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**UWorld Test Bank Questions &
Answers 2024
BPH assessment? - ✔> voiding difficulty/urgency incomplete emptying straining to void nocturia urine retention Should never have burning with uriantion! this indicates a UTI Sexual intercourse does not have anything to do with this PAtient with altered level of consciousness positioning? - ✔side lying position septic shock symptoms - ✔Tachycardia, fever,hypotension (SYSTOLIC lower then 90), pallor, fatigued, cold, reduced urine output, SOB, Decreased LOC,N/V, sweating, most reliable indicator of neurological status? - ✔level of consciousness Herpes Zoster (Shingles) - ✔VZV virus amyotrophic lateral sclerosis (ALS) - ✔Survival is 3-5 years difficulty swallowing and breathing inability to communicate constipation EVERYTHING is down What should we implement immediately in a burn patient? - ✔ABCs! Fluids almost always first due to hypovolemia from loss of fluid in tissue Cushings triad - ✔Appears when a patient has an increased ICP for some time
Brdycardia, ^ systolic BP and wide pulse pressure, irregular respirations. Assess patient for brain swelling Ampule medication withdrawal - ✔use filter needle do not touch filter needle to edge of ampule receptive aphasia - ✔inability to understand spoken or written words Hotspot injection site for Enoxaparin - ✔Right or left side of abdomen 2inch from belly button Abdominal wound healing - ✔docusate nausea treatment pillow to cough abdominal binder monitor blood sugar Isotonic fluids - ✔include NS 0.9% NaCl and LR used for fluid resuscitation and hypovolemic shock and dehydration Blind person walking technique - ✔walk slightly ahead and to the side of the client with their hand on your elbow How is medication measured for pediatric clients? - ✔oral syringe How do you dress someone with a stroke? - ✔Affected side first SLE s/s - ✔elevated ESR +ANA Decreased WBC count, thrombocytopenia and anemia are common Monitor for kidney damage Halo device - ✔Clean pin sites with sterile solution Keep vest liner dry with cool blow dryer Foam inserts under pressure points Small pillow under head to reduce pressure Have wrench available in emergencies Lithotripsy - ✔increase fluid intake
Respirations are 12 or above Reflexes + Oxytocin/Pitocin - ✔Can cause hyperstimulation of the uterus Contractions >90 seconds or closer than 2 minutes Betamethasone - ✔For fetal lung maturity in preterm labor given to the mother, two IM injections 24 hours apart, before the baby is born (tocolytics are being administered to slow labour) Survanta (synthetic surfactant): - ✔given to the neonate after it is born, transtracheal route (blow in through the trachea) total weight gain for a normal pregnancy is? - ✔28lb +/- 3 lbs Methergine/ergometrine - ✔can cause HTN in mom This is an oxytocic to strengthen labor Terbutaline in pregnancy? - ✔Tocolytics Causes maternal tachycardia Relaxes uterus and stops preterm labor pathological jaundice - ✔occurs before 24 hours and may indicate early hemolysis caput succidaneum - ✔bruise that crosses sutures and is symmetrical Normal erythema toxicum neonatorum - ✔Benign papular rash Only tranq/psych medication that can be given during pregnancy? - ✔Haldol Probably signs of pregnancy? - ✔Chadwicks, godels, and Hegars signs In alphabetical order Chawdwicks - vagina is purplish/blue Godels - cervical softening Hegars - uterine softening
Latent phase of labor? - ✔0-4 dilation Contraction 5-30 minutes # 15-30 seconds Mild! Pain medications in labor? - ✔do not give the mother a pain med right before the baby is born - it will go straight to the infant also give during contractions Prolapsed cord? - ✔Push and position! Variable decelerations - ✔VERY bad Slow FHR Prolapsed cord Push and position! Placenta? - ✔3 vessels 2 arteries and 1 vein make sure al there upon delivery or the mom will hemorrhage What must the baby have before it leaves the delivery area? - ✔an ID band immediately Not sure what to answer on an OB question? - ✔Check FHR Veal Chop - ✔Variable Cord compression Early decels Head compression Accelerations Ok Late decels Placental insufficiency If the FHR tracing starts with L its bad and you LION, if it doesnt, you document, and if its variable this is horrible and push-position - ✔ Late decels on FHR? - ✔Bad LION High baseline variability? - ✔6-25 point variability
✔Press into the sacrum for counter pressure or place the mom into knee to chest or ahnds and knees to get the baby of the back How to time contractions? - ✔measure with one hand on fundus and time with other with a watch Uterine tetany - ✔-Too frequent contractions -decreased placental perfusion -No resting tone -Late deceleration contractions should NOT be what? - ✔Longer than 90 seconds or closer than 2 minutes apart This is uterine tetany and hyperstimlation Contraction frequency is what? - ✔beginning of one contraction to the beginning of the next Transition phase of labor? - ✔8- 2- 60- strong Stages of labor? - ✔Stage 1 - Dilate and efface the cervix This includes Latent,Active,Transition Sage 2 - push the baby out Stage 3 - push the placenta out Stage 4 - stop bleeding Best position of the infant when giving vaginal birth? - ✔ Vertical lie in pregnancy of the infant? - ✔means it can be born vaginally Dilation? - ✔opening of the cervix from 0- Effacement - ✔thinning of the cervix When do we take apical hr? - ✔prior to giving digitalis Back pain in pregnancy? - ✔do pelvic tilt exercises 2nd and 3rd trimester breathing problems? - ✔tripod position
Urinary incontinence is a problem in pregnancy when? - ✔1st and 3rd trimester Go to the bathroom every 2 hours Morning sickness in pregnancy treatment? - ✔Ginger Give dry carbs before getting out of bed 7 months until 9 months she will come in how often? - ✔every 2 weeks after 9 months you will see the doctor every? - ✔1 week How often will a female come in for prenatal visits from month 1-7? - ✔only once a month First auscultate fetal heart? When would you most likely? - ✔8 weeks 10 weeks Calculating due date - ✔Naegels rule First day a menstrual period, subtract 3 days and add 7 months When does the fundus reach the umbilicus? - ✔at 20-22 weeks and above umbilicus When is the fundus palpable? - ✔12 weeks which means its the end of the first trimester Trisomy 18 - ✔MAny die within the first week of life or do not make it to their first birthday Oxytocin increases risk for? - ✔Postpartum hemorrhage Uterine Tachysystole abnormal FHR and pattern Placenta abruption Uterine abruption What should a client do during a chest tube removal? - ✔Valsalva Manuever Take a deep breath, hold it, and bear down A suture removal kit, petroleum gauze, and occlusive dressing supplies will be needed.
LDL - <
Triglyceride - < Total cholesterol - < Cystoscopy teaching - ✔report inability to void gross hematuria blood clots fever chills severe pain Obstructive sleep apnea teaching - ✔Limit alcohol Lose weight avoid sedatives Use CPAP at night Multiple Sclerosis Symptoms - ✔1) optic neuritis
- motor and sensory problems
- bladder defects (atonic bladder)
- fatigue
- hyperreflexia
- spasticity
- depression muscle weakness spasticity incoordination loss of balance and fatigue are usually present Worse with exercise and better with rest Walk with feet apart slowly and with a cane frequent rest periods Upper drugs and their withdrawal symptoms? - ✔CAffeine
Cocaine PCP/LSD Methamphetamine Adderall Upper drugs have downer withdrawal symptoms Downer drugs and their withdrawal symptoms? - ✔demerol, piperazine, prolixin, ativan, xanax, valium, phenobarbitol, heroin, hashish, marijuana, alcohol Downer drugs have upper withdrawal symptoms Wernicke-Korsakoff's - ✔Psychosis caused by Vitamin B1(thiamine) deficiency Just redirect these patients Take B1 if you are a heavy drinker Never pick the answer where you are not involved and dont do something Never just pass it off to someone else - ✔ High pressure alarm? - ✔Obstructions which can be: Kinks - unkink it Biting Water/condensation - remove water from tube Mucus - turn patient, cough, deep breathe, suction Ventilator setting too high? Setting too low? - ✔Respiratory alkalosis - blowing off to much Co Respiratory Acidosis - not blowing off enough Low pressure alarm - ✔something disconnected - reconnect it Most high priority rhythms? - ✔Asystole and V-Fibrillation SEE these first!
pad rails suction and oxygen available PICC care? - ✔change gauze dressing every 48 hours or 7 days with transparent dressing flush line before and after each medication pause all infusing medications (except for vasopressors) prior to blood draw Scrub the hub 10-15 seconds TB symtpoms? - ✔Night sweats blood or pus-tinged sputum weight loss low-grade fever fatigue SOB dyspnea LAtex allergy associations? - ✔allergy to avocado and bananas allergy to balloons foley catheters LTBI Latent TB infection - ✔This just means the patient had a positive TB test and is not infectious Patient at high risk for falls and frequently leaves bed? - ✔round hourly put close to nurses station Activate bed alarms ask family members to stay with patient A-Fib - ✔Common after cardiac surgery Irregular rythym No P Waves rate control and anticoagulation needed Chest tube drainage? - ✔The patient cant have large amount of DARK red blood when repositioning or coughing. This can be due to retained blood.
Become concerned and notify physician if the blood is BRIGHT red with more than > ml an hour Psoriasis - ✔CAused by stress, trauma, infection use moisturizers Phototherapy Methotrexate infliximab phototherapy Normal A1C? Abnormal A1C? - ✔4-6% <7% is good for diabetics Open pneumothorax? - ✔FIRST priority is to cover on three sides to prevent air filling the pleural space and collapsing the lung Best oxygen mask used for asthma, pneumonia, sepsis or trauma? - ✔non-rebreather mask delivers 60-95% oxygen and is used short term NEVER use in COPD Abdominal Aortic Aneurysm (AAA) repair leak s/s? - ✔ecchymosis of the groin, penis, scrotum, perineum Groin, pelvic, or back pain Increased abdominal girth Tachycardia and hypotension decrease urine output MAcrocytic anemia - ✔seen in Vegans with B12 deficiency irritable bowel syndrome (IBS) - ✔Keep a record of diet and stress levels limit gas producing foods exercise limit caffeine Dairy is high in? - ✔Potassium phosphorous calcium Vitamin D
✔Empty bladder Obtain baseline vitals, circumference of abdomen and weight DOCTOR obtains consent Higher fowlers or sitting positioning Client positioning for chest tube insertion? - ✔Arms raised above the head on the affected side NEVER raise all 4 rails on the bed! - ✔This is considered imprisonment only 2-3! Severe neutropenia WBC and ANC? - ✔4-11k ANC - 2200- Provide neutropenic precautions immediately! When are thrombocytopenia precautions immediate? - ✔Avoid IM injections and venipunctures when the platelet count is below 50k IS nodding an appropriate form of stating understanding? - ✔NO Continuous tube feeding steps - ✔Identify client Elevate bed (30-45 degrees) Validate tube placement Flush tube with 30ml water Administer tube feeding Pull the pinna up and back in what age? Down and back in what age? - ✔> < Best oxygen mask for clients with respiratory failure or COPD? - ✔Venturi mask They deliver oxygen that does not vary concentration with breathing 4-person sling lift - ✔used in a heavy bariatric client who cannot bear weight or cooperate with transfer When determining whether a client can transfer safely we must ask? -
✔Whether the client can bear weight Whether the client is cooperative If they are both they Ascending stairs steps - ✔Assume tripod position (place weight onto the crutches) Place unaffected leg onto stair Transfer body weight from crutches to the unaffected leg and raise the body up Advance the leg Peak flow meter red zone in asthma? - ✔<50% can mean hospitalization Disaster triage - ✔ Signs of trauma with a urinary catheter, what do we do? - ✔There may be blood due to the patient pulling on it and it is best that we remove it Breast Cancer causes? - ✔1st degree relative with BC BRCA1 or BRCA2 mutations period starting before age 12 Late menopause after age 55 Birth control use Increase in weight This tumor is hard, irregular, non-mobile and non-tender Neonate normal resting heart rate? - ✔110- Oculocephalic reflex - ✔Dolls eyes this is normal! Eyes should move in the opposite direction of the head turned Normal pupil size? - ✔3- Sign of increasing ICP? - ✔Change in LOC
Guillain-Barre Syndrome (GBS) - ✔ascending paralysis Moves upward over days/weeks Can cause respiratory compromise (but moves slowly from the feet up) Colorectal cancer symptoms? - ✔Blood in stool - anemia abdominal pain/bloating change in bowel habits unexplained weight loss routine cancer screening done after 50 Q10 years priapism - ✔Persistent painful erection lasting more than 2 hours common in sickle cell anemia Can cause bluish discoloration and can mean hypoxia of the tissue and necrosis Diabetic and would like to fast for religious perposes - ✔Assess for clinical stability and glycemic control. Can they monitor their own glucose during fasting? Ramadan - ✔Do not eat from dawn to sunset VAP - ✔>2-3 days after mechanical ventilation Symptoms are purulent sputum, positive sputum culture, ^ temp, New infiltrates on chest x-ray When can a patient resume sexual activity after an MI? - ✔NEVER give Sildenafil if taking nitrates Can resume if they are able t walk 1 block, or climb two flights of stairs without symptoms 7-10 after an uncomplicated MI COPD? - ✔Get vaccinated Report signs of infection (more sputu than usual) Use inhalers Knee amputation -
✔AKA - place prone for 30 minutes 3-4x per dat and use figure 8 compression bandage to decrease edema. If you elevate the leg it will cause flexion contractures. Bucks traction - ✔Client supine Weights hang freely - never move them Foot of bed raised Keep limb in neutral position Do not reposition DVT s/s - ✔unilateral swelling Local warmth Erythema Low-grade fever Monitor what in heparin drip? - ✔PTT Target is 1.5-2x the normal of 25-35seconds this is 50-70 seconds anything >100 seconds is critical Bleeding occurs in thrombocytopenia in a platelet count of? - ✔<50k Infective Endocarditis (IE) symptoms? - ✔FEver Arthralgia Weakness fatigue monitor for stroke! PSVT (Paroxysmal Supraventricular Tachycardia) - ✔Adenosine to reset! 150-
