Medical Surgical Nursing Exam 2: Questions and Answers, Exams of Nursing

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Questions and answers

What kinds of diseases would require contact isolation precautions? - correct answer ✅- salmonella

• scabies
• shigella
• c-diff
• MRSA
• herpes & fungal infections What is required to discontinue contact isolation precautions for MRSA? - correct answer ✅- may occur when clearance of the organism has been documented with 3 or more surveillance tests What kinds of diseases would require airborne isolation precautions? - correct answer ✅- MMR (measles, mumps, rubella)
• TUberculosis (N95 mask, - air flow)
• Varicella (chicken pox)

• thanks to Tiffany What kinds of diseases would require droplet isolation precautions? - correct answer ✅- Corona virus

• Pertussis/whooping cough
• Influenza/flu
• Meningitis
• Pneumonia

• thanks to Tiffany & Jay

Questions and answers

Reverse isolation - correct answer ✅- neutropenic isolation precautions What are neutropenic isolation precautions used for? - correct answer ✅- Patient that is immunocompromised with low # of neutrophils. In this incidence were more concerned about the patient acquiring a disease. radiation isolation precautions - correct answer ✅- steps taken to isolate a patient who has received radiation from others who might be harmed by the radiation from a distance

• all equipment must stay in room until removed by someone who knows how to decontaminate it Airborne precautions distance - correct answer ✅- 10 feet or more Droplet precautions distance - correct answer ✅- 3 to 6 feet Clinical manifestations of TB - correct answer ✅- fatigue
• weight loss & anorexia
• night sweats
• cough with rusty colored/blood streaked sputum
• dyspnea, orthopnea, and rales as disease progresses Treatments for anaphylactic reaction - correct answer ✅- removal of triggering agent - prompt recognition & treatment

Questions and answers

• pt maintains their airway and responds to verbal cues
• usual meds are benzos like diazepam, midazolam & narcotics like fentanyl & meperidine Absolute Neutrophil Count (ANC) - correct answer ✅- # of neutrophils available to fight infection
• (%bands+%segs)xWBC
• normal range 1500- CBC with differential - correct answer ✅• Provides the # and types of WBCs (e.g., Neutrophils, lymphocytes, monocytes, eosinophils, and basophils)
• Help clinicians pinpoint the type of infection a patient might have (e.g., Bacterial vs. viral) What would cause a rise in neutrophils & monocytes? - correct answer ✅- bacteria infections
• neutrophils = new bacteria infection
• monocytes = adaptive response What would cause an increase in eosinophils? - correct answer ✅- allergens, parasite, cocci, fungus What would cause an increase in basophils? - correct answer ✅- release heparin & histamine which allow cells to get to an area of infection easily
• released during early inflammation stage

Questions and answers

left shift - correct answer ✅common term for an alteration in the distribution of leukocytes in which there are increases in banded neutrophils usually in response to severe bacterial infection caused by inflammation What causes an increase in lymphocytes? - correct answer ✅- TB, viral infection Band Neutrophil - correct answer ✅- immature neutrophil

• "baby" increase with infection Segmented neutrophil - correct answer ✅- mature neutrophil
• "senior" phagocytes How might an older persons immune system respond differently to infection? - correct answer ✅- may not show typical signs/labs for infection Local signs of infection - correct answer ✅- pain/tenderness, swelling, redness, warmth Complications of regional anesthesia - correct answer ✅- hypotension
• spinal headache
• respiratory paralysis
• seizure if med delivered IV
• nerve damage

Questions and answers

• Trendelenburg = resp monitoring slow changes
• reverse Trendelenburg = SCDs foot pad
• prone = pressure reducing/chest rolls/resp monitoring
• jackknife = check distal pulses b4, during, and after positioning SCDs
• lateral = distal pulses, slow changes, pillows & pressure
• lithotomy = distal pulses, support, stability benign tumor - correct answer ✅- an abnormal mass of cells that remains at site of development
• grow slowly
• encapsulated & easily removed malignant tumor - correct answer ✅- A cancerous tumor that is invasive enough to impair the functions of one or more organs.
• doesn't stop at tissue border & destroys surrounding tissue
• metastasizes & grows rapidly Grading of tumors - correct answer ✅- evaluates the amount of the cells differentiation from normal cells
• estimates the rate of cell growth (aggressiveness of tumor) Staging of tumors - correct answer ✅- system of evaluating the extent of spread of tumors
• 1-4 stages

Questions and answers

TNM staging system - correct answer ✅- T= tumor size

• N= node involvement
• M= metastasis present? What is the goal of radiation therapy? - correct answer ✅- death of abnormal cells
• minimize injury to normal cells What are side effects of radiation? - correct answer ✅- alopecia
• erythema
• mucous membrane changes
• anorexia, n/v, diarrhea
• fatigue
• myelosuppression Risk factors for cancer - correct answer ✅- carcinogen exposure
• age/genetic predisposition
• lifestyle
• environmental
• hormonal
• infectious disease
• medications
• immune and nutritional status

Questions and answers

Tumor classification by tissue type - correct answer ✅- CARCINOMA originate from epithelial cells

• LYMPHOMA originate from organs that fight infection
• LEUKEMIA originate from organ that form blood
• SARCOMA originate from supporting tissue (muscle & bone) Management of cancer medical surgical - correct answer ✅- surgery
• radiation therapy
• chemotherapy
• bone marrow/stem cell transplant
• immunotherapy, gene therapy, alternative therapy What is primary cancer surgery used for? - correct answer ✅- remove entire tumor & involved tissue What is prophylactic cancer surgery used for? - correct answer ✅- removes tissue for organs that are likely to develop cancer What is diagnostic cancer surgery used for? - correct answer ✅- ensures histologic diagnosis & staging What is palliative cancer surgery used for? - correct answer ✅- relieve uncomfortable symptoms to relieve pain, maintain comfort, and bypass obstruction

Questions and answers

What is reconstructive cancer surgery used for? - correct answer ✅- correct defects such as breast implants after masectomy What are the two main types of radiation? - correct answer ✅- teletherapy (external radiation)

• brachytherapy (radioactive seeds are implanted in patient
• systemic (iodine injection) What are normal rapidly dividing cells that can be destroyed with cancer cells? - correct answer ✅- hair
• skin
• intestinal tissues
• blood forming cells (bone marrow) Nursing interventions for chemotherapy - correct answer ✅-administer antiemetic for N&V -limit oral intake to clear liquids on day of chemo -use mild soap and wash hair every 3-4 days and purchase a wig for alopecia -bland cool foods or liquids to treat stomatitis -use a soft toothbrush -avoid ETOH mouthwash -frequent oral care -assess for bruising or bleeding,WBC count -isolation(antibiotics)

Questions and answers

CD4 count - correct answer ✅- Number of CD4 cells in a sample of blood HIV infection stage 1 - correct answer ✅- @ least 500 cells HIV infection stage 2 - correct answer ✅- 200-499 cells HIV infection stage 3 AIDS - correct answer ✅- <200 cells Pain mgmt for cancer patient - correct answer ✅- up to 95% of pt with advanced cancer experience pain that requires analgesia

• morphine & transdermal fentanyl are most commonly used
• narcotic doses are increased gradually to allow limitless amount What increases the risk of developing HIV? - correct answer ✅- syphilis
• unprotected sex & multiple partners
• dirty/non-sterile needles
• infected blood transfusions
• bite wounds
• pregnancy (mom-baby) What indicates a positive response to antiviral therapy? - correct answer ✅- increase in cd4 count
• decreased or non-detectable level of viral load

Questions and answers

What kind of precautions are taken by the nurse when caring for a HIV+ patient? - correct answer ✅- utilize universal precautions consistently (gown, glove, goggles)

• good hand hygiene What should compliance be for HIV medication? - correct answer ✅- 100% adherence rate to decrease possibility of viral resistance
• prescribed 3 minimum meds from 2 different classes Left shift - correct answer ✅- increase in the number of immature neutrophils in response to infection