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Mark Klimek Blue Book Flashcards

Prepare for the NCLEX-RN exam with the complete Mark Klimek Blue Book Flashcard Collection! This resource features over 2,000 verified NCLEX-style questions and answers drawn from Mark Klimek’s renowned Blue Book lectures — now fully organized by official NCLEX Test Plan categories.

Each section below contains categorized flashcards that cover critical nursing concepts — from Management of Care and Infection Control to Pharmacology and Physiological Adaptation. Use these to reinforce your clinical reasoning, strengthen memory retention, and boost your confidence on test day.

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Safe and Effective Care Environment – Management of Care

[{"q":"Is informed consent required before cystoscopy?","a":"Yes."},{"q":"Is hospitalization required for mild preeclampsia?","a":"No, managed at home with rest."},{"q":"Is informed consent required for a spinal tap?","a":"Yes."},{"q":"What is the best way to identify a patient accurately before a procedure?","a":"Check the identification wristband."},{"q":"Is informed consent required for ECT?","a":"Yes."},{"q":"Is informed consent required for an EEG?","a":"No."},{"q":"Can EGD be performed on an uncooperative client?","a":"No, cooperation is required."},{"q":"What pre-test steps must be completed before EGD?","a":"Remove dentures and eyeglasses, sign consent form, and remain NPO after midnight."},{"q":"During which step of the nursing process does the nurse ask the family about their beliefs regarding illness?","a":"The assessment phase."},{"q":"Before evidence can be collected in a rape case, what must be completed?","a":"Signed consent forms."},{"q":"Should a female staff member be present during examination of a rape victim?","a":"Always."},{"q":"The rape victim requires only a pelvic exam. (T\/F)","a":"False — a complete head-to-toe examination is required for evidence collection."},{"q":"Should the vaginal speculum be lubricated during the rape exam?","a":"No, lubrication may alter or destroy evidence."},{"q":"After discharge, how is contact with the rape victim typically maintained?","a":"By telephone follow-up."}]

Safe and Effective Care Environment – Safety and Infection Control

[{"q":"In the emergent phase (field) of burn care, should you cover burns?","a":"Yes, cover with anything clean and dry."},{"q":"Should adhered clothing be removed from a burn?","a":"No."},{"q":"If a child swallows a potentially poisonous substance, what should be done first?","a":"Call for medical help immediately."},{"q":"Should vomiting be induced after ingestion of gasoline or petroleum products?","a":"No, never induce vomiting for petroleum ingestion."},{"q":"When taking a child to the ER after accidental poisoning, what should accompany the child?","a":"The suspected poison container."},{"q":"Which age groups are at high risk for accidental poisoning?","a":"Elderly clients (due to poor eyesight) and school-age children."},{"q":"Through which four routes is AIDS transmitted?","a":"Blood, sexual contact, breastfeeding, and transplacental (in utero)."},{"q":"Is HIV present in all body fluids?","a":"Yes, but it is transmitted only through blood, semen, and breast milk."},{"q":"If the AIDS patient has leukopenia, what type of isolation is used?","a":"Protective (reverse) isolation."},{"q":"Without leukopenia, what precautions should AIDS patients be under?","a":"Standard or blood and body fluid precautions."},{"q":"When the AIDS patient has a low platelet count, what precautions are indicated?","a":"Bleeding precautions—no IM injections, no rectal temperatures, and careful monitoring."},{"q":"Does AIDS require a private room?","a":"Yes, if WBC count is low."},{"q":"When is a gown needed for AIDS patient care?","a":"When contact with secretions is likely."},{"q":"When is a mask needed for AIDS patient care?","a":"Only if the patient has an airborne infection."},{"q":"When are goggles needed for AIDS patient care?","a":"During suctioning, central line starts, or arterial procedures."},{"q":"How should an area contaminated by an AIDS patient’s blood be cleaned?","a":"With a 1:10 bleach-to-water solution."},{"q":"Are all articles used by AIDS patients double-bagged?","a":"No, only items contaminated with secretions."},{"q":"Can AIDS patients leave the floor?","a":"Yes, unless WBC count is extremely low."},{"q":"What is the main danger to staff caring for a client with a cesium implant?","a":"Radiation hazard."},{"q":"What are the three key principles of radiation safety?","a":"Distance, shielding, and time."},{"q":"Does a woman with a cesium implant have a Foley catheter?","a":"Yes."},{"q":"From where should the nurse provide care to a client with a cesium implant?","a":"From the head of the bed."},{"q":"How may a woman with a cesium implant move in bed?","a":"Side to side only."},{"q":"What four symptoms in a client with a cesium implant must be reported immediately?","a":"Profuse vaginal discharge, elevated temperature, nausea, and vomiting (signs of infection or perforation)."},{"q":"Should pregnant staff care for a client with a cesium implant?","a":"No."},{"q":"Can the head of bed be elevated for a woman with a cesium implant?","a":"Yes, but not more than 45 degrees."},{"q":"From where should the nurse communicate with the client with a cesium implant?","a":"From the doorway."},{"q":"Is bed rest necessary while a cesium implant is in place?","a":"Yes, absolute bed rest."},{"q":"How long can a nurse attend a client with a cesium implant each day?","a":"No more than 30 minutes total."},{"q":"What should the nurse do if the cesium implant falls out?","a":"Pick it up with forceps only—never touch it, even with gloves."},{"q":"Should the nurse provide perineal care to a client with a cesium implant?","a":"No, due to radiation hazard."},{"q":"What is a high-priority nursing diagnosis after cataract surgery?","a":"Safety."},{"q":"What is the number one problem associated with central lines?","a":"Infection."},{"q":"How often should central line dressings be changed?","a":"Every other day (QOD)."},{"q":"What type of dressing is used on a central line insertion site?","a":"Sterile occlusive dressing."},{"q":"What should the patient do during central line tubing changes?","a":"Turn head away, hold breath, and perform the Valsalva maneuver."},{"q":"If a central line is found open accidentally, how should the patient be positioned?","a":"On the left side."},{"q":"Should CVA patients have all four side rails up at all times?","a":"Yes, but restraints should not be used unless necessary for safety."},{"q":"Do preschoolers sometimes require physical restraint during painful procedures?","a":"True."},{"q":"Which age group most often uses stalling tactics before painful procedures?","a":"School-age children."},{"q":"Which age groups are most likely to physically resist the nurse during procedures?","a":"School-age children and adolescents."},{"q":"Do toddlers sometimes require restraint for painful procedures?","a":"True."},{"q":"Is the infant restrained before cleft repair surgery?","a":"No, only after surgery."},{"q":"What device is used to restrain the infant after cleft repair?","a":"Elbow restraints."},{"q":"How is the Logan bow cared for?","a":"Remove gauze before feeding, cleanse after feeding with hydrogen peroxide and saline."},{"q":"Should hearing aids be removed before surgery?","a":"Yes, but only immediately before surgery."},{"q":"What solution should be used to clean a hearing aid?","a":"Soap and water."},{"q":"What solution is best when removing a client’s contact lenses?","a":"Sterile saline."},{"q":"Can alcohol be used to clean a hearing aid’s earmold?","a":"No, it dries and cracks the material."},{"q":"What can be used to clean the connecting tube of a hearing aid?","a":"A pipe cleaner."},{"q":"Should PCA drug cartridges be discarded when discontinued?","a":"No, they must be returned to the pharmacy per narcotic laws."},{"q":"Which patients should never be allowed to smoke or smoke alone?","a":"Those using oxygen or who are confused, sedated, or sleepy."},{"q":"When applying restraints, what precautions must be taken?","a":"Avoid bruising, impaired circulation, or accidental entanglement."},{"q":"How can privacy be maintained in shared rooms?","a":"Use drapes or screens during personal care."},{"q":"When restraining clients who object, what legal concern must be avoided?","a":"False imprisonment."},{"q":"When the nurse is not at the bedside, what position should the bed always be in?","a":"Lowest position."},{"q":"Can nurses be held liable if a client is injured after not being told how to use the call light?","a":"Yes."},{"q":"What danger is associated with drafts in hospital rooms?","a":"Spread of microorganisms through air currents."},{"q":"What should the nurse do first if a client objects to side rails?","a":"Explain why they are being used."},{"q":"Is verbal identification by the client adequate for safety purposes?","a":"No, identification bands must always be used."},{"q":"For which clients should bedside rails always be raised?","a":"Elderly, unconscious, infants, children, restless or confused clients."},{"q":"If a family member requests side rails down while visiting, what should the nurse do?","a":"Decline politely; the nurse is responsible for client safety."},{"q":"Are pillows sterilized between uses?","a":"No."},{"q":"What is pediculosis commonly known as?","a":"Lice."},{"q":"What finding is common with pediculosis pubis?","a":"Reddish-brown powder (lice feces) in underwear."},{"q":"What household solution helps remove lice eggs (nits)?","a":"Vinegar."},{"q":"Where are head lice most commonly found?","a":"Back of the head and behind the ears."},{"q":"On what do lice feed?","a":"Human blood."},{"q":"How long should a client be inspected for lice after treatment?","a":"2 weeks."},{"q":"What is the most common symptom of lice infestation?","a":"Itching."},{"q":"What main safety precaution is important during PD?","a":"Prevent falls and dizziness due to fluid shifts."},{"q":"What precautions are essential for severe preeclampsia?","a":"Seizure precautions."},{"q":"Name five seizure precaution measures.","a":"Suction and oxygen at bedside, padded side rails ×4, remain on unit, supervised ambulation, ≤1 pillow."},{"q":"What is the major danger of PROM?","a":"Infection."},{"q":"How can you tell if a woman with PROM has infection?","a":"Maternal fever, fetal tachycardia, foul vaginal discharge."},{"q":"If infection signs appear after PROM, what must be done?","a":"Immediate delivery."},{"q":"Should sexual intercourse be avoided after PROM?","a":"Yes."},{"q":"Should clients on Heparin use an electric or safety razor?","a":"Electric razor."},{"q":"What are Montgomery straps used for?","a":"To change dressings without tape and protect skin."},{"q":"Leaving a wound open to air decreases infection by eliminating what 3 conditions?","a":"Darkness, warmth, and moisture."},{"q":"When removing tape, pull (toward\/away) from the wound.","a":"Toward the wound."},{"q":"What type of dressing prevents microorganisms from entering or leaving the wound?","a":"Occlusive dressing."},{"q":"What solution protects the skin from tape irritation?","a":"Tincture of benzoin."},{"q":"When cleaning an incision, where should you start?","a":"At the incision site and move outward."},{"q":"After removing a soiled dressing, what must be done before applying a sterile one?","a":"Wash hands and don sterile gloves."},{"q":"When a dressing is saturated, can germs enter from outside?","a":"Yes, through capillary action."},{"q":"When is it inappropriate to change a dressing?","a":"During mealtime."},{"q":"What solution should be applied to skin under a brace?","a":"Tincture of benzoin or alcohol (no lotions)."},{"q":"After scoliosis surgery, how is the client turned?","a":"Log-rolled while in a body cast."},{"q":"What is the number one goal in emergency spinal cord injury management?","a":"Immobilize the spine."},{"q":"What maneuver is used to open the airway if spinal injury is suspected?","a":"Modified jaw thrust."},{"q":"In spinal cord injury, the neck should never be ______.","a":"Moved or hyperextended."},{"q":"Define asepsis.","a":"Absence of disease-causing microorganisms."},{"q":"Define antiseptic.","a":"A substance that destroys or inhibits pathogen growth but not spores; safe for use on people."},{"q":"Define disinfectant.","a":"A substance that destroys pathogens but not spores; not intended for human use."},{"q":"Define bactericide.","a":"A substance that kills microorganisms but not necessarily their spores."},{"q":"Define bacteriostatic.","a":"A substance that inhibits the growth of microorganisms."},{"q":"Define anaerobe.","a":"An organism that lives without oxygen."},{"q":"Define aerobe.","a":"An organism that requires oxygen to live."},{"q":"Define pathogen.","a":"A microorganism that causes disease."},{"q":"Define clean technique.","a":"Practices that reduce the number and spread of microorganisms (medical asepsis)."},{"q":"Define sterile.","a":"Free from all microorganisms."},{"q":"Define host.","a":"A living organism that harbors microorganisms."},{"q":"Define portal of entry.","a":"The route through which microorganisms enter the body."},{"q":"Define contaminate.","a":"To make something unclean or unsterile."},{"q":"Define surgical asepsis.","a":"Practices that eliminate all microorganisms (sterile technique)."},{"q":"Define medical asepsis.","a":"Practices that reduce microorganisms (clean technique)."},{"q":"Define spore.","a":"A dormant form of a microorganism that can survive in harsh conditions."},{"q":"Which hand holds the suction catheter and which holds the connecting tube?","a":"Dominant hand holds the catheter; non-dominant holds the connecting tube."},{"q":"What type of asepsis is required during airway suctioning?","a":"Surgical asepsis (sterile technique)."},{"q":"What type of lubricant is used for suctioning?","a":"Sterile water-soluble lubricant."},{"q":"Should suction be continuous or intermittent?","a":"Intermittent, to prevent mucosal damage."},{"q":"For how long should suction be applied per entry?","a":"No longer than 10 seconds."},{"q":"How often should the tubing be cleared during suctioning?","a":"After each pass or removal."},{"q":"To suction the right mainstem bronchus, which way should the head be turned? The left mainstem bronchus?","a":"Turn head to the left for right bronchus, to the right for left bronchus."},{"q":"When should suction be applied—during insertion or removal?","a":"During removal of the catheter."},{"q":"What solution is used to clear the suction tubing?","a":"Sterile saline."},{"q":"What safety measures are included in standard suicide precautions?","a":"Remove sharp objects, drugs, or hanging devices and maintain constant one-to-one observation."},{"q":"Should the nurse change the initial post-mastoidectomy dressing?","a":"No, only reinforce it; the physician performs the first change."},{"q":"In the chain of infection, handwashing breaks which link?","a":"The mode of transmission."},{"q":"What is the most effective way to reduce hospital-acquired (nosocomial) infections?","a":"Proper hand hygiene."},{"q":"Should sterile gloved hands be kept above the waist?","a":"Yes, always."},{"q":"When putting on the second sterile glove, should you grasp the cuff?","a":"No, insert fingers under the cuff to avoid contamination."},{"q":"When putting on the first sterile glove, should you grasp the cuff?","a":"Yes."},{"q":"Should the thumb of the gloved hand be used while donning the second glove?","a":"No, this could contaminate the glove."},{"q":"Airborne microorganisms travel on what particles?","a":"Dust or water droplets."},{"q":"What is another term for medical asepsis?","a":"Clean technique."},{"q":"When opening a sterile pack, how should you unfold the top flap?","a":"Away from your body."},{"q":"What is another name for surgical asepsis?","a":"Sterile technique."},{"q":"Where should a sterile field be set up in a client’s room?","a":"On the overbed table."},{"q":"What is the goal of medical aseptic technique?","a":"To reduce the number of microorganisms, not eliminate all of them."},{"q":"What does “nosocomial infection” mean?","a":"An infection acquired in a healthcare facility."},{"q":"When pouring sterile liquid, from what height should you pour?","a":"6 to 8 inches above the sterile field."},{"q":"Should you wash your hands before putting on gloves?","a":"Yes, always. Handwashing is required even if gloves are used."},{"q":"Do surgical aseptic techniques eliminate all microorganisms?","a":"Yes, they maintain a sterile environment."},{"q":"Should you ever turn your back to a sterile field?","a":"No, it may contaminate the field."},{"q":"What should you do if you accidentally reach across a sterile field?","a":"Consider the field contaminated and replace the sterile setup."},{"q":"In what type of environment do microorganisms grow best?","a":"Warm, dark, and moist conditions."},{"q":"Are the edges of a sterile field considered sterile?","a":"No, the outer one-inch border is considered contaminated."},{"q":"Can you pour sterile water directly into a sterile basin after opening the bottle?","a":"No, pour a small amount into a waste container first to cleanse the bottle lip (“lipping”)."},{"q":"Should nurses wear gloves when applying topical skin preparations?","a":"Yes."},{"q":"Is strict sterile technique required for vaginal medication administration?","a":"No, medical asepsis (clean technique) is sufficient."},{"q":"Is sterile technique required for rectal drug administration?","a":"No, clean technique is adequate."},{"q":"Is it safe to administer medications prepared by another nurse?","a":"No, each nurse must administer only drugs they prepare."},{"q":"Can medications be left at the bedside without an order?","a":"No, a physician’s order is required."},{"q":"Should needles ever be recapped after use?","a":"No, never recap used needles."},{"q":"What should you do if blood appears in the syringe upon aspiration?","a":"Remove the syringe immediately, apply pressure, discard it, and prepare a new syringe with fresh medication."},{"q":"What safety precautions are important for clients with Meniere’s disease?","a":"Keep side rails up and assist with ambulation."},{"q":"What isolation precautions are required for meningitis?","a":"Contact and respiratory precautions."},{"q":"How long should isolation be maintained in meningitis?","a":"Until the patient has been on antibiotic therapy for at least 48 hours."},{"q":"What emergency equipment should be kept at the bedside for MG patients?","a":"Suction apparatus and a tracheostomy or endotracheal setup for airway support."},{"q":"Which clients should have toenails trimmed only by a physician?","a":"Diabetics, clients with peripheral vascular disease, or those with very thick nails."},{"q":"Can nurses provide perineal care to clients of the opposite sex?","a":"Yes, it is permitted professional care."},{"q":"Clients on which therapy must use a safety blade (non-electric) razor?","a":"Oxygen therapy (to prevent sparks)."},{"q":"How should a nurse carry soiled linen?","a":"In a neat bundle held away from the body."},{"q":"What pre-procedure orders are common before ECT?","a":"NPO after midnight, remove dentures, have the client void, raise side rails."},{"q":"When are activity restrictions necessary after an EEG?","a":"Only if sedatives were used; side rails should remain up."},{"q":"Should the client wash their hair before an EEG?","a":"Yes, to remove oils that interfere with electrode contact."},{"q":"What should the client do after an EEG?","a":"Wash their hair to remove electrode paste."},{"q":"What should parents do if epiglottitis is suspected?","a":"Take the child to the emergency department immediately."},{"q":"Should side rails be up after EGD?","a":"Yes, until sedative effects have worn off."},{"q":"Should side rails be raised after stapedectomy?","a":"Yes, the client may experience dizziness."},{"q":"What activities should be avoided post-stapedectomy?","a":"Coughing, sneezing, nose blowing, swimming, showers, and flying."},{"q":"Should a woman douche after surgery to remove an ovarian cyst?","a":"No, douching is not recommended as it destroys the natural protective vaginal flora."},{"q":"When using nasal cannulae, besides the nares, where should the nurse check for skin irritation?","a":"Behind and on top of the ears."},{"q":"Can a client smoke in a room if the oxygen is turned off?","a":"No, the oxygen source must be completely removed from the room before smoking."},{"q":"What are the three safety principles for nurses caring for clients with sealed radioactive implants?","a":"Time, distance, and shielding."},{"q":"Which radiation treatment is most dangerous to nurses: sealed internal, unsealed internal, or external?","a":"Sealed internal radiation, followed by unsealed internal; external therapy poses no danger unless the nurse is in the treatment room during exposure."},{"q":"Should pregnant nurses care for clients receiving sealed internal radiotherapy?","a":"No, absolutely not."},{"q":"Should pregnant nurses care for clients receiving unsealed internal radiotherapy?","a":"Only if they avoid contact with the client’s body secretions."},{"q":"When a patient is receiving radioactive iodine, what precautions are essential?","a":"Wear gloves when in contact with urine and follow strict urine disposal procedures."}]

Health Promotion and Maintenance

[{"q":"Name the six essential nutrients.","a":"Carbohydrates, fats, proteins, vitamins, minerals, and water."},{"q":"What is the major source of energy for the body?","a":"Carbohydrates."},{"q":"How many kilocalories per gram do carbohydrates provide?","a":"4 kcal per gram."},{"q":"Sucrose is a sugar found in what foods?","a":"Fruits and vegetables."},{"q":"Where is lactose found?","a":"Milk."},{"q":"What is glycogen?","a":"A stored form of glucose manufactured by the liver."},{"q":"Is glycogen consumed in food?","a":"No, it is stored and produced by the liver."},{"q":"When the body does not get enough carbohydrates, it burns what for energy?","a":"Protein and fat."},{"q":"What is the most concentrated source of energy for the body?","a":"Fats."},{"q":"How many kilocalories per gram do fats provide?","a":"9 kcal per gram."},{"q":"Fats help carry which vitamins?","a":"Vitamins A, D, E, and K (remember “FADE K”)."},{"q":"Which nutrient is most needed for growth and tissue repair?","a":"Protein (Vitamin C is second best)."},{"q":"How many kilocalories per gram do proteins provide?","a":"4 kcal per gram."},{"q":"Do vitamins and minerals provide energy for the body?","a":"No, they are necessary for metabolic reactions."},{"q":"Is water present in all body tissues?","a":"Yes, even in bone."},{"q":"What percentage of an adult’s total body weight is water?","a":"50% to 60%."},{"q":"Name the four basic food groups.","a":"Milk & Cheese; Meat & Legumes; Fruits & Vegetables; Bread & Cereal."},{"q":"What percentage of an infant’s total body weight is water?","a":"70% to 75%."},{"q":"An individual is overweight if they weigh what percent above their ideal weight?","a":"10%."},{"q":"An individual is considered obese if they weigh what percent above their ideal weight?","a":"20%."},{"q":"With what solution and when should a breastfeeding mother cleanse the areola?","a":"With plain water before and after each feeding."},{"q":"For mothers without retracted nipples, which is better—towel drying or air drying?","a":"Air drying is best."},{"q":"How long should the infant breastfeed on each side?","a":"Approximately 20 minutes per side."},{"q":"How should the mother break the suction of a breastfeeding infant?","a":"By inserting her little finger into the side of the infant’s mouth."},{"q":"When should the breastfeeding infant be burped?","a":"After feeding from each breast."},{"q":"On which side should breastfeeding begin if there is no mastitis?","a":"Begin on the side the baby finished on during the previous feeding."},{"q":"How long can breast milk be safely refrigerated?","a":"Up to 24 hours."},{"q":"How long can breast milk be safely frozen?","a":"Up to 6 months."},{"q":"In what type of container should breast milk be stored?","a":"Sealed plastic bags or containers."},{"q":"Can you microwave frozen breast milk to warm or thaw it?","a":"Never."},{"q":"Which two nutrients are lower in breast milk?","a":"Fluoride and iron."},{"q":"What should you tell a breastfeeding mother about her milk supply when discharged from the hospital?","a":"Milk should come in around postpartum day 3; breastfeed every 2–3 hours to establish good milk supply."},{"q":"Can a woman on oral contraceptives breastfeed?","a":"Oral contraceptives should not be used during the first 6 weeks after birth; estrogen decreases milk supply. Use non-hormonal methods. Breastfeeding alone is not a reliable contraceptive."},{"q":"At what age are accidental poisonings most common?","a":"Around 2 years old."},{"q":"Are poor hygiene and diet the causes of acne?","a":"No, that is false."},{"q":"How often should a client with acne wash their face each day?","a":"Twice a day."},{"q":"Name the five high-risk groups for AIDS.","a":"Homosexual\/bisexual men, IV drug users, hemophiliacs, heterosexual partners of infected people, and infants born to infected mothers."},{"q":"How can AGN be prevented?","a":"By culturing all sore throats for strep and treating strep infections promptly."},{"q":"What are the three adult developmental stages?","a":"Early adulthood, middle adulthood, and later adulthood."},{"q":"What is the age range for early adulthood?","a":"19 to 35 years."},{"q":"What is the age range for middle adulthood?","a":"35 to 64 years."},{"q":"What is the age range for late adulthood?","a":"64 years to death."},{"q":"What is the developmental task for early adulthood according to Erikson?","a":"Intimacy vs. Isolation."},{"q":"What is the developmental task for middle adulthood according to Erikson?","a":"Generativity vs. Stagnation."},{"q":"What does “Intimacy vs. Isolation” mean in Erikson’s theory?","a":"The stage in which individuals form close relationships, marry, and begin families."},{"q":"What does “Generativity vs. Stagnation” mean in Erikson’s theory?","a":"Middle-aged adults focus on contributing to society, helping others, and fulfilling life potential."},{"q":"What is the developmental task for late adulthood according to Erikson?","a":"Ego Integrity vs. Despair."},{"q":"What does “Ego Integrity vs. Despair” mean in Erikson’s theory?","a":"Older adults reflect on their lives with a sense of fulfillment or regret."},{"q":"People over what age should have a yearly cancer screening exam?","a":"Over age 40."},{"q":"Cardiovascular disease (CD) ranks what among the leading causes of maternal death?","a":"Fourth."},{"q":"What is the number one cause of CD in pregnancy?","a":"Rheumatic heart disease."},{"q":"Pregnancy increases cardiac output by what percentage?","a":"30–50%."},{"q":"What is the number one cause of maternal death in CD of pregnancy?","a":"Cardiac decompensation."},{"q":"Is cesarean section mandatory for women with CD of pregnancy?","a":"No."},{"q":"Besides rest, what other treatment is important for CD in pregnancy?","a":"Weight control."},{"q":"Do women have a higher or lower incidence of stroke than men?","a":"Lower."},{"q":"Does use of oral contraceptives increase the risk of CVA?","a":"True."},{"q":"Does chronic alcohol abuse increase the risk of CVA?","a":"False."},{"q":"Does obesity increase the risk of CVA?","a":"True."},{"q":"Does smoking increase the risk of CVA?","a":"True."},{"q":"Does atrial fibrillation increase the risk of CVA?","a":"True, particularly due to emboli."},{"q":"Which meats are highest in cholesterol?","a":"Organ meats such as liver, heart, brain, and kidneys."},{"q":"Which foods are second highest in cholesterol?","a":"Shellfish such as shrimp, crab, and lobster."},{"q":"Is egg white high or low in cholesterol?","a":"Low."},{"q":"Is egg yolk high or low in cholesterol?","a":"High."},{"q":"Which three meats are lowest in cholesterol?","a":"Chicken, pork, and mutton."},{"q":"Is milk high or low in cholesterol?","a":"Low."},{"q":"Is cheese high in cholesterol?","a":"Moderately high."},{"q":"Which oils are high in cholesterol?","a":"Animal fats and oils."},{"q":"Is cholesterol a triglyceride?","a":"No."},{"q":"Do plant foods contain cholesterol?","a":"No."},{"q":"By which post-op day should the client begin stoma self-care?","a":"By day 3 or 4; they should start observing by day 2."},{"q":"Is cystic fibrosis (CF) hereditary?","a":"Yes."},{"q":"Increasing dietary fiber lowers the risk of what disease?","a":"Cancer of the colon."},{"q":"Foods lose fiber when they are __________, __________, __________, or __________.","a":"Processed, cooked, peeled, or refined."},{"q":"Whole grains and grain products are (high\/low) in fiber.","a":"High."},{"q":"Fruits are (high\/low) in fiber.","a":"High."},{"q":"Vegetables are (high\/low) in fiber.","a":"High."},{"q":"Milk and milk products are (high\/low) in fiber.","a":"Low."},{"q":"Meats are (high\/low) in fiber.","a":"Low."},{"q":"Nuts, seeds, and legumes are (high\/low) in fiber.","a":"Low."},{"q":"Which foods have the highest fiber content?","a":"Grains, especially bran."},{"q":"When increasing fiber intake, how should it be done?","a":"Gradually, to prevent discomfort."},{"q":"What are the side effects of a high-fiber diet?","a":"Gas (flatus) and mineral malabsorption."},{"q":"Which type of bread has the highest fiber: milled, enriched, fortified, or whole grain?","a":"Whole grain bread."},{"q":"What is “conservation” in child development, and when does it appear?","a":"Understanding that quantity remains constant despite appearance; develops in the concrete operational stage."},{"q":"What is the age range for formal operational thinking?","a":"12–15 years."},{"q":"What is the sensorimotor stage of intellectual development?","a":"Birth to 2 years; learning through senses and movement."},{"q":"What is the age range for concrete operational thinking?","a":"7–11 years."},{"q":"What is the age range for preoperational thinking?","a":"3–6 years."},{"q":"What is the hallmark of formal operational thinking?","a":"Abstract reasoning."},{"q":"What is egocentricity, and in which stage is it found?","a":"Viewing everything from one’s own perspective; preoperational stage."},{"q":"Prefix “ante-” means what?","a":"Before in time or place."},{"q":"Prefix “im-” or “in-” means what?","a":"Not or into."},{"q":"Prefix “intra-” means what?","a":"Within."},{"q":"Prefix “inter-” means what?","a":"Between."},{"q":"Prefix “per-” means what?","a":"Throughout or completely."},{"q":"Prefix “ec-” means what?","a":"Out of."},{"q":"Prefix “e-” or “ex-” means what?","a":"Out from or away from."},{"q":"Prefix “iso-” means what?","a":"Equal."},{"q":"Prefix “para-” means what?","a":"Beside or similar."},{"q":"How can pyelonephritis be prevented?","a":"By preventing or promptly treating cystitis (UTIs)."},{"q":"Which age group should be routinely screened for scoliosis?","a":"Young adolescents."},{"q":"Scoliosis most commonly affects which group?","a":"Teenage females."},{"q":"What is the average duration of menstrual flow, and what is the normal range?","a":"Average 5 days; normal range is 3–6 days."},{"q":"What is the average blood loss during menstruation?","a":"50–60 mL."},{"q":"What are the two phases of the ovarian cycle?","a":"Follicular phase (first 14 days) and luteal phase (last 14 days)."},{"q":"In the menstrual cycle, what marks day 1?","a":"The onset of menstrual bleeding."},{"q":"How long does the ovarian cycle last on average?","a":"About 28 days."},{"q":"How many days after ovulation does menstruation begin?","a":"Approximately 14 days."},{"q":"Which hormones are active during the follicular phase?","a":"FSH and estrogen."},{"q":"During the luteal phase, which hormones increase?","a":"Progesterone and LH."},{"q":"What is the main function of the luteal phase?","a":"To maintain the corpus luteum, which secretes progesterone to support early pregnancy."},{"q":"If fertilization occurs during the luteal phase, which hormone is secreted?","a":"Human chorionic gonadotropin (hCG)."},{"q":"What is the average daily iron loss during menstruation?","a":"0.5–1.0 mg."},{"q":"What occurs during the follicular phase?","a":"Maturation of the Graafian follicle, leading to ovulation."},{"q":"In what climate is MS most common?","a":"Cool climates."},{"q":"When can sexual activity be resumed after an MI?","a":"Approximately 6 weeks after hospital discharge."},{"q":"What does measurement of skin-fold thickness determine?","a":"The amount of body fat."},{"q":"Do males generally have a higher risk of heart disease than females?","a":"Yes."},{"q":"Do post-menopausal women have a lower risk of heart disease than men aged 25–40?","a":"No, they have a higher risk."},{"q":"Does a family history of diabetes increase the risk of heart disease?","a":"Yes."},{"q":"Does a family history of liver disease increase the risk of heart disease?","a":"No."},{"q":"Does cigarette smoking increase the risk of heart disease?","a":"Yes, significantly."},{"q":"Do oral contraceptives reduce the risk of heart disease?","a":"No, their use increases the risk."},{"q":"Does regular exercise reduce the risk of heart disease?","a":"Yes."},{"q":"What is the inheritance pattern of hemophilia?","a":"Sex-linked recessive."},{"q":"Hypertension is more common among which group: Blacks or Whites?","a":"Blacks."},{"q":"Does aging increase or decrease the risk of hypertension?","a":"It increases the risk."},{"q":"Does obesity increase the risk of hypertension?","a":"Yes, it significantly increases risk."},{"q":"Do oral contraceptives affect blood pressure?","a":"Yes, they increase blood pressure."},{"q":"Name two common dietary changes for hypertension management.","a":"Calorie reduction for weight loss and sodium restriction."},{"q":"Name two common lifestyle changes used to manage hypertension.","a":"Reducing stress and increasing physical activity."},{"q":"After a hysterectomy, how long should a woman wait before resuming sexual activity?","a":"4 to 6 weeks."},{"q":"The development of emphysema is most strongly associated with what history?","a":"Cigarette smoking."},{"q":"What advice should be given to women with endometriosis who wish to have children?","a":"Do not delay pregnancy, as fertility may decrease."},{"q":"Epiglottitis most commonly occurs in children aged ______ to ______.","a":"1 to 8 years."},{"q":"How can epiglottitis be prevented?","a":"Vaccination with H. influenzae type B (Hib) starting at 2 months of age."},{"q":"Autonomy vs. Shame and Doubt corresponds to which developmental stage?","a":"Toddler."},{"q":"Industry vs. Inferiority corresponds to which stage?","a":"School-age child."},{"q":"Ages 18 to 25 years correspond to which developmental stage?","a":"Young adult."},{"q":"The child who frequently says “no” is in which stage?","a":"Toddler stage."},{"q":"Encouraging creativity and collecting things is characteristic of which stage?","a":"School-age stage."},{"q":"Offering limited choices is appropriate for which developmental stage?","a":"Toddler."},{"q":"Centering on basic needs being met characterizes which stage?","a":"Infancy."},{"q":"Ages 18 months to 3 years correspond to which stage?","a":"Toddler."},{"q":"Ages 3 to 6 years correspond to which stage?","a":"Preschooler."},{"q":"Ages 12 to 20 years correspond to which stage?","a":"Adolescent."},{"q":"Initiative vs. Guilt corresponds to which developmental stage?","a":"Preschooler."},{"q":"Ages 6 to 12 years correspond to which developmental stage?","a":"School-age."},{"q":"Trust vs. Mistrust corresponds to which developmental stage?","a":"Infancy."},{"q":"In which stage is the peer group most important?","a":"Adolescent."},{"q":"Encouraging imagination and role play is best for which stage?","a":"Preschooler."},{"q":"Identity vs. Role Confusion corresponds to which stage?","a":"Adolescent."},{"q":"Intimacy vs. Isolation corresponds to which stage?","a":"Young adult."},{"q":"Birth to 18 months corresponds to which developmental stage?","a":"Infancy."},{"q":"Define a nuclear family.","a":"A family consisting of parents and their children."},{"q":"When does a nuclear family become an extended family?","a":"When grandparents, aunts, or uncles live with the family."},{"q":"In the U.S., what is the basic unit of society?","a":"The family."},{"q":"What are the two major roles of the family in society?","a":"Protection and socialization."},{"q":"What percentage of North American families are single-parent families?","a":"Approximately 50%."},{"q":"Who heads 90% of single-parent families?","a":"A female."},{"q":"What does “lightening” mean in pregnancy?","a":"The descent of the fetal head into the pelvis."},{"q":"When does lightening usually occur?","a":"About 2–3 weeks before birth in a primigravida."},{"q":"What is the most common positive effect of lightening?","a":"The woman can breathe more easily after the fetus drops."},{"q":"What are the two earliest signs that a woman is likely in labor?","a":"Low back pain and the appearance of “show” (a blood-tinged mucus plug)."},{"q":"What is the most reliable indication that a woman is in true labor?","a":"Regular contractions that cause progressive cervical dilation and effacement."},{"q":"What is cervical effacement?","a":"The thinning of the cervix."},{"q":"Into how many stages is labor divided?","a":"Four stages."},{"q":"What is accomplished during the first stage of labor?","a":"Full cervical effacement and dilation."},{"q":"How long does the first stage of labor usually last for a primigravida and a multigravida?","a":"About 12 hours for a primigravida, 6 hours for a multigravida."},{"q":"The cervix is fully dilated when it measures how many centimeters?","a":"10 cm."},{"q":"What is accomplished during the second stage of labor?","a":"Delivery of the infant."},{"q":"The second stage of labor begins with ______ and ends with ______ of the ______.","a":"Full dilation; delivery; infant."},{"q":"How long does the second stage of labor last?","a":"Approximately 1½ hours for a primigravida and ½ hour for a multigravida."},{"q":"What is accomplished during the third stage of labor?","a":"Expulsion of the placenta."},{"q":"How long does the third stage of labor usually last?","a":"Less than one hour."},{"q":"What occurs during the fourth stage of labor?","a":"Recovery and stabilization after delivery."},{"q":"When does the fourth stage of labor end?","a":"About 2 hours after placental expulsion."},{"q":"What is the average blood loss during labor?","a":"Approximately 500 mL."},{"q":"When referring to “the three phases of labor,” what does this mean?","a":"It refers to the latent, active, and transitional phases within the first stage of labor."},{"q":"What is the normal length of pregnancy?","a":"240 to 300 days."},{"q":"How many trimesters is pregnancy divided into?","a":"Three trimesters."},{"q":"During the first trimester, are vaginal secretions increased or decreased?","a":"Increased."},{"q":"When do urine pregnancy tests become positive?","a":"Around the time of the first missed menstrual period."},{"q":"Pregnancy tests detect the presence of what hormone?","a":"Human chorionic gonadotropin (hCG)."},{"q":"Are urine and blood pregnancy tests conclusive proof of pregnancy?","a":"No, they only suggest pregnancy."},{"q":"What is Hegar’s sign?","a":"Softening of the uterus."},{"q":"What is Chadwick’s sign?","a":"Bluish discoloration of the cervix."},{"q":"The first trimester covers which weeks of pregnancy?","a":"Weeks 1 to 13."},{"q":"The second trimester covers which weeks of pregnancy?","a":"Weeks 14 to 27."},{"q":"During which weeks can the mother first feel fetal movement?","a":"Between the 16th and 20th weeks."},{"q":"What is the term for the first sensation of fetal movement?","a":"Quickening."},{"q":"The third trimester covers which weeks of pregnancy?","a":"Weeks 28 to 40."},{"q":"In which trimester does backache most commonly occur?","a":"The third trimester."},{"q":"During which trimester is the fetus most vulnerable to external teratogens?","a":"The first trimester."},{"q":"What is the term for the process in which external agents cause birth defects?","a":"Teratogenesis."},{"q":"During which trimester are nausea and vomiting most common?","a":"The first trimester."},{"q":"During which trimester do Braxton-Hicks contractions typically begin?","a":"The third trimester."}]

Psychosocial Integrity

[{"q":"Does stress worsen acne?","a":"Yes."},{"q":"The statement “Time is too short to start another life, though I wish I could,” is an example of what?","a":"Despair."},{"q":"The statement “If I had to do it over again, I’d live my life just about the same,” is an example of what?","a":"Ego integrity."},{"q":"Anorexia nervosa is most common in which group?","a":"Females under 25 years old."},{"q":"What is the primary psychological nursing diagnosis in anorexia nervosa?","a":"Altered body image."},{"q":"What does an infant fear most when hospitalized?","a":"Separation from their primary caregiver."},{"q":"What does a toddler fear most when hospitalized?","a":"Separation from family."},{"q":"What does a preschooler fear most in addition to separation?","a":"Mutilation due to vivid imagination."},{"q":"The toddler and preschooler often believe illness is caused by what?","a":"Something they did wrong."},{"q":"The school-aged child fears separation from whom when hospitalized?","a":"Their peer group."},{"q":"Does the school-aged child see illness as external or internal in cause?","a":"External; they understand illness is not caused by bad behavior."},{"q":"The hospitalized adolescent fears separation from whom and loss of what?","a":"Peers and independence."},{"q":"What should you tell a client embarrassed by colostomy noises post-op?","a":"The noises will subside within a few days to a week."},{"q":"What client behavior best indicates acceptance of the stoma?","a":"Performing their own stoma care."},{"q":"What are symptoms of sensory overload or sensory deprivation?","a":"Fear, panic, depression, poor concentration, restlessness, agitation."},{"q":"What does self-disclosure mean in nursing?","a":"When the nurse shares personal information with the patient."},{"q":"Is nurse self-disclosure always inappropriate?","a":"No, if brief and clearly therapeutic."},{"q":"If the nurse self-discloses, how should it be done?","a":"Keep it short and quickly refocus on the patient."},{"q":"What does insight mean in mental health nursing?","a":"The patient’s ability to understand their problem."},{"q":"During which phase should the nurse examine personal feelings?","a":"Pre-interaction phase."},{"q":"What is “flight of ideas”?","a":"Rapid shifting from one topic to another."},{"q":"The foundation of a therapeutic relationship begins with the nurse’s ______ and ______.","a":"Self-awareness and self-understanding."},{"q":"What are the four phases of the nurse–patient relationship?","a":"Pre-interaction, Orientation, Working, Termination."},{"q":"Should the nurse self-disclose just because the patient asks?","a":"No, only if it serves a therapeutic purpose."},{"q":"The nurse should discuss termination of the relationship during which phase?","a":"Orientation phase."},{"q":"The termination phase actually begins during which phase?","a":"Orientation phase."},{"q":"When a patient expresses thoughts of dying or self-harm, what is the first nursing action?","a":"Immediately assess for suicide potential before anything else."},{"q":"Are children at high or low risk for suicide?","a":"Low risk."},{"q":"Are adolescents at high or low risk for suicide?","a":"High risk."},{"q":"Are young adults at high or low risk for suicide?","a":"Moderate to high risk."},{"q":"Which age group between 25 and 50 years has the risk level for suicide?","a":"Low to moderate risk."},{"q":"In adults over age 50, how does the suicide risk change?","a":"It becomes high."},{"q":"How does having a specific, detailed suicide plan affect risk level?","a":"It increases risk to moderate or high, depending on the plan’s feasibility."},{"q":"What is the suicide risk level for someone planning to use pills?","a":"Moderate risk."},{"q":"What is the suicide risk level for someone with no specific plan?","a":"Low risk."},{"q":"The use of which three methods indicates high suicide risk?","a":"Guns, ropes, and knives."},{"q":"Between men and women, who is generally at higher risk for suicide?","a":"Men."},{"q":"How does marital status affect suicide risk?","a":"Highest risk: separated or divorced; lowest risk: married."},{"q":"What is the nurse’s goal when a suicidal person is on the phone?","a":"To get another person physically present with them, since being alone increases risk."},{"q":"Should a nurse discuss the details of a patient’s suicide attempt after admission?","a":"No, focus on the present condition and future coping, not the attempt itself."},{"q":"Is hyperemesis gravidarum associated with emotional factors?","a":"Yes, it occurs more often in women ambivalent about pregnancy."},{"q":"What are two common psychological reactions after a hysterectomy?","a":"Grief and depression."},{"q":"What is ECT (electroconvulsive therapy)?","a":"A treatment using electrical current to induce a controlled seizure for depression."},{"q":"What condition is primarily treated with ECT?","a":"Major depression."},{"q":"What cognitive function is temporarily impaired after ECT?","a":"Memory."},{"q":"How long does memory impairment last after ECT?","a":"2 to 3 weeks."},{"q":"How will the client appear immediately after ECT?","a":"Drowsy, dull, and apathetic."},{"q":"What should you tell a client worried about being shocked during EEG?","a":"They won’t be shocked; the test only records electrical activity from the brain."},{"q":"What is the first thing a nurse must do to help a family in crisis?","a":"Examine their own personal values."},{"q":"Anxiety-producing thoughts are called _______.","a":"Obsessions."},{"q":"Repetitive actions performed to reduce anxiety are called _______.","a":"Compulsions (e.g., excessive handwashing, repeated cleaning, or checking behaviors)."},{"q":"Which defense mechanism is most closely associated with obsessive-compulsive disorder (OCD)?","a":"Displacement."},{"q":"Should clients with OCD be allowed to perform their compulsive behaviors?","a":"Yes, but limits should be set, and they should be gently redirected."},{"q":"Should you force a client with OCD to stop their compulsive rituals?","a":"No, this increases anxiety."},{"q":"Is obsessive-compulsive disorder classified as neurosis or psychosis?","a":"Neurosis—the client is aware of reality."},{"q":"Should the nurse confront the absurdity of an OCD client’s behavior?","a":"No, instead acknowledge their anxiety (e.g., “You must have been very anxious to wash your hands that long.”)."},{"q":"What can you do if a client with OCD is consistently late due to rituals?","a":"Start preparations earlier to accommodate their routine while maintaining structure."},{"q":"Rape is a crime of passion. (T\/F)","a":"False — it is a violent act, not an act of passion."},{"q":"Most rapes involve people of different races. (T\/F)","a":"False — they usually occur between people of the same race."},{"q":"When should psychological care for a rape victim begin?","a":"Immediately in the emergency room."},{"q":"What are the two phases of Rape Trauma Syndrome?","a":"Disorganization phase and reorganization phase."},{"q":"A rape victim who appears calm and composed is adjusting well. (T\/F)","a":"False — calmness often indicates emotional shock and is a symptom of Rape Trauma Syndrome."},{"q":"What are three common physical symptoms of Rape Trauma Syndrome?","a":"Gastrointestinal irritation, painful urination with itching or burning, and muscle tension with pain."},{"q":"Rape victims often blame whom?","a":"Themselves."},{"q":"In the reorganization phase of Rape Trauma Syndrome, what change is common?","a":"The victim may change residence or telephone number."},{"q":"During the reorganization phase, what sleep disturbance is common?","a":"Nightmares."},{"q":"What four fears are common during the reorganization phase of Rape Trauma Syndrome?","a":"Fear of being indoors or outdoors (depending on the scene), fear of being alone or in crowds, fear of people behind them, and fear of sexual activity."},{"q":"How should rape victims be treated?","a":"With dignity and respect."}]

Physiological Integrity – Basic Care and Comfort

[{"q":"When cleansing an infant's eye, should you cleanse from outer to inner canthus?","a":"No, cleanse from inner to outer canthus."},{"q":"Should you retract the foreskin of a 5-week-old uncircumcised infant to cleanse the area?","a":"No, not until the foreskin retracts naturally and without resistance; then it should be retracted, cleansed, and replaced."},{"q":"What is the correct temperature for tepid sponge bathing water?","a":"98.6°F."},{"q":"How long does it take for the umbilical stump to fall off?","a":"7 to 14 days."},{"q":"What is the main purpose of draping an infant during a bath?","a":"To prevent chilling."},{"q":"Should friction be used to remove vernix caseosa from an infant’s skin?","a":"No, it can cause damage or bruising."},{"q":"What solution is commonly used for umbilical cord care?","a":"70% alcohol to promote drying (though the current trend is toward soap and water)."},{"q":"What are three eye care interventions for a client with Bell’s Palsy?","a":"Use dark glasses, apply artificial tears, and cover the eye at night."},{"q":"What is enuresis?","a":"Involuntary urination or inability to control urine flow."},{"q":"Should fluids be forced or restricted in BPH?","a":"Forced."},{"q":"What solution and material are used to cleanse an infant’s eyes?","a":"Plain water with cotton balls or a soft washcloth."},{"q":"Can cotton swabs be used to clean the eyes, nares, or ears of an infant?","a":"No, it is dangerous."},{"q":"Can the same cotton ball or cloth edge be used for both eyes?","a":"No, it would cause cross-contamination."},{"q":"Should an unhealed umbilical site be covered with the diaper?","a":"No, fold the diaper down."},{"q":"What temperature is appropriate for the water used to bathe an infant?","a":"100°F to 105°F."},{"q":"What is the main purpose of a tepid sponge bath?","a":"To lower body temperature during fever."},{"q":"How should water temperature be tested if a thermometer is not available?","a":"Drop water on the inside surface of your forearm."},{"q":"With which body part do you begin when bathing an infant?","a":"The eyes."},{"q":"What exercises should a post-prostatectomy patient perform after discharge, and why?","a":"Perineal exercises (start and stop urine stream) to reduce temporary dribbling."},{"q":"How often should the urinary drainage bag be emptied?","a":"Every 8 hours."},{"q":"Is dietary protein limited in acute glomerulonephritis (AGN)?","a":"Not usually; restricted only in severe azotemia."},{"q":"What is the most important nursing intervention in treating AGN?","a":"Bed rest until hematuria, edema, and hypertension resolve."},{"q":"What is the most common dietary restriction for AGN?","a":"Moderate sodium restriction; fluid restriction if severe edema."},{"q":"After an above-knee amputation (AKA), the patient should lie in what position several times per day?","a":"Prone position to prevent flexion contracture."},{"q":"What position prevents hip flexion contracture after AKA?","a":"Lying prone several times per day."},{"q":"How can flexion contracture of the knee be prevented after a BKA?","a":"Remind the patient to keep the knee straight when standing."},{"q":"To prevent post-operative swelling, how should the stump be positioned?","a":"Elevated."},{"q":"For how long should the stump be elevated post-operatively?","a":"12 to 24 hours."},{"q":"How often should a stump be washed?","a":"Daily."},{"q":"When wrapping a stump, the bandage should be tightest where and loosest where?","a":"Tightest distally (far from the body) and loosest proximally (near the body)."},{"q":"What is the top priority in caring for a client with anorexia nervosa?","a":"Ensuring adequate food intake and weight gain to sustain life."},{"q":"What is the best goal to evaluate progress in a client with anorexia nervosa?","a":"Achieving adequate weight gain."},{"q":"To lessen pain in appendicitis, what position should the client assume?","a":"Fowler’s position (sitting position)."},{"q":"What is the primary dietary prescription for calcium nephrolithiasis?","a":"Low-calcium diet."},{"q":"The diet for calcium nephrolithiasis should be what type of ash?","a":"Acid ash."},{"q":"If the kidney stone is calcium phosphate, what nutrient must also be restricted?","a":"Phosphorus."},{"q":"What is the primary diet treatment for uric acid nephrolithiasis?","a":"Low-purine diet."},{"q":"The diet for uric acid nephrolithiasis should be low in what?","a":"Methionine."},{"q":"What is methionine?","a":"An amino acid precursor to cystine."},{"q":"Name two foods high in methionine.","a":"Milk and eggs."},{"q":"Clients with cystine nephrolithiasis should have what type of ash diet?","a":"Alkaline ash diet."},{"q":"Increasing fluid intake above 3000 mL per day is more effective in treating kidney stones than any dietary modification. (True\/False)","a":"True."},{"q":"Must clients receiving chemotherapy be kept NPO?","a":"False."},{"q":"With what solution should clients with chemotherapy-induced stomatitis rinse after meals?","a":"Hydrogen peroxide (H₂O₂) solution."},{"q":"What lubricant can safely be applied to cracked lips in chemotherapy-induced stomatitis?","a":"K-Y Jelly."},{"q":"Can women with CD of pregnancy receive analgesics during labor?","a":"Yes; analgesics reduce anxiety and cardiac stress."},{"q":"What is the most common dietary modification for a woman with CD showing decompensation?","a":"Sodium and fluid restriction."},{"q":"How long should a woman with CD of pregnancy remain on bed rest after delivery?","a":"At least one week."},{"q":"What nutrients should be included in the diet of a pregnant woman with CD?","a":"Iron and folic acid to prevent anemia."},{"q":"What is the best position for a woman with cardiac disease during labor?","a":"Semi-recumbent with the head of bed elevated."},{"q":"The nurse should limit the client’s efforts to do what during labor with cardiac disease?","a":"Bearing down."},{"q":"What type of diet is prescribed for a client with a cesium implant?","a":"Low-residue diet to decrease bowel motility."},{"q":"What part of the hand is used to handle a wet cast?","a":"The palm."},{"q":"On what should a wet cast be supported while drying?","a":"Pillows (no plastic covers)."},{"q":"How long does it take for a cast to dry completely?","a":"About 24 hours."},{"q":"Should a wet cast be covered while drying?","a":"No."},{"q":"Can a heat lamp or hair dryer be used to speed cast drying?","a":"No heat lamps or hair dryers; only a fan may be used."},{"q":"To prevent skin irritation near cast edges, the edges should be what?","a":"Petaled (covered with soft tape)."},{"q":"What color is a dry cast?","a":"White."},{"q":"Is a dry cast dull or shiny?","a":"Shiny."},{"q":"When tapped, is a dry cast dull or resonant?","a":"Resonant."},{"q":"Traction is used to do what?","a":"Reduce and immobilize a fracture, relieve muscle spasms, and prevent deformities."},{"q":"Can skin traction be removed for skin care?","a":"Yes."},{"q":"Can skeletal traction be removed for care?","a":"No."},{"q":"Name three types of skin traction.","a":"Buck’s, Bryant’s, and pelvic traction."},{"q":"Name three types of skeletal traction.","a":"Cranial tongs, Thomas splint with Pearson attachment, and 90°–90° traction."},{"q":"What traction is most commonly used for adult hip fractures?","a":"Buck’s traction."},{"q":"What traction is most commonly used for hip fractures in children?","a":"Bryant’s traction."},{"q":"What bed position should be maintained for a client in pelvic traction?","a":"Semi-Fowler’s with knees slightly flexed (knee gatch)."},{"q":"What is the main advantage of balanced countertraction?","a":"Allows easier movement and repositioning in bed."},{"q":"When in Buck’s traction, a patient may turn toward which side?","a":"Toward the unaffected side."},{"q":"What is the prescribed activity level in early management of CVA?","a":"Absolute bed rest."},{"q":"Should fluids be restricted or forced in early CVA care?","a":"Restricted."},{"q":"How high should the head of the bed be after a stroke?","a":"30 degrees."},{"q":"Can a stroke victim be turned side-to-side?","a":"Yes."},{"q":"How often should the CVA patient be turned or repositioned?","a":"Every 2 hours."},{"q":"Should the CVA patient remain on the paralyzed side longer than 20 minutes?","a":"No."},{"q":"How often should range of motion (ROM) exercises be done in CVA patients?","a":"Every 4 hours or three times daily."},{"q":"Should urinary incontinence in CVA be treated with catheterization?","a":"No, incontinence is not a valid reason for catheterization."},{"q":"After meals, what must the nurse check in a CVA patient?","a":"Inside the mouth and cheeks for retained food."},{"q":"Describe bottle nipples used for feeding infants with cleft lip.","a":"Large-holed, soft nipples."},{"q":"Infants with cleft lip\/palate require more frequent what?","a":"Burping."},{"q":"In what position should children with cleft lip\/palate be fed?","a":"In an almost upright position."},{"q":"Before surgery, can an infant with cleft lip cry or breastfeed?","a":"Yes, crying is allowed; breastfeeding is possible with a simple cleft lip but not with a cleft palate."},{"q":"After cleft lip repair, can the infant cry or breastfeed?","a":"No; crying and sucking increase stress on the incision."},{"q":"What device is applied after cleft lip repair?","a":"Logan bow."},{"q":"What is the purpose of a Logan bow?","a":"To reduce tension on the suture line."},{"q":"Can infants with cleft lip\/palate sleep on their backs?","a":"Yes."},{"q":"Which position is contraindicated after cleft lip repair?","a":"Prone (on the abdomen)."},{"q":"What is used to feed an infant after cleft lip repair?","a":"A dropper or syringe with a rubber tip to avoid suction."},{"q":"After feeding, what should the caregiver do for a baby with cleft lip\/palate repair?","a":"Rinse the mouth with water."},{"q":"What is the technique used to remove feces and gas from a colostomy?","a":"Colostomy irrigation."},{"q":"How many times per day is colostomy irrigation performed?","a":"Once daily."},{"q":"Which solution is used to irrigate a colostomy?","a":"Tap water."},{"q":"How warm should colostomy irrigation fluid be?","a":"Slightly warmer than body temperature (99–100°F)."},{"q":"In what position should the client be during colostomy irrigation?","a":"Sitting position."},{"q":"What activity order is prescribed for CHF clients?","a":"Bed rest."},{"q":"Should a client sleep with a hearing aid in place?","a":"No, hearing aids should be removed before sleep."},{"q":"What is the recommended diet for cystic fibrosis?","a":"High-calorie, high-protein, moderate-fat diet."},{"q":"What is the most common intervention for airway clearance in CF?","a":"Postural drainage."},{"q":"Do Parkinson’s patients experience constipation or diarrhea?","a":"Constipation."},{"q":"What type of chair is best for a Parkinson’s patient?","a":"Firm, straight-backed chair."},{"q":"Clients on PCA pumps are less likely to develop postoperative complications. (T\/F)","a":"True, because adequate pain control promotes mobility and prevents complications."},{"q":"Name three common indications for PCA therapy.","a":"Postoperative pain, cancer pain, sickle-cell crisis pain."},{"q":"Do PCA pumps delay ambulation?","a":"False, patients usually ambulate earlier."},{"q":"What is the comfort range for room humidity?","a":"30–60%."},{"q":"What are the disadvantages of plastic pillowcases?","a":"They are hot and slippery."},{"q":"Individuals who are ill are ______ sensitive to noise than healthy individuals.","a":"More sensitive."},{"q":"What is the comfort range for room temperature?","a":"68–74°F (20–23°C)."},{"q":"What skin care is typical in pemphigus?","a":"Cool, wet dressings."},{"q":"What are the top three nursing interventions in pemphigus?","a":"Oral care, infection prevention, high fluid intake."},{"q":"What type of fluids are best tolerated by pemphigus clients?","a":"Cold fluids."},{"q":"Should the head of bed be raised to enhance drainage?","a":"Yes."},{"q":"Can clients on PD sit, eat, urinate, or defecate during dialysis?","a":"Yes, all are allowed."},{"q":"If the client reports abdominal pain during PD, what should the nurse do first?","a":"Encourage movement to improve dialysate distribution."},{"q":"What type of diet is prescribed for polycythemia vera?","a":"Low-iron diet."},{"q":"How often should a post-operative client cough and deep breathe?","a":"Every 2 hours."},{"q":"How often should the post-operative patient turn?","a":"Every 2 hours."},{"q":"How often should the incentive spirometer be used post-op?","a":"Every 1–2 hours."},{"q":"How often should a bedridden post-op patient perform leg exercises?","a":"Every 2 hours."},{"q":"Unless contraindicated, when should a post-op client be out of bed?","a":"Within 24 hours."},{"q":"If a post-op patient reports gas and cramping, what should the nurse do first?","a":"Assess, then ambulate the client."},{"q":"What diet is recommended for mild preeclampsia?","a":"High protein, normal salt intake."},{"q":"What position should a woman with severe preeclampsia rest in?","a":"Left side-lying position."},{"q":"What diet is ordered for severe preeclampsia?","a":"Low salt, high protein."},{"q":"In what position should a child with pyloric stenosis be fed?","a":"High Fowler’s position."},{"q":"Should feedings for an infant with pyloric stenosis be thick or thin?","a":"Thickened feedings."},{"q":"After feeding, in what position should a child with pyloric stenosis be placed?","a":"Right side with head elevated."},{"q":"How does an infant with pyloric stenosis behave after vomiting?","a":"Remains hungry."},{"q":"What does “advance the drain 1 inch” mean?","a":"Gently pull the drain out by 1 inch."},{"q":"After advancing a Penrose drain, should excess tubing be cut off?","a":"Yes."},{"q":"Name four exercises for mild scoliosis.","a":"Heel lifts, sit-ups, hyperextension, breathing exercises."},{"q":"What cast is used after scoliosis surgery?","a":"Risser cast."},{"q":"How many hours per day should a Milwaukee brace be worn?","a":"23 hours."},{"q":"Should clients with Milwaukee brace avoid vigorous exercise?","a":"True."},{"q":"What activity order is prescribed for a client in sickle cell crisis?","a":"Bed rest."},{"q":"When halo traction is used, may the client ambulate?","a":"Yes."},{"q":"When the client is in tongs, on a Stryker frame, or on a circoelectric bed, what is the activity order?","a":"Absolute bed rest."},{"q":"For a neurogenic bladder, how often should straight catheterization be done?","a":"Every 6 hours."},{"q":"Should the client drink fluids after a spinal tap?","a":"Yes, encourage fluids to replace CSF."},{"q":"Can the client turn side to side after a spinal tap?","a":"Yes."},{"q":"What position is used during a spinal tap?","a":"Lateral decubitus (side-lying) position with knees to chest."},{"q":"How long should the client lie flat after a lumbar puncture?","a":"6 to 12 hours."},{"q":"Does the client require sedation before a spinal tap?","a":"No."},{"q":"What is the best position for airway suctioning?","a":"Semi-Fowler’s position."},{"q":"What position should the unconscious client be in during suctioning?","a":"Side-lying, facing the nurse."},{"q":"What is the preferred treatment for breast engorgement?","a":"Application of ice packs to reduce swelling."},{"q":"Should a mother with mastitis stop breastfeeding?","a":"No, she should continue breastfeeding, starting with the unaffected breast."},{"q":"If a mother has an open abscess on her breast, should she continue breastfeeding?","a":"No, breastfeeding must be stopped on that side until healed."},{"q":"Should a non-breastfeeding mother with engorgement express milk to relieve discomfort?","a":"No, expressing milk increases production; use ice or gentle warmth to relieve pressure."},{"q":"What is the best natural treatment for breast engorgement?","a":"Frequent breastfeeding to balance milk supply and demand."},{"q":"When irrigating the eye, in which direction should the solution flow?","a":"From the inner canthus to the outer canthus (I → O)."},{"q":"How should the nurse straighten the ear canal for an adult?","a":"Pull the pinna up and back."},{"q":"How should the nurse straighten the ear canal for a child under 3 years old?","a":"Pull the pinna down and back."},{"q":"After ear drops are given, how long should the client remain on their side?","a":"5 minutes."},{"q":"How far above the ear canal should the dropper be held?","a":"About ½ inch."},{"q":"What should the client do during a Meniere’s attack?","a":"Rest in bed and avoid sudden movements."},{"q":"What activity order is prescribed after labyrinthectomy?","a":"Strict bed rest."},{"q":"What environment is best for a patient with meningitis?","a":"A dark and quiet room."},{"q":"In what position should a patient with opisthotonos be placed?","a":"Side-lying position."},{"q":"What environment helps relieve a migraine headache?","a":"A dark, quiet environment."},{"q":"How should patients with MS walk?","a":"With a wide-based gait for balance."},{"q":"Should MS patients increase or restrict fluid intake?","a":"Increase fluids to prevent urinary tract infections."},{"q":"What type of diet is recommended for MS?","a":"Acid-ash diet."},{"q":"What type of diet is recommended for a patient with MG?","a":"Soft diet to reduce fatigue while chewing and swallowing."},{"q":"What is the activity order for a post-MI patient?","a":"Strict bed rest with bedside commode use only."},{"q":"What is the #1 nursing diagnosis for shingles?","a":"Acute pain; #2 is impaired skin integrity."},{"q":"What are two main purposes of a bed bath?","a":"To cleanse the skin and promote comfort."},{"q":"Should hospitalized clients wear their dentures?","a":"Yes, unless contraindicated."},{"q":"What motion should be used when cleansing the eyes?","a":"From the inner canthus to the outer canthus."},{"q":"If a client cannot hold dentures in place, what should the nurse do?","a":"Leave them out."},{"q":"How often should mouth care be performed for clients on oxygen therapy?","a":"Every 2 hours."},{"q":"Should lemon and glycerin swabs be used for oral cleansing?","a":"No, they are moisturizers used after cleaning, not cleansing agents."},{"q":"How should toenails be trimmed?","a":"Straight across."},{"q":"When giving a bed bath, which body part should the nurse begin with?","a":"The eyes."},{"q":"What are three reasons for giving a back rub?","a":"Comfort, relaxation, and stimulation of circulation."},{"q":"When shaving a client, should the water be hotter or cooler than bath water?","a":"Hotter."},{"q":"What does evening (HS) care include?","a":"Oral hygiene, washing the face and hands, back rub, and straightening linens."},{"q":"What is dentifrice?","a":"A denture adhesive (e.g., Polygrip) that helps dentures adhere to gums."},{"q":"What is sordes?","a":"Crusts on the teeth and gums due to poor oral hygiene."},{"q":"What facilitates trimming brittle toenails?","a":"Soaking them in warm water."},{"q":"What is the initial diet order for clients with hyperemesis gravidarum?","a":"NPO (nothing by mouth)."},{"q":"What instruction is given to clients recovering from hyperemesis gravidarum after meals?","a":"Remain seated upright for at least 45 minutes after eating."},{"q":"What is the biggest challenge in nursing care for clients with hyperemesis gravidarum?","a":"Encouraging and maintaining adequate nutrition."},{"q":"What is the best intervention for abdominal gas after a hysterectomy?","a":"Ambulation to promote peristalsis and relieve discomfort."},{"q":"What position is best for clients with emphysema under normal conditions?","a":"Semi-Fowler’s or high-Fowler’s position."},{"q":"If a client with emphysema experiences severe dyspnea, what position is best?","a":"Sitting upright with arms resting and head forward on an overbed table."},{"q":"What dietary recommendation is most appropriate for clients with emphysema?","a":"Frequent small meals to avoid fatigue."},{"q":"What daily fluid intake is recommended for clients with emphysema?","a":"Approximately 3 liters per day, unless contraindicated."},{"q":"What two discomforts are common during an EGD?","a":"Gagging and nausea\/vomiting."},{"q":"What is the most common complaint after an EGD?","a":"Sore throat."},{"q":"How should eye ointments be applied?","a":"Place a thin strip on the lower inner eyelid, then ask the client to close the eyes gently."},{"q":"How should eye drops be administered?","a":"Instill into the lower conjunctival sac."},{"q":"How should eye irrigation fluid flow be directed?","a":"From the inner canthus to the outer canthus."},{"q":"To control the pain of osteoarthritis, should heat or cold be applied?","a":"Heat."},{"q":"Are rest periods and range-of-motion exercises appropriate in osteoarthritis care?","a":"Yes; rest helps relieve pain, and gentle ROM prevents stiffness."}]

Physiological Integrity – Pharmacological and Parenteral Therapies

[{"q":"What drug is used to treat bladder spasms?","a":"Belladonna and opiate (B&O) suppositories."},{"q":"With what solution should blood be transfused?","a":"0.9% normal saline."},{"q":"If blood is infused through a central line, what must be done?","a":"The blood must be warmed."},{"q":"How long should it take for one unit of blood to infuse?","a":"Between 1 and 3 hours."},{"q":"What IV solution is hung with a blood transfusion?","a":"0.9% normal saline (never glucose)."},{"q":"What gauge needle is used for a blood transfusion?","a":"A large-bore needle, typically 18 gauge."},{"q":"Can blood be given immediately after removal from refrigeration?","a":"No, it must be warmed for about 20 to 30 minutes first."},{"q":"What is the only intramuscular injection given to a burn patient?","a":"Tetanus toxoid (if previously immunized) or tetanus antitoxin\/immune globulin (if not immunized)."},{"q":"What does Sulfamylon cream cause when applied?","a":"A burning sensation."},{"q":"What does silver nitrate cream do to the skin?","a":"Stains the skin."},{"q":"When should pain medication be administered to burn patients?","a":"30 minutes before wound care."},{"q":"When using silver nitrate, how should dressings be kept?","a":"Wet."},{"q":"What drugs prevent Curling’s ulcers?","a":"H2 receptor antagonists such as Tagamet, Zantac, Pepcid, or proton pump inhibitors like Protonix and Prilosec."},{"q":"What gauge needle should be used to start an IV for a client with abruptio placenta?","a":"18 gauge (in case blood transfusion is needed)."},{"q":"Name three drugs used to treat acne.","a":"Vitamin A, antibiotics, and retinoids."},{"q":"What is the most common retinoid prescribed for acne?","a":"Isotretinoin (Accutane)."},{"q":"Accutane is an analog of which vitamin?","a":"Vitamin A."},{"q":"What is the most common side effect of Accutane, and what is the most important teaching point?","a":"Inflammation of the lips (cheilitis); causes birth defects—strict pregnancy prevention is required."},{"q":"What antibiotic is most commonly prescribed for acne?","a":"Tetracycline."},{"q":"How long does it take for acne treatment to show results?","a":"4 to 6 weeks."},{"q":"What instructions should be given to a client taking tetracycline?","a":"Take on an empty stomach and avoid sunlight (photosensitivity)."},{"q":"Which two classes of drugs are given in combination for HIV-positive patients?","a":"NRTIs (nucleoside reverse transcriptase inhibitors) and PIs (protease inhibitors)."},{"q":"What do NRTIs and PIs do?","a":"They prevent viral replication."},{"q":"What is the mechanism of action of NRTIs?","a":"They integrate into viral DNA, causing incomplete replication and preventing new virus formation."},{"q":"What is the mechanism of action of protease inhibitors (PIs)?","a":"They inhibit protein synthesis needed for viral replication, reducing viral load and delaying disease progression."},{"q":"What is the physician’s goal in prescribing NRTIs and PIs for HIV?","a":"To delay the onset of AIDS as long as possible, often 10–15 years."},{"q":"What is the most common NRTI used for HIV?","a":"AZT (zidovudine)."},{"q":"What is the most challenging aspect of combination drug therapy for HIV?","a":"The large number and frequency of pills required; patients may need reminders such as alarm watches."},{"q":"What class of medication is commonly prescribed for aneurysm patients?","a":"Antihypertensives."},{"q":"What drug treats angina pectoris?","a":"Nitroglycerin."},{"q":"How many nitroglycerin tablets can be taken before calling the doctor?","a":"Up to three."},{"q":"How much time should pass between each nitroglycerin tablet?","a":"Five minutes."},{"q":"By what route is nitroglycerin taken?","a":"Sublingual."},{"q":"What is the action of nitroglycerin?","a":"Dilates coronary arteries to increase oxygen supply and reduces preload."},{"q":"What are the two most common side effects of nitroglycerin?","a":"Headache and hypotension."},{"q":"What precaution must the nurse take when applying topical nitroglycerin paste?","a":"Wear gloves to avoid absorbing the medication."},{"q":"Cancer drugs most commonly cause side effects in which three body systems?","a":"Gastrointestinal, hematologic, and integumentary systems."},{"q":"What are the three most common gastrointestinal side effects of chemotherapy?","a":"Nausea and vomiting, diarrhea, and stomatitis (oral sores)."},{"q":"Is it permissible to give viscous lidocaine before meals for chemotherapy-induced stomatitis?","a":"True."},{"q":"What are the three hematologic side effects of chemotherapy?","a":"Thrombocytopenia, leukopenia, and anemia."},{"q":"Which blood cells are decreased in thrombocytopenia?","a":"Platelets."},{"q":"What drug should not be given to a client with chemotherapy-induced thrombocytopenia?","a":"Aspirin (ASA)."},{"q":"When should intramuscular injections be withheld from a chemotherapy client?","a":"When platelet count is low."},{"q":"What is the number one integumentary side effect of chemotherapy?","a":"Alopecia."},{"q":"What is alopecia?","a":"Hair loss."},{"q":"Is chemotherapy-related hair loss usually temporary?","a":"True."},{"q":"Can scalp tourniquets prevent chemotherapy-induced alopecia?","a":"In some cases, yes."},{"q":"Can ice packs to the scalp prevent chemotherapy-induced alopecia?","a":"In some cases, yes."},{"q":"What are the three most common drugs given to women with CD in pregnancy?","a":"Diuretics, heparin, and digitalis."},{"q":"Why are diuretics given to women with CD of pregnancy?","a":"To promote diuresis, reduce blood volume and preload, and decrease cardiac workload."},{"q":"Why is heparin given to women with CD of pregnancy?","a":"To prevent thrombophlebitis caused by venous congestion."},{"q":"Why is digitalis prescribed for CD of pregnancy?","a":"To increase myocardial contractility and decrease heart rate, improving efficiency."},{"q":"Can morphine be given to a woman with CD during labor?","a":"Yes, because it decreases preload and pain, resting the heart."},{"q":"What are the two primary treatments for cataracts?","a":"Laser treatment or surgical removal (intraocular or extraocular lens extraction)."},{"q":"What drugs are given preoperatively for cataract extraction?","a":"Mydriatics, dilating drops, and antibiotic eye drops."},{"q":"What drugs are given postoperatively after cataract removal?","a":"Stool softeners, antiemetics, and mild analgesics."},{"q":"Can medications be piggybacked into the TPN lumen of a central line?","a":"No, use a separate lumen."},{"q":"Which chemotherapy drug causes hemorrhagic cystitis?","a":"Cytoxan (cyclophosphamide)."},{"q":"Which chemotherapy drug causes peripheral neuropathy, constipation, and ototoxicity?","a":"Cisplatin."},{"q":"Which drug causes pulmonary fibrosis?","a":"Bleomycin."},{"q":"Which chemotherapeutic agent is cardiotoxic?","a":"Adriamycin (doxorubicin)."},{"q":"Which drug causes peripheral neuropathy and adynamic ileus?","a":"Vincristine."},{"q":"Which chemotherapeutic drug causes flu-like symptoms?","a":"DTIC (dacarbazine)."},{"q":"Which drug is toxic to most organs except the heart, worsened by aspirin use?","a":"Methotrexate."},{"q":"What are two common medical treatments for otitis media?","a":"Systemic antibiotics and antibiotic ear drops."},{"q":"Name three drug groups used to treat CHF.","a":"Diuretics, vasodilators, and digitalis."},{"q":"What must you do before administering digitalis?","a":"Measure the apical pulse for one full minute."},{"q":"If an adult’s apical pulse is below 60 bpm, what should you do?","a":"Hold the dose and notify the provider. (Below 70 for children, 90 for infants.)"},{"q":"Which mineral is most often lost due to diuretic therapy in CHF?","a":"Potassium (K⁺)."},{"q":"Name four common toxic effects of digitalis.","a":"Anorexia, nausea\/vomiting, yellow vision, and arrhythmia."},{"q":"Chronic use of what medication can mimic Cushing’s syndrome?","a":"Steroid therapy."},{"q":"Which vitamins must be replaced in cystic fibrosis?","a":"Fat-soluble vitamins A, D, E, and K (in water-soluble form)."},{"q":"What supplement should CF clients take in hot weather?","a":"Sodium chloride (NaCl) tablets."},{"q":"Why is the child with cystic fibrosis given pancreatin, viokase, or pancreas enzymes?","a":"These are pancreatic enzymes that help digest and absorb nutrients."},{"q":"When should pancreatic enzyme replacements be taken in cystic fibrosis?","a":"With meals, so the enzymes mix with food to enhance nutrient absorption."},{"q":"Which pre-procedure medications are commonly given before cystoscopy?","a":"Valium or Demerol for relaxation."},{"q":"Which drugs can induce Parkinson-like symptoms?","a":"Haldol and other antipsychotics ending in -azine."},{"q":"Name four drugs used to treat Parkinson’s disease.","a":"Levodopa, Sinemet, Symmetrel, Cogentin (also Artane, Parlodel)."},{"q":"Which vitamin should be avoided with Levodopa therapy?","a":"Vitamin B6 (pyridoxine)."},{"q":"Should Levodopa be taken with or without food?","a":"With food, to prevent GI upset."},{"q":"What effect can Levodopa have on urine color?","a":"It can darken the urine."},{"q":"PCA pumps maintain a more constant serum drug level than IM analgesia. (T\/F)","a":"True."},{"q":"Do PCA pump clients use more or less medication than those receiving IM injections?","a":"Less."},{"q":"What medicated shampoo treats lice infestations?","a":"Kwell (lindane)."},{"q":"What is the most dangerous toxicity of Kwell?","a":"Central nervous system toxicity."},{"q":"What chemical may be added to bath water in pemphigus care?","a":"Potassium permanganate."},{"q":"What precaution must be taken when using potassium permanganate?","a":"Ensure all crystals are fully dissolved; undissolved ones burn the skin."},{"q":"What drugs are most commonly used for pemphigus?","a":"Steroids."},{"q":"Should steroids be taken with meals?","a":"Yes, always take steroids with meals."},{"q":"Does PD require heparinization?","a":"No, unlike hemodialysis."},{"q":"What is the PD solution called?","a":"Dialysate."},{"q":"To what temperature should dialysate be warmed before use?","a":"Body temperature."},{"q":"How high should the dialysate bag be hung during infusion?","a":"At shoulder height."},{"q":"What is the treatment for pernicious anemia?","a":"IM Vitamin B12 injections."},{"q":"How long must clients with pernicious anemia receive treatment?","a":"For life."},{"q":"Should B12 be given orally in pernicious anemia?","a":"No, it will not be absorbed."},{"q":"Should systemic pain relief be given in active placenta previa labor?","a":"No, it may depress the fetus."},{"q":"What size IV needle should be used for placenta previa with bleeding?","a":"18-gauge or larger."},{"q":"Define phlebotomy.","a":"Withdrawal of 200–500 mL of blood, opposite of transfusion."},{"q":"What drug is commonly used to treat polycythemia vera?","a":"Myleran."},{"q":"Does insulin dosage remain constant throughout pregnancy?","a":"No, it varies by trimester."},{"q":"Are oral hypoglycemics safe during pregnancy?","a":"No, they are teratogenic."},{"q":"What IV solution is used during labor for diabetic clients?","a":"D5W (5% dextrose in water)."},{"q":"Are diuretics used in preeclampsia?","a":"Yes."},{"q":"What medication reduces pulmonary congestion in pulmonary edema?","a":"Diuretics (e.g., Lasix)."},{"q":"What medication improves ventilation in pulmonary edema?","a":"Aminophylline (bronchodilator)."},{"q":"Since pulmonary edema is caused by left ventricular failure, which drug is used?","a":"Digitalis."},{"q":"Why is morphine given in pulmonary edema?","a":"To reduce anxiety and preload, easing the heart’s workload."},{"q":"What anticoagulant is given immediately (IV\/SQ)?","a":"Heparin."},{"q":"What drug is used for long-term anticoagulation?","a":"Coumadin (warfarin)."},{"q":"What is Lovenox?","a":"Low-molecular-weight heparin used post-op to prevent thrombophlebitis (not for PE)."},{"q":"After the acute phase of pulmonary embolus, what drug is given for 6 months?","a":"Coumadin."},{"q":"What medical treatment is required for pyelonephritis?","a":"IV antibiotics for 1–2 weeks, plus follow-up urine culture."},{"q":"Which pain medication should never be given in sickle cell crisis?","a":"Aspirin, because it causes acidosis and worsens sickling."},{"q":"Name three drugs used to treat muscle spasms in spinal cord injury.","a":"Valium, Baclofen, Dantrium."},{"q":"Define antibiotic.","a":"A drug that destroys or inhibits the growth of microorganisms."},{"q":"What is the treatment of choice for syphilis?","a":"Penicillin."},{"q":"Why is penicillin often given with procaine and probenecid?","a":"Procaine reduces injection pain; probenecid prolongs penicillin action."},{"q":"What is the drug class used to treat mastitis?","a":"Antibiotics."},{"q":"What is the medical treatment for mastoiditis?","a":"Systemic antibiotic therapy."},{"q":"What is an emulsion?","a":"A mixture of oil and water."},{"q":"Why are syrups and elixirs a concern for diabetic clients?","a":"They contain sugar."},{"q":"Oral medications have a faster or slower onset than intramuscular (IM) drugs?","a":"Slower onset."},{"q":"Oral medications have a shorter or longer duration than IM medications?","a":"Longer duration."},{"q":"How should medications that can stain teeth be given?","a":"Through a straw."},{"q":"Do parenteral drugs act outside the gastrointestinal (GI) tract?","a":"Yes."},{"q":"What are the four most common parenteral routes?","a":"Subcutaneous (SQ), Intramuscular (IM), Intravenous (IV), and Intradermal (ID)."},{"q":"What size needle should be used for IV blood administration?","a":"18-gauge needle or catheter."},{"q":"How many milliliters (mL) can be injected into one IM site in adults?","a":"Up to 3 mL per site."},{"q":"What is the maximum volume per IM site for children?","a":"2 mL."},{"q":"What is the preferred IM injection site for children under 3 years old?","a":"Vastus lateralis muscle."},{"q":"Why should the dorsogluteal site be avoided for children under 3 years old?","a":"The muscle is not well developed."},{"q":"Can 3 mL be injected into the deltoid muscle of an adult?","a":"No, only 1 mL maximum."},{"q":"What is the main danger when using the dorsogluteal site?","a":"Risk of damaging the sciatic nerve."},{"q":"At what angle should IM injections be administered?","a":"90 degrees."},{"q":"What needle length is preferred for IM injections?","a":"1 to 2 inches."},{"q":"What needle gauge is typically used for IM injections?","a":"21 to 22 gauge."},{"q":"What type of medications are given by the Z-track method?","a":"Medications that are irritating or can stain tissue."},{"q":"How long should the needle remain in place after Z-track injection?","a":"10 seconds."},{"q":"What should be done before giving a Z-track injection?","a":"Change the needle before injecting."},{"q":"When giving a Z-track injection, how should the skin be pulled?","a":"Laterally to one side."},{"q":"At what angle are subcutaneous (SQ) injections typically given?","a":"45 degrees (or as needed to reach SQ tissue)."},{"q":"What needle gauge is preferred for SQ injections?","a":"25 gauge."},{"q":"What needle length is preferred for SQ injections?","a":"5\/8 inch."},{"q":"What is the intradermal route primarily used for?","a":"Skin testing."},{"q":"What are common sites for intradermal injections?","a":"Inner forearm and upper back."},{"q":"After using nasal drops, how long should the client remain supine?","a":"About 5 minutes."},{"q":"What should a client do before receiving vaginal medication?","a":"Void to increase comfort."},{"q":"After vaginal medication is given, how long should the client remain supine?","a":"10 minutes."},{"q":"Should rectal suppositories with an oil base be refrigerated?","a":"Yes."},{"q":"How can the effectiveness of a rectal suppository be ensured?","a":"Place the suppository against the rectal wall."},{"q":"How deep should a rectal suppository be inserted?","a":"4 inches for adults and 2 inches for children."},{"q":"Should the client remain supine after rectal suppository insertion?","a":"No, the client should lie on their side for 5 minutes."},{"q":"What type of lubricant should be used for rectal suppositories?","a":"Water-soluble lubricant."},{"q":"Should eye drops be applied directly onto the cornea?","a":"No, apply into the conjunctival sac, never on the cornea."},{"q":"Eye drops should be placed into which area of the eye?","a":"The conjunctival sac."},{"q":"To prevent systemic absorption of eye drops, where should pressure be applied?","a":"To the nasolacrimal duct for about 10 seconds."},{"q":"Liquid medications should be measured at what level?","a":"Eye level."},{"q":"From which side of the bottle should liquid medications be poured?","a":"The side opposite the label."},{"q":"How should medication be administered to young infants?","a":"Using a dropper."},{"q":"When should Tagamet (cimetidine) be given?","a":"With meals. (Note: Zantac does not need to be given with meals.)"},{"q":"When should Capoten (captopril) be administered?","a":"On an empty stomach, one hour before meals."},{"q":"When should Apresoline (hydralazine) be given?","a":"With meals."},{"q":"How should iron be given if it causes nausea?","a":"With meals."},{"q":"What is important when giving sulfonamides such as Bactrim or Septra?","a":"Take with plenty of water, regardless of meals, to prevent crystalluria."},{"q":"How should codeine be taken?","a":"With plenty of water, regardless of meals, to prevent constipation."},{"q":"When should antacids be given?","a":"On an empty stomach, one hour before meals and at bedtime."},{"q":"How is Ipecac syrup administered?","a":"With 200–300 mL of water; do not give if poison is caustic or petroleum-based."},{"q":"When should Rifampin be taken?","a":"On an empty stomach; note that it may cause red or orange urine."},{"q":"How should NSAIDs be taken?","a":"With food to reduce gastric irritation."},{"q":"When should Aldactone (spironolactone) be given?","a":"With meals."},{"q":"When iron does not cause nausea, how should it be given?","a":"On an empty stomach with orange juice to enhance absorption."},{"q":"When should penicillin be administered?","a":"On an empty stomach."},{"q":"When should erythromycin be administered?","a":"On an empty stomach."},{"q":"How should stool softeners be taken?","a":"With plenty of water, regardless of meals."},{"q":"When should griseofulvin be taken?","a":"With meals—preferably with high-fat foods—to improve absorption."},{"q":"What are tetracycline precautions?","a":"Do not give with milk or dairy; avoid in pregnancy or in children under 8 to prevent tooth enamel damage."},{"q":"When should theophylline derivatives such as aminophylline or Theodur be given?","a":"With meals to decrease gastric irritation."},{"q":"When should corticosteroids be taken?","a":"With meals; taper off slowly, never stop abruptly."},{"q":"When should pancreatic enzyme supplements (pancreatin) be given?","a":"With meals to aid digestion, especially in cystic fibrosis."},{"q":"When should para-aminosalicylic acid (PAS) be given?","a":"With food or meals; used for tuberculosis treatment."},{"q":"When should colchicine be given?","a":"With meals; discontinue if diarrhea develops."},{"q":"How should Thorazine (chlorpromazine) be taken?","a":"With plenty of water, regardless of meals, to prevent constipation."},{"q":"What is the general rule for drugs ending in “-zine”?","a":"They are major tranquilizers that can cause extrapyramidal or pseudo-Parkinsonian effects."},{"q":"When should Carafate (sucralfate) be taken?","a":"On an empty stomach, one hour before meals and at bedtime; give separately from other medications."},{"q":"When should Allopurinol be taken?","a":"With meals and plenty of water; it reduces uric acid buildup in gout and chemotherapy."},{"q":"What electrolyte is sometimes prescribed for Meniere’s disease?","a":"Ammonium chloride."},{"q":"Which two classes of drugs are commonly used to treat Meniere’s disease?","a":"Antihistamines and diuretics (e.g., Diamox)."},{"q":"Name drugs used to treat or prevent migraines.","a":"Sansert (methysergide), Cafergot; for prevention, Imipramine."},{"q":"Is Inderal (propranolol) used to treat or prevent migraines?","a":"It is used to prevent migraines, not to treat acute attacks."},{"q":"Why are ACTH and prednisone given in acute MS?","a":"To reduce inflammation and edema during demyelination."},{"q":"What IV drug is often used for acute MS exacerbations?","a":"ACTH (Corticotropin)."},{"q":"What drug is used to treat urinary retention in MS?","a":"Urecholine (bethanechol)."},{"q":"Name three drugs used to treat muscle spasms in MS.","a":"Valium, Baclofen (Lioresal), and Dantrium."},{"q":"Does Baclofen cause constipation or diarrhea?","a":"Constipation."},{"q":"Does Dantrium cause constipation or diarrhea?","a":"Diarrhea."},{"q":"What class of drugs is used to treat MG?","a":"Anticholinesterase medications."},{"q":"What is the common drug suffix for anticholinesterases?","a":"“-stigmine.”"},{"q":"Are anticholinesterases sympathetic or parasympathetic in action?","a":"Parasympathetic."},{"q":"What type of side effects do anticholinesterases produce?","a":"Cholinergic effects (they mimic the parasympathetic system)."},{"q":"What is the most important nursing point when giving Mestinon or other anticholinesterases?","a":"They must be administered exactly on time; patients may need to set an alarm."},{"q":"Should anticholinesterases be given with or without food?","a":"With food, about 30 minutes before meals to strengthen swallowing muscles."},{"q":"What medications are given to relieve pain during an MI?","a":"Morphine, Demerol, and Nitroglycerin."},{"q":"Why is aspirin (ASA) given after an MI?","a":"To prevent platelet aggregation and further clot formation."},{"q":"Name a newer anti-platelet drug used after MI.","a":"Plavix (clopidogrel)."},{"q":"What drug is used to treat PVCs following an MI?","a":"Lidocaine."},{"q":"What is the name of frozen Factor VIII given to hemophiliacs?","a":"Cryoprecipitate."},{"q":"What topical medications can be used to stop bleeding?","a":"Epinephrine or topical fibrin foam."},{"q":"Name three drugs commonly used to treat shingles.","a":"Acyclovir (antiviral), Tegretol (carbamazepine for nerve pain), and corticosteroids."},{"q":"Why are antiemetics used cautiously in hyperemesis gravidarum?","a":"To avoid potential harm to the fetus."},{"q":"What class of drugs is typically used first to treat hypertension?","a":"Diuretics."},{"q":"What is the most common side effect of antihypertensive drugs?","a":"Orthostatic hypotension (feeling weak or dizzy upon standing)."},{"q":"Would vasodilators or vasoconstrictors treat hypertension?","a":"Vasodilators (they reduce vascular resistance)."},{"q":"Would sympathetic stimulators or sympathetic blockers treat hypertension?","a":"Sympathetic blockers (they reduce cardiac output and resistance)."},{"q":"What gauge IV catheter should be used for a client in hypovolemic shock?","a":"16 gauge or larger."},{"q":"During ECT, is the client awake or under anesthesia?","a":"Under general anesthesia with assisted ventilation."},{"q":"What drug class is given with ECT?","a":"Muscle relaxants, such as succinylcholine."},{"q":"Should sedatives be given before an EEG?","a":"Only if specifically ordered."},{"q":"What class of drugs is used to conservatively treat endometriosis?","a":"Androgens."},{"q":"Which androgen is most commonly used to treat endometriosis?","a":"Danazol."},{"q":"What antibiotics are used to treat epiglottitis?","a":"Penicillin or ampicillin."},{"q":"Is the client sedated before EGD?","a":"Yes, commonly with diazepam (Valium) or another sedative."},{"q":"What drug is used to anesthetize the pharynx during an EGD?","a":"Xylocaine, a local anesthetic."},{"q":"What is the purpose of carbonic anhydrase inhibitors?","a":"To treat glaucoma by decreasing aqueous humor production and lowering intraocular pressure; they also have diuretic effects."},{"q":"Give an example of a carbonic anhydrase inhibitor.","a":"Diamox (acetazolamide)."},{"q":"What are the effects of anticholinergics on the eyes?","a":"They dilate the pupils (mydriasis), cause photophobia, and are used preoperatively for cataract surgery."},{"q":"Give an example of an anticholinergic.","a":"Atropine."},{"q":"What do miotic eye medications do?","a":"Constrict the pupils (e.g., Timoptic, Pilocarpine)."},{"q":"What do mydriatic eye medications do?","a":"Dilate the pupils, cause tachycardia and photophobia; contraindicated in glaucoma."},{"q":"Give an example of a mydriatic.","a":"Neo-Synephrine."},{"q":"What is the most common side effect of carbonic anhydrase inhibitors?","a":"Diuresis."},{"q":"Which two drug classes commonly cause photophobia?","a":"Mydriatics and anticholinergics."},{"q":"Which class of eye medications may cause contact dermatitis?","a":"Miotics."},{"q":"What effect do anticholinergics have on the eye?","a":"Pupil dilation (mydriasis) and paralysis of accommodation (cycloplegia)."},{"q":"Define cycloplegia.","a":"Paralysis of the ciliary muscle, causing loss of lens accommodation."},{"q":"Which two eye drug classes may cause tachycardia due to sympathetic stimulation?","a":"Mydriatics and anticholinergics."},{"q":"What is the main purpose of anticholinergics in ophthalmology?","a":"To dilate the pupil and induce cycloplegia for eye examinations."},{"q":"Name two miotic drugs.","a":"Pilocarpine and Timoptic (or any drug ending in -lol)."},{"q":"Name two anticholinergics used in ophthalmology.","a":"Cyclogel and Atropine."},{"q":"What are the two types of oral contraceptive pills?","a":"Progestin-only and combination estrogen-progestin."},{"q":"For how many days each month is the progestin-only pill taken?","a":"All 28 days of the menstrual cycle."},{"q":"For how many days each month is the combination oral contraceptive taken?","a":"From day 5 through 24, with no pills taken on days 25–4 (8 pill-free days)."},{"q":"How long before surgery should oral contraceptives be discontinued?","a":"One week before surgery."},{"q":"If a woman forgets to take her oral contraceptive for one day, what should she do?","a":"Take the missed pill as soon as she remembers, then take the next pill at the regularly scheduled time."},{"q":"What should a woman do if she forgets to take the oral contraceptive pill for two days in a row?","a":"Take two pills a day for two consecutive days, then resume the normal schedule."},{"q":"What should a woman do if she forgets to take her oral contraceptive pill for three or more days?","a":"Discard the pack, start a new one immediately, and use a backup contraceptive method for 7 days."},{"q":"If a woman on oral contraceptives misses a period, should she continue taking the pills?","a":"Yes, but if two consecutive periods are missed, stop and take a pregnancy test."},{"q":"Will breakthrough bleeding, nausea, and breast tenderness disappear after some time on oral contraceptives?","a":"Yes, usually after 3–6 months of consistent use."},{"q":"What three medications are commonly used for osteoarthritis?","a":"Aspirin, NSAIDs (e.g., Indocin, Ibuprofen), and corticosteroids."},{"q":"What two drugs are commonly prescribed post-stapedectomy?","a":"Codeine or Demerol for pain, and Dramamine for dizziness."},{"q":"How do oral contraceptives affect ovarian cysts?","a":"They stop cyst growth and help reduce cyst size."},{"q":"What is the main difference between sealed and unsealed internal radiation therapy?","a":"In sealed therapy, a solid radioactive implant is placed in a body cavity; in unsealed therapy, a liquid radioactive substance is injected intravenously."},{"q":"What is another term for external radiation therapy?","a":"Beam therapy or external X-ray therapy."},{"q":"How does external radiation differ from internal radiation?","a":"External therapy directs radiation at the tumor from outside the body; internal therapy involves placing or injecting radioactive material inside the body."},{"q":"What skin products should patients receiving external radiotherapy avoid?","a":"Avoid ointments containing metals such as zinc oxide, and do not use talcum powder."},{"q":"What hygiene measures should be taught to patients receiving external radiotherapy?","a":"Use plain water only, avoid soap, pat the skin dry gently, and use cornstarch to relieve itching."},{"q":"What are the major side effects of radiotherapy?","a":"Pruritus, erythema, burning, skin sloughing, anorexia, nausea, vomiting, diarrhea, and bone marrow suppression."},{"q":"What drugs are used to prevent pregnancy after rape?","a":"FDA-approved kits such as Preven (levonorgestrel and ethinyl estradiol) or Plan B (levonorgestrel)."},{"q":"What medication is given to treat RDS and how is it administered?","a":"Survanta (surfactant) given via endotracheal tube; multiple doses may be required."},{"q":"What IV additive may be given to correct acidosis in RDS?","a":"Sodium bicarbonate."}]

Physiological Integrity – Reduction of Risk Potential

[{"q":"What is the best screening method for BPH?","a":"Digital rectal examination."},{"q":"What is the primary purpose of a three-way continuous bladder irrigation (CBI) after TURP?","a":"To keep the catheter clear of clots and to drain urine."},{"q":"What solution is used for continuous bladder irrigation (CBI)?","a":"Normal saline (0.9% NaCl)."},{"q":"How fast should the CBI run?","a":"At whatever rate keeps the urine flowing and free of clots."},{"q":"After prostatectomy, should you take rectal temperatures or give stool softeners?","a":"No rectal temperatures, but give stool softeners."},{"q":"When should the nurse call the physician after TURP?","a":"When there is bright thick bleeding, persistent clots, or continued urine drainage on the dressing."},{"q":"If blood content of urine increases after TURP, what should you do first?","a":"Pull gently on the catheter to apply local pressure on the prostate with the Foley balloon."},{"q":"If clots appear in the catheter tubing, what should you do first?","a":"Increase the flow rate of the irrigation."},{"q":"What is the most common problem related to catheterization?","a":"Urinary tract infection (UTI)."},{"q":"What is the most common organism causing UTI with catheterization?","a":"Escherichia coli (E. coli)."},{"q":"What is the most common route for organisms to enter the bladder when a catheter is used?","a":"Through the inside of the catheter after insertion."},{"q":"Name foods that make the urine acidic.","a":"Cranberry juice and apple juice (avoid citrus juices—they make urine alkaline)."},{"q":"Why must the urinary drainage bag be kept below bladder level?","a":"To prevent backflow of urine, which can cause infection."},{"q":"How should the catheter be taped in a male client?","a":"To the lateral thigh or abdomen."},{"q":"How should the catheter be taped in a female client?","a":"To the upper thigh."},{"q":"What urinary pH helps prevent urinary tract infection?","a":"Acidic (low pH)."},{"q":"Should the drainage bag ever touch the floor?","a":"No."},{"q":"Is it okay to routinely irrigate indwelling catheters?","a":"No."},{"q":"What agents are best for catheter care?","a":"Soap and water."},{"q":"What is the most effective way to reduce UTI risk with catheters?","a":"Keep the drainage system closed; do not disconnect tubing junctions."},{"q":"What are signs of infection in a client with a Foley catheter?","a":"Cloudy urine, foul-smelling urine, and hematuria."},{"q":"Is urinary incontinence an indication for catheterization?","a":"No."},{"q":"What are three appropriate indications for bladder catheterization?","a":"Urinary retention, checking for residual urine, and monitoring hourly urine output."},{"q":"What are the top two nursing diagnoses for a client with a catheter?","a":"#1—Potential for infection; #2—Potential impairment of urethral tissue integrity."},{"q":"What is systole?","a":"The maximum force of blood on the artery walls."},{"q":"What is diastole?","a":"The lowest force of blood on the artery walls."},{"q":"How wide should the blood pressure cuff be relative to the arm?","a":"About two-thirds of the arm’s width."},{"q":"Which artery is most commonly used to measure blood pressure?","a":"The brachial artery."},{"q":"Can the thigh ever be used to obtain a blood pressure?","a":"Yes, but it is rarely done."},{"q":"When auscultating blood pressure, the first sound heard corresponds to which measurement?","a":"The systolic pressure."},{"q":"The change in the character of Korotkoff sounds is known as what?","a":"The first diastolic sound."},{"q":"The cessation of sounds is known as what?","a":"The second diastolic sound."},{"q":"When two values are given in a blood pressure reading, what does the top number represent?","a":"The systolic pressure."},{"q":"In a blood pressure reading, what does the bottom number represent?","a":"The diastolic pressure (cessation of sounds)."},{"q":"What is the normal adult blood pressure?","a":"120\/80 mmHg."},{"q":"What is abnormally high blood pressure called?","a":"Hypertension."},{"q":"What is pulse pressure?","a":"The difference between the systolic and diastolic pressures."},{"q":"If the blood pressure cuff is deflated too slowly, will the reading be high or low, and why?","a":"High—venous congestion raises arterial pressure."},{"q":"If the cuff is too narrow, will the reading be high or low?","a":"High."},{"q":"Vasoconstriction will __________ blood pressure.","a":"Increase."},{"q":"What blood test must be done before a transfusion?","a":"Type and crossmatch."},{"q":"What does a type and crossmatch determine?","a":"Whether the client’s blood and donor blood are compatible."},{"q":"What should the nurse measure before starting a blood transfusion?","a":"Vital signs."},{"q":"How many nurses are required to verify the blood before transfusion?","a":"Two nurses."},{"q":"What happens if blood is administered with dextrose IV solutions?","a":"The blood cells clump together and do not flow properly."},{"q":"If a transfusion reaction occurs, what should the nurse do first?","a":"Stop the blood flow and start running normal saline."},{"q":"How long can a unit of blood remain on the nursing unit before transfusion must begin?","a":"Less than 30 minutes."},{"q":"What should the nurse do with the IV line if a transfusion reaction is suspected?","a":"Keep the line open with normal saline."},{"q":"If a transfusion reaction is suspected, what two samples are collected and sent to the lab?","a":"Urine and blood samples."},{"q":"Which of the following are signs of a transfusion reaction: bradycardia, fever, hives, wheezing, increased blood pressure, or low back pain?","a":"Low back pain, wheezing, fever, and hives."},{"q":"What are the three main types of transfusion reactions?","a":"Hemolytic, febrile, and allergic."},{"q":"What is the first nursing action when a transfusion reaction is suspected?","a":"Stop the blood and start the saline."},{"q":"What are the signs and symptoms of a hemolytic transfusion reaction?","a":"Shivering, headache, low back pain, increased pulse and respirations, decreased blood pressure, oliguria, and hematuria."},{"q":"What are the signs and symptoms of a febrile transfusion reaction?","a":"Low back pain, headache, increasing temperature, confusion, and hemoptysis."},{"q":"What are the signs and symptoms of an allergic transfusion reaction?","a":"Hives (urticaria), wheezing, pruritus, and joint pain (arthralgia)."},{"q":"What does blood typing determine?","a":"The presence of surface antigens on red blood cells."},{"q":"When must typing and crossmatching be performed?","a":"Whenever a client is to receive blood; results are valid for 24 hours."},{"q":"What does blood crossmatching involve?","a":"Mixing a small amount of the client’s blood with donor blood to check for agglutination."},{"q":"When are hemolytic transfusion reactions most likely to occur?","a":"Within the first 10 to 15 minutes of the transfusion."},{"q":"When is a febrile transfusion reaction most likely to occur?","a":"Within 30 minutes of beginning the transfusion."},{"q":"What test identifies Rh factor?","a":"The Coombs test, which detects antibodies to Rh."},{"q":"What is the difference between whole blood and packed red cells?","a":"Packed cells contain less plasma and volume than whole blood."},{"q":"What should the nurse do if the client’s temperature increases before receiving blood?","a":"Notify the physician; blood may be withheld if the temperature is elevated."},{"q":"How long should the nurse remain with the client after starting a transfusion?","a":"At least 15 to 30 minutes."},{"q":"Which blood type is the universal recipient?","a":"Type AB."},{"q":"Which blood type is the universal donor?","a":"Type O."},{"q":"What is the routine schedule for taking vital signs during a transfusion?","a":"Once before transfusion, every 15 minutes ×2 after starting, and once after completion."},{"q":"What nursing actions are appropriate after a transfusion reaction?","a":"Notify the physician, obtain blood and urine samples, monitor vital signs, and send the blood bag to the lab."},{"q":"What blood value dictates IV flow rate in burn patients?","a":"Hematocrit."},{"q":"If IV fluids are run at shock-phase rates during the diuretic phase, what complication may occur?","a":"Pulmonary edema."},{"q":"Burn patients must be monitored for _______ urine output and daily _______.","a":"Hourly urine output and daily weight."},{"q":"How often should vital signs, vaginal bleeding, and fetal heart rate be measured during abruptio placenta?","a":"Every 5–15 minutes for bleeding and maternal vital signs; continuous fetal monitoring; deliver at the earliest sign of fetal distress."},{"q":"What chemicals cause oral mucosa burns when ingested?","a":"Lye and caustic household cleaners."},{"q":"Children who ingest which substances are at high risk for seizures?","a":"Drugs and insecticides."},{"q":"Can impaired skin integrity be a nursing diagnosis after poisoning?","a":"Yes, especially when lye or caustic agents are ingested."},{"q":"What is the initial test used to detect HIV antibodies?","a":"ELISA test."},{"q":"What test confirms a positive ELISA result?","a":"Western Blot test."},{"q":"Which test best indicates the progression of HIV disease?","a":"CD4 count."},{"q":"A CD4 count below what level is associated with the onset of AIDS-related symptoms?","a":"Below 500 cells\/mm³."},{"q":"A CD4 count below what level is associated with opportunistic infections?","a":"Below 200 cells\/mm³."},{"q":"What lab findings are typical in AIDS?","a":"Decreased RBCs, WBCs, and platelets."},{"q":"Define leukopenia.","a":"A decrease in white blood cells, often indicating viral infection."},{"q":"Define azotemia.","a":"Accumulation of nitrogenous wastes in the blood (elevated BUN and creatinine)."},{"q":"What is the best indicator of renal function?","a":"Serum creatinine."},{"q":"What urinalysis findings are seen in AGN?","a":"Hematuria, proteinuria (+3 to +4), and elevated specific gravity."},{"q":"How is fluid excess assessed in a child with AGN?","a":"By daily weight monitoring."},{"q":"How often should vital signs be measured in AGN?","a":"Every 4 hours, with blood pressure monitoring."},{"q":"How can a stump be toughened to prevent skin breakdown from a prosthesis?","a":"Push the stump against a wall or hit it with a pillow to desensitize the area."},{"q":"Which vital signs are most important to monitor with aneurysms?","a":"Pulse and blood pressure."},{"q":"Which vital sign is affected first if an aneurysm ruptures?","a":"The pulse (tachycardia before blood pressure drops)."},{"q":"What type of tube is expected after thoracic aneurysm repair?","a":"Chest tube (due to chest incision)."},{"q":"What type of tube is expected after abdominal aneurysm repair?","a":"NG tube for bowel decompression."},{"q":"After femoral-popliteal resection surgery, what should be checked hourly for the first 24 hours?","a":"The distal extremity for color, temperature, pain, and pulse, and document findings."},{"q":"How can you distinguish angina from myocardial infarction (MI)?","a":"Angina pain is relieved by nitroglycerin and rest; MI pain is not."},{"q":"Is the pulse rate of anorexic clients tachycardic or bradycardic?","a":"Bradycardic."},{"q":"What is the most common gynecologic symptom of anorexia nervosa?","a":"Amenorrhea."},{"q":"What physical finding appears on the body of a client with anorexia nervosa?","a":"Lanugo (soft downy hair)."},{"q":"What is the Apgar scale?","a":"A quick, objective method to evaluate the vital functions of a newborn."},{"q":"When is the Apgar score assessed?","a":"At 1 minute and again at 5 minutes after birth."},{"q":"Name the five criteria measured in the Apgar scale.","a":"Heart rate, respiratory effort, muscle tone, reflex irritability, and color."},{"q":"What is the total scoring range of the Apgar scale?","a":"0 to 10."},{"q":"What is the maximum score an infant can receive on any single Apgar criterion?","a":"2."},{"q":"What does a total Apgar score of 10 indicate?","a":"The baby is in excellent health."},{"q":"What does an Apgar score of 0 indicate?","a":"The baby is stillborn."},{"q":"On the heart rate criterion, a score of 2 means the heart rate is above what?","a":"Above 100 beats per minute."},{"q":"On the heart rate criterion, a score of 1 means what?","a":"Heart rate greater than 0 but less than 100."},{"q":"What heart rate gives a score of 0 on the Apgar scale?","a":"Zero (no heartbeat)."},{"q":"A score of 2 for respiratory effort is given when the newborn does what?","a":"Cries vigorously."},{"q":"A score of 1 for respiratory effort is given when respirations are what?","a":"Slow or irregular."},{"q":"A score of 0 for respiratory effort is given when the infant does what?","a":"Does not breathe."},{"q":"To score 2 on muscle tone, the infant must do what?","a":"Move spontaneously and actively."},{"q":"A score of 1 for muscle tone is given when the newborn does what?","a":"Holds extremities in flexion."},{"q":"A score of 0 for muscle tone is given when there is what?","a":"No movement (limp)."},{"q":"To score 2 on neuromuscular reflex irritability, the infant must do what?","a":"Cry."},{"q":"A score of 1 on reflex irritability is given when the infant does what?","a":"Grimaces."},{"q":"A score of 0 on reflex irritability is given when the infant does what?","a":"Shows no response."},{"q":"To score 2 on color, the infant must be what?","a":"Completely pink."},{"q":"A score of 1 on color is given when what is observed?","a":"The extremities are blue but the trunk and face are pink."},{"q":"A score of 0 on color means the infant is what?","a":"Completely blue or pale."},{"q":"What is acrocyanosis?","a":"Temporary bluish discoloration of the lips, hands, or feet in newborns that disappears with warming."},{"q":"What does rebound tenderness indicate?","a":"Peritoneal inflammation."},{"q":"What is the highest temperature usually seen in appendicitis?","a":"102°F."},{"q":"What blood count is elevated in appendicitis?","a":"White blood cell (WBC) count."},{"q":"What is the term for elevated WBC count?","a":"Leukocytosis."},{"q":"What should be avoided before the physician evaluates a client with suspected appendicitis?","a":"Pain medications, enemas, laxatives, and food (NPO)."},{"q":"What should never be applied to the appendix area?","a":"Heat, because it may cause rupture."},{"q":"After appendectomy, what should be documented in the nurse’s notes?","a":"The return of bowel sounds (peristalsis)."},{"q":"What are the three objective signs of thrombocytopenia (P.E.E.)?","a":"Petechiae, epistaxis, and ecchymosis."},{"q":"What is epistaxis?","a":"Nosebleed."},{"q":"What is ecchymosis?","a":"Bruising."},{"q":"What is petechiae?","a":"Small pinpoint hemorrhages on the skin."},{"q":"Which blood cells are decreased in leukopenia?","a":"White blood cells."},{"q":"When the absolute neutrophil count (ANC) is below what value should reverse isolation be initiated?","a":"Below 500."},{"q":"What are the two most common subjective complaints of a woman decompensating during labor?","a":"Shortness of breath and palpitations."},{"q":"In addition to usual labor assessments, what special assessment is needed for a woman with cardiac disease?","a":"Frequent lung sound assessment."},{"q":"How often should lung sounds be assessed during the first, active, and transition stages of labor?","a":"Every 30 to 10 minutes."},{"q":"What signs and symptoms should be reported after cast application?","a":"Numbness, tingling, burning, pallor, unequal or absent pulses, or coolness."},{"q":"If inflammation occurs under a cast, how will it appear externally?","a":"As a hot spot on the cast surface."},{"q":"What type of cast can cause cast syndrome?","a":"A body cast."},{"q":"What causes cast syndrome?","a":"Anxiety and stress leading to sympathetic shutdown of bowel motility."},{"q":"What is the number one symptom of cast syndrome?","a":"Nausea and vomiting due to bowel obstruction."},{"q":"What is the primary treatment for cast syndrome?","a":"NPO status and nasogastric tube for decompression."},{"q":"How can you tell if Bryant’s traction is working correctly?","a":"The child’s hips\/sacrum should be just off the bed (a hand can slide underneath)."},{"q":"Patients in Russell’s traction are especially prone to what?","a":"Thrombophlebitis."},{"q":"What is a cataract?","a":"Opacity of the crystalline lens."},{"q":"Is cataract surgery performed immediately after diagnosis?","a":"No, surgery is delayed until vision interferes with activities of daily living (ADLs)."},{"q":"What are the three most common visual defects seen in cataracts?","a":"Cloudy vision, diplopia (double vision), and photophobia (light sensitivity)."},{"q":"What does the eye look like when cataracts are present?","a":"The pupil appears cloudy or milky white."},{"q":"What protective device is used after cataract surgery?","a":"A patch or shield for 24 hours, then a metal eye shield at night for three weeks."},{"q":"What should you tell a client about glasses or contacts after cataract surgery?","a":"If an intraocular lens is implanted, glasses may not be needed; if not, temporary glasses are used until permanent ones are prescribed in 2–3 months."},{"q":"Should the client ambulate independently after cataract surgery?","a":"No, depth perception is altered and increases the risk of falls."},{"q":"What positions must be avoided after cataract surgery?","a":"Lying face down or on the operative side for one month."},{"q":"What are signs of postoperative hemorrhage into the eye?","a":"Severe pain and restlessness."},{"q":"What movements must be avoided after cataract surgery?","a":"Coughing, sneezing, bending, straining at stool, rubbing eyes, or sudden head movements."},{"q":"What positions are acceptable after cataract surgery?","a":"Avoid lying on the operative side and lying flat on the back."},{"q":"Should talcum powder or pepper be used near a post-cataract client?","a":"No, they can trigger sneezing and increase eye pressure."},{"q":"What are three signs of increased intraocular pressure?","a":"Moderate to severe pain, restlessness, and increased pulse rate."},{"q":"What is the main nursing goal after cataract removal surgery?","a":"Prevent pressure in or on the eyes."},{"q":"What are five possible causes of cataracts?","a":"Injury, congenital defects, excessive heat exposure, heredity, and aging."},{"q":"What activity restrictions apply when ear tubes are in place?","a":"No swimming, showering, or diving."},{"q":"What is the number one complication of cleft lip\/palate?","a":"Aspiration."},{"q":"A fresh new stoma should appear ________, ________, and ________.","a":"Red, large, and moist."},{"q":"What device helps prevent venous stasis in CHF patients?","a":"Anti-embolism (TED) hose."},{"q":"How often should TED hose be removed?","a":"Daily."},{"q":"When should TED hose be applied?","a":"Before the patient gets out of bed."},{"q":"Can powder be used with TED hose?","a":"Yes."},{"q":"Should the nurse massage the legs of a CHF patient?","a":"Never."},{"q":"What daily measurement best reflects fluid retention in CHF?","a":"Daily weight."},{"q":"Should CHF clients have Foley catheters?","a":"Yes, to monitor urine output accurately when on diuretics."},{"q":"What serious complication is common in CHF?","a":"Pulmonary edema."},{"q":"How much weekly weight gain should a CHF client report immediately?","a":"Three pounds or more in one week."},{"q":"Hearing aids are more useful in which type of hearing loss: sensory or conductive?","a":"Conductive hearing loss."},{"q":"What are the two most common causes of whistling or squealing in a hearing aid?","a":"Loose earmold and low battery."},{"q":"Do hearing aids make sound clearer and more distinct?","a":"False, they only amplify sound but do not clarify it."},{"q":"What is the most common complication of malpositioned contact lenses in confused or comatose patients?","a":"Corneal ulceration."},{"q":"1 kilogram equals how many cubic centimeters (cc)?","a":"1000 cc."},{"q":"1 inch equals how many centimeters?","a":"2.5 cm."},{"q":"1 milliliter equals how many cubic centimeters?","a":"1 cc."},{"q":"1 teaspoon equals how many cubic centimeters?","a":"4–5 cc."},{"q":"1 gram equals how many milligrams?","a":"1000 mg."},{"q":"1 liter equals how many cubic centimeters?","a":"1000 cc."},{"q":"1 ounce equals how many cubic centimeters?","a":"30 cc."},{"q":"1 kilogram equals how many pounds?","a":"2.2 lbs."},{"q":"1 tablespoon equals how many cubic centimeters?","a":"15 cc."},{"q":"1 tablespoon equals how many teaspoons?","a":"3 tsp."},{"q":"1 gram equals how many grains?","a":"15 gr."},{"q":"1 grain equals how many milligrams?","a":"60 mg."},{"q":"Do Cushing’s clients have increased or decreased resistance to infection?","a":"Decreased."},{"q":"What is the classic diagnostic test for cystic fibrosis?","a":"Iontophoresis (sweat chloride test)."},{"q":"How can clients evaluate pancreatic function at home?","a":"By observing stools for steatorrhea."},{"q":"Define cystoscopy.","a":"Direct visualization of the urethra and bladder using a cystoscope."},{"q":"What should the nurse do if the client experiences bladder spasm, burning, or frequency after cystoscopy?","a":"Record the symptoms; no need to notify the provider unless they worsen."},{"q":"What should the nurse do if urine is pink-tinged after cystoscopy?","a":"Document it in the chart; this is expected."},{"q":"Is the client NPO before cystoscopy?","a":"No, unless a child is under general anesthesia; adults are encouraged to drink fluids."},{"q":"Are enemas required before cystoscopy?","a":"No, but they may be ordered."},{"q":"Should fluids be encouraged after cystoscopy?","a":"Yes, to flush the bladder."},{"q":"What vital sign changes are most concerning after cystoscopy?","a":"Decreased blood pressure and increased pulse — signs of hemorrhage."},{"q":"What type of anesthesia is used for cystoscopy?","a":"Local anesthesia; general anesthesia may be used for children."},{"q":"What time of day is most dangerous for Parkinson’s patients?","a":"Mealtime, due to choking risk."},{"q":"Why should patients on Levodopa get assistance when rising from bed?","a":"Risk of orthostatic hypotension."},{"q":"Are clients with COPD good candidates for PCA pumps?","a":"False, narcotics can depress their respiratory drive."},{"q":"Can clients overdose on PCA pumps?","a":"No, due to the lock-out feature."},{"q":"What is the leading cause of death in pemphigus?","a":"Overwhelming infection."},{"q":"Is there a high or low risk of peritonitis with PD?","a":"High risk."},{"q":"Can clients with recent bowel surgery undergo PD?","a":"No."},{"q":"Should clients with respiratory compromise receive PD?","a":"No."},{"q":"What should be done before starting PD?","a":"Weigh the client to monitor fluid balance."},{"q":"If drainage is sluggish, what should the nurse do first?","a":"Reposition the client side-to-side."},{"q":"What color should the dialysate be when drained?","a":"Clear, straw-colored."},{"q":"How often should vital signs be measured during PD?","a":"Every 15 minutes for the first cycle, then hourly."},{"q":"If too much fluid is removed during peritoneal dialysis, what occurs?","a":"Hypotension (low blood pressure)."},{"q":"If the client absorbs too much dialysate during PD, what happens?","a":"Hypertension or circulatory overload."},{"q":"If the client reports dyspnea during PD, what should the nurse do first?","a":"Slow the flow rate and elevate the head of bed."},{"q":"What does cloudy dialysate drainage indicate?","a":"Peritonitis — notify the provider immediately."},{"q":"What should you do if a small amount of blood appears in the first few bottles of PD fluid?","a":"Nothing; it is normal due to initial needle puncture."},{"q":"Is accurate intake and output recording necessary during PD?","a":"Yes, essential for fluid balance monitoring."},{"q":"What condition can mimic pernicious anemia?","a":"Angina pectoris."},{"q":"What test diagnoses pernicious anemia?","a":"Schilling test."},{"q":"What neurologic test is used for this anemia?","a":"Romberg test (positive result indicates imbalance)."},{"q":"What is the hallmark symptom of placenta previa?","a":"Painless third-trimester bleeding."},{"q":"Is placenta previa more common in primigravidas or multigravidas?","a":"Multigravidas."},{"q":"What are three major complications of placenta previa?","a":"Shock, maternal death, fetal death."},{"q":"What is the safest diagnostic method for placenta previa?","a":"Ultrasound."},{"q":"Should all women with placenta previa be hospitalized?","a":"Yes, especially if bleeding."},{"q":"Why might a C-section for placenta previa be delayed?","a":"To allow fetal maturity."},{"q":"Once diagnosed, is C-section usually required if fetus is mature?","a":"Yes, almost always."},{"q":"How should fetal heart tones be monitored in placenta previa with bleeding?","a":"Continuously by electronic fetal monitor."},{"q":"Which acid-base disorder is most common in pneumonia?","a":"Respiratory alkalosis due to hyperventilation."},{"q":"What procedure relieves symptoms in polycythemia vera?","a":"Phlebotomy (removal of blood)."},{"q":"What oral problem occurs in polycythemia vera?","a":"Bleeding mucous membranes."},{"q":"What blood level rises in polycythemia vera due to increased RBC destruction?","a":"Uric acid."},{"q":"How often should lung sounds be auscultated after surgery?","a":"Every 4 hours."},{"q":"The post-op patient should void by how many hours after surgery?","a":"6–8 hours."},{"q":"What post-op findings are typical for lungs, bowels, and temperature?","a":"Lungs: present; Bowels: absent; Temp: mild elevation normal."},{"q":"DVT is most common after which type of surgery?","a":"Lower abdominal or pelvic."},{"q":"What is the major complication of deep vein thrombosis?","a":"Pulmonary embolism."},{"q":"What is the best prevention for thrombophlebitis?","a":"Early ambulation and leg exercises."},{"q":"What is the typical mild post-op inflammatory temperature range?","a":"99.8–101°F."},{"q":"Infection after surgery usually appears on which day?","a":"2nd or 3rd post-op day."},{"q":"Define dehiscence.","a":"Separation of surgical incision edges."},{"q":"Define evisceration.","a":"Protrusion of abdominal organs through a dehiscence."},{"q":"What should be done for dehiscence?","a":"Lower the head of bed slightly, cover with moist sterile gauze, and call the physician."},{"q":"What should be done for evisceration?","a":"Same as dehiscence: lower the head of bed, cover with moist sterile gauze, and call the physician immediately."},{"q":"What is the #1 infant complication from maternal diabetes?","a":"Neonatal hypoglycemia."},{"q":"When does neonatal hypoglycemia most often occur?","a":"Within hours after delivery."},{"q":"Gestational diabetics are prone to which infection?","a":"Yeast (monilial) infections."},{"q":"What test confirms gestational diabetes?","a":"3-hour glucose tolerance test."},{"q":"If ketosis is a big problem before birth, what is the main neonatal risk after delivery?","a":"Hypoglycemia."},{"q":"Why is hypoglycemia so dangerous in infants?","a":"Brain cells die without glucose, leading to brain damage."},{"q":"What daily measurement should women with preeclampsia perform?","a":"Daily weight."},{"q":"When hospitalized for severe preeclampsia, what should the nurse assess most closely?","a":"Deep tendon reflexes and urine protein."},{"q":"When preeclampsia worsens, reflexes become (hyper\/hypo)active.","a":"Hyperreflexic."},{"q":"Preeclampsia makes the neuromuscular system more or less irritable?","a":"More irritable."},{"q":"What visual disturbance is common in preeclampsia?","a":"Blurred vision."},{"q":"When does preeclampsia become eclampsia?","a":"When convulsions occur."},{"q":"What ominous sign usually precedes seizures in eclampsia?","a":"Severe epigastric pain."},{"q":"In eclampsia, urine output usually (increases\/decreases).","a":"Decreases."},{"q":"How can uterine contractions be palpated in an eclamptic woman?","a":"Place flat hand on the fundus and press lightly."},{"q":"Define premature rupture of membranes (PROM).","a":"Spontaneous rupture of amniotic sac before onset of contractions."},{"q":"Labor usually begins within how many hours after PROM?","a":"24 hours."},{"q":"What should be checked in amniotic fluid to confirm rupture?","a":"pH level."},{"q":"Amniotic fluid is (acidic\/alkaline).","a":"Alkaline."},{"q":"Alkaline fluid has a (high\/low) pH.","a":"High pH."},{"q":"What color does nitrazine paper turn in amniotic fluid?","a":"Deep blue."},{"q":"The best test for fetal lung maturity after PROM is the ______ ratio.","a":"L\/S (lecithin\/sphingomyelin)."},{"q":"An L\/S ratio greater than ____ indicates lung maturity.","a":"2.0."},{"q":"If labor doesn’t begin within how many hours after PROM, induction is likely?","a":"24 hours."},{"q":"PROM always causes a large gush of fluid. (T\/F)","a":"False."},{"q":"Can IVs running too fast cause pulmonary edema?","a":"Yes, in clients with poor cardiovascular function."},{"q":"What will the nurse hear when auscultating lungs in pulmonary edema?","a":"Crackles (rales)."},{"q":"What does sputum look like in severe pulmonary edema?","a":"Frothy and blood-tinged."},{"q":"What condition increases pulmonary embolus risk due to inactivity?","a":"Bed rest."},{"q":"What class of medications can lead to pulmonary embolus?","a":"Oral contraceptives."},{"q":"What lab tests monitor Coumadin therapy?","a":"Prothrombin Time (PT) and INR."},{"q":"What is the target INR range for Coumadin therapy?","a":"2.0–3.0."},{"q":"What lab test monitors Heparin therapy?","a":"PTT (partial thromboplastin time)."},{"q":"Effective Heparin therapy raises PTT to about how many times normal?","a":"2.5 times."},{"q":"What is the best prevention of pulmonary embolus postoperatively?","a":"Early ambulation."},{"q":"Should legs be massaged to prevent pulmonary embolus?","a":"No, it may dislodge a clot."},{"q":"What test monitors daily Coumadin therapy?","a":"Prothrombin Time (PT)."},{"q":"Should daily weights be recorded for clients with pyelonephritis?","a":"Yes, to monitor fluid balance."},{"q":"What test confirms pyloric stenosis?","a":"Upper GI series (barium swallow)."},{"q":"Sutures are generally removed on which post-op day?","a":"7th day."},{"q":"What test confirms scoliosis?","a":"X-ray of the spine."},{"q":"What type of brace is commonly used for scoliosis?","a":"Milwaukee brace."},{"q":"How often should neurovascular status be checked post-op in a Risser cast?","a":"Every 2 hours initially."},{"q":"What is a common complication of clients in a body cast (Risser)?","a":"Cast syndrome."},{"q":"Who is at risk for cast syndrome?","a":"Anyone in a body cast."},{"q":"What is the treatment for cast syndrome?","a":"Remove the cast, insert an NG tube for decompression, and keep the patient NPO."},{"q":"How can the nurse assess for developing cast syndrome?","a":"Ask about abdominal symptoms and monitor bowel movements and passage of flatus."},{"q":"What specifically causes cast syndrome in a Risser cast?","a":"Hyperextension of the spine interrupts blood and nerve supply to the bowel."},{"q":"Should a child in sickle cell crisis wear tight clothing?","a":"No, it may further restrict circulation."},{"q":"How should the position of a spinal cord injury patient be changed once mobility is allowed?","a":"Slowly, to prevent severe orthostatic hypotension (use a tilt table)."},{"q":"What is autonomic dysreflexia (hyperreflexia)?","a":"A sudden, severe hypertensive response in quadriplegics triggered by a full bladder or bowel."},{"q":"What vital sign changes occur in autonomic dysreflexia?","a":"Sweating, severe hypertension, headache, nausea, vomiting, and gooseflesh."},{"q":"What is the first nursing action during autonomic dysreflexia?","a":"Raise the head of the bed (HOB)."},{"q":"What is the second nursing action during autonomic dysreflexia?","a":"Check the bladder and bowel for distention or impaction."},{"q":"Should the doctor be called immediately for autonomic dysreflexia?","a":"Only if draining the bladder and relieving impaction do not resolve symptoms."},{"q":"What is the number one treatment for autonomic dysreflexia?","a":"Drain the bladder and empty the bowel."},{"q":"Why is activity restricted after a spinal tap?","a":"To prevent headache due to cerebrospinal fluid (CSF) loss."},{"q":"Should cerebrospinal fluid contain blood?","a":"No, it should be clear and colorless."},{"q":"Must the client be NPO before a spinal tap?","a":"No."},{"q":"What is the normal color of cerebrospinal fluid (CSF)?","a":"Clear and colorless."},{"q":"Into what space is the needle inserted during a spinal tap?","a":"The subarachnoid space."},{"q":"What are the two main purposes of a spinal tap?","a":"To measure or relieve pressure and obtain a CSF sample."},{"q":"Define coagulate.","a":"The process of thickening or clotting."},{"q":"What indicates that suctioning was effective?","a":"Clear lung sounds and stable vital signs."},{"q":"How often should the airway be suctioned?","a":"As needed, based on moist lung sounds, restlessness, or ineffective coughing."},{"q":"What action before suctioning helps prevent hypoxia?","a":"Pre-oxygenate the client with 100% oxygen."},{"q":"What catheter size is used for adult suctioning?","a":"12 to 16 French."},{"q":"What suction pressure is used for an infant?","a":"Less than 80 mm Hg."},{"q":"What suction pressure is used for a child?","a":"80 to 100 mm Hg."},{"q":"What suction pressure is used for an adult?","a":"120 to 150 mm Hg."},{"q":"What postoperative complication can occur after mastoidectomy?","a":"Facial nerve paralysis due to accidental surgical damage."},{"q":"How can a nurse assess facial nerve function after mastoidectomy?","a":"Ask the patient to smile and wrinkle their forehead."},{"q":"Does a simple mastoidectomy cause hearing loss?","a":"No, but a radical mastoidectomy may."},{"q":"What common side effect may occur after mastoidectomy?","a":"Dizziness or vertigo."},{"q":"What is a key nursing diagnosis after mastoidectomy?","a":"Risk for injury related to vertigo—safety is the top priority."},{"q":"What does “sensitivity” (susceptibility) mean in microbiology?","a":"The organism’s response or vulnerability to a particular antimicrobial agent."},{"q":"What does “virulence” mean?","a":"The ability of a microorganism to cause disease."},{"q":"What does “bacteriostatic” mean?","a":"Capable of inhibiting bacterial growth."},{"q":"What does “bactericidal” mean?","a":"Capable of killing bacteria."},{"q":"What does “culture” mean in microbiology?","a":"Growing colonies of organisms for identification and study."},{"q":"What may happen if ear medications are not at room temperature?","a":"The client may experience dizziness or nausea."},{"q":"How can Meniere’s attacks be prevented?","a":"Avoid sudden movements or position changes."},{"q":"What should clients avoid after labyrinthectomy?","a":"Sudden movements and high-sodium foods."},{"q":"What type of diet is prescribed for Meniere’s disease?","a":"Low-sodium diet."},{"q":"What is the definitive diagnostic test for meningitis?","a":"Lumbar puncture with cerebrospinal fluid (CSF) culture."},{"q":"What changes are seen in CSF with bacterial meningitis?","a":"Increased pressure, WBCs, and protein; decreased glucose."},{"q":"What complication can develop in meningitis?","a":"Seizures."},{"q":"What does long-term migraine management focus on?","a":"Identifying and avoiding triggers such as stress."},{"q":"Besides vision, what major sense is commonly affected in MS?","a":"Tactile sense (touch), increasing risk of burns."},{"q":"What temperature conditions can trigger an MS exacerbation?","a":"Both overheating and chilling; symptoms worsen in hot weather."},{"q":"What result indicates a positive Tensilon test in MG?","a":"A sudden, temporary improvement in muscle strength."},{"q":"Besides the Tensilon Test, what other diagnostic test confirms myasthenia gravis (MG)?","a":"Electromyography (EMG)."},{"q":"Name the two types of crises that may occur in MG.","a":"Myasthenic crisis (underdose of Mestinon) and cholinergic crisis (overdose of Mestinon)."},{"q":"What is the primary danger in both myasthenic and cholinergic crisis?","a":"Respiratory arrest."},{"q":"What are the three most common complications following an MI?","a":"Cardiogenic shock, arrhythmias, and congestive heart failure (CHF)."},{"q":"What is the most common arrhythmia after an MI?","a":"Premature ventricular contractions (PVCs)."},{"q":"Which cardiac enzymes indicate an MI?","a":"Elevated CPK, LDH, and SGOT (AST)."},{"q":"Which serum protein rises earliest after myocardial injury?","a":"Troponin."},{"q":"Is troponin normally present in healthy individuals?","a":"No, it is detectable only after myocardial cell injury."},{"q":"How soon after injury does troponin increase?","a":"Within 3 hours, remaining elevated for up to 7 days."},{"q":"What permanent ECG change is seen after an MI?","a":"ST-segment changes."},{"q":"Between CPK and LDH, which rises first?","a":"CPK."},{"q":"What is done in a graft for hemodialysis access?","a":"A synthetic blood vessel is sutured between an artery and a vein."},{"q":"What is an AV fistula?","a":"A surgically created direct connection (anastomosis) between an artery and a vein."},{"q":"Does an AV fistula have anything exiting the skin?","a":"No, it is completely internal."},{"q":"How long can an AV fistula be used?","a":"Indefinitely, if it remains patent."},{"q":"Who is most likely to require a graft for dialysis access?","a":"Patients with diabetes mellitus."},{"q":"How often do clients with renal failure typically undergo dialysis?","a":"Three times per week."},{"q":"Is hemodialysis a short-term or long-term treatment?","a":"It can be both, though short-term dialysis is most often hemodialysis."},{"q":"How long does a typical dialysis session last?","a":"4 to 6 hours."},{"q":"What are the three methods of vascular access for hemodialysis?","a":"AV shunt, AV fistula, and AV graft."},{"q":"What is the most common site for an AV shunt?","a":"Radial artery to radial vein."},{"q":"What must be avoided in the arm with a shunt, graft, or fistula?","a":"No venipunctures or blood pressure measurements."},{"q":"What syndrome occurs when fluid is removed too rapidly during hemodialysis?","a":"Disequilibrium syndrome."},{"q":"What are the symptoms of disequilibrium syndrome?","a":"Altered level of consciousness, nausea, vomiting, headache, and muscle twitching."},{"q":"Does an AV shunt have an external component?","a":"Yes, the plastic tube connecting the artery and vein exits the skin."},{"q":"How long can an AV shunt be used?","a":"Only for a few weeks."},{"q":"During an acute bleeding episode in hemophilia, what should you do?","a":"Apply firm pressure and ice to the area for 15 minutes."},{"q":"In hemophilia, how are the PTT, clotting time, and platelet count affected?","a":"PTT and clotting time are increased (prolonged); platelet count is normal."},{"q":"During bleeding into a joint, should the extremity be immobilized or mobilized?","a":"Immobilized, to prevent dislodging clots that form."},{"q":"To treat hemarthrosis, what should be done with the affected limb?","a":"Elevate the extremity above heart level."},{"q":"After joint bleeding stops, how long should the patient wait before bearing weight or performing range of motion?","a":"48 hours."},{"q":"Before applying elastic stockings, what should the nurse do?","a":"Elevate the legs for 3–5 minutes to reduce venous stasis."},{"q":"Clients on what medications should use an electric razor?","a":"Anticoagulants (e.g., heparin, warfarin, enoxaparin)."},{"q":"What is the greatest danger of placing water in the mouth of an unconscious patient?","a":"Aspiration."},{"q":"Should clients roll elastic stockings down to wash their legs?","a":"No, it can create a constrictive band and impair circulation."},{"q":"Should elastic stockings be removed for bathing?","a":"Yes."},{"q":"When should a patient put on TED hose?","a":"Before getting out of bed, before swelling develops."},{"q":"What are the two major complications of hyperemesis gravidarum?","a":"Electrolyte imbalance (dehydration) and starvation."},{"q":"How many separate measurements are needed to confirm hypertension?","a":"At least three readings."},{"q":"What blood pressure value is considered hypertensive?","a":"Greater than 140\/90 mmHg."},{"q":"Which is more damaging—an elevated systolic or diastolic pressure?","a":"An elevated diastolic pressure."},{"q":"When taking multiple BP readings, how far apart should they be?","a":"At least one week apart."},{"q":"Can hypertension be cured?","a":"No, it can only be managed, not cured."},{"q":"When assessing BP in a hypertensive client, you should measure ________ while the client is ________, ________, and ________.","a":"Both arms; lying, sitting, and standing."},{"q":"What effect do caffeine and smoking have on blood pressure?","a":"They increase it."},{"q":"How is pulse pressure calculated?","a":"Subtract diastolic pressure from systolic pressure."},{"q":"If the BP is 100\/60, what is the pulse pressure?","a":"40 mmHg."},{"q":"What is the normal pulse pressure range?","a":"Approximately 40 mmHg (±10)."},{"q":"Should a Foley catheter be inserted in clients with hypovolemic shock?","a":"Yes, to monitor urine output (shock is resolving when >30 mL\/hour)."},{"q":"How often should vital signs be measured in hypovolemic shock?","a":"Every 15 minutes."},{"q":"Is a Foley catheter typically used after a hysterectomy?","a":"Yes."},{"q":"Are enemas commonly ordered before a hysterectomy?","a":"Yes."},{"q":"What should you do if a post-hysterectomy client reports flank or back pain?","a":"Notify the physician immediately—it may indicate ureteral injury."},{"q":"What causes thrombophlebitis after a hysterectomy?","a":"Venous stasis in the abdomen due to prolonged lithotomy positioning during surgery."},{"q":"What sign indicates the presence of thrombophlebitis?","a":"A hard, red, swollen area in the posterior calf."},{"q":"Should you assess for Homan’s sign in suspected thrombophlebitis?","a":"No, it is no longer recommended as it may dislodge a clot."},{"q":"How long before a hysterectomy should oral contraceptives be discontinued?","a":"3 to 4 weeks prior to surgery."},{"q":"How long should a woman wait before lifting heavy objects after a hysterectomy?","a":"2 months."},{"q":"When can a woman safely resume driving after a hysterectomy?","a":"After 3 to 4 weeks."},{"q":"What are two major complications of a hysterectomy besides hemorrhage?","a":"Thrombosis or pulmonary embolism, and urinary retention."},{"q":"What position should be avoided after a hysterectomy, and why?","a":"Avoid knee flexion—it promotes venous stasis and thrombophlebitis."},{"q":"When do bowel sounds typically return after a hysterectomy?","a":"Within 24 to 72 hours."},{"q":"What are three common complications of ECT?","a":"Aspiration of vomitus, joint dislocation, and rare bone fractures."},{"q":"What position should the client be placed in immediately after ECT?","a":"Side-lying to prevent aspiration."},{"q":"Is the seizure from ECT violent?","a":"No, modern ECT uses muscle relaxants to minimize movement."},{"q":"What does an EEG measure?","a":"Electrical activity of the brain."},{"q":"Should the client be NPO before an EEG?","a":"No, fasting can cause hypoglycemia and alter results."},{"q":"What is the most important instruction during an EEG?","a":"Remain still and avoid movement."},{"q":"How much sleep should the client get before an EEG?","a":"At least 4–5 hours unless it’s a sleep-deprivation EEG."},{"q":"Should caffeine be restricted before an EEG?","a":"Yes, avoid caffeine for 24 hours before the test."},{"q":"What do fatty stools look like?","a":"Large, pale, greasy, and foul-smelling."},{"q":"What is the medical term for fatty stools?","a":"Steatorrhea."},{"q":"Name three types of intestinal parasites found in stool.","a":"Roundworms, tapeworms, and pinworms."},{"q":"What does occult blood in stool indicate?","a":"Hidden bleeding somewhere in the gastrointestinal tract."},{"q":"Are fats a normal component of stool?","a":"Yes, but only in small, normal amounts."},{"q":"A decrease in urobilin causes stool to appear _______.","a":"Clay-colored."},{"q":"Name two common stool tests.","a":"Occult blood and ova\/parasite testing."},{"q":"Is blood normally present in stool?","a":"No."},{"q":"What is melena?","a":"A black, tarry stool indicating gastrointestinal bleeding."},{"q":"What oxygen flow rate is appropriate for clients with emphysema (COPD)?","a":"Low flow—less than 2.5 L\/min; never exceed 2.5 L."},{"q":"What physical sign may be observed on the hands of clients with emphysema?","a":"Clubbing of the fingernail beds."},{"q":"What diagnostic test confirms endometriosis?","a":"Laparoscopy."},{"q":"Women with endometriosis should use (pads\/tampons) during menstruation.","a":"Pads only."},{"q":"What is the greatest danger in epiglottitis?","a":"Airway obstruction."},{"q":"Should you ever use a tongue depressor to examine a child suspected of epiglottitis?","a":"No, never—this may trigger complete airway obstruction."},{"q":"Should a throat culture be done on a child with suspected epiglottitis?","a":"No, inserting anything in the mouth is dangerous."},{"q":"Which behaviors indicate the need for a tracheotomy in epiglottitis?","a":"Restlessness, tachycardia, and retractions."},{"q":"What is an EGD (esophagogastroduodenoscopy)?","a":"Insertion of a fiber-optic scope to visualize the esophagus, stomach, and duodenum."},{"q":"What procedures can be done during an EGD besides visualization?","a":"Removal of polyps, tissue biopsies, and coagulation of bleeding vessels."},{"q":"Can EGD be used for clients with GI bleeding?","a":"Yes."},{"q":"When can a client begin to eat after an EGD?","a":"When the gag reflex returns (it is temporarily suppressed with xylocaine)."},{"q":"Is an EGD a fasting procedure?","a":"Yes, the client must be NPO after midnight."},{"q":"What are potential complications of an EGD?","a":"Perforation of the gastrointestinal tract, aspiration due to vomiting, and respiratory arrest from sedatives like Valium."},{"q":"What is the most dangerous complication of EGD?","a":"Respiratory arrest secondary to Valium administration."},{"q":"Why should anticholinergics not be used in glaucoma?","a":"They increase intraocular pressure."},{"q":"If a woman does not stop taking oral contraceptives one week before surgery, she is at risk for developing what condition?","a":"Thrombophlebitis."},{"q":"People who smoke more than how many cigarettes per day should avoid oral contraceptives?","a":"More than 15 cigarettes, due to increased risk of vessel constriction and thrombophlebitis."},{"q":"What device may be prescribed for cervical osteoarthritis?","a":"A cervical collar."},{"q":"What precaution should clients take when getting up after stapedectomy?","a":"Get up slowly to prevent dizziness."},{"q":"What should clients expect regarding hearing after stapedectomy?","a":"Temporary decrease initially; improvement occurs in about 6 weeks."},{"q":"What should a client do if they must sneeze after a stapedectomy?","a":"Open the mouth to reduce middle ear pressure."},{"q":"Do hearing aids help with otosclerosis?","a":"Yes."},{"q":"What will the Rinne test show in otosclerosis?","a":"Bone conduction is better than air conduction."},{"q":"Is stapedectomy performed under general or local anesthesia?","a":"Local anesthesia."},{"q":"If a client reports decreased hearing after stapedectomy, what should the nurse say?","a":"It’s normal due to postoperative edema; hearing will improve within six weeks."},{"q":"Which side should the client lie on after a stapedectomy?","a":"Depends on physician preference: operative side promotes drainage, unoperative side prevents graft displacement."},{"q":"What is the main reason doctors remove ovarian cysts?","a":"To prevent malignant transformation."},{"q":"What is the major danger of ovarian cyst torsion?","a":"Necrosis and rupture of the ovary."},{"q":"What other disorders may mimic a ruptured ovarian cyst?","a":"Appendicitis or ruptured ectopic pregnancy."},{"q":"What are three signs of a ruptured ovarian cyst?","a":"Pain, abdominal distention, and abdominal rigidity."},{"q":"Compare the symptoms of non-ruptured and ruptured ovarian cysts.","a":"Non-ruptured: dull pelvic pain, low back pain, abnormal bleeding. Ruptured: acute pain, distention, and rigidity."},{"q":"After ovarian cyst removal surgery, when can a woman return to normal activities?","a":"After 4–6 weeks."},{"q":"How soon after removal of an ovarian cyst can a woman resume sexual intercourse?","a":"After 4–6 weeks."},{"q":"What are two early signs of hypoxia?","a":"Restlessness and tachycardia."},{"q":"What is the maximum oxygen flow rate for a nasal cannula?","a":"6 L\/min."},{"q":"How often should the nares be assessed for skin breakdown when using a nasal cannula?","a":"Every 6–8 hours."},{"q":"What is the maximum oxygen flow rate for a client with COPD?","a":"2 L\/min."},{"q":"What are common signs of oxygen toxicity?","a":"Confusion and headache."},{"q":"What can happen if a client with COPD receives high-flow oxygen?","a":"The client may stop breathing due to loss of hypoxic drive."},{"q":"What is a common problem associated with high-flow oxygen via nasal cannula?","a":"Drying of the mucous membranes."},{"q":"When oxygen is administered, what must be added?","a":"Humidification."},{"q":"Do masks deliver higher or lower concentrations of oxygen than nasal cannulae?","a":"Higher concentrations."},{"q":"How often should the nurse check the oxygen flow rate?","a":"At least once per shift."},{"q":"Is oxygen itself explosive?","a":"False — oxygen supports combustion but does not explode."},{"q":"After rape, what follow-up testing is required?","a":"Screening for sexually transmitted diseases (STDs) such as HIV, gonorrhea, and syphilis."},{"q":"In the recovery room (PACU), what position should the patient be placed in?","a":"On either side."},{"q":"What reflex is commonly tested in the recovery room?","a":"The gag reflex."},{"q":"When is the artificial airway removed postoperatively?","a":"When the gag reflex returns."},{"q":"How often are vital signs measured in the recovery room?","a":"Every 15 minutes."},{"q":"In the recovery room, how should the head and neck be positioned?","a":"Head turned to the side with the neck slightly extended downward."},{"q":"Can postoperative pain medications be given in the recovery room?","a":"Yes."},{"q":"What lab test assesses the risk of RDS?","a":"L\/S ratio (lecithin\/sphingomyelin ratio)."},{"q":"What L\/S ratio indicates fetal lung maturity?","a":"A ratio of 2:1."},{"q":"What other test confirms fetal lung maturity?","a":"Presence of phosphatidylglycerol (PG) in amniotic fluid."},{"q":"Severe RDS may require what type of ventilation?","a":"PEEP (positive end-expiratory pressure) or CPAP (continuous positive airway pressure); high-frequency jet ventilation may also be used."},{"q":"High oxygen flow rates in RDS can cause what eye complication?","a":"Retrolental fibroplasia."},{"q":"Retrolental fibroplasia can lead to what condition?","a":"Blindness due to retinal damage."},{"q":"High ventilatory pressures can lead to what chronic lung condition?","a":"Bronchopulmonary dysplasia."}]

Physiological Integrity – Physiological Adaptation

[{"q":"Which cranial nerve is affected in Bell’s Palsy?","a":"The facial nerve (cranial nerve VII)."},{"q":"What is the number one symptom of Bell’s Palsy?","a":"Unilateral (one-sided) facial paralysis."},{"q":"Complete recovery from Bell’s Palsy usually occurs in how many months?","a":"4 to 6 months."},{"q":"In Bell’s Palsy, which sense is also affected besides facial movement?","a":"Taste."},{"q":"Will the patient with Bell’s Palsy be able to close the eye on the affected side?","a":"No."},{"q":"As the prostate enlarges in BPH, what structure does it compress, and what does this cause?","a":"It compresses the urethra and causes urinary retention."},{"q":"At what age does benign prostatic hypertrophy (BPH) commonly occur?","a":"In men over 50 years of age."},{"q":"What does the abbreviation BPH stand for?","a":"Benign Prostatic Hypertrophy."},{"q":"In BPH, does the frequency of urination increase or decrease?","a":"It increases."},{"q":"In BPH, what happens to the force of the urinary stream?","a":"It decreases."},{"q":"How is the urinary stream described in a man with BPH?","a":"Forked stream."},{"q":"What does “hesitancy” mean in a man with BPH?","a":"Difficulty starting urination."},{"q":"Will a man with BPH have enuresis, nocturia, or hematuria?","a":"Enuresis – No; Nocturia – Yes; Hematuria – Maybe."},{"q":"What does TURP stand for?","a":"Transurethral resection of the prostate."},{"q":"What is the most radical prostate surgery for BPH?","a":"Perineal prostatectomy."},{"q":"What type of diet is used for clients with BPH?","a":"Acid-ash diet."},{"q":"What is the purpose of an acid-ash diet?","a":"To decrease urine pH and make it more acidic."},{"q":"Which foods are included in the acid-ash diet?","a":"Cheese, eggs, meat, fish, oysters, poultry, bread, cereal, whole grains, pastries, cranberries, prunes, plums, tomatoes, peas, corn, and legumes."},{"q":"Will a post-prostatectomy patient be impotent?","a":"After TURP—No; after perineal prostatectomy—Yes."},{"q":"Vasodilation will __________ blood pressure.","a":"Decrease."},{"q":"Shock will __________ blood pressure.","a":"Decrease."},{"q":"Increased intracranial pressure will have what effect on pulse pressure?","a":"It increases (widens) the pulse pressure."},{"q":"If a person’s blood pressure is 190\/110 mmHg, what is the pulse pressure?","a":"80 mmHg."},{"q":"Give three reasons for a blood transfusion.","a":"To restore blood volume after hemorrhage, maintain hemoglobin in anemia, and replace specific blood components."},{"q":"What is another name for Buerger’s disease?","a":"Thromboangiitis obliterans."},{"q":"Which extremities are affected by Buerger’s disease?","a":"The lower extremities."},{"q":"Which sex is most commonly affected by Buerger’s disease?","a":"Males."},{"q":"Which group has the highest incidence of Buerger’s disease?","a":"Smokers."},{"q":"What symptom does a patient with Buerger’s disease experience when walking?","a":"Intermittent claudication."},{"q":"What is intermittent claudication?","a":"Pain in the calf during walking due to poor circulation."},{"q":"What color is a first-degree burn?","a":"Red."},{"q":"Do first-degree burns have vesicles?","a":"No."},{"q":"What color is a second-degree burn?","a":"Red."},{"q":"Are second-degree burns dull or shiny?","a":"Shiny."},{"q":"Do second-degree burns have vesicles?","a":"Yes."},{"q":"Are second-degree burns wet or dry?","a":"Wet."},{"q":"What color is a third-degree burn?","a":"White."},{"q":"Are third-degree burns wet or dry?","a":"Dry."},{"q":"Are third-degree burns hard or soft?","a":"Hard."},{"q":"Which burn degree causes the least pain and why?","a":"Third-degree burns, because nerve endings are destroyed."},{"q":"What is the purpose of using the Rule of Nines?","a":"To estimate the percentage of body surface burned (not used for children)."},{"q":"In the Rule of Nines, what percentage is assigned to the head and neck, and to each arm?","a":"Head and neck: 9%; each arm: 9%."},{"q":"In the Rule of Nines, how much is assigned to the front trunk, back trunk, each leg, and genitalia?","a":"Front trunk: 18%; back trunk: 18%; each leg: 18%; genitalia: 1%."},{"q":"What are the three phases of burn care?","a":"Shock, diuretic, and recovery phases."},{"q":"During the shock phase, fluid moves from the _________ to the _________.","a":"Bloodstream to interstitial space."},{"q":"The shock phase of a burn lasts how long?","a":"24 to 48 hours."},{"q":"During the shock phase of a burn, are potassium levels increased or decreased? Why?","a":"Increased, due to potassium release from damaged cells."},{"q":"What acid-base imbalance occurs in the shock phase of a burn?","a":"Metabolic acidosis."},{"q":"What is the number one therapy in the shock phase of a burn?","a":"Fluid replacement\/resuscitation."},{"q":"What is the simple formula for calculating fluid replacement needs in the first 24 hours after a burn?","a":"3 cc × body weight (kg) × % body surface burned per day."},{"q":"If 2,800 cc of fluid is ordered for the first 24 hours after a burn, how much should be infused in the first 8 hours?","a":"Half, or 1,400 cc."},{"q":"How can you tell that the burn patient has entered the fluid mobilization or diuretic phase?","a":"Urine output increases."},{"q":"How long does the diuretic phase of a burn last?","a":"2 to 5 days."},{"q":"During the diuretic phase, do potassium levels rise or fall?","a":"Fall (diuresis causes hypokalemia)."},{"q":"What is Curling’s ulcer, and why is it a problem in burn patients?","a":"A stress-related gastrointestinal ulcer that occurs after severe physical stress."},{"q":"In abruptio placenta, the placenta __________ from the uterine wall __________.","a":"Separates prematurely."},{"q":"Abruptio placenta typically occurs in __________ women over the age of ________.","a":"Multigravida women over 35 (often with hypertension, trauma, or cocaine use)."},{"q":"How does bleeding in abruptio placenta differ from that in placenta previa?","a":"Bleeding in abruptio placenta is painful; in previa it is painless but more voluminous."},{"q":"How is an infant usually delivered when abruptio placenta is present?","a":"By cesarean section."},{"q":"Is fetal death more common in abruptio placenta or placenta previa?","a":"Higher incidence in abruptio placenta."},{"q":"In which trimester does abruptio placenta most commonly occur?","a":"The third trimester."},{"q":"What is the causative organism of acne?","a":"Propionibacterium acnes (P. acnes)."},{"q":"What structures are primarily involved in acne vulgaris?","a":"The sebaceous glands."},{"q":"What are the three major causative factors in acne vulgaris?","a":"Heredity, bacterial infection, and hormonal influences."},{"q":"What are comedones?","a":"Blackheads and whiteheads."},{"q":"What virus causes AIDS?","a":"Human immunodeficiency virus (HIV)."},{"q":"The AIDS virus invades which immune cells?","a":"Helper T-lymphocytes (CD4 cells)."},{"q":"List six common symptoms of HIV disease.","a":"Anorexia, fatigue, weakness, night sweats, fever, and diarrhea."},{"q":"Do clients with AIDS tend to gain or lose weight?","a":"Lose weight."},{"q":"What microorganism causes the typical pneumonia in AIDS patients?","a":"Pneumocystis carinii."},{"q":"What type of oral or esophageal infections are common in AIDS patients?","a":"Candida infections (thrush)."},{"q":"What is the most common cancer in AIDS patients?","a":"Kaposi’s sarcoma."},{"q":"Kaposi’s sarcoma is a cancer of what tissue?","a":"The skin."},{"q":"Do AIDS patients commonly develop lymphomas?","a":"Yes."},{"q":"Do most clients recover from acute glomerulonephritis (AGN)?","a":"Yes, the majority recover completely."},{"q":"How long after a strep infection does AGN develop?","a":"About 2 to 3 weeks."},{"q":"What organism causes acute glomerulonephritis?","a":"Group A beta-hemolytic streptococcus."},{"q":"What happens to the kidneys in AGN?","a":"They become inflamed and clogged with antigen-antibody complexes, reducing function."},{"q":"Will clients with AGN have hypo- or hypertension, and why?","a":"Hypertension due to fluid retention."},{"q":"What are the first signs of AGN?","a":"Puffiness of the face and dark-colored urine."},{"q":"What does AKA stand for?","a":"Above-the-knee amputation."},{"q":"What does BKA stand for?","a":"Below-the-knee amputation."},{"q":"What is the number one contracture problem in AKA?","a":"Flexion of the hip."},{"q":"What is the number one contracture problem after a BKA?","a":"Flexion of the knee."},{"q":"Pain felt in a missing limb after amputation is known as what?","a":"Phantom limb sensation."},{"q":"How long does phantom limb sensation usually last?","a":"A few months."},{"q":"What is an aneurysm?","a":"An abnormal widening and weakening of an arterial wall."},{"q":"Which artery is affected in a thoracic aneurysm?","a":"The aorta."},{"q":"What are two causes of aneurysms?","a":"Infection and syphilis."},{"q":"What is the most common symptom of an abdominal aneurysm?","a":"A pulsating mass above the umbilicus."},{"q":"Which aneurysm is often asymptomatic?","a":"The abdominal aneurysm (“silent”)."},{"q":"What is the prescribed activity level for a client with an aneurysm?","a":"Strict bed rest."},{"q":"Should unstable aneurysm patients be encouraged to cough, turn, and deep breathe?","a":"No, keep on bed rest until stable."},{"q":"What is the greatest danger of an aneurysm?","a":"Rupture leading to shock and death."},{"q":"What are the signs of a ruptured aneurysm?","a":"Restlessness or decreased level of consciousness, tachycardia, and hypotension (signs of shock)."},{"q":"What is the number one priority if an aneurysm ruptures?","a":"Transport the patient to the operating room immediately."},{"q":"What can be done before surgery for a ruptured aneurysm?","a":"Apply antishock trousers if available, but only if it doesn’t delay surgery."},{"q":"What causes angina pectoris?","a":"Decreased blood supply to the myocardium, leading to ischemia and pain."},{"q":"Describe the pain of angina pectoris.","a":"Crushing substernal chest pain that may radiate."},{"q":"Does every patient with angina require bypass surgery?","a":"False; many are treated medically."},{"q":"The diagnosis of anorexia nervosa is made when weight loss exceeds what percent of body weight?","a":"15% or more (hospitalize if 30% weight loss)."},{"q":"What is appendicitis?","a":"Inflammation of the appendix due to obstruction."},{"q":"Appendicitis occurs most commonly in what age group?","a":"Between 15 and 35 years old."},{"q":"What is the most common complication of appendicitis?","a":"Peritonitis."},{"q":"What is peritonitis?","a":"Inflammation of the peritoneum."},{"q":"What is the first sign of appendicitis?","a":"Right upper quadrant abdominal pain."},{"q":"What symptom follows the initial abdominal pain of appendicitis?","a":"Nausea and vomiting."},{"q":"Where does the pain of appendicitis eventually localize?","a":"Right lower quadrant (McBurney’s point)."},{"q":"What is the only treatment for appendicitis?","a":"Surgical removal (appendectomy)."},{"q":"Does the term “neoplasm” refer to benign or malignant tumors?","a":"Both; it refers to all new tissue growths."},{"q":"Which type of tumor is more malignant: differentiated or undifferentiated?","a":"Undifferentiated."},{"q":"When cancer spreads to a distant site, what is it called?","a":"Metastasis."},{"q":"Is the exact cause of cancer known?","a":"False."},{"q":"What does “decompensation” mean?","a":"Failure of the heart to maintain adequate circulation."},{"q":"What physical finding is seen in the neck of a client with CD of pregnancy?","a":"Jugular venous distension (JVD)."},{"q":"What heart sound is heard in clients with CD of pregnancy?","a":"Murmurs."},{"q":"What lung sounds are heard in CD of pregnancy?","a":"Crackles or rales."},{"q":"If a client with CD of pregnancy develops sudden heart failure, what is the most common symptom?","a":"Sudden shortness of breath (dyspnea)."},{"q":"What is the number one treatment for CD during pregnancy?","a":"Rest."},{"q":"What type of disease is celiac disease?","a":"Malabsorption disorder."},{"q":"What substance can clients with celiac disease not tolerate?","a":"Gluten."},{"q":"What is gluten?","a":"A protein."},{"q":"What does gluten do to the intestines of clients with celiac disease?","a":"It damages and destroys the intestinal lining."},{"q":"How are the stools of clients with celiac disease described?","a":"Large, greasy, and foul-smelling."},{"q":"Which mineral is poorly absorbed in celiac disease?","a":"Iron."},{"q":"Clients with celiac disease do not absorb fats; therefore, they lack which nutrients?","a":"Fat-soluble vitamins (A, D, E, and K)."},{"q":"Malabsorption of which vitamin causes bleeding disorders?","a":"Vitamin K."},{"q":"How does the abdomen of a client with celiac disease typically appear?","a":"Distended with gas and bloating."},{"q":"What is the number one treatment for celiac disease?","a":"Gluten-free diet."},{"q":"Are vegetables allowed in a gluten-free diet?","a":"Yes."},{"q":"Are fruits allowed in a gluten-free diet?","a":"Yes."},{"q":"Are all grains prohibited in celiac disease?","a":"False."},{"q":"Which grains are allowed in a gluten-free diet?","a":"Rice and corn."},{"q":"Which grains are not allowed in a gluten-free diet?","a":"Wheat, oats, rye, alfalfa, and barley."},{"q":"Are foods made with wheat, oat, or rye flour allowed on a gluten-free diet?","a":"No."},{"q":"Is milk allowed on a gluten-free diet?","a":"Yes."},{"q":"Are meats allowed on a gluten-free diet?","a":"Yes, but avoid breaded meats and processed items like hot dogs that may contain grains."},{"q":"Are eggs allowed on a gluten-free diet?","a":"Yes."},{"q":"Is commercial ice cream allowed on a gluten-free diet?","a":"No, it often contains grain-based additives."},{"q":"Are puddings allowed on a gluten-free diet?","a":"No, they often contain flour."},{"q":"Which soups are not allowed on a gluten-free diet?","a":"Creamed soups, as they commonly contain flour."},{"q":"A CVA is the __________ of brain cells due to decreased ________ and ________.","a":"Destruction; blood flow and oxygen."},{"q":"Name the three types of cerebrovascular accidents (CVA).","a":"Embolic, thrombotic, and hemorrhagic."},{"q":"What is a transient ischemic attack (TIA)?","a":"A temporary neurologic deficit lasting 30 seconds to 24 hours, a warning sign of CVA."},{"q":"Do CVA patients experience headaches?","a":"Yes."},{"q":"What is usually the first sign of CVA?","a":"Change in level of consciousness (LOC)."},{"q":"What type of paralysis is typical in CVA?","a":"Hemiplegia."},{"q":"Why does the right brain control the left body side and vice versa?","a":"Motor tracts cross over (decussate) in the medulla."},{"q":"If the patient has right hemiplegia, which side of the brain was affected?","a":"The left side."},{"q":"What is hemianopsia?","a":"Loss of half of the visual field."},{"q":"How should a patient with hemianopsia be taught to compensate?","a":"By scanning—moving the head side to side."},{"q":"If a client has right homonymous hemianopsia, which side of the tray may be ignored?","a":"The right side."},{"q":"When a patient cannot understand incoming language, what type of aphasia is it?","a":"Receptive aphasia."},{"q":"When a patient understands but cannot express language, what type of aphasia is it?","a":"Expressive aphasia."},{"q":"What is global aphasia?","a":"Both receptive and expressive language impairment."},{"q":"Aphasia is most common with a stroke in which hemisphere?","a":"The dominant hemisphere."},{"q":"How do you determine the dominant hemisphere?","a":"It controls the dominant hand (e.g., right-handed → left-brain dominant)."},{"q":"What communication strategy is best for receptive aphasia?","a":"Use short, simple, slow instructions."},{"q":"What strategy is best for expressive aphasia?","a":"Anticipate needs and listen carefully."},{"q":"What is apraxia?","a":"Loss of ability to perform purposeful, skilled movements (e.g., brushing teeth)."},{"q":"What is otitis media?","a":"Chronic infection or inflammation of the middle ear."},{"q":"Is otitis media more common in adults or children?","a":"Children."},{"q":"Which part of the ear is affected in otitis media?","a":"The middle ear."},{"q":"What are two common subjective symptoms of otitis media?","a":"Hearing loss and a feeling of fullness in the ear."},{"q":"What are two objective signs of otitis media?","a":"Fever (hyperpyrexia) and ear drainage."},{"q":"What complication commonly occurs secondary to otitis media?","a":"Perforation of the tympanic membrane (eardrum)."},{"q":"Do all children with otitis media need ear tubes?","a":"No."},{"q":"What is the most severe complication of otitis media?","a":"Meningitis or mastoiditis."},{"q":"What is a cholesteatoma?","a":"An epidermal cyst in the ear often associated with otitis media."},{"q":"What is a cleft lip?","a":"An opening in the upper lip extending to the nostrils."},{"q":"What is a cleft palate?","a":"An opening in the roof of the mouth into the nasopharynx."},{"q":"Can cleft lip or palate occur independently?","a":"Yes, one or both may occur."},{"q":"When is cleft lip usually repaired?","a":"Between 10 weeks and 6 months of age."},{"q":"When is cleft palate usually repaired?","a":"Between 1 and 5 years of age."},{"q":"Why is cleft lip repaired early?","a":"It improves feeding and appearance, helping parental bonding."},{"q":"Children with cleft lip\/palate often have long-term problems with what?","a":"Hearing, speech, and teeth."},{"q":"How many surgeries are usually required to repair a cleft palate?","a":"Two — the first at 12–18 months, the final at 4–5 years."},{"q":"Why is final cleft palate repair delayed until 4–5 years?","a":"To prevent interference with tooth development."},{"q":"What is the primary treatment for cleft lip and cleft palate?","a":"Surgical repair."},{"q":"What is a colostomy?","a":"A surgically created opening of the colon through the abdominal wall."},{"q":"Name three common reasons for performing a colostomy.","a":"Cancer, diverticulitis, and ulcerative colitis."},{"q":"What does “temporary colostomy” mean?","a":"It’s not permanent; the bowel will later be reconnected for normal defecation."},{"q":"What is a “double-barrel” colostomy?","a":"A procedure in which the colon is cut and both ends are brought out through the abdominal wall."},{"q":"Colostomies performed for cancer are usually (temporary\/permanent).","a":"Permanent."},{"q":"Colostomies performed for a gunshot wound are usually (temporary\/permanent).","a":"Temporary."},{"q":"In a double-barrel colostomy, from which stoma will stool be expelled?","a":"From the proximal stoma."},{"q":"The more colon removed, the more _______ the stool.","a":"Liquid."},{"q":"Describe stool characteristics for an ileostomy.","a":"Liquid stool, mild odor, highly irritating to skin, continuous drainage, risk for electrolyte imbalance, incontinent, never irrigate."},{"q":"Describe stool characteristics for a transverse colostomy.","a":"Soft stool, typical odor, may irritate skin, empties several times daily, may irrigate, moderate fluid imbalance risk."},{"q":"Describe stool characteristics for a descending colostomy.","a":"Formed stool, typical odor, predictable emptying (2–3 times\/day), lowest fluid imbalance risk, continent, can irrigate."},{"q":"Can congestive heart failure (CHF) affect one or both sides of the heart?","a":"True; it can be right-sided, left-sided, or both."},{"q":"What does right-sided CHF mean?","a":"Right ventricle failure causing dependent edema, JVD, abdominal distention, hepatosplenomegaly, anorexia, weight gain, nocturnal diuresis, and hand swelling."},{"q":"What does left-sided CHF mean?","a":"Left ventricular failure leading to pulmonary congestion and shortness of breath."},{"q":"Can CHF result from myocardial infarction?","a":"True."},{"q":"Name three compensatory mechanisms of the failing heart.","a":"Ventricular hypertrophy, dilation, and increased heart rate."},{"q":"What does “cardiac decompensation” mean?","a":"Failure of compensatory mechanisms—heart can no longer maintain adequate output."},{"q":"Some women experience discomfort when wearing contact lenses during pregnancy or menstruation. (T\/F)","a":"True."},{"q":"Cushing’s syndrome is caused by what?","a":"Oversecretion of glucocorticoids, mineralocorticoids, and androgens by the adrenal gland."},{"q":"In Cushing’s syndrome, blood sugar levels are (increased\/decreased).","a":"Increased."},{"q":"In Cushing’s syndrome, sodium levels are (increased\/decreased).","a":"Increased."},{"q":"What is the characteristic facial appearance of Cushing’s syndrome?","a":"Moon face."},{"q":"In Cushing’s, the trunk is _______ and the extremities are _______.","a":"Obese; thin."},{"q":"What is seen on the abdomen of a Cushing’s patient?","a":"Purple striae (stretch marks)."},{"q":"Men with Cushing’s often develop what condition?","a":"Gynecomastia (female-type breast enlargement)."},{"q":"What is gynecomastia?","a":"Development of female-type breasts in men."},{"q":"What changes occur in women with Cushing’s?","a":"Hirsutism and amenorrhea."},{"q":"What is hirsutism?","a":"Excess hair growth in abnormal locations (e.g., face)."},{"q":"The Cushing’s patient may develop what on their upper back?","a":"A “buffalo hump.”"},{"q":"In Cushing’s syndrome, blood pressure is (increased\/decreased).","a":"Increased due to sodium and water retention."},{"q":"In Cushing’s syndrome, patients experience _______natremia, _______kalemia, and _______glycemia.","a":"Hypernatremia, hypokalemia, and hyperglycemia."},{"q":"Summarize “Cushing’s Man.”","a":"Moon face, infection, buffalo hump, central obesity, thin limbs, striae, high glucose and salt, low potassium."},{"q":"Which glands are affected in cystic fibrosis?","a":"Exocrine glands."},{"q":"What is the appearance of stool in cystic fibrosis?","a":"Fatty, frothy, foul-smelling, floating stools (steatorrhea)."},{"q":"What are the two primary nursing diagnoses for cystic fibrosis?","a":"Ineffective airway clearance and altered nutrition\/absorption."},{"q":"Which two organ systems are most affected in cystic fibrosis?","a":"Lungs and pancreas."},{"q":"What is the major pathophysiologic problem in cystic fibrosis?","a":"Thickened secretions causing obstruction of exocrine ducts."},{"q":"What neonatal history is often seen in CF patients?","a":"Meconium ileus due to thick, sticky stool causing obstruction."},{"q":"What brain structure is most affected in Parkinson’s disease?","a":"Basal ganglia."},{"q":"The neurotransmitter imbalance in Parkinson’s disease involves a decrease in ______ activity.","a":"Dopamine activity."},{"q":"What is the classic motor symptom of Parkinson’s disease?","a":"Pill-rolling tremor."},{"q":"What type of rigidity is seen in Parkinson’s disease?","a":"Cogwheel rigidity."},{"q":"Parkinson’s patients move (fast\/slow).","a":"Slow."},{"q":"What type of gait is typical of Parkinson’s disease?","a":"Shuffling gait."},{"q":"Parkinson’s patients typically have what type of speech?","a":"Monotone speech."},{"q":"Do Parkinson’s tremors improve or worsen with purposeful movement?","a":"Improve; tremors lessen during voluntary activity."},{"q":"What are typical lesions seen in pemphigus?","a":"Foul-smelling blisters that rupture easily; common in the elderly."},{"q":"What is the characteristic lesion of pemphigus?","a":"Large vesicular bullae (fluid-filled blisters)."},{"q":"What are bullae?","a":"Large fluid-filled blisters."},{"q":"What unusual high-priority nursing diagnosis is associated with pemphigus?","a":"Fluid and electrolyte imbalance."},{"q":"Define pemphigus briefly.","a":"Autoimmune blistering skin disorder causing painful bullae, often fatal if untreated."},{"q":"What is peritoneal dialysis (PD)?","a":"Removal of wastes and fluids using the peritoneum as a semipermeable membrane."},{"q":"How long does one PD session usually last?","a":"About 10 hours."},{"q":"When fluid accumulates during PD, what problem occurs first?","a":"Dyspnea (shortness of breath) from pressure on the diaphragm."},{"q":"What nutrient is most lost during PD?","a":"Protein."},{"q":"What area is punctured to perform PD?","a":"Abdominal wall."},{"q":"What force allows dialysate to flow into the peritoneal cavity?","a":"Gravity."},{"q":"How long does the inflow of dialysate take?","a":"About 10 minutes."},{"q":"How long is dialysate left in the abdomen before draining?","a":"15–30 minutes."},{"q":"How long does the drainage phase take?","a":"About 10 minutes."},{"q":"What factor is missing in pernicious anemia?","a":"Intrinsic factor."},{"q":"Which vitamin is not absorbed in pernicious anemia?","a":"Vitamin B12."},{"q":"What is another name for Vitamin B12?","a":"Extrinsic factor."},{"q":"Why isn’t Vitamin B12 absorbed in pernicious anemia?","a":"Because intrinsic factor is absent."},{"q":"What happens to RBCs in pernicious anemia?","a":"They fail to mature properly, leading to anemia."},{"q":"What are classic signs of pernicious anemia?","a":"Beefy red tongue, mouth sores, paresthesia, chest pain."},{"q":"Can pernicious anemia be cured?","a":"No, only managed."},{"q":"In placenta previa, the placenta is implanted _______ and covers the _______.","a":"Lower in the uterus; cervical os."},{"q":"What do “total” and “partial” placenta previa mean?","a":"Total: placenta covers entire cervical opening; Partial: covers part of it."},{"q":"Pneumonia is an ______ of the ______ in the ______.","a":"Infection of the alveoli in the lungs."},{"q":"Pneumonia is only caused by bacteria. (T\/F)","a":"False — it can also be viral or due to aspiration."},{"q":"What is polycythemia vera?","a":"Blood disorder with excessive RBCs, WBCs, and platelets."},{"q":"What is the typical appearance of a client with polycythemia vera?","a":"Ruddy or purplish skin tone."},{"q":"What are three signs of polycythemia vera?","a":"Headache, weakness, itching."},{"q":"Is hemoglobin increased or decreased in polycythemia vera?","a":"Increased."},{"q":"Which organ enlarges in polycythemia vera?","a":"Spleen (due to excessive RBC destruction)."},{"q":"Define paralytic ileus.","a":"Temporary bowel paralysis after surgery, especially abdominal."},{"q":"Does pregnancy increase or decrease insulin requirements?","a":"Increases."},{"q":"Can pregnancy induce diabetes in non-diabetic women?","a":"Yes."},{"q":"What is diabetes that begins during pregnancy called?","a":"Gestational diabetes."},{"q":"Is gestational diabetes more common with age?","a":"Yes, incidence increases with age."},{"q":"Do pregnancy hormones oppose insulin?","a":"Yes."},{"q":"What is a common sign of gestational diabetes?","a":"Excessive weight gain."},{"q":"Which women are at highest risk for gestational diabetes?","a":"Obese women."},{"q":"Does thirst increase or decrease in gestational diabetes?","a":"Increases (polydipsia)."},{"q":"Does urine output increase or decrease in gestational diabetes?","a":"Increases (polyuria)."},{"q":"What obstetric history is associated with gestational diabetes?","a":"Large baby (>9 lb), stillbirth, miscarriage, congenital defects."},{"q":"Babies of gestational diabetics are usually (small\/large)?","a":"Large for gestational age."},{"q":"What are the two main treatments for gestational diabetes?","a":"Diet and insulin."},{"q":"How often should diabetic pregnant women visit their doctor?","a":"Twice monthly, then weekly in the third trimester."},{"q":"How much weight should be gained per week in 2nd–3rd trimesters for diabetics?","a":"About 1 lb per week."},{"q":"Should carbohydrates be severely restricted in gestational diabetes?","a":"No, risk of ketosis."},{"q":"Which macronutrients are increased in the diet of gestational diabetics?","a":"Protein and fat."},{"q":"When is insulin indicated in gestational diabetes?","a":"When diet alone doesn’t control glucose."},{"q":"When should diabetic pregnant women be delivered?","a":"Between 37–39 weeks."},{"q":"After delivery, the mother's insulin requirements will (rise\/fall).","a":"Fall."},{"q":"During pregnancy, what fetal complication is most dangerous for diabetic mothers?","a":"Ketosis."},{"q":"Which gravidas are most likely to develop pregnancy-induced hypertension (PIH)?","a":"Primigravidas."},{"q":"Which age groups are at highest risk for PIH?","a":"Under 18 and over 35 years."},{"q":"After which week of gestation does preeclampsia typically develop?","a":"After 20 weeks."},{"q":"What are the three main signs of preeclampsia?","a":"Hypertension, edema (weight gain), and proteinuria."},{"q":"What are the three primary treatment goals in eclampsia?","a":"Lower BP, control seizures, promote diuresis."},{"q":"What is typical management if PROM occurs before fetal viability?","a":"Termination of pregnancy."},{"q":"What is typical management for PROM after viability but before 36 weeks?","a":"Hospitalization, monitor for infection, allow fetal maturation."},{"q":"Pulmonary edema is accumulation of ______ in the lungs.","a":"Fluid."},{"q":"Pulmonary edema is a common complication of what disorders?","a":"Cardiovascular disorders."},{"q":"Pulmonary edema usually results from failure of which heart chamber?","a":"Left ventricle."},{"q":"What pressure causes pulmonary edema in left ventricular failure?","a":"Increased hydrostatic pressure in pulmonary capillaries."},{"q":"What are the four classic signs of pulmonary edema?","a":"Dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, and coughing."},{"q":"What does “dyspnea on exertion” mean?","a":"Shortness of breath during activity."},{"q":"What does “paroxysmal nocturnal dyspnea” mean?","a":"Sudden nighttime episodes of difficulty breathing."},{"q":"What does “orthopnea” mean?","a":"Difficulty breathing when lying flat."},{"q":"Is the heart rate fast or slow in pulmonary edema?","a":"Fast (tachycardia)."},{"q":"Is oxygen therapy indicated in pulmonary edema?","a":"Yes."},{"q":"What is the first nursing action when a client suddenly develops pulmonary edema?","a":"Elevate head of bed, give oxygen, then call the physician."},{"q":"Define pulmonary embolus.","a":"Obstruction of the pulmonary capillary bed by a dislodged thrombus or foreign material."},{"q":"Where do most pulmonary emboli originate?","a":"In the legs (deep veins)."},{"q":"What besides a thrombus can cause a pulmonary embolus?","a":"Air, fat, or tumor cells."},{"q":"What cardiac arrhythmia can cause a pulmonary embolus?","a":"Right atrial fibrillation."},{"q":"Which genetic disease predisposes to pulmonary embolus?","a":"Sickle cell anemia."},{"q":"What is the first symptom of pulmonary embolus?","a":"Sudden dyspnea."},{"q":"Dyspnea in pulmonary embolus is accompanied by what?","a":"Pleuritic chest pain."},{"q":"Does heart rate increase or decrease in pulmonary embolus?","a":"Increase (tachycardia)."},{"q":"How will a client with severe pulmonary embolus appear?","a":"In shock."},{"q":"What are two main treatments for pulmonary embolus?","a":"Oxygen and anticoagulants."},{"q":"What is pyelonephritis?","a":"Bacterial infection of the kidneys."},{"q":"What is the most common organism causing pyelonephritis?","a":"E. coli."},{"q":"What symptoms are common to both pyelonephritis and cystitis?","a":"Frequency, urgency, burning, cloudy and foul-smelling urine."},{"q":"How does pyelonephritis differ from cystitis?","a":"Cystitis = bladder infection; Pyelonephritis = kidney infection."},{"q":"What usually precedes pyelonephritis?","a":"Cystitis (lower UTI)."},{"q":"Name five signs of pyelonephritis not seen in cystitis.","a":"Fever, flank pain, chills, elevated WBC, malaise."},{"q":"What is the major danger of pyelonephritis?","a":"Permanent renal scarring and damage."},{"q":"Is hematuria common in pyelonephritis?","a":"Yes, but not always present."},{"q":"Does pyelonephritis cause hypertension or hypotension?","a":"Hypertension."},{"q":"Where is the pyloric sphincter located?","a":"At the distal end of the stomach, leading to the duodenum."},{"q":"What does “stenosis” mean?","a":"Narrowing or constriction."},{"q":"How is pyloric stenosis treated?","a":"Surgical correction (pyloromyotomy)."},{"q":"Infants with pyloric stenosis are prone to what complications?","a":"Dehydration and failure to thrive."},{"q":"Why does the pyloric valve become stenosed?","a":"It hypertrophies."},{"q":"What visible sign is seen during and after feeding?","a":"Peristaltic waves moving left to right."},{"q":"Is vomiting projectile or non-projectile in pyloric stenosis?","a":"Projectile and not bile-stained."},{"q":"What finding is palpated under the right rib cage in pyloric stenosis?","a":"An olive-sized mass (hypertrophied pylorus)."},{"q":"At what age do symptoms of pyloric stenosis appear?","a":"Between 4 and 6 weeks."},{"q":"Describe the typical child with pyloric stenosis.","a":"Firstborn, full-term, white male."},{"q":"Define contusion.","a":"Internal bruise."},{"q":"Define debridement.","a":"Removal of necrotic tissue from a wound."},{"q":"What is the purpose of a wound drain?","a":"To remove secretions and promote healing."},{"q":"A round wound closed by sutures, staples, or steri-strips heals by which intention?","a":"First intention."},{"q":"What is another term for second intention healing?","a":"Granulation."},{"q":"Define laceration.","a":"A cut or tear in the tissue."},{"q":"Scoliosis is a ______ curvature of the ______.","a":"Lateral curvature of the spine."},{"q":"Which spinal regions are most affected by scoliosis?","a":"Thoracic and lumbar."},{"q":"Thoracic scoliosis is usually convex to which side?","a":"Right side."},{"q":"Lumbar scoliosis is usually convex to which side?","a":"Left side (think “Lumbar = Left”)."},{"q":"With which other spinal deformities is scoliosis associated?","a":"Kyphosis (humpback) and Lordosis (swayback)."},{"q":"Define Kyphosis.","a":"Humpback in the thoracic region."},{"q":"Define Lordosis.","a":"Swayback in the lumbar region."},{"q":"Difference between structural and functional scoliosis?","a":"Structural = congenital; Functional = due to poor posture."},{"q":"What are three common complaints in scoliosis?","a":"Back pain, dyspnea, fatigue."},{"q":"What treatment is used for severe scoliosis?","a":"Surgical spinal fusion with rod insertion."},{"q":"What rod is commonly used to correct spinal curvature?","a":"Harrington rod."},{"q":"What is cast syndrome?","a":"Nausea, vomiting, and abdominal distention resulting in intestinal obstruction."},{"q":"What is the inheritance pattern of sickle cell anemia?","a":"Autosomal recessive."},{"q":"What does heterozygous mean?","a":"Having one defective gene from one parent."},{"q":"People who are heterozygous for the sickle gene have what condition?","a":"Sickle cell trait."},{"q":"What does homozygous mean?","a":"Having defective genes from both parents."},{"q":"People who are homozygous for the sickle gene have what condition?","a":"Sickle cell disease."},{"q":"Do individuals with sickle cell trait have symptoms?","a":"Usually no, but severe stress may cause mild symptoms."},{"q":"What are the top two causes of sickle cell crisis?","a":"Hypoxia and dehydration."},{"q":"What type of crisis is most common in sickle cell disease?","a":"Vaso-occlusive crisis."},{"q":"In vaso-occlusive crisis, what occludes the vessels?","a":"Abnormally shaped red blood cells."},{"q":"What is the abnormal hemoglobin in sickle cell anemia called?","a":"Hemoglobin S (Hgb S)."},{"q":"What shape do sickled RBCs take?","a":"Crescent-shaped."},{"q":"Why do sickled RBCs cause vessel occlusion?","a":"They clump together, forming sludge and blocking blood flow."},{"q":"What are the top three nursing priorities during a sickle cell crisis?","a":"Oxygenation, hydration, and pain control."},{"q":"At what age is death most likely in sickle cell anemia?","a":"Young adulthood."},{"q":"Symptoms of sickle cell anemia usually appear after what age?","a":"Six months, when fetal hemoglobin decreases."},{"q":"Sickle cell anemia is most common among which population?","a":"African Americans."},{"q":"Are spinal cord injuries more common in males or females?","a":"Males."},{"q":"What age range has the highest incidence of spinal cord injury?","a":"Ages 15 to 25."},{"q":"What two surgeries are commonly used to treat spinal cord injury?","a":"Laminectomy and spinal fusion."},{"q":"What is spinal shock?","a":"Temporary loss of all reflex activity below the level of injury due to cord swelling."},{"q":"When does spinal shock occur?","a":"Immediately or within 2 hours after injury."},{"q":"How long does spinal shock last?","a":"From 5 days to 3 months."},{"q":"Injury at what level results in quadriplegia?","a":"C1 to C8."},{"q":"Injury at what level causes permanent respiratory paralysis?","a":"C1 to C4."},{"q":"Can a patient with a C7 spinal injury experience respiratory arrest?","a":"Yes, during spinal shock, but it is temporary."},{"q":"Injury in the thoracic or lumbar regions results in what type of paralysis?","a":"Paraplegia."},{"q":"Do spinal cord injury patients have flaccid or spastic muscles?","a":"Spastic."},{"q":"What does the suffix “-pathy” mean in medical terms?","a":"Disease or suffering."},{"q":"What does the suffix “-penia” indicate?","a":"A deficiency or lack of something."},{"q":"What does the root “-sect” mean?","a":"To cut."},{"q":"What does the suffix “-plast” refer to?","a":"Surgical repair or plastic surgery of a specific part."},{"q":"What is meant by the term “-sclerosis”?","a":"Hardening of tissue due to inflammation or mineral deposits."},{"q":"What does the suffix “-centesis” mean?","a":"Surgical puncture or perforation."},{"q":"What does the suffix “-genic” mean?","a":"To produce, originate, or cause."},{"q":"What does the suffix “-emia” indicate?","a":"A condition of the blood."},{"q":"What does “-otomy” mean in medical terminology?","a":"To cut or make an incision."},{"q":"What does “-pexy” mean?","a":"Surgical fixation of an organ or structure."},{"q":"What does the suffix “-atresia” describe?","a":"A condition involving closure or absence of a normal opening."},{"q":"What does “-desis” mean?","a":"Surgical binding or fusion."},{"q":"What does “-cele” refer to?","a":"A tumor, swelling, or cavity."},{"q":"What does “-cis” mean in medical context?","a":"To cut or destroy."},{"q":"What does “-rhaphy” mean?","a":"Suturing or surgical joining of tissues."},{"q":"What does “-scope” or “-scopy” refer to?","a":"An instrument or procedure for visual examination."},{"q":"What does “-osis” indicate?","a":"A process, condition, or disease state."},{"q":"What does “-oma” mean?","a":"Tumor or neoplasm."},{"q":"What does “-ostomy” mean?","a":"Creation of a surgical opening."},{"q":"What does “-stasis” mean?","a":"Stoppage or control of flow."},{"q":"What does “-itis” signify?","a":"Inflammation."},{"q":"What does “-ology” refer to?","a":"The study or science of something."},{"q":"What does “-lysis” mean?","a":"Breaking down or destruction."},{"q":"What does “-ectomy” mean?","a":"Surgical removal."},{"q":"What does “-tripsy” mean?","a":"Crushing with a surgical instrument."},{"q":"What does “-ase” mean in a biological term?","a":"Denotes an enzyme."},{"q":"What does “-gram” or “-graphy” mean?","a":"To write or record."},{"q":"How is syphilis transmitted?","a":"Sexually transmitted."},{"q":"Which tissues are first infected in syphilis?","a":"Mucous membranes."},{"q":"What are the stages of syphilis infection?","a":"Primary, secondary, latent, and late."},{"q":"Is untreated syphilis fatal?","a":"Yes, it can be fatal if not treated."},{"q":"What organism causes syphilis?","a":"Treponema pallidum."},{"q":"What lesion appears during primary syphilis?","a":"A chancre (painless ulcer)."},{"q":"Are chancres of syphilis painful?","a":"No, they are painless."},{"q":"Do chancres disappear without treatment?","a":"Yes, but the disease progresses internally."},{"q":"Which organs are affected in late-stage syphilis?","a":"Liver, heart, and brain."},{"q":"What test confirms the presence of syphilis?","a":"Dark-field microscopic examination for Treponema pallidum."},{"q":"What is the most common sign of neurosyphilis?","a":"Ataxia or unsteady gait."},{"q":"Mastitis and breast engorgement are more common in which mothers?","a":"Primiparas (first-time mothers)."},{"q":"Where does the organism that causes mastitis usually come from?","a":"The infant’s mouth or nose."},{"q":"Which microorganism most commonly causes mastitis?","a":"Staphylococcus."},{"q":"How do long intervals between breastfeeding affect mastitis risk?","a":"They increase the risk."},{"q":"Can tight bras contribute to mastitis?","a":"Yes, they can obstruct milk ducts."},{"q":"Mastitis typically occurs how many days after delivery?","a":"About 10 days postpartum."},{"q":"How do the breasts appear in mastitis?","a":"Hard, swollen, and warm."},{"q":"What temperature indicates mastitis?","a":"Fever above 102°F (38.9°C)."},{"q":"What causes breast engorgement (not infection)?","a":"Temporary increase in blood and lymph supply for milk production."},{"q":"When does breast engorgement occur compared with mastitis?","a":"Usually 2–5 days after delivery, earlier than mastitis."},{"q":"Does breast engorgement interfere with breastfeeding?","a":"Yes, it makes latching difficult."},{"q":"Are antibiotics indicated for breast engorgement?","a":"No, because it is not an infection."},{"q":"What is mastoiditis?","a":"Inflammation or infection of the mastoid bone."},{"q":"What is the most common cause of mastoiditis?","a":"Chronic otitis media (middle ear infection)."},{"q":"What are common symptoms of mastoiditis?","a":"Ear drainage, high fever, headache, ear pain, and tenderness over the mastoid process."},{"q":"What surgical procedure is performed for mastoiditis?","a":"Simple or radical mastoidectomy."},{"q":"What is Meniere’s disease?","a":"A disorder caused by excess endolymph in the inner ear, leading to severe vertigo."},{"q":"What is the classic triad of Meniere’s disease?","a":"Vertigo, sensorineural hearing loss, and tinnitus (ringing in the ears)."},{"q":"Does Meniere’s disease occur more often in men or women?","a":"Women."},{"q":"What is the most common age range for Meniere’s disease?","a":"Between 40 and 60 years old."},{"q":"What surgery is performed for severe Meniere’s disease?","a":"Labyrinthectomy."},{"q":"What condition may occur after a labyrinthectomy?","a":"Bell’s palsy (temporary facial paralysis)."},{"q":"What is a permanent effect of labyrinthectomy?","a":"Total hearing loss in the operated ear."},{"q":"Meningitis is an inflammation of which structures?","a":"The meninges, the protective linings of the brain and spinal cord."},{"q":"What are common causes of meningitis?","a":"Viruses, bacteria, or chemical irritants."},{"q":"Name four organisms that commonly cause meningitis.","a":"Pneumococcus, Meningococcus, Streptococcus, and Haemophilus influenzae."},{"q":"Is the child with meningitis initially lethargic or irritable?","a":"Irritable."},{"q":"What visual symptom is common in meningitis?","a":"Photophobia (sensitivity to light)."},{"q":"What is the most common musculoskeletal sign of meningitis?","a":"Nuchal rigidity (stiff neck)."},{"q":"Does the patient with meningitis typically have a headache?","a":"Yes, severe headache is common."},{"q":"What is a positive Kernig’s sign?","a":"Pain in the knee when the leg is straightened with the hip flexed."},{"q":"What type of vomiting occurs in meningitis?","a":"Projectile vomiting."},{"q":"What is opisthotonos?","a":"Severe hyperextension causing arching of the back, neck, and ankles due to meningeal irritation."},{"q":"What type of pain characterizes a migraine?","a":"Throbbing pain."},{"q":"Are migraines more common in men or women?","a":"Women."},{"q":"What other symptoms commonly accompany migraines?","a":"Nausea, vomiting, and visual disturbances."},{"q":"What physiological process occurs during migraines?","a":"Reflex constriction followed by dilation of cerebral arteries."},{"q":"Where is migraine pain usually located?","a":"Temporal or supraorbital region."},{"q":"Are migraines typically unilateral or bilateral?","a":"Unilateral."},{"q":"Multiple sclerosis (MS) is a progressive ______ disease of the CNS.","a":"Demyelinating."},{"q":"What is the function of myelin?","a":"It allows fast, smooth conduction of nerve impulses."},{"q":"Does MS affect men or women more?","a":"Women."},{"q":"What is the typical age range for MS onset?","a":"20–40 years old."},{"q":"What is usually the first sign of MS?","a":"Blurred or double vision (diplopia)."},{"q":"Can MS lead to urinary incontinence?","a":"Yes."},{"q":"Can MS cause impotence in men?","a":"Yes."},{"q":"Are the muscles in MS spastic or flaccid?","a":"Spastic."},{"q":"In myasthenia gravis (MG), where is the transmission defect located?","a":"At the neuromuscular junction."},{"q":"What is the primary sign of MG?","a":"Severe muscle weakness."},{"q":"What are the early symptoms of MG called?","a":"Bulbar signs — difficulty swallowing and visual disturbances."},{"q":"Who is more commonly affected by MG, men or women?","a":"Women."},{"q":"At what age does MG usually occur in women?","a":"Younger adults."},{"q":"At what age does MG usually occur in men?","a":"Older adults."},{"q":"Which neurotransmitter is affected in MG?","a":"Acetylcholine."},{"q":"What surgical treatment may be performed for MG?","a":"Thymectomy (removal of the thymus gland)."},{"q":"Does muscle weakness in MG improve with exercise?","a":"No, it worsens with activity."},{"q":"What facial appearance is typical in MG?","a":"Mask-like face with a “myasthenic smile.”"},{"q":"How do patients typically describe the pain of a myocardial infarction (MI)?","a":"Crushing, heavy, squeezing pain radiating to the left arm, neck, jaw, or shoulder."},{"q":"What is a myocardial infarction (MI)?","a":"An obstruction of coronary blood flow due to a clot, spasm, or plaque, resulting in myocardial cell death."},{"q":"What is the #1 symptom of an MI?","a":"Severe chest pain unrelieved by rest or nitroglycerin."},{"q":"Are men or women more likely to experience an MI?","a":"Men."},{"q":"Death due to MI occurs within what time frame in 50% of cases?","a":"Within one hour of symptom onset."},{"q":"What is another name for an MI?","a":"Heart attack."},{"q":"Does fluid resuscitation correct cardiogenic shock?","a":"No, it requires cardiac medications; fluids may worsen the condition."},{"q":"Will a client with an MI experience nausea and diaphoresis?","a":"Yes, both are common symptoms."},{"q":"How will the extremities feel in a patient with an MI?","a":"Cold and clammy."},{"q":"Does the MI patient require 100% oxygen for the entire hospital stay?","a":"No, moderate flow (3–6 L\/min) is sufficient for the first 48 hours."},{"q":"Hemophilia is what type of disorder?","a":"A bleeding disorder."},{"q":"Hemophilia A is caused by a deficiency of which clotting factor?","a":"Factor VIII."},{"q":"What does hemarthrosis mean?","a":"Bleeding into the joints."},{"q":"Which symptom is NOT seen in hemophilia: prolonged bleeding, petechiae, ecchymosis, or hematoma?","a":"Petechiae."},{"q":"Hepatitis is an _____, ______ disease of the _______.","a":"Acute, inflammatory disease of the liver."},{"q":"Hepatitis A, B, C, and D are caused by what type of organism?","a":"Viruses."},{"q":"What is an early sign of hepatitis A?","a":"Anorexia or fatigue."},{"q":"Early-stage hepatitis often resembles which common illness?","a":"Influenza (the flu)."},{"q":"In later stages of hepatitis, what happens to the urine?","a":"It becomes dark due to bilirubin accumulation."},{"q":"What does “pre-icteric” mean?","a":"The stage before jaundice appears."},{"q":"What is the “icteric stage” of hepatitis?","a":"The phase when jaundice is present."},{"q":"What two skin symptoms are common in hepatitis?","a":"Pruritus (itching) and jaundice, caused by elevated bilirubin levels."},{"q":"Which type of hepatitis has more severe symptoms—A or B?","a":"Hepatitis B."},{"q":"Patients with hepatitis often have an aversion to what?","a":"Cigarettes."},{"q":"In hepatitis, what color are the stools?","a":"Light-colored; bilirubin is excreted in urine instead of stool."},{"q":"What is the common name for herpes zoster?","a":"Shingles."},{"q":"What type of rash occurs with shingles?","a":"A vesicular rash following the path of a sensory nerve."},{"q":"How long does it usually take for shingles to heal?","a":"About 30 days."},{"q":"What is the most common symptom reported by patients with shingles?","a":"Severe pain."},{"q":"What other disease is related to shingles?","a":"Chickenpox (varicella)."},{"q":"What organism causes shingles?","a":"Varicella-zoster virus."},{"q":"Describe key facts about Hepatitis A.","a":"Fecal–oral transmission; incubation 3–5 weeks; vaccine and immune globulin available; enteric precautions."},{"q":"Describe key facts about Hepatitis B.","a":"Transmitted via blood and body fluids; incubation 5–35 weeks; vaccine and immune globulin (HBIG) available; HBsAg positive in blood."},{"q":"Describe key facts about Hepatitis C.","a":"Transmitted via blood only; incubation 2–23 weeks; no vaccine and immune globulin is ineffective."},{"q":"Hyperemesis gravidarum is ______ and ______ vomiting that persists into the ______ trimester.","a":"Severe and prolonged vomiting that continues into the second trimester."},{"q":"Give three possible causes of hyperemesis gravidarum.","a":"Pancreatitis, multiple pregnancies, and hydatidiform mole."},{"q":"Hypertension is an ________ or sustained elevation in the ________ blood pressure.","a":"Intermittent or sustained elevation in diastolic blood pressure."},{"q":"If untreated, hypertension can be fatal. (T\/F)","a":"True."},{"q":"Which four organs are most affected by hypertension?","a":"Brain (stroke), eyes (blindness), heart (MI), and kidneys (renal failure)."},{"q":"In hypovolemic shock, there is a ________ in circulating ________, resulting in ________ tissue perfusion with ________.","a":"Decrease; blood volume; decreased perfusion; reduced oxygen delivery."},{"q":"What is the most common cause of hypovolemic shock?","a":"Acute blood loss."},{"q":"What happens to blood pressure in hypovolemic shock?","a":"It decreases."},{"q":"What happens to pulse pressure in hypovolemic shock?","a":"It narrows (the difference between systolic and diastolic becomes smaller)."},{"q":"In hypovolemic shock, the level of consciousness (LOC) is (increased\/decreased).","a":"Decreased."},{"q":"What type of heart rate occurs in hypovolemic shock: bradycardia or tachycardia?","a":"Tachycardia."},{"q":"In hypovolemic shock, urine output falls below how many cc per hour?","a":"Less than 25–30 mL\/hour."},{"q":"Describe the skin appearance in hypovolemic shock.","a":"Cool, pale, and clammy due to vasoconstriction."},{"q":"What acid-base imbalance is most common in hypovolemic shock?","a":"Metabolic acidosis (from lactic acid buildup due to poor oxygenation)."},{"q":"Which two vital signs increase during hypovolemic shock?","a":"Heart rate and respiratory rate."},{"q":"What are the first two signs of hypovolemic shock?","a":"Change in level of consciousness and tachycardia."},{"q":"What is the #1 medical treatment for hypovolemic shock?","a":"Replace blood and fluids."},{"q":"What are MAST trousers?","a":"Pneumatic garments inflated around the legs to push blood toward vital organs."},{"q":"In what position should you place a client with suspected hypovolemic shock?","a":"Supine with legs and arms elevated."},{"q":"If systolic BP drops below 80 mmHg during hypovolemic shock, what should be done first?","a":"Increase the oxygen flow rate."},{"q":"What is a hysterectomy?","a":"Surgical removal of the uterus."},{"q":"What is an ectopic pregnancy?","a":"Implantation of a fertilized ovum outside the uterus."},{"q":"What is the most common site for ectopic pregnancy?","a":"The fallopian tube (≈90% of cases)."},{"q":"Have IUDs or pelvic infections been linked to ectopic pregnancies?","a":"Yes, both increase the risk."},{"q":"What is the most common symptom of fallopian tube ectopic pregnancy?","a":"Unilateral pelvic pain."},{"q":"What is the most dangerous complication of ectopic pregnancy?","a":"Rupture of the fallopian tube."},{"q":"If a fallopian tube ruptures in an ectopic pregnancy, care resembles that for _________.","a":"Shock and peritonitis."},{"q":"How does the uterus feel after rupture of a fallopian ectopic pregnancy?","a":"Boggy and tender."},{"q":"What is usually the first sign of a ruptured ectopic pregnancy?","a":"Sudden, sharp abdominal pain."},{"q":"Are ectopic pregnancies usually carried to term?","a":"Almost never."},{"q":"What is the usual medical-surgical treatment for ectopic pregnancy?","a":"Surgical removal of the embryo and damaged tissue."},{"q":"What surgery is performed for ectopic pregnancy?","a":"Exploratory laparotomy."},{"q":"In emphysema, the alveoli are over-_____ and under-_____.","a":"Over-enlarged and under-ventilated, causing air trapping."},{"q":"In emphysema, appetite ______, body weight ______, and the anterior-posterior chest diameter ______.","a":"Decreases, decreases, increases."},{"q":"What is the term for the increased anterior-posterior chest diameter in emphysema?","a":"Barrel chest."},{"q":"Clients with emphysema often have ______, ______ lips and (slow\/rapid) breathing.","a":"Pursed, grunting lips and rapid breathing."},{"q":"The client with emphysema is typically (ruddy\/pale\/cyanotic).","a":"Cyanotic."},{"q":"Overproduction of thyroid hormone is known as what disorder?","a":"Graves’ disease (hyperthyroidism)."},{"q":"Excess growth hormone in childhood causes what disorder?","a":"Gigantism."},{"q":"Oversecretion of mineralocorticoids only results in what disease?","a":"Conn’s disease."},{"q":"Deficiency of growth hormone results in what condition?","a":"Pituitary dwarfism."},{"q":"Excess growth hormone in adulthood causes what disorder?","a":"Acromegaly."},{"q":"Undersecretion of adrenal cortex hormones causes what disorder?","a":"Addison’s disease."},{"q":"Hypothyroidism in an adult is known as what?","a":"Myxedema."},{"q":"Oversecretion of adrenal cortex hormones results in what syndrome?","a":"Cushing’s syndrome."},{"q":"Oversecretion of adrenal medulla hormones causes what condition?","a":"Pheochromocytoma."},{"q":"Hypothyroidism in a child is known as what?","a":"Cretinism."},{"q":"Oversecretion of ACTH leads to what disease?","a":"Cushing’s disease."},{"q":"What is endometriosis?","a":"Growth of endometrial tissue outside the uterus."},{"q":"Endometriosis most commonly occurs in women aged ______ to ______.","a":"25 to 40 years."},{"q":"After menopause, endometriosis (increases\/decreases).","a":"Decreases."},{"q":"What is the most common symptom of endometriosis?","a":"Dysmenorrhea (painful menstruation)."},{"q":"What is the major complication of endometriosis?","a":"Infertility."},{"q":"Is endometriosis life-threatening?","a":"No, it is not life-threatening."},{"q":"What organism most commonly causes epiglottitis?","a":"Haemophilus influenzae type B."},{"q":"What level of fever is typical in epiglottitis?","a":"Above 102°F (39°C)."},{"q":"What are the classic symptoms of epiglottitis?","a":"Muffled voice, drooling, and inspiratory stridor."},{"q":"Does a child with epiglottitis usually cough?","a":"No, there is typically no spontaneous cough."},{"q":"How does a child with epiglottitis position themselves to breathe?","a":"Leaning forward with flared nostrils (“tripod position”)."},{"q":"Osteoarthritis is a ______ disease of the ______.","a":"Degenerative disease of the joints."},{"q":"Osteoarthritis is most commonly caused by wear and tear over time. (T\/F)","a":"True."},{"q":"What is the most common symptom of osteoarthritis?","a":"Joint pain."},{"q":"Which joints are most commonly affected by osteoarthritis?","a":"The knees and hips."},{"q":"What physical finding may appear on the fingers of clients with osteoarthritis?","a":"Heberden’s nodes."},{"q":"Are Heberden’s nodes painful?","a":"Not initially, but they can become painful with swelling."},{"q":"Is the pain of osteoarthritis better or worse with rest? With activity?","a":"Better with rest, worse with activity."},{"q":"What age group is most affected by osteoarthritis?","a":"Adults aged 60–80 years."},{"q":"Osteoarthritis occurs more often in women than in men. (T\/F)","a":"False; incidence is about equal."},{"q":"What is arthroplasty?","a":"Surgical joint replacement."},{"q":"What is arthrodesis?","a":"Surgical joint fusion."},{"q":"What is otosclerosis?","a":"Overgrowth of spongy bone in the middle ear that prevents ossicle vibration and impairs hearing."},{"q":"What additional symptom occurs with otosclerosis besides hearing loss?","a":"Tinnitus (ringing in the ears)."},{"q":"What type of hearing loss occurs in otosclerosis?","a":"Conductive hearing loss."},{"q":"What surgery is used to correct otosclerosis?","a":"Stapedectomy."},{"q":"Which gender has a higher incidence of otosclerosis?","a":"Women."},{"q":"Are ovarian cysts usually malignant?","a":"False; most are benign."},{"q":"Do small ovarian cysts cause symptoms?","a":"No, only large cysts cause noticeable symptoms."},{"q":"What are common symptoms of large ovarian cysts?","a":"Low back pain, pelvic pain, and abnormal uterine bleeding."},{"q":"What does torsion of an ovarian cyst mean?","a":"Twisting of the cyst, cutting off its blood supply."},{"q":"Raynaud’s disease is an arterial or venous disorder?","a":"It is an arterial disorder characterized by vasospasms."},{"q":"What part of the body is most affected by Raynaud’s disease?","a":"The fingers."},{"q":"Raynaud’s disease affects men or women more commonly?","a":"Women, particularly young women."},{"q":"What three factors can trigger a Raynaud’s attack?","a":"Exposure to cold, emotional stress, and tobacco use."},{"q":"Are the digits hot or cold during a Raynaud’s attack?","a":"Cold."},{"q":"What do the fingers look like during a Raynaud’s episode?","a":"Pale or bluish in color."},{"q":"What will you find when assessing the legs of patients with arterial insufficiency?","a":"Weak or absent pulses, cool pale skin, loss of hair, and shiny thin skin."},{"q":"What three sensations does the client with Raynaud’s experience?","a":"Pain, numbness, and tingling."},{"q":"What should clients with Raynaud’s avoid?","a":"Exposure to cold and smoking; they should wear warm gloves."},{"q":"What are the three stages of acute renal failure?","a":"Oliguric, diuretic, and recovery stages."},{"q":"Define renal failure.","a":"Inability of the kidneys to excrete waste and maintain fluid and electrolyte balance."},{"q":"What is the greatest danger in renal failure?","a":"Hyperkalemia and its effect on the heart."},{"q":"What is anuria?","a":"Urine output less than 50 mL in 24 hours."},{"q":"What is oliguria?","a":"Urine output less than 500 mL in 24 hours."},{"q":"What dietary changes are needed during the recovery phase of acute renal failure?","a":"Increased carbohydrates and protein intake."},{"q":"What are the dietary needs during the diuretic phase of acute renal failure?","a":"Increased carbohydrates and protein; moderate potassium and sodium; possible fluid increase to prevent dehydration."},{"q":"What dietary modifications are required during the oliguric phase of acute renal failure?","a":"Increased carbohydrates; decreased protein, sodium, potassium, and water."},{"q":"What causes the itching seen in end-stage renal failure?","a":"Accumulation of waste products in the blood."},{"q":"What is the first phase of acute renal failure?","a":"The oliguric phase."},{"q":"During the oliguric phase, what happens to blood volume, sodium, and potassium levels?","a":"All increase."},{"q":"How long does the oliguric phase last?","a":"7–10 days."},{"q":"During the diuretic phase, what happens to blood volume, sodium, and potassium levels?","a":"All decrease."},{"q":"How long does the diuretic phase last?","a":"3–4 days, up to 2–3 weeks in some cases."},{"q":"During the diuretic phase, urine output can reach how many liters per day?","a":"4–5 liters per 24 hours."},{"q":"Which is more dangerous: oliguria or anuria? Why?","a":"Oliguria, because concentrated potassium increases the risk of severe hyperkalemia."},{"q":"Respiratory Distress Syndrome (RDS) occurs in full-term infants. (T\/F)","a":"False — it primarily affects premature infants."},{"q":"RDS rarely occurs after which week of gestation?","a":"After the 37th week."},{"q":"Another name for Respiratory Distress Syndrome is _______.","a":"Hyaline Membrane Disease (HMD)."},{"q":"What causes RDS in premature infants?","a":"A lack of surfactant in the lungs."},{"q":"What does surfactant do?","a":"Decreases surface tension inside the alveoli to keep them open."},{"q":"Surfactant prevents what in the alveoli?","a":"Collapse of the alveoli."},{"q":"Lack of surfactant causes the neonate to lose lung capacity with each what?","a":"Breath."},{"q":"Death from Respiratory Distress Syndrome most often occurs within how many hours of birth?","a":"Within 96 hours."},{"q":"Within minutes of birth, what three respiratory signs occur in RDS?","a":"Retractions, nasal flaring, and grunting."},{"q":"What acid–base imbalance occurs in RDS?","a":"Respiratory acidosis due to CO₂ retention."},{"q":"What lung sounds are heard in a neonate with RDS?","a":"Diminished breath sounds with crackles."},{"q":"In what season do rheumatoid arthritis flare-ups commonly occur?","a":"Spring."},{"q":"Clients with rheumatoid arthritis often have a low-_____ fever.","a":"Low-grade fever."},{"q":"What factor is found in the blood of clients with rheumatoid arthritis?","a":"Rheumatoid factor."}]

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