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1)     Assign CPT code(s) and appropriate modifiers to each statement.

 

 

The physician performed a complex repair during resection of the diaphragm and closed the residual defect with synthetic graft material.

2)      Mediastinotomy to remove foreign body using transthoracic approach, including median sternotomy.

3)      Patient underwent repair, laceration of diaphragm.

4)      Physician inserted a mediastinoscope through an incision in the sternal notch and performed a mediastinal lymph node biopsy.

 

5)      Physician  repaired an acute traumatic diaphragmatic hernia.

Patient underwent alveoloplasty to remove sharp areas or undercuts of alveolar bone, one quadrant.

Surgeon used a scalpel to slice off a cancerous portion of the vermillion border of the patient’s lip: mucosal advancement was performed after excision.

Surgeon made an incision through submucosal tissue and removed a lesion in the vestibule of the mouth. Wound repair was not required.

Patient underwent simple incision of the lingual frenum to free the tongue.

Patient underwent incision in the parotid gland to remove calcified stone.

Surgeon repaired a tear at the pharyngeal esophageal junction.

Physician drained and abscess near the tonsil.

Surgeon removed an 8 year old patient’s tonsils and adenoids.

Physician controlled secondary oropharyngeal hemorrhaging, status post tonsillectomy, by using cellulose sponges that expanded when placed in the tonsillar cavity.

 

Physician performed a tonsillectomy on a 12 year old male patient.

Physician inserted a flexible esophagoscope into the esophagus and destroyed a lesion, using snare technique.

Surgeon made an incision in the left posterior chest wall into the esophagus to remove a foreign body from the esophagus.

Physician inserted a balloon endoscopically for tamponade of bleeding esophageal varices.

Dr. Smith performed a partial cervical esophagectomy while Dr. Jones performed a jejunum transfer with microvascular anastomosis.

The physyician passed an endoscope through the patient’s mouth and visualized the entire esophagus, stomach, duodenum, and jejunum. One lesion was removed using biopsy forceps. Another was remove using snare.

Patient underwent incision of the pyloric muscle.

The physician performed an open revision of a previously performed gastric restrictive procedure and reversed the previously partitioned stomach to restore normal gastrointestinal continuity.

Using fluoroscopic guidance, the physician repositioned a gastric feeding tube through the duodenum.

The physician performed a laparoscopic surgical gastric restrictive procedure with gastric bypass and roux-en-Y gastroenterostomy.

 

The physician percutaneously place a gastrostomy tube into the stomach under fluoroscopic guidance including contrast injection(s), image documentation.

Question

Week 6 quiz

Question 1

A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D

Question 2

To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

A) administer calcium supplements.
B) position the patient in the side-lying position.
C) administer carbohydrates.
D) monitor for nausea and vomiting.

Question 3

A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient’s care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient’s existing drug regimen?

A) The patient may be required to temporarily hold her other medications until a stable serum level of gabapentin is achieved.
B) It is unlikely to influence the patient’s other medications because gabapentin does not interact with other drugs.
C) Gabapentin is contraindicated with the use of exogenous insulin.
D) The patient’s medication-related risk for renal failure must be assessed prior to the use of gabapentin.

Question 4

A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following?

A) History of taking anticoagulant drugs
B) Allergy to seafood
C) Hirsutism
D) The patient’s age

Question 5

A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following?

A) Prothrombin time and partial thromboplastin time
B) Urine specific gravity
C) Alanine aminotransferase and total bilirubin levels
D) Follicle-stimulating hormone levels

Question 6

A nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that “puts me at risk of becoming physically dependent.” Which of the following medications would the nurse question, if ordered?

A) Methocarbamol (Robaxin)
B) Orphenadrine (Norflex)
C) Cyclobenzaprine (Flexeril)
D) Metaxalone (Skelaxin)

Question 7

A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

A) Risk for Injury related to CNS depressant effects
B) Diarrhea related to anticholinergic effects
C) Altered Nutrition, Less than Body Requirements, related to appetite suppression
D) Impaired Swallowing related to increased muscle tone

Question 8

A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?

A) Avoid high-fat foods
B) Drink plenty of water every day
C) Take the tablets before bedtime
D) Avoid red meat

Question 9

Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

A) The resident has not eaten breakfast because of a recent loss of appetite
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm
C) The resident had a fall during the night while transferring from her bed to her bathroom
D) The resident received her annual influenza vaccination the previous day

Question 10

A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to

A) avoid aggravating the gastrointestinal tract.
B) ensure quick distribution of the drug.
C) prevent the risk of infection or bleeding.
D) minimize the risk of depressed bone marrow function.

Question 11

A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

A) After breakfast
B) Before lunch
C) Late afternoon
D) Bedtime

Question 12

A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s

A) blood pressure.
B) potassium level.
C) use of alcohol.
D) use of salt in his diet.

Question 13

A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize

A) the need to rotate the injection site of the drug.
B) the need to avoid crushing the tablet.
C) the need to place the tablet under the tongue.
D) the need to use only the thigh muscle for the drug injection site.

Question 14

A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?

A) Decreased libido
B) Increased blood glucose
C) Dry eyes
D) Jittery feeling

Question 15

A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?

A) Wash hands before and after taking the medicine
B) Keep track of any gastrointestinal tract infections
C) Monitor glucose levels closely
D) Note the time the medicine is taken each day

Question 16

A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?

A) Bronchoconstriction
B) Hepatotoxicity
C) Aplastic anemia
D) Agranulocytosis

Question 17

A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?

A) “Drug therapy can consist of one or more drugs to eliminate the symptoms of these diseases.”
B) “Drugs do not cure these disorders; they instead enhance quality of life.”
C) “Persons of all cultures are treated similarly and respond in similar ways to treatment.”
D) “Drugs used to treat these disorders always pose a risk of severe liver and kidney dysfunction.”

Question 18

A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?

A) Hypothermia
B) Hypotension
C) Renal dysfunction
D) Bleeding

Question 19

A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain.
B) fatigue.
C) breathing difficulties.
D) heart palpitations.

Question 20

A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the patient and her husband that the adverse effect that poses the greatest safety risk to the patient is

A) constipation.
B) dry mouth.
C) fatigue.
D) hypotension.

Question 21

A 34-year-old male patient is prescribed methimazole (MMI).The nurse will advise him to report which of the following immediately?

A) Vertigo
B) Intolerance to cold
C) Loss of appetite
D) Epigastric distress

Question 22

A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium).In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?

A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”
B) “We’ll need to closely monitor your blood sugar levels for the next week.”
C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”
D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”

Question 23

A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?

A) Small doses of long-acting insulin administered four to five times daily
B) Doses of basal insulin twice daily with regular insulin before each meal
C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening
D) Divided doses of intermediate-acting insulin every 2 hours, around the clock

Question 24

During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?

A) The patient’s environment
B) The patient’s diet
C) The condition of the patient’s skin
D) The condition of the patient’s nasal passages

Question 25

A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

A) crush the tablet before swallowing.
B) swallow the tablet whole.
C) swallow the tablet with milk or food.
D) avoid drinking milk for 3 hours after swallowing the tablet.

Question 26

A nurse will instruct a patient taking allopurinol to take each dose

A) at night.
B) first thing in the morning.
C) after a meal.
D) before a meal.

Question 27

The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug?

A) To balance urate concentration and prevent gout attacks
B) To promote the remodeling of damaged synovium
C) To potentiate the metabolism of dietary purines
D) To achieve pain relief in joints affected by gout

Question 28

A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?

A) Green beans
B) Shrimp
C) Eggs
D) Milk

Question 29

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?

A) Eat a high-protein diet
B) Decrease the dosage if any adverse effect is experienced
C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight
D) Have a complete blood cell count done weekly

Question 30

A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

A) Dietary habits
B) Work environment
C) Typical daily fluid intake
D) Ethnicity