Medical-Surgical Nursing Flashcards

A patient with COPD is receiving oxygen therapy at 2 L/min via nasal cannula. What fraction of inspired oxygen (FiO2) does this approximately deliver?

Answer: 28%

With nasal cannula, each 1 L/min increase in flow rate increases FiO2 by approximately 4% above room air (21%). At 2 L/min: 21% + (2 × 4%) = 29%, typically approximated as 28%. This provides supplemental but not high-concentration oxygen.

The nurse is caring for a patient with a spinal cord injury at T4. Which complication should the nurse monitor for most closely?

Answer: Autonomic dysreflexia

Autonomic dysreflexia is a life-threatening complication in spinal cord injury at T6 or above, caused by uncontrolled sympathetic response to stimuli below the injury level (e.g., full bladder). It causes severe hypertension, bradycardia, and can lead to stroke or death.

A patient is prescribed warfarin for atrial fibrillation. What is the target INR range for this indication?

Answer: 2.0–3.0

For non-valvular atrial fibrillation, the therapeutic INR range for warfarin is 2.0–3.0. This range balances adequate stroke prevention against bleeding risk. A higher range (2.5–3.5) is used for mechanical heart valves.

A nurse is caring for a patient with nephrotic syndrome. Which finding is the hallmark feature of this condition?

Answer: Massive proteinuria (>3.5 g/day)

The hallmark of nephrotic syndrome is heavy proteinuria (>3.5 g/day) due to increased glomerular permeability to proteins. This leads to hypoalbuminemia, generalized edema (anasarca), hyperlipidemia, and lipiduria.

A patient develops hypersensitivity reaction after receiving penicillin. Which drug class should the nurse flag as potentially cross-reactive?

Answer: Cephalosporins

Penicillins and cephalosporins share a beta-lactam ring structure, and cross-reactivity can occur in patients with penicillin allergy. The risk is approximately 1–2%. Carbapenems also carry a small cross-reactivity risk.

The nurse is preparing to administer a unit of packed red blood cells (PRBCs). Which solution should be used to prime the IV tubing?

Answer: Normal saline (0.9% NaCl)

Only normal saline (0.9% NaCl) should be used with blood products. Dextrose solutions cause red blood cell clumping (agglutination), and lactated Ringer's solution contains calcium that can cause clotting. Normal saline is isotonic and compatible with blood.