Mixed Deck — All AMSN Topics Flashcards

A patient with a draining wound has periwound skin breakdown from moisture. The nurse should apply which product to protect the surrounding skin?

Answer: Moisture barrier ointment or liquid skin protectant to the periwound area

Moisture barrier ointments or liquid skin protectants create a waterproof barrier over the periwound skin, preventing further maceration from wound exudate.

A patient returns from surgery for an open reduction and internal fixation (ORIF) of the femur. The nurse assesses the 5 Ps of neurovascular status. Which finding requires immediate intervention?

Answer: Pulselessness and pallor of the affected extremity

Pulselessness and pallor indicate arterial compromise or compartment syndrome, which are surgical emergencies requiring immediate action.

A patient with a recent ischemic stroke is on aspirin and clopidogrel (Plavix) dual antiplatelet therapy. The nurse's priority teaching includes:

Answer: Reporting unusual bleeding, bruising, or black tarry stools

Dual antiplatelet therapy significantly increases bleeding risk; patients must recognize and report signs of bleeding including GI bleeding (melena).

A nurse is caring for a patient with a dehisced abdominal wound healing by secondary intention with a wound VAC. The nurse understands that the primary goal of secondary intention healing is:

Answer: Gradual filling of the wound with granulation tissue from the base upward

Secondary intention healing allows wounds to fill from the base with granulation tissue; wound contraction and epithelialization occur over time without surgical closure.

In patients with Addison's disease, which hormone is deficient?

Answer: Cortisol

Addison's disease is a rare but serious condition characterized by the adrenal glands' inability to produce sufficient amounts of certain hormones. The most significant deficiency in Addison's disease is cortisol, a glucocorticoid vital for stress response, metabolism, and immune function. Aldosterone, a mineralocorticoid, may also be deficient, leading to electrolyte imbalances.

A patient with osteoporosis is starting alendronate (Fosamax). The nurse should instruct the patient to:

Answer: Take it with a full glass of water and remain upright for 30 minutes

Bisphosphonates like alendronate must be taken with a full glass of water, and the patient must remain upright for at least 30 minutes to prevent esophageal irritation and ulceration.

A patient is receiving negative pressure wound therapy (NPWT/VAC). The nurse notes the therapy has lost suction. The priority action is:

Answer: Inspect the dressing for air leaks, reinforce with foam and drape to restore seal

Loss of suction in NPWT is most commonly due to a dressing air leak; inspecting and reinforcing the seal restores therapeutic function without discontinuing treatment.

Which medication is commonly prescribed to manage chronic heart failure by reducing fluid overload?

Answer: Diuretics

Diuretics are commonly prescribed medications for patients with chronic heart failure because they help reduce fluid overload. These drugs promote the elimination of excess fluid and sodium through increased urine output, thereby decreasing congestion and symptoms like swelling and shortness of breath. This action helps to reduce the workload on the failing heart.

A patient with a hip replacement is being repositioned by the nurse. Which action should be AVOIDED to prevent hip dislocation?

Answer: Adducting the leg across the midline

After total hip arthroplasty, adduction beyond midline, extreme flexion >90°, and internal rotation are the three movements most likely to cause dislocation.

A patient recovering from acute tubular necrosis (ATN) is now in the diuretic phase. The nurse's priority is monitoring for:

Answer: Dehydration, hypokalemia, and hyponatremia from excessive urine output

During the diuretic phase of ATN, massive fluid and electrolyte losses (hypokalemia, hyponatremia) can lead to dehydration and hemodynamic instability.

A patient with gout is having an acute attack. Which dietary teaching is most appropriate?

Answer: Increase fluid intake and avoid purine-rich foods and alcohol

Adequate hydration promotes uric acid excretion; avoiding purines (organ meats, shellfish) and alcohol reduces uric acid production during a gout attack.

A patient is receiving IV phenytoin for seizure management. The nurse should monitor for which priority adverse effect?

Answer: Cardiac dysrhythmias

IV phenytoin administered too rapidly can cause severe cardiac dysrhythmias, including bradycardia and heart block.

A patient with a fractured hip is placed in Buck's traction pre-operatively. The PRIMARY purpose is to:

Answer: Reduce muscle spasm and pain while maintaining alignment

Buck's traction is applied pre-operatively to reduce painful muscle spasms and maintain alignment of the fractured hip until surgical repair.

A patient with a venous stasis ulcer on the lower leg is prescribed compression therapy. The nurse should apply compression wraps:

Answer: After assessing for arterial insufficiency — do not apply if ABIs are below 0.5

Compression is contraindicated in severe arterial disease (ABI <0.5); assessing ankle-brachial index (ABI) before applying compression prevents dangerous ischemia.

What is the recommended lifestyle modification for a patient with hypertension to reduce cardiovascular risk?

Answer: Engaging in regular physical activity

Engaging in regular physical activity is a cornerstone of lifestyle modification for managing hypertension and reducing overall cardiovascular risk. Exercise helps lower blood pressure, improve cholesterol levels, manage weight, and enhance cardiovascular health. This intervention is highly effective in preventing and controlling cardiovascular diseases.

A patient receiving IV patient-controlled analgesia (PCA) morphine is found with a respiratory rate of 7 breaths/min and is difficult to arouse. The nurse's priority action is:

Answer: Stop the PCA, administer naloxone (Narcan), and call for emergency assistance

Respiratory depression from opioid overdose is life-threatening and requires immediate PCA cessation, naloxone administration, and emergency response.

A patient is receiving a blood transfusion and develops chills, fever, and back pain 15 minutes after initiation. What is the FIRST nursing action?

Answer: Stop the transfusion and keep the IV line open with normal saline

Stopping the transfusion immediately while maintaining IV access with normal saline is the priority to prevent further exposure to incompatible blood products.

A patient with CKD receives erythropoietin (EPO) therapy. The nurse should monitor for which serious adverse effect?

Answer: Hypertension and thromboembolic events

EPO stimulates RBC production and can elevate hematocrit rapidly, increasing blood viscosity and the risk of hypertension, thrombosis, and stroke.

Which of the following dietary recommendations is most appropriate for a patient with irritable bowel syndrome (IBS)?

Answer: Low-FODMAP diet

For patients with irritable bowel syndrome (IBS), a low-FODMAP (Fermentable Oligo-, Di-, Mono-saccharides And Polyols) diet is often recommended and has strong evidence for symptom relief. FODMAPs are types of carbohydrates that can be poorly absorbed and fermented in the gut, leading to gas, bloating, and abdominal pain in sensitive individuals. Reducing their intake can significantly alleviate IBS symptoms.

A patient with a diabetic foot ulcer has a wound covered with a black, hard, leathery crust. The nurse recognizes this as:

Answer: Necrotic eschar that typically requires debridement to assess wound base

Black, hard eschar is necrotic tissue that prevents wound assessment and healing; debridement is generally required unless the wound is on a heel with good perfusion.