NSG123/ NSG 123 Exam 3: (New 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified, Exams of Nursing

Download NSG123/ NSG 123 Exam 3: (New 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified and more Exams Nursing in PDF only on Docsity! NSG123/ NSG 123 Exam 3: (New 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified Answers| 100% Correct| All Units Covered| A Grade – Herzing QUESTION qualitative platelet defects Answer: - number of platelets may be normal, but their function is not normal - ask about OTC medications such as aspirin or NSAIDs QUESTION thrombocytopenia (quantitative platelet defect) Answer: low platelet count QUESTION signs and symptoms of thrombocytopenia Answer: - bruising - petechiae (platelets <20,000) - excessive bleeding (platelets <5,000) - nasal and gingival bleeding QUESTION What is the medication treatment for thrombocytopenia? Answer: corticosteroids QUESTION Thalassemia Answer: - inherited defect - unable to produce hemoglobin - type of hemolytic anemia QUESTION Patient education for thalassemia Answer: - many medications exacerbate the dis- ease - it is important to review all medications with prescriber - stem cell transplants and blood transfusions may be used for treatment QUESTION iron deficiency anemia Answer: - anemia caused by inadequate iron intake - most common type of anemia - type of hypoproliferative anemia QUESTION Risk factors for iron deficiency anemia Answer: - living in developing country (low iron intake) - premenopausal women - vegetarians - medications QUESTION causes of PAD Answer: - nicotine - hypertension - diabetes - obesity - stress - sedentary lifestyle - age - gender - family history QUESTION foot care for PAD Answer: - avoid restrictive clothing/socks/shoes - wash feet daily - dry thoroughly - apply moisturizer QUESTION PAD post operative care Answer: - assess every 15 minutes - monitor pedal pulses - check leg/foot color - assess capillary refill QUESTION urge incontinence Answer: - inability to stop the flow of urine - bladder is irritated and it contracts - can be due to a neurologic problem QUESTION functional incontinence Answer: - urine loss caused by the inability to reach the toilet because of environmental barriers, physical limitations, loss of memory, or disorientation - ex: nurse does not come to the room in time QUESTION stress incontinence Answer: inability to control urination under physical stress such as running, sneezing, laughing, or coughing QUESTION treatment for incontinence Answer: behavioral therapy: - fluid management (drink earlier in the day, less fluid after 6pm) - voiding pattern (develop a routine) - pelvic muscle exercises (Kegel) medications: - Oxybutynin (anticholinergic) - relaxes the bladder - Elavil (tricyclic antidepressant) - increases bladder neck resistance surgical management QUESTION Correct technique for obtaining blood pressure Answer: - select correct BP cuff size - measure BP right after you wake up or before going to bed - try to measure BP at the same time every day - rest for 5 minutes - sit with feet flat on floor and back straight - place arm at the level of your heart - stay still and do not move QUESTION Hypertensive emergency Answer: a situation where blood pressure is very elevated and there is evidence of actual or probable target organ damage QUESTION Hypertensive urgency Answer: a situation where blood pressure is very elevated but there is no evidence of target organ damage QUESTION Treatment for hypertensive emergency Answer: - reduce BP 20-25% in first hour - gradually reduce BP to normal over a few days - IV vasodilators (sodium nitroprusside), Enalapril, Nitroglycerin Answer: - ACE inhibitors - slows progression of heart failure (may cause cough) - Beta blockers - relaxes the heart (caution with asthma) - ARB - alternative to ACE inhibitors - Neprilysin inhibitor (Entresto) - removes BNP from blood - diuretics - decrease fluid volume - digitalis (Digoxin) - improves contractility (monitor for toxicity) QUESTION signs and symptoms of digitalis (DIgoxin) toxicity Answer: - vision problems*** - nausea - bradycardia - anorexia - confusion QUESTION How does the nurse know medications are effective for heart failure? Answer: - increased energy - decreased edema - less shortness of breath - increased activity tolerance - able to walk further QUESTION Nursing assessment for heart failure Answer: - mental status - pink, frothy sputum - heart sounds - S3 typical - crackles or wheezes in lungs - daily weights - fluid volume overload signs QUESTION patient education for heart failure Answer: - no more than 2L of fluid per day - smoking cessation - DASH diet (low sodium <2g per day) - exercise - monitor for signs of fluid volume excess - daily weight (notify doctor if more than 2-3lbs/day or 5lbs/week) QUESTION What is ITP? Answer: - idiopathic thrombocytopenic purpura (immune thrombocytope- nia) - low platelet count due to body's development of antiplatelet antibodies QUESTION Causes of ITP Answer: - autoimmune disorders - viral infections - medications (Cephalosporins, Sulfa) QUESTION Diagnostic tests for ITP Answer: - History and physical - Hep C - HIV - H. pylori QUESTION Patient education for ITP Answer: - avoid activities where bleeding can occur - use electric razors - avoid constipation - avoid injections - avoid sulfa QUESTION side effect of Oxybutynin Answer: urinary retention QUESTION patient education for incontinence Answer: - avoid caffeine, alcohol, citric juices*** - avoid diuretics after 4pm - stop smoking - avoid constipation - void regularly - perform pelvic floor exercises QUESTION risk factors for UTI Answer: QUESTION What is the most common type of urinary stone? Answer: calcium oxalate: comes from breakdown of oxalate from plants that bind to calcium in the body QUESTION symptoms of stone in the ureter Answer: - acute, excruciating pain - colicky (wave-like) pain - radiates down to thigh and genitalia - nausea and vomiting QUESTION symptoms of stone in the kidney Answer: - constant pain that increases with move- ment - deep ache in the costovertebral region - hematuria - pyuria QUESTION first line treatment for kidney stones Answer: RELIEVE THE PAIN (opioids, NSAIDs, hot packs) (do not select any other answer) QUESTION treatments for kidney stones Answer: - opioids, NSAIDs - hot packs - increased fluid intake - strain the urine to check for passage of stones - nutrition changes - lithotripsy or ureteroscopy - surgical removal QUESTION What nutrition changes are needed for kidney stones? Answer: - calcium stones - restrict calcium intake - uric acid stones - avoid organ meats, alcohol, soft drinks - oxalate stones - avoid strawberries, rhubarb, chocolate, spinach, peanuts QUESTION Patient education for kidney stones Answer: - signs and symptoms to report (UTI, hematuria, urinary retention) - strain the urine - fluid intake - dietary education QUESTION diagnostic tests for prostate issues Answer: - digital exam - PSA lab study - ultrasonography QUESTION signs and symptoms of BPH Answer: - urinary frequency - nocturia - weak urinary stream - urinary hesitancy - urinary retention - UTIs QUESTION How can a nurse tell if medications are working for BPH? Answer: patient will report urinary flow is easier and urinary stream is better (DO NOT select option about size of prostate) QUESTION If a patient with BPH has not urinated in 8 hours, what will the nurse do? Answer: place a REGULAR Foley catheter QUESTION patient education for a TURP (transurethral resection of prostate) before the procedure Answer: - procedure is done under general anesthesia - a large Foley will be in place after surgery - there will be a lot of pain and discomfort - output will be red and bloody at first because the prostate is very vascular high blood pressure with no verifiable physical cause, which makes up the majority of high blood pressure cases QUESTION Secondary hypertension Answer: hypertension is a secondary symptom of a primary disease like sleep apnea or pregnancy QUESTION manifestations of hypertension Answer: - retinal and other eye changes - renal damage - myocardial infarction - cardiac hypertrophy - stroke - headaches - nosebleeds - dizziness - fatigue QUESTION Risk factors for hypertension Answer: - smoking - obesity - physical inactivity - microalbumin or GFR < 60mL/min - family history - diabetes - African Americans QUESTION Which labs are assessed for hypertension? Answer: - sodium - potassium - cholesterol - fasting blood glucose - creatinine QUESTION If a patient complains of vision changes, headaches, and nosebleeds, what should the nurse assess? Answer: Blood pressure QUESTION What should the nurse assess before giving IV Lasix or Hydralazine? Answer: Blood pressure because these medications quickly decrease BP QUESTION Hypertension medications regulate what 3 things Answer: - fluid level - heart - kidneys QUESTION Which medications regulate fluid? Answer: - diuretics (cause potassium loss) - thiazides ex: Furosemide, Lasix QUESTION What medications regulate the heart? Answer: - beta blockers (Atenolol) - decrease heart rate - vasodilators (Hydralazine) - alpha blockers (Cardura) - calcium channel blockers (Norvasc) QUESTION side effects of Norvasc Answer: constipation and abdominal pain QUESTION What medications regulate the kidneys? Answer: - ACE inhibitors (Lisinopril) - de- crease Na & water retention - ARBs (Losartan) QUESTION Medication treatment of hypertension Answer: - African Americans and patients >60 - calcium channel blocker or thiazide diuretic - non-African American and patients <60 - ACE or ARB