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MedSurg 1 RN Final Exam Questions and Answers: A Comprehensive Review of Key Concepts, Exams of Nursing

A comprehensive set of questions and answers covering essential concepts in medsurg 1 nursing. It covers topics such as risk factors, health promotion, pain management, electrolyte imbalances, and acid-base balance. Designed to help students prepare for their final exam by providing a structured review of key concepts and their applications in clinical practice.

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2024/2025

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Jersey College MedSurg 1 RN FINAL
EXAM QUESTIONS AND ANSWERS,
NEW UPDATE!!
weight, smoking, sex practices, diet - CORRECT ANSWER-List four modifiable
risk factors. (general health promotion)
age, genetics, sex - CORRECT ANSWER-List three non-modifiable risk factors.
(general health promotion)
cultural assessment - CORRECT ANSWER-What type of assessment should
the nurse preform prior to initiating health teaching?
physiological integrity
safety and security
belongingness and affection
esteem and self-respect
self-actualization
-- physiologic needs and life threatening issues are a priority
-- confirm that these needs are met in the order listed above - CORRECT
ANSWER-Maslow's Hierarchy of Needs
--priorities?
--what order?
Healthy People 2020 - CORRECT ANSWER-Organization that identifies health
promotion and disease prevention goals and lists strategies along with resources in an
attempt to improve the nation's health
The Institute of Medicine's report on the Future of Nursing - CORRECT
ANSWER-Organization that recommends ways to strengthen the practice of nursing
in order to improve health care.
The National Patient Safety Goals - CORRECT ANSWER-The Joint
Commission lists the top patient safety concerns and includes medication safety,
infection prevention, surgery-related mistakes, patient identification and improving staff
communication. What is this list called?
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Download MedSurg 1 RN Final Exam Questions and Answers: A Comprehensive Review of Key Concepts and more Exams Nursing in PDF only on Docsity!

Jersey College MedSurg 1 RN FINAL

EXAM QUESTIONS AND ANSWERS,

NEW UPDATE!!

weight, smoking, sex practices, diet - CORRECT ANSWER -List four modifiable

risk factors. (general health promotion)

age, genetics, sex - CORRECT ANSWER -List three non-modifiable risk factors.

(general health promotion)

cultural assessment - CORRECT ANSWER -What type of assessment should

the nurse preform prior to initiating health teaching? physiological integrity safety and security belongingness and affection esteem and self-respect self-actualization -- physiologic needs and life threatening issues are a priority

-- confirm that these needs are met in the order listed above - CORRECT

ANSWER -Maslow's Hierarchy of Needs

--priorities? --what order?

Healthy People 2020 - CORRECT ANSWER -Organization that identifies health

promotion and disease prevention goals and lists strategies along with resources in an attempt to improve the nation's health

The Institute of Medicine's report on the Future of Nursing - CORRECT

ANSWER -Organization that recommends ways to strengthen the practice of nursing

in order to improve health care.

The National Patient Safety Goals - CORRECT ANSWER -The Joint

Commission lists the top patient safety concerns and includes medication safety, infection prevention, surgery-related mistakes, patient identification and improving staff communication. What is this list called?

Nurse Practice Acts - CORRECT ANSWER -This governs nursing practice and is

a law that is put into place to protect the public - nurses must follow and comply with their state's regulations

QSEN - Quality and Safety Education for Nurses Institute - CORRECT

ANSWER -Institute that seeks to strengthen the knowledge, skills, and attitudes of

nurses in providing continuous quality improvement in health care

whatever the patient says it is - CORRECT ANSWER -What is pain?

actual or potential tissue damage - CORRECT ANSWER -Pain is associated with

__________________________________.

the patient's self report - CORRECT ANSWER -The single most reliable indicator

of pain is _______.

blood pressure, heart rate, and respirations - CORRECT ANSWER -Pain

stimulates the sympathetic nervous system and could result in an increase in ___________, ___________, and ____________. increases glucagon production decreases insulin secretion depresses immune function

can lead to addictive behaviors - CORRECT ANSWER -physiologic effects of

unrelieved pain (4)

prostaglandins - CORRECT ANSWER -initiate inflammation and contribute to

tissue swelling and pain

NSAIDS - CORRECT ANSWER -______ primarily produce pain relief by

preventing prostaglandin formation.

Acetaminophen - CORRECT ANSWER -_____________ does not have anti-

inflammatory properties.

tissue damage - CORRECT ANSWER -______________ stimulates the

inflammatory response and puts the patient at risk for pain.

local anesthetics, non-opioids or opioids - CORRECT ANSWER -manage

nociceptive pain with?

allodynia - CORRECT ANSWER -pain that is associated with a noxious stimulus

provide PCA (patient controlled analgesia) - CORRECT ANSWER -Provide

____________ to help reduce complications related to pain. Used in postoperative patients as a preventative measure for pain.

around the clock - CORRECT ANSWER -Provide administration of analgesics

(frequency) for chronic and postoperative pain, never wait for chronic pain to reoccur.

aspirin or acetaminophen - CORRECT ANSWER -given for mild to moderate

pain

NSAIDS - CORRECT ANSWER -given for moderate pain

opioid analgesics (Morphine) - CORRECT ANSWER -given for severe pain

rectal route - CORRECT ANSWER -Avoid which medication administration route

for patients who are thrombocytopenic?

Acetaminophen - CORRECT ANSWER -Use of this analgesic could result in

hepatoxicity and should not exceed 4,000mg/day.

NSAIDS - CORRECT ANSWER -analgesic that could result in gastric ulcers or

contribute to cardiovascular events such as MI or stroke

NSAIDS - CORRECT ANSWER -analgesic that could lead to acute renal failure

in patients with volume depletion or who take it for chronic pain

prostaglandin - CORRECT ANSWER -needed for renal blood flow

constipation, nausea, pupil constriction, and respiratory depression - CORRECT

ANSWER -undesirable side effects of opioids

could increase absorption and result in lethal complications - CORRECT

ANSWER -Never apply heat over transdermal patches. Why?

antidepressants or anticonvulsants - CORRECT ANSWER -adjuvant medications

used to manage neuropathic pain

metabolic alkalosis - CORRECT ANSWER -Vomiting can lead to what acid-base

imbalance

metabolic acidosis - CORRECT ANSWER -Diarrhea can lead to what acid-base

imbalance

calcium - CORRECT ANSWER -Mineral that helps to regulate muscle

contraction and relaxation

high in calcium and low in phosphorus - CORRECT ANSWER -In the setting of

hypoparathyroidism, provide a diet that is high in _______ and low in __________.

osmotic pressure - CORRECT ANSWER -Chloride works with sodium to

determine _______________.

hypochloremic metabolic alkalosis - CORRECT ANSWER -If chloride levels drop,

bicarbonate is retained and results in _______________________________. action potentials

weakness or excitability - CORRECT ANSWER -Changes in electrolytes impair

_________________ resulting in ________ or ____________.

fluid volume deficit (FVD) - CORRECT ANSWER -Small shifts in intravascular

volume in children increases their risk for __________________.

albumin - CORRECT ANSWER -Proteins like _______ create an oncotic

pressure.

oncotic pressure - CORRECT ANSWER -________________ pulls fluid from the

interstitial compartment into the intravascular compartment to maintain volume.

D5W - CORRECT ANSWER -becomes a hypotonic solution as the cells absorb

the dextrose

dextrose - CORRECT ANSWER -________ should not be given to patients with

a head injury.

low Magnesium - CORRECT ANSWER -This mineral stimulates parathyroid

hormone secretion when low.

Magnesium - CORRECT ANSWER -This mineral helps with carbohydrate and

protein metabolism, affects neuromuscular function, and produces vasodilation.

abdominal cramps - CORRECT ANSWER -Clinical manifestations of

hyponatremia. (8)

electrolyte imbalance - CORRECT ANSWER -Assess patients for

_____________________ in the setting of vomiting, diarrhea, or suctioning.

elevate the HOB 30-45 degrees - CORRECT ANSWER -Place patient in what

position to prevent aspiration in the setting of mechanical ventilation, altered consciousness, or tube feedings? muscle weakness

coma - CORRECT ANSWER -hypercalcemia results in

muscle irritability

tetany - CORRECT ANSWER -hypocalcemia results in

Chvostek's and Trousseau's Signs - CORRECT ANSWER -Classic tests/signs

that are indicative of hypocalcemia.

osteoporosis - CORRECT ANSWER -Prolonged immobility contributes to shifting

of Ca out of the bones leading to ____________.

laryngospasms - CORRECT ANSWER -can occur with low Ca and is a medical

emergency

calcium gluconate - CORRECT ANSWER -given to reverse CNS depression

caused by magnesium

ADH (vasopressin) - CORRECT ANSWER -hormone that promotes fluid re-

absorption by the kidneys

aldosterone - CORRECT ANSWER -hormone that promotes sodium retention

and potassium excretion

angiotensin - CORRECT ANSWER -one of the most powerful vasoconstrictors in

the body

brain natriuretic peptide (BNP) - CORRECT ANSWER -hormone that triggers Na

excretion and a decrease in total fluid volume

hydrostatic pressure - CORRECT ANSWER -moves fluid from the intravascular

compartment to the intercellular compartment

edema - CORRECT ANSWER -An increase in hydrostatic pressure or a

decrease in oncotic pressure could result in _____.

delirium - CORRECT ANSWER -typical sign of dehydration in the elderly

pinching the skin over the sternum or the forehead - CORRECT ANSWER -how

to determine skin turgor

fever and burns - CORRECT ANSWER -_____ and _____ contribute to an

insensible(non-visible) water loss and contribute to dehydration drop in perfusion hypovolemic shock

death - CORRECT ANSWER -loss of fluid volume could result in? (3)

changes in LOC decreased urinary output dizziness dry mucosal membranes hypotension

tachycardia - CORRECT ANSWER -signs of fluid volume deficit

coughing and deep breathing

use of incentive spirometer - CORRECT ANSWER -Encourage patient to do

these things to help remove secretions and promote lung expansion.

2.2 pounds - CORRECT ANSWER -A weight gain of __pounds is equivalent to a

liter of fluid retention.

supine - CORRECT ANSWER -What position promotes renal blood flow and the

formation of urine?

impaired thirst mechanism - CORRECT ANSWER -Why are the elderly at an

increased risk for hypernatremia?

LR(Lactated Ringer's Solution) - CORRECT ANSWER -should never be given

with metabolic alkalosis, lactic acidosis, or renal failure

3% NaCl - CORRECT ANSWER -infuse ______ slowly because it could lead to

pulmonary edema

Potassium (NO IM either) - CORRECT ANSWER -These two electrolytes MUST

be administered IV via a pump. One must not be given IM either.

could cause asystole - CORRECT ANSWER -Why must magnesium be

administer via IV pump?

deep tendon reflexes and respirations - CORRECT ANSWER -with

hypermagnesmia or when administering magnesium sulfate the nurse should assess ______ and ______.

Digitalis/Digoxin - CORRECT ANSWER -This cardiac drug's effects are

increased in the presence of hypokalemia - monitor patients closely.

cardiac arrest - CORRECT ANSWER -_____________ is more likely with

hyperkalemia. low sodium low fat

low cholesterol - CORRECT ANSWER -In the management of cardiovascular

disease what diet should be ordered? vomiting suctioning

severe pain - CORRECT ANSWER -causes of vagal stimulation

bradycardia - CORRECT ANSWER -vagal stimulation results in _____________.

corticosteroids and alcohol - CORRECT ANSWER -in the perioperative setting

these substances may increase the risk of infection

2 weeks - CORRECT ANSWER -herbal medicine cessation time prior to a

surgical procedure?

7-10 days - CORRECT ANSWER -Aspirin cessation time prior to a surgical

procedure? venous thromboembolism surgical site infection

cardiovascular & respiratory complications - CORRECT ANSWER -Surgery

increases ones risk for ________________, __________________, and ______________________&________________.

hemmorhage - CORRECT ANSWER -All surgical procedures have the risk of

__________.

False - CORRECT ANSWER -T/F - All patients need to be NPO prior to surgery.

raise side rails - CORRECT ANSWER -Following administration of pre-anesthetic

medications what should the nurse do to increase patient safety?

metabolic acidosis - CORRECT ANSWER -When glucose metabolism is reduced

this acid-base imbalance may occur.

epidural anesthesia - CORRECT ANSWER -This type of anesthesia could result

in life-threatening hypotension and respiratory depression.

regional or local anesthesia - CORRECT ANSWER -When using these two types

of anesthesia the patient is awake.

moderate/conscious sedation - CORRECT ANSWER -This type of anesthesia

allows ventilation and protective airway reflexes to be maintained.

aspirating vomitus - CORRECT ANSWER -may trigger an asthma-like reaction

bowel preps - CORRECT ANSWER -increase the risk for fluid and electrolyte

deficits

the chest to the level of the table and 2 inches above the elbow - CORRECT

ANSWER -What part of surgical gowns are considered sterile?

tachycardia and muscle rigidity - CORRECT ANSWER -early signs of malignant

hyperthermia (2)

dantrolene - CORRECT ANSWER -antidote for malignant hyperthermia

anaphylaxis - CORRECT ANSWER -life threatening sudden allergic reaction

hypothermia - CORRECT ANSWER -decreases cellular oxygen requirements

hyperglycemia - CORRECT ANSWER -What physiologic condition can increase

the risk for surgical site infection?

use lotion assess for signs of skin breakdown change incontinence pads frequently void after intercourse pneumococcal and influenza vaccine cough and deep breathing exercises

sit up when eating - CORRECT ANSWER -Nursing interventions to reduce the

risk of skin breakdown in the elderly prior to discharge

many postoperative infections are not evident until after discharge - CORRECT

ANSWER -When does the nurse educate the patient on signs and symptoms of

infection? Why? SNS Response: increased BP, HR, RR*** pupils dilate bronchodialation vasodilation of cardiac vessels vasoconstriction of peripheral vessels

inhibits GI/GU (peristalsis) - CORRECT ANSWER -Pain stimulates the

sympathetic nervous system. What physiologic effects does this have on the body?

ATC - around the clock - CORRECT ANSWER -How often should the nurse

administer analgesics for chronic and postoperative pain?

PCA - CORRECT ANSWER -Type of analgesic administration that helps reduce

complications related to pain.

less than 90 - CORRECT ANSWER -The nurse should report a systolic blood

pressure immediately if it is less than ____.

shock - CORRECT ANSWER -This reaction creates a state where the cells are

not perfused. Types of shock: (a) heart pump fails (b) intravascular volume drops

(c) widespread vasodilation along with increased permeability - CORRECT

ANSWER -Types of shock:

(a) cardiogenic

(b) hypovolemic (c) distributive

weak thready pulse - CORRECT ANSWER -The patient has a decrease in

cardiac output. What will the pulse feel like?

volume replacement - CORRECT ANSWER -Nursing priority during hypovolemic

shock flat on their back with legs elevated at a 20-degree angle (knees kept straight) -

CORRECT ANSWER -How should the nurse position the patient when the

patient is in shock?

intravascular fluid - CORRECT ANSWER -This type of fluid contributes to one's

blood pressure or perfusion pressure.

urinary output - CORRECT ANSWER -___________ decreases with

hemmorhage.

the elderly - CORRECT ANSWER -This age group has a greater risk for

hypothermia.

30 mL/hour - CORRECT ANSWER -Report urinary output less that

________mL/hour.

hemoglobin and hematocrit - CORRECT ANSWER -A drop in _________ and

__________ could result in bleeding or hemodilution. <13.5 g/dL males

<12g/dL females - CORRECT ANSWER -Normal values for Hemoglobin (g/dL)

Male Female

hemorrhage - CORRECT ANSWER -Large amounts of bloody drainage in a

wound drain could suggest __________ and must be reported immediately!

hypercoagulation - CORRECT ANSWER -Stress increases the risk for this

clotting disorder. lower cardiac reserve

depressed renal and liver function - CORRECT ANSWER -The elderly have a

greater risk of complications following surgery. Why? (physiological)

A.. as we age, the capacity to diffuse oxygen decreases and results in a lower level of

oxygen in the arterial circulation. - CORRECT ANSWER -Which patient is

expected to have a lower level of oxygen in the arterial circulation? a. An 84 year old male with HTN. b. A 42 year old female with a recent fracture. c.. A 22 year old male with asthma.

to remove secretions and protect the lungs from foreign bodies - CORRECT

ANSWER -Why do we have a cough reflex?

hypoventilation obesity pain

abdominal distention - CORRECT ANSWER -Any condition that restricts chest

expansion could result in _______________. List three examples.

5g/dL - CORRECT ANSWER -Cyanosis occurs when there is a minimum loss of

______g/dL of unoxygenated hemoglobin in the blood.

True - CORRECT ANSWER -T/F - Cyanosis is a late sign of hypoxia.

atelectasis - CORRECT ANSWER -Prolonged hypoventilation could result in

____________.

culture - CORRECT ANSWER -What lab test should be done before an antibiotic

is prescribed?

Bleeding - CORRECT ANSWER -________ is always a risk of angiography and

procedures ending in -oscopy.

egophony - CORRECT ANSWER -This adventitious breath sound changes the E

to an A sound with consolidation.

a secure connection - CORRECT ANSWER -Tidaling in the water seal chamber

of a traditional water seal chest drainage system indicates what?

long-standing hypoxia - CORRECT ANSWER -Clubbing of the nails could be

indicative of what?

grayish cast in darker complexion mouth lips cheekbones

earlobes - CORRECT ANSWER -Where should the nurse assess the patient for

cyanosis? What color will the skin be if the patient has a darker complexion?

peak flow meters - CORRECT ANSWER -These devices can be used to

determine the adequacy of interventions to improve expiratory function. restlessness confusion pallor tachycardia

tachypnea - CORRECT ANSWER -Signs of hypoxia (5)

before meals - CORRECT ANSWER -When is postural drainage performed in

relation to meals?

cardiac disrhythmias and death - CORRECT ANSWER -Hypoxia can lead to

___________________ and _______.

onto the operative side - CORRECT ANSWER -Following a pneumonectomy

how should the nurse position the patient?

onto the unaffected side - CORRECT ANSWER -Following a lobe resection how

should the nurse position the patient?

milking the chest tube - CORRECT ANSWER -This action by the nurse helps

prevent obstructions but could increase negative pressure and damage pleural tissue.

q2h - CORRECT ANSWER -The nurse instructs the client to perform coughing

and deep breathing exercises to prevent atelectasis. How often should the client perform these exercises? (ventilation - perioperative care)

inflate the cuff on the trach - CORRECT ANSWER -While using mechanical

ventilation, the nurse can do this to the tracheostomy device to help prevent aspiration.

obstruction - CORRECT ANSWER -What does a high pressure alarm on a

mechanical ventilator signal?

positive-pressure ventilation - CORRECT ANSWER -This type of ventilation

could lead to a decrease in venous return and cardiac output.

15 seconds - CORRECT ANSWER -Suctioning for longer than _____ could lead

to dysrhythmias and cardiac arrest.

air leak - CORRECT ANSWER -Bubbling in the water seal chamber of a dry

suction water seal system may indicate a(n)__________________.

15-20mmHg - CORRECT ANSWER -Cuff pressures on an endotracheal tube

should be maintained at what level?

laryngeal swelling - CORRECT ANSWER -Accidental removal of the

endotracheal tube could cause laryngeal swelling.

PRN - as needed - CORRECT ANSWER -How often should the nurse suction

the patient with an endotracheal tube?

Acute Respiratory Failure - CORRECT ANSWER -Manifested by a decrease in

PaO2(<50mmHg) and an increase in PaCO2(>50mmhg) with respiratory acidosis.

elevate the head of the bed - CORRECT ANSWER -If the patient is

hemodynamically stable, the nurse can do this intervention to promote lung excursion.

negative pressurized room with the door kept closed - CORRECT ANSWER -The

patient on airborne precaution should have what type of room? elevate HOB 30-45 degrees provide histamine-2 blockers daily

administering oral care with chlorhexidine rinses - CORRECT ANSWER -Nursing

interventions to reduce ventilator associated pneumonia. surgery pregnancy crossing the legs

prolonged immobility - CORRECT ANSWER -Factors that increase ones risk for

developing a thrombus.

vasoconstrictor - CORRECT ANSWER -Norepinephrine is a

powerful______________________. vasodilator/vasoconstrictor

TB exposure, but not necessarily disease - CORRECT ANSWER -A positive

Mantoux test suggests what?

delayed hypersensitivity (type IV) - CORRECT ANSWER -The tuberculin

(Mantoux) test is a classic example of this type of hypersensitivity.

  1. puritis - itching
  2. vesicles - A small, superficial, circumscribed elevation of the skin, less than 1 cm, that contains serous fluid. (herpes)
  3. erythema - redness/bumps - localized eruption of the skin with minimal or no mucosal

involvement. - CORRECT ANSWER -Delayed hypersensitivity (Type IV) follows

direct skin contact with an allergen and induces what clinical manifestations in the patient? (3)

Fremitus - CORRECT ANSWER -In the presence of consolidation, what

becomes more pronounced. indicates denser or inflamed lung tissue

can be caused by diseases such as pneumonia. - CORRECT ANSWER -

Increase in tactile fremitus indicates that lung tissue is ________ or _________, which can be caused by diseases such as _________. decreasing pleural

COPD or Asthma - CORRECT ANSWER -A decrease in tactile fremitus suggests

that lung tissue density is __________ or that there is air or fluid in the _______ spaces, which can be caused by diseases such as _________ or __________.

5mm or larger - CORRECT ANSWER -Positive Mantoux reaction for patients

with HIV, who are immunocompromised, or had close contact with an infected individual appear as _____mm or larger on the patient's skin?

sputum culture - CORRECT ANSWER -This diagnostic test confirms the

diagnosis of TB. coughing wheezing increased mucous production

dyspnea - CORRECT ANSWER -Physiologic clinical manifestations of an

asthmatic attack. (4)

peak flow meter - CORRECT ANSWER -Device used to determine the patient's

highest airflow during a forced exhalation.