Final Exam

Question 1

airborne precautions

Answer 1

• negative pressure room, mask, gloves, gown

- TB, measles, chicken pox, herpes zoster, SARS

Question 2

droplet precautions

Answer 2

• private room, mask when within 3 feet of the client, gloves, gown
• mumps, pertussis, pneumonia

Question 3

contact precautions

Answer 3

• private room, gloves, gown

- impetigo, C. diff

Question 4

hematocrit and dehydration

Answer 4

HCT goes up with dehydration, down with fluid overload

Question 5

types of play in relation to ages

Answer 5

-infancy: onlooker and solitary
-toddlers: parallel play
-3-4: associative
4-6+: cooperative

Question 6

negativism

Answer 6

• toddlers
• doing the opposite of what others want; closely related to autonomy… the toddler wants to do things independently
• negative toward anyone that tries to take away their independence

Question 7

ages of stranger anxiety

Answer 7

8 or 9 months to 2 years

Question 8

3 C’s of tracheoesophageal fistula

Answer 8

• coughing and choking during feedings

- unexplained cyanosis

Question 9

maintenance of tracheoesophageal fistula

Answer 9

• NPO
• suction accumulated secretions
• maintain supine, upright position of at least 30 degrees to facilitate drainage of secretions

Question 10

iron supplements

Answer 10

• start at 6 months if only breastfed
• never with milk because it binds free iron
• Vit C helps absorption
• can cause constipation

Question 11

vitamin D supplements

Answer 11

• deficiency leads to rickets

- 400 IU/day shortly after birth

Question 12

Meckel’s diverticulum

Answer 12

• fibrous band connecting SI to umbilicus
• most common congenital malformation of the GI tract
• painless rectal bleeding
• currant jelly stool or dark red
• can cause hypotension because of blood loss

Question 13

3 C’s of measles and other telling sign

Answer 13

• coryza (inflammation of the mucus membranes in the nose
• cough
• conjunctiva
• other: Koplik spots

Question 14

erythema infectuosum

Answer 14

• Fifth Disease
• asymptomatic before rash, possible mild fever, malaise, headache, runny nose
• face-slap rash develops and disappears by 1-4 days
• rash progresses to extremeties
• common with sickle cell

Question 15

immunization schedule

Answer 15

• Birth: Hep B
• 1 month: hep B
• 2 months: inactivated poliovirus vaccine (IPV), DTaP, Hib, pneumococcal (PCV), rotavirus (RV)
• 4 months: DTaP, Hib, IPV, PVC, RV
• 6 months: DTaP, Hib, HepB, IPV, PVC, RV
• 12-15 months: Hib, PVC,MMR, HepA first dose (second dose given 6-18 months after first dose, varicella
• 15-18 months: DTaP
• 18-33 months: HepA (second dose)
• 4-6 years: DTaP, IPV, MMR, varicella
• 11-12 years: MMR (if not administered at 4-6 years, Tdap, meningococcal vaccine (MCV4) with a booster at age 16, HPV (first dose to girls at age 11 to 12, second dose 2 months after first dose, and third dose 6 months after firsts dose

Question 16

aphthous stomatitis

Answer 16

• canker sore
• painful, small, whitish ulcerations surrounded by a red border
• healthy adjacent tissues, absence of vesicles, and no systemic illness

Question 17

herpetic gingivostomatitis

Answer 17

• cold sores/ fever blisters
• caused by HSV
• fever, pharynx becomes edematous and erythematous; vesicles erupt on the mucosa, causing severe pain
• exacerbated by emotional stress, trauma, immunosupression, or exposure to excessive sunlight

Question 18

rule of 5s

Answer 18

takes a drug 5 half lives to build to a steady state in the body, by the time the five half-lives have occurred, the body has eliminated a single dose

Question 19

somatoform disorder

Answer 19

• persistent worry or complains regarding physical illness without supportive physical findings
• increases with psychological stressors
• identify alternative methods of coping
• assist the pt to relate feelings and conflicts to the physical symptoms
• convey understanding that the physical symptoms are real to the client, but avoid responding with positive reinforcement about physical symptoms

Question 20

what to monitor with a pt on TPN

Answer 20

• glucose q6h
• weight qd with same linens
• I&O

Question 21

GERD education

Answer 21

• avoid foods that cause irritation: peppermint, chocolate, coffee, fried or fatty foots, carbonated beverages, alcohol, smoking
• low-fat, high-fiber diet
• elevate head of the bed
• avoid anticholinergics and NSAIDS
• instruct on use of antacids

Question 22

prevalence of eating disorders

Answer 22

• both: 1 - 4% of US population
• 89% of pts hospitalized are women
• 2:1 women to men for anorexia; 3:1 for bulimia

Question 23

nephrotic syndrome

Answer 23

-proteinuria and hyperlipidemia 
NAPHROTIC:
N - Na+ decrease
A - Albumin decrease
P - Proteinuria >3.5 g/day
H - Hyperlipidemia 
R - Renal vein thrombosis
O - Orbital edema
T - Thromboembolism 
I - Infection
C - Coagulability

Question 24

glomerulonephritis

Answer 24

• 2 to 3 week after strep infection
• decreased urinary output
• cloudy, smoky, brown-colored urine (hematuria)
• headaches, abdominal pain or flank pain, dysruia
• HTN
• proteinuria with foam
• azotemia

Question 25

talipes varus

Answer 25

inversion

Question 26

talipes valgus

Answer 26

eversion

Question 27

talipies equinus

Answer 27

plantar flexion with the toes lower than the heel

Question 28

talipes calcaneus

Answer 28

plantar flexion with the toes higher than the heel

Question 29

avoiding contractures

Answer 29

place limb flat on firm bed after 24 hours of elevations

Question 30

wound care for burns

Answer 30

- reposition | - change every 8-12 hours

Question 31

3-point gait

Answer 31

both crutches and foot of affected extremity are advanced together, followed by the foot of the unaffected extremity

Question 32

oliguric phase of acute renal failure

Answer 32

- sudden decrease in urine output; less than 400 ml/day - signs of excess fluid volume - restrict fluid intake

Question 33

diuretic phase of acute renal failure

Answer 33

excessive urine output indicates that damaged nephrons are recovering their ability to excrete waste -IV fluids to maintain fluid and electrolyte balance

Question 34

sign of end stage renal disease

Answer 34

GFR less than 15 ml/min

Question 35

management of anemia r/t chronic kidney disease

Answer 35

administer epoetin alpha (Epogen, Procrit) to promote maturity of the RBCs

Question 36

Cast care

Answer 36

-examine the cast for pressure areas... check for unrelieved pain; pale, dusky, or edematous tissue distal to the involved area; parasthesias; pulselessness

Question 37

cast education for children

Answer 37

- big toys - instruct parents and child not to stick objects down the cast - teach parents and child to keep cast clean and dry - instruct parents and child in isometric exercises to prevent muscle atrophy

Question 38

position for BPH surgery

Answer 38

lithotomy

Question 39

meds associated with refractory mania

Answer 39

- refractory mania is bipolar mania that does not respond well to meds - treated with clozapine (or other atypical antipsychotics) and ECT

Question 40

3-way catheter

Answer 40

Transurethral Resection of Prostate (TURP) - microscope - scissors - foley