Medical Surgical Nursing Review Questions Part 4

A - Pulsating abdominal mass denotes that the build up clot is located at the abdominal area. B - Distended abdomen may mean that there is accumulation of air or liquid or substances. C - Decreased bowel sounds may mean indigestion or for post operated patients, it is common that there is decreased bowel sounds. D - Blood in stools or melena may mean colorectal cancer or just a damage on the veins near the rectal area.

Difference between the systolic and diastolic readings – The definition of pulse pressure. Blood pressure is the force against an arterial wall. Pulse deficit is the difference between the apical and radial rates.

Prothrombin formation by the liver – Vitamin K is responsible for the normal blood clotting. Platelet aggregation is done by thromboxane. Ionization of blood calcium and prothrombin formation by the liver are not the responsibility of the vitamins since calcium in the first place is the most abundant metal by mass in many animals.

Pain is the priority nursing diagnosis since gout is a metabolic disease marked by the urate crystal deposits in joints throughout the body which causes inflammatory responses. Choices B to D are secondary only to pain.

A - Atrophy of the stomach lining happens since during Vit B12 deficiency, there is also lack of intrinsic factor B - Reduced function of the bone marrow happens when chemotherapy is rendered since it kills not only the cancer cells but also affects the source of cells such as the bone marrow C - Diminished liver metabolism is apparent for cases like liver cancer or encephalopathy D - Erosion of intestinal rugae is present for ulcer.

Supply blood to the endocardium – this is the function of the coronary arteries. Right ventricle carry reduced oxygen-content blood to the lungs. Pulmonary veins carry high-oxygen content blood from the lungs towards the heart.

Septum - A muscular structure that separates the right and left side of the heart. Pericardium is a double-walled sac that contains the heart and the roots of the great vessels. SA Node is the impulse-generating (pacemaker) tissue located in the right atrium of the heart, and thus the generator of normal sinus rhythm. Atrium refers to a chamber in which blood enters the heart.

“I hear buzzing sounds” is associated with aspirin toxicity a sign of tinnitus which is a a nonspecific nonsensitive clinical effect of salicylism. Choice A is a sign of UTI, Choices C & D are general symptoms and signals a wide array of diseases.

Lower the oxygen rate this enables the patient breathe in and cope up with the normal breathing, the prescribed oxygen level for COPD should not exceed 4 liters per minute. A – it is important to give an intervention first before calling the doctor. B – Positioning could be done after lowering the oxygen. D – This could be done after positioning the patient properly.

Erythrocytes – It is the result of the reticulocytes, it is another name of Red blood cells. Megakaryocytes is a bone marrow cell responsible for the production of blood thrombocytes (platelets). Granulocytes re a category of white blood cells characterized by the presence of granules in their cytoplasm. Reticulocytes are the precursors of the major formed elements of blood.

A - “Do you urinate often at night?” – This is only appropriate for patients with enuresis or urinary tract infection. B - “Are you buying larger shoe sizes?” – This denotes growth in the bone structure of the feet. C - “Is your mouth frequently dry after meals?”. D - “Have you had alopecia lately?” – This type of question is for patients who have undergone chemotherapy or some kind of integumentary dysfunction.

Fibrin - soluble substance becomes an insoluble gel. Thrombin is also known as coagulation factor II. Fibrinogen is a soluble plasma glycoprotein, synthesised by the liver. Prothrombin is a glycoprotein formed by and stored in the liver and present in the blood plasma that is converted to thrombin in the presence of thromboplastin and calcium ion during blood clotting.

A - Prepare the woman for induced abortion. This is not appropriate since this type of abortion is only done when the fetus does not have signs of life or does not have heartbeat anymore. This could save the mother’s life when the fetus is already dead inside the mother’s womb. B - Place the patient on bedrest for at least 1 week and reevaluate. More delay to the initial assessment may compromise not only the mother’s life but as well as the status of the fetus. C - Prepare the woman for sonogram to determine the integrity of the gestational sac. An ultrasound exam is a procedure that uses high-frequency sound waves to scan a woman's abdomen and pelvic cavity, creating a picture (sonogram) of the baby and placenta. As long as the placenta or gestational sac is found intact, the fetus will have adequate nutrition needed for its growth as well as protection from the outside environment. D - Comfort the woman by telling her that if she losses the baby she can try to get pregnant again in about one month. This is not qualified as an example of therapeutic approach. The nurse here tends to give suggestion which not therapeutic at this time.

Mental retardation is the complication of phenylketonuria since the baby has an inborn abnormality of lacking the ability to break down phenylalanine. A - Hydrocephalus is a complication for meningitis. B - Paralysis is a complication for cases like tetanus or nerve damage. C - Malnutrition is a case when a vitamin or mineral is depleted in the body.

Evaluating SaO2 levels is a concrete measure of the oxygen levels and the drive to take in more oxygen. Choices B to D serves as a supportive assessment finding only.

“ I am sorry. All your nail polish must be removed” – is a firm and concised information for the patient. A – this is not a hospital protocol. B & D are not therapeutic for the patient and may cause anxiety.

Diastolic phase is the period of time when the heart fills with blood after systole (contraction). Systolic phase is the period when the heart contracts. term. Lub-dub phase is not an accepted medical term. Resting phase is seen between electrical activity of the heat.

SA node – The pacemaker serves as a substitute to the pacemaker. AV node atrioventricular node (abbreviated AV node) is a part of electrical control system of the heart that co-ordinates heart rate. Bundle of His is known as the AV bundle or atrioventricular bundle, is a collection of heart muscle cells specialized for electrical conduction that transmits the electrical impulses from the AV node (located between the atria and the ventricles) to the point of the apex of the fascicular branches. Accelerator nerve to heart are simply called heartbeats.

Atrioventricular valves are Tricuspid and mitral valves. Semilunar valves either of two valves, one located at the opening of the aorta and the other at the opening of the pulmonary artery, each consisting of three crescent-shaped cusps and serving to prevent blood from flowing back into the ventricles. Pulmonic valve A fold in the pulmonary artery that directs blood to the lungs. It may be transferred to replace a severely diseased aortic valve during heart valve replacement surgery for aortic stenosis. Aortic valve is the guarding the entrance to the aorta from the left ventricle.

The heart is not beating during asystole. Bradycardia happens when the heart beats slowly. Tachycardia happens when the heart is beating rapidly.

A – A 13-year-old boy with chicken pox means that he is contagious enough to compromise the child who was recently undergone a chemotherapy. B – 9-year-old girl post appendectomy has a non-infectious case, however the gender of the child is not appropriate. C – A 10-year-old boy with CHF is appropriate to be his roommate since they are of the same age and gender. This lowers the anxiety as well as it promotes a familiarity for both kids. D- An 8-year-old-boy with salmonellosis is not also appropriate to be place with the child since it is an infectious type of case.

Begin intravenous therapy is the initial nursing intervention since the patient is actively losing blood. Choice B won’t solve the current alteration in the vital signs. Choice C solves the problem about the respiratory distress but not the blood loss. Choice D only give data about the cardiac status but does not stop the active blood loss.

A – Night sweats is one of the signs that is apparent during the severe stage of the disease. B – Patients are initially asymptomatic which means, the patient has an active tubercle bacilli but does not show signs of the disease. C – Productive cough is manifested as a defences from foreign bodies or microbes that enters the respiratory tract. D – Pain on the lower lobe belongs to signs of pneumonia not tuberculosis.

A - Increased blood pressure may mean cardiac demand only. B - Flushed dry skin is a sign of dehydration. C - Distended neck veins is present for Congestive Heart Failure or right-sided heart failure.. D - Bilateral basal rales may denote fluid overload on the lungs.

5 minutes – The ample time for the clot to form and the bleeding will stop. A – is too short for clot formation. C & D is too long and the clot has already formed.