Professional Documents
Culture Documents
1.
2.
3.
How can heart failure cause hypervolemia (or fluid volume excess)?
4.
5.
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7.
8.
9.
10.
11.
12.
What is the name of the disease a client can have that will induce hypervolemia due to too
much aldosterone?
13.
14.
15.
What is the normal action of ADH, and what does ADH stand for?
16.
17.
18.
What will the effects be on the body if a client is producing too much ADH? What is the
name of this disease?
19.
What will the effects be on the body if the client does not have enough ADH? What is the
name of this disease?
20.
21.
22.
23.
24.
25.
26.
If a client is hypervolemic, what are the lung sounds like and why?
27.
28.
What happens to the blood pressure and pulse with hypervolemia? Explain why.
29.
30.
What type of diet is prescribed for the hypervolemic client? Explain why.
31.
32.
33.
34.
35.
What is the major electrolyte imbalance to watch for with thiazide diuretics?
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
The person with polyuria will eventually develop what life threatening complication?
47.
What three changes will you see in the urine output that will indicate the body is
compensating?
48.
49.
During hypovolemia, what happens to the blood pressure and pulse and why?
50.
51.
52.
53.
54.
55.
56.
What safety precautions are needed for the FVD client and why?
IV Fluids
57.
58.
59.
60.
61.
62.
Why would I worry about FVD in the client receiving a hypotonic solution?
63.
64.
65.
Why would I worry about FVE in the client receiving a hypertonic solution?
66.
67.
68.
69.
If a client has hypermagnesemia, what will happen to their DTRs, muscle tone,
respirations, and level of consciousness?
70.
71.
Why does the client who has hypermagnesemia develop flushing and warmth?
72.
What effect will this flushing and warmth from hypermagnesemia have on the blood
pressure?
73.
74.
75.
Hypercalcemia:
76.
77.
78.
79.
80.
If a client has too much calcium in the blood, what kind of muscle tone will the client have?
81.
82.
How will it affect the clients LOC, pulse, and respirations? Could the client have an
arrhythmia?
83.
84.
85.
86.
87.
88.
89.
What drug will return calcium to the bones? What disease is this drug used for?
Hypomagnesemia:
90.
91.
92.
If you have a client with hypomagnesemia, what will the clients muscles be like?
93.
94.
95.
Why does the client with hypomagnesemia have a positive Chvosteks and Trousseaus,
and what will happen to the DTRs?
96.
97.
98.
99.
100.
Why are seizure precautions necessary when caring for a client with hypomagnesemia?
101.
Hypocalcemia:
102.
103.
How could a radical neck dissection/thyroidectomy affect the serum calcium level?
104.
List symptoms of hypocalcemia and explain why the client has these symptoms.
105.
106.
107.
108.
Why do we give the hypocalcemic client calcium carbonate and calcium gluconate?
109.
When you are giving someone IV calcium, what is the most important thing you need to
remember to do? Explain why.
Sodium:
Hypernatremia:
110.
If you have a client who is very dehydrated, what will happen to their serum sodium level?
Explain why.
111.
If you have a client who is dehydrated, what will happen to their H&H? Explain why.
112.
Why does the client who is hypernatremic have dry sticky mucous membranes and why are
they thirsty?
113.
There is one organ in the body that really does not like it when sodium is out of balance.
What is it?
114.
Why is it so important when you are trying to lower someones serum sodium level that you
dilute the client with IV fluid gradually?
115.
If you have a client who is becoming dehydrated, what will begin to happen to their sodium
level? And what should you do before the client becomes hypernatremic?
116.
10
Hyponatremia:
117.
118.
119.
How can drinking too much water make your serum sodium go down?
120.
When you have a hyponatremic client, it is important that you restrict water. Explain why.
121.
What IV fluids are used to treat hyponatremia? What nursing alerts are necessary when
administering these fluids?
Potassium:
Hyperkalemia:
122.
What organs must be working properly to help maintain the normal potassium level in your
blood?
123.
124.
125.
11
126.
When a client with a potassium imbalance has an arrhythmia, they are very dangerous.
Why? What type of arrhythmias will the client have?
127.
128.
129.
130.
131.
When you give sodium polystyrene sulfonate (Kayexalate), you can expect the serum
potassium level to go down; therefore, what will happen to the serum sodium level? Explain
Hypokalemia:
132.
133.
134.
Why is it so important that you monitor the digoxin client closely for hypokalemia or other
electrolyte imbalances?
135.
12
136.
137.
138.
13
Acid Base
1.
What are the major acid/base chemicals? Are they acids or bases? What organs control each
chemical?
2.
3.
4.
5.
6.
7.
8.
When you think of the lungs, what chemical needs to pop into your mind?
9.
When you think of the kidneys, what chemicals needs to pop into your mind?
10.
Can CO2 be a chemical that makes you sick and be a chemical that makes you compensate?
11.
Can bicarb and hydrogen be chemicals that make you sick and be chemicals that make you
compensate?
12.
What is the only way you can have a buildup of CO2 in your blood?
13.
Respiratory Acidosis:
14.
In respiratory acidosis, which organs are not working right? Who is going to compensate?
How does the compensation work?
15.
In respiratory acidosis, what has happened to the CO2 level in your blood? What caused the
increase? Give examples.
16.
In respiratory acidosis, how is the client breathing? And how does this affect the CO2 level
in the blood?
17.
18.
19.
When someone gets very acidotic, what happens to their level of consciousness?
20.
When a client has a high CO2 level in their blood, what is going to happen to the oxygen
level in their blood?
21.
22.
When you have a client in respiratory acidosis, what is the primary thing that has to be
fixed? Explain some ways this can be fixed.
Respiratory Alkalosis:
23.
When someone is in respiratory alkalosis, what organs are going to compensate? With what
chemicals are they going to compensate? Explain the compensation.
24.
25.
26.
27.
28.
29.
30.
If you have a client who is on the ventilator, and the respiratory rate is set too high, will the
client go into respiratory acidosis or respiratory alkalosis? Explain why.
31.
Metabolic Acidosis:
32.
In metabolic acidosis, what are the problem organs? What chemicals are altered?
33.
34.
Which organs are going to compensate? With what chemical will they compensate?
35.
If you have a client who is in acidosis, do you want that client to retain CO2 to compensate,
or do you want this client to lose more CO2?
36.
CO2 is a what?
37.
If you have a client in metabolic acidosis, what is going to happen to their respiratory rate
and why?
38.
39.
40.
41.
42.
In any type of metabolic acidosis, what is going to happen to the serum potassium level?
Therefore, what is the major electrolyte imbalance they will have, and what is the major side
effect they will have?
Metabolic Alkalosis:
43.
In metabolic alkalosis, which organ has the problem? Therefore, what chemicals are going
to be altered?
44.
In metabolic alkalosis, which organs are going to compensate? What chemical are they
going to compensate with? Explain compensation.
45.
46.
47.
Why do we have to worry about hypokalemia in the alkalotic client? What life threatening
complication can occur?
48.
Burns
1.
If someone has been burned, fluid seeps out into the tissue, why?
2.
When the fluid seeps into the tissue, what happened to the blood pressure and the pulse?
Explain why.
3.
Why does the cardiac output decrease when the fluid seeps out into the tissue?
4.
During this phase (when the fluid is seeping into the tissue), is this client in a fluid volume
deficit or fluid volume excess?
5.
When a client is in a fluid volume deficit, why does their urine output decrease?
6.
After a major burn, when fluid is seeping out into the tissue, why is it important that ADH
and aldosterone are secreted?
7.
8.
When a client has any type of upper body burns, why do we have to worry about the
airway?
9.
10.
11.
Using the Parkland formula, what percent volume of fluid is given the 1st 8 hours, 2nd 8
hours, and 3rd 8 hours?
12.
What measurement is the best to way evaluate fluid volume status in the burn client?
13.
How will an IV with albumin help fight shock? What are the risks with albumin
administration?
14.
Explain the difference between the tetanus toxoid and the tetanus immune globulin.
15.
16.
17.
Why do clients with burns take a GI protectant medication, like an antacid or proton-pump
inhibitor?
18.
19.
20.
When a client has an electrical injury, they are at a high risk for what arrhythmia?
21.
22.
Oncology
1.
2.
3.
4.
When a client has a radiation implant, why do we put them on a low fiber diet?
5.
6.
Why do we want to keep the client with a radiation implant on bed rest?
7.
When a client has a radiation implant, there is a chance it will become dislodged. What
would you do?
8.
Explain the nursing care for the markings that a client will have when they are receiving
external radiation therapy.
9.
10.
What is a vesicant?
11.
12.
13.
14.
15.
When a client has had an abdominal hysterectomy, what is the position to avoid? Explain
why.
16.
Explain the post op care for a client who has had a mastectomy.
17.
Why is it so important that the mastectomy client elevate her arm on the affected side?
18.
Why is it important that the client exercise the affected side after a mastectomy?
19.
20.
When a client has a bronchoscopy, they are NPO until what returns?
21.
What are some complications of a bronchoscopy that you need to watch for?
22.
23.
When a client has had a pneumonectomy, what is the nursing care as far as positioning and
why?
24.
Why does the client who has had a total laryngectomy need to have a tracheostomy?
25.
Why does the client who had a total laryngectomy need to be positioned in Fowlers
position?
26.
27.
Why is it important that the laryngectomy client have frequent mouth care?
28.
Explain suctioning.
29.
Why are Ulcerative Colitis and Crohns disease considered to be risk factors for colon
cancer?
30.
31.
32.
Why is it important that hourly outputs be monitored after a client has had an ileal conduit?
33.
34.
Why is it important that the ileal conduit client change their appliance in the morning?
35.
Explain the pathophysiology behind urinary retention with an enlarged prostate (benign
prostatic hypertrophy), BPH.
36.
What are the symptoms of BPH? Why do they get these symptoms?
37.
What is the major lab work assessed when prostate cancer is suspected?
38.
39.
40.
When a client has had a TURP, why do they not have to worry about impotency and
infertility?
41.
Explain how a three-way catheter works and why the prostatectomy client has to have it.
42.
43.
Why is it important that the prostatectomy client avoid sitting, driving, strenuous exercise,
and lifting?
44.
45.
46.
When a client has had a fresh GI surgery, such as gastrectomy, is it okay for the nurse to
manipulate the NG tube?
47.
48.
Endocrine
1.
2.
3.
4.
5.
6.
7.
8.
9.
Why do you have to give iodine compounds in milk or juice and use a straw?
10.
Why would the hyperthyroid client be put on beta blockers? How does this help the client?
11.
12.
13.
When a client has had a thyroidectomy, why is it so important for them to support their
neck?
14.
15.
Why do we check for bleeding behind the neck with a thyroidectomy client?
16.
17.
How do you assess for recurrent laryngeal nerve damage in the thyroidectomy client?
18.
19.
20.
21.
When someone is hypothyroid, what has happened to their thyroid hormone levels?
22.
23.
What is cretinism?
24.
25.
When a client has started on drug therapy for hypothyroidism, is it temporary or permanent?
26.
When somebody is hyperparathyroid, what is the major electrolyte imbalance they have?
27.
Why do you have to worry about the bones of a client with hyperparathyroidism?
28.
29.
30.
31.
32.
Why does the hypoparathyroid client need a trach tray at the bedside?
33.
Why is it important that the hypoparathyroid client have a diet that is limited in phosphorus?
34.
When a client has a Pheochromocytoma, what is the major problem they have?
35.
36.
37.
38.
When you hear the word mineralocorticoids, what is the major word you need to think of?
39.
40.
41.
42.
If a client is making too much aldosterone, what is going to happen to the vascular space?
Explain why.
43.
44.
What is the major electrolyte imbalance a client with Addisons disease will have?
45.
46.
Could the Addisons disease client also have a life-threatening arrhythmia? If so, why?
47.
Does the Addisons disease client have too many steroids in their blood or not enough
steroids in their blood?
48.
Why does the Addisons disease client have trouble with shock?
49.
Why does the Addisons disease client need more sodium in their diet?
50.
Why is I&O such an important nursing intervention with the Addisons disease client?
51.
Is the Addisons disease client in a fluid volume deficit or a fluid volume excess?
52.
53.
When a client has Cushings syndrome, explain briefly, in your own words, what the client
will look like?
54.
a.
b.
c.
d.
e.
Growth arrest
Thin extremities and skin
Increased risk for infection
Hyperglycemia
Psychosis to depression (changes in mood)
55.
56.
Why does the Cushings syndrome client develop high blood pressure and heart failure?
57.
When a client has Cushings syndrome, their serum potassium level goes down. Why?
58.
Why does the Cushings syndrome client need more calcium in their diet?
59.
Does the Cushings syndrome client need to be on a low-sodium diet or a high-sodium diet?
Explain.
60.
Why does the Cushings syndrome client have ketones and glucose in their urine?
61.
Why does the Cushings syndrome client not have protein in their urine? Is it normal to have
protein in the urine?
62.
In the diabetic client, why does the glucose build up in their blood?
63.
In the diabetic client, why does the body start breaking down protein and fat?
64.
Anytime you break down fat, you are going to get production of what?
65.
66.
What is the major acid base imbalance the diabetic client can develop and explain why.
67.
a.
b.
c.
d.
Polyuria
Weight loss
Polydypsia
Polyphagia
68.
69.
70.
Why does a Type II diabetic have problems with wounds that will not heal or repeated
vaginal infections?
71.
72.
In the treatment of a diabetic, why do we have to limit the protein in the diet?
73.
74.
75.
When the diabetic client exercises, why do they have to worry about hypoglycemia and how
can they prevent it?
76.
Why is it important that a diabetic client exercise when their blood sugar is at its highest?
77.
How does the primary healthcare provider determine the insulin dose? What would it be for
a 175 pound client? Round to nearest whole number.
78.
79.
80.
What two assessments indicate that the insulin dose is adjusted properly?
81.
82.
When is the Basal insulin given? When is the Bolus insulin given?
83.
84.
85.
Explain how the Basal/Bolus method is similar to the bodys natural response to insulin
needs?
86.
When insulin is at its peak, that means the insulin is working really hard; therefore, what is
going to happen to the blood sugar at the peak time?
87.
88.
89.
What is going to happen to anybodys blood sugar when they are sick or stressed?
90.
When a diabetic client is sick, their blood sugar is going to go up; therefore, what do they
need to do with the dose of their insulin?
91.
What major complication can occur in a Type I diabetic when the blood sugar is
uncontrolled?
92.
What are some general S/S of hypoglycemia, and what is the immediate nursing action?
93.
After giving a simple sugar to the hypoglycemic client, what would the nurse do next?
94.
95.
If you walk into a diabetic clients room and find the client unconscious, do you treat the
client as hypoglycemic or hyperglycemic?
96.
Why is it so important that a diabetic client eat regularly and take their insulin regularly?
97.
98.
When a client has diabetic ketoacidosis, why is it important that we measure the blood sugar
and the potassium hourly?
99.
When you give a client insulin, what do you expect it to do to the clients blood sugar?
Why?
100.
When you give a client insulin, what do you expect it to do to the clients serum potassium
level? Explain why.
101.
Why is it so important that we monitor the diabetic ketoacidotic clients EKG so closely?
102.
103.
When a client has oliguria and anuria, what do you really have to start worrying about and
why?
104.
10
Cardiac
1.
2.
3.
If your cardiac output is decreased, do you perfuse as well as you normally do?
4.
5.
If you are taking care of a client with decreased cardiac output, what is going to happen to
their level of consciousness?
6.
7.
Why does a clients (whose cardiac output is low) skin feel cool and clammy?
8.
When you are taking care of a client who has decreased cardiac output, why do they get
short of breath and have wet lung sounds?
9.
When you are taking care of a client who has decreased cardiac output, why do their
peripheral pulses diminish?
10.
What is going to happen to urine output when you have a client who has decreased cardiac
output?
11.
When you have a client with decreased cardiac output, why does their blood pressure drop?
12.
13.
How can tachycardia (i.e., heart rate> 150) affect cardiac output?
14.
When someone has had an MI, how can this affect cardiac output and why?
15.
If my blood pressure is really high, how will this affect cardiac output and why?
16.
Draw a picture of my square heart and include the lungs and the aorta and trace the normal
blood flow through the heart.
17.
18.
19.
20.
When you give somebody nitroglycerine, more ________________ is going to get to the
heart muscle?
21.
22.
23.
24.
When you give somebody nitroglycerine, are they going to vasoconstrict or vasodilate?
Therefore, what is going to happen to their blood pressure?
25.
Why do clients with angina need beta blockers? List several examples.
26.
27.
Why is it so important that the angina client avoid isometric exercise, overeating, caffeine,
or any drugs that increase the heart rate and avoid cold weather?
28.
29.
30.
Before they take their nitroglycerine, should the client sit down or stand up? Explain.
31.
Why is it so important that you ask the client if they are allergic to iodine before they go for
a heart catheterization?
32.
Any time you have a client who is injected with iodine-based dye, what is the common
complaint the client will have?
33.
In post-cardiac catheterization, you have to watch the puncture site closely. What
watching it for?
34.
When a client has had a heart cath, you have a pertinent nursing assessment you need to do
distal to the insertion site. Explain.
35.
36.
37.
38.
Why does an MI client get cold, clammy, and their blood pressure drop?
39.
Which biomarker would be appropriate if the client has delayed treatment post MI?
40.
are we
41.
42.
When a client goes into V-fib, what is the priority nursing action?
43.
44.
What drugs are used for chest pain when the MI client arrives to the ED?
45.
46.
47.
Before you give a thrombolytic, you are supposed to get a good history. What did I tell you
to focus on (what type of disease or illness)?
48.
After someone has received a thrombolytic, why is it so important that we decrease puncture
sites?
49.
50.
51.
52.
53.
54.
55.
If cardiac output is decreasing, that means the blood is not moving forward. If blood is not
moving forward, then it has got to go backwards, so therefore where is it going to wind up?
56.
What are the major symptoms of left-sided heart failure and explain why.
57.
Why does a client with left-sided failure have restlessness and tachycardia?
58.
59.
Why does the client with left-sided failure basically have pulmonary symptoms?
60.
61.
When a client is in right-sided failure, is the blood backing up into the arterial system or the
venous system?
62.
63.
64.
What is an A-line?
65.
Why is it so important that the distal circulation be checked when a client has an A-line?
Explain your checks that you are going to do (nursing assessment).
66.
If an A-line is accidentally pulled out, what is the first thing that needs to be done?
67.
When a client has an A-line, pressure has to be kept in the infusion bag. Why? What would
happen if you didnt keep the pressure on the infusion bag?
68.
69.
Which two medication groups are the standard for heart failure?
70.
71.
72.
When you start a client on an ACE, ARB or digoxin expect their cardiac output to increase;
therefore, what should happen to their:
a.
b.
c.
d.
e.
f.
Level of consciousness?
Lung sounds?
Urine output?
Skin?
Peripheral pulses?
Blood pressure?
73.
74.
When a client goes on a low-sodium diet and bed rest, what might happen to them?
75.
76.
77.
78.
Can the electrical part of your heart be working and the pumping mechanism not?
79.
80.
You really need to get worried about a pacemaker malfunctioning when the rate of the
pacemaker does what?
81.
Why is it so important that we immobilize the arm on the affected side after pacemaker
insertion?
82.
Why does the pacemaker client need to check their pulse every day?
83.
Why does the pacemaker client have to avoid electromagnetic fields? Give some examples
84.
If a HF client notices their weight increasing, what could that put them at risk for?
85.
86.
87.
What time of day does pulmonary edema usually occur and why?
88.
89.
90.
Why is it so important that we hurry up and decrease the circulating volume in the
pulmonary edema client?
91.
When a client is in pulmonary edema, why do we give them oxygen? How much do we give
them?
92.
93.
When a client is in pulmonary edema, why is it important that you sit them up with their
legs down?
94.
95.
96.
97.
98.
When a client has an arterial problem, it means the oxygen/blood are having a hard time
getting to the tissue, so therefore different S/S develop. Explain the S/S.
99.
Could a client with an arterial problem develop ischemia and necrosis in the affected
extremity? Explain.
10
100.
101.
When a client has a venous disorder, are they having trouble with oxygenation of the
affected extremity?
102.
Do you elevate venous disorders or lower venous disorders (such as an affected extremity)?
103.
104.
105.
106.
When taking care of a client with a venous disorder, do you use warm moist heat or cold
wet packs?
107.
client.
11
Psychiatric Nursing
1.
2.
3.
4.
5.
6.
7.
Why do you not want to argue with or try to reason with the manic client?
8.
9.
10.
11.
If you use restraints for a suicidal client what must you do?
12.
13.
14.
Why do we include time in the schedule for rituals with an obsessive compulsive disorder
client?
15.
Why does the alcoholic have trouble with losing their magnesium and potassium?
16.
Why would you observe the bulimic client for one hour after they have eaten a meal?
17.
18.
How can the client with panic attacks learn to stop their anxiety?
19.
20.
Renal
1.
2.
When a client has glomerulonephritis, are they in a fluid volume deficit or a fluid volume
excess?
3.
When a client has glomerulonephritis. Why do they develop malaise and headache?
4.
When a client has glomerulonephritis, why does their urine output go down?
5.
When a client has glomerulonephritis, why does their BUN and creatinine go up?
6.
When a client has glomerulonephritis, why do they get protein in their urine?
7.
8.
9.
10.
With any type of kidney disease, it is common for the BUN to be elevated; therefore, why
do we limit the protein in the diet?
11.
If you add protein to the diet of anyone with renal disease, what will happen to their BUN?
12.
13.
When determining fluid replacement for a renal disease client (glomerulonephritis), you
always give them what they lost in a 24- hour period plus 500 mL. What is the purpose of
adding 500 mLs?
14.
Once diuresis begins in glomerulonephritis, will the client be at risk for a fluid volume
deficit or fluid volume excess?
15.
When a client has nephrotic syndrome, what is the major element that is leaking out in their
urine?
16.
17.
If a client does not have protein or albumin in their vascular space (blood), what is going to
happen to all the fluid that is supposed to stay in their vascular system?
18.
19.
Therefore, will the nephrotic syndrome client (in the acute stages) be in a fluid volume
deficit or fluid volume excess?
20.
When a client has nephrotic syndrome, they develop total body edema, what is the proper
term for total body edema?
21.
When a client has nephrotic syndrome, it is common for them to be placed on prednisone.
Why?
22.
Does the nephrotic syndrome client need a high-sodium diet or a low-sodium diet? Explain
why.
23.
Does the nephrotic syndrome client need a high-protein diet or a low-protein diet? Explain
why.
24.
25.
26.
27.
28.
29.
30.
31.
32.
When a client is in renal failure, why does their BUN and creatinine go up?
33.
34.
35.
36.
37.
Why does the renal failure client develop anorexia, nausea, and vomiting?
38.
39.
Why does the renal failure client have to worry about osteoporosis?
40.
There are two phases of renal failure. The first phase is an oliguric phase, if a client is
oliguric, what has happened to the urine output?
41.
42.
43.
The second phase of renal failure is called the diuretic phase. When a client is diuresing,
what has happened to their urine output?
44.
45.
If a client goes into a fluid volume deficit, what will happen to their blood pressure?
46.
47.
When a client is diuresing, their serum potassium level goes down (hypokalemia). Explain
why.
48.
49.
50.
Does the client who is being hemodialyzed have to watch what they eat and drink in
between treatment? Why?
51.
Explain the basic nursing care for a circulatory access (A-V shunt, fistula, or graft).
52.
Why cant a client who has an alternate circulatory access device have blood pressures or
venipunctures in that extremity?
53.
54.
When a client is having peritoneal dialysis, where is the fluid going into?
55.
What would you do if you instilled 1,000 mL of fluid into the peritoneal dialysis client and
only 700 mL came back?
56.
57.
58.
When a client has peritoneal dialysis for renal failure, why do they have to increase protein
and fiber in their diet?
59.
When a client has peritoneal dialysis, why do they have a constant sweet taste and why do
they have anorexia?
60.
61.
What is the number one thing you need to remember with kidney stones?
62.
63.
64.
Gastrointestinal
1.
2.
3.
4.
6.
7.
Is it possible that a pancreatitis client might have to have insulin? Explain why.
8.
What are the dietary changes needed for the pancreatitis client?
9.
What is cirrhosis?
10.
When a client has cirrhosis, what happens to the blood pressure in their liver and what is the
proper term for this?
11.
Explain the S/S of cirrhosis and explain why the client develops each symptom.
12.
Why does the cirrhosis client sometimes develop hepatic encephalopathy and coma?
13.
Your client is going to have a liver biopsy. What clotting studies should be checked? Please
explain why.
14.
15.
16.
17.
Why does the client have to exhale and hold while the primary healthcare provider is
puncturing into the liver?
18.
Why are we worried about I & O and daily weights with the cirrhosis client?
19.
20.
21.
Why do we measure the abdominal girth in the cirrhosis client and what will it tell us?
22.
What is a paracentesis?
23.
When a client is having a paracentesis, what position do you put them in?
24.
25.
26.
During a paracentesis, could the client could go into a fluid volume deficit or a fluid volume
excess?
27.
Where is the first place that a cirrhosis client might develop jaundice?
28.
When jaundice gets to the skin, what is one of the major nursing diagnoses?
29.
30.
When a client has a liver disease, what should be done with protein in the diet?
31.
32.
What chemical builds up in the blood that causes a client to go into a hepatic coma?
33.
34.
What are symptoms of a hepatic coma? Explain why the client develops these symptoms.
35.
36.
If a client is in hepatic failure and eats protein, what is going to happen to the ammonia level
in their blood? Explain why.
37.
38.
39.
Why is oxygen important with a client who has bleeding esophageal varices?
40.
41.
42.
Why does the client with bleeding esophageal varices need a Sengstaken Blakemore tube?
43.
44.
45.
What is the pre-procedure care of a gastroscopy? Explain what a client should expect if they
are going to have a gastroscopy.
46.
When a client has a gastroscopy, they have to be NPO until their gag reflex returns. Why?
47.
48.
Why do we give the peptic ulcer client antacids? What type of antacids would be the bestliquid or tablet?
49.
Why do we give the client with peptic ulcer disease H-2 receptor antagonists? List some
examples.
50.
51.
52.
53.
Explain what you would teach a peptic ulcer client about diet.
54.
55.
56.
57.
What are the major nursing interventions for a client who has a hiatal hernia?
58.
59.
60.
61.
What are the major nursing interventions for a client who has dumping syndrome?
62.
63.
64.
65.
When a client has ulcerative colitis or Crohns disease, do they need a high-fiber or lowfiber diet? Why?
66.
Why does the client with ulcerative colitis or Crohns need to avoid cold foods and
smoking?
67.
Why does the client with ulcerative colitis or Crohns disease need steroids?
68.
69.
Why would an ileostomy client need to avoid rough foods or high-fiber foods?
70.
71.
72.
When a client has an ileostomy, what electrolyte are they losing a lot of?
73.
74.
75.
76.
77.
When a client has had any abdominal surgery, what is the position of choice and why?
78.
79.
80.
Why is it so important that we monitor daily weight in the client receiving TPN?
81.
82.
When a client is on TPN we check their urine every day. What are some things you should
be checking it for?
83.
84.
85.
86.
How should you position your client for central line insertion?
87.
88.
If air gets into the central line, what is going to happen? What position should you place the
client in?
89.
After the central line has been inserted, we always get a chest x-ray. What two things are we
checking for in this chest x-ray?
Respiratory
1.
2.
When a client is having a thoracentesis, where is the fluid being removed from?
3.
4.
When the pleural space fills with fluid, what happens to the lungs?
5.
Any time you are pulling fluid from a clients body (thoracentesis, paracentesis, foley
catheter), are you putting the client at risk for going into a fluid volume deficit or a fluid
volume excess? Why?
6.
7.
8.
Chest systems have a water seal. What is the purpose of the water seal and what would
happen if there was not water seal?
9.
When a client has chest tubes, hopefully the lungs will do what?
10.
What critical numbers would you report related to oxygenation and drainage in a closed
chest drainage system?
11.
12.
13.
What should the nurse do if the water seal in the chest system is broken?
14.
What life threatening complication can occur if you clamp a chest tube?
15.
What is a hemothorax?
16.
What is pneumothorax?
17.
When blood, air or fluid accumulates in the pleural space, what is going to happen to the
lung?
18.
What should you do if a client presents with a penetrating object to the chest?
19.
20.
21.
When a client has an open pneumothorax, you are supposed to put a piece of occlusive
gauze over the area. How many sides are taped down? Why do we leave one side open?
22.
When a client has a fractured sternum or ribs, why are the respirations so shallow? What
acid base imbalance will this put them at risk for?
23.
24.
25.
26.
Why does the client with flail chest develop paradoxical chest wall movement?
27.
With a fractured sternum or ribs, why is the client put on a ventilator with PEEP?
28.
What is PEEP?
29.
What is CPAP?
30.
What is the major difference between the two (PEEP and CPAP)?
31.
32.
33.
When a client has a pulmonary embolus, why does their pulse go up?
34.
35.
When a client has a pulmonary embolus, the blood pressure is going to go up in their lungs.
What effect will this have on the right side of the heart?
36.
With a pulmonary embolus, the client will have fever and their WBC count will go up.
Why?
37.
38.
How will Heparin help the client who has developed a pulmonary embolus?
39.
40.
Orthopedics
1.
2.
3.
4.
5.
7.
8.
9.
11.
When a client with an orthopedic injury complains of pain, what is the first thing you should
do?
12.
13.
14.
15.
What type of assessment is very important when a client has skin traction? Explain why.
16.
17.
18.
When a client has a total hip replacement, there are some important things to remember
about positioning. Explain why each of these is important:
a. Neutral rotation.
b. Limit flexion.
c. Promote extension.
d. Abduction
19.
Discuss the general nursing care for someone with a continuous passive motion (CPM)
machine.
20.
What are some good exercises for the total hip replacement client?
21.
Give examples of things a total hip replacement client should avoid specifically related to
flexion.
22.
23.
24.
What can we do in the amputation client to prevent hip and knee contractures?
25.
26.
Maternity
1.
2.
When teaching a pregnant client about exercise what heart rate do you tell her not to get
above when exercising? And why?
3.
The client should be taught to be alert for what danger signs during pregnancy?
4.
What signs of true labor would the nurse teach the client?
5.
6.
The nurse caring for a laboring client receiving Pitocin would discontinue the Pitocin if
what occurred?
7.
When you assess tachycardia in a postpartum client, what should you think?
8.
What should the nurse do when palpating the postpartum clients fundus that is boggy? And
why?
9.
The nurse teaching a group of pregnant clients about breast feeding would include what
important points?
10.
What assessments are scored with the Apgar and when is it done?
Complications of Maternity
1.
2.
3.
4.
5.
6.
What are priority assessments for the client receiving magnesium sulfate?
7.
The nurse caring for a client in preterm labor would observe for which side effects of
terbutaline (Brethine)?
8.
9.
10.
When are pregnant clients routinely assessed for GBS risk factors?
Neuro
1.
2.
3.
4.
Explain the Babinski and the difference for a child less than one year of age and anyone
greater than one year of age.
5.
6.
7.
8.
9.
10.
11.
12.
Why is it so important that a client who is about to have cerebral angiography be well
hydrated?
13.
Why is it so important that we assess the peripheral pulses before a cerebral angiography?
14.
When a client is having a cerebral angiography, it is not uncommon for them to complain of
a warmth in the face. Explain why.
15.
Why is it so important that you ask a client who is about to have a cerebral angiography if
they have any allergies? What are you worried about?
16.
Explain the post-procedure care for the cerebral angiography client and explain why.
17.
Why is it so important that we watch for an embolus after cerebral angiography? Explain
what you would watch for specifically in your client.
18.
What is an EEG?
19.
What is the pre-procedure care for a client who is going to have an EEG?
20.
If a client were about to have an EEG, what would you tell them about the procedure?
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
Describe decorticate and decerebrate posturing. What do they mean, which is worse?
32.
33.
Why are osmotic diuretics used in the treatment of intracranial pressure? Explain exactly
how they work.
34.
When a client is on an osmotic diuretic, they better have two organs that are working
perfectly. What are they?
35.
36.
What would happen to the intracranial pressure if the temperature were to exceed 100.4F?
37.
When taking care of a head injury client with increased intracranial pressure, why is it so
important that you space your nursing interventions?
38.
39.
40.
If a client were to become bradycardic, what would happen to the cerebral perfusion?
Explain why.
41.
If a client were to develop an increased blood pressure, what will happen to cardiac output?
Explain how this would affect cerebral perfusion.
42.
43.
Why is it so important that we keep the connections tight on an ICP monitoring device and
also why is it so important to keep the dressings dry?
44.
45.
Which isolation precautions should be adhered to for a client with bacterial meningitis?
Which precautions for viral meningitis?
46.
Define what a seizure is, discuss the difference between a partial and generalized seizure.
47.
48.
49.
50.
51.
Is the client most at risk for infection with an open or closed head injury?
52.
53.
54.
55.
56.
57.
58.
If a client has been diagnosed with a concussion, what things should you teach before they
go home?
59.
60.
If a client has an epidural hematoma, explain the sequence of events that will occur and why
the client has these changes.
61.
62.
63.
When you have a head injury client, why is it so important that we keep the environment
quiet?
64.
65.
Pediatrics
1.
2.
3.
Discuss nursing strategies that could be used to communicate with a child with
developmental disabilities.
4.
Why might nebulized epinephrine be used to treat LTB? What should you observe for after
its use?
5.
6.
7.
Why do we need to feed the pediatric client with heart failure when they are well rested,
when they wake up and are showing signs of hunger, and before they start crying?
8.
Why should an infant with a cleft lip and palate be burped frequently?
9.
10.
Why is the child, post tonsillectomy, positioned on their side, or head of bed elevated, or
prone?
Why would we want the child with Otitis Media to lie on the affected side?
1.
Why do you need to know med-surg core content first when delegating routine tasks to
LPNs and unlicensed assistive personnel (UAPs)?
2.
Why can UAPs only perform routine, simple, repetitive common activities on stable clients
in uncomplicated situations?
3.
4.
Why is the RN responsible for knowing the staffs strengths and weaknesses in regards to
delegation?
5.
6.
7.