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

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NSG123/ NSG 123 Final Exam: (Latest 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified Answers| 100% Correct| All Units Covered| Grade A – Herzing Q: buffer systems in the body Answer: - chemical buffers (NaHCO3) - works within seconds - respiratory - regulates CO2 - works within minutes - metabolic - regulates HCO3 - may take days to regulate Q: risk factors for ABG imbalance Answer: - burns - trauma - surgery - abnormal loss of body fluids - acute/chronic illness Q: symptoms of respiratory acidosis Answer: - suddenly increased HR, BP, RR - mental changes - always due to respiratory problem Q: symptoms of respiratory alkalosis Answer: - light headedness - inability to concentrate - seizures - numbness/tingling Q: symptoms of metabolic acidosis Answer: - increased RR and depth (Kussmaul res- pirations) - headache - confusion - drowsiness - commonly due to kidney injury Q: nursing interventions for metabolic acidosis Answer: - administer sodium bicarbon- ate - monitor potassium levels (hyperkalemia) - Q: symptoms of metabolic alkalosis Answer: - respiratory depression - tachycardia - hypokalemia - commonly due to vomiting or gastric suction, long-term diuretics Q: treatment for metabolic alkalosis Answer: restore fluid volume with NaCl (allows ex- cretion of excess bicarbonate) Q: normal K+ range Answer: 3.5-5 mEq/L Q: normal Hgb range Answer: 12-18 g/dL Q: normal Hct range Answer: 38-48% Q: normal creatinine range Answer: 0.7-1.4 mg/dL Q: normal BUN range Answer: 7-20 mg/dL Q: normal urine specific gravity range Answer: 1.005-1.030 Q: isotonic solution Answer: - has the same concentration of solutes as blood - no fluid shift - given for FVD, blood loss, hypotension, hypovolemia*** Ex: 0.9% NaCl, lactated ringers, 5% dextrose in water Q: hypotonic solution Answer: - has less concentration of solutes than blood - fluid shifts INTO the cells - given for NPO Ex: 0.45% NaCl, water, 2.5% dextrose in water Q: hypertonic solution Answer: - has more concentration of solutes than blood - fluid shifts OUT of the cells - given for 3rd spacing, later stages of DKA Ex: 3% NaCl, 5% NaCl Q: IV insertion steps Answer: - open and prepare sterile packages - prepare extension tubing: clean connection port, attach 0.9% NS syringe to tubing and prime tubing, leave syringe attached - apply tourniquet - select vein to be used - release tourniquet temporarily - apply clean gloves - clean site - reapply tourniquet - insert needle with bevel up - check for blood return/flashback - advance needle 1/4" and then loosen stylet - using index finger, advance catheter off the needle into the vein - stabilize catheter and release tourniquet - connect extension tubing to catheter - aspirate to assess blood return, then flush line with 0.9% NS - secure catheter with tape/transparent dressing - label dressing with date, time, initials, type and size of catheter used Q: osteoporosis Answer: - rate of bone resorption is greater than rate of bone formation - most common bone disease in the world - bones become porous and brittle Q: risk factors for osteoporosis Answer: - female - small bone frame - age - low estrogen (menopause) - decreased calcitonin - low calcium & vitamin D intake - sedentary lifestyle - long-term corticosteroids - GI disease (cannot absorb calcium) Q: diagnostic studies for osteoporosis Answer: - DEXA scan - labs: Ca, vitamin D, phosphate Q: gout Answer: - inflammatory arthritis - increased uric acid in the blood Q: symptoms of gout Answer: - severe pain - redness - swelling - warmth - symptoms especially at night - joint enlargement - limited range of motion (mostly great toe) Q: triggers for gouty attacks Answer: - alcohol (especially red wine) - trauma - diet (purine foods - organ meat) - medications - stress - illness Q: treatment for acute gout attack Answer: - colchicine (Colcrys) - indomethacin (NSAID) - corticosteroid Q: long-term treatment of gout Answer: - Allopurinol (Zyloprim) - diet (avoid high purine foods) - give 1mg Glucagon subQ or IM OR - 25-50mL of 50% Dextrose IV Q: clinical signs of diabetic ketoacidosis Answer: - more likely in type 1 diabetics - hyperglycemia (>300) - fruity breath - polyuria - dehydration - metabolic acidosis - glucose AND ketones in urine - rapid deep breathing (Kussmaul respirations) - hyponatremia - rapid onset - low pH (acidosis) Q: treatment for diabetic ketoacidosis Answer: - IV insulin (regular only) - IV fluids - check electrolytes (especially potassium) Q: What are the "sick day" rules for diabetics? Answer: - take insulin or oral medication as usual - check blood glucose and urine ketones - report elevated glucose levels/urine ketones to provider - report nausea, vomiting, and diarrhea to provider Q: clinical signs of hyperglycemic hyperosmolar syndrome (HHS) Answer: - mostly occurs in type 2 diabetics - slower onset than DKA - hyperglycemia (>650+) - tachycardia - shallow breaths - polyuria - glucose in urine - hypotension - normal pH Q: long-term complications of diabetes Answer: - atherosclerosis - peripheral vascular disease - diabetic retinopathy - nephropathy - peripheral neuropathy - sexual dysfunction Q: health recommendations for diabetics Answer: - annual eye exam - inspect and wash feet daily - no lotion between toes - avoid heating pads - annual vaccines - no sandals (DMARDs) - COX 2 inhibitors - NSAIDs - corticosteroids (persistent RA) - immunosuppressants (advanced RA) Q: How can the nurse tell medications are working for rheumatoid arthritis? Answer: - decreased pain - increased motion - decreased inflammation around the joint Q: patient education for rheumatoid arthritis Answer: - keep joints moving - low-stress exercise (swimming or cycling, no jumping or running) - adequate sleep - diet with high vitamins, protein, and iron (red meat, leafy vegetables) - avoid caffeine - avoid heavy meals at night Q: systemic lupus erythematosus (SLE) Answer: - autoimmune disease affects every organ in the body - B lymphocytes attack the body - unknown cause - periods of exacerbation and no symptoms - affects females more than males Q: triggers for SLE Answer: - smoking - illness - stress - sunlight Q: Criteria for diagnosis of SLE Answer: - malar rash (facial butterfly rash) - discoid rash (scaly rash on arms, legs) - lab test antinuclear antibodies (ANA)*** Q: signs and symptoms of SLE Answer: - fatigue - anorexia - photosensitivity*** - oral ulcers - dyspnea - hypertension Q: patient education for SLE Answer: - stop smoking - avoid sunlight - walk in the evenings*** - use soft toothbrush*** - weight bearing exercise - adequate rest Q: management of SLE Answer: - monoclonal antibody (Benlysta given IV) - corticosteroids - anti-malaria medication (Plaquenil) - NSAIDs