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

Download Exam 1: NUR209/ NUR 209 (New 2024/ 2025 Update) Medical Surgical Nursing II | Q&A and more Exams Nursing in PDF only on Docsity! Exam 1: NUR209/ NUR 209 (New 2024/ 2025 Update) Medical Surgical Nursing II | Questions and Verified Answers| 100% Correct| A Grade – Fortis QUESTION what should a patient do if their blood sugar is 100 before they start exercising? Answer: they should eat 15g of a carbohydrate, recheck in 15-30 min and delay exercise if still under 100 QUESTION what should a patient do if their blood sugar is above 250 before exercise? Answer: check urine for ketones if type 1 diabetic (delay vigorous activity is present) -drink fluids QUESTION how long can hypoglycemia occur after exercise? Answer: up to 48 hours QUESTION What is the A1C goal for diabetics? Answer: 6.5%-7.0% QUESTION how often should a diabetic check their A1C? Answer: every 3-6 months QUESTION signs of DKA Answer: -dehydration (dry mucous membranes), tachycardia, orthostatic hypotension, fruity breath, ketonuria, and kussmaul respirations QUESTION what insulin is rapid acting? whats its onset and peak? Answer: Humalog and Novolog -onset: 10-30 min -peak: 30min-3 hrs QUESTION what insulin is short acting, what its onset and peak? Answer: Regular, Humalin, Novalin onset: 30-60 min peak: 2-5 hrs QUESTION how to know if patient is fully compensated? Answer: pH will be normal QUESTION clinical manifestations of melanoma Answer: -irregular color, surface, border -color (red, white, blue, black, grey, brown) -flat, elevated, eroded, or ulcerated -usually <1cm QUESTION management for pt vomiting with metastatic colon cancer Answer: -administer antiemetic 1 hr before treatment -eat small frequent meals QUESTION A patient has the following risk factors for melanoma. Which risk factor should the nurse assign as the priority focus of patient teaching?a. The patient has multiple dysplastic nevi. b. The patient is fair-skinned and has blue eyes. c. The patient's mother died of a malignant melanoma. d. The patient uses a tanning booth throughout the winter. Answer: D Because the only risk factor that the patient can change is the use of a tanning booth, the nurse should focus teaching about melanoma prevention on this factor. The other factors also will contribute to increased risk for melanoma. QUESTION Identify the patients below who are at a HIGH risk for developing skin cancer. Select all that apply: A. A 22-year-old female who reports using a tanning bed three times per week. B. A 55-year-old male with dark skin that reports always wearing sunscreen while outdoors. C. A 35-year-old female with light-colored skin and eyes that reports frequent sunburns as a child. D. A 29-year-old who reports a family history of melanoma. Answer: The answers are A, C, and D. Risk factors for skin cancer include too much exposure to the sun, usage of tanning beds, family history, light-colored skin and eyes, exposure to toxic chemicals on the skin, and frequent sunburns as a child QUESTION You're providing an in-service on skin cancer prevention to a local group of parents and grandparents. One topic you discuss is the identification of melanoma. Select all the characteristics of this type of skin cancer you will educate the participants about: A. Diameter of 8 mm or higher B. Red, purple, and black color C. Dissimilar borders D. Uniform appearanceE. Increase in size, shape, color Answer: The answers are B, C, and E. When educating about how to identify melanoma using the ABCDE acronym. A: asymmetrical, B: borders uneven (dissimilar), C: color dark or multiple colors, D: diameter greater than 6 mm (NOT 8 mm). E: evolution (lesion increases in size, shape, color) QUESTION What are the clinical manifestations of type 1 diabetes mellitus? Select all that apply .1 Fatigue 2 Excessive thirst 3 Frequent urination 4 Recurrent infections 5 Unexplained weight loss Answer: 2, 3, 5 Excessive thirst, frequent urination, and unexplained weight loss are clinical symptoms of both type 1 and type 2 diabetes mellitus. Fatigue and recurrent infections are clinical manifestations of type 2 diabetes.Text Reference - p. 1157 QUESTION Which symptom reported by a patient would lead the nurse to suspect early undiagnosed type 2 diabetes? 1Blurred vision 2Gradual weight gain 3A wound that will not heal 4Insomnia Answer: 3 Type 2 diabetes presents with vague complaints including fatigue, frequent infections, and delayed wound healing. Blurred vision is a late symptom of uncontrolled diabetes. The patient will present with weight loss. Insomnia is not related to symptoms of undiagnosed diabetes. QUESTION A patient is prescribed lispro therapy. Related to meal times, the nurse should instruct the patient to administer the insulin when? 1. On an empty stomach, between meals 2. Simultaneously with a meal 3. 15 minutes after a meal 4. 30 to 45 minutes before a meal Answer: 3 Lispro is a rapid-acting synthetic insulin that has an onset of action of approximately 15 minutes. Lispro should be administered 15 minutes after mealtime because its rapid action closely mimics natural insulin secretion in response to a meal. Lispro is not administered on an empty stomach or simultaneously with a meal. Short-acting regular insulin, not rapid-acting synthetic insulin, is administered 30 to 45 minutes before a meal to ensure the onset of action coincides with meal absorption.Text Reference - p. 1160 QUESTION what is the rule of 15? Answer: if blood sugar less than 70 give 15g carbohydrate -recheck in 15 min, if still under 70, give 15g more carbohydrate (repeat up to 3 times) -once stable (100), give pt carbohydrate & protein QUESTION what is DKA? Answer: deficiency of body insulin resulting in hyperglycemia, formation of ketosis, acidosis, and dehydration QUESTION What are the symptoms of type 1 diabetes? Answer: polyuria (excessive urination), polydipsia (excessive thirst), polyphagia (excessive hunger) QUESTION what is type 1 diabetes? Answer: -insulin dependent diabetes -the body develops antibodies against insulin and/or the pancreatic B cells that make insulin QUESTION what is type 2 diabetes? Answer: adult-onset or non-insulin dependent diabetes -the pancreas makes sone insulin but they body does not make enough or use it correctly QUESTION what are the symptoms of type 2 diabetes? Answer: fatigue, recurrent infections, vaginal yeast or candid infections, prolonged wound healing, and vision problems QUESTION what is hypoglycemia? Answer: when there is too much insulin in proportion to available glucose in the blood QUESTION what are the assessment findings of hypoglycemia? Answer: -blood glucose <70 -cold, clammy skin -numbness of fingers, toes, mouth -tachycardia -emotional changes -headache -nervousness, tremors -faintness, dizziness -unsteady gait, slurred speech -hunger -changes in vision -seizures, coma QUESTION what is the normal Ph Range? Answer: 7.35-7.45 QUESTION what is the normal HCO3 range? Answer: 22-26 QUESTION what are the clinical manifestations of melanoma? Answer: a. irregular color, surface, and border b. variegated color, including red, white, blue, black, grey, brown c. flat or elevated. Eroded or ulcerated d. often <1cm in size e. most common sites in males are back, then chest f. most common sites in females are legs, then back QUESTION what are the high risk factors for skin cancer? Answer: a. having fair skin, blonde or red hair with blue eye color b. history of outdoor sun bathing c. living near the equator or at high altitudes d. family or personal history of skin cancer e. having an outdoor occupation f. spending a lot of time in outdoor recreation activities g. indoor tanning what to teach patients at high risk for lung cancer? Answer: avoid smoking cigarettes QUESTION what to teach a patient with a family history of colon cancer? Answer: get routine colonoscopies, starting 10 years before family member was diagnosed QUESTION what is the rule of 15's for hypoglycemia? Answer: a. If BS less then 70, have patient eat or drink 15 grams of a quick acting carbohydrate (4-6 oz of a regular sod, 5-8 life savers, 1 tbsp syrup or honey, 4 tsp jelly, 4-6 oz orange juice, commercial dextrose products) b. Wait 15 min, check blood glucose again c. If still less than 70, have patient repeat treatment of 15 grams of carbohydrate d. Once pts blood glucose is stable, have them eat additional carbohydrates plus protein or fat (crackers with peanut butter or cheese) if the next meal is more than 1 hour away or if the patient is engaging in physical activity e. Immediately notify HCP or ED if symptoms do not subside after 2-3 doses of carbs QUESTION effects of exercise on diabetics, when to check their blood sugar and eat a snack? Answer: a. Before exercise if blood glucose is less than 100: i. eat 15grams of a carbohydrate snack, ii. after 15-30 min, recheck blood glucose and delay exercise if still under 100 b. Before exercise if blood glucose is greater then 250: i. In type 1 diabetes if ketones are present, delay vigorous activity until ketones are gone ii. Drink fluids QUESTION what does the ADA recommend for physical activities for a person with diabetes? Answer: recommends at least 150 minutes per week of moderate physical activity a. Active housework b. Bicycling c. Bowling d. Dancing e. Gardening f. Golf g. Roller skating h. Walking briskly QUESTION What is hemoglobin A1C? Answer: a. A1C provides a measurement of blood glucose levels over the previous 2-3 months, with increases in the Hb A1C reflecting elevated blood glucose levels b. A1C is monitored regularly to determine how well the current treatment plan is working and changes can be made in the plan if glycemic goals are not achieved QUESTION patient teaching for a diabetic taking steroids Answer: a. Check blood sugar more often b. Increase the dose of insulin if needed c. Monitor urine or blood ketones QUESTION how to prevent DKA? Answer: -Sick day rules: (increase insulin when ill) -monitor BS every 2-4 hours -check urine for blood or ketones every 2-4 hours -eat your normal diet -8-12oz water every hour -continue insulin/ pre-established sliding scale QUESTION patient teaching for type 2 diabetes Answer: a. Healthy eating, regular exercise, and healthy weight, may need medication as the disease progresses QUESTION How to assess hypoglycemia in a sleeping or unconscious patient? Answer: a. check the blood glucose b. If pt is unconscious: subcutaneous or IM injection of 1mg glucagon or IV administration of 20-50ml of 50% glucose and turn the patient on their side to prevent aspiration QUESTION what is DKA? Answer: deficiency of body insulin resulting in hyperglycemia, formation of ketoacids, osmotic diuresis, and metabolic acidosis QUESTION