“Medical Surgical Nursing Review Questions” plus 1 more nursing article(s): NursingCrib.com Updates

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Medical Surgical Nursing Review Questions Posted: 30 Oct 2010 11:00 PM PDT December 2010 Nursing Board Exam Practice Test on Medical Surgical Nursing. Mark the letter of your choice then click on the next button. Your score will be posted as soon as the you are done with the quiz. We will be posting more of this soon. If you want a simulated Nursing Board Exam, get a copy of our Nursing Board Exam Reviewer v1.0 and v2 now. 1. The nurse discusses to the nursing students on duty about colostomy. If sigmoid colostomy is done, what type of feces would the students expect to be expelled? a. Mushy b. Fluid c. Formed d. Semi-mushy 2. Upon assessment the nurse notes that the client has a deep vein thrombosis (DVT). The client asked what might have caused it. The nurse enumerated the causes of the thrombus formation by saying that a Virchow's triad are the following except: a. Venous stasis b. Homan's sign c. Vessel wall injury d. Too much blood coagulating ability 3. One of the collaborative management for DVT is an anticoagulant therapy. The antidote for heparin is: a. Coumadin b. Vitamin K c. Protamin sulfate d. Succimer 4. During the lecture-discussion in a nursing university, the clinical instructor focused on peripheral vascular disorders. Included in this disorders is a disease causing arterial vasospasm in the fingers when exposed to cold which is called: a. Aneurysm b. Raynaud's disease c. Buerger's disease d. Cold stress 5. A nurse is conducting a health teaching on thrombophlebitis. The most effective action to prevent thrombophlebitis after a vein surgery is done is to do which of the following: a. Elevating the leg when lying or sitting b. Compression with elastic bandage c. Allying pressure on the site d. Early ambulation 6. A client is diagnosed with a heart failure. The nurse keeps in mind that a special consideration of what laboratory value should be carefully monitored if a patient is on digitalis therapy (Digoxin). a. Serum Potassium b. BUN and creatinine c. Heart Rate d. Calcium 7. A potassium sparing diuretic is prescribed to a patient with heart failure. Which of the following drugs is a potassium-sparing diuretic? a. Furosemide b. Triamterene c. Diuril d. Bumex 8. Mr. B is on chest tube. A three way bottle system is used. The patient is asking what should be observed on the bottle at the middle (water seal). The nurses best response is: a. "The bottle at the middle should have an intermittent bubbling." b. "The bottle at the middle should have a continuous bubbling." c. "No bubbling should be seen on that bottle. Please call me immediately if you observe bubbling in it." d. "Just be sure all the bottles are not bubbling." 9. As the nurse is administering medications to Mr. B, he again inquired about his chest tube. He was asking what possible reason would cause "no bubbling" on the suction bottle. The nurse's best response is: a. It is caused by an electrical fluctuation. b. It is just a normal observation for a suction bottle. c. It is caused by too much water on the suction bottle. d. It is caused by the overexpansion of the lungs. 10. Mr. B is scheduled for chest tube removal. During the tube withdrawal, which is vital to prevent the entrance of air in the tube? a. Observe patient for signs of distress. b. Clamp the tubes. c. Instruct the patient to exhale forcefully with a closed mouth or pinching the nose. d. Encourage the client to perform arm exercises. 11. Cancer surgery is an example of what operation type basing on the time it is required to be performed? a. Optional surgery b. Imperative surgery c. Emergency surgery d. Elective surgery 12. Hysterectomy is the removal of the uterus. It is what type of surgery based on its purpose? a. Ablative b. Diagnostic c. Constructive d. Exploratory 13. Preoperative teaching least likely includes: a. Deep breathing exercises b. Extremity exercises c. Nutritional status d. Purse-lip breathing 14. At what stage of anesthesia administration does a client is observed to be unconscious? a. First stage b. Second stage c. Third stage d. Fourth stage 15. The main goal after a surgery is: a. Promotion of wound healing b. Promotion of adequate respiratory function c. Promotion of adequate cardiac function d. Promotion of adequate fluid and electrolyte balance 16. Open wound healing that requires regeneration of much more tissue that at times may require grafting is healing by: a. Primary intention b. Dehiscence c. Tertiary intention d. Secondary intention 17. The following are risk predictors of decubitus ulcers except: a. Friction b. Activity c. Moisture d. Thrombophlebitis 18. Which of the following hormone increases calcium deposition in the bones? a. Calcitonin b. Thyroxine c. Parathormone d. Tyrosine 19. Which of the following is done for the management of pain in myocardial infarction? a. Rest b. Administering nitroglycerine c. Administering Mefenamic Acid d. Administering Demerol 20. A client has a diagnosis of right-sided heart failure. You expect to note which manifestations during assessment and work-up: a. Coughing b. Ascites c. Hemoptysis d. Dyspnea 21. A hypertensive client has been prescribed with Apresoline. What drug classification does this drug belong? a. Diuretics b. Beta blockers c. Vasodilator d. Calcium channel blocker 22. Upon reading the client's chart, Verapamil (Calan) is also prescribed for the client. This drug is an antihypertive that specifically is classified as: a. Diuretics b. Beta blockers c. Vasodilator d. Calcium channel blocker 23. A 33 year old male client enters the clinic with complaints of pain at the calf muscle. He said that pain aggravates when he ambulates or walks. You expect this disorder to be an: a. Arterial disorder b. Hypertension c. Venous disorder d. Raynaud's disease 24. Buerger's disease or thromboangitis Obliterans commonly affects: a. Medical professionals b. Smokers c. Adolescents d. A and B 25. A client was admitted in the ER with profuse bleeding due to a vehicular accident. You expect what type of shock will occur in this client if prompt treatment is not implemented? a. Cardiogenic b. Neurogenic c. Anaphylactic d. Hypovolemic Related posts: Nursing Board Review: Medical Surgical Nursing Practice Test Part 1 Nursing Board Review: Medical Surgical Nursing Practice Test Part 2 Maternal and Child Health Nursing Review Questions Part 1

Galactosemia Posted: 30 Oct 2010 09:35 PM PDT Galactosemia Definition Galactosemia is an inherited carbohydrate metabolism disorder.  This metabolic disorder is characterized by the abnormal levels of galactose in the blood (galactosemia) and in the urine (galactosuria). People with this disorder are unable to breakdown the simple sugar galactose to glucose. Incidence This inborn error of metabolism occurs 1 in every 60,000 births. Higher incidence rate is noted in Ireland with about 1 case in every 20,000 population. It is less common in Asian people. Causes Galactosemia follows an autosomal recessive mode of inheritance that is typified by the absence or deficiency of any of the three enzymes that are involved in galactose to glucose conversion which are: Galactokinase – uncommon Galactose 1-phosphate uridyltransferase or GALT – most common deficiency Uridine diphosphate (UDP)-galactose4-epimerase or GALE – uncommon Physiology Galactose, a type of sugar, has to be converted to glucose before it can be used by the body. Lactose, the sugar found in milk, is normally broken down into galactose and glucose. 1. Galactokinase (GALK) converts galactose to galactose 1-phosphate. 2. Galactose 1-phosphate uridyltransferase (or GALT) converts galactose 1-phosphate to UDP galactose. It also converts UDP glucose to glucose 1-phosphate. 3. Finally, Uridine diphosphate (UDP)-galactose 4-epimerase (or GALE) converts UDP galactose to UDP glucose to be used by the body. To summarize, the order of galactose conversion in its metabolic pathway in relation to the enzymes it encounters starts with GALK then GALT and finally GALE. Types of Galactosemia Type 1 – characterized by absence of the liver enzyme GALT. It is termed as the classic galactosemia. This is the most common type. People with absent or deficient GALT have intolerance to galactose. Type 2 – characterized by the absence of the enzyme Galactokinase (GALK). It is called as galactokinase deficiency. Type 3 – characterized by absence of the enzyme GALE. This form of galactosemia is termed as UDP-Galactose-4-epimerase deficiency. Pathophysiology Absence or deficiency of galactose 1-phosphate uridyltransferase (GALT) prevents the conversion of galactose into glucose. When an infant or neonate is given milk (formula milk or breast milk), the substances made from galactose builds up in the bloodstream (galactosemia) and spills into the urine (galactosuria). These can cause severe damage to the eyes, kidneys, liver and brain. Diagnosis Beutler's test – a screening test used to analyzed the cord blood if a child is known to be at risk for the disorder. Newborn Screening Test – a heel puncture test done in newborns. Clinical Manifestations The symptoms begin to appear when the neonate is started on formula feeding or breastfeeding. Lethargy Hypotonia Diarrhea Vomiting The symptoms start abruptly and develop rapidly leading to further manifestations: Hepatomegaly – liver enlarges Persistent jaundice Bilateral cataracts Brain damage Ascites – fluid in the abdomen Galactosuria – galactose in urine Untreated neonates may die by 3 days of age. Those who survived beyond the untreated 3 days may have bilateral cataracts and will be cognitively challenged. Management Early detection prevents fatal complications. Timely identification and management of galactosemia prevents brain damage.  Any neurologic or cataract damage present before the treatment will persist. Galactose-free diet for life Milk substitute such as casein hydrolysates (Nutraminogen) image from learn.genetics.utah.edu, nlm.nih.gov Related posts: Phenylketonuria (PKU) Fasting Plasma Glucose Thrombin Time Test

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