Medical Surgical Nursing Final Exam Review.Guaranteed A+.Latest Update.2023, Exams of Nursing

Download Medical Surgical Nursing Final Exam Review.Guaranteed A+.Latest Update.2023 and more Exams Nursing in PDF only on Docsity!

Medical Surgical Nursing Final

Exam Review.Guaranteed

A+.Latest Update.

1 A Patients who have seizure will complain of an aura. What is the patient experiencing when they have an aura?  Visual distortion, odor, sound.

1. Patient who had a traumatic head injury. What would you report immediately?  When you have increased intracranial pressure = decreased level of consciousness; changes in mental status , they were alert and are no longer alert and difficult to/can not arouse.
2. Adult patient with meningococcal meningitis, they have signs and symptoms different than a

viral meningitis. ( Something goes hand in hand with meningococcal meningitis)  High fever; severe headaches; nausea & vomiting; stiff neck; lethargy; fatigue; sensitivity to light ( photophobia ) seizures; purple skin rash; coma.

3. What is the definition of myopia?  Nearsightedness. When you can see objects that are close but not far away.
4. Cognitive problems associated with Parkinson’s disease. What kind of things do you see with that? - Problems with memory; cognitive impairment (dementia). - Slowness of thinking, struggling to find the right words in conversations. Declining visual perceptions. Difficulty concentrating.

Difficulty with problem solving. Language problems.

5. A nurse is developing a plan of care what would be included in the plan of care for the nutritional needs of a patient with stage 4 Parkinson’s disease.  Record diet and fluid intake daily. Add thickener to liquids. Offer nutritional supplements between meals. Careful documentation of I&O.
6. What structure would the nurse instruct the patient that electrically insulates neurons?  Myelin Sheath.
7. What would be included in teaching for patient having an EEG (electroencephalogram)?  Encourage patient to be sleep deprived; assure hair clean and dry.  Post-procedure – wash hair.

8. Patient with lumbar puncture post-op teaching.  Lay flat 6-8 hours & encourage PO fluids
9. Patient with A fib and they’ve had a TIA what can you anticipate being ordered for your patient?  Warfarin, Aspirin, and/or Clopidogrel.
10. You know your patient understands the instructions for an MRI when they make this statement.  No pacemaker, no metal, or jewlery on patient.
11. Reviewing teaching with a patient that had a TIA. What statement would indicate that more teaching is required?  “My risk for Alzheimer’s disease is increased so now ill have to stop driving” there is no association with TIA and the development of Alzheimer’s disease.

12. Patient comes to ER with right facial drooping and slurred speech. The nurse suspects they are having a stroke. What other manifestations would you see in a patient having a stroke?
    • Sudden numbness/weakness, sudden confusion, sudden change in vision, sudden trouble walking/dizziness, sudden severe headache, depends on area of brain affected. If you have stroke on the right side, you will have weakness on the left side.
    • F.A.S.T -FACE, ARM, SPEECH, TIME!
13. Patient with newly diagnosed with Parkinson’s and asks the nurse “why can’t I control these tremors”
    • Decreased dopamine production.
14. Patient has hearing loss do to aging how would you increase communication with the patient?

 Bring voice down to a lower pitch and face the patient.

15. Patient with trigeminal neuralgia is in hospital for testing. What intervention would be most appropriate for patient?
    • Keep them out of cold. Warm food.
16. Patient has acute angle closure glaucoma and administering meds. What medication would you question before administering med?
    • Mydriatics – learning tip – constricts pupil - atropine, antihistamines, and Vistaril can cause blindness*
17. Patient is having a Edrophonium (Tensilon) test for Myasthenia Gravis. You would know if they had myasthenia gravis if you give them the medication and their condition improve temporarily.

• If muscle strength improves dramatically (pt. can open suddenly open eyes wide) MG is diagnosed. After a brief period of rest the eyelids can be opened without difficulty.

18. Substance that gives shape to the eye and fills the space behind the lens of the eye.

• Vitrius – gelatinous and if not, enough eye will be soft. Vitreous Humor – holds retina in place

19. Questioning if your patient has cataracts – what symptom would you expect because of the health problem?

• Loss of visual acuity. Halos around lights. Sensitivity to glare. Decreased color vision.

20. Patient that’s had a stroke, right sided weakness in a patient with suspected CVA, what is the cause?

• Left sided hemiparesis (inability to move one side of body)

21. How would you administer a Romberg test?

• Patient will stand with feet together. Stand with eyes open then eyes closed. They are scored by counting the seconds they can stand with eyes closed without swaying/loosing balance. Test is positive when patient sways and looses balance with eyes closed.

22. Patient has Meniere’s disease – what statement said by the patient would the nurse question? Negative question – patient said something that is not right.

• How do you know patient needs more teaching – chose diet that has salty foods** Restrict salt.

23. Definition of receptive and expressive aphasia.

• Receptive aphasia – inability to understand spoken and/or written words.
• Expressive aphasia – patient knows what he wants to say but cannot speak or make sense.

24. Patient is unable to speak but seems to understand what you are saying. What would this be called?

• Expressive aphasia.

25. Assessment of patient with pulmonary edema and what order would the nurse question? Question gives signs and symptoms – doctors order that you need to question. 
26. Testing patients visual field – what part of vision are you testing?

• Check peripheral vision – how far you can see object (pen) up, down, R and L while looking straight ahead.

27. Patient who is dehydrated due to fluid volume deficit expected findings. 
28. Who is most at risk for fluid excess?

• Age related changes in cardiovascular and renal functions and excessive sodium intake.  Older adult patient receiving IV therapy.

29. Risk factors that make Myasthenia Gravis worse.

• Extreme heat/cold, fatigue, infection, physical, and emotional stress.

30. How would you describe diabetic retinopathy?

• Vascular changes in retinal blood vessels.

31. The term that indicates to the nurse that substance is toxic to the ear.
    • Ototoxic.
32. Chart with 4 diseases – know that the 4 diseases all have difficulty swallowing & breathing.  MS; ALS; MG; GBD
33. Caring for 4 patients. What patient would you see first?  Always look for the most unstable patient.
34. Data collection on eyes and ears – what would you ask the patient?  When was your last examination of eyes or ears?
35. Symptom of ICP that should be reported to HCP
    • has to do with vital signs.
      • Restlessness, irritability, decrease LOC, hyperventilation, pupil changes, Cushing’s response.

• Cushing’s response triad (hypertension, bradycardia, abnormal respiratory pattern).

36. What test would the nurse use as an initial screening test to determine hearing loss?  Whisper voice test – least invasive test.
37. Patient being discharged for fluid imbalance – what instruction by the nurse would take priority?

• Weigh yourself at the same time everyday and report changes.

38. Signs and symptoms of dehydration in elderly population.

• Thirst, rapid weak pulse, low BP, dry skin, dry mucous membranes, poor skin turgor, increase temp.

39. Dilantin, how do you know the patient understands the teaching?

• Patient knows good mouth care and dental hygiene is crucial. Dilantin can cause overgrowth of gum tissue – hyperplasia of the gums. They will be able to repeat back to you what you told them.

40. How would you document that an ear is draining?

• Otorrhea.

41. Patient has acute bacterial conjunctivitis and they prescribed ophthalmic ointment. How would you administer the ointment?

• Pull lower eyelid down, squeeze a ribbon of ointment out and from inner to our canthusdo not touch eye with dropper.

42. How do you know medication has been effective in patient with Parkinson’s disease and prescribed Levodopa?

• Levodopa is turned into dopamine in the body and therefore increases levels of this chemical. When giving medication for Parkinson’s disease you are replacing the dopamine and you should see improvement in symptoms. Helps disable tremors by slowing/stopping them.

43. What is the term for procedure that is used to drain fluid from ear?

• Myringotomy – tube in the ears to help drainage.

44. Patient comes to clinic complaining of diarrhea for 3 days – what lab data would the nurse monitor?

• Electrolytes (K+, Na+ Ca+ Mg, Cr).

45. Pathophysiological change that causes the manifestations of MS – what is it?

• Degeneration of myelin sheath. Inflamed nerves. Slowed or block nerve impulses. Muscle weakness-respiratory issues/failure and pneumonia.
• Remember ABCs in patients with neurological diseases – everything is affected in myelin sheaths*

46. Ringing in the ears – what is the term?

• Tinnitus.

47. Patient prescribed neostigmine for newly diagnosed Myasthenia Gravis – they ask how the medication works – what would your response be?

• Relieve MG symptoms by increasing the amount of acetylcholine at the junctions between nerves and muscles.

48. Patient comes to ER after getting chemical splashed in eyes – what intervention would you implement first?
    • Eye irrigation – Morgan lens – looks like contact lens goes over eye with a tube and syringe that you can use to irrigate the eye.
49. What is a symptom that patient with newly diagnosed retinal detachment would report to nurse?
    • Separation of Retina from choroid layer of eye (back of eye). Looks like curtain coming down, may see cobwebs. Sudden change in vision, flashing lights, floaters, curtain being lowered over vision, looking through veil, no pain.
50. Patient having CVA and starts to complain nausea and vomiting, what is your intervention? Least invasive first.

• If patient is vomiting put them on their side to prevent aspiration.

51. Developing plan of care for patient at home and prevent complications in patient with impaired respiratory function – what would you include in the plan? SIMPLE answer

• Elevate the head of bed 30 degrees when eating. If they vomit, put them on their side
• they can aspirate if you sit them up.

52. Nursing interventions to help prevent complications in a patient with Bells Palsy.

• Patient is not able to close eye properly – ointment to protect eye or patch eye.

53. 19-year-old with Trigeminal Neuralgia – what is most likely to trigger pain?  Very sensitive to heat and cold.
54. What drug class is used to reduce symptoms of muscle weakness from myasthenia gravis.

• Acetylcholinesterase inhibitors first line of treatment. They relieve symptoms by increasing the amount of acetylcholine at the junction between the nerves and muscles. Muscles contract.

55. Patient on low sodium diet. Nurse recognizes that further teaching is necessary if the patient chooses which menu?

• Tomato soup, grilled cheese, salad & chocolate chip cookie. Processed cheese & canned soups are high in sodium.

56. Collecting data from patient that is diagnosed with Myasthenia Gravis what data is most important for the nurse to obtain?

• Determine muscle strength. How much activity can they tolerate before weakness and fatigue occur?

57. Patient with spine injury who BP spiked and restless. What actions by the nurse is most appropriate?
    • Perform a bladder scan.
    • Most common issue is bladder distension – high BP, agitated, complain of headache – if it is full, empty the bladder to stop complications.
58. Collecting data on patient with cataract – what is first symptom of cataract that patient would report to you?
    • Loss of visual acuity. Halos around light. Sensitivity to glare. Decreased color vision.
59. How do you know that patient with Myasthenia gravis that has severe muscle weakness – interventions have been effective?

• Promote mobility and prevent fatigue – assist the patient in planning periods of rest.

60. How would you conduct a Chvostek sign?

• Tap the cheek.

61. CT scan with contrast dye – what would you recommend to client post-procedure?  Encourage fluids if dye used.

• Teach: contrast may cause feeling of warmth, signs, and symptom of allergic reaction to report.

62. Patient diagnosed with glaucoma – what symptoms would you expect the patient to report?  Mild eye aching, headache, halos around lights, frequent visual changes.
63. Patient has Bradykinesia – moving very slow from Parkinson’s disease – how can you best help that patient?

• Be patient.

64. Caring for patient with Guillain Barre disease – what nursing diagnosis should take priority?

• Ask before giving flu shot if every had GB as you can get it again. Monitor airway because accessory muscles are affected.
• Monitor vital capacity and ABG’s. Check breathing – ineffective airway because muscles for breathing are affected.

65. Administering ear drops to adult client – what technique do you use?

• Pull pinna up and back.

66. Patient who has had lumbar puncture and you see red drainage on the dressing – what is the most appropriate action by the nurse?

• Report ASAP.

67. Patient has IV site in left forearm it has become red and tender (phlebitis) – priority nursing intervention?
    • Stop IV and remove it.
68. Patient with Alzheimer’s disease and they fall frequently – what action would be priority to keep client safe?
    • Room closes to nurses station and take to bathroom frequently.
69. Which statement made by the patient indicates they understands teaching about an angiogram. (Look up – what it is to have angiogram).
    • Keep flat in bed 6 to 8 hours - Encourage fluids
70. Patient has macular degeneration – what symptom would patient report?
    • Lose of central vision in eye, lose independence, get depressed, can’t read,

drive, or watch TV – vision gets distorted and blind spots occur.

71. Patient with fluid excess – what intervention is the best to relieve respiratory distress.  Elevate the head of the bed.
72. How soon after symptom onset must a person having a stroke receive TPA?
    • 3-to-4.5-hour time window – may reduce symptoms – TIME LOST IS BRAIN LOST!
73. Patient having a tonic clonic seizure asleep for 30 minutes meal is about to be delivered – what nursing action is most appropriate?
    • [Prodromal stage] – let them sleep.
74. What patient is at risk for respiratory acidosis?
    • The patient with chronic pulmonary disease.
75. Patient who had ischemic stroke – did not eat whole breakfast tray and they only had food

from right side and not left side. What should nurse do?  Turn the tray.

76. Nurse is concerned that patient has high volume insensible water loss – what is the patient experiencing?
    • Perspiration – occur without the person recognizing the loss - lost through respiration and feces are examples.
77. Patient with serum pH less than 6.35 the nurse should plan care for which of the following health problems?  Acidosis.
78. Patient having tonic clonic seizure & see them in bed when entering room – what would you do first?
    • SAFETY FIRST - do not leave patient alone.
    • Monitor airway, turn on side, pad side rails, prevent injury, do not restrain, suction PRN, observe & document.

79. What foods should be avoided for patient on low sodium diet?
    • Cheese.
80. Lumbar puncture post-op care (SATA)
    • Maintain flat bedrest 6 to 8 hours
    • Encourage fluids
    • Monitor puncture site
    • Monitor movement, sensation, headache
81. Nursing care for cerebral aneurysm (SATA)
    • CT scan – what is going on.
    • Surgical clipping of the aneurysm.
    • Reduce noise level in patients room & administer stool softener.
82. Nursing interventions for Bell’s Palsy (SATA)  Prednisone- for inflammation.  Analgesics, antiviral medications, moist heat, gentle massage, facial sling. Always protect eye because they can’t close the