(B ) 154Ibs

(C) 154× 10 = 1540mg.

(D) All of the above.

Correct answer : A 175mg

(5 )The nurse observes that Mr Tony did not touch his food.He told the nurse that his food is tasteless and besides my tongue hurts too much to eat.Based on this information, the first action taken by the nurse should be to?.

Answers

(A)Examine Tony’s mouth .

(B)Tell Tony to stop the jokes.

(C) Tell Tony to eat small piece at a time.

(D)All of the above.

Correct answer A.

( 6)Mr Tony Parken will call the nursing stations frequently making unreasonable demands. The nurse identifies this behavior characteristic of which stage of grieving process?.

(A)It has nothing to do with grieving.

( B)He is mad the nurses.

(C )Denial.

D The acceptance stage.

Correct answer C.The stage of Denial .The denial is a shock absorber of trying to cope with the new diagnosis and what is happening.

( 7) Mr Tony is ready to be discharged home to his parents and siblings. During the discharge teaching, the nurse explains the transmission of aids to mr Tony parents. Which of the following statement if made by Tony will indicate that he understands the teaching?.

(A) I will not shave with my father’s razor.

(B )Aids doesn’t transmit so fast.

(C )My father will not notice.

(D) None of the above.

Correct answer A.

(8) What causes AIDS?.

(9) What are the symptoms of HIV?.

( 10) Is there are cure for HIV/AIDS?.

(11)What advice will you the nurse give to your patient who has HIV and refuses treatment?.

(A) Find out why he refused treatment and re – educate him.

(B) I don’t blame you this medication don’t work.

(C )If you said no we ( nurses) cannot force you.

(D) All of the above.

Correct answer A.

HIV/AIDS HOTLINE- National

800- 342-2437 English.

800 -222-9432 Spanish.

800-243- 7889 TTY/TDD users.

AIDS HOTLINE WEBSITE.

http://www.aidshotline.org

44TH CASE SCENARIO NGT PLACEMENT. NURSING.(NASOGASTRIC TUBE)

Ngt is the placement of a flexible 14 – 18inches French plastic tube from the nose into the stomach. It can be placed in right or left nare. If the patient has facial or nasal trauma, ngt should be inserted orally.The ng tubes are use when swallowing is compromised.For example Patient fails swallow evaluation.

PROCEDURES:

(1)Gather supplies : 14- 18inches flexible French nasogastric tube.

Gloves.

60syringe french Catheter tip.

2% Xylocaine lubricant.

Adhesive tape.

Cup of Ice chips or water.

Emesis basin.

Portable suction with tubing and yankauer tip.

(2)Sit the patient up in flexed upright position.

(3)Explain procedure to patient. The risk and benefits of ngt.

(4) Put on your gloves and eye goggle.

(5) Measure the tube from the tip of nose to the Xyphoid process or tip of breast nipples.Know how many centimeters. It is usually 50cm to 60cm for most people. Mark your measurements.

(6)Check and examine the nose to make sure that there is no obstruction.

(7)Apply Xylocaine 2% 5- 10cm to tip of nasal.

(8)Turn on the suction .

(9)Place cup of ice or water and emesis basin close to patient.

(10)Remove the cap of nasal gastric tube and lubricate the first 6inches of the tube.

(11)With patient head flexed,place the ngt to the unobstructed nostril.

(12) Check placement by attaching the catheter tip syringe and aspirate.You aspirate for gastric content. Also chest Xray to make sure that the tube is in the right position.

Questions:

(1) The doctor orders a nasogastric tube inserted and connected to low intermittent suction for patient with an intestinal obstruction. Two hours after the insertion of the nasogastric tube. The patient vomits 200ml into an emesis basin. What is the first action that the nurse should take?.

Answer: Irrigate the nasogastric tube.Tube is obstructed. Use only normal saline for irrigation (Isotonic)Water is hypotonic solution.

(2 )An 88years old woman is admitted to the hospital from a nursing home.She refuses to eat food and removes her nasogastric tube each time that it is inserted. Total Parental nutrition(TPN)is ordered. Initially patient is to receive 1000ml of TPN in 24hours.The intravenous set delivers 15drops per milliliter. The nurse should regulate the flow so that it can deliver how many drops of per minute.

Correct answer: 10 drop per minutes.

( 3)The nurse cares for a patient with bowel obstruction .A nasogastric tube is to be inserted. Before the insertion of the nasogastric tube, the nurse should explain the purpose of the nasogastric tube to the patient. Which of the following statement if made by the nurse, is most appropriate

Answer:

(A)It is inserted to empty fluid from the stomach .Used to decompress your stomach, gastric immobility, and gastric content removal.

(B)Your doctor is like that.He like to do this to his patients.

(C )It is also use for feeding tube and medications.

( D)All of the above is correct.

Correct answer A.

(4) What is the size of the nasogastric tube?.

(A)Size depends on what your patient want.

(B)14 to 18 inches flexed French nasogastric tube.

(C )Size doesn’t matter at all.

(D) All of the above.

Correct answer B.

( 5)Why is it important to check for placement after insertion of nasogastric tube.

(A) To make sure that the nasogastric tube is in the stomach. ( The right place)

(B ) To follow the doctor orders.

(C ) To check for nasal obstruction.

(D) All of the above.

Correct answer A.

Nursing Consideration.

Perform oral care for your patient.

Apply lubricant to lips.

Provide support.

Empty canisters 2/3 full.

(6 )Mr James Nutmeg is a 77 years old man with CVA left side weaker than the right side.Failed swallow evaluation.Slightly facial drooping left side .Follows simple commands. Can pull self up.

MRSA of sputum.

Cardiac : Left chest pacemaker. ( Occasionally pacing)

Restraint bilateral upper Extremity.

Diet Strict NPO :Ngt to right nare.Glucerna 1.5 at 60ml/hour ,flush with 30ml of water Q6hours.

Lungs : Coarse

Suction prn.

Neurological:Alert and oriented ×1.

Confused

GU/GI Incontinent bowel and bladder.

Skin : Intact.

Blood sugar Q6hours.

MRI on hold due to pacemaker.

PLAN:

NPO after midnight the night before. ( ngt feeding on hold)

Peg tube placement in two days.

Plavix on hold for 7 days.

Restraint to be renewed in 24hours.

(7)Why is this patient NPO?.

(8)Why is patient on restraint?.

(9)Why is plavix on hold for seven days?.(10) Is patient really confused or language barrier issue?.

43RD CASE SCENARIO QUESTIONS AND ANSWERS ON NUTRITION.

(1)A 68years old female is brought to the Emergency room with her daughter who reports that her mother is not eating well.The patient is not on any prescription medication. After examining the patient and obtaining a diet history from the patient, the nurse determined that which meal will be best choice for this patient?.

A Broiled chicken, broccoli, skim milk.

B. Rice,soup and broccoli.

Chips and skim milk.

D None of the above.

Correct answer A.This meal will provide a balanced diet for the patient.

(2)What is the purpose of WIC program?.This program was enacted in 1966.

(A) There is no intended purpose for the WIC started in 1966.

(B) To punish pregnant women and deny services to low income women.

(C )A program developed to support drug abuse,and Uncontrolled pregnancy out of wedlock.

(D) It is a program designed to assist low income families with supplemental food assistance and nutritional education.It support pregnant, postpartum, infants and their lactating women, and children until the children are five years old. It is a great program.

Correct answer: D.

Rationale : In 1966 the federal government established WIC to supplement nutritional needs for low income families (for infants, children and women).

(3) A client who has rectal cancer has just completed a course of Radiation treatment. What will be the best food that nurse should have available for the patient in anticipation of his return from radiation therapy to his room.

(A) cool smoothie.

( B) hot coffee.

(C) Frozen yogurt.

D Room temperature lemon-lime juice.

Correct answer : D. Room temperature lemon- lime drink.

Treatment of radiation therapy can cause diarrhea, fluids and electrolytes imbalance. Diet should be fluids, low residue, low lactose ,low fat,room temperature fluids is easier to tolerate. Avoid hot and cold fluids.

(4) Nurse Jennifer is caring for a patient receiving full strength of Ensure by tube feeding. The nurse knows that the most common complications of a tube feeding is?

(A) Constipation.

(B) Nausea,Vomiting bloody urine.

( C )Headache.

(D) Diarrhea.

Correct answer:Diarrhea.

This is due to intolerance to solution rate, give slowly. Other symptoms of intolerance are nausea/Vomiting, aspiration, glycosuria,diaphoresis.

(5) The nurse supervises care at an adult daycare center. Four meal choices were available to the residents. The nurse should ensure that a resident on a low cholesterol diet receives of the following meals?.

(A) Grilled flounder, green beans, fish instead of meat,increased vegetables.

(B )Milk,eggs, stew ,cow meat.

( C)Vegetables, rice and stew,goat meat.

(D )Meat,fish,rice and okra.

Correct answer A.

(6) The Registered nurse discusses nutritional benefits with a client with cystic fibrosis. Which of the following diets should the nurse recognize as usually recommended for this condition?.

(A) High carbohydrate diet.

(B )Fatty foods and vegetables.

(C )High vitamin, low protein ,and high fat.

(D )High protein and high vitamin. Patient losses 2to 3 protein lost in stool due to lack of enzyme trypsin fat soluble vitamins ( A,D,E,K)

Correct answer D.

(7) The nurse teaches a client about a low fat and cholesterol restricted diet.

Which of the following food should be allowed on this meal?.

( A) 5oz lean meat allowed,poultry,fish,fruits, vegetables, whole grains.

B Cow meat, fish,vegetable oil, whole meal.

(C ) Whole grain, beefy pork with soup and white rice.

(D)Tomatoes juice, pork,potatoes, vegetables and steamed rice.

Correct answer A.

(8)The nurse obtains a diet history from a female patient who requires a high protein diet. Which of the following meals should the nurse recognize as appropriate diet for this patient?.

Answer:

(A)Cheeseburger,milk, fruits.

Cheese,beef ,milk.

Protein 20grams.

(B)All of the above.

(C )None of the above.

(D)One of the above.

Correct answer B.The emails divided into three for breakfast, lunch and dinner.

(9)A patient is placed on a low sodium diet. Which of the following foods should the nurse recognize as low in sodium .

(A )Beans and rice.

(B) Turkey 25mg/oz.

(C) Salad and cereal.

(D) All of the above.

Correct answer B.

(10) The nurse teaches one of her patients about vitamin C content in food. The nurse will evaluate the patient understanding of her teaching if the patient is able to identify foods rich in vitamin C.

(A) Rice and bread.

(B) Tomatoes juice and fries.

(C)Spinach and eggs.

(D) Broccoli (113mg raw).

Correct answer D

(11) Patient is placed on low protein diet The nurse is to perform dietary teaching on this patient. The nurse should know that her teaching is successful, if patient is able to identify foods lowest in protein?.

(A)Cranberries and broiled chicken.

(B )No cranberries, chicken 7gm/oz.

(C )A & B.

(D )None of the above.

Correct answer A.

(12)The patient called the clinic to report symptoms of diarrhea. Which of the following over the counter medications is most likely to cause the symptoms of diarrhea?.

(A) Cathartics.

(B) Papaya.

(C )laxatives .

(D) None of the above .

Correct answer:A.

Cathartics accelerates defecation. This is the opposite of laxatives which eases defecation .A good example of Cathartics are magnesium sulfate, Phillips of magnesia.

Rationale:It promotes the evacuation of bowel by increasing the motor activity of the intestine.

(13) The nurse prepares a nutritional education program for a group of patients who have new ileostomy. The nurse should educate the patients that which of the following food is most likely to cause obstruction of the G.I tract.

Answer:

(A )Corn and coconut. Also nuts,seeds, popcorn, tough fibrous meat.

B Salad,rice beans and yam.

C Papaya, rice and stew.

D All of th above

Correct answer A.

Rationale: Diet after surgery will be increase in fluid intake, high protein, high cholesterol, increase Calories, supplements of Vitamins A,D,E,K,Berries, whole grains cereals. Raw fruits should be limited if can cause problems.

(14)A 64years old woman is brought into the hospital with elevated blood sugar. History of diabetes, hypertension, high cholesterol, left BKA,seizure disorder. Case manager consulted for disposition, PT/OT consulted.Hemodialysis every day except Saturday and Sunday. The nurse is to educate patient on the diet that she needs. What will be the most appropriate recommendation for this patient.

Correct answer: To avoid foods and vegetables rich in potassium,phosphorus and to watch sodium intake.No added sodium to diet.Patient to substitute food without potassium and phosphorus because the kidney has difficulty to eliminate it. This nutritional teaching is very important because it is challenging for many dialysis patients. And nutritional consult ordered.

(15) Why is it that the doctor orders PT/OT consult?.

(A) That is the routine. PT/OT is ordered for every patient.

(B) The doctor has PT/OT franchise.

(C )Physical therapy and occupational therapy is ordered for evaluation and treatment since patient will be discharge home.The doctor want to sure that it is safe to discharge.

D All of the above.

Correct answer C.

COVID19 PANDEMIC.

( 1 )What are the symptoms of COVID19 PANDEMIC?.

(A)fever, sore throat, cough,headache , lack of Smell or taste ,sleepy all the time or difficulty to keep awake.

(B) Nausea,Vomiting and headache.

(C )Weight loss and nausea.

(D)None of the above.

Correct answer A.

(2) Mr. Michael Lee just returned from China in January 2020.He was coughing, temperature of 102.7°F.He is diagnosed with COVID19. Which of the following action is expected from the nurse when going to the patient’s room?.

A Gloves and hand washing.

(B) Goggles, gloves, gowns and hand washing.

(C) All of the above.

( D)Wear gloves, mask, goggles and gown and hand washing before and after.

Correct answer D.

(3) The nursing assistant went into the patient room with only gloves.What will the nurse educate the nursing assistant about?.

(A)The nursing assistant should put on gloves, goggles, mask and gown.

( B)She doesn’t need to wear the above since she is not touching the patient.

(C)All of the above.

Correct answer A.

(D ) None of the above is correct.

4 Can mosquitoes or insects help to spread COVID19.

(A)No mosquitoes or insects cannot spread COVID19. Follow with CDC .

( B)Yes it can be spread through insects and mosquitoes.

( C )Though no records but mosquitoes are blood suckers.

(D) None of the above.

Correct answer A.

(5)What do you do if you are sick ?.

(A)If you are feeling sick stay home and follow up with your doctor.

(B )Wear you mask and continue going about your business.

(C)Do nothing. It will go away. It will disappear.

(D) All of the above.

Correct answer A

(6)What is novel Coronavirus?.

A novel Coronavirus (new virus) is defined as a new Coronavirus that was not previously identified. This Coronavirus disease ( COVID19)is not the same as the previous Coronavirus that we all know circulating among humans causing common cold and other illnesses. This Coronavirus is very dangerous. It originated from WUHAN China in 2019.And we are still learning about the disease.

(7)Why are schools not reopening?.

(A)Schools are not reopening in areas where there are high rates of transmission, poor disease control and inadequate equipments to support schools. And the review of epidemiology data before granting waiver and transparency on results.

( B)President Trump want schools to open. So they must reopen.

(C )All schools must apply and get waiver before they can stay close.

(D) None of the above.

Correct answer A.