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

Download NSG123/ NSG 123 Final Exam: (New 2024/ 2025 Update) Med Surg 1 ReviewQ&A and more Exams Nursing in PDF only on Docsity! NSG123/ NSG 123 Final Exam: (New 2024/ 2025 Update) Med Surg 1 Review| Questions and Verified Answers| 100% Correct| All Units Covered| A Grade – Herzing QUESTION 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 QUESTION 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 QUESTION 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 QUESTION 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 QUESTION 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 QUESTION risk factors for osteoporosis Answer: - female - small bone frame - age - stiffness - functional impairment - crepitus - inflammation QUESTION diagnostic test for osteoarthritis Answer: x-rays QUESTION medications for osteoarthritis Answer: - NSAIDs (first line treatment) - topical Voltaren - corticosteroids - opioids - Hyaluronic acid injections - joint replacement surgery QUESTION gout Answer: - inflammatory arthritis - increased uric acid in the blood QUESTION symptoms of gout Answer: - severe pain - redness - swelling - warmth - symptoms especially at night - joint enlargement - limited range of motion (mostly great toe) QUESTION triggers for gouty attacks Answer: - alcohol (especially red wine) - trauma - diet (purine foods - organ meat) - medications - stress - illness QUESTION treatment for acute gout attack Answer: - colchicine (Colcrys) - indomethacin (NSAID) - corticosteroid QUESTION 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 QUESTION 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 QUESTION risk factors for ABG imbalance Answer: - burns - trauma - surgery - abnormal loss of body fluids - acute/chronic illness QUESTION symptoms of respiratory acidosis Answer: - suddenly increased HR, BP, RR - mental changes - always due to respiratory problem QUESTION symptoms of respiratory alkalosis Answer: - light headedness - inability to concentrate - seizures - numbness/tingling QUESTION symptoms of fluid volume excess Answer: - hypervolemia, water intoxication - caused by heart failure, kidney failure, alcoholism, too much salt - increased blood pressure - bounding pulse - shortness of breath - crackles in lung sounds - distended neck veins - edema QUESTION nursing interventions for fluid volume excess Answer: - low sodium diet (avoid ba- con, fast food, pickled foods) - restrict fluids - assess lung sounds - diuretics (monitor K+ levels) - monitor I&O - daily weight QUESTION lab findings for fluid volume excess Answer: - decreased BUN - decreased creatinine - decreased Hgb - decreased Hct (report if < 30%) - decreased urine specific gravity QUESTION normal Na+ range Answer: 135-145 mEq/L QUESTION normal K+ range Answer: 3.5-5 mEq/L QUESTION normal Hgb range Answer: 12-18 g/dL QUESTION normal Hct range Answer: 38-48% QUESTION normal creatinine range Answer: 0.7-1.4 mg/dL QUESTION normal BUN range Answer: 7-20 mg/dL QUESTION normal urine specific gravity range Answer: 1.005-1.030 QUESTION 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) QUESTION treatment for diabetic ketoacidosis Answer: - IV insulin (regular only) - IV fluids - check electrolytes (especially potassium) QUESTION 3 criteria for a diagnosis of rheumatoid arthritis Answer: - signs and symptoms com- patible to disease - lab studies - x-rays QUESTION signs and symptoms of rheumatoid arthritis Answer: - decreased joint motion (espe- cially in the morning) - stiffness - symmetric pain - swelling - warmth - joint deformity (later stages - swan neck) QUESTION labs for rheumatoid arthritis Answer: - antibodies to cyclic citrullinated peptide (anti-CCP)*** - rheumatoid factor*** - ESR - CRP QUESTION lab tests obtained prior to initiating medications for rheumatoid arthritis Answer: - CBC (anemia, platelets) - TB - Hep B (liver issues) - Hep C (liver issues) QUESTION What will nurse monitor when patient is on DMARDs? Answer: - liver enzymes (AST) - kidney function (creatinine, BUN) - CBC QUESTION treatments for rheumatoid arthritis Answer: - disease modifying antirheumatic drugs (DMARDs) - COX 2 inhibitors - NSAIDs - corticosteroids (persistent RA) - immunosuppressants (advanced RA) QUESTION How can the nurse tell medications are working for rheumatoid arthritis? Answer: - decreased pain - increased motion - decreased inflammation around the joint QUESTION 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 QUESTION 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 QUESTION triggers for SLE Answer: - smoking - illness - stress - sunlight QUESTION Criteria for diagnosis of SLE Answer: - malar rash (facial butterfly rash) - discoid rash (scaly rash on arms, legs) - lab test antinuclear antibodies (ANA)*** QUESTION