Exam 1: NUR209/ NUR 209 (2024/ 2025 Update) Medical Surgical Nursing II Review | Q&A, Exams of Nursing

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Exam 1 : NUR20 9 / NUR 20 9 (2024/ 2025

Update) Medical Surgical Nursing II

Review | Questions and Verified Answers|

100% Correct| A Grade – Fortis

QUESTION

S/s of type 1 DM: SATA Answer: 3' P Excessive thirst Excessive urination Excessive hunger

QUESTION

signs and symptoms of DM type 2 Answer: urinating more often than usual, particu- larly at night. feeling very thirsty. feeling very tired. unexplained weight loss. itchiness around the genital area, or regular bouts of thrush (a yeast infection) cuts or wounds that heal slowly. blurred vision - caused by the lens of the eye becoming dry.

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. Gestational Diabetic patient Answer: Fast blood glucose

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What symptoms would you expect in a patient with Cushing's syndrome?- Answer: weight gain. thin arms and legs. a round face. increased fat around the base of the neck. a fatty hump between the shoulders. easy bruising. wide purple stretch marks, mainly on the abdomen, breasts, hips, and under the arms. weak muscles.

QUESTION

What lab test would you order for a patient with Cushing's disorder Answer: 24 - hour urine free cortisol

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When should you administer Lispro insulin Answer: 15mins before or immediately after

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S/S of hypoglycemia Answer: shakiness, diaphoresis, anxiety, nervousness, chills, nausea, headache, weakness, confusion pg. 1131 table 48.

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Blood glucose downs low during late evening, and shoots up in AM Answer: So- mogyi

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. Meal planning for diabetics? Answer: eat with family but cut back

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Complications of type 2 DM Answer: Renal failure/ nephritis

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. DKA patient is admitted to hospital, what do you do? Answer: Start insulin drip

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. Pt has DM 2 nurse should educate Answer:

selects food high in trans fats

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If the patient has acromegaly, what would you ask them? Answer: Medical history

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What assessment finding is consistent with panhypopituitarism? Answer: de- creased facial hair

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SIADH, and what they are at risk for Answer: The body makes too much ADH, At risk of retaining to much fluid

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What lab will tell you they have diabetes insipidus Answer: Checking the levels of certain substances in the blood, such as sodium, potassium and calcium, pg. 1148

QUESTION

How do you know the med for hypothyroidism has been effective? Answer: set up a plan to test and measure thyroid-stimulating hormone (TSH) every few weeks after beginning medication.

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What does hypovolemia release? Answer: The loss of blood or water

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What medication will you have available for tetany for a patient with thy- roidectomy Answer: Calcium glucoate IV

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education for a patient on synthroid Answer: apical pulse rate can take up to 8 weeks to notice full effect lifelong therapy is required carefully monitor patients with CVD Monitor HR and report pulse greater than 100 beats/min or an irregular HR Treatment for hypothyroidism promptly report chest pain, weight loss, nervousness, tremors, and/or insomnia In a patient without side effects the dose is increased at 4-6 was intervals as needed based on TSH levels

QUESTION

What are interventions for a pheochromocytoma Answer: Rare condition caused by a tumor in the adrenal medulla Treat symptoms associated with disease most dangerous immediate effect is severe hypertension postural changes cautiously medication can decrease tumor if surgery is not an option-demser can decrease catacholamine monitor bp monitor bs

QUESTION

What will skin look like in a patient with Addisons' disease Answer: Bronze or smoky hyperpigmentation of face, neck, hands (especially creases) buccal membranes, nipple genitalia, and scars

QUESTION

What is a post-surgical priority of a patient who has Cushings disease after an adrenal tumor resection Answer: eat a 15 G carb snack if bs is <100, then recheck in 15 - 30 min if still <100 delay exercise monitor blood glucose levels before, during and after complex carb

QUESTION

What is a major characteristic of hypoglycemia, DM that would cause you to be unalert? or alert Answer: cold and clammy need some candy

shaking low blood sugars

QUESTION

What is the smogyi phenonium Answer: hyperglycemia in the morning check patients' glucose levels between 2-4 am for hypoglycemia will help to deter- mine may report headaches on awakening and recall having night sweats or nightmares check sugars during the night

QUESTION

What would you educate a patient on? newly dx patient with DM II Answer: BS control diet and exercise foot care

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What is some education for foot care for DM Answer: advise patients to inspect feet daily avoid going barefoot wear shoes that are supportive and comfortable if cuts, scrapes or burns occur monitor them carefully If new wound on foot does not begin to heal after 24 hours or signs of infection notify the provider

QUESTION

Type II diabetic and taking prednisone what do you think will happen? Answer:

Require administration of insulin while taking prednisone- increase need glucose levels increase when patients are taking corticosteroids

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Why would you send a patient to teach about DKA Answer: monitor when you are ill infection inadequate insulin dosage

QUESTION

pa0 7.48 pac02 32 hco3 25 Answer: respiratory alkalosis

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ph 7.32, pao2, 88 paco2 35 hco3 16 Answer: metabolic acidosis

QUESTION

ABGs with COPD

Answer: co2 will be high retaining-respiratory acidosis ph: 7.35 paCo2 45 above paco2 out of range respiratory: metabolic out of range

QUESTION

What would ABGs Answer: acidic numbers will be higher

QUESTION

Trousseau's sign Answer: worried about calcium carpal spasms induced by inflating BP cuff on the arm Inflate the cuff above systolic pressure carpal spasms will occur after 3 mins if hypocalcium is present positive hypothyroidism sign

QUESTION

NG tube and diarrhea patient is receiving Lasix and K+ is 3, what do you do? Answer: Hold Lasix

QUESTION

symptoms of hypervolemia Answer:

Increased BP Bounding pulse Increased respirations and shallow Neck veins are distended Edema Pale cool skin Urine is dilute and increased volume rapidly gains weight Moist crackels in the lungs and syspnea BUN

QUESTION

.Which IV fluids are needed for a patient that has had diarrhea for 5 days? Answer: Lactate Ringer

QUESTION

ABGs Answer: Arterial Blood Gases pH 7.35- 7. HCO3 (Bicarbonate) normal values 22-26 mEq/L PaCO2 ( CO2 or carbon dioxide content) 35- 45 mm Hg PaO2 (oxygen saturation in arteria blood)- 80 - 100 mm Hg

QUESTION

What are the risk factors for developing skin cancer Answer: uv rays, fair skin blue eyes

QUESTION

How would you characterize actinic keratosis?

Answer: A thick, scaly patch of skin that may become cancer

QUESTION

A patient believes a lesion on the arm is cancer, what would make you think it is? Answer: ABCDE is answer I put diameter greater 6

QUESTION

.What would be your priority teaching for a patient with melanoma? Answer: Ask family history for it or tanning

QUESTION

. Burns, know the 9's Answer: : 40.

QUESTION

What are the characteristics of a full thickness burn? Answer: Dry waxy hard skin page 434

QUESTION

A patient was in a burning house, now has singed facial hair, hoarse and coughing up black sputum, what is the priority? Answer: Airway, breathing

QUESTION

What are emergency interventions for electrical burns? In a concussion patient? SATA Answer: Withhold meds Remove clothes Use a 24-gauge needle These are all the wrong answers the one left is right answer

QUESTION

. Labs in a chemically burned patient? Answer: Sodium 135-145, potassium 3.5-5, Hct M 41- 50 W 36-48, pH 7.35-7.

QUESTION

.Pt has severe burns, what would tell you they are having complications?- Answer: Vs, Hypovolemic shock low fluid volume, cardiovascular complications like Dysrhythmias

QUESTION

Parkland Baxter formula Answer: 4ml LR per kg of body weight, per % of TBA, ½,S S

QUESTION

subjective data regarding the endocrine system Answer: fatigue, weakness, men- strual irregulations weight changes skin changes, thicker or dryer elimination increased urination or diarrhea sleep pattern, sleep problems memory

QUESTION

testing for hypothyroidism Answer: serum calcium levels pth levels serum phosphate levels

QUESTION

diet for a patient with parathyroid hormone deficit Answer: high calcium meal plan foods such as dark green vegetables, soybeans, tofu

QUESTION

priority for a patient who has an irregular heart rate, eccomosis, increase blood sugar, +4 pitting with cushings Answer: ABCs hypertension hypokalemia

QUESTION

math-parkland formula Answer: patient is to be administered 24 hours is 30,000 ml= 938ml hour 1/2 the fluids for the first 8 hours then other half over the next 16 hours

QUESTION

characteristics of melanoma Answer: irregular color, surface and boarder variegated color, including red, white, blue, black, gray, brown flat or elevated, eroded or ulcerated often <1 cm in size most common sites in males are on back then chest females are legs then back

QUESTION

Adrenal carcinoma Answer: it spreads to other parts of the body

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TNM classification Answer: T: primary tumor N: reginal lymph nodes M: distant metastasis T1- the cancer is too small to be seen on a scan, or felt during an examination of the prostate. N3- The cancer has spread to 10 or more axillary lymph nodes, or it has spread to the lymph nodes located under the clavicle, or collarbone M1- Cancer has spread to other parts of the body.

QUESTION

Early warning signs of cancer : CAUTION Answer: Change in bowel and bladder habits, A sore that will not heal, unusual bleeding or discharge, Thickening of lump in breast or elsewhere, Indigestion or difficulty swallowing, Obvious changes in wart or moles, Nagging cough or hoarseness

QUESTION

Pt receiving chemotherapy what assessment findings would you see and effects on bone marrow and stem cells? Answer: SATA Neutropenic, decreased WBC, RBC, and platelets

QUESTION

Myelosuppression: effects of chemo Answer:

Thrombocytopenia: increased bleed- ing/risk for bleeding Neutropenic: observe for infection

QUESTION

Pt with inadequate nutrition r/t oral ulcers what can you do to increase oral intake? Answer: Oral care

QUESTION

Metastatic lung cancer patient vital sign status change, what interventions are good??? Answer: instruct the patient to inspire fully and cough two to three times in one breath keep monitoring An increased breathing rate (tachypnea) and an increased heart rate (tachycardia) may also be observed, but these signs are non-specific and, therefore, less mean- ingful in diagnosing lung cancer

QUESTION

.Metastatic cancer for pain SATA Answer: *Increase pain meds *Get order for anxiety med *PRN medication

QUESTION

Nursing intervention for Hodgkin's lymphoma patient that can't get out of bed r/t fatigue? Answer:

Get them walking

QUESTION

Pt admit for intractable vomiting? What intervention can be delegated to the UAP? SATA Answer: Daily weights and vitals Freq oral care Record intake and output

QUESTION

Labs results for SIADH? Answer: Hyponatremia sodium <135, and low serum osmo- lality <280mosm/kg,

QUESTION

.Patient Sodium level 183 hypotonic solution Answer: solution give slowly and watch for edema