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MEDICAL 2 POST CONFERENCE EXAMTest 1: Knowledge

1. The following are the health related behaviors that contribute markedly to the Cerebrovascular Disease except:

a. Poor Nutrition c. Lack of Physical Activityb. High Blood Pressure d. Tobacco Usec.

2. When handling a patient with CVD all but one are your nursing priorities:a. Promote adequate cerebral perfusion and oxygenationb. Assist patient in gaining independence in ADLsc. Prevent Complicationsd. None of the above

3. The most important independent nursing intervention in patients with CVD is:b. encourage patient to have adequate rest b. vital signs monitoringc. administration of oxygen d. administration of prescribed drugs

4. How do you position your patient with CVD?a. flat on bed c. moderate trendelenburg b. with head slightly elevated d. with head lower than the feet

5. What is the purpose of putting the patient with CVD in that position?a. reduces venous pressure, promoting venous drainageb. increases venous pressure, promoting venous drainagec. prevents rebleeding in case of hemorrhaged. all of the above

6. One the important instructions you should give to your patient is to avoid valsalva maneuver or avoid straining. Therefore you should encourage them to take fiber-rich foods all but one are examples of those:

a. Sweet potato c. Pineappleb. Guava d. Papaya

7. To prevent adduction of shoulder and flexion of elbow, what should the attending nurse do to her patient with CVD?

a. Place hand rolls in palms with fingers C. Place sandbags on under patient’s axillaB . Place pillow under patient’s axilla. D. Place foot board between patient’s arm

8. One of the nursing priorities you should observe when handling CVD patient is enhancement on their communication skills whenever there is speech deficit. All but one are your actions to be taken:

a. ask patient to write name in a short sentenceb. provide alternative methods of communicationc. use questions answerable by yes or nod. talk directly to patient use simple words and open-ended questions

9. When feeding patients with CVD you should start first with thick fluid or soft foods. All are examples of the desired foods except:

a. peanut butter c. eggb. custard d. applesauce

`10. What is the normal intracranial pressure?a. 10-30 mmHg b. 5-15mmHg c. 20-50mmhg d.15-21 mmHg

Test II: Application and analysis1. If a male client experienced a cerebrovascular accident (CVA) that damaged the hypothalamus, the nurse would anticipate that the client has problems with:a. body temperature control. b.balance and equilibrium. c.visual acuity. d.thinking and reasoning

2.. A female client admitted to the hospital with a neurological problem asks the nurse whether magnetic resonance imaging may be done. The nurse interprets that the client may be ineligible for this diagnostic procedure based on the client’s history of:a. Hypertension c. Heart failureb. Prosthetic valve replacement d. Chronic obstructive pulmonary disorder

3. The nurse is teaching family members of a patient with CVA about the early signs of increased intracranial pressure (ICP). Which of the following would she cite as an early sign of increased ICP?a. Decreased systolic blood pressure c. Headache and vomiting

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b. Inability to wake the patient and disorientation d. Dilated pupils that don’t react to light

4. What would be the MOST therapeutic nursing action when a client’s expressive aphasia is severe?A. Anticipate the client wishes so she will not need to talk B. Communicate by means of questions that can be answered by the client shaking the head C. Keep us a steady flow rank to minimize silence D. Encourage the client to speak at every possible opportunity.

5. Patient X was inserted with nasogastric tube for feeding. Which among the following is the most definitive approach in checking tube patency?

a. aspiration of gastric contents c. x-ray examination of tube placementb. Auscultation of gurgling sound d. dipping of tube end in water

6. Nurse Noy was feeding a patient via NGT. The nurse correctly performs NGT feeding in the following except:a. Placed patient in semi fowlers or high fowlers positionb. allow the blenderized feeding to flow not by gravityc. auscultate LUQ to check for tube patencyd. none of the above

7. A CVD patient was ordered with lactulose (duphalac) PO qHS. What is the rationale for giving lactulose to patients with CVD?

a. to reduce absorption of sal;t and fats in diet thereby lowering BPb. to reduce exertion during defecationc. to reduce excess fluids in the peritoneal cavity thereby lowering BPd. to reduce patient’s weight thereby making lifting and other nursing interventions more easier.

8. Ms. Arroyo is a stroke patient with a Nicardipine piggyback drip of 90cc PNSS mixed with 10cc Nicardipine. The physician ordered the Nicardipine piggyback solution to run @ 5cc/hr . The solution was run starting at 10 am in the morning of January 8, 2011. When will the solution be consumed?

a. January 8, 2011 @ 6pm c. January 8, 2011 @6amb. January 9, 2011 @6am d. January 9,2011 @6pm

9. The physician ordered Citicholine 500 mg IVTT stat. The drug is available at 250mg/ml in a 4 ml vial. How much should the nurse prepare?

a. 4 ml b. 2ml c. 3ml d. 1ml

10. What should be the rate of the IVF if the physician ordered PNSS 1 liter to consume in 12 hours using macroset?

a. 21 gtts/min b. 30 gtts/min c. KVO d. 45gtts/min

11. In planning care of a patient admitted to thoracic ICU with pneumothorax, the nurse should recognize that a opening in the chest wall- whether due to a deliberate surgical intervention or to a traumatic injury—causes the lung in that side to

a. expand due to the intake of atmospheric airb. collapse due to the disturbed negative pressue in the pleural spacec. expand due to altered pressures of the lungsd. collapse due to the disturbed positive pressure in the pleural space

12. The physician orders Cefuroxime 1gm IVTT q8h ANST. Prior to skin testing the nurse shoulda. incorporate 0.1cc of sterile water for injection and 0. 9cc of the medication in a 1cc syringeb. incorporate 0.9cc of sterile water for injection and 0.9cc of the medication in a 1cc syringec. incorporate 0.9cc of sterile water for injection and 0.1cc of the medication in a 1cc syringed. incorporate 0.1cc of sterile water for injection and 0.1cc of the medication in a 1cc syringe

13. How many hours will an IVF of PLR 1L be consumed if it is to run @ 125cc/hour?a. 2 hrs. b. 15 hours c. 8 hrs d. 10 hours

14. A client with diagnosis of Ischemic stroke is receiving aspirin therapy for 2 weeks. The nurse should be alert of symptoms of:

a. Urinary calculi C. Prolonged clotting timeb. Atrophy of the liver d. premature erythrocyte destruction

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15. The purpose of the water in the closed chest drainage chamber is to:a. Facilitate emptying bloody drainage from chestb. Foster removal of secretions by capillaryc. Prevent entrance of air into pleural cavityd. Decrease danger of sudden change of pressure in the tube

16. The nurse understands that hemiplegia involves:a. Paresis of both lower extremities c. Paralysis of both lower extremitiesb. Paresis of one side of the body d. Paralysis of one side of the body

17. A hemiplegic patient frequently loses calcium from the skeletal system. A factor that contributes to this is:a. Decreased activity c. inadequate production of calcitoninb. Inadequate kidney function d. inadequate fluid intake

18. The client is diagnosed with having expressive aphasia. The nurse anticipates that the client will have a difficulty with;

a. Following specific instructions c. Recognizing familiar objectsb. Speaking and/or writing d. Understanding speech

19. During a tube feeding, the observation that indicates that the client is unable to tolerate the next scheduled feeding would be:

a. Passage of flatus c. rapid flow of feedingb. A rise of formula in the tube d. a gurgling sound

20. The client is to receive 0.2mg of Digoxin IM. The ampule is labeled 0.5 mg= 2 mL. the nurse should administer:

a. 8 ml b. 0.8 ml c. 1 ml d. 1.2 mL21. The finding the nurse should consider unusual when performing an assessment of a client for increased

ICP;a. Seizures b. rapid pulse c. psychotic behavior d. nausea and vomiting

22. A physician writes orders for a client with increased ICP. The nurse should question the order that states:a. Administer osmotic diuretic c. administer laxativeb. Administer steroids d. place in trendelenburg

23. A client has sustained a bleed in the cerebellum due to CVD. In view of the organ, the nurse should expect:a. Absence of reflexes c. inability to execute voluntary movementsb. Unconsciousness d. inability to raise eyelids

III. ENUMERATION and IDENTIFICATION 1.-5. Give at least 5 independent nursing interventions for patient with CVD.6.-8. Enumerate 3 foods that you can give to CVD patient on swallowing therapy to prevent aspiration.9.-10. Give at least two diagnostic procedure to diagnose CVD.

ECG 12 LEADS11.__________________- 4TH intercostal space Left12. brown - _________________13. __________________ - 4th intercostal space Right14. violet- __________________15. black- ___________________16. ___________________ - midway between cardiac lead 2 and 4

MARK JOHNUEL DUAVIS, RNUBCN-2010