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NUR 242 MED SURG EXAM 1 NEWEST 2025 ACTUAL EXAM COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+||LATEST VERSION!!!
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Four Major subgroups of Late Adulthood - Answer- 65 - 74 young old 75 - 84 middle old 85 - 99 old old 100 and older elite old Lifestyle and Practice to Promote Wellness older adults - Answer-Yearly flu vaccine pneumococcal vaccine Shingles vaccine tetanus and booster every 10 years wear seat belts alcohol in moderation avoid smoking smoke detectors prevent falls - waxed floors and scattered rugs
medications as prescribed avoid OTC medications unless primary care phyisican directs Yearly physicial regular exercise socialization reminisce Common health Issues and Concerns older adults - Answer-Decreased nutrition and hydration Decreased mobility Stress and loss Accidents - falls most common/MVA Drug use and misuse Mental health/cognition problems (including substance abuse) Elder neglect and abuse GFTT ( Geriatric Failure To Thrive) Complex Syndrome - Answer-Under nutrition Impaired mobility
Symptoms - inattentiveness, disorganized thinking, and altered level of consciousness Nurse's role in Rehab - Answer-Advocate for the patient and family Create therapeutic rehab milieu provide whole person patient-centered care Collaborate with healthcare team for patient outcome and develop care plan Communicate with effectively with all members of the health care team, patient and family Evaluate effectiveness of plan of care for the patient and family Use Braden scale - skin break down risk Safe Patient Handing and Mobility (SPHM) - Answer-- Maintain a wide, stable base with your feet
SCIP infection - 3 - Answer-Prophylactic Antibiotics discontinued within 24 hours after surgery end time (provides benefit without risk) SCIP infection - 4 - Answer-Cardiac surgery patients with controlled 6 am postoperative blood glucose (cardiac patients only) To avoid hyperglycemia SCIP infection - 6 - Answer-Surgery patients with appropriate hair removal (removal is performed with electric clippers or chemical depilatories) to avoid skin abrasions and increase risk of surgical site infections SCIP infection - 9 - Answer-Urinary catheter removed on postoperative day 1 or postoperative day 2 with day of surgery being day zero ( to avoid urinary tract infections) SCIP infection - 10 - Answer-Surgery patients with preoperative temperature management (prevent prolonged hyperthermia, which is associated with wound healing, serious cardiac complications, altered drug metabolism, coagulation problems, and higher surgical infections.
SCIP CARD - 2 - Answer-Surgery patients on beta-blocker therapy prior to arrival who received a beta-blocker during the perioperative period ( receive beta-blocker prior and continue immediately after surgery) SCIP Venous Thromboembolism - 1 - Answer-Surgical patients with recommended venous thromboembolism prophylaxis ordered (reduce complications from postoperative VTE) SCIP Venous Thromboembolism - 2 - Answer-Surgery Patients who received appropriate Venous thromboembolism prophylaxis within 24 hours of prior to surgery to 24 hours after surgery ( reduce complications from postoperative VTE particularly among patients undergoing the types of surgeries in which the risk was highest Chapter 24 - skin layers - Answer-- Epidermis
Skin assessment - Color - Answer-- is affected by blood flow, gas exchange, body temperature, and pigmentation. describe by their appearance. Are changes general or confined to one body region Skin assessment - ABCDE - Answer-A - Asymmetry B- border irregularity C- color variation within one lesion D- Diameter greater than 6 mm E - Evolving or changing in any feature (shape, size, color, elevation, itching, bleeding, or crusting) Changes in Dark skin - cyanosis - Answer-- examine lips and tongue for gray color
Stage 2 pressure ulcer - Answer-- skin is not intact
Unstageable - Answer-- skin loss is full thickness and the base is completely covered with slough, or eschar, obscurring the true depth of the wound Wet to damp saline moistened gauze - Answer-necrotic debris is mechanically removed but with less trauma to healing tissue Continuous wet gauze - Answer-wound surface continually bathed with wetting agent of choice, promoting dilution of viscous exudate and softening of dry eschar Topical enzyme preparations - Answer-proteolytic action of thick, adherent eschar causes breakdown of denatured protein and more rapid separation of necrotic tissue Moisture - retentive dressing - Answer-Spontaneous separation of necrotic tissue is promoted by autolysis Wound - vac - negative pressure wound therapy - Answer- can reduce and or close chronic injuries by removing fluids or infectious materials, enhancing granulation. Should be changed every 48 to 72 hours.
Patient at risk for pressure injury - understanding of illness and compliance with treatment - Answer--s/s to report to primary care doctor
Hand Hygiene - Answer-wash hands with soap and water when hands are visible soiled or contaminated not visible soiled may use ABHR before direct contact with patients wash or use ABHR Decontaminate hands before putting on sterile gloves, to after contact with patients intact skin (taking a pulse) Standard precautions - Answer-should be used when caring for all patients. includes: hand hygiene between each patient contact, after removing gloves, after touching bloody, body fluids or secretions, when touching mucous membranes and non- intact skin Contact precautions - Answer-private room, wear gloves when entering the room, wash hands with soap and water when leaving the room, dedicated equipment for patient C-diff scabies impetigo respiratory syncytial virus (RSV) in infants and children
Airborne Precautions - Answer-private room with negative pressure airflow, keep door closed, N95 respirator, patient to wear surgical mask when leaving room a clinical reason M - measles T - tuberculosis V - varicella (including disseminated zoster) Droplet precautions - Answer-Private room, if private room not available, may share with patient having the same infectious disease and microorganism, wear mask when working within 3 feet of the patient, patient to wear mask when leaving room for clinical reasons S - sepsis/streptococcal pharyngitis P - pneumonia/pertussis I - influenza D- Diptheria (pharyngeal) E - epiglottitis R - Rubella M - Mumps/meningitis AN _ Adenovirus