FREE CMSRN Medical-Surgical Nursing Trivia Questions and Answers
Which medication is contraindicated in a pregnant patient, as far as the perianesthesia nurse is aware?
A suitable drug schedule that includes, but is not limited to, preventive measures, little deviations from the regular schedule
For the treatment of angina pectoris, a patient has been given a prescription for sublingual nitroglycerine. What action taken by the client demonstrates that he is aware of a crucial aspect of this medication?
Explanation:
When exposed to light and heat, nitroglycerine gradually loses its effectiveness, so I always have a tiny, labeled case with a few of the pills with me. The tablets need to be stored in a dark, dry, and cool environment. Tablets should be taken 5 minutes apart; taking more than one pill at a time might actually reduce the effectiveness of the medication and may even result in severe hypotension. Customers should purchase fresh bottles every 6 months, and they should store them in a cold environment.
The nurse is taking care of Mrs. Dela Rosa, a 47-year-old Filipina woman who underwent coronary artery bypass graft (CABG) surgery on the third postoperative day. What is the optimal nursing strategy given that an important nursing diagnosis for post-CABG clients is an inadequate breathing pattern?
Explanation:
For these individuals, incentive spirometry and deep breathing are the go-to lung expansion methods. It is not recommended for post-CABG patients to cough vigorously since it could increase intrathoracic pressure and lead to sternal instability. Premedication before walking will promote activity intolerance rather than an effective breathing pattern; auscultating the lungs will identify atypical lung sounds brought on by an ineffective breathing pattern but this is not a method to promote an effective breathing pattern.
A twelve-year-old boy diagnosed with autism and sickle cell disease has had an inguinal hernia repaired. The anesthesia nurse is aware that this patient's primary surgical risk is:
"In this case, hypoxia from anesthesia is the greatest surgical risk for a 12-year-old patient with known sickle cell disease and autism who is having an inguinal hernia repaired.
Abnormal red blood cells with a sickle shape are the hallmark of sickle cell disease. These cells can clog blood vessels and restrict the amount of oxygen that reaches organs, a situation known as hypoxia. Stress, dehydration, and hypoxia can cause sickle cell crisis, which can occur during surgery. Because anesthesia lowers oxygen saturation levels and suppresses respiratory function, it can increase this risk even further."
A veteran of the Gulf, Mr. Smith, 53, received a PTCA (percutaneous transluminal coronary angioplasty). When the nurse looked over his chart four hours after the surgery, she saw that neither his vital signs nor the catheter had changed since he had returned. A 12-lead ECG is obtained by the nurse, who observes that the client exhibits ST depression. Chest discomfort is denied by Mr. Smith. Which of the following should the nurse do as her next move?
Explanation:
ST depression should be reported to the doctor right away because they are a symptom of ischemia. The nurse should continue to check the client for chest pain after taking this first step, which is the best course of action.
Based on ECG alterations, the doctor has determined that Mr. Stanford, a 67-year-old retired college professor who collapsed in his front yard and was taken to the emergency room, had a myocardial infarction. Mr. Stanford is being routinely evaluated by the nurse, who observes that he frequently forgets what the ECG and non-invasive blood pressure monitors are for. Which of the following best explains Mr. Stanford's response, according to the nurse?
Memory lapses are common with clients experiencing myocardial infarction
Intern Jane, age 24, was identified as having mitral stenosis. The nurse may discover the following in addition to hearing a murmur during the physical examination:
Explanation:
The left atrium grows larger as a result of mitral stenosis, which eventually raises pulmonary pressure and causes jugular vein distention. Aortic valve anomalies are linked to dyspnea upon exercise and syncope upon exertion. Aortic stenosis is related to angina.
When preparing to discharge a patient who has undergone six units of subcutaneous recombinant human insulin (humulin), the perianesthesia nurse notes that the following will be the patient's peak action:
When ordinary recombinant human insulin (Humulin) is injected subcutaneously, its maximal effect usually happens one to five hours later. In contrast to other insulin formulations, which exhibit a rapid onset of peak action, this time frame represents the delayed onset of action. As a result, it's critical to consider this peak action time for efficient blood glucose management while discharge planning.
Continuous ECG monitoring for a patient at a hospital reveals that the rhythm has altered to ventricular tachycardia. What should the nurse do first out of the options below?
Explanation:
Assessing the client's degree of consciousness and determining whether the ventricular tachycardia is perfusing the body are the best first steps. An ACLS-certified nurse administers urgent defibrillation for pulseless ventricular tachycardia. The nurse may deliver lidocaine as directed or, in some circumstances, give the client a precordial thump if they have good blood pressure and pulse, are awake, and are alert.
The central venous pressure (CVP) of a patient who has congestive heart failure and acute pulmonary edema is continuously monitored. Which of the following describes a successful treatment plan for the client?
Explanation:
One of the therapeutic aims for this client is to reduce fluid in the vascular space, which is shown by a decrease in central venous pressure. Greater central venous pressure denotes greater fluid in the vascular space, which is not the desired outcome.
One week prior to a patient's operation. During the patient's physical examination and history, acute bronchitis was identified. The ideal course of action for a perianesthesia nurse is:
Because acute bronchitis can raise the risk of perioperative complications, alerting the surgeon is essential. Depending on the patient's state, the surgeon must determine whether to perform the surgery now, postpone it, or administer antibiotics.