NSG123/ NSG 123 Exam 1: (New 2024/ 2025 Update) Med Surg 1 Review Q&A, Exams of Nursing

Download NSG123/ NSG 123 Exam 1: (New 2024/ 2025 Update) Med Surg 1 Review Q&A and more Exams Nursing in PDF only on Docsity! NSG123/ NSG 123 Exam 1: (New 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified Answers| 100% Correct| All Units Covered| A Grade – Herzing QUESTION What is the nurse's role for informed consent? Answer: - clarify facts presented by the physician - witness signature QUESTION If a patient cannot explain the procedure, what should the nurse do? Answer: have the doctor return and explain the procedure again QUESTION If a patient is supposed to be NPO but reports eating breakfast, what should the nurse do? Answer: - ask what the patient ate and when it was eaten - after assessment of patient, call provider to discuss QUESTION circulating nurse roles Answer: - manages patient care in the OR - protects the patient's safety and health needs - performs all security checks (correct surgery, correct limb) QUESTION types of anesthesia Answer: Unconscious: - general (inhalation or IV, unable to maintain airway function, requires LMA or intubation) - moderate sedation (IV, patient able to maintain airway) - monitored anesthesia care Conscious: - local (injected at site of surgery) - epidural (in the dura around the spinal cord) - spinal (in the subarachnoid space of the spinal cord) QUESTION adverse effects of anesthesia Answer: - allergic reactions - drug toxicity or reactions - malignant hyperthermia - cardiac dysrhythmias - CNS changes - oversedation (especially in elderly) - undersedation - trauma (laryngeal, oral, nerve, skin) - hypotension - thrombosis QUESTION malignant hyperthermia - hypoglycemia QUESTION What should a nurse do if there is blood seen on a dressing 1 hour after a patient returns from the OR? Answer: - reinforce the dressing - if bleeding comes through the reinforcement, then call the doctor QUESTION Penrose drain Answer: - a flat, thin, rubber tube inserted into a wound to allow for fluid to flow from the wound - it has an open end that drains onto a dressing - sterile safety pin used to stop drain from slipping back into the wound - physician order indicates how much of tube to be cut off during drain care QUESTION closed drainage systems Answer: - Jackson-Pratt (emptied when about half full, release suction before removal) - Hemovac (usually removed by doctors because they are sutured in place) QUESTION Coordinator of care transitions Answer: - nurse navigator: ensures smooth transition through the hospital - case manager: assesses needs of patient before going home from the hospital - clinical nurse leader: maintains health records for employees, manages learning modules for nurses QUESTION Interprofessional collaborative practice Answer: comprehensive health care by different health care professionals who work with each other, the patient, the family, and other caregivers to meet the patient's needs QUESTION 3 phases of operative care Answer: - preoperative: begins with decision to proceed with surgery, ends with transfer of patient onto OR bed - intraoperative: begins with transfer of patient onto OR bed, ends with admission of patient to PACU - postoperative: begins with admission of patient to PACU, ends with follow-up evaluation in clinic or home QUESTION Pre-admission testing Answer: - obtain patient's data (demographics, history, meds) - verify completion of preoperative diagnostic testing - begin discharge planning QUESTION Pre-operative assessment includes** Answer: - health history (heart disease, kidney disease, clotting disorders, COPD, asthma, sleep apnea, diabetes) - previous surgeries (previous general anesthesia reaction) - meds (anticoagulants, hypertensive drugs, diabetic drugs, antidepressants) - allergies (latex, avocado, eggs, chestnuts) - nutrition (special diets, height and weight) - dentition (dentures, crowns, bridges, loose teeth) - drug/alcohol use (alcohol can cause issues with anesthesia) - lab work (CBC, WBC, H&H, electrolytes, BUN) - immune function (lupus, diabetes) - psychosocial factors (is pt ready for changes after surgery) - spiritual beliefs (important to know before surgery) QUESTION Normal BUN levels Answer: 5 - 20 mg/dL decreased = malnutrition, overhydration increased = starvation, severe dehydration QUESTION Normal creatinine levels Answer: 0.4 - 1.5 mg/dL decreased = severe malnutrition increased = dehydration Answer: - shortness of breath - tachycardia - expiratory wheezing - use of accessory muscles - hypoxemia QUESTION What lab is used for asthma diagnosis? Answer: - CBC, look at eosinophils QUESTION status asthmaticus Answer: - emergency situation - "silent chest" - absence of wheezing after patient had been wheezing - RR > 30/min - HR > 120/min QUESTION treatment for status asthmaticus Answer: - short-acting bronchodilator (nebulizer) - oxygen - IV corticosteroids - IV magnesium QUESTION asthma treatment Answer: - short-acting bronchodilator/rescue inhaler (Albuterol) - low-dose inhaled corticosteroid (ICS) - low-dose ICS and long-acting bronchodilator OR medium-dose ICS QUESTION What is immediate treatment for a patient with an asthma attack?*** Answer: short-acting bronchodilator in a nebulizer QUESTION Correct order of steps to administer 2 inhalers Answer: - give bronchodilator first - wait 5 minutes - give steroid inhaler second - rinse patient's mouth to avoid infection QUESTION aerosol metered dose Inhaler steps Answer: 1. Shake well immediately before each use. 2. Remove the cap from the mouthpiece. 3. Exhale to the end of a normal breath. 4. With the inhaler in the upright position, place the mouthpiece just inside the mouth, and use the lips to form a tight seal or hold the mouthpiece approximately two finger widths from the open mouth. 5. While pressing down on the inhaler, take a SLOW, DEEP breath for 3 to 5 seconds, hold the breath for approximately 10 seconds, and exhale slowly. 6. Wait 3 to 5 minutes before taking a second inhalation of the drug. 7. Rinse the mouth with water after each use. 8. Rinse the mouthpiece and store the inhaler away from heat. 9. If you have difficulty using an inhaler, ask your provider about a spacer device (a tube attached to the inhaler that makes it easier to use). QUESTION PEAK flow meter Answer: - measures PEFR (peak expiratory flow rate) - must be used daily and when experiencing SOB QUESTION nursing management for asthma Answer: - ABCs - place patient in semi-Fowler to high Fowler position - administer oxygen - administer medications - assess triggers - teach proper inhaler technique - teach use of PEAK flow meter QUESTION tuberculosis (TB) Answer: - infectious disease caused by Mycobacterium tuberculosis - airborne transmission (small particles) - diagnosed by skin test or blood test, x-ray, sputum tests over 3 consecutive days (early morning) - treated with combination of medications (6-12 months) QUESTION nutritional therapy for pneumonia Answer: - adequate hydration (loosens secretions) - small frequent high calorie meals QUESTION nursing considerations for pneumonia Answer: - monitor O2 and vitals as they walk to determine activity limits - incentive spirometry - encourage fluids - sit patient up in bed - frequent assessments - oxygen therapy QUESTION therapeutic position for right lower lobe pneumonia Answer: lying on left side with head down QUESTION pneumonia prevention Answer: - hand hygiene - suctioning - avoid unnecessary antibiotics - elevate HOB 30 degrees - assess for gag reflex - early mobilization QUESTION pneumonia vaccines Answer: - PCV13: >65, >19 with immunocompromise - PPSV23: >65, >19 who smoke/have asthma QUESTION risk factors for COPD Answer: - cigarettes smoking - occupational dust - air pollution - frequent respiratory infections - asthma - alpha-antitrypsin deficiency (genetic) QUESTION signs and symptoms of COPD Answer: - shortness of breath - chronic cough - lots of sputum - easily fatigued - barrel chest - digital clubbing - use of accessory muscles - weight loss - sit forward QUESTION classification of COPD severity Answer: - Mild: FEV >80% - Moderate: FEV 50-80% - Severe: FEV 30-50% - Very severe: FEV <30% (forced expiratory volume) QUESTION management of COPD Answer: - smoking cessation - bronchodilators (short & long acting) - corticosteroids QUESTION How does a nurse know COPD medications are working? Answer: - O2 level increases - expiration rate has increased - decreased SOB - more activity tolerance QUESTION Oxygen therapy for COPD Answer: - PaO2 >60mmHg = O2 sat 90% - increase O2 if PaO2 is <60mmHg - safety concerns for home O2 QUESTION Answer: - contract of nursing with society and society's contract with nursing - What does society expect from nursing - stay up to date with nursing practice, continuing education - What does nursing expect from society - provide facilities, allow nursing to grow QUESTION What organization is responsible for developing standards of practice and code of ethics? Answer: American Nursing Association QUESTION Standards of Practice Answer: - basic competencies in delivering care - expectations for nurses - set up based on nursing process (ADPIE) - ex: practices ethically, practices in a healthy manner QUESTION Nurse Practice Act Answer: - laws in each state that regulate the practice of nursing - sets scope of practice in each state - sets requirements for nursing school curriculum QUESTION Code of ethics for nurses Answer: - statements of the professional nurse values and beliefs - 9 total provisions - practice with compassion and respect - primary commitment is to the patient - promotes, advocates, and protects patients' rights QUESTION Effective communication techniques Answer: - listening - silence - restating - reflection - clarification - focusing - broad opening questions - humor - informing - sharing perceptions - theme identification -suggesting