QUESTION
Advanced Medical Surgical Nursing Week 3 Quiz ( Chapters 33-40)
Question
Question 1
A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic. What response by the nurse instructor is best?
a. It is due to side effects of medications for bronchodilation.
b. It is from overactive bone marrow in response to chronic disease.
c. It combats the anemia caused by an increased metabolic rate.
d. It compensates for tissue hypoxia caused by lung disease.
Question 2
A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional assessment finding should the nurse expect?
a. Heart rate of 120 beats/min
b. Cool, clammy skin
c. Oxygen saturation of 90%
d. Respiratory rate of 8 breaths/min
Question 3
A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?
a.“I have been drinking more water than usual.”
b.“I am awakened by the need to urinate at night.”
c.“I must stop halfway up the stairs to catch my breath.”
d.“I have experienced blurred vision on several occasions.”
Question 4
A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk for the development of left-sided heart failure?
a. A 36-year-old woman with aortic stenosis
b. A 42-year-old man with pulmonary hypertension
c. A 59-year-old woman who smokes cigarettes daily
d. A 70-year-old man who had a cerebral vascular accident
Question 5
A client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it works. What response by the nurse is best?
a. “It inhibits thrombin.”
b. “It inhibits fibrinogen.”
c. “It thins your blood.”
d. “It works against vitamin K.”
Question 6
A client undergoing hemodynamic monitoring after a myocardial infarction has a right atrial pressure of 0.5 mm Hg. What action by the nurse is most appropriate?
a. Level the transducer at the phlebostatic axis.
b. Lay the client in the supine position.
c. Prepare to administer diuretics.
d. Prepare to administer a fluid bolus.
Question 7
A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition?
a. Sinus tachycardia
b. Speech alterations
c. Fatigue
d. Dyspnea with activity
Question 8
A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best?
a.“Do you have trouble affording your medications?”
b.“Most people with hypertension do not have symptoms.”
c.“You are lucky; most people get severe morning headaches.”
d.“You need to take your medicine or you will get kidney failure.”
Question 9
A client received tissue plasminogen activator (t-PA) after a myocardial infarction and now is on an intravenous infusion of heparin. The client’s spouse asks why the client needs this medication. What response by the nurse is best?
a.“The t-PA didn’t dissolve the entire coronary clot.”
b.“The heparin keeps that artery from getting blocked again.”
c.“Heparin keeps the blood as thin as possible for a longer time.”
d.“The heparin prevents a stroke from occurring as the t-PA wears off.”
Question 10
The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning?
a. Cholesterol: 126 mg/dL
b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL
c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL
d. Triglycerides: 198 mg/dL
Question 11
A hospitalized client has a platelet count of 58,000/mm3. What action by the nurse is best?
a. Encourage high-protein foods.
b. Institute neutropenic precautions.
c. Limit visitors to healthy adults.
d. Place the client on safety precautions.
Question 12
A client is in the hospital after suffering a myocardial infarction and has bathroom privileges. The nurse assists the client to the bathroom and notes the client’s O2 saturation to be 95%, pulse 88 beats/min, and respiratory rate 16 breaths/min after returning to bed. What action by the nurse is best?
a. Administer oxygen at 2 L/min.
b. Allow continued bathroom privileges.
c. Obtain a bedside commode.
d. Suggest the client use a bedpan
Question 13
A nurse is working with a client who takes atorvastatin (Lipitor). The client’s recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?
a. Ask if the client eats grapefruit.
b. Assess the client for dehydration.
c. Facilitate admission to the hospital.
d. Obtain a random urinalysis.
Question 14
While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. Which action should the nurse take next?
a. Assess for symptoms of left-sided heart failure.
b. Document this as a normal finding.
c. Call the health care provider immediately.
d. Transfer the client to the intensive care unit.
Question 15
The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates the client is managing this condition well with diet?
a. A 4-ounce steak, French fries, iceberg lettuce
b. Baked chicken breast, broccoli, tomatoes
c. Fried catfish, cornbread, peas
d. Spaghetti with meat sauce, garlic bread
Question 16
A client is in shock and the nurse prepares to administer insulin for a blood glucose reading of 208 mg/dL. The spouse asks why the client needs insulin as the client is not a diabetic. What response by the nurse is best?
a. “High glucose is common in shock and needs to be treated.”
b. “Some of the medications we are giving are to raise blood sugar.”
c. “The IV solution has lots of glucose, which raises blood sugar.”
d. “The stress of this illness has made your spouse a diabetic.”
Question 17
The nurse gets the hand-off report on four clients. Which client should the nurse assess first?
a. Client with a blood pressure change of 128/74 to 110/88 mm Hg
b. Client with oxygen saturation unchanged at 94%
c. Client with a pulse change of 100 to 88 beats/min
d. Client with urine output of 40 mL/hr for the last 2 hours
Question 18
A nurse cares for a client with right-sided heart failure. The client asks, “Why do I need to weigh myself every day?” How should the nurse respond?
a. “Weight is the best indication that you are gaining or losing fluid.”
b. “Daily weights will help us make sure that you’re eating properly.”
c. “The hospital requires that all inpatients be weighed daily.”
d. “You need to lose weight to decrease the incidence of heart failure.”
Question 19
A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate?
a. “Make certain that your bath water is warm.”
b.“Avoid straining while having a bowel movement.”
c.“Limit your intake of caffeinated drinks to one a day.”
d.“Avoid strenuous exercise such as running.”
Question 20
A nurse is caring for a client after surgery. The client’s respiratory rate has increased from 12 to 18 breaths/min and the pulse rate increased from 86 to 98 beats/min since they were last assessed 4 hours ago. What action by the nurse is best?
a. Ask if the client needs pain medication.
b. Assess the client’s tissue perfusion further.
c. Document the findings in the client’s chart.
d. Increase the rate of the client’s IV infusion.
Question 21
An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?
a. “I get short of breath when I climb stairs.”
b. “I see halos floating around my head.”
c. “I have trouble remembering things.”
d. “I have lost weight over the past month.”
Question 22
The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?
a. Clopidogrel (Plavix)
b. Enoxaparin (Lovenox)
c. Reteplase (Retavase)
d. Warfarin (Coumadin)
Question 23
A nurse assesses a client’s electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The client’s chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites.
Question 24
A nurse caring for a client with sickle cell disease (SCD) reviews the client’s laboratory work. Which finding should the nurse report to the provider?
a. Creatinine: 2.9 mg/dL
b. Hematocrit: 30%
c. Sodium: 147 mEq/L
d. White blood cell count: 12,000/mm3
Question 25
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?
a. An 86-year-old man with a history of asthma
b. A 32-year-old Asian-American man with colorectal cancer
c. A 45-year-old American Indian woman with diabetes mellitus
d. A 53-year-old postmenopausal woman who is on hormone therapy
Question 26
A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene?
a. Assessing blood pressure in both upper extremities
b. Auscultating the carotid arteries for any bruits
c. Classifying capillary refill of 4 seconds as normal
d. Palpating both carotid arteries at the same time
Question 27
A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?
a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min
c. Oxygen saturation increased from 88% to 96%
d. Pulse decreased from 100 beats/min to 80 beats/min
Question 28
A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client’s medication administration record to prevent a common complication of this condition?
a. Sotalol (Betapace)
b. Warfarin (Coumadin)
c. Atropine (Sal-Tropine)
d. Lidocaine (Xylocaine)
Question 29
A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?
a. Document the finding in the chart.
b. Initiate external pacing.
c. Assess the client’s medications.
d. Administer 1 mg of atropine.
Question 30
A client presents to the emergency department in sickle cell crisis. What intervention by the nurse takes priority?
a. Administer oxygen.
b. Apply an oximetry probe.
c. Give pain medication.
d. Start an IV line.
Question 31
A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure?
a.“I sleep with four pillows at night.”
b.“My shoes fit really tight lately.”
c.“I wake up coughing every night.”
d.“I have trouble catching my breath.”
Question 32
A nursing student is caring for a client who had a myocardial infarction. The student is confused because the client states nothing is wrong and yet listens attentively while the student provides education on lifestyle changes and healthy menu choices. What response by the faculty member is best?
a.“Continue to educate the client on possible healthy changes.”
b.“Emphasize complications that can occur with noncompliance.”
c.“Tell the client that denial is normal and will soon go away.”
d.“You need to make sure the client understands this illness.”
Question 33
A client is receiving an infusion of tissue plasminogen activator (t-PA). The nurse assesses the client to be disoriented to person, place, and time. What action by the nurse is best?
a. Assess the client’s pupillary responses.
b. Request a neurologic consultation.
c. Stop the infusion and call the provider.
d. Take and document a full set of vital signs.
Question 34
A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to start an IV. Which fluid choice is best?
a.0.45% normal saline
b.0.9% normal saline
c. Dextrose 50% (D50)
d. Lactated Ringer’s solution
Question 35
A student is caring for a client who suffered massive blood loss after trauma. How does the student correlate the blood loss with the client’s mean arterial pressure (MAP)?
a. It causes vasoconstriction and increased MAP.
b. Lower blood volume lowers MAP.
c. There is no direct correlation to MAP.
d. It raises cardiac output and MAP.
Question 36
A client has a serum ferritin level of 8 ng/mL and microcytic red blood cells. What action by the nurse is best?
a. Encourage high-protein Foods.
b. Perform a Hemoccult test on the client’s stools.
c. Offer Frequent oral care.
d. Prepare to administer cobalamin (vitamin B12).
Question 37
A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation?
a. A 45-year-old who takes an aspirin daily
b. A 50-year-old who is post coronary artery bypass graft surgery
c. A 78-year-old who had a carotid endarterectomy
d. An 80-year-old with chronic obstructive pulmonary disease
Question 38
A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When the client requests pain medication, what action by the nurse is best?
a. Give the client pain medication if it is time for another dose.
b. Instruct the client not to request pain medication too early.
c. Request the provider leave a prescription for a placebo.
d. Tell the client it is too early to have more pain medication.
Question 39
A nurse is caring for a client after surgery who is restless and apprehensive. The unlicensed assistive personnel (UAP) reports the vital signs and the nurse sees they are only slightly different from previous readings. What action does the nurse delegate next to the UAP?
a. Assess the client for pain or discomfort.
b. Measure urine output from the catheter.
c. Reposition the client to the unaffected side.
d. Stay with the client and reassure him or her.
Question 40
A nurse is assessing a dark-skinned client for pallor. What action is best?
a. Assess the conjunctiva of the eye.
b. Have the client open the hand widely.
c. Look at the roof of the client’s mouth.
d. Palpate for areas of mild swelling.
Diagnostic data and medical orders
UncategorizedDevelop and Concept Map, using the form provided, on the following patient. Include Diagnostic data and medical orders that you expect to be ordered on the patient.
T.J., a 30-year-old African American client, is in his last year of law school and is clerking for a prestigious law firm. He and his fiancé plan to marry as soon as he graduates. During the last week he has had four dizzy spells and a headache at the base of his skull upon awakening for the last 2 days. His father has a history of hypertension, so T.J. is aware that his symptoms may indicate high blood pressure. On his way home from work, T.J. stops by the clinic and asks the nurse to check his blood pressure. The nursing assessment yields the following data.
Subjective data: States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content. T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having hypertension because he does not want to take medication.
Objective data: T 98.6°F(37°C), AP 78 beats/min, R 16 breaths/min, BP 142/92 mm Hg, Wt 190 lbs (optimum weight 160). No edema noted in hands, feet, or legs.
A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic. What response by the nurse instructor is best?
UncategorizedQUESTION
Advanced Medical Surgical Nursing Week 3 Quiz ( Chapters 33-40)
Question
Question 1
A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic. What response by the nurse instructor is best?
a. It is due to side effects of medications for bronchodilation.
b. It is from overactive bone marrow in response to chronic disease.
c. It combats the anemia caused by an increased metabolic rate.
d. It compensates for tissue hypoxia caused by lung disease.
Question 2
A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional assessment finding should the nurse expect?
a. Heart rate of 120 beats/min
b. Cool, clammy skin
c. Oxygen saturation of 90%
d. Respiratory rate of 8 breaths/min
Question 3
A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?
a.“I have been drinking more water than usual.”
b.“I am awakened by the need to urinate at night.”
c.“I must stop halfway up the stairs to catch my breath.”
d.“I have experienced blurred vision on several occasions.”
Question 4
A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk for the development of left-sided heart failure?
a. A 36-year-old woman with aortic stenosis
b. A 42-year-old man with pulmonary hypertension
c. A 59-year-old woman who smokes cigarettes daily
d. A 70-year-old man who had a cerebral vascular accident
Question 5
A client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it works. What response by the nurse is best?
a. “It inhibits thrombin.”
b. “It inhibits fibrinogen.”
c. “It thins your blood.”
d. “It works against vitamin K.”
Question 6
A client undergoing hemodynamic monitoring after a myocardial infarction has a right atrial pressure of 0.5 mm Hg. What action by the nurse is most appropriate?
a. Level the transducer at the phlebostatic axis.
b. Lay the client in the supine position.
c. Prepare to administer diuretics.
d. Prepare to administer a fluid bolus.
Question 7
A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition?
a. Sinus tachycardia
b. Speech alterations
c. Fatigue
d. Dyspnea with activity
Question 8
A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best?
a.“Do you have trouble affording your medications?”
b.“Most people with hypertension do not have symptoms.”
c.“You are lucky; most people get severe morning headaches.”
d.“You need to take your medicine or you will get kidney failure.”
Question 9
A client received tissue plasminogen activator (t-PA) after a myocardial infarction and now is on an intravenous infusion of heparin. The client’s spouse asks why the client needs this medication. What response by the nurse is best?
a.“The t-PA didn’t dissolve the entire coronary clot.”
b.“The heparin keeps that artery from getting blocked again.”
c.“Heparin keeps the blood as thin as possible for a longer time.”
d.“The heparin prevents a stroke from occurring as the t-PA wears off.”
Question 10
The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning?
a. Cholesterol: 126 mg/dL
b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL
c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL
d. Triglycerides: 198 mg/dL
Question 11
A hospitalized client has a platelet count of 58,000/mm3. What action by the nurse is best?
a. Encourage high-protein foods.
b. Institute neutropenic precautions.
c. Limit visitors to healthy adults.
d. Place the client on safety precautions.
Question 12
A client is in the hospital after suffering a myocardial infarction and has bathroom privileges. The nurse assists the client to the bathroom and notes the client’s O2 saturation to be 95%, pulse 88 beats/min, and respiratory rate 16 breaths/min after returning to bed. What action by the nurse is best?
a. Administer oxygen at 2 L/min.
b. Allow continued bathroom privileges.
c. Obtain a bedside commode.
d. Suggest the client use a bedpan
Question 13
A nurse is working with a client who takes atorvastatin (Lipitor). The client’s recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?
a. Ask if the client eats grapefruit.
b. Assess the client for dehydration.
c. Facilitate admission to the hospital.
d. Obtain a random urinalysis.
Question 14
While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. Which action should the nurse take next?
a. Assess for symptoms of left-sided heart failure.
b. Document this as a normal finding.
c. Call the health care provider immediately.
d. Transfer the client to the intensive care unit.
Question 15
The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates the client is managing this condition well with diet?
a. A 4-ounce steak, French fries, iceberg lettuce
b. Baked chicken breast, broccoli, tomatoes
c. Fried catfish, cornbread, peas
d. Spaghetti with meat sauce, garlic bread
Question 16
A client is in shock and the nurse prepares to administer insulin for a blood glucose reading of 208 mg/dL. The spouse asks why the client needs insulin as the client is not a diabetic. What response by the nurse is best?
a. “High glucose is common in shock and needs to be treated.”
b. “Some of the medications we are giving are to raise blood sugar.”
c. “The IV solution has lots of glucose, which raises blood sugar.”
d. “The stress of this illness has made your spouse a diabetic.”
Question 17
The nurse gets the hand-off report on four clients. Which client should the nurse assess first?
a. Client with a blood pressure change of 128/74 to 110/88 mm Hg
b. Client with oxygen saturation unchanged at 94%
c. Client with a pulse change of 100 to 88 beats/min
d. Client with urine output of 40 mL/hr for the last 2 hours
Question 18
A nurse cares for a client with right-sided heart failure. The client asks, “Why do I need to weigh myself every day?” How should the nurse respond?
a. “Weight is the best indication that you are gaining or losing fluid.”
b. “Daily weights will help us make sure that you’re eating properly.”
c. “The hospital requires that all inpatients be weighed daily.”
d. “You need to lose weight to decrease the incidence of heart failure.”
Question 19
A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate?
a. “Make certain that your bath water is warm.”
b.“Avoid straining while having a bowel movement.”
c.“Limit your intake of caffeinated drinks to one a day.”
d.“Avoid strenuous exercise such as running.”
Question 20
A nurse is caring for a client after surgery. The client’s respiratory rate has increased from 12 to 18 breaths/min and the pulse rate increased from 86 to 98 beats/min since they were last assessed 4 hours ago. What action by the nurse is best?
a. Ask if the client needs pain medication.
b. Assess the client’s tissue perfusion further.
c. Document the findings in the client’s chart.
d. Increase the rate of the client’s IV infusion.
Question 21
An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?
a. “I get short of breath when I climb stairs.”
b. “I see halos floating around my head.”
c. “I have trouble remembering things.”
d. “I have lost weight over the past month.”
Question 22
The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?
a. Clopidogrel (Plavix)
b. Enoxaparin (Lovenox)
c. Reteplase (Retavase)
d. Warfarin (Coumadin)
Question 23
A nurse assesses a client’s electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The client’s chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites.
Question 24
A nurse caring for a client with sickle cell disease (SCD) reviews the client’s laboratory work. Which finding should the nurse report to the provider?
a. Creatinine: 2.9 mg/dL
b. Hematocrit: 30%
c. Sodium: 147 mEq/L
d. White blood cell count: 12,000/mm3
Question 25
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?
a. An 86-year-old man with a history of asthma
b. A 32-year-old Asian-American man with colorectal cancer
c. A 45-year-old American Indian woman with diabetes mellitus
d. A 53-year-old postmenopausal woman who is on hormone therapy
Question 26
A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene?
a. Assessing blood pressure in both upper extremities
b. Auscultating the carotid arteries for any bruits
c. Classifying capillary refill of 4 seconds as normal
d. Palpating both carotid arteries at the same time
Question 27
A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?
a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min
c. Oxygen saturation increased from 88% to 96%
d. Pulse decreased from 100 beats/min to 80 beats/min
Question 28
A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client’s medication administration record to prevent a common complication of this condition?
a. Sotalol (Betapace)
b. Warfarin (Coumadin)
c. Atropine (Sal-Tropine)
d. Lidocaine (Xylocaine)
Question 29
A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?
a. Document the finding in the chart.
b. Initiate external pacing.
c. Assess the client’s medications.
d. Administer 1 mg of atropine.
Question 30
A client presents to the emergency department in sickle cell crisis. What intervention by the nurse takes priority?
a. Administer oxygen.
b. Apply an oximetry probe.
c. Give pain medication.
d. Start an IV line.
Question 31
A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure?
a.“I sleep with four pillows at night.”
b.“My shoes fit really tight lately.”
c.“I wake up coughing every night.”
d.“I have trouble catching my breath.”
Question 32
A nursing student is caring for a client who had a myocardial infarction. The student is confused because the client states nothing is wrong and yet listens attentively while the student provides education on lifestyle changes and healthy menu choices. What response by the faculty member is best?
a.“Continue to educate the client on possible healthy changes.”
b.“Emphasize complications that can occur with noncompliance.”
c.“Tell the client that denial is normal and will soon go away.”
d.“You need to make sure the client understands this illness.”
Question 33
A client is receiving an infusion of tissue plasminogen activator (t-PA). The nurse assesses the client to be disoriented to person, place, and time. What action by the nurse is best?
a. Assess the client’s pupillary responses.
b. Request a neurologic consultation.
c. Stop the infusion and call the provider.
d. Take and document a full set of vital signs.
Question 34
A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to start an IV. Which fluid choice is best?
a.0.45% normal saline
b.0.9% normal saline
c. Dextrose 50% (D50)
d. Lactated Ringer’s solution
Question 35
A student is caring for a client who suffered massive blood loss after trauma. How does the student correlate the blood loss with the client’s mean arterial pressure (MAP)?
a. It causes vasoconstriction and increased MAP.
b. Lower blood volume lowers MAP.
c. There is no direct correlation to MAP.
d. It raises cardiac output and MAP.
Question 36
A client has a serum ferritin level of 8 ng/mL and microcytic red blood cells. What action by the nurse is best?
a. Encourage high-protein Foods.
b. Perform a Hemoccult test on the client’s stools.
c. Offer Frequent oral care.
d. Prepare to administer cobalamin (vitamin B12).
Question 37
A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation?
a. A 45-year-old who takes an aspirin daily
b. A 50-year-old who is post coronary artery bypass graft surgery
c. A 78-year-old who had a carotid endarterectomy
d. An 80-year-old with chronic obstructive pulmonary disease
Question 38
A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When the client requests pain medication, what action by the nurse is best?
a. Give the client pain medication if it is time for another dose.
b. Instruct the client not to request pain medication too early.
c. Request the provider leave a prescription for a placebo.
d. Tell the client it is too early to have more pain medication.
Question 39
A nurse is caring for a client after surgery who is restless and apprehensive. The unlicensed assistive personnel (UAP) reports the vital signs and the nurse sees they are only slightly different from previous readings. What action does the nurse delegate next to the UAP?
a. Assess the client for pain or discomfort.
b. Measure urine output from the catheter.
c. Reposition the client to the unaffected side.
d. Stay with the client and reassure him or her.
Question 40
A nurse is assessing a dark-skinned client for pallor. What action is best?
a. Assess the conjunctiva of the eye.
b. Have the client open the hand widely.
c. Look at the roof of the client’s mouth.
d. Palpate for areas of mild swelling.
Information Systems homework help
Uncategorized******Answer your questions using the MEAL format (Main idea, Evidence, Analysis, Link). The first sentence of your answer should include the main idea, or thesis, for the question. Next, provide evidence with a specific quote or a page number from the case. Next, analyze the evidence. Conclude by linking the evidence back to your thesis.
Accounting homework help
UncategorizedWeek 3 Discussion Topic 2:
Instructions:
All posts (both initial and responses) must be substantial (several paragraphs each) and each of your initial posts must be supported by 3 peer reviewed authoritative sources, not including the textbook, cited properly in APA format. Responses should have proper support with at least 1 different source as applicable.
https://youtu.be/qwBS_IXw3JQ
Review the video above and using peer reviewed articles to back up your position, discuss why you think big data analysis is useful in the retail environment. As part of your discussion discuss how the goals of big data mentioned in the text would relate to retail operations. Be sure to provide specific examples to support your position.
Catherine Williams is a 67-year-old Caucasian female who was brought to the hospital via an ambulance and subsequently admitted to the hospital on 1/19/2015 for dysphasia, dysphagia, and right hemiparesis.
UncategorizedQuestion Description
PATIENT NAME: Catherine Williams
DATE OF BIRTH:3/26/1947DATE OF ADMISSION:1/19/2015
PROGRESS NOTE
HISTORY: Catherine Williams is a 67-year-old Caucasian female who was brought to the hospital via an ambulance and subsequently admitted to the hospital on 1/19/2015 for dysphasia, dysphagia, and right hemiparesis. Ms. Williams has history of HTN, and high cholesterol. Husband states that patient is taking medication daily. No problems have been noted prior to 1 ½ hours ago when she began to show signs of right facial drooping and complained of cephalgia. Husband states the patient was unable to drink her coffee without the liquid spilling down her face.Per the husband, the patient was reaching in the cupboard for a dish, when her right arm started to fall. After sitting at the breakfast table, the patient began to rise, when she fell to the floor, and was unable to stand up without help. She showed a steady decline within minutes developing ataxia, dysphagia, and dysarthria.
OBJECTIVE FINDINGS: Physical examination shows the patient was alert, and oriented x 2. Mild confusion noted to place. Gait was not assessed at this time due to hemiparesis. Grips were unequal. Right pupil was sluggish to respond to light. Right lower extremity was flaccid. Blood pressure was 180/92 mm Hg. Pulse, 78. Respirations, 18. Temperature 98.7.Chest radiograph, Urinalysis, CBC, PTT, Basic Chemistry Panel and ABGs were obtained. ABGs showed low 02saturation. CT scan showed negative for an intracerebral hemorrhage. A neurology consultation was obtained. Neurologist confirmed the diagnosis of an ischemic stroke after an MRI of the brain demonstrated an ischemic area of the left cerebral cortex caused by a cerebral embolism.
IMPRESSION: Hemiparesis, HTN, Ischemic Stroke
TREATMENT SUMMARY: The patient was given Alteplase 0.9 mg/kg IV infused over 1 hour for first bolus. Continued with 0.81 mg/kg as continuous infusion over 60 minutes. Mannitol was started IV post Alteplase infusion. Patient transferred to ICU.Neuro checks ordered q 2 hrs.On the second hospital day, the patient developed hypotension, N & V. Reglan given IV and normal saline was increased to 150 drops per minute for 2 hours, then titrated down to 75. After 5 hours, patient BP was within normal limits, N & V subsided.Aggrenox started one capsule bid. Third day inpatient stay was unremarkable. Patient was transferred to medical floor.PT/OT, speech therapy ordered. Neuro checks reduced to every 4 hours. No further decline noted. Fourth inpatient stay, patient responding to PT/OT well. Use of walker with one assist. Gait and grip improving. No further neurological deficits noted. Discharge planning started. Rehabilitation facility recommended for continued PT/OT and speech therapy. Family educated on treatment plan, patient transferred to extended care facility for rehabilitation. Continue antiplatelet therapy. Informed patient and family to follow-up with neurologist one week after discharge from rehab.
PART 1: Using the information provided in Progress Note above, please complete the following information.
In this Assignment 2, imagine you are a medical professional working at XYZ Medical Center. Your patient is Mrs. Williams. Her son, Sam Williams, has just arrived from Montana. He is concerned about his mother’s wellbeing. You will be meeting with the patient’s son to update him on what has occurred during her hospital stay, the subsequent transfer to the rehabilitation facility and a discharge plan.
Use the information from the Progress Note to update Sam Williams on his mother’s condition. You will be translating the medical information from the report into layman’s terms in order for the patient and patient’s daughter to understand.
Please be sure use complete sentences, proper grammar, and spelling. You can use medical terms, however, you must also use layman’s terminology. Remember, it is your job to explain to the patient’s son what has occurred. You must use outside sources, including your textbook.
Your explanation to Sam Williams should be 500 words or more. Cite your reference/referencesin APA format at the end of your explanation.
Written Assignment requirements: Written work should be free of spelling, grammar, and APA errors. Points deducted from the grade for each writing, spelling, or grammar error are at your instructor’s discretion. Please be sure to view “Writing Center Resources” to assist you with meeting APA expectations. You may also access the link from Course Resources/AcademicSupport Center.
Write a 1,250-1,500 word paper discussing the role of quality and/or safety in nursing science.
UncategorizedThe Quality and Sustainability Paper is a practice immersion assignment designed to be completed in three sections. This is part one of the assignment. Learners are required to analyze and apply quality and/or safety measures specific to contemporary nursing science. General Guidelines: Use the following information to ensure successful completion of the assignment: · This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. · Doctoral learners are required to use APA style for their writing assignments. · This assignment requires that you support your position by referencing at least six to eight scholarly resources. At least three of your supporting references must be from scholarly sources other than the assigned readings. · This Assignment will be thoroughly checked for Plagiarism. Directions: Write a 1,250-1,500 word paper discussing the role of quality and/or safety in nursing science. Include the following: 1. Define quality or safety measures and describe their relationship and role in nursing science today. 2. Provide a contemporary example of how quality or safety measures are applied in nursing science. 3. Identify the quality and/or components needed to analyze a health care program’s outcomes. Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting.
Nurse Practitioner Interview
Nursing HomeworksNurse Practitioner Interview
I need at least a 6-slide Microsoft® PowerPoint® presentation with detailed speaker notes. The professor wants us to individually locate a nurse practitioner, who has been practicing for at least 3 years, and conduct an interview with them using the questions developed by the team. You need to interview a Nurse practitioner using the questions below and do 6-slide Microsoft® PowerPoint® presentation with detailed speaker notes.The 5 interview questions are below:
1. How, or did, your previous nursing experience help you progress from the novice to proficient/expert APRN role?
2. What are the roles and functions of a nurse practitioner in your workplace? What are some of the challenges that you are currently facing and how do you handle them?
3. Does your employer require you to participate in ongoing competencies or nursing organizations? If so, how does this requirement add value to your APRN practice?
4. Are you currently in a leadership position that has the ability to bring positive changes in health policy for your patients?
5. Did you have any challenges developing positive interprofessional relationships in your transition from a novice APRN to a proficient/expert level? What opportunities do you have to build strong interprofessional relationships with physicians and other APRNs?
Add a reference slide
Brain Modularity
Nursing HomeworksBrain Modularity
Using the your school Online Library; find two peer-reviewed journal articles on brain modularity, with a focus on visual sensation and perception. In your synopsis, you will include:
Submission Details:
Perceiving visually presented objects: recognition, awareness, and modularity Anne M Treisman* and Nancy G Kanwisherf
Object perception may involve seeing, recognition,
preparation of actions, and emotional responses-functions
that human brain imaging and neuropsychology suggest are
localized separately. Perhaps because of this specialization,
object perception is remarkably rapid and efficient.
Representations of componential structure and interpolation
from view-dependent images both play a part in object
recognition. Unattended objects may be implicitly registered,
but recent experiments suggest that attention is required to
bind features, to represent three-dimensional structure, and to
mediate awareness.
Addresses *Department of Psychology, Princeton University, Princeton, New Jersey 08544-1010, USA; e-mail: treisman@phoenix.princeton.edu tDepartment of Brain and Cognitive Sciences, El O-243, Massachusetts Institute of Technology, Cambridge, Massachusetts 02138, USA; e-mail: ngk@psyche.mit.edu
Current Opinion in Neurobiology 1998, 8:218-226
http://biomednet.com/elecref/0959438800800218
0 Current Biology Ltd ISSN 0959-4388
Abbreviations
ERP event-related potential fMRl functional magnetic resonance imaging IT inferotemporal cortex
Introduction It is usually assumed that perception is mediated by specific patterns of neural activity that encode a selective
description of what is seen, distinguishing it from other
similar sights. When we perceive an object, we may form
multiple representations, each specialized for a different
purpose and therefore selecting different properties to
encode at different levels of detail. There is empirical
evidence supporting the existence of six different types
of object representation. First, representation as an ‘object
token’-a conscious viewpoint-dependent representation
of the object as currently seen. Second, as a ‘structural de-
scription’- a non-visually-conscious object-centered rep-
resentation from which the object’s appearance from other
angles and distances can be predicted. Third, as an
‘object type’-a recognition of the object’s identity (e.g. a
banana) or membership in one or more stored categories.
Fourth, a representation based on further knowledge
associated with the category (such as the fact that the
banana can be peeled and what it will taste like). Fifth, a
representation that includes a specification of its emotional
and motivational significance to the observer. Sixth, an
‘action-centered description’, specifying its “affordances”
[l], that is, the properties we need in order to program
appropriate motor responses to it, such as its location,
size and shape relative to our hands. These different
representations are probably formed in an interactive
fashion, with prior knowledge facilitating the extraction of
likely features and structure, and vice versa.
Evidence suggests that the first four types of encoding
depend primarily on the ventral (occipitotemporal) path-
way, the fifth on connections to the amygdala, and the
sixth on the dorsal (occipitoparietal) pathway; however,
object tokens have also been equated with action-centered
descriptions [PI. Dorsal representations appear to be
distinct from those that mediate conscious perception;
for example, grasping is unaffected by the Titchener
size illusion [3]. Emotional responses can also be evoked
without conscious recognition (e.g. see [4**]). Object
recognition models differ over whether the type or identity
of objects is accessed from the view-dependent token or
from a structural description; in some cases, it may also be
accessed directly from simpler features.
The goal of perception is to account for systematic
patterning of the retinal image, attributing features to their
real world sources in objects and in the current viewing
conditions. In order to achieve these representations,
multiple sources of information are used, such as color,
luminance, texture, relative size, dynamic cues from mo-
tion and transformations, and stereo depth; however, the
most important is typically shape. Many challenges arise in
solving the inverse problem of retrieving the likely source
of the retinal image: information about object boundaries
is often incomplete and noisy; and three-dimensional
objects are seen from multiple views, producing different
two-dimensional projections on the retina, and objects in
normal scenes are often partially occluded. The visual
system has developed many heuristics for solving these
problems. Continuity is assumed rather than random varia-
tion. Regularities in the image are attributed to regularities
in the real world rather than to accidental coincidences.
Different types of objects and different levels of specificity
require diverse discriminations, making it likely that
specialized modules have evolved, or developed through
learning, to cope with the particular demands of tasks
such as face recognition, reading, finding our way through
places, manipulating tools, and identifying animals, plants,
minerals and artifacts.
Research on object perception over the past year has made
progress on a number of issues. Here, we will discuss
recent advances in our understanding of the speed of
object recognition, object types and tokens, and attention
and awareness in object recognition. In addition, we will
review evidence for cortical specializations for particular
components of visual recognition.
The speed of object recognition Evolutionary pressures have given high priority to speed
of visual recognition, and there is both psychological and
neuroscientific evidence that objects are discriminated
within one or two hundred milliseconds. Behavioral
studies have demonstrated that we can recognize up to
eight or more objects per second, provided they are
presented sequentially at fixation, making eye movements
unnecessary [S]. Although rate measurements cannot tell
us the absolute amount of time necessary for an individual
object to be recognized, physiological recordings reveal
the latency at which the two stimulus classes begin to
be distinguished. Thorpe et al. [6”] have demonstrated significant differences in event-related brain potential
(ERP) waveforms for viewing scenes containing animals
versus scenes not containing animals at 150 ms after stim-
ulus onset. Several other groups [7,8*,9-111 have found
face-specific ERPs and magnetoencephalography (MEG)
waveforms with latencies of 155-190 ms. DiGirolamo and
Kanwisher (G DiGirolamo, NG Kanwisher, abstract in
Psychonom Sot 1995, 305) found ERP differences for line drawings of familiar versus unfamiliar three-dimensional
objects at 170 ms (see also [S]).
Parallel results were found in the stimulus selectivity
of early responses of cells in inferotemporal (IT) cortex
in macaques, initiated at latencies of 80-looms. On
the basis that IT cells are selective for particular faces
even in the first 50ms of their response, Wallis and
Rolls [12] conclude that “visual recognition can occur
with largely feed-forward processing”. The duration of
responses by these face-selective cells was reduced from
250ms to 25 ms by a backward mask appearing 20ms
after the onset of the face, a stimulus onset asynchrony
at which human observers can still just recognize the
face. The data suggest that “a cortical area can perform
the computation necessary for the recognition of a visual
stimulus in ZO-30ms”. Thus, a consensus is developing
that the critical processes involved in object recognition
are remarkably fast, occurring within lOO-200ms of
stimulus presentation. However, it may take another
1OOms for subsequent processes to bring this information
into awareness.
Object tokens How then does the visual system solve the problems of
object perception with such impressive speed and accu-
racy? A first stage must be a preliminary segregation of the
sensory data that form separate candidate objects. Even
at this early level, familiarity can override bottom-up cues
such as common region and connectedness, supporting
an interactive cascade process in which “partial results of
the segmentation process are sent to higher level object
representations”, which, in turn, guide the segmentation
process [ 13.1.
Kahneman, Treisman, and Gibbs [14] have proposed
that conscious seeing is mediated by episodic ‘object
files’ within which the object tokens defined earlier
are constructed. Information about particular instances
currently being viewed is selected from the sensory
array, accumulates over time, and is ‘bound’ together in
structured relations. Evidence for this claim came partly
from the observation of ‘object-specific’ priming- that
is, priming that occurs only, or more strongly, when the
prime and probe are seen as a single object. This occurs
even when they appear in different locations, if the
object is seen in real or apparent motion between the
two. Object-specific priming occurs between pictures and
names when these are perceptually linked through the
frames in which they appear (RD Gordon, DE Irwin,
personal communication), suggesting that object files
accumulate information not only about sensory features
but also about more abstract identities. However, priming
between synonyms or semantic associates is not object
specific [15], that is, it occurs equally whether they
are presented in the same perceptual object or in
different objects. It appears that object files integrate
object representations with their names, but maintain
a distinct identity from other semantically associated
objects. Priming at this level would be between object
types rather than tokens. Irwin [ 161 has reviewed evidence on transsaccadic integration, suggesting that it is limited to
about four object files.
A similar distinction between tokens and types has
emerged from the study of repetition blindness, a failure
to see a second token of the same type, which was
attributed to refractoriness in attaching a new token to
a recently instantiated type [17]. Recent research has
further explored this idea. One role of object tokens is
to maintain spatiotemporal continuity of objects across
motion and change. Chun and Cavanagh [18”] confirmed
that repetition blindness is greater when repeated items
are seen to occur within the same apparent motion
sequence and hence are integrated as the same perceived
object. They suggest that perception is biased to minimize
the number of different tokens formed to account for the
sensory data. Objects that appear successively are linked
whenever the spatial and temporal separations make
this physically plausible. This generally gives veridical
perception because in the real world, objects seldom
appear from nowhere or suddenly vanish. Arnell and
Jolicoeur [ 191 have demonstrated repetition blindness for novel objects for which no pre-existing representations
existed. According to Kanwisher’s account [ 171, this implies that a single presentation is sufficient to establish
an object type to which new tokens will be matched.
The ‘attentional blink’ [ZO] describes a failure to de-
tect the second of two different targets when it is
presented soon after the first. Chun (21’1 sees both
repetition blindness and the attentional blink as failures
of tokenization, although for different reasons, because
they can be dissociated experimentally. Attentional blinks
(reduced by target-distractor discriminability) reflect a
Di I,ollo, JT Enns, personal communication). The account proposed
is that awareness depends on a match between re-entrant
information and the current sensory input at early
visual levels. A mismatch erases the initial tentative
representation. “It is as though the visual system treats the
trailing configuration as a transformation or replacement
of the earlier one.” Conversely, repetition blindness for
locations (R Epstein, NG Kanwisher, abstract in Psychononz
Sot 1996, 593) may result when the representation of an
earlier-presented letter prevents the stable encoding of
a subsequently presented letter appearing at the same
location.
Attention and awareness in object perception Attention seems, then, to be necessary for object tokens
to mediate awareness. However, there is evidence (see
[Z-l’]) that objects can be identified without attention
and awareness. If this is so, do the representations differ
from those formed with attention? Activation (shown
by brain-imaging) in specialized regions of cortex for
processing faces [26] and visual motion [27] is reduced
when subjects direct attention away from the faces or
moving objects (respectively), even when eye movements
are controlled to guarantee identical retinal stimulation
(see also [28]), consistent with the effects of attention
on single units in macaque visual cortex. Unattended
objects are seldom reportable. However, priming studies
suggest that their shapes can be implicitly registered
[?.9,30**], although there are clear limits to the number of
unattended objects that will prime [31]. Representations
formed without attention may differ from those that
receive attention: they appear to be viewpoint-dependent
[32’], two-dimensional, with no interpretation of occlusion
or amodal completion [30”]. On the other hand, in
clinical neglect, the ‘invisible’ representations formed in
a patient’s neglected field include illusory contours and
filled-in surfaces [33-l, suggesting that neglect arises at
stages of processing beyond those that are suppressed in
normal selective attention. With more extreme inattention,
little explicit information is available beyond simple
features such as location, color, size, and gross numerosity;
even these simple features may not be available, produc-
ing ‘inattentional blindness’ [34’]. Again, however, some
implicit information is registered: unseen words may prime
word fragment completion, and there is clear selectivity
for emotionally important objects such as the person’s own
name and happy (but not sad) faces.
Binding of features to objects is often inaccurate unless
attention is focused on the relevant locations [35].
My Nursing Ethic
Nursing HomeworksMy Nursing Ethic
After reading the Topic 1 materials, complete the questionnaire titled, “My Nursing Ethic.”
Using the reading and the questionnaire, write a paper of 750-1,000 words in which you describe your professional moral compass. As you write your paper, include the following: 1.What personal, cultural, and spiritual values contribute to your worldview and philosophy of nursing? How do these values shape or influence your nursing practice? 2.Define values, morals, and ethics in the context of your obligation to nursing practice. Explain how your personal values, philosophy, and worldview may conflict with your obligation to practice, creating an ethical dilemma. 3.Reflect and share your own personal thoughts regarding the morals and ethical dilemmas you may face in the health care field. How do your personal views affect your behavior and your decision making?
Do not be concerned with the use of ethical terminology for this paper.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin.
Nursing homework help
UncategorizedYou may use Google scholars or any other nursing journal.
Make sure all reference sources are within 5 years.
APA format and not Turnitin but plagiarism-free.
Please use this website for more help Reference List: Other Print Sources // Purdue Writing Lab
ALWAYS use in-text citation, many only used reference, but without in-text citation your work could be considered a plagiarism.
Always use the article ( this time it as Reese) in your writing, some people did not use it, used other sources. You can use both.