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Text Mode – Text version of the exam 1. When the nurse observes diffuse swelling involving the deeper skin layers in the patient who has experienced an allergic reaction, the nurse records the finding as 2. Atopic allergic disorders are characterized by 3. The nurse teaches the patient with allergies about anaphylaxis including which of the following statements? 4. Which of the following statements describes the clinical manifestations of a delayed hypersensitivity (type IV) allergic reaction to latex? 5. Which of the following terms refers to fixation or immobility of a joint? 6. Accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage is referred to as 7. Passive range-of-motion exercises are indicated during which stage of rheumatic disease? 8. Which of the following connective tissue disorders is characterized by insoluble collagen being formed and accumulating excessively in the tissues? 9. Osteoarthritis is known as a disease that 10. Which of the following newer pharmacological therapies used for the treatment of osteoarthritis is thought to improve cartilage function and retard degradation as well as have some anti-inflammatory effects? 11. Which of the following statements reflect nursing interventions in the care of the patient with osteoarthritis? 12. Fibromyalgia is a common condition that 13. Which of the following terms refers to a condition characterized by destruction of the melanocytes in circumscribed areas of the skin? 14. Of the following types of cells, which are believed to play a significant role in cutaneous immune system reactions? 15. When the nurse assesses the patient and observes blue-red and dark brown plaques and nodules, she recognizes that these manifestations are associated with 16. The nurse reading the physician’s report of an elderly patient’s physical examination knows a notation that the patient demonstrates xanthelasma refers to 17. The nurse notes that the patient demonstrates generalized pallor and recognizes that this finding may be indicative of 18. Which of the following terms refers most precisely to a localized skin infection of a single hair follicle? 19. The nurse recommends which of the following types of therapeutic baths for its antipruritic action? 20. Which of the following materials consists of a powder in water? 21. Which of the following skin conditions is caused by staphylococci, streptococci, or multiple bacteria? 22. The nurse teaches the patient who demonstrates herpes zoster (shingles) that 23. Development of malignant melanoma is associated with which of the following risk factors? 24. When caring for a patient receiving autolytic debridement therapy, the nurse 25. Which of the following reflect the pathophysiology of cutaneous signs of HIV disease? 26. Most skin conditions related to HIV disease may be helped primarily by 27. Which of the following terms refers to a graft derived from one part of a patient’s body and used on another part of that same patient’s body? 28. When the emergency nurse learns that the patient suffered injury from a flash flame, the nurse anticipates which depth of burn? 29. Regarding emergency procedures at the burn scene, the nurse teaches which of the following guidelines? 30. The first dressing change for an autografted area is performed 31. Which of the following observations in the patient who has undergone allograft for treatment of burn site must be reported to the physician immediately? 32. Which of the following factors are associated with increased fluid requirements in the management of patients with burn injury? 33. Antimicrobial barrier?Acticoat dressings used in the treatment of burn wounds can be left in place for five days. Antimicrobial barrier dressings can be left in place for? 34. A new biosynthetic dressing used , is used to treat?in the treatment of burns, TransCyte 35. Which of the following statements reflect current research regarding the utilization of non-pharmacological measures in the management of burn pain? 36. The most important intervention in the nutritional support of a patient with a burn injury is to provide adequate nutrition and calories to: 37. Which of the following terms refers to the absence of the natural lens? 38. Edema of the conjunctiva is termed 39. When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs the patient that a person with 20/200 vision 40. Which type of glaucoma presents an ocular emergency? 41. Which of the following categories of medications increases aqueous fluid outflow in the patient with glaucoma? 42. Which of the following statements describe refractive surgery? 43. The nurse knows that a postoperative vision-threatening complication of LASIK refractive surgery, diffuse lamellar keratitis (DLK) occurs 44. The nurse advises the patient undergoing photodynamic therapy (PDT) for macular degeneration to avoid exposure to direct sunlight or bright lights for 45. Retinoblastoma is the most common eye tumor of childhood; it is hereditary in 46. Which of the following terms refers to altered sensation of orientation in space? 47. Of the following terms, which describes a condition characterized by abnormal spongy bone formation around the stapes? 48. Ossiculoplasty is defined as 49. Which of the following terms refers to surgical repair of the tympanic membrane? 50. Of the following tests, which uses a tuning fork between two positions to assess hearing?Practice Mode
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The area of skin demonstrating angioneurotic edema may appear normal but often has a reddish hue and does not pit.
Urticaria (hives) is characterized as edematous skin elevations that vary in size and shape, itch, and cause local discomfort.
Contact dermatitis refers to inflammation of the skin caused by contact with an allergenic substance, such as poison ivy.
Pitting edema is the result of increased interstitial fluid and associated with disorders such as congestive heart failure.
Atopic allergic disorders are characterized by a hereditary predisposition and production of a local reaction to IgE antibodies produced in response to common environmental allergens.
Atopic and nonatopic allergic disorders are IgE-mediated allergic reactions.
Atopic allergic disorders are characterized by a hereditary predisposition and production of a local reaction to IgE antibodies produced in response to common environmental allergens.
Atopic allergic disorders are characterized by a hereditary predisposition and production of a local reaction to IgE antibodies produced in response to common environmental allergens.
The most common cause of anaphylaxis, accounting for about 75% of fatal anaphylactic reactions in the U.S., is penicillin.
Although possibly severe, anaphylactoid reactions are rarely fatal.
Food items that are common causes of anaphylaxis include peanuts, tree nuts, shellfish, fish, milk, eggs, soy and wheat.
Local reactions usually involve urticaria and angioedema at the site of the antigen exposure. Systemic reactions occur within about 30 minutes of exposure involving cardiovascular, respiratory, gastrointestinal, and integumentary organ systems.
Clinical manifestations of a delayed hypersensitivity reaction are localized to the area of exposure.
Clinical manifestations of an irritant contact dermatitis can be eliminated by changing glove brands or using powder-free gloves.
With an irritant contact dermatitis, avoid use of hand lotion before donning gloves as this may worsen symptoms as lotions may leach latex proteins from the gloves.
Described as a latex allergy, when clinical manifestations occur within minutes after exposure to latex, an immediate hypersensitivity (type I) allergic reaction has occurred.
Ankylosis may result from disease or scarring due to trauma.
Hemarthrosis refers to bleeding into the joint.
Diarthrodial refers to a joint with two freely moveable parts.
Arthroplasty refers to replacement of a joint.
Tophi, when problematic, are surgically excised.
Subchondral bone refers to a bony plate that supports the articular cartilage.
Pannus refers to newly formed synovial tissue infiltrated with inflammatory cells.
Joint effusion refers to the escape of fluid from the blood vessels or lymphatics into the joint cavity.
Passive range of motion is indicated because the patient is unable to perform exercises alone during an acute stage of rheumatic disease.
Active assistive or active range of motion is recommended during the subacute stage of rheumatic diseases.
Active range of motion and isometrics are recommended during the inactive stage of rheumatic diseases.
Active range of motion and isometrics are recommended during the remission stage of rheumatic diseases.
Scleroderma occurs initially in the skin but also occurs in blood vessels, major organs, and body systems, potentially resulting in death.
Rheumatoid arthritis results from an autoimmune response in the synovial tissue with damage taking place in body joints.
SLE is an immunoregulatory disturbance that results in increased autoantibody production.
In polymyalgia rheumatic, immunoglobulin is deposited in the walls of inflamed temporal arteries.
The functional impact of osteoarthritis on quality of life, especially for elderly patients, is often ignored.
Reiter’s syndrome is a spondyloarthropathy that affects young adult males and is characterized primarily by urethritis, arthritis, and conjunctivitis.
Psoriatic arthritis, characterized by synovitis, polyarthritis, and spondylitis requires early treatment because of early damage caused by disease.
Ankylosing spondylitis causes the described problem and is usually diagnosed in the second or third decade of life.
Viscosupplementation, the intraarticular injection of hyaluronic acid, is thought to improve cartilage function and retard degradation. It may also have some anti-inflammatory effects.
Glucosamine and chondroitin are thought to improve tissue function and retard breakdown of cartilage.
Chondroitin and glucosamine are thought to improve tissue function and retard breakdown of cartilage.
Weight loss and an increase in aerobic activity such as walking, with special attention to quadriceps strengthening are important approaches to pain management.
Patients should be assisted to plan their daily exercise at a time when the pain is least severe, or plan to use an analgesic, if appropriate, prior to their exercise session.
Gastrointestinal complications, especially GI bleeding, are associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Topical analgesics such as capsaicin and methylsalicylate may be used for pain management.
Fibromyalgia, is a common condition that involves chronic fatigue, generalized muscle aching, and stiffness.
The cause is unknown and no pathological characteristics have been identified that are specific for the condition
Treatment consists of attention to the specific symptoms reported by the patient. NSAIDs may be used to treat the diffuse muscle aching and stiffness. Tricyclic antidepressants are used to improve or restore normal sleep patterns and individualized programs of exercise are used to decrease muscle weakness and discomfort and to improve the general de-conditioning that occurs in these individuals
Fibromyalgia, is a common condition that involves chronic fatigue, generalized muscle aching, and stiffness. It is very typical for patients to have endured their symptoms for a long period of time.
Vitiligo results in the development of white patches that may be localized or widespread.
Hirsutism is the condition of having excessive hair growth.
Lichenification refers to a leathery thickening of the skin.
Telangiectases refers to red marks on the skin caused by stretching of the superficial blood vessels.
Langerhans’ cells are common to the epidermis and are accessory cells of the afferent immune system process.
Merkel’s cells are the receptor cells in the epidermis that transmit stimuli to the axon via a chemical response.
Melanocytes are special cells of the epidermis that are primarily involved in producing melanin, which colors the hair and skin.
Phagocytes are white blood cells that engulf and destroy foreign materials.
Kaposi’s sarcoma is a frequent comorbidity of the patient with AIDS.
With platelet disorders, the nurse observes ecchymoses (bruising) and purpura (bleeding into the skin).
Urticaria (wheals or hives) is the manifestation of allergic reactions.
A painless chancre or ulcerated lesion is a typical finding in the patient with syphilis.
The change is a common, benign manifestation of aging skin or it can sometimes signal hyperlipidemia.
Solar lentigo is the term that refers to liver spots.
Melasma is the term that refers to dark discoloration of the skin.
Cherry angioma is the term that is used to describe a bright red mole.
In the light-skinned individual, generalized pallor is a manifestation of anemia. In brown- and black-skinned individuals, anemia is demonstrated as a dull skin appearance.
Albinism is a condition of total absence of pigment in which the skin appears whitish pink.
Vitiligo is a condition characterized by the destruction of the melanocytes in circumscribed areas of skin, resulting in patchy, milky white spots.
Local arterial insufficiency is characterized by marked localized pallor.
Furuncles occur anywhere on the body, but are most prevalent in areas subjected to irritation, pressure friction, and excessive perspiration, such as the back of the neck, the axillae, or the buttocks.
A carbuncle is a localized skin infection involving several hair follicles.
Chelitis refers to dry cracking at the corners of the mouth.
Comedones are the primary lesions of acne, caused by sebum blockage in the hair follicle.
Aveeno or oatmeal baths are recommended to decrease itching associated with a dermatologic disorder.
Baking soda baths are cooling but dangerous. The tub gets very slippery and a bath mat must be used in the tub.
Water baths have the same effect as wet dressings, not known to counteract itching.
Saline baths have the same effects as saline dressings, not known to counteract itching.
A suspension requires shaking before application, exemplified by calamine lotion.
A hygroscopic agent is a powder that acts to absorb and retain moisture from the air and to reduce friction between surfaces.
A paste is a mixture of powder and ointment.
Impetigo is seen at all ages, but is particularly common among children living under poor hygienic conditions.
Scabies is caused by the itch mite.
Pediculosis capitis is caused by head lice.
Poison ivy is a contact dermatitis caused by the oleoresin given off by a particular form of ivy.
It is assumed that herpes zoster represents a reactivation of latent varicella (chickenpox) virus and reflects lowered immunity.
It is believed that the varicella zoster virus lies dormant inside nerve cells near the brain and spinal cord and is reactivated with weakened immune systems and cancers.
A person who has had chickenpox is immune and, therefore, not at risk of infection after exposure to patients with herpes zoster.
There is some evidence that infection is arrested if oral antiviral agents are administered within 24 hours of the initial eruption.
Ultraviolet rays are strongly suspected as the etiology of malignant melanoma.
Fair-skinned, blue-eyed, light-haired people of Celtic or Scandinavian origin are at higher risk for development of malignant melanoma.
People who burn and do not tan are at risk for development of malignant melanoma.
Elderly individuals who retire to the southwestern United States appear to have a higher incidence of development of malignant melanoma.
During autolytic debridement therapy a foul odor will be produced by the breakdown of cellular debris. This odor does not indicate that the wound is infected.
During autolytic debridement therapy the wound is kept moist.
During autolytic debridement therapy the wound is covered with an occlusive dressing.
Commercially available enzymatic debriding agents include Accuzyme, Clooagenase, Granulex, and Zymase.
Cutaneous signs may be the first manifestations of HIV, appearing in more than 90 per cent of HIV infected patients as the immune function deteriorates. Common complaints include pruritis, folliculitis, and chronic actinic dermatitis.
Cutaneous signs of HIV disease correlate to low CD4 counts.
Cutaneous signs of HIV disease appear as immune function deteriorates.
Cutaneous signs of HIV disease appear as immune function deteriorates.
The goals of all HIV-related conditions include improvement of CD4 count and lowering of viral load. Initiation of HAART (highly active antiretroviral therapy) will help improve most skin conditions related to HIV disease. Symptomatic relief will be required until the skin condition improves.
Initiation of HAART (highly active antiretroviral therapy) will help improve most skin conditions related to HIV disease. Symptomatic relief will be required until the skin condition improves.
High-potency, not low-potency, topical corticosteroid therapy may be helpful for some skin conditions.
Improvement of the patient’s nutritional status is beneficial for the overall treatment of HIV disease; it is not specific for treatment of skin conditions.
Autografts of full-thickness and pedicle flaps are commonly used for reconstructive surgery, months or years after the initial injury.
An allograft is a graft transferred from one human (living or cadaveric) to another human.
A homograft is a graft transferred from one human (living or cadaveric) to another human.
A heterograft is a graft obtained from an animal of a species other than that of the recipient.
A deep partial thickness burn is similar to a second-degree burn and is associated with scalds and flash flames.
Superficial partial thickness burns are similar to first-degree burns and are associated with sunburns.
Full thickness burns are similar to third-degree burns and are associated with direct flame, electric current, and chemical contact.
Injury from a flash flame is not associated with a burn that is limited to the epidermis.
Such procedure may worsen the tissue damage and lead to hypothermia in patients with large burns.
Ice must never be applied directly to a burn because it may worsen the tissue damage.
Chemical burns resulting from contact with a corrosive material are irrigated immediately.
Such procedures may worsen the tissue damage and lead to hypothermia in patients with large burns.
A foul odor or purulent infection may indicate infection and should be reported to the surgeon immediately.
The first dressing change usually occurs 3-5 days after surgery.
The first dressing change usually occurs 3-5 days after surgery.
Crackles in the lungs may indicate a fluid buildup indicative of congestive heart failure and pulmonary edema.
Pain at the allograft donor site is anticipated, since the nerve endings have been stimulated.
Sanguineous drainage at the allograft donor site is anticipated, since upper layers of tissue have been removed.
Decreased pain at the recipient site is anticipated since the wound has been protected by the graft.
Factors associated with increased fluid requirements include inhalation injuries, delayed resuscitation, scald burn injuries, high-voltage electrical injuries, hyperglycemia, alcohol intoxification and chronic diuretic therapy.
Chemical burn injuries are not associated with increased fluid requirements.
Low-voltage electrical injuries are not associated with increased fluid requirements.
Hypoglycemia is not associated with increased fluid requirements.
thus helping to decrease discomfort to the patient, decrease costs of dressing supplies, and decrease nursing time involved in burn dressing changes.
antimicrobial barrier dressings?Acticoat can be left in place for up to five days.
Acticoat antimicrobial barrier dressings can be left in place for up to five days.
antimicrobial barrier dressings can be left in?Acticoat place for up to five days.
is used to treat burns in which the depth is?TransCyte indeterminate or between superficial and deep partial thickness in depth.
is a temporary biosynthetic?BCG Matrix wound covering intended for use with partial-thickness burns and donor sites
is used to treat burns in which?TransCyte the depth is indeterminate or between superficial and deep partial thickness in depth.
is a temporary biosynthetic wound?BCG Matrix covering intended for use with partial-thickness burns and donor sites
Researchers have found that music affects both the physiologic and psychological aspects of the pain experience. Music diverts the patient’s attention away from the painful stimulus. Music may also provide reality orientation, distraction, and sensory stimulation. It also allows for patient self-expression.
Music diverts the patient’s attention away from, not toward, the painful stimulus.
Humor therapy has proven effective in the management of burn pain.
Pet therapy has not proven effective in the management of burn pain.
The most important intervention in the nutritional support of a patient with a burn injury is to provide adequate nutrition and calories to decrease catabolism. Nutritional support with optimized protein intake can decrease the protein losses by approximately 50%.
A marked increase in metabolic rate is seen after a burn injury; interventions are instituted to decrease metabolic rate and catabolism.
A marked increase in glucose demands are seen after a burn injury; interventions are instituted to decrease glucose demands and catabolism.
Rapid skeletal muscle breakdown with amino acids serving as the energy source is seen after a burn injury; interventions are instituted to decrease catabolism.
When a cataract is extracted, and an intraocular lens implant is not used, the patient demonstrates aphakia.
Scotoma refers to a blind or partially blind area in the visual field.
Keratoconus refers to a cone-shaped deformity of the cornea.
Hyphema refers to blood in the anterior chamber of the eye.
Chemosis is a common manifestation of pink-eye.
Papilledema refers to swelling of the optic disk due to increased intracranial pressure.
Proptosis is the downward displacement of the eyeball.
Strabismus is a condition in which there is a deviation from perfect ocular alignment.
The fraction 20/20 is considered the standard of normal vision.
Most people, positioned 20 feet from the eye chart, can see the letters designated as 20/20 from a distance of 20 feet.
The standard of normal vision, 20/20 means that the patient can read the 20/20 line from a distance of 20 feet.
In order to read the 20/20 line, the person of normal vision will be standing at a distance of 20 feet from the chart.
Acute angle-closure glaucoma results in rapid progressive visual impairment.
Normal tension glaucoma is treated with topical medication.
Ocular hypertension is treated with topical medication.
Cholinergics increase aqueous fluid outflow by contracting the ciliary muscle, causing miosis, and opening the trabecular meshwork.
Beta-blockers decrease aqueous humor production.
Alpha-adrenergic agonists decrease aqueous humor production.
Carbonic anhydrase inhibitors decrease aqueous humor production.
Refractive surgery is an elective procedure and is considered a cosmetic procedure (to achieve clear vision without the aid of prosthetic devices). It is performed to reshape the cornea for the purpose of correction of all refractive errors.
Refractive surgery will not alter the normal aging process of the eye.
Patients with conditions that are likely to adversely affect corneal wound healing (corticosteroid use, immunosuppression, elevated IOP) are not good candidates for the procedure.
The corneal structure must be normal and refractive error stable.
DLK is a peculiar, non-infectious, inflammatory reaction in the lamellar interface after LASIK. It is characterized by a white granular, diffuse culture-negative lamellar keratitis occurring in the first week after surgery. Studies suggest that since no single agent appears to be solely the cause of DLK, a multifactorial etiology is likely.
DLK occurs in the first week after surgery.
DLK occurs in the first week after surgery.
DLK occurs in the first week after surgery.
Photodynamic therapy includes the use of verteporfin, a light-activated dye. The dye within the blood vessels near the surface of the skin could become activated with exposure to strong light, such as sunlight or bright lights. Ordinary indoor light is not a problem. The patient should be counseled to wear protective clothing, such as long-sleeved shirts, sunglasses, and wide-brimmed hats, if the patient has to go outdoors during daylight hours in the first five days post-treatment. Inadvertent sunlight exposure can lead to severe blistering of the skin and sunburn.
The patient should avoid exposure to direct sunlight or bright lights for the first five days post-treatment.
The patient should avoid exposure to direct sunlight or bright lights for the first five days post-treatment.
The patient should avoid exposure to direct sunlight or bright lights for the first five days post-treatment.
Retinoblastoma can be hereditary or nonhereditary. It is hereditary in 30-40% of cases. All bilateral cases are hereditary.
Retinoblastoma is hereditary in 30-40% of cases.
Retinoblastoma is hereditary in 30-40% of cases.
Retinoblastoma is hereditary in 30-40% of cases.
Dizziness may be associated with inner ear disturbances.
Vertigo is the illusion of movement where the individual or the surroundings are sensed as moving.
Tinnitus refers to a subjective perception of sound with internal origin.
Nystagmus refers to involuntary rhythmic eye movement.
Otosclerosis is more common in females than males and is frequently hereditary.
A middle ear effusion is denoted by fluid in the middle ear without evidence of infection.
Chronic otitis media is defined as repeated episodes of acute otitis media causing irreversible tissue damage and persistent tympanic membrane perforation.
Otitis externa refers to inflammation of the external auditory canal.
Ossiculoplasty is performed to restore hearing.
Surgical repair of the eardrum is termed tympanoplasty.
Tympanotomy or myringotomy is the term used to refer to incision into the tympanic membrane.
Tympanotomy or myringotomy is the term used to refer to incision into the tympanic membrane.
Tympanoplasty may be necessary to repair a scarred eardrum.
A tympanotomy is an incision into the tympanic membrane.
A myringotomy is an incision into the tympanic membrane.
An ossiculoplasty is a surgical reconstruction of the middle ear bones to restore hearing.
In the Rinne’s test, the examiner shifts the stem of a vibrating tuning fork between two positions to test air conduction of sound and bone conduction of sound.
The whisper test involves covering the untested ear and, whispering from a distance of 1 or 2 feet from the unoccluded ear, and the ability of the patient to repeat what was whispered.
The watch tick test relies on the ability of the patient to perceive the high-pitched sound made by a watch held at the patient’s auricle.
Medical-Surgical Nursing Exam 17
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