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med surg final

Total questions: 102

Worksheet time: 1hrs 2mins

Name
Class
Date
1.

A student is discussing concussions, which statement would require further teaching?

a)

a concussion is a result of Trama

b)

a concussion can be seen on a CT

c)

there are symptoms present

d)

can involve a LOC

2.

A nurse is talking to a child's patients after the child suffered a concussion. The nurse will further educate the parents when they state:

a)

I won't let my child sleep because this will worsen their condition

b)

symptoms may come on gradually

c)

headache and confusion are expected symptoms

d)

these symptoms are temporary

3.

cerebral contusion is :

a)

occur deep within the brain/ in the frontal and temporal lobes

b)

scattered areas of bleeding on the surface of the brain

c)

b/t dura mater and skull

d)

- b/t dura mater and brain

4.

Symptoms of basilar skull fracture:

a)

dysfunction of cranial nerves vll and vlll

b)

subdural hematoma

c)

periorbital ecchymosis

d)

retroarticular ecchymosis

5.

Epidural hematoma:

a)

located in temporal regions

b)

tear in middle mengeal artery- due to fracture

c)

significant decrease in condition after seeming fine

d)

symptoms can develop slowly

6.

what hematoma occurs in the older population and alcoholic's- causes a sheering force of bridging vessels of cerebral cortex

a)

subdural

b)

epidural

c)

intracerebral

d)

diffuse

7.

subarachnoid hemorrhage classic presentation:

a)

thunderclap headache

b)

fast decline in LOC after seeming fine

c)

ataxia

d)

arthralgia

8.

Subarachnoid hemorrhage-

a)

Typically caused from ruptured aneurysm

b)

Blood between dura and arachnoid mater

c)

Bleeding in the space between the brain and the tissue covering the brain

d)

Tear in middle mengeal artery due to fracture (arterial bleed)

9.

Spinal shock/ areflexia:

a)

temporary symptoms

b)

occurs immediately after injury

c)

effects BP

d)

poikilothermic

10.

autonomic dysreflexia occurs at :

a)

C5 and below

b)

L5 and above

c)

T-6 and above

d)

C2

11.

causes of Autonomic Dysreflexia(Hyperreflexia)-

a)

full bladder/ uti

b)

tight clothing

c)

pressure areas/ fecal impaction

d)

anxiety

12.

What type of shock occurs as a result of loss of sympathetic tone :

a)

spinal shock

b)

neurogenic shock

c)

autonomic dysreflexia

d)

concussion

13.

cauda equine syndrome occurs from:

a)

head injury

b)

myocardial infarction

c)

neurogenic shock

d)

fall on sacral area

14.

The nurse determines a patient who had a spinal injury and is now in spinal shock requires further teaching when they state:

a)

these symptoms are permanent

b)

my symptoms may improve over time

c)

spinal shock occurs immediately after a injury

d)

i may have incontinace as a result of spinal shock

15.

symptoms of neurogenic shock include :

a)

tachycardia

b)

hypotension

c)

bradycardia

d)

hypertension

16.

what test will be done to see if CSF is present in the blood

a)

kerngis sign

b)

halos signs

c)

brudzikis signs

d)

romberg sign

17.

Contradictions for TPA:

a)

BP 185/110 or higher

b)

INR greater than 1.7

c)

recent head injury

d)

symptoms that stated 2 hours ago

18.

what NIH scale range would indicate severe stroke:

a)

1-4

b)

15-20

c)

5-15

d)

21-42

19.

Cushings triad

a)

decreased in bp

b)

increase in bp

c)

decrease pulse

d)

chyne stokes breathing

20.

A patient with Guillain-Barre syndrome states, "it is feeling harder and harder to breath". what is the priority nursing intervention?

a)

sit the client in a high fowlers position

b)

encourage deep breathing and medication

c)

suction the clients secretions

d)

prepare to intubate

21.

what are priority nursing interventions for a patient with increased ICP?

a)

dim lights, reduced stimuli

b)

head of bed 30*

c)

encourage frequent ambulation

d)

prophylactically give anticonvulsants

22.

Pulmonary ventilation refers to:

a)

Exchange of 02 and c02 between the blood and the cells

b)

exchange of air between the atmosphere and the alveoli

c)

transferring a substance from an area of higher to lower concentration

d)

movement of air in and out the respiratory tract

23.

the amount of air inhaled and exhaled

a)

pulmonary ventilation

b)

bronchial circulation

c)

total volume

d)

Tital volume

24.

Hyperventilation causes:

a)

increased blood Ph, high 02, low CO2

b)

decreased blood pH, high co2, high 02

c)

decreased blood ph, low c02, low 02

d)

Increased blood ph, low c02, high 02

25.

What supplies blood, nutrients and o2 to lungs?

a)

cellular respiration

b)

bronchial circulation

c)

pulmonary ventilation

d)

pulmonary perfusion

26.

factors that determine lung compliance:

a)

elasticity of lung issue

b)

its ability to expand and recoil

c)

asthma, chronic bronchitis

d)

increased 02

27.

what lung disease make it hard to fully expand lungs:

a)

obstructive lung disease

b)

restrictive lung disease

c)

increased surface tension

d)

lung compliance

28.

What are examples of obstructive lung diseases:

a)

pneumonia

b)

asthma

c)

bronchitis

d)

emphysema

29.

Gerontologic changes that occur in the respiratory system:

a)

cartilage in nasal septum increases causing deviated septum

b)

increased muscle tone

c)

increased compliance

d)

alveoli walls become thinner and contains fewer capillaries causing decreased gas exchange

30.

stimulates coughing:

a)

turbinate

b)

adenoiditis

c)

carina

d)

surfactant

31.

surfactant:

a)

produced in alveoli

b)

mixture of proteins and lipids

c)

contains connective tissue

d)

reduces surface tension of the alveoli to prevent collapse

32.

A nurse is educating a patient prior to a pulmonary angiography. Which statement is correct?

a)

It is normal for you to experience pain during this procedure

b)

iodine is not used

c)

you may feel a warm flush feeling and chest pressure upon instillation

d)

you have resume activity right away

33.

Priority nursing interventions for thoracentesis:

a)

give cough syrup prior

b)

lay of unaffected side post procedure

c)

asses for respiratory depression post procedure

d)

encourage coughing and deep breathing immediately after procedure

34.

serous fluid would indicate :

a)

trauma

b)

infection

c)

cancer, inflammation, heart failure

d)

fluid overload

35.

The nurse is assessing a patient who is post op from sinus surgery. The patient is swallowing frequently, the nurse would suspect:

a)

dry mouth

b)

cough reflex returned

c)

bleeding

d)

decreased 02

36.

Complications of pharyngitis:

a)

endocarditis/ rhematic fever

b)

RDH

c)

glomerulonephritis

d)

pulmonary edema

37.

Hot potato voice indicates what disease:

a)

pharyngitis

b)

laryngitis

c)

peritonsillar abscess

d)

tonsillitis

38.

A patient complains of a persistent cough that lasts longer than 2 weeks. The nurse would suspect :

a)

chronic seasonal rhinitis

b)

peritonsillar abscess

c)

cancer

d)

infection

39.

Obstructive lung disorders cause:

a)

difficulty exhaling air

b)

difficulty inhaling air

c)

cant fully expand lungs

d)

stiff lungs

40.

What are early signs of chronic bronchitis:

a)

yellow, purulent, blood streaked sputum

b)

barrel chest, hyperinflation of lungs

c)

productive cough in morning and evening, bronchospasm w/ coughing

d)

cyanosis, fever, pain

41.

A group of nursing students are discussing a patient that has pulmonary emphysema. Which statement is incorrect?

a)

This obstructive disease is common in COPD

b)

late stage symptoms include: speaking in short sentences, leaning forward, memory loss, confusion, stridor, lethargy

c)

They will have decreased vital capacity, increased residual volume, and increased total lung capacity

d)

patients with pulmonary emphysema require a minimum of 5L of oxygen at all times

42.

The nurse is administering o2 via nasal canula to a pt with pulmonary emphysema. The patients color improves but the pt also has a decrease in LOC. The nurses priority action should be to:

a)

this is normal for patients with COPD

b)

call the PCP

c)

asses the BP

d)

Stop the 02

43.

cystic fibrosis :

a)

caused by inflammation and bronchoconstriction of airway ad hypersensitivity of airway

b)

faulty transport of sodium and chloride, production of abnormally thick, sticky mucus

c)

alveoli lose elasticity trapping air

d)

collapse of alveoli

44.

A pt presents to the Ed with purulent sputum, finger clubbing, salty skin, and steatorrhea. The nurse would suspect what obstructive lung disease?

a)

asthma

b)

bronchiectasis

c)

pulmonary emphysema

d)

Cystic fibrosis

45.

Priority nursing interventions for cystic fibrosis:

a)

limit fluids

b)

Postural drainage, percussion and vibration

c)

Administer 02

d)

increased fluid intake

46.

What symptoms are consistent with CO2 narcosis:

a)

lethargy, stupor, decreased breath sounds, wheezing and crackles

b)

cough, purulent sputum, finger clubbing, hemoptysis

c)

cyanosis, fever, pain, sob, increased pulse and respiratory rate

d)

chronic cough, wheezing, bronchospasm

47.

Characteristics of restrictive lung disease:

a)

low compliance

b)

high compliance

c)

hard to fully expand lungs

d)

stiffer lungs

48.

Virchow's triad :

a)

hardening of vessels

b)

venostasis

c)

disruption of vessel lining

d)

hypercoagulability

49.

What symptoms are consistent with pulmonary edema:

a)

feeling of suffocation, cool moist and cyanotic, skin cyanotic and grey, moist frothy cough, hemoptysis

b)

apprehension, restlessness, wheezing, cyanosis, dyspnea, hypoxemia, hypercapnia,

c)

hoarseness, cough, lump in throat, bad breath, ear ache, sore throat

d)

dyspnea, cyanosis, CP, tachycardia, hypotension

50.

What are late signs respiratory failure:

a)

SOB, feeling of suffocation, cool moist and cyanotic,

b)

Immediately onset, pain, tachycardia, dyspnea

c)

chest pain, JVD, orthopnea, peripheral edema,

d)

confusion, lethargy, LOC, hypotension, tachypnea, tachycardia

51.

what occurs when 2 or more adjacent ribs fracture in multiple places decreasing movement of air:

a)

flail chest

b)

compression of chest wall

c)

pulmonary edema

d)

pneumoconiosis

52.

The nurse is caring for a patient with a chest tube. What findings would require the nurse to contact the PCP immediately?

a)

No movement in water chamber

b)

fluctuation of water chamber with inhalation and exhalation

c)

excessive bubbling

d)

bright red copious blood

53.

Cardiac output is:

a)

normal cardiac output is 8L/min

b)

the amount of blood pumped out the ventricle each beat

c)

the amount of blood pumped by each ventricle in 1 minute

d)

regulated by baroreceptors

54.

Systole:

a)

closure of the mitral and tricuspid valves

b)

closure of aortic and pulmonic values

c)

Loudest over apex

d)

occurs simultaneously with palpated pulse

55.

The P wave represents:

a)

depolarization from the AV node through out the ventricles

b)

firing of SA node, represents depolarization to atrial fibers

c)

Impulse delay at the av node

d)

repolarization of ventricles

56.

QT interval:

a)

caused by: antiarrhythmics', antihistamines, antidepressants, antibiotics

b)

can cause torsade's de pointes and ventricular fibrillation

c)

can cause sudden cardiac death

d)

has saw tooth appearance

57.

Symptoms of rhematic carditis:

a)

Polyarthritis, chorea, Erythema marginatum, arthralgia

b)

petechiae, Osler nodes, splinter hemorrhages, Roth spots, Janeway lesions

c)

general chest discomfort, low grade fever, tachycardia, SOB, fatigue

d)

ascites, hepatomegaly, dependent edema

58.

Diagnostic finding for rheumatic carditis:

a)

elevated troponin

b)

prolonged PR interval

c)

decreased troponin

d)

Cardiac isoenzymes elevated

59.

The nurse determines a patient with endocarditis understands the disease when they state the following:

a)

this is caused by a viral infection

b)

This will be treated with IV antibiotics 2-6 weeks

c)

i will have to take antibiotics before invasive dental procedures

d)

this is inflammation of the myocardium

60.

signs and symptoms of dilated cardiomyopathy:

a)

Syncope, fatigue, sob, chest pain

b)

DOE, palpations and chest pain Wet sounding lung, moist cough, fluid overload, edema

c)

DOE, change in mental status, dependent edema, ascites, hepatomegaly

d)

Fever, malaise, dyspnea, precordial pain,

61.

What type of cardiomyopathy occurs in children:

a)

dilated

b)

restrictive

c)

hypertrophic

d)

obstructive

62.

Complication of acute pericarditis:

a)

pericardial effusion

b)

cardiac tamponade

c)

thrombophlebitis

d)

DVT

63.

A nurse is education a patient on burgers disease, which statement by the patient would require further education:

a)

this disease is inflammation of vessels w/ clot formation

b)

blood flow is restricted in the lower extremities causing vascular occlusion

c)

i should avoid caffeine and smoking

d)

its expected that my pain will not ease with rest

64.

What valve disorder is characterized by obstruction L ventricular outflow:

a)

aortic regurgitation

b)

aortic stenosis

c)

mitral stenosis

d)

mitral valve prolaspse

65.

3 may symptoms of aortic stenosis:

a)

dizziness/syncope

b)

DOE

c)

angina on exertion

d)

palpitations

66.

symptoms of aortic regurgitation:

a)

S3 heart sound

b)

Displaced PMI

c)

Corgans pulse

d)

DOE

67.

PT wont experience symptoms of a coronary occlusion of its ___ occludes:

a)

60%

b)

80%

c)

50%

d)

20%

68.

What patients will have atypical signs of MI:

a)

PT with diabetes

b)

patients with pneumonia

c)

pt with osteoporosis

d)

women

69.

Characteristics of STEMI:

a)

irreversible tissue death

b)

complete occlusion

c)

elevated ST

d)

cant see on EKG

70.

A nurse is caring for a patient with an MI. What findings would the nurse report immediately to the PCP:

a)

blood in stool

b)

mental changes

c)

cold pulseless extremity

d)

pulse oximetry of 94%

71.

Contraindications for PTCA:

a)

acute MI

b)

single or double vessel disease

c)

left main coronary artery blockage

d)

one occlusion

72.

A patient w/ an MI is having a PTCA done. Which statement requires further teaching by the nurse regarding the procedure:

a)

"a flexible balloon catheter is threaded through peripheral artery"

b)

"complications can include artery rupture, MI, occlusion"

c)

"I will be fully sedated for this procedure"

d)

"this will help my artery to open"

73.

What refers white ring opaque around periphery of cornea

a)

Xanthelasma

b)

Arcus senillis

c)

angina pectoris

d)

henmocyteine

74.

Phlebothrombosis:

a)

clot in a vein without inflammation

b)

clot in vein with inflammation

c)

moving clot

d)

embolus

75.

presentation of arterial peripheral disease:

a)

pain better with dangling

b)

intermittent claudication

c)

punched out dry ulcer

d)

heat helps improve system

76.

venous peripheral disease:

a)

heavy throbbing pain due to pooling blood

b)

sores- wet wounds in lower legs/ ankles

c)

elevate legs

d)

intermitent caludicaton

77.

Supraventricular tachycardia:

a)

shortened diastole

b)

low cardiac output-heart failure

c)

angina , hypotension, syncope, reduced cardaic output

d)

treat with beta blockers

78.

Retinopathy is a sign of :

a)

severe hypertension

b)

MI

c)

Peripheral artery disease

d)

uncontolled diabetes

79.

Malignant hypertension:

a)

Hemorrhages and exudates in eyes

b)

Dangerously elevated BP

c)

Papilledema

d)

Diabetes and chronic kidney disease

80.

What is normal ejection fraction:

a)

41-50%

b)

50-75%

c)

30%

d)

40%

81.

The nurse is caring or a pt with left sided heart failure. The pt presents with rapid onset of air hunger, hypoxic, pink frothy sputum, hypertension. The nurse would suspect what:

a)

right sided heart failure

b)

hypertrophy

c)

mitral regurgitation

d)

flash pulmonary edema

82.

Cardiogenic shock occurs because of what issue:

a)

systolic heart failure

b)

diastolic dysfunction

c)

fluid overload

d)

Mi

83.

HIV type 1:

a)

less transmittable; longer interval between virus and aids

b)

mutates easily and frequently

c)

in the US

d)

in western Africa

84.

Where is HIV not found

a)

stool and urine

b)

sweat

c)

vomit

d)

breast milk

85.

The nurse determines a pregnant patient requires further teaching when she states:

a)

"i cannot transmit HIV through my breast milk"

b)

"i cannot donate blood"

c)

"i cant transmit HIV through my urine or stool"

86.

What precautions should the nurse implement when caring for a patient with HIV:

a)

droplet

b)

contact

c)

standard

d)

airborne

87.

What cellular changes happen in HIV:

a)

increased T4 cells

b)

decreased t4 cells

c)

increased B cells

d)

decreased B cells

88.

Pathophysiology of HIV:

a)

proliferation of leukocytes

b)

Impairs the ability of infected T4 cells to recognize foreign antigens and stimulate B-cells

c)

Destroys T4 cells

89.

Assessment findings of acute retroviral syndrome:

a)

fever, swollen and tender lymph nodes, pharyngitis, rash, muscle and joint pain

b)

pain, headache, vomiting

c)

increased heart rate, altered LOC

90.

Adjunct drug therapy's for HIV:

a)

Hydroxyurea: interferes with viral replication

b)

IL-2: boost immune defense

c)

Nsaids: decrease inflammation

91.

in HIV drug resistance can occur due to noncompliance:

a)

TRUE

b)

FALSE

92.

Canditis can occur as result of opportunistic infection form HIV:

a)

TRUE

b)

FALSE

93.

Safety consideration for HIV:

a)

leakproof containers for specimen transport

b)

report any exposure to blood

c)

recap needles

94.

Opportunist infections that can develop secondary to HIV:

a)

Pneumocystis pneumonia

b)

candidiasis

c)

cytomegalovirus

95.

Complications of AIDS;

a)

dementia complex

b)

distal sensory polyneuropathy

c)

gi upset

96.

The standard test for aids is PCR/ western blot

a)

true

b)

false

97.

Common symptoms of antivirals:

a)

N/V

b)

peripheral neuropathy

c)

ABD pain

d)

dry mouth

98.

What are early signs of TB:

a)

night sweats, productive cough w/ purluent and blood, weakness, SOB, hemoptysis

b)

weight loss, nonproductive cough, anorexia, fatigue

c)

fever, chest pain, finger clubbing

99.

What result of PPD test would indicate a positive response:

a)

less than 3mm

b)

5 or more mm

c)

1.5mm

100.

CO2 drives the need to breath:

a)

false

b)

true

101.

high 02 and low C02 can cause dizziness and tingling sensations:

a)

true

b)

false

102.

An increase in blood ph would cause a __ is Co2 levels:

a)

decrease

b)

increase

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