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Pharmacology Review . generzc Brand usual dosage range mg/day Tegretol Klonopin Depakote Zarontin Neurontin Lamictal Luminal Dilantin Mysoline Depakene 200 anti convulsant carbamazepine clonazepam divalproex ethosuximide gabapentin lamotrigine phenobarbital phenytoin primidone valproic acid 1200 1.5 - 20 1000 4000 750 1500 300 1800 150 - 500 60 - 200 300 - 600 750 2000 1000 4000 anti psychotic Thorazine Prolixin Haldol Serentil Compazine Mellaril Navane Stelazine chlorpromazine fluphenazine haloperidol mesoridazine prochlorperazine thioridazine thiothixene trifluoperazine 50 - 1500 3 - 45 (1M 25 2 -40 50 5 00 15 - 40 50 400 5 60 30 150 anti psychotic (atypical) clozapine olanzapine quetiapine risperidone ziprasidone Clozaril Zyprexa Seroquel Risperdal Geodon 300 900 20 400 - 800 4 -16 40 - 200 Symmetrel Cogentin Artane 200 - 400 0.5- 8.0 5- 2 0 5 ~1JJ:iparkinson amantadine benztropine trihexyphenidyl anti depressant (tricyclic) amitriptyline clomipramine desipramine doxepin imipramine Elavi.l Anafranil Norpramin Sinequan Tofranil 150 - 300 150 - 250 75 - 300 150 - 300 75 - 300 ~ntid~pressant(SSRl) fluoxetine paroxetine sertraline Prozac Paril Zoloft 20- 80 20-50 50 - 200 anti depressant (MAOn phenelzine tranylcypromine Nardi! Parnate 30-90 20-60 Wellbutrin Desyrel 150 - 400 Eskalith, Lithonate 600 - 2400 anti depressant (mise) bupropion trazodone 200 -450 anti manic lithium 100 mgjweek) generic Brand single dose range mg Xanax Tenormin BuSpar Libruim Catapres Valium Benadryl Vistaril Ativan Inderal 0.25 - 2.0 anti anxi~!y alprazolam atenolol buspirone chlordiazepoxide clonidine diazepam diphenhydramine hydroxyzine lorazepam propranolol 25 - 100 5 - 20 10 - 50 0.1- 3.0 2-10 25 -100 10 -50 0.5 - 2.0 10 80 sedative - hy:nnotic Sodium Amytal Noctec Dalmane Halcion amobarbital chloral hydrate flurazepam triazo]am 65 - 200 250 -1500 IS - 60 0.25 - 0·5 Medication Side effects (a partial list of some of the more common ones) anti convulsant: nausea, vomiting, anorexia, constipation, diarrhea, dry mouth, headache, vertigo, ataxia, drowsiness, fatigue, blurred or double vision, rash abnormal liver function, abnormalities in white or red blood cells e.g. agranulocytosis, leucocytopenia, aplastic anemia, thrombocytopenia anti psychotic: mov~m~nt Qlli<2rQ~rs/ abnormal involuntary movements (AIMS) I extra pyramidal effects (EPS) parkinsonian effects: difficulty speaking or swallowing, loss of balance control, pill rolling, mask-like face (flat affect), shuffling gait, rigidity, tremors, lethargy dystonia: muscle spasms, hvisting motions, twitching, inability to move eyes, weakness of arms or legs tardive dyskinesia: uncontrolled rhythmic movement of mouth, face, and extremities; lip smacking or puckering, puffing of cheeks, uncontrolled chewing, rapid or worm-like movements of tongue, writhing movements, jerky movements akathisia: restlessness, urgent need to keep moving paroxysm: abrupt nonpurposeful movements such as tics and twitches neuroleptic malignant syndrome fever, respiratory distress, tachycardia, convulsions, diaphoresis, hyper or hypo tension, pallor, fatigue, muscle stiffness, loss of bladder control gnticholinergic effects - dry mouth, constipation, blurred vision, dilated pupils, headache, weakness, urinary retention, increased heart rate, decreased sweating, confusion, memory impairment, attention deficit se9ation, orthostatic hypotension, photosensitivity Medication Side effects -continued anti parkinson: anticholinergic effects, anxiety, hyper or hypotension anti depressant: (tricyclic) anticholinergic effects, orthostatic hypotension, sedation, heart rhythm irregularities, photosensitivity, weight gain GI disturbances nausea, vomiting, diarrhea (SSRI) anxiety, dizziness, drowsiness, fatigue, headache, insomnia, dry mouth, diarrhea, nausea, sexual dysfunction, sweating, pruritis, tremor (MAOI) dizziness, headache, insomnia, restlessness, weakness, blurred vision, diarrhea, hypertensive crisis (Parnate cheese reaction) (mise) agitation, headache, drowsiness, dry mouth, nausea, vomiting, tremor lithium: fatigue, headache, impaired memory, abdominal pain, anorexia, diarrhea, nausea, polyuria, tremors, ataxia, acne, arrhythmias lithium toxicity can occur at doses close to therapeutic levels: (0.5 - 1.5 mEqJ} therapeutic, 2.0 mEqJl toxic) slurred speech, decreased coordination, muscular weakness, mental confusion, twitching, vomiting, coma anxiolytic diarrhea, nausea, vomiting, ataxia, drowsiness, dizziness, weakness, confusion, dry mouth, headache, lethargy, depression, dependence, tolerance sedative & hypnotic confusion, dizziness, headache, hangover, constipation, diarrhea, nausea, vomiting, excessive sedation, dependence, tolerance PT REVIEW BASIC NURSING CONCEPTS 1. Mr. Johnson, a 68-yr. old man with congestive heart failure, has been. prescribed a low-sodium diet. In instructing him on appropriate food choices, which would the nurse counsel him against eating? a. b. c. d. 2. The PT notes that the postoperative patient has been put on a clear diet. Which of the following items would not be included? a. b. c. d. 3. Caesar salad with a spinach frittata Steak, french fries, and a milkshake Chicken tettrazini and fresh fruit salad Chile con carne with garlic bread The vegetarian presents with anemia, fatigue, and loss of sensation in her hands and feet. The woman states that she does not eat any meat, chicken, or fish. The PT, suspecting a vitamin B12 deficiency, asks if she il1c1udes the following in her diet: a. b. c. d. 5. Apple juice Beef broth Orange juice Herbal tea John A is on coumadin therapy, which he takes because he has an artificial heart valve. Which meal plan would suggest the need for further teaching about the effects on this medication? a. b. c. d. 4. Spinach salad Canned chicken noodle soup Whole wheat bread Apples Green, leafy vegetables Fresh fruits Nuts, seeds, and dried fruits Eggs and milk The PT is counseling the 58-yr old male whose cholesterol reading was 250. She is instructing him in diet, exercise, and the avoidance of high cholesterol foods. Which of the following food choices would indicate the need for further teaching? a. b. c. d. Pasta primavera Large salad with lowfat dressing Turkey sandwich on whole-grain bead Cheese omelet PT REVIEW BASIC NURSING CONCEPTS 6. The PT is caring for an overweight 65-yr old man with gout. After discussion of the need to avoid high-purine foods since they promote uric acid formation, which comment by the man indicates he has understood the material? a. b. c. d. 7. Mary J. has had a gastrectomy because of stomach cancer. In order to prevent anemia, the PT will administer a(n) a. b. c. d. 8. Standard precautions Airborne precautions Droplet precautions Contact precautions A patient asks how to help protect her infant son from catching her upper respiratory infection. The PT replies that the most effective way to prevent the spread of infections is a. b. c. d. fa. iron supplement. folic acid supplement. list of foods to eat. vitamin 812 injection. A patient has been admitted to the hospital with infectious pulmonary tuberculosis. In order to protect the PT and prevent the spread of infection, which type of isolation precautions wi!! the nurse use when caring for him? a. b. c. d. 9. "I will try to avoid high-carbohydrate and sugary foods." "I will eat more foods with high fiber such as beans, oatmeal, and whole grains." "I will avoid organ meats, alcohol, fat, beans, lentils, and bran." "I will eat more low-fat protein and vegetables." coveting the mouth when coughing or sneezing. using sodium hypochlorite (bleach) and water to clean room surfaces. careful hand wasrling. using disposable tissues and wipes. The PT has been assigned to care for the patients listed below. For which patient is it essential that the nurse wear a gown? a. b. c. d. A patient with measles A patient with clostridium dificlle. A patient with pertussis. A patient wit streptococcal pharyngitis. PT REVIEW BASIC NURSING CONCEPTS 11. The nursing care plan for a confused client incontinent of urine should include which of the following programs? a. b. c. d. 12. The PT writes a note, and writes 12/240700 before describing her patient's dressing change. Seven a.m. refers to the a. b. c. d. 13. have a PT summarize his plan of care. review the records pertaining to his/her care. see lab reports and other data, but not narrative notes. have the physician explain what is in the chart. The PT is caring for Mr. Smith, who has advanced lung cancer. He has been given information about Advance Directives. Which of the following comments indicates the need for further teaching? a. b. c. d. 15. time the dressing change was done. time the note was written. time the nurse's shift ends. scheduled time for the dressing change. The hospitalized patient tells the PT he wants to see his chart. The PT correctly explains that the "Patient Bill of Rights" gives a patient the right to a. b. c. d. 14. Fluid restriction. Bladder training. Remotivation therapy. Occupational therapy. "I don't need Advance Directives. I don't expect to get better." "I want my nephew to make decisions fro me if I am unable to." "What if I want them to do everything they can to keep me alive?" "I want to make a Living Will to specify that I don't want to be intubated." The elderly cardiac patient informs the PT that he does not want to "be hooked up to a bunch of machines", and does not want to have CPR or other aggressive treatments done to prolong his life. The PT tells him that the most effective way for him to assure that he Will not have treatments he doesn't want is to a. b. c. d. inform the hospital chaplain of his wishes. inform his primary physician. discuss the matter with his family. prepare a Living Will. PT REVIEW BASIC NURSING CONCEPTS 16. The PT -orientee asks if she may hang intravenous fluids or insert lVs after she finishes her orientation. Her preceptor replies that her scope of practice is determined by hospital policy as well as the a. b. c. d. 17. In caring for a client with cerebral palsy, the PT should plan to institute all of the following EXCEPT a. b. c. d. 18. c. d. discard the page with the incorrect entry and rewrite the notes. move the page to the correct chart an change the patient's name on the top. cross out the wrong entry several times so that it cannot be read. draw a line throughout the incorrect entry and initial it. When filling out an incident report, it may be helpful for the PT to remember that the primary purpose of an incident report is to a. b. c. d. 20. frequent suctioning. assessing pupil size. adimistration of oxygen. seizure precautions. The PT has written his nursing note on the wrong patient's chart. It is one of the first entries on a new page. The best way for him to correct this is to a. b. 19. state's Psychiatric Technician Practice Act. PI's association charter. medical association guidelines for practice. Patient's Bill of Rights identify employees who make frequent errors. help lawyers defend the hospital against malpractice. prevent future incidents by identifying high risk practices. keep accurate records on patients prone to accidents. The patient who has been treated in the hospital for pneumonia has decided to leave the hospital even though she has not been discharged. The most important obligation of the PT or other medical provider is to a. b. c. d. attempt to convince the patient to remain in the hospital. notify d:scharge plann'ng. advise the patient of the risks of their decision. inform the next of kin. PT REVIEW NURSING PROCEDURES 1. The PT needs to perform the following procedures on her elderly patient. For which procedure is it essential that she use surgical asepsis? a. b. c. d. 2. The PT must obtain a clean catch urine specimen. She is responsible for all EXCEPT a. b. c. d. 3. Putting on stenle gloves. Opening the side flaps of the sterile pack Opening the flap of the sterile pack which is closest to the nurse Opining the outermost flap of the sterile pack The PT documents the characteristics of wound drainage after she changes the dressing. She includes all of the following observations EXCEPT a. b. c. d. 5. Instructing the client in the proper technique to obtain a clean catch specimen. Determining if the test is necessary. Preventing contamination of the specimen. Labeling the specimen and sending it to the lab. The PT is preparing to catheterize her patient prior to surgery. After gathering all of the necessary equipment, the PT begins to open the sterile pack containing the catheter set. Which of these steps should be taken first when implementing this aseptic procedure? a. b. c. d. 4. Intramuscular injection Removal of an indwelling catheter Colostomy Irrigation Gastric tube feeding color. amount. odor. temperature. The PT knows to maintain medical asepsis (clean technique) when performing the following procedure: a. b. c. d. Insertion of an IV catheter. Endotracheal suctioning Gastric tube feeding Foley catheter insertion PT REVIEW NURSING PROCEDURES 6. Ann Taylor has just been transferred to her p9tpartum room after delivering a stillborn infant. Her husband is with her, and they ask if they may see the baby. Which is the best response by the PT? a. b. c. d. 7. The PT is caring for a 62-year-old woman who is dying of gastric cancer. The woman's daughter tells the nurse that they do not want her told that she is dying because she "would not be able to handle it." The PT is concerned that this approach will hurt the family because a. b. c. d. S. the older woman might learn the truth from someone else and feel betrayed. she might not be as cooperative with the medical plans if she feels it is useless. it prevents open discussion about what is happening to the dying woman and her loved ones and doesn't allow her to express her feelings. it is difficult to conceal the truth from someone who knows you well. The doctor has ordered a urinalysis and C-S on a patient in your care. She has an indwelling Foley catheter to bedside drainage. The best way to obtain the specimen is to: a. b. c. d. 9. Offer to bring them a Polaroid picture of the infant Bring them a hospital bereavement package - a lock of hair, ID bands, footprints, and other keepsakes Suggest that it would be best not to see the baby, since they don't want to remember him that way Bring the baby to the parents and allow them to spend time alone with him open the port on the holding bag and obtain approximately 100cc to use for both tests. separate the catheter from the drainage bag tubing and drain only from the catheter. empty the collecting bag and collect the next 1OOcc that drains into the bag. use a sterile needle and withdraw urine through the rubber port on the drainage tubing. Which of the following sets of vital signs are within the normal range for an adult? a. b. c. d. BP SalSa, P 110, R 32. BP 110/S0, P 56, R 20 BP120/70,P6S,R16 BP 130/90, P 72, R 24 2 PT REVIEW NURSING PROCEDURES 10. The MOST appropriate method for assessing the temperature of a client on seizure precaution is a. b. c. d. 11. The correct area to assess the apical pulse is a. b. c. d. 12. nipple line and the sternal notch. fourth and fifth intercostal spaces, midaxillary line. fourth and fifth intercostal spaces, midclavicular line. second and third intercostal spaces, midsternal line. Elevating the foot of the bed with the knee gatch and pillows. Applying Ace bandages from ankle to thigh. Instructing the patient to flex and point his toes every 2 hours. Massaging the patient's legs, except for the calf area, several times a day. Monitor the client's temperature. Observe the client for arrhythmias. Check the extremities for pulses. Encourage coughing and deep breathing. The PT knows the primary purpose of an ear irrigation is to a. b. c. d. 15. the the the the Which of the following nursing measures would be MOST important immediately following cardiac catheterization? a. b. c. d. 14. between between between between Which of the following nursing measures would be MOST effective for preventing thrombophlebitis for a patient while on bedrest? a. b. c. d 13. oral. axillary. rectal. electronic. test for labyrinth function. facilitated surgery on the external ear. remove impacted cerumen. apply heat to the tissues of the ear canal. A patient scheduled for laryngectomy undergoes laryngoscopy pre-operatively. Which of the following activities is contraindicated immediately after this procedure? a. b. c. d. Talking. Coughing. Taking fluids orally. Moving about in bed. PT REVIEW NURSING PROCEDURES 16. The nurse suctions a client via his tracheostomy. When performing this procedure, in which of the following positions should the client's head be placed in order to clear his right bronchus of debris? a. b. c. d. 17. water. mineral oil. hydrogen peroxide. K-Y jelly. have the client drink several glasses of water. instill 5 cc of sterile saline into the client's tracheostomy. administer chest percussion and vibration for several minutes. reposition the client frequently. The outer cannula of a client's tracheostomy tube is aCCidentally expelled Which of these actions should the nurse take FIRST? a. b. c. d. 20. head turned to the left. head turned to the right. head tilted froward toward his chest. head tilted backward even with his shoulders. To help decrease the viscosity of respiratory secretions before suctioning a tracheostomy, the PT should a. b. c. d. 19. client's client's client's client's The PT should lubricated catheter used to suction a client's tracheostomy with sterile a. b. c. d. 18. The The The The Get a physician immediately. Cut the tracheostomy neck ties. Insert the emergency outer tube that is taped to the head of the bed. Put on the emergency call bell, then dilate the stoma until assistance arrives. The PT should instruct a patient undergoing nasal surgery not to blow his nose after surgery because a. it increases intercranial pressure. b. it decreases the patient's oxygen supply. c. it encourages bruising and edema. d. it may cause a fracture. 4 PTREVI W NElJROLOGIC SYSTE~1 The PT answers a cal! bell and finds a frightened mother whose child. the is having 3 seizure. Which of actions Id the nurse take'! 1. a. b. c. 2. TIle PT should insen a padded blade in the patient's mouth to prevent the child from swallowing or choking on his tongue. The PT should help the mother restrain the child to prevent him injuring himself The PT should PT should the client The PT admits a patient who intracranial pressure. Which help this patient'l [t. b. d. a. 0. c. d. inj ury and is at risk for' followir:g interventions will a clear nasal discharge suction the to prevent coughing or discllss administering an antihistamine to promote test the discharge agd inform the RN or encourage the client to blow his l'.ose The PT is assigned to report sign of increased intracranial patient. Wbat would most likely be the first sign of this'; a. b. c. d. to the Glasgow es to assess level of conSClOllsness hourly Assess pupi Is movement response to light Administer acetaminophen C] 3-4 hours for lleadache Elevate the head appro\.imately 30 degrees client with a head' 4. stimuli a VVl conSCIOLlSl1eSS 011 this 5. patient the ER was in a car accident and. while not seriously inj is of the or [ sympathetic nervous system response. exhibiting The knows to expect findings: a. b. c. d. 6. Sarah J. is admitted to the l:nit a CV A that damaged the brain. The nurse knows to position her a. b. c. d. 7. bradycardia cold hands pinpol!1t pupils diarrhea diarrhea side ofber on her side with the head of the bed slightly elevated on her left side with head the bed slightly elevated in prone position supine with the bed in trendelenberg The PT working in a college health center aim young woman who complains a severe headache. fever. and neck sti Her care is on the these symptoms are characteristic of knowledge a. 1~10nonuc b. men111gJtls s c. d. 8. Asian f1u The PT bappens to be at scene of an accident where an unconscious man who is not breathing is lying next to a ladder. Suspecting a possible neck' ury. the PT initiates rescue breathing the following maneuver: a. b. c. d. head tilt breathing through nose sweep mouth 9. elderly male patient has Parkinson'5 disease. fie been on !evodopa (L-Dopa) mg bid. Which of the following observations would indicate medication was having desired effect? a. b. c. d, 10, patient is able to walk to the bathroom patient's sister states that is more cheerful The patient exhibits a decrease in rigidity of movement The patient is able to eat soft food PT is assisting the physician the patient a. b, c. d, a lying prone with her arms extended leaning over the the bed on her side with her knees up on hands and knees tremors puncture. She helps to position \0 her chest PTREVIEW SENSORY SYSTElVl 1. The PT is assessing a patient with cataracts. She \\ould expect the patient to helVe had all ortlle follO\ving symptoms EXCEPT: a. b. c. d. J blurred vision that has getting progressively worse difficulty \vith glare and seeing in bright light a persistent. dull pam Intact peripheral vision The PT is providing preventive health teachi to the adult group and explains that glaucoma is the most preventable caLIse of blindness. She describes the the follov"ing EXCEPT: symptoms. which include a!l a. b. c. d. gradually decreasing peripheral vision A persistent duJ! ache in the eyes. Seei halos around I Decreased accol1lll1odatio:l to near The patient receiving treatment getting instructions from the need for further teaching') a. b. c. d, 4. g!auCOl1lJ with the miotic agent pilocarpine is Which comment by the patient indicates the "It will great to be able to see more clearly now. need these eyedrops for the rest of Illy life" These drops will 100ver the pressure inside my "I will take an antiemetic to prevent \olllit:ng. which increases intraocular pressure. "j ,v,'ili The PT is teaching an elderly man with diminished viSIon and is him independence. The include all of suggestions about 110\1, to maintain safe!:the following EXCEPT: a. b. c. d. putting medications ill different-shaped containers to tel] them apart using :elephones that h2\\ e programmed. automatic dial! llsing a microwave ovell for cooking that it is not to c1ange al1\ Llrnishi:1g. the 0" rugs. SInce you know where everything is. 5. The elderly man is Which comment ind a. b. c. d. 6. instructions the PT about he'ari 'J the need for further care. "Jt will be nice to be able to 111) grandchildren when we go s\Vlmml "When I'm not using it. I'll take battery out and turn it "I'll clean the hole \\ith a toothpick or pipe cJeaner.'· "I need to keep extra on hand." The PT is a patient who l1as just been tested for visual acuity and was told his vision v.,as The patient \vhat this means, and PT ansvvers. a. b. c. d. "You can see approximately 2/5 as well as the normal person." can see at tv,ent\ \\hat a person \\ith normal vision can see al fifty "Your vision is the same as thill a [wenty-year-old man. even tilOugh you are fi feel what a person with norma: vision can see at "You can see at twenty feet." PT REVIEW RESPIRATORY SYSTEM 1. Paula is admitted to the unit with pulmonary emphysema. You know that the oxygen must be delivered a. b. c. d. by a mask that will maintain a high 02 concentration. at 1OLlminute or more. only at night. in low concentrations. Which of the following factors, noted in a child's history, would MOST likely be significant in terms of precipitating an asthma attack? a. b. c. d. 3. A 55-yr old man with chronic obstructive pulmonary disease (COPO) is admitted to the hospital. Which of the following factors noted in the admitting history is probably related to his development of COPO? a. b. c. d. 4. He smoked for more than 30 years. He worked in an orchard for 20 years. he drinks four cans of beer a day. he has had pancreatitis four times. Which of the following signs or symptoms would the exhibit if he is hypoxic? a. b. c. d. 5. he slept on a new pillow last night. he exercises moderately three times a week. He takes vitamin supplements. He is allergic to shrimp. expect a client to Cool, bluish skin. Abnormal blood gases. Elevated temperature. Increased sputum production. A patient with chronic obstructive pulmonary disease (COPD) is drowsy and is unable to cough up his secretions. The PT should a. b. c. d. force fluids to liquefy secretions. administer high-flow oxygen via mask. perform nasotracheal suction. perform postural drainage. PT REVIEW RESPIRATORY SYSTEM 6. Blood gas results on a patient with emphysema indicated severe hypoxia. Oxygen therapy is ordered. Which of the following methods of oxygen administration will MOST likely be used? a. b. c. d. 7. A patient started on rifampin and isoniazid. Which of the following explanations concerning these medications is MOST appropriate for the PT to give? a. b. c. d. 8. suction every hour. clean the inner cannula after suctioning. clean the sited every 4 hours. hyperextend the client's neck to maintain patency. Tuberculosis is caused by a. b. c. d. 10. "You will have to take these medicines for the rest of your life." "You must isolate yourself from your family while on this medicine." "you will have to take this medicine for about a year." "You will need to take this medicine only when you have symptoms." A client requires an emergency tracheostomy. In caring for the tracheostomy, the PT should a. b. c. d. 9. Face mask with reservoir. Face mask without reservoir. Nasal cannula. Venturi mask. a virus. poor sanitation. poor nutrition. a bacterium. Which of the following organs is MOST commoonly affected in patients with cystic fibrosis? a. b. c. d. Thyroid. Pancreas. AdrEITials. Ovary. CARDIOVASCULAR QUESTIONS 1. lvIr. Graham is scheduled for an ECG. The best way to describe this test to him . a. It won't hurt and just be very still. b. It is a test that measures the electrical activity of your heart. c. It is a diagnostic procedure that will record impulses from the SA node through the electrical pathway throughout the cardiac tissue. d. It is a necessary test that will help the doctor determine how to take care of your heart. 2. Two ways to increase oxygenation to the myocardium are by administering a. Nitroglycerin and providing nasal 02 b. 02 and performing CPR c. Digoxin d. 02 through a venti mask and administering lidocaine 3. Fluid retention has become a problem for a patient with coronary artery disease. What is the best information to include in a teaching plan for this patient. a. Take a walk for 10 minutes every day b. Report any chest pain to the doctor immediately c. Take your diuretic on schedule and eat a banana every day d. Don't drink any water during meals 4. Peripheral vascular disease is most common in patients with a. An aneurysm b. Viral pneumonia c. Leukemia d. Diabetes Mellitus The health care provider is preparing to teach a patient with angina who is taking nitroglycerin. \Nhich of the following points should not be included in the instnlction? a. Nitroglycerin should be kept in a clear plastic or glass container b. Modification of risk factors such as obesity and smoking c. Prophylactic use of nitroglycerin d. Identifying factors that precipitate angina 6. The ill Team is planning a diet for a patient on digitalis and lasix. What foods would be included in the meal plan? a. bananas, orange juice, tomatoes, and potatoes b. milk, cheese, and yo gurt c. beef, pork, and lamb d. fish, chicken, beans and soy products 7. A 55 year old female was admitted to the unit exhibiting right sided hemiplegia, expressive aphasia, and history of hypertension. The physician has not diagnosed the patient. Based on the symptoms the health care provider could assume the patient has a diagnosis of: a. Ruptured aneurysm b. Myocardial infarction c. Cerebrovascular accident d. Buerger's disease 8. You walk into a patient's sleeping area and find the patient unresponsive. You go and call 911. VI'hen you return to the patient your next step will be: a. attach the AED . b. provide 5 abdominal thru§ts~;0; c. insert a breathing tube d. open the airway and look, listen, and feel for breathing 9. The adult chain of survival includes all of the following a. early defibrillation b. early advanced care c. early CPR d. early cardiac dnlgs ex~ept: I 10. You are canng for a patient that is 3 days post heart attackand is being discharged. When teaching the patient about risk factors for coronary artery disease, the health care provider should discuss: a. factors that contribute to hY'Perlipidemia b. turning, coughing, and deep breathing exercises . ., c. a VIgorous JQggmg program d. hy'Potension regulation PTREVIEW HEMATOLOGIC I. .-\ post-surgIcal patient has a platelet count of 5.000. The PT should carefully monitor the patient for symptoms of a. b. c. d. I b. c. d. Lkmoglobin-16 gram per deciliter \\:hitc blood Is-30.000 per cubic millimeter PIJtelets-:200.000 per cubic millimeter Glucosc-120 milligrams per 100 milliliters The !yr has just finished gl\'ing: an intramuscular injection to a patient. In order to prc\ent an accidenwl puncture from a contaminated needle. the !Jest Qction for [he PT \\Duld he 10 a. b. c. d. -L " The PT is re\'iewing the patient's laboratory values. Which of the following \\ould indicate that the patient probable has some type of infection? 8. .3. phlebitis bleeding infection neuropathy reGlp tnc needle and dispose of it In the si18rps container do not'recap the needle and dispose of it in sharps container break the needle 8nd deposit it in the hazardous waste container not break the needle and deposit it in the hazardous waste container The PT is h:=lping Sally. u young woman with Systemic Lupus Erythremuto::ius. prepare for discharge and is giving her instructions for self-care. All of the foilo\\i suggestions are correct EXCEPT ~1. b. c. d. "Stay out of the sun as much as possible" "Call the doctor if you have any symptoms of decreased urine output or "It i::i important that you not J.bruptly stop taking your prednisone." "\'ou must be cmeful to LIse YOllr own toilet articles so you will not infect others" ). WhiC::1 comment by the A.IDs patient indicates the :reed for further teaching" a. b. c. d. I must ~1me gotten infected when I used IV drugs and \\ollid share needles rm afrilid to touch my granddaughter for fear I might g;\I:; it to 11er It is important to :'emembe:' that HIV may be transrnirred through se:;ual colltact I \\ill nor be able to donate blood or body organs in the future PT REVIEW ENDOCRINE SYSTEM 1. clinic PT is evaluating a man \\earing a diabetic medic alert band. who appears confused. with hoI. dry. tlushed skin. His respirations are and fast. he is nauseated. His breath smells fruity. The nurse recognizes thaI and he he need immediate care because he has the following diabetes-related condition: a. b. c. d. Ketoacidosis Hypoglycemia "Jeurupathy RClinopath) The breakfast [my:; are dela) cd. ~li1d the di~lhelic. \\ho eecel\er her insulill an hour Is the PT that 1::i l'eelin~ ::i\\e:.H:. :ohQk~. lhal she.' l'ee: sensation on her al1d around her mOLlth. The nurse quick!) her a. a glass of or:mge juice b. Q supplemental dose coffee pectl1Ul butler c. (1. 3. The PT is nforcing the importance of proper foot core 10 the elderl) diabetic. The v,oman states that they surely must Ilel\e something more important to discLiss. The PT correctly replies. c. d. 4. insulin lit' hygiene is ah\ay:: important." "FOOl care as \\ell as Jll\ uther "We call skip this it\()u prefer." ":\11 just remember thZll you \\ill more prone 10 foot odor." "Diabetics can easily de\eil)p Se\erl' fOOl injLlJ') or infection \\irhollt knc)\\ing it." The PT is drClv..ing blood from the diabetic patient for a glycosolated hemoglobin res:. She ex 10 the \\0111i111 lh;}t the test is used to determine u. b. c. d. \\ed. the higi1esl glucose je\ el in her insulin le\el glucose levels O\er the past foul' months her Llsualfasting glucose Ie\e l :5. '-. Mrs. Stevenson has been ciiaf!l1osed \vith Graves' disease. or hvperthvroidislll, .. . The PT 'vvauld expect \vhich findings on assessment? J. b. c. d. ~ decre:Jsed level of consciousness. irregular breathing. and hypenensiull dry skin. sensiri\it) to cold. weight gain. and decreased pulse pressure weight loss. increased acti\ir y. '\ity to heat and tachycardia Diaphoresis tlushed skin, extreme decrease heart rate. PT REVIEW GASTROINTESTINAL 1. The newly admitted patient has just had colon surgery. action important to this patient's care is a. b. c. d. 2. obtaining a stool specimen maintaining the suction on the NG tube, which provides gastric decompression taking the patients VS 30 minutes after he returns to his room offering a bedpan immediately after the patient is in bed Tamika C., a 23 year-old one-day postoperative cholecystectomy patient, is to be kept NPO until she a. b. c. d. 3. A nursing voids a minimum of 200cc has a gag reflex has active bowel sounds and IS passing flatus is alert and oriented and has been out of bed to the chair Elizabeth has been experiencing constipation after a hip fracture. know that her problem is a result of immobility, decrease in fluid intake, and a lack of interest in her food. What nursing measure would NOT help relieve her constipation! a. b. c. d. You increase the attractiveness of high fiber foods and offer drinks that are appealing to her provide mild stool softeners that have been ordered for her make sure that she has sufficient high quality protein in her diet offer her the bedpan each day at the same time to establish a pattern 4. A patient. diagnosed with pancreatitis is admitted to your unit. His wife states that he likes to drink beer at night when he watc TV. An astute PT would include which of the following in her plan of care for this patient7 a. b, c. d. 5. The PT was instructing the woman who suffered from Crohn's disease in a high-calorie, high-protein, low residue diet. The woman seemed to understand the teaching and I foods that she should avoid, incl uding all of the following EXCEPT a. b. c. d. 6. raw vegetables whole grain breads and cereal popcorn sponge cake The PT is caring for Mr. Beecham, who suffers from peptic ulcer d se. One of her most important nursing responsibilities is to assess for signs of hemorrhage, which Include all of the following EXC a. b. c. d. 7. ask his physician if he can approve an order for his wife to bring beer for the patient check his urinary output hold all pain medication monitor him for symptoms of alcohol withdrawal melena hematemesis rigid abdominal muscles tachycardia The PT is admitting a patient with acute abdominal pain of unknown etiology. In caring for this patient, she must never a. b. c. d, give the patient something to eat or drink change the patient's position apply cold packs assess bowel sounds 8. The PT works with elderly long-term care patients who are at risk for constipation. Which of the following interventions would be least effective in the prevention and treatment of this problem? a. b. c. d. 9. The PT is caring for an elderly patient suffering from diarrhea. When caring for the patient, which assessment should receive priority in his care'l a. b. c. d. 10. increasing fluid intake increasing dietary fiber use of stimulant laxatives use of bulk-forming laxat auscultation of bowel wounds dietary history urinary output stool guiac In caring for a patient with peptic ulcer who is at risk for hemorrhage, the nurse must be alert for early signs of hypovolemic shock, which include a. b. c. d. pale, clammy skin and decreased blood pressure bradycardia and irregular respirations tachycardia and increased blood pressure Incre pulse rate and decreased urine output PTREVIEW GENITOURINARY 1, PT is treating incontinent patier:ts who have catheterized on the ward of the hospital. She is aware one of the most common sites of a nosocomial infection is urinary tract. order to minimize the possibility of her patients acquiring a urinary tract infection, the nurse is careful to a, b, c. d. 2. wear when handling catheter irrigate the catbeter daily empty the collection bag several a shift use strict aseptic teclmique \vhen inserting a Foley catheter 56 year-old female patient states that is having problems holding her llr1l1e. PI's assessment take il~to consideration possible causes of incontinence include all of following a. b. c. d. un nary tract infection neurogemc due to diabetes relaxation of pelvic n~Llsculature excessi ve tluid in take 3. In a report you learn that Mrs. Watson has determining that no physiological problem exists. the incontinence would be a. b. c d. incontinent of urine. After way to prevent her the clinical assistant whenever she feel the call bell To tell her to the need to void, might cause her Put a brief on her to prevent "accideEts" embarrassment Insert a Foley catheter commode 2 hours Offer her the pan or assist to 4. must is concern that Mrs. Thompson is retaining fluid. How much urine output patient have per day to be considered within 110rmallimits? a. b. c. d. 1200-1500cc 1750-2250cc 5000-10,000cc 300-750cc of the urine C&S on a reason for an indwelling Foley are infection. What is the most infection? a. transmission from another patient b. c. l~sing a PI failing to wash her ~1ands d. 6. A injuring the uretlu'al tissue the \\Tong size Foley catheter the collecting bag above the reflux of urine into the bladder due to level of the bladder transported to xray. The patient caught a cold while who you discharged from your 8 pounds. You know he has Lasix ordered. You a. b. c. d. tell him to Weigh him at the same time the accuracy Make an appointment with his Start exercising more frequently Have him call 911 for transport to 7. Mr. has glomeruloneplu'itis and is that he is at risk for a. b. c. d. calls and tells you he he states he is taking as fluid overload hypokalemia urea nitrogen decrease hyponatremia wearing similar or no clothes to is reponing. to evaluate the situation room about his diet. You explain PT REVIEW REPRODUCTIVE SYSTEM 1. Melanie, a 25 yr. old woman, who is being treated with Zoloft for depression, tells the nurse that she has not been enjoying sex as much as she had before taking the drug. Aware of the side effects of this medication, the PT replies that SSRI antidepressants as well as some of the followirig types of drugs can affect sexual function in men and women. All of the following medications may have this effect EXCEPT a. b. c. d. 2. antihypertensives phenothiazines. non-steroidal anti-inflammatory drugs (NSAIDs). anti-psychotic medications. Adele Franklin, an 80-yr. old woman, in the hospital for a broken hip, has had a longstanding problem with urinary retention. Which of the following assessments would the PT be sure to include when she checks this patient? a. b. c. d. Ask her if she has problems with frequency, urgency, or burning with urination. Assess the color of her urinary output. Determine the specific gravity of her urine. Ask about her bowel habits. .'.-~" PTREVIEW· GROWTH AND DEVELOPMENT I. A -+8 :e~lr-old mother delivers a baby-girl \vith a tranS\-efse palmar creClse. e:\cess skin folds at the back of the neck and a protruding tongue. The PT realizes that this infant is likely to have Cl. b. c. d. mongolian spots a chromosome disorder telJngiectatic ne\'i Duane' s syndrome The young mother tells the PT that she is concerned Clbout the safety of her .15 month-old son. \\"110 seems to be "getting into everything" and needs to be watched constantly. The PT responds that the most impoI1ant consideration in accident j1rT\ention \\ith toddlers is a. b. c. d. 3. The PT is ~lssessing J 9 month-old bov for a \Veil-baby check up. Which ot"the follO\\ing lJosen:.ltiol1s \\ould be of most concern? J. b. c. d. .f. teaching them the meaning of "no" buying only age-appropriClte toys not allo\\ing them to play with dangerous items ensuring Cl safe em ironment by childprootlng the the the thL' bClb\. cannot sav. "mama" when he \vants his mother mother has not given him finger foods child does not sit unsupported baby cries \vhene\'er the mother goes out The ne\\ mother asks the PT \vhetl1er or not she should pick up'the baby when he cries. According to Erikson's theory of psychosocial development. the PTs most appropriate reply should take into consideration his developmental task. which is a. b. c. d. tl'ust \s. mistrust intimac\ \s. isolation :.1utonom\ \·s. doubt and shame idelltit\ \s. Role confusion PTREVIEW IN'TEGUMEN'TARY 1. After changing the incision dressing on his elderly patient. the PT reports the following findings. Which is no! consistent with the presence of an infection? a. b. c. d. 2. The PT gives the elderly male patient meticulous care and is careful to turn and reposition him every two ilOurS. PT includes a discussion of why elderly. skin changes require extra precautions to t h e ' s daughter during a visit. All of the following contribute to skin breakdown in the elderly EXCEPT a. b. c. d, 3. observed on the ski;l surrounding the i:1Cision skin warmt 11 It aroLlnd the incision patient reporting increased 1ncisional pain patient complaining of nausea the skin becomes increasingly tl'agile transparent oil and sweat glands become active subcutaneous tissue decreases and bruising is increased the skin becomes more b to al Mr. Bummel's hematology reports indicate that he is thrombocytopenic. Which of the following symptoms might the nurse observe during the assessment? a. b. c. d. beadache and hypertension ecdlymosis and hypertension purpura and petechiae enlarged lymph nodes Miss Cope is on bed rest and developed a reddened are on her buttocks. 4. Which of the following would be the most effective nursing intervention. a. b. c. d. sit her on a pilloV'\' IJ1crease fluid intake turn and position her at least every :2 hours get her bed rest order changed. 5. The most important a. b. c. d. a burn victim is: when maintaining a sterile to prevent infection a patent airway and determining the extent of the injury fluid and electrolyte losses and determining replacement therapy Determining circulation to burned extremities may need escharotomies. 6. Marcia, a Haitian woman. has been complaining of chronic fatigue. You want to assess her so the place for you to check is a. b. c. d. sclera 1111JCOUS mem branes mouth toenail scalp 7. The PT knows when caring patients like Mr. Lee. who are in traction. the PT must work to prevent complications ting fj'om immobility and rest. She includes alJ following interventions in her care EXC a. b. c. d. turn and position patient q 2 hours fluid and fiber intake monitor CPK and other muscle enzymes have patient perform range of motion exercises 8. Frank. a patient with shingles (herpes zoster). asks the PI ifhis disorder is contagious to others. correctly a. b. c. d. except for persons who are immunocompromised." any person who comes in contact with you is susceptible to infection." Yes. those W;10 have a compromised immune system and/or those who are not immune a previous infection with varicella (chicken pox) can be 9. young man was for skin cancer at clinic. He was very that his form of skin cancer is likely to and the PT reassured metastasize. although he should continue to monitor his skin carefully and stay out of the sun. The man's cancer is called: a. b. c. d. 10. '" 'On squamous cell carcinoma melanoma teratoma noma basal cell While assessing a PTvthematous base. a. b. c. d. shingles a cold sore psonasls genital herpes the PT notes that :owing d:sorders are clustered vesicles this de-finitely NOT MUSCULOSKELETAL QUESTIONS , 1. You as the health care provider is caring for a patient with a total hip replacement and places a pillow between her knees. The purpose of this intervention is to prevent a. abduction b. adduction c. flexion d. rotation 2. The nursing home patient has severe rheumatoid arthritis. The health care provider knows to expect all of the following findings except a. symmetrical joint pain b. pain that is worse in the morning than later in the day c, swelling of the small joints d. asymmetrical joint pain 3. The health care provider who works on an orthopedic unit, finds that hip fractures typically occur in older patients who suffer from a. Paget's disease b. osteoarthritis c, osetoporosis d, osteomyelitis 4. Mrs. Smith, an ovenveight middle aged woman with osteoarthritis of the knee, asks you (the health care provider) what would help her to reduce the pain, You reply that the most effective intervention for her would be a. antispasmodics to decrease muscle spasms b. regular program of weight bearing exercise c. steroid injections d. weight loss 5. • • The health care provider is caring for a patient with an arm fracture. The patient complains of numbness and tingling of the hand and pain unrelieved by analgesics, and the radial pulse is diminished. You realize the patient may have the following complication, which requires prompt intervention: a. fat embolism b. infection c. compartmental syndrome d. venous stasis 6. A serious complication that occurs after bone fracture is fat embolism. Which is the first sign that this may have occurred? a. respiratory distress b. cardiogenic shock c. hypoactive bowel sounds d. positive homan's sign 7. Which of the following best characterizes rheumatoid arthritis? a. infection of the bone b. bones that become porous c. joint degeneration d. chronic inflammation of the synovial membrane 8. A patient is readmitted to your unit only one day after discharge for an open reduction for a fractured humerous. Upon assessment you find fever, chills; and the patient is complaining of pain in his arm, the area is also warm to the touch. The patient probably has: a. osteopenia b. osteomyelitis c. osteoporosis d. osteomalacia 9. Nursing interventions for osteoarthritis would include all of the following nursing measures except: a. rest to the affected area b. exercise that does not stress joints c. warmth to the affected area d. 2000 mg ASA per day in divided doses 10. You are caring for a patient that has h~d a stroke. When they are trying to feed themselves, they cannot hold the fork, and always are dropping it. You as a health care provider know that there is: a. hypertrophy in their hand b. atrophy in their hand c. the patient is depressed d. the patient is stubborn PTREVIEW ONCOLOGY 1. Two weeks receiving chemotherapy, Mrs. Constant develops sores in mouth. hair loss, and complains of being extremely tired. She asks happening to her. Your best answer is a. b. c. d. 2. 3. "The chemotherapy is designed to rapidly mUltiplying cells but doesn't distinguish between cancer cells and normal cells." "Chemotherapy is very toxic. and she was told would experience before the therapy was started." "These arc normal effects and away after awhile." "Give her a booklet she can read. and her to ask her doctor if she has questions. ,. Tumors that have broken a. b. c. d. from the original malignant site are referred to as infectiolls cancerous sarcomas metastatic Bria,n Shatz is treated with radiation leukenlia. to prevent excesslve . damage from this therapy. the nurse instructs him to do which the following? a. b. c. d. lS sunbathe for short periods of time to help the skin heal wash it thoroughly with soap and water radiation avoid applying cream and powders to the area areas use a wet to dry dressing on PT BOARD REVIEW MEDICAL-SURGICAL ANSWER KEY BASIC NURSING CONCEPTS 1. 2. 3. B C A 6. 7. 8. C D B 11. _B 12. B 13. B 4. D 9. C 14. A 16.' A 17. B 18. D 19. C 5. D 10. B 15. D 20. C 11. 12. 13. C C C A A D D C NURSING PROCEDURES 1. 2. 3. A B D 6. 7. 8. D C D 4. D 9. C 14. C 16. 17. 18. 19. 5. C 10. C 15. C 20. NEUROLOGY 1. 2. 3. 4. 5. D D C D B 6. 7. 8. 9. 10. B B A C C SENSORY 1. 2. 3. 4. 5. 6. C D A D A B RESPIRATORY 1. 2. 3. 4. 5. D A A B C 6. 7. 8. 9. 10. D C C D B CARDIOVASCULAR 1. 2. 3. 4. 5. B A C D A 6. 7. 8. 9. 10. A C D D A PT BOARD REVIEW MEDICAL-SURGICAL ANSWER KEY HEMATOLOGY 1. B 2. 3. 4. 5. B B D B ENDOCRINE 1. 2. 3. 4. 5. A A D C C GASTROINTESTINAL 1. B 6. C 2. C 7. A 3. C 8. C 4. 5. D D 9. C 10. D GENITOURINARY 1. D 6. A 2. D 7. A 3. D 4. 5. A C REPRODUCTIVE 1. C 2. A GROWTH & DEVELOPMENT 1. B 2. D 3. 4. 5. C A A PT BOARD REVIEW MEDICAL-SURGICAL ANSWER KEY INTEGUMENTARY 1. 0 6. B 2. 0 7. C 3. C 8. 0 4. 5. C B 9. 10. D C MUSCULOSKELETAL 1. B 6. A 2. 0 7. D 3. C 8. B 4. 0 9. D 5. C 10. B ONCOLOGY 1. A 2. 0 3. C