Test I
1. A patient was rushed in the hospital following a bloody diarrhea several times. He was noted with a blood pressure of 78/40mmHg, respiration of 30, shallow and rapid, cold clammy skin, lethargic and is pale. Which of the following nursing intervention should the nurse anticipate? Select all that apply. *
4 points
A. IV fluid of 0.9% NSS using a gauge 22 needle inserted at the metacarpal veins.
B. Oxygen support at 5 liters per minute of oxygen using non-rebreather face mask.
C. IV line of PLRS given as IV bolus using a gauge 18 needle and another line of 0.9% NSS regulated at 140cc per hour.
D. STAT blood typing and securing type-specific blood product.
E. Elevating the head of the head at 90 degrees
F. Coordinating with the OR team for possible surgery.
2. A patient has been on steroid therapy for a longtime. She came in the hospital complaining of edema on both feet. Upon assessment, the nurse noted bilateral edema, pitting 2+, with coarse crackles on both lung fields and elevated blood pressure of 150/97mmHg. Which of the following nursing diagnosis is appropriate for the client?
A. Fluid volume deficit
B. Fluid volume excess
C. Risk for infection
D. Deficient knowledge
3. You are a nurse caring for a client with fluid volume excess secondary to SIADH. The physician orders: weigh patient daily. What are following are the rules in implementing the order to weigh patient daily.
4. The nurse was caring for a client with hyperkalemia secondary to acute renal failure. The serum K+ was noted at 6.8mmol/L. Which of the following interventions should the nurse anticipate implementing? Select all that apply
A. Attaching the patient to cardiac telemetry
B. Infusing normal balance maintenance IV fluids
C. Preparing to administer 10 units of regular insulin in 50ml of 50% dextrose in water solution to be given IVbolus
D. Preparing calcium gluconate slow IV push
E. Administering spironolactone
F. Preparing the patient for possible STAT hemodialysis
5. The patient has undergone total thyroidectomy 16 hours ago. While you are assessing her blood pressure, you noticed a slight twitching of the arm while inflating the cuff of the sphygmomanometer. Which of the following should the nurse suspect?
A. Hypernatremia
B. Hyponatremia
C. Hypocalcemia
D. Hypercalcemia
6. A patient is diagnosed with pre-eclampsia and is maintained on magnesium sulfate infusion at 1 gram per hour. At around 8am, the urine drainage in her IFC is at 50cc. At 9am, the drainage was at 40cc and at 10am at drainage is at 38cc. Which of the following action should the nurse do? Select all that apply.
A. Stop the magnesium sulfate infusion
B. Report the finding to the physician
C. Continue the magnesium infusion, however, regulate it at 0.5 grams per hour.
D. Encourage oral fluid intake
E. Assess the respiratory rate and DTR of the client
7. A newly-hired nurse has been assigned in your floor. She is about give potassium IV to a client who was diagnosed with severe gastroenteritis with a serum potassium of 2.7mmol/L. You are observing her as she administer the drug. You noticed her that she connected the syringe in the needleless port of the 3-way stopcock in the main IV line. Which of the following is the appropriate intervention.
A. Interrupt the newly-hired nurse, instruct him to get another IV set for you and remove the syringe from the 3-way stopcock
B. Let the newly-hired nurse give the potassium direct IV telling her to give it via very slow IV push
C. Yell at the nurse and tell her she's committing a mistake.
D. Let the nurse give the potassium direct IV but report the incident to the supervisor.
8. The nurse was caring for a client with on total parenteral nutrition. He noted that the client has dry mouth, poor skin turgor with elevated serum sodium. Which of the following reasons may cause a person to be hypernatremic while on TPN? Select all that apply.
A. TPN does not contain enough water to meet the daily fluid requirement of the client.
B. Clients on tube or parenteral feeding usually are not given enough water.
C. TPN solutions are very high in sodium.
D. The patient in TPN is taking sodium supplements and diuretics

Describe in your own works Criteria of Causation and how it relates to exposure and a suspected risk factor? (EPIDEMIOLOGY)

You are required to use at least 3 different ACADEMICALLY credible articles/books/websites as references. You can use whatever search method you like but make sure your information is credible AND published within the last 5 years. The paper should be 3 full pages, no plagiarism

The following needs to be covered in the paper:

1. Describe the heart disease.

2. What happens to the person who has the heart disease?

3.How it is diagnosed

4. How it is treated

5.How it can be prevented

explain why having Parkinson's disease increases the risk of fall

A 3-year-old child is presenting with a general failure to thrive in combination with mild splenomegaly and hepatomegaly, as well as peripheral lymphadenopathy. The child has a history of recurrent viral respiratory infections and molluscum contagiosum. At the age of 20 months, he had to undergo surgery to remove a tumor from his bowel. Pathology indicated it was most likely the result of a lymphoproliferative disorder. The patient was found to be positive for Epstein Barr Virus (EBV) using blood serology. Serology also indicated the patient was positive for Herpes Simplex Virus (HSV), Varicella Zoster Virus (VZV) and Cytomegalovirus (CMV). Flow cytometry indicated that total lymphocyte count, total B-cell and T-cell count, including T-cell subsets, were within normal limits. Family history indicates that the patient is from a consanguineous lineage and that several cousins also had a history of recurrent viral infections and failure to thrive.

1. What is this patient likely suffering from?

2. How would you confirm your provisional diagnosis?

Case study

Chief Complaint

“It feels like an elephant is sitting on my chest! I’m too young to die!”

HPI

Larry Stanton is a 46-year-old man transported by paramedics to the ED of a large community hospital. He presents with severe, substernal chest pain for the last 6 hours. He states he was fine until about an hour after he ate breakfast. The pain radiates to his jaw and neck and is accompanied by N/V and diaphoresis. In the ambulance, his chest pain is unrelieved by three SL NTG tablets.

PMH

No significant past medical history

FH

Father with heart failure and Type 2 DM and questionable history of “mild heart attack” at age 42; mother alive with HTN. He has one sister who is 48, alive and well, and one brother who died suddenly at age 46.

SH

(+) tobacco × 20 years; drinks beer usually on weekends; states he hasn’t been to a physician since his appendectomy 10 years ago

Meds

Acetaminophen PRN and Pepcid AC PRN

Therapeutic Alternatives

3.a. What nonpharmacologic therapeutic alternative can also achieve the immediate goal in this patient? The nonpharmacologic therapeutic alternative for Mr. Larry is to initiate reperfusion

3.b. What is the role of glycoprotein IIb/IIIa inhibitors (GPIs) in the setting of PCI with coronary artery stenting, and how should these agents be used?

3.c. How should therapy with GPIs be monitored?

MEDICAL TERMINOLOGY REVIEW

For the following word parts, write the definition

1. phleb/o:

2. -otomy:

3. hepat/o:

4. -itis:

5. ven/i-:

6. -puncture:

7. syncop/o:

8. nos/o:

9. comi/o:

10. -al:

11. ante-:

12. cubit/o:

13. anti-:

14. -sepsis:

15. coagul/o:

16. glyc/o:

17. -lysis:

18. ped/o:

19. iatr/o:

20. hem/o:

21. hemat/o:

22. -oma:

23. inter-:

24. -stitial:

25. capillar/o:

26. thromb/o:

27. -sis:

28. derm/o:

29. plant/o:

30. palm/o:

31. -rrhage:

32. PPE:

33. ASCP:

34. HBV:

35. HCV:

36. HIV:

37. OSHA:

38. IAPS:

39. NCA:

40. NPA:

41. POL:

42. CLSI:

43. CBC:

44. EDTA:

45. SST:

46. PST:

47. PT:

48. APTT:

49. FDA:

50. POCT:

51. PKU:

• Student will answer all four of the following questions: (Must cite your sources for each question)
  • What are the implications of “mutual recognition for nursing” on nursing licensure?
  • What alternatives are available for demonstration of competency instead of attending continuing education seminars?
    • Which might be better?
  • What organization should credential and license advanced practitioners?

Grading Rubric to Achieve the Full 5 Points (See Grading Rubric for Complete Grading Breakdown)

• Demonstrates critical thinking. Student answers question(s) and relates key points to the discussion topic.
• Student uses Internet sources from acceptable research sites (see above) or course’s textbook to answer question(s)
• Answer met the required minimum of 150 words.

should dementia patients be involved in decision making or not

What is your take on our media's influence both social and public aspect regarding a client’s expectations placed upon nurses and revealing HIV status?

What is the rationale for a provider to order NGT insertion, NPO status, large bore IVs, CBC, Type and screen and EGD on a patient with GI bleed?

Why are areas of a healthcare system particularly vulnerable to ransomware and should be especially protected?  What might patients do to ensure their information is safeguarded?

Who are the key players possibly consulted for interprofessional collaboration for a patient with RA and OA?