Download MedSurg 1 RN FINAL EXAM: Questions and Answers for Nursing Students and more Exams General Surgery in PDF only on Docsity!
Jersey College MedSurg 1 RN FINAL EXAM
questions with correct answers
List four modifiable risk factors. (general health promotion) - CORRECT ANSWERS ✔✔weight, smoking, sex practices, diet List three non-modifiable risk factors. (general health promotion) - CORRECT ANSWERS ✔✔age, genetics, sex What type of assessment should the nurse preform prior to initiating health teaching? - CORRECT ANSWERS ✔✔cultural assessment Maslow's Hierarchy of Needs --priorities? --what order? - CORRECT ANSWERS ✔✔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 Organization that identifies health promotion and disease prevention goals and lists strategies along with resources in an attempt to improve the nation's health
- CORRECT ANSWERS ✔✔Healthy People 2020
Organization that recommends ways to strengthen the practice of nursing in order to improve health care. - CORRECT ANSWERS ✔✔The Institute of Medicine's report on the Future of Nursing 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? - CORRECT ANSWERS ✔✔The National Patient Safety Goals 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 - CORRECT ANSWERS ✔✔Nurse Practice Acts Institute that seeks to strengthen the knowledge, skills, and attitudes of nurses in providing continuous quality improvement in health care - CORRECT ANSWERS ✔✔QSEN - Quality and Safety Education for Nurses Institute What is pain? - CORRECT ANSWERS ✔✔whatever the patient says it is Pain is associated with __________________________________. - CORRECT ANSWERS ✔✔actual or potential tissue damage The single most reliable indicator of pain is _______. - CORRECT ANSWERS ✔✔the patient's self report
________________ could lead to allodynia. - CORRECT ANSWERS ✔✔nerve route injury What does a comprehensive pain assessment include? - CORRECT ANSWERS ✔✔timing: onset - when it started duration - where it started frequency - how often/for how long type - includes intensity, associated factors influencing factors - what makes it better/worse intensity - how bad does it hurt quality - what does it feel like location - where does it hurt effects on function/daily activities 10cm line that represents no pain to worst pain on each end of the line and the patient places a mark somewhere between the two ends depending on the severity of pain - CORRECT ANSWERS ✔✔visual analog scale
ranges from 0 to 10 with 0 representing no pain - CORRECT ANSWERS ✔✔numeric rating scale consists of cartoon faces that the patient selects to report their pain - CORRECT ANSWERS ✔✔Wong-Baker FACES Scale (ages 3+) uses words to help individuals describe the intensity of their pain - CORRECT ANSWERS ✔✔verbal descriptor scale should never be used by the provider to match the patient's facial expression - CORRECT ANSWERS ✔✔Wong-Baker FACES Scale effect produced by topical analgesics - CORRECT ANSWERS ✔✔produce a local effect effect produced by transdermal route of analgesics - CORRECT ANSWERS ✔✔produces drug absorption into the systemic circulaiton Provide ____________ to help reduce complications related to pain. Used in postoperative patients as a preventative measure for pain. - CORRECT ANSWERS ✔✔provide PCA (patient controlled analgesia) Provide administration of analgesics (frequency) for chronic and postoperative pain, never wait for chronic pain to reoccur. - CORRECT ANSWERS ✔✔around the clock
adjuvant medications used to manage neuropathic pain - CORRECT ANSWERS ✔✔antidepressants or anticonvulsants Vomiting can lead to what acid-base imbalance - CORRECT ANSWERS ✔✔metabolic alkalosis Diarrhea can lead to what acid-base imbalance - CORRECT ANSWERS ✔✔metabolic acidosis Mineral that helps to regulate muscle contraction and relaxation - CORRECT ANSWERS ✔✔calcium In the setting of hypoparathyroidism, provide a diet that is high in _______ and low in __________. - CORRECT ANSWERS ✔✔high in calcium and low in phosphorus Chloride works with sodium to determine _______________. - CORRECT ANSWERS ✔✔osmotic pressure If chloride levels drop, bicarbonate is retained and results in _______________________________. - CORRECT ANSWERS ✔✔hypochloremic metabolic alkalosis Changes in electrolytes impair _________________ resulting in ________ or ____________. - CORRECT ANSWERS ✔✔action potentials weakness or excitability
Small shifts in intravascular volume in children increases their risk for __________________. - CORRECT ANSWERS ✔✔fluid volume deficit (FVD) Proteins like _______ create an oncotic pressure. - CORRECT ANSWERS ✔✔albumin ________________ pulls fluid from the interstitial compartment into the intravascular compartment to maintain volume. - CORRECT ANSWERS ✔✔oncotic pressure becomes a hypotonic solution as the cells absorb the dextrose - CORRECT ANSWERS ✔✔D5W ________ should not be given to patients with a head injury. - CORRECT ANSWERS ✔✔dextrose This mineral stimulates parathyroid hormone secretion when low. - CORRECT ANSWERS ✔✔low Magnesium This mineral helps with carbohydrate and protein metabolism, affects neuromuscular function, and produces vasodilation. - CORRECT ANSWERS ✔✔Magnesium Can be given to relax smooth muscle. Calcium antagonist. - CORRECT ANSWERS ✔✔Magnesium Sulfate The antidote for tetany or hypermagnesmia - CORRECT ANSWERS ✔✔Calcium gluconate
the primary factor for osmolality and intravascular fluid volume - CORRECT ANSWERS ✔✔sodium Clinical manifestations of hyponatremia. (8) - CORRECT ANSWERS ✔✔headaches seizures lethargy tachycardia decreased blood pressure thready pulse hyperactive bowel sounds abdominal cramps Assess patients for _____________________ in the setting of vomiting, diarrhea, or suctioning. - CORRECT ANSWERS ✔✔electrolyte imbalance Place patient in what position to prevent aspiration in the setting of mechanical ventilation, altered consciousness, or tube feedings? - CORRECT ANSWERS ✔✔elevate the HOB 30-45 degrees hypercalcemia results in - CORRECT ANSWERS ✔✔muscle weakness coma hypocalcemia results in - CORRECT ANSWERS ✔✔muscle irritability tetany
Classic tests/signs that are indicative of hypocalcemia. - CORRECT ANSWERS ✔✔Chvostek's and Trousseau's Signs Prolonged immobility contributes to shifting of Ca out of the bones leading to ____________. - CORRECT ANSWERS ✔✔osteoporosis can occur with low Ca and is a medical emergency - CORRECT ANSWERS ✔✔laryngospasms given to reverse CNS depression caused by magnesium - CORRECT ANSWERS ✔✔calcium gluconate hormone that promotes fluid re-absorption by the kidneys - CORRECT ANSWERS ✔✔ADH (vasopressin) hormone that promotes sodium retention and potassium excretion - CORRECT ANSWERS ✔✔aldosterone one of the most powerful vasoconstrictors in the body - CORRECT ANSWERS ✔✔angiotensin hormone that triggers Na excretion and a decrease in total fluid volume - CORRECT ANSWERS ✔✔brain natriuretic peptide (BNP) moves fluid from the intravascular compartment to the intercellular compartment
- CORRECT ANSWERS ✔✔hydrostatic pressure
use of incentive spirometer A weight gain of __pounds is equivalent to a liter of fluid retention. - CORRECT ANSWERS ✔✔2.2 pounds What position promotes renal blood flow and the formation of urine? - CORRECT ANSWERS ✔✔supine Why are the elderly at an increased risk for hypernatremia? - CORRECT ANSWERS ✔✔impaired thirst mechanism should never be given with metabolic alkalosis, lactic acidosis, or renal failure - CORRECT ANSWERS ✔✔LR(Lactated Ringer's Solution) infuse ______ slowly because it could lead to pulmonary edema - CORRECT ANSWERS ✔✔3% NaCl only solution that can be used with blood transfusions - CORRECT ANSWERS ✔✔0.9% normal saline these types of fluids cause extracellular fluid volume expanison - CORRECT ANSWERS ✔✔isotonic This solution is both hypotonic and isotonic and should NEVER be used in the presence of increased intracranial pressure. - CORRECT ANSWERS ✔✔D5W
Give _________ solutions to treat hyperosmolar disorders. - CORRECT ANSWERS ✔✔hypotonic solutions This location for IV therapy increases the risk for thromboembolism. - CORRECT ANSWERS ✔✔the leg What size catheter is used to administer blood and viscous solutions? - CORRECT ANSWERS ✔✔14-18 gauge Use these type of catheters on the elderly patient for IV therapy. - CORRECT ANSWERS ✔✔smaller size angio-catheters start IV sites where? - CORRECT ANSWERS ✔✔most distal area of the arm Prior to initiating intravenous therapy on peripherally inserted central catheters the nurse should do what to check placement of the PICC line? - CORRECT ANSWERS ✔✔obtain an x-ray puts the client at risk for circulatory overload - CORRECT ANSWERS ✔✔IV therapy how to position the patient to treat air embolism - CORRECT ANSWERS ✔✔Left side in trendelenburg How do you treat non-vesicant infiltration? - CORRECT ANSWERS ✔✔warm compress and elevate the extremity
causes of vagal stimulation - CORRECT ANSWERS ✔✔vomiting suctioning severe pain vagal stimulation results in _____________. - CORRECT ANSWERS ✔✔bradycardia in the perioperative setting these substances may increase the risk of infection - CORRECT ANSWERS ✔✔corticosteroids and alcohol herbal medicine cessation time prior to a surgical procedure? - CORRECT ANSWERS ✔✔2 weeks Aspirin cessation time prior to a surgical procedure? - CORRECT ANSWERS ✔✔7-10 days Surgery increases ones risk for ________________, __________________, and ______________________&________________. - CORRECT ANSWERS ✔✔venous thromboembolism surgical site infection cardiovascular & respiratory complications All surgical procedures have the risk of __________. - CORRECT ANSWERS ✔✔hemmorhage
T/F - All patients need to be NPO prior to surgery. - CORRECT ANSWERS ✔✔False Following administration of pre-anesthetic medications what should the nurse do to increase patient safety? - CORRECT ANSWERS ✔✔raise side rails When glucose metabolism is reduced this acid-base imbalance may occur. - CORRECT ANSWERS ✔✔metabolic acidosis This type of anesthesia could result in life-threatening hypotension and respiratory depression. - CORRECT ANSWERS ✔✔epidural anesthesia When using these two types of anesthesia the patient is awake. - CORRECT ANSWERS ✔✔regional or local anesthesia This type of anesthesia allows ventilation and protective airway reflexes to be maintained. - CORRECT ANSWERS ✔✔moderate/conscious sedation may trigger an asthma-like reaction - CORRECT ANSWERS ✔✔aspirating vomitus increase the risk for fluid and electrolyte deficits - CORRECT ANSWERS ✔✔bowel preps What part of surgical gowns are considered sterile? - CORRECT ANSWERS ✔✔the chest to the level of the table and 2 inches above the elbow
General anesthesia causes loss of _____ and _______ - CORRECT ANSWERS ✔✔ventilatory function and consciousness How to position a patient for a lumbar puncture - CORRECT ANSWERS ✔✔side-lying knee chest position Who should mark the surgical site? - CORRECT ANSWERS ✔✔both the patient and the surgeon This exercise helps to eliminate residual anesthetic agents. - CORRECT ANSWERS ✔✔deep breathing How should the patient be positioned to prevent aspiration from vomitus? - CORRECT ANSWERS ✔✔onto their side Post-operatively, these nursing interventions promote venous return in the patient. (4) - CORRECT ANSWERS ✔✔ambulation sequential compression devices anti-embolism stockings sequential teds Increases the risk for DVT when under the knees - CORRECT ANSWERS ✔✔constricting blood vessels __________ or __________ could indicate hypoxia. - CORRECT ANSWERS ✔✔restlessness or a change in mental status
Device used to detect hypoxemia. - CORRECT ANSWERS ✔✔pulse oximetry Nursing interventions to reduce the risk of skin breakdown in the elderly - CORRECT ANSWERS ✔✔drink plenty of fluids 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 When does the nurse educate the patient on signs and symptoms of infection? Why? - CORRECT ANSWERS ✔✔prior to discharge many postoperative infections are not evident until after discharge Pain stimulates the sympathetic nervous system. What physiologic effects does this have on the body? - CORRECT ANSWERS ✔✔SNS Response: increased BP, HR, RR*** pupils dilate bronchodialation vasodilation of cardiac vessels vasoconstriction of peripheral vessels inhibits GI/GU (peristalsis)
