English in Nursing: Case Studies

By Irena Baumruková

The book, English in Nursing, contains 1,113 casuistics. The students will try to fill in suitable English terms and check their solutions in the key at the end of the textbook. All texts are short, understandable, and always contain the right answer (marked with ?), which makes them suitable for self-study and testing the nurses professional knowledge at the same time.

• Language: English
• Publisher: Xlibris UK
• Release date: Oct 18, 2017
• ISBN: 9781543487244

Irena Baumruková

The author has been teaching medical English for more than fifteen years. She would like to draw the readers’ attention to other materials published to help physicians, dentists, dental hygienists, medical students, paramedics, and nurses to learn professional English in an interesting and pleasant way.

Book preview

Copyright © 2017 by Irena Baumruková.

ISBN:      Softcover      978-1-5434-8725-1

      eBook         978-1-5434-8724-4

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Any people depicted in stock imagery provided by Thinkstock are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

Rev. date: 10/11/2017

Xlibris

800-056-3182

www.Xlibrispublishing.co.uk

750240

Contents

Preface

Bibliography

Part 1

Unit 1

1. Miscellaneous conditions

Vocabulary 1

Unit 2

Musculoskeletal system

Vocabulary 2

Unit 3

Cardiovascular system

Vocabulary 3

Unit 4

Respiratory system

Vocabulary 4

Unit 5

Nervous system

Vocabulary 5

Unit 6

Gastrointestinal system

Vocabulary 6

Unit 7

Urinary system

Vocabulary 7

Unit 8

Endocrine system

Vocabulary 8

Unit 9

Reproductive system

Vocabulary 9

Unit 10

Pregnancy

Vocabulary 10

Unit 11

Obstetrics

Vocabulary 11

Unit 12

Paediatrics

Vocabulary 12

Unit 13

Mental problems

Vocabulary 13

Part 2

Unit 1

Nursing care of the adult

Vocabulary 1

Unit 2

Nursing care of the childbearing family.

Vocabulary 2

Unit 3

Nursing care of the child

Vocabulary 3

Unit 4

Nursing care of the client with psychosocial and mental health problems.

Vocabulary 4

Subject index

Key to case studies

Preface

The book English in Nursing contains 1113 casuistics. The students will try to fill in suitable English terms and check their solutions in the Key at the end of the textbook. All texts are short, understandable and always contain the right answer (marked with ◄), which makes them suitable for self-study and testing the nursesʼ professional knowledge at the same time.

The first part is divided into 13 units. You can find casuistics on these topics there: miscellaneous conditions; musculoskeletal system; cardiovascular system; respiratory system; nervous system; gastrointestinal system; urinary system; endocrine system; reproductive system; pregnancy; obstetrics; paediatrics; mental problems.

In the second part there are four units. The cases in the first unit Nursing care of the adult cover the following topics: cardiopulmonary arrest; congestive heart failure; circulatory problems; chronic obstructive pulmonary disease; pneumonia; tuberculosis; peptic ulcer disease; appendicitis; cholecystitis; pancreatitis; hepatitis; oesophageal varices; hepatic coma; acromegaly; hyperpituitarism; thyroidectomy; diabetes mellitus; hypofunction of the adrenal glands; elimination; urinary tract infection; benign prostatic hypertrophy; ulcerative colitis; bowel obstruction; colostomy; cancer of the rectum/colon; diverticulitis; cerebrovascular accident; spinal cord injury; burns; Parkinsonʼs syndrome; multiple sclerosis; seizure dissorders; myasthenia gravis; vision and hearing problems; cataract extraction; glaucoma; epistaxis; cancer of the larynx; mobility; fractures; fractured hip; amputation; arthritis; spinal fusion; cellular aberration; cancer prevention; cancer treatment; Hodgkinʼs disease.

The second unit "Nursing care of the childbearing family" deals with: antepartal care; normal childbearing; high-risk childbearing; abortion; incompetent cervical os; ectopic pregnancy; placenta praevia; abruptio placentae; pregnancy-induced hypertension; diabetes; cardiac disorders; adolescent pregnancy; intrapartal care; normal childbearing; emergency birth; caesarean delivery; induction; postpartal care; normal childbearing; postpartum haemorrhage; drug addiction and hepatitis; mastitis; normal newborn.

The third unit Nursing care of the child contains casuistics concerning: sensation; perception; protection; tonsillitis; meningitis; pinworms; cerebral palsy; burns; Down syndrome; spina bifida; seizures; oxygenation; bronchiolitis; airway obstruction and tracheostomy care; asthma; sicle cell disease; haemophilia; tuberculosis; congenital heart disease; nutrition and metabolism; dehydration; cleft palate; pyloric stenosis; diabetes mellitus; cystic fibrosis; elimination; glomerulonephritis; appendicitis; Hirschsprungʼs disease; mobility; scoliosis; cellular aberration; acute lymphatic leukaemia; Wilmsʼ tumour.

The last unit is devoted to Nursing care of the client with psychosocial and mental health problems and the topics found there are: anxious behaviour; phobias; obscessive compulsive behaviour; anorexia nervosa; psychosomatic illness; confused behaviour; elated-depressive behaviour; depression; elated and hyperactive behaviour; acting out; hostile, assaultive, and aggressive behaviour.

Bibliography

1. AJN/MOSHBY: Question and Answer Book. For the NCLEX-RN Examination. St Luis 4th ed 1994. 342 p.

2. http://www.thefreedictionary.com/

3. http://www.dictionary.com/

4. http://ipa.typeit.org/full

Part 1

Unit 1

Nursing care of the client with psychosocial and mental health problems.

1. Miscellaneous conditions

Case study 1

Which action is inappropriate when caring for the arteriovenous shunt?

1. Palpate to assess 1 _________.

2. Apply a tight dressing to prevent cannula 2 ____________. ◄

3. Avoid blood pressure readings in the 3 ____________.

4. Apply antibiotic 4 ________ to the shunt site.

Blood flow must be maintained in the cannula to prevent 5________. A tight dressing constricts flow.

Case study 2

When administering a blood transfusion, what is a nursing 1_________ function requiring two nurses?

1. Check the type and crossmatch data, numbers on the 2 ________, and the information on the blood with that on the patientʼs blood band. ◄

2. Check the type and 3 ______________, numbers on the lab slips, and the information on the blood with that on the patient’s chart.

3. Check for the best possible vein to ensure correct 4 ________.

4. Ensure that the patient is 5 ________ in order to establish a baseline of behaviour.

This procedure is essential to prevent the administration of 6 ____________ blood, which could result in the patient’s death. It is essential to 7_____ the patient’s blood band on his arm. Just checking the chart does not ensure that the patient receives the correct blood. Options 3 and 4 are important but do not require two nurses.

Case study 3

When 1 __________ ________ to start a blood transfusion, which of the following solutions is used to start the IV?

1. 2 _______ water.

2. Normal saline. ◄

3. 10% dextrose in water.

4. Lactated Ringer’s 3 ________.

Normal saline is used because it is an 4________ solution.

Case study 4

The nurse must remain at the 1_______ for 15 minutes after blood is started to assess for any transfusion reaction. Which of the following is not found during a 2___________ ________?

1. 3 ______, fever, and dyspnoea.

2. Decreased blood pressure and increased 4_________.

3. Bleeding under the skin at the IV site.◄

4. 5 _______________.

Bleeding under the skin at the IV site indicates 6 ____________ __ _______ around the site. All the other options given are signs of a transfusion reaction.

Case study 5

Which of the following nursing actions must be taken 1___________ if a transfusion reaction occurs?

1. 2 ______ the physician.

2. Check the 3 __________, and take a urine sample.

3. Stop the blood transfusion, and 4 ______ normal saline. ◄

4. 5 ________ the rate of blood flow and continue the assessment.

It is 6__________ that the blood be stopped and the IV needle be 7____ __ ____ and kept patent to administer fluids and medications to 8__________ the reaction. Option 2 is a second action, and 1 is a third action.

Case study 6

A 21-year-old male patient 1__ _________ to the postanaesthesia room. The nurse obtains taking vital signs of blood pressure 90/60 mm Hg, pulse 100, and respiration 18. Which of the following actions would the nurse take?

1. Recheck the vital signs in 5 minutes.◄

2. Increase the rate of the IV slightly.

3. 2 ____________ and elevate his feet.

4. Cover him with a warm blanket.

Movement of the patient from the 3_________ ____ table to the postanaesthesia room may cause a 4_________ ____ in blood pressure.

Case study 7

It is now 7 hours after a male patient’s 1_________ _______. He complains of being unable to void, even though he has the 2____. Which nursing action is most appropriate?

1. Obtain an order to 3 ___________ him.

2. Help him to stand at the bedside to void. ◄

3. Wait one more hour before taking any action.

4. Explain to him that this is a 4 _______________ postoperatively.

5 ________ _ ____ patient who is experiencing postoperative 6_______ _________ at the bedside may facilitate 7_______. Waiting is not appropriate, and explanations will not solve the problem. Catheterization may eventually be necessary but is not the first step.

Case study 8

If a limited amount time available, the nurse recognizes the need to include which of the following in the preoperative teaching for a patient with acute appendicitis?

1. Leg exercises to prevent 1 ____________.

2. Abdominal splinting for coughing and deep breathing. ◄

3. Explanation of the 2 _______________ that he can expect postoperatively.

4. Explanation of drainage on his 3 ________.

The practice of abdominal splinting 4 ___________ postoperative performance of coughing and deep breathing. Practising leg exercises is inappropriate because they would increase abdominal pain preoperatively. A nasogastric tube is usually not required following a simple 5 ____________. There is usually little wound 6 ________ as a result of a simple appendectomy.

Case study 9

Before administering a patient’s preoperative medication, which of the following nursing actions is 1 ____ _________?

1. Report to the physician the elevated 2 ___________________.

2. Check to ensure that the laboratory has completed the 3 __________.

3. Ensure that the surgical consent form has been signed. ◄

4. Provide a quiet environment.

After the patient has received 4____________ ________, he is no longer considered 5_________ sign the operative permit. The other options are true but unrelated to preoperative medication.

Case study 10

A patient is taken to the operating room, and 1___________ ___ _______ begins. The circulating nurse’s primary goal when positioning a patient on the operating room table is to achieve

1. A 2 ___________ position for the patient.

2. A position that is acceptable to the 3 _______.

3. A position that prevents 4 ________ and promotes privacy.

4. A position that avoids circulatory impairment and protects nerve function. ◄

The circulating nurse is 5 ___________ ___ ensuring the safety of the patient and preventing any 6____ ____ ___________.

Case study 11

A patient’s laboratory values show 1_____________ as a result of the adequate metabolism of which of the following?

1. Fat. ◄

2. Protein.

3. 2 ______

4. Glucose.

Fats are 3____________ metabolized, and calcium ions are bound to fats; thus 4_______ ____ are not absorbed in normal amounts.

Case study 12

Mr. Ray is admitted to the 1 _________ ____ with a stiff neck and temperature of 102˚ F (38.8˚ C). He has had an earache for 1 week, but has not sought treatment for it. Mr. Ray is placed on a hypothermia blanket. Twenty minutes following the start of hypothermia 2 __________, what response would the nurse most likely expect to find?

1. 3 _______ vital signs.

2. Elevated vital signs. ◄

3. Unchanged vital signs.

4. 4 ____________ hot and cold flashes

The body will attempt to 5 __________ ___ hypothermia therapy, and the vital signs will initially become elevated; later, they decrease.

Case study 13

A serious complication associated with hypothermic therapy is which of the following?

1. 1 _______.

2. Burns.

3. Frostbite. ◄

4. 2 ______________.

During 3 ___________ _______ the patient’s skin must be protected from 4 _________, most commonly caused by skin contact with the hypothermic 5 _______.

Case study 14

Which of the following is a 1________ _____ of aplastic anaemia?

1. Vitamin B12 malabsorption.

2. Drugs. ◄

3. Folic acid 2__________.

4. Genetic factors.

Many drugs can cause 3___________ of the bone marrow and 4________ _______.

Case study 15

To facilitate the 1__________ of myasthenia gravis which is the most important information to discuss with a patient?

1. No 2 ______________ medications are known to affect the action of anticholinesterase medications used in the treatment for myasthenia gravis.

2. Observe for symptoms of thyroid disease because patients with myasthenia gravis also experience 3 __________________.

3. Planned rest periods throughout the day will maximize strength. ◄

4. Good body mechanics will prevent 4 ___________

5________ becomes worse on exertion and at the end of the day (as opposed to morning). Rest typically increases 6______ ________.

Case study 16

A patient asks, what myasthenia gravis is. What is the pathophysiological principle upon which the nurse would base a response?

1. It is an 1 __________ process affecting nerves and muscles.

2. It is an autoimmune process 2 _________ the myoneural junction.◄

3. It is a genetic defect that destroys 3 ______.

4. It is a slow viral infection that attacks 4 ______________.

5__________ ______ is caused by an autoimmune process that impairs receptor function at the myoneural junction.

Case study 17

What side effect is a patient having external 1_________ for lung cancer most likely to experience?

1. Alopecia.

2. Bone marrow suppression.

3. 2 __________.

4. Dyspnoea. ◄

The majority of 3____ _______ of external radiation are dependent on the specific site being radiated. Because the patient’s 4______ ____ is the lung, radiation will result in irritation of the 5____ ______, resulting in dyspnoea.

Case study 18

Nursing management of a patient’s irradiated skin will not include which of the following?

1. Applying A and D 1 ________ prn to relieve dry skin.

2. 2 _________ the skin with tepid water and a soft cloth.

3. Avoiding 3 ______________ to the sun.

4. Redrawing the skin markings if they are accidentally removed. ◄

4____ ________ must not be removed in any way. If they are inadvertently 5______ ___, markings are redrawn only by the radiation technician.

Case study 19

The nurse notes that a patient with lymphoblastic leukaemia has 1_________; bleeding from his gums, lips and nose, and 2_______ on various parts of his body. Which one of the 3__________ ________ would the nurse expect to find?

1. Low serum calcium level.

2. Faulty thrombin production.

3. Decreased platelet count. ◄

4. Elevated partial thromboplastin time.

Platelets are involved in 4 ________ ___ __________ and are 5 _________ in number because of leukocytosis.

Case study 20

When giving 1_____ ____ to a client with cancer and with mouth ulcers, what would the nurse use?

1. A toothbrush.

2. 2 ________________.

3. A mild mouthwash solution. ◄

4. Nothing; it will only 3 _____ the patient.

The toothbrush and peroxide solution might further damage an 4_________ ___ ________ mouth. Doing nothing is not an appropriate measure because 5__________ will be increased.

Case study 21

Lucas is admitted to the emergency room with an abdominal gunshot wound. Towels can be used to pack the 1 _______ _____ because

1. The injury is usually 2 _____.

2. The wound is already grossly contaminated. ◄

3. Towels 3 ______ more than ABD pads.

4. The patient is probably bleeding minimally.

A gunshot wound is 4 _______ ____________, and an abdominal wound would bleed 5 _________; any clean towels would be appropriate.

Case study 22

A male patient enters the emergency room with a knife protruding from his chest. The best 1 _______ ______ is to do which of the following?

1. Immediately remove the knife.

2. 2 _____ the knife in until an operative setup is arranged. ◄

3. Clean the exposed 3 ___________ with povidone-iodine solution.

4. Cover area with a sterile towel soaked in saline.

Removing or disturbing the knife in a 4 _____ _____ can cause severe damage or massive 5 ___________. The knife acts as a tamponade to the affected sizes.

Case study 23

Select the most correct statement about subcutaneous emphysema.

1. It is caused by air sucked into the chest wall from a 1 ___________ wound.

2. It is caused by internal injury.◄

3. It can always 2 _______ easily.

4. It is not 3 ___________ by coughing.

Internal injury leads to an air leak within the tissues, thereby causing 4 ____________ _________.

Case study 24

Why is dexamethasone the corticosteroid drug of choice for 1 ____ ______ patients?

1. It is an antiinflammatory drug.

2. It decreases the amount of 2 ___________ secreted.

3. It crosses the blood-brain barrier.◄

4. It causes fewer side effects than any other 3 _______________.

Dexamethasone is the only corticosteroid that crosses 4_____-_____ _______. It is the most commonly used steroid in patients with neurological damage because of its 5________________ action.

Case study 25

The victim of a car accident becomes confused during the night and falls quietly asleep. The nurse 1 _____ ___ _____ _____ and finds the blood pressure is 155/60 mm Hg, pulse is 64, and respirations are 18. The physician suspects increased 2 ____________ _______ (ICP). Which of the following nursing actions would be first?

1. Institute seizure precautions.◄

2. Start an IV infusion.

3. Order a 3 ______________.

4. Start oxygen by cannula at 6L.

All the choices listed are important, but instituting 4 _______ ___________ is the priority.

Case study 26

Which symptoms indicate overhydration in a 1____ _______ after the first 24 hours?

1. 2 ________.

2. 3 __________.

3. Dyspnoea, moist rales.◄

4. Warmth and redness around the 4 _______________.

These symptoms are indicative of fluid overload resulting in 5 __________ ____ _______.

Vocabulary 1

absorbed /əbˈzɔːbd/

acceptable /əkˈsept.ə.bl ̩/

accidentally /ˌæk.sɪˈden.təl.i/

achieve /əˈtʃiːv/

affected /əˈfek.tɪd/

alopecia /ˌæləˈpiːʃɪə/

anaemia /əˈniː.mi.ə/

annoy /əˈnɔɪ/

anticholinesterase /ˌæntɪˌkɒləˈnɛstəˌreɪz/

antiinflammatory/ˌæn.ti.ɪnˈflæm.əˌtɔr.i/

aplastic /əˈplæs.tɪk/

appendectomy /ˌæp.ənˈdɛk.tə.mi/

appendicitis /əˌpen.dɪˈsaɪ.tɪs/

arrange /əˈreɪndʒ/

arteriovenous /ɑː.tɪə.ri.əʊˈviː.nəs/

attack /əˈtæk/

autoimmune /ˈɔː.təʊ.ɪˈmjuːn/

avoid /əˈvɔɪd/

band /bænd/

bedside /ˈbedˌsaɪd/

bind /baɪnd/

blade /bleɪd/

blanket /ˈblæŋ.kɪt/

blood /blʌd/ flow /fləʊ/

bone /bəʊn/ marrow /ˈmær.əʊ/

breathing /ˈbriː.ðɪŋ/

burn /bɜːn/

cannula /ˈkæn.jʊ.lə/ pl cannulae

catheterize /ˈkæθɪtəˌraɪz/

chart /tʃɑːt/

cleansing /ˈklen.zɪŋ/

clotting /ˈklɑt̬.ɪŋ/

coagulation /kəʊˈæg.jʊ.leɪ.ʃən/

comfortable /ˈkʌmp .fə.tə.bl ̩/

competent /ˈkɒm.pɪ.tənt/

complete /kəmˈpliːt/

confused /kənˈfjuːzd/

congestive /kənˈdʒes.tɪv/

consent /kənˈsent/

contaminated /kənˈtæm.ɪ.neɪ.tɪd/

corticosteroid /ˌkɔːtɪ.kəʊˈstɪə.rɔɪd/

coughing /kɒf.ɪŋ/

count /kaʊnt/

counteract /ˌkaʊn.tərˈækt/

cross /krɒs/

crossmatch /krɒs.mætʃ/

deep /diːp/

deficiency /dɪˈfɪʃ.ənt .si/

deformity /dɪˈfɔː.mɪ.ti/

dexamethasone /ˌdɛk.səˈmɛθ.əˌsoʊn/

dextrose /ˈdek.strəʊs/

discomfort /dɪˈskʌm.fət/

disease /dɪˈziːz/

dislodgement /dɪˈslɒdʒ.mənt/

diuresis /ˌdaɪ.jʊəˈriː.sɪs/

drainage /ˈdreɪ.nɪdʒ/

dressing /ˈdres.ɪŋ/

drop /drɒp/

drowsiness /ˈdraʊ.zɪ.nəs/

dyspnoea /dɪs.pniː.ə/

earache /ˈɪə.reɪk/

elevate /ˈel.ɪ.veɪt/

emphysema /ˌem.fəˈsiː.mə/

essential /ɪˈsen.ʃəl/

exacerbate /ɪɡˈzæs.ə.beɪt/

exercise /ˈek.sə.saɪz/

exertion /ɪɡˈzɜː.ʃən/

exhaustion /ɪgˈzɔːs.tʃən/

exposure /ɪkˈspəʊ.ʒər/

facilitate /fəˈsɪl.ɪ.teɪt/

fall /ˈfɔːl/ asleep /əˈsliːp/

flash /flæʃ/

flat /flæt/

flow /fləʊ/

folic /ˈfoʊ.lɪk/ acid /ˈæsɪd/

form /fɔːm/

frostbite /ˈfrɒst.baɪt/

genetic /dʒɪˈne.tɪk/

grossly /ˈgrəʊ.sli/

gum /gʌm/

gunshot /ˈgʌn.ʃɒt/ wound /wuːnd/

harm /hɑːm/

heart /hɑːt/ failure /ˈfeɪ.ljər/

hives /haɪvz/

hypocalcaemia /ˌhaɪ.pəʊ.kælˈsiː.mi.ə/

impair /ɪmˈpeər/

impairment /imˈpeərˌmənt/

incompatible /ˌɪn.kəmˈpæt.ɪ.bl̩/

incompletely /ˌɪn.kəmˈpliːt.li/

indicative /ɪnˈdɪk.ə.tɪv/ of /əv/

infiltration /ˌɪn.fɪlˈtreɪ.ʃən/

infuse /ɪnˈfjuːz/

infusion /ɪnˈfjuː.ʒən/

institute /ˈɪn.stɪ.tjuːt/

intravenous /ˌɪn.trəˈviː.nəs/

irritation /ˌɪr.ɪˈteɪ.ʃən/

isotonic /aɪ.səʊ ˈtɒn.ɪk/

itching /ˈɪtʃ.ɪŋ/

IV—intravenous /ˌɪn.trəˈviː.nəs/

lab /læb/

lactate /lækˈteɪt/

leak /liːk/

leukaemia /luːˈkiː.mi.ə/

leukocytosis /lu.koʊ.saɪˈtoʊ.sɪs/

lower /ˈləʊ.ə/

lymphoblast /ˈlɪm fəˌblæst/

majority /məˈdʒɒrɪtɪ/

malabsorption /mæl.əbˈzɔːp.ʃən/

male /meɪl/

management /ˈmæn.ɪdʒ.mənt/

mandatory /ˈmæn.də.tri/

marking /mɑːk.ɪŋ/

mechanic /məˈkæn.ɪk/

miscellaneous /ˌmɪs.əlˈeɪ.ni.əs/

moist /mɔɪst/

mouthwash /ˈmaʊθ.wɒʃ/

mucosa /mjuːˈkəʊ.sə/

myasthenia /ˌmaɪəˈsθɪːnɪ.ə/ gravis /græv.ɪs/

myelin /ˈmaɪə.lɪn/

myoneural /ˌmaɪ.əˈnʊər.əl/

nasogastric /neɪ.zəˈɡæs.trɪk/ tube /tjuːb/

ointment /ˈɔɪnt.mənt/

operating /ˈɒp.əˌreɪt.ɪŋ/ room /ruːm/

opposed /əˈpəʊzd/

order /ˈɔː.dər/

over-the-counter /ˌəʊ.və.ðəˈkaʊn.tər/

overhydration /ˈəʊvəˈhaɪdreɪʃən/

overload /ˌəʊ.vəˈləʊd/

pack /pæk/

pad /pæd/

palpate /ˈpæl.peɪt/

partial /ˈpɑː.ʃəl/

patent /ˈpeɪ.tənt/

pathophysiological /ˌpæθ.əˌfɪzɪəˈlɒd.ʒɪk.əl/

performance /pəˈfɔː.məns/

permit /pəˈmɪt/

peroxide /pəˈrɒk.saɪd/ solution /səˈluː.ʃən/

petechia /pɪˈtiːkɪ.ə/ pl petechiae

platelet /ˈpleɪt.lət/

position /pəˈzɪʃ.ən/

postanaesthesia /pəʊstˌæn.əsˈθi.ʒə/

postoperative /pəʊst.ɒprətɪv/

povidone-iodine /ˈpoʊ.vɪ.doʊnˌaɪ.əˌdaɪn/

practice /ˈpræk.tɪs/

precaution /prɪˈkɔː.ʃən/

preoperative /ˌpriːˈɒp.ər.ə.tɪv/

preparation /ˌprepəˈreɪʃən/

prevent /prɪˈvent/

principle /ˈprɪn.sɪ.pl̩/

privacy /ˈprɪv.ə.si/

prn, in priscription /prɪˈskrɪp ʃən/

profusely /prəˈfjuːslɪ/

promote /prəˈməʊt/

protruding /prəˈtruːd.ɪŋ/

rale /raːl/

rate /reɪt/

rational /ˈræʃ.ən.əl/

reading /ˈriː.dɪŋ/

recheck /riː.tʃek/

redraw /riːˈdrɔː/

remove /rɪˈmuːv/

report /rəˈpoːt/

report /rɪˈpɔːt/

retention /rɪˈten.ʃən/

Ringerʼs /ˈrɪŋ.ər/ solution /səˈlu.ʃən/

saline /ˈseɪ.laɪn/

sample /ˈsɑːm.pl̩/

seizure /ˈsiː.ʒə/

sensation /senˈseɪ.ʃən/

setup /ˈsetˌʌp/

shunt /ʃʌnt/

side /saɪd/ effect /ɪˈfekt/

sign /saɪn/

skeletal /ˈskel.ɪ.təl/ muscle /ˈmʌs.l ̩/

slightly /ˈslaɪt.li/

slip /slɪp/

soaked /səʊkt/

solution /səˈluː.ʃən/

spinal /ˈspaɪ.nəl/ fluid /ˈfluː.ɪd/

splint/splɪnt/

standing /stænd.ɪŋ/

starch /stɑːtʃ/

stasis /ˈsteɪ.sɪs/

stiff /stɪf/

stomatitis /ˌstoʊ.məˈtaɪ.tɪs/

subcutaneous /ˌsʌb.kjʊˈteɪ.ni.əs/

suck /sʌk/

suction /ˈsʌk.ʃən/

sunburn /ˈsʌn.bɜːn/

superficial /ˌsuː.pəˈfɪʃ.əl/

suppression /səˈpreʃ.ən/

surgeon /ˈsɜːdʒən/

surgery /ˈsɜː.dʒər.i/

surgical /ˈsɜː.dʒɪ.kəl/

take /teɪk/ vital /ˈvaɪ.təl/ signs /saɪnz/

tamponade /tæm.pəˈneɪd/

tepid /ˈtep.ɪd/

thrombin /ˈθrɒm.bɪn/

thromboplastin /θrɒmˈbəʊˈplæst.ɪn/

thyroid /ˈθaɪə .rɔɪd/

tight /taɪt/

transient /ˈtræn.zi.ənt/

trauma /ˈtrɔː.mə/

urge /ɜːdʒ/

urinalysis /ˌ jʊə.rɪ.ˈnæl.ə.sɪs/

urinary /ˈjʊə.rɪ.nər.i/

venous /ˈviː.nəs/

void /vɔɪd/

warmth /wɔːmθ/

WBC—white /waɪt/ blood /blʌd/ cell /sel/

Unit 2

Musculoskeletal system

Case study 1

Which of the following best describes a compound comminuted fracture?

1. The fracture is associated with injury to 1 ___________ tissue and structures.

2. 2 _____________ are forcibly driven into one another.

3. The bone is 3 __________ into fragments that extend through the skin. ◄

4. The line of the fracture forms a 4 ______ that encircles the bone.

Option 1 describes a 5______ fracture, 2, an 6________fracture; 4, a spiral fracture.

Case study 2

Mrs. Brown, 60-year-old patient, is admitted to the AM admissions unit for a left total hip replacement. She states that she has had severe pain in the hip for several years and takes large doses of aspirin. She says she has no other health problems. Which of the following would normally not be included as part of her preoperative lab work?

1. Blood type and crossmatch.

2. 1_______________.

3. 2_________________.

4. Bence Jones protein.◄

The Bence Jones protein is a test for multiple myeloma. A type and crossmatch would be done because of anticipated 3 _____ ____, which is substantial in 4 ____ __ _____ _______. The prothrombin time is required because she has been taking large doses of aspirin. A sedimentation rate can 5____ ___ the possibility of infection.

Case study 3

A patient for joint surgery is at risk for an infection developing in the 1 _________ ____. Which of the following 2________ will not prevent this complication?

1. Scrub the leg bid before surgery with a 3 __________________.

2. 4 _______ the patient not to shave any part of the body.

3. Use reverse isolation for 3 days preoperatively. ◄

4. Restrict in-and-out traffic in the 5 _____________ during the operation.

Reverse isolation is not used, but the other interventions listed are done in an effort to 6 _______ _________.

Case study 4

Which of the following postoperative nursing measures would be inappropriate for a female patient with a hip replacement?

1. Schedule active 1 _____________ to both ankles.

2. Remind her to keep her toes pointed outward. ◄

3. Help her to 2 _____ on the unaffected foot.

4. Remind her not to 3 _____ her legs.

The patient should keep her toes pointed toward the ceiling to prevent 4 _________ __ ________ ________. Plantar and dorsiflexion of both ankles should be encouraged to promote 5 ______ ______. Legs should not be crossed because this abducts the hip. The patient will pivot on the unaffected leg until full 6 ______ ______ is allowed.

Case study 5

Which of the following 1 __________ ________ indicates an abnormality in a patientʼs cardiovascular status?

1. Capillary refill: 10 seconds. ◄

2. Apical pulse rate: 74/min.

3. Absence of 2 _____________.

4. Feet warm and pink; 3 ___________ posterior tibial pulse.

Normal 4 _________ ______ occurs within 2 seconds. A delay of over 5 seconds is considered abnormal. 5 __ ______ _____ of 74 is within normal limits. Pitting oedema is an abnormality that indicates accumulation of excess fluid in the body tissues. A 6 _________ ______ _____ is frequently nonpalpable; this absence is considered a normal variation if 7 ____ ______ ___ ___________ are normal.

Case study 6

A patient with a hip replacement has an 1 ________ ______ in place. What is the best guide to the placement of the splint?

1. 2 ______ the splint firmly in place.

2. Position the splint so that it does not interfere with the use of the 3 ______.

3. Position the 4 _____ so that it is not directly over the peroneal nerve.

4. Position the proximal strap just above the knee. ◄

Pressure on the peroneal nerve places the patient at risk for foot drop. The other three options are 5 ___________ _____________ for the use and placement of abductor splints.

Case study 7

Which of the following would best be included in the plan of care for a patient with a below-the-knee amputation during the first 24 hours postoperatively?

1. Apply a heating pad to the stump to 1 _________________.

2. Have a tourniquet in view at the bedside. ◄

3. 2 __________ the need for large doses of narcotic analgaesics.

4. Encourage him to look at the 3 _____.

Haemorrhage has very serious 4 ____________. The first postoperative day is too early for the patient to accept his loss (option 4), and 5 __________ _____ in the stump is too impaired to risk a hot pad. The pain after amputation is almost always quite mild.

Case study 8

An amputee patient will be taught to use 1 _______ until he can manage with a prosthesis independently. Which of the following crutch-walking instructions would be incorrect?

1. 2 _______ the arms while holding weights to strengthen the triceps.

2. The crutches should be 16 inches less than the patientʼs total height.

3. The axillary bars on the crutches should support the patientʼs weight. ◄

4. Both crutches and the affected leg are moved forward first, followed by the normal leg.

The weight of the patient should be carried on the 3 ______ ___ _____. The weight should not be carried on the axillae, because this can damage the radial nerve and cause paralysis of the elbow and wrist extensor muscles. The 4 ________ ___ should be 1 to 2 inches below the axilla. Crutches should be 16 inches shorter than the patient for best fit. The elbow should be fully extended when a step is taken. In the three-point gait (the most common crutch-walking gait), both crutches are moved forward, first with the 5 ________ leg, then the unaffected leg.

Case study 9

During morning care, how would the nurse assist a patient 1 __ ___ ____ with preventing joint and muscle complications?

1. Active 2 _____________ to all extremities.

2. Passive range of motion to all extremities. ◄

3. Exercises to augment 3 _____________ as it returns.

4. Nerve stimulation.

During the acute phase, complete bed rest and passive range of motion will help to conserve energy, yet maintain good 4_____ ________.

Case study 10

Which of the following is most characteristic of rheumatoid arthritis?

1. It most often occurs in women between the ages of 40 and 80.

2. Nonsystemic involvement is most common in 1 ___________________.

3. Joints are affected bilaterally and symmetrically. ◄

4. It first occurs in a joint following a 2 _______________.

The other options are characteristic of 3 ______________. Rheumatoid arthritis has 4 ________ __________ and commonly occurs between the ages of 25 and 55 years.

Case study 11

Which of the following would be inappropriate to include in a plan of care for arthritis?

1. 1 ________ the patientʼs activities to allow for at least 8 to 10 hours of sleep every night, with naps during the day.

2. 2 _______ the patient and family to avoid quackery in health service providers.

3. Put the 3 ____________ in high position when helping the patient out of bed.

4. Help the patient to select a high-calorie, high-protein, and high-calcium diet. ◄

Increasing calories and weight would place extra 4 ______ __ ______. Added calcium would cause serum calcium to be high with increased risk of 5 ______ ______. The patient needs rest with spacing of activities to facilitate treatments for this systemic disease. Putting the head of the bed in high position prevents stress and strain on the joints when the patient 6 ____ ___ __ ___.

Case study 12

Preventing deformities is a major goal for arthritics. Which of the following 1 _______ _______ would be inappropriate to achieve this goal?

1. Place pillows under the major joints. ◄

2. 2 _________ the patient to lie prone several times a day.

3. Place a pillow between the legs when the patient is 3 __________________.

4. Provide her with a small pillow for her head.

Pillows under 4_____ ______ contribute to the complication of 5_______ ____________. Option 2 and 4 prevent contractures. Option 3 maintains skin integrity.

Case study 13

Which of the following is an incorrect method of relieving pain for patients with arthritis?

1. Apply hot, 1 __________ to the affected joints.

2. Apply cold packs to the affected joints.

3. Give anaelgesics on a 2 _______________ every 3 to 4 hours.

4. Massage the joints when they ache. ◄

Massage tends to further 3 __________ _______, ________, and _______ ______. Cold packs produce an anaesthetic effect. Heat or cold can both be used effectively in the treatment of arthritis to decrease muscle spasms.

Case study 14

The physician may prescribe a gold preparation for arthritis patients if the present medications are not effective. What is a major disadvantage of 1 ____ ____________?

1. They must be administered several months before benefits can be determined. ◄

2. They must be given intravenously.

3. The urine will turn green.

4. Serious 2 _______________ commonly occur during the first week.

Several months of therapy are required before 3 _____________ can be determined. The drug is commonly given deep 4 ______________. Adverse effects most commonly occur late, often after treatment has been discontinued.

Case study 15

When assessing a patient with a gangrenous toe, the nurse will least likely expect which of the following?

1. Intense pain in the affected area. ◄

2. 1 _________ of the metatarsal-phalangeal joints.

3. Changes in skin temperature of both feet.

4. 2 _________________.

Levels of pain will vary in the foot and leg. However, as the 3 __________ ____ develops, pain decreases because of the 4 _____ _________ that occurs. Despite the occurence of gangrene, infection, or inflammation, pain may be totally absent in the patient with 5________ __________.

Case study 16

1 ___ ____ is prescribed for a patient with gangrene of the toes. Which nursing care measure would be least therapeutic for this patient?

1. 2 ______________.

2. Footboard. ◄

3. Foot craddle.

4. 3 _________________.

A footboard is not used for the same reasons that 4 __________ is not allowed. The nursing actions are directed at 5 _________ ___________ by 6 _________ ________ _____ from developing in dependent areas.

Case study 17

To prevent complications of the bed rest imposed on a patient with gangrene, which nursing action would be contraindicated?

1. 1 _______ the patientʼs feet.

2. Teach about appropriate 2 _________.

3. Restrict fluid intake. ◄

4. 3 ________ joints and muscles.

When bed rest is prescribed for a patient, fluids are 4 _________, not decreased, in order to 5 _______ ________ ______.

Case study 18

The nurse would perform which of the following when providing care to the skin surrounding a gangrene lesion on the toe?

1. Apply an 1 __________________.

2. Dry the skin thoroughly. ◄

3. 2 _________ on the healthy tissue.

4. Soak the foot.

Keeping the area dry 3 ________ ________ from promoting the 4 _______ __ _________ and macerating the skin. The other options would 5 _________ ____ this.

Case study 19

A nursing home client spends a lot of time sitting in a chair. Where do 1 _________ ulcers most often develop when clients spend most of their time sitting?

1. Over the 2 ______.

2. Over the 3 ______.

3. Over the ischial tuberosities. ◄

4. On the 4 _____.

Most pressure is on the ischial tuberosities when sitting. Any redness that does not resolve 20 minutes after the pressure is relieved is at risk for 5 ______ _________.

Vocabulary 2

abduct /æbˈdʌkt/

abductor /æbˈdʌk.tə/

accumulation /əˌkjuː.mjʊˈleɪ.ʃən/

added /ˈædɪd/

adduction /əˈdʌkʃən/

advanced /ədˈvɑːnt st/

adverse /ˈæd.vɜːs/

ambulation /ˈæm.bjʊ.lən.ʃən/

anticipate /ænˈtɪs.ɪ.peɪt/

apical /ˈeɪ.pɪ.kəl/

arthritis /ɑːˈθraɪ.tɪs/

associated /əˈsəʊ.si.eɪ.tɪd/

augment /ɔgˈmɛnt/

axilla /ækˈsɪl.ə/ pl axillae

axillary /æˈksɪl.ər.i/

bar /bɑr/

bear /beə/

bedpan /ˈbɛdˌpæn/

Bence Jones /bents jəʊnz/ proteins /ˈprəʊ.tiːns/ test /test/

bid /bɪd/

bilaterally /ˌbaɪˈlæt.ər.ə.li/

breakdown /ˈbreɪk.daʊn/

capillary /kəˈpɪl.ər.i/ refill /ˈriː.fɪl/

caution /ˈkɔː.ʃən/

closed /kləʊzd/

coccyx /ˈkɒk.sɪks/

comminuted /ˌkə.mɪ.ˈnjuː.tɪd/

commonly /ˈkɒ.mən.lɪ/

compound /ˈkɒm.paʊnd/

consequence /ˈkɒn.sɪ.kwəns/

conserve /kənˈsɜːv/

contracture /kənˈtræk.tʃə/

contribute /kənˈtrɪb.juːt/

craddle /ˈkreɪ.dəl/

crutch /krʌtʃ/

decubitus /dɪˈkjuː.bit.əs/

dependent /dɪˈpen.dənt/

despite /dɪˈspaɪt/

destruction /dɪˈstrʌk.ʃən/

directly /daɪˈrekt .li/

disadvantage /ˌdɪs.ədˈvɑːn.tɪdʒ/

discontinue /ˌdɪs.kənˈtɪn.juː/

dorsiflexion /ˌdɔr.səˈflɛk.ən/

educate /ˈedjʊˌkeɪt/

effectiveness /ɪˈfek.tɪv.nəs/

effort /ˈef.ət/

encircle /ɪnˈsɜː.kl̩/

encourage /ɪnˈkʌr.ɪ.dʒ/

excess /ekˈses/

extend /ɪkˈstend/

extension /ɪkˈsten.t ʃən/

extensor /ɪkˈsten.sər/

external /ɪkˈstɜː.nəl/

extremity /ɪkˈstrem.ɪ.ti/

familial /fəˈmɪlɪəl/

fasten /ˈfɑː.sən/

fit /fɪt/

flexion /flek.ʃən/

foam /fəʊm/

foot /fʊt/

footboard /ˈfʊtˌbɔrd/

forcibly /ˈfɔːsəbəlɪ/

fragment /ˈfræɡ.mənt/

frozen /ˈfrəʊ.zən/

gait /ɡeɪt/

gangrene /ˈɡæŋ.ɡriːn/

gangrenous /ˈɡæŋ.ɡrɪ.nəs/

heel /hiːl/

hip /hɪp/

holding /ˈhoʊl.dɪŋ/

impact /ˈɪm.pækt/

impose /ɪmˈpəʊz/

inflamed /ɪnˈfleɪmd/

integrity /ɪnˈteɡ.rə.ti/

interfere /ˌɪn.təˈfɪər/

intramuscularly /ˌɪn.trəˈmʌs.kjʊ.lər.li/

intravenously /ˌɪn.trəˈviː.nəs.li/

involved /ɪnˈvɒlvd/

involvement /ɪnˈvɒlv.mənt/

ischial /ˈɪs.ki.əl/

isolation /ˌaɪ.səl.eɪ.ʃən/

joint /dʒɔɪnt/

line /laɪn/

lotion /ˈləʊ.ʃən/

macerate /ˈmæs.əˌreɪt/

maintain /meɪnˈteɪn/

major /ˈmeɪ.dʒər/

massage /ˈmæs.ɑːʒ/

measure /ˈmeʒ.ər/

metatarsal /ˌmɛtəˈtɑːsəl/ -phalangeal /fəˈlændʒɪəl/ joint /dʒɔɪnt/

mild /maɪld/

moisture /ˈmɔɪs.tʃər/

motion /ˈməʊ.ʃən/

myeloma /ˌmɑɪ.əˈloʊ.mə/

neuropathy /ˌnjʊə.rəˈpæθ.ɪ/

nonsystemic /ˌnɒn.sɪˈstɛm.ɪk/

normotensive /ˌnɔr.moʊˈtɛn.sɪv/

nursing /ˈnɜː.sɪŋ/ home /həʊm/

occlusive /ɒˈkluː.sɪv/ dressing /ˈdres.ɪŋ/

occur /əˈkɜːr/

occurrence /əˈkʌr.ənt s/

osteoarthritis /ˌɒs.ti.oʊ.ɑrˈθraɪ.tɪs/

outward /ˈaʊtwəd/

pad /pæd/

palm /pɑːm/

paralysis /pəˈræl.ə.sɪs/ pl paralyses

peroneal /ˌper.əˈniː.əl/

pitting /pɪt.ɪŋ/ oedema /ɪˈdiː.mə/

pivot /ˈpɪvət/

plantar /plænt.ə/

pointed /ˈpɔɪn.tɪd/

posterior /pɒsˈtɪə.ri.ər/

prone /prəʊn/

prosthesis /ˈprɒs.θiː.sɪs/ pl prostheses

prothrombin /proʊˈθrɒm bɪn/ time /taɪm/

provider /prəˈvaɪ.dər/

proximal /ˈprɒk.sɪ.məl/

pulse /pʌls/

quackery /ˈkwækərɪ /

radial /ˈreɪ.di.əl/

range /reɪndʒ/

regular /ˈreɡ.jʊ.lər/

relieve /rɪˈliːv/

remind /rɪˈmaɪnd/

replacement /rɪˈpleɪs.mənt/

resolve /rɪˈzɒlv/

rest /rest/

restrict /rɪˈstrɪkt/

reverse /rɪˈvɜːs/

rheumatoid arthritis /ˌruː.mə.tɔɪd.ɑːˈθraɪ.tɪs/

rotation /rəʊ ˈteɪ.ʃən/

rule /ruːl/ out /aʊt/

sacrum /ˈseɪ.krəm/

schedule /ˈʃedjuːl/

scrub /skrʌb/

sedimentation /ˌsɛd.ə.mənˈteɪ.ʃən/ rate /reɪt/

serum /ˈsɪə.rəm/ pl sera

sheep /ʃiːp/ skin /skɪn/

spacing /speɪsɪŋ /

spasm /ˈspæz.əm/

spiral /ˈspaɪə.rəl/

splint /splɪnt/

splinter /ˈsplɪn.tər/

strain /streɪn/

strap /stræp/

strengthten /ˈstreŋθən/

stump /stʌmp/

substantial /səbˈstæn.ʃəl/

suite /swiːt/

surrounding /səˈraʊn.dɪŋ/

swollen /ˈswəʊ.lən/

symmetrically /sɪˈmetrɪkəl.i/

tend to /tend/

tibial /ˈtɪb.i.əl/

tourniquet /ˈtʊə.nɪ.keɪ/

traffic /ˈtræf.ɪk/

traumatize /ˈtrɔː.mə.taɪz/

triceps /ˈtraɪ.sɛps/

unaffected /ˌʌn.əˈfek.tɪd/

venous /ˈviː.nəs/ return /rɪˈtɜːn/

weight /weɪt/

wrist /rɪst/

Unit 3

Cardiovascular system

Case study 1

Discharge planning for a patient with a new pacemaker would not include which of the following?

1. Activity and exercise.

2. Awareness of 1 ____________________ that might interfere with the function of the 2 _________.

3. How to take a 3 ___________ daily.

4. How to care for a permanently implanted pacemaker. ◄

4 ___________ _________ pacemakers require no physical or technical care. Teaching must focus on any adjustments to be made in activities of 5 _____ ______ and of recreation (e.g., no contact sports).

Case study 2

When applying electrode patches to monitor a patientʼs cardiac activity, which of the following assessments will the nurse not be able to make?

1. Level of 1 ____________ and orientation.

2. Skin colour and temperature.

3. Muscle tension and motor activity.

4. Cardiac output. ◄

When 2 _________ __________, an assessment using touch can be done concurrently to determine 3 ____ ___ ______ _________. Level of consciousness and orientation are assessed when evaluating her response to the explanation of 4 _________ ___________. 5 _______ ______ is determined by actual monitoring, either noninvasively by blood pressure or invasively by 6 ________ ____ (e.g., Swan-Ganz).

Case study 3

A complete 12-lead ECG applied to a patient shows that the patient has a heart rate of 48 beats per minute. The patient is given a diagnosis of sinus bradycardia. The most common cause of this condition is which of the following?

1. Stress and 1 __________.

2. 2 __________.

3. Digitalis toxicity. ◄

4. Hyperthyroidism.

Stress, severe pain, and 3 _______________ are causes of tachycardia. 4 _____ ___________ in patients over age 65 is usually a result of 5 ___________, especially digoxin. Remember that 6 _________ ________ can also result in a heart rate grater than 100 beats per minute.

Case study 4

When planning care for a patient with a heart rate of 30, what would the primary goal be at this time?

1. The patient will be free from 1 _____________ to her myocardium.

2. The patient will maintain optimum cardiac output.◄

3. The patient will experience a decrease in 2 _____________.

4. The patient will maintain close communication with her 3 _________________.

Bradycardia results in a decrease in cardiac output: therefore all nursing activity would be directed at 4 _________ the best possible cardiac output. Options 1 and 3 are related to this 5 _______ ____. Maintaining close contact with significant others is important, but it does not receive priority over maintaining cardiac output.

Case study 5

Which of the following interventions would not be appropriate for a patient in the immediate postoperative period after a permanent pacemaker insertion?

1. 1 _________________ q30 min for bleeding.

2. Monitor for 2 _________, _____-__________, and chest pain.

3. Monitor the ECG for pacing, spikes, or pacing artifacts.

4. Use active and passive ROM exercises of the left arm and shoulder.◄

Excess arm movement and 3 ___ _______ should be avoided for 5 weeks after the 4 _________ __ ___ _________. The incision should be assessed q30 min for bleeding. Dizziness, light-headedness, and chest pain are all signs of 5 _________ ________ and should be monitored. A pacing spike or artifact is a 6 ________ ____ that appears on the ECG each time the pulse generator fires an impulse.

Case study 6

Which of the following would be most appropriate to teach a patient with angina about what to report immediately?

1. The 1 _______________ after a business meeting.

2. A change in the pattern of pain.◄

3. Pain that occurs with eating.

4. The fact that nitroglycerin does not cause a 2 _________________ under the tongue.

3 ____ ________ of angina vary from individual to individual but usually are the same in one individual. A change may indicate 4 ___ __________ _____. Anginal pain frequently occurs with stress or after 5 ______ _ _____ ____. The patient needs to purchase a 6 _____ ______ of nitroglycerin if the current medication does not cause a tingling sensation under the tongue.