Comp study – NUR 280 Galen
187 test answers
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Good therapy for rheumatoid arthritis?
answer
music therapy
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Where is the tragus?
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a small cartilaginous flap in front of the external opening of the ear
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What is transphenoidal hypophysectomy?
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removal of pituitary gland through the nose
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What are the most significant risk factors for bladder cancer?
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Smoking and previous cancers
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Where to you auscultate to hear a bruit for a dialysis patient?
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At the AV fistuala (arteriovenous)
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Name a complication of thyroidectomy:
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Bleeding behind the neck.
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How to prepare a client for an MRI
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Wheelchair transporting and remove all metal
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MAOI inhibitiors are used for what?
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Depression and for HTN
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What foods to avoid with MAOI inhibitors?
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Tyramine containing ie: dried fruit, organ meats, red wine, cheese, alcohol
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MAOI inhibitors can cause?
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HTN crisis
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Mechanical Ventilators Low alarm means?
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Leak or disconnect, bag client
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Mechanical ventilators High alarm means?
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Dry or obstruction, suction client
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Symptoms of Addison's disease?
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Bronze, dehydrated, hyponatremia
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Complications of burns?
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dehydration - need fluid replacement
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What is used to reduce serum potassium in a renal patient?
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Kaexalate by mouth or retention enema or insulin and glucose IV
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Ketoacidosis s/s's
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Fruity breath, Kussmal's respirations
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Kussmal's respirations
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deep and rapid
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Type ___ diabetics can get ketoacidosis?
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2
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Internal radiation
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do not stand over pt's bed, visitors for 10 min, no pregnant or children (colds), limit time in room, call Nuclear department if become contaminated, nothing to leave room unless gone through scanner, food delivered by nurse, any vomit or excretions need to be handled special way, flush toilet three times after bathroom, WEAR BADGE, NO KID SITTING ON LAP
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Hepatitis preicteric phase s/s's
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N/V, RUQ pain
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Allen's test
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occlude both ulnar and radial artery until hand blanches then release ulnar. If the hand pinks up, ulnar artery is good and you can carry on with ABG
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Agranulocytosis
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The extreme reduction in the number of leukocytes or WHITE BLOOD CELLS in the blood.
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Trousseau's sign
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A sign of HYPOCALCEMIA . Carpal spasm caused by inflating a blood pressure cuff above the client's systolic pressure and leaving it in place for 3 minutes.
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What is a normal side effect of nitroglycerin therapy?
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Headache
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Incident reports
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are not charted in the nurses notes
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Smoke inhalation
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AIRWAY first
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16 year old and pregancy?
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assess how the patient feels 1st
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When to hold TPN?
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If temperature is elevated 101.0 F
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Borderline personality
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personality disorder characterized by instability in many areas, as mood, identity, self-image, and behavior, and often manifested by impulsive actions, suicide attempts, inappropriate anger, or depression and POWERLESSNESS
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What medications reduce the effectiveness of birth control?
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antibiotics such as AMPICILLIN, need another form
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What needs to be taken before dental work is performed after a total knee replacement has been done?
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Prophylactic antibiotics
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Do not what with a pressure ulcer?
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massage around the area
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Compartment syndrome
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injury caused when tissues such as blood vessels and nerves are constricted within a space as from swelling or from a tight dressing or cast, PAIN WITHOUT MOVEMENT under a cast, BAD
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A patient with shoulder pain who also has heart failure should be assessed _________.
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first
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What to do with a patient with decreased appetite related to s/s's of depression from diagnosis of Myasthenia Gravis?
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Admit to psychiatric unit
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Dilantin administration
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take with food, avoid antacids and milk
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Lithium administration
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take with milk and maintain sodium
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Foods to avoid with hypertension
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canned foods and soup, sodium
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Transdermal
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a method of administering medication through the unbroken skin via patch or ointment, DO NOT NEED PLASTIC COVER WITH SHOWERS
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Positioning for lumbar puncture
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supine (lay flat)
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Dietary status for Barium enema?
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NPO
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Can a family change the patient's organ donation wishes?
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YES, get the donation experts involved
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Cardiac catherization
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80 ml in 3 hours is TOO LOW
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PEG tube
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A feeding tube inserted through the stomach wall; Used to provide nutrition to pt's who can't feed themselves; Not used when pt. cant' digest and absorb - parenteral (IV) feeding is used no CRANBERRY
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Walker
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Do not use for support
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When are eye exams needed every year?
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After age 65
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Breast Cancer
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\"my life won't be the same\"
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calcium oxalate
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what kidney stones are made from, AVOID CAFFIENE
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what can a 2 month old baby do?
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laugh
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How often should a pacemaker battery be changed?
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every year
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Do not shoot a gun on the side that a what is?
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pacemaker
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What kind of room should a pt with suspected TB be placed in?
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Negative airflow private room
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What will be auscultated in a patient with left sided heart failure?
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crackles
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What kind of precautions are necessary for herpes?
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Contact/airborne
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What medication should be avoided when also taking Coumadin?
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NSAIDS
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What changes should be avoided with Lasix?
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Quick position changes
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What side should you approach a stroke patient on?
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the unaffected side
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What kind of milk can a 1 year old drink?
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whole (vit D)
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Gingival Hyperplasia
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an enlargement of the gums frequently seen in pregnancy, in leukemia, or after prolonged use of phenytoin (Dilantin)
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Dilantin normal range
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10-20, anticonvulsant
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Hepatic encephalopathy
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clinical: complication of liver failure, disturbance in consciousness, seizures, asterixis, rigidity and hyperreflexia, also DECREASED PROTEIN and CRAZY MOVEMENT
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safe lifting
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Lift from knees, don't bend back, UP TO HIP (teaching is needed)
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Post thyroidectomy tingle around mouth what drug helps?
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calcium gluconate
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calcium gluconate
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given IV to correct hypocalcemia
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diabetes insipidus
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a rare form of diabetes resulting from a deficiency of vasopressin (the pituitary hormone that regulates the kidneys) characterized by the chronic excretion of large amounts of pale dilute urine which results in DEHYDRATION and extreme thirst
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A food tray is considered what?
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a restraint
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Need further teaching for a transfussion reaction of the nurse does what?
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discards the tubing in a waterproof bag
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What should be avoided with a person with calculi?
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caffiene (cola or coffee)
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Chron's disease
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inflammatory disease, occurs anywhere in the GI tract, most often effects terminal ileum, frequent remissions/exacerbations LOW RESIDUE DIET (no fruit), BLAND
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A patient needs to follow up after surgery if what appears on the body?
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rashes all over
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At risk for slander if patient is
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my neighbor
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Monitor what if C7 injury?
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Pulse pressure
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If BP is 156/98 what should the nurse do first?
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raise the HOB up
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What equipment is needed for contact isolation?
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Gown and gloves
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Does the LPN talk to the families?
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NO
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What patient needs a room immediately?
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Had TB test with 10mm raised area at site
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What does a normal stoma look like 8 hrs after surgery?
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red, moist just document d/t normal finding
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tylenol does not contain
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aspirin
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zithromax does not contain
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penicillin
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informed consent is not accepted when?
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after medication has been taken (alters mental status)
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Babinski
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infant reflex that causes toes to fan out when soles of feet are touched, babies have positive sign UNTIL YEAR 1
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Guillian Barre
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ascending paralysis. Keep eye on respiratory system.
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Plasmapheresis
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plasma is separated from whole blood and the rest is returned to the donor used with GUILLIAN BARRE SYNDROME
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When thinking about delegation, what task is everyone responsible for?
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SAFETY
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False imprisonment
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restraining an individual or restricting an individual's freedom a LAP BAND OR A TRAY on a GERIATRIC PATIENT
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Post cardiac cath care
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bed rest, don't move legs for 4-6 hours (bleeding)
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S/s of partial seizure
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picking at clothing, lip smacking
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Celiac disease
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a disorder in children and adults, a disorder in children and adults inability to tolerate wheat protein (gluten); symptoms include foul-smelling diarrhea and emaciation; often accompanied by lactose intolerance
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What kind of procedure is tracheostomy care?
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Sterile
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What position for pneumonectomy?
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place on operative side
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VRE precautions
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Contact precautions
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Name airborne precaution diseases
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My (measles), Chicken (Varicella), Hez (Rubeola), TB
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HIV
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avoid bird droppings, soil, cat litter
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Toxoplasmosis
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protozoan (parasitic) infection associated with AIDS. Produces pneumonitis, hepatitis, and encephalitis
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What signs show a patient is already dead?
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unconsious, pulseless, dilated pupils
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How are wounds cleaned?
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inner to outer (to prevent spread of infection)
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What medication is initially prescribed for Rheumatoid arthritis?
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NSAIDS
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5 month old infant can do what?
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no head lag and rolls prone to back
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normal 2 year old BP
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100/60
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Cleft lip teaching
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provide frequent rest periods during feedings
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Guillian Barre is a disease with _________ progression.
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rapid
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Guillian Barre can cause
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neuromuscular respiratory failure
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Example of negligence in nursing
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telling a suicidal bipolar patient that it is okay for them to refuse their medication
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Example of battery in nursing
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placing hands on a client who said, \"don't touch me\"
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Vomiting and diarrhea for an HIV patient is emergent or non emergent?
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Non emergent
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A patient with abd pain who is 6 weeks pregnant could be experiencing what life threatening event?
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eptopic pregnancy
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What kind of sputum is expected after bronchoscopy?
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blood tinged
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How long is a mild to severe headache after lumbar puncture expected?
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hours to days
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Automatism
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any reaction that occurs automatically without conscious thought or reflection (especially the undirected behavior seen in psychomotor epilepsy)
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Normal after indewlling cath is removed
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dribbling, urinary frequency and burning
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Elevate stump after amputation for how long to prevent what?
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1st 24 hours, prevention of hip or knee flexion contracture
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Why put pneumonectomy pt on operative side?
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to promote lung expansion of unaffected lung
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Car seat postion for baby?
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rear facing in back middle seat until 20 lbs
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Under 12 car position?
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in back
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Protective precautions
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barrier protection designed to prevent infection in clients who are severely compromised and highly susceptible to infection; also known as reverse isolation. low WBC's
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HIV patient precautions
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increase protein intake, no birds, no crowds, no gardening
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When does a baby get solid foods?
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6 mths of age
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What solid foods are introduced when and how?
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rice cereal first then add fruits, veggies, meats. one per week, solids are to be pureed
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No honey for infants why?
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botulism
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What kind of toy for toddler with thrombocytopenia?
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stuffed toy
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What kind of toy for preschooler with thrombocytopenia?
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finger paints
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Thrombocytopenia
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a bleeding disorder characterized by an abnormal decrease in the number of platelets in the blood, which impairs the clotting process, RISK FOR BLEEDING - don't want patient injured
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Expected in ulcerative colitis?
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10 - 20 bloody stools per day
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Cleft lip instructions
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feed upright, prone, no pacifiers, rest after each swallow, risk for aspiration
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Freud phallic stage is what ages?
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3-6
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Oedipus complex
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A boy's sexual desires toward his mother and feelings of jealousy and hatred for the rival father
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Coarction of the aorta
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constriction or narrowing of the aortic arch or of the descending aorta **classic Sx: marked difference in the blood pressure and pulses of the upper and lower extremeties**
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What is not expected with coarction of the aorta?
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high pitched murmur
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What IS expected with coarction of the aorta?
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no femoral pulses, weight loss, increased BP in upper extremities
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Acyanotic defects cause
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tachycardia, tachypnea, delay in growth and development
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Cyanotic defects cause
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poor reflexes, bradycardia and fainting
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Acellular pertussis vaccine
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less side effects vs whole cell, a vaccine that uses proteins from the microorganism rather than the whole cell to stimulate the process of active immunity.
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What does an infant have if they have an olive shaped mass on their abdomen?
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Pyloric stenosis
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pyloric stenosis
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narrowing of the pyloric sphincter that blocks the passage of food from the stomach into the duodenum, projectile vomiting
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Hirschsprung's disease
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caused when parasympathetic innervation that causes normal peristalsis to a portion of colon is absent, results in abd obstruction and distention of bowel, FOWEL, RIBBON LIKE STOOL
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AIDS patient given Zidovidine what should be assessed?
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CBC, hepatic & renal studies
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Order of assessment for abdomen?
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Inspection, auscultation, palpation, percussion
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What is the antidote for Heparin?
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Protamine sulfate
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Hindu faith death practices
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only family members touch the body
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Patient taking Lithium snack options
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tuna fish salad on saltine crackers (need sodium)
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What electrolyte is needed for a patient taking digoxin or Bumex (bumetanide) or Torsemide (Demadex)?
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Potassium
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Potassium containing foods
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avacado, grapefruit
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What culture, gender and age is ulcerative colitis common in?
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Jewish, male, 30 - 50
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What position should a patient with ulcerative colitis be in after eating?
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laying flat
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How to detect correct placement of nasogastric tube other than an xray?
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30 cc of air, not fluid
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Clear liquid
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broth, bouillon, fruit juices, jello, ice, hard candy, popsicles NOT ORANGE JUICE
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Typical amt of penicillin prescribed for a child?
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50 mcg/kg/day
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Who should sickle cell children avoid?
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children with infection
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Sign of suicidal ideation?
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giving away personal belongings
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When should antacids be administered? and what should they not be administered with?
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1-3 hrs after meals, Iron
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What is NOT given for macular degeneration?
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Vitamin B6
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congenital hypothyroidism
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Babies lack a thyroid hormone. Can cause poor growth or mental retardation, can be treated medically. COMMON TO SLEEP 6 HRS AT A TIME
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Do not induce vomiting in what kind of poisoning?
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chemical ingestion
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Avonex
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interferon beta-1A (Multiple Sclerosis Agent)
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Meniere's disease
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a disease of the inner ear characterized by vertigo, nerve deafness, and a roar or buzzing in the ear, EXCESS FLUID IN EAR
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Meniere's disease teaching
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low salt diet, avoid stress
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glaucoma
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progressive visual impairment, loss of peripheral vision
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macular degeneration
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loss of central vision
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EEG preparation
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Not NPO, no caffeine before test
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Blood patch
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A procedure in which a cerebrospinal fluid leak is closed by means of an injection of the patient's blood into the area used during spinal anesthesia
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What foods should be avoided with oxalate kidney stones?
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spinach and rhubarb and Vit C foods
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Age highest risk for testicular cancer?
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15-35 years
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Ego vs. despair
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Erikson 8: final challenge of life where people try to achieve wisdom, spiritual tranquility, and acceptance of their lives OVER 65 YEARS OF AGE
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Sustained release (SR)
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do not crush
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Fibromyalgia
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sleep pattern disturbance
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Myelogram
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X-ray of the spinal column using contrast medium, patient needs to be HYDRATED FOR AT LEAST 12 hours PRIOR to test
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What topical agent is used for soft tissue injury?
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Aloe Vera
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Herbal remedy for depression
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St. John's Wart
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How to hold a cane?
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on unaffected side, move with affected extremity
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Brethine
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Terbutaline. stops pre term labor and for asthma, watch for TACHYCARDIA, may decrease k
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Order for rescussitation
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Verify unresponsiveness, call 911, chin lift
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RACE
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rescue, alarm, contain, extinguish
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Cocaine user will have these expected findings
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increased heart rate, decreased respirations, hallucinations
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What kind of foods should be provided for a bipolar patient in the manic stage?
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finger foods (small attention span)
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Elavil teaching
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take with food, dry mouth expected, use sunscreen
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Major depression new admission do first
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search belongings for sharps
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If patient gets fever and chills while getting a blood transfussion what should the nurse do?
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STOP, means reaction
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How long are TB drugs taken and with what?
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9-12 mths, food
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Kids should never have a pulse ox of less than what?
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95
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After 2 weeks on a ventilator what is needed?
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trach, frequent oral care
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Cystic fibrosis patient needs what with every meal?
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pancreatic enzymes
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First action for MI?
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nitro under tongue
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Patient with hypothyroidism who is also having palpitations and is jittery?
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Hold medication
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