NUR 2755 / MDC 4 Exam Study Guide: Questions & Answers (2024/2025), Exams of Nursing

Download NUR 2755 / MDC 4 Exam Study Guide: Questions & Answers (2024/2025) and more Exams Nursing in PDF only on Docsity!

NUR 2755 / NUR2755: Multidimensional Care IV / MDC 4 Exam

1 Study Guide Questions and Correct Answers (2024 / 2025)

(Verified Answers)

1. Which Migraine medications cannot be used in a patient with cardiac dis- eases and why?: Triptans and Ergotamine preparations- they will cause additional vasoconstriction of the head blood vessels
2. What does abortive therapy do for migraines?: alleviate pain after the headache starts
3. What does preventative therapy do for migraines?: prevent a headache is it occurs more than twice a week or is severe.
4. A patient is taking beta blocker and calcium channel blockers to prevent a migraine. What education should the nurse give to the patient regarding these

medications?: Do not stop the medications

5. What are some trigger foods for migraines?: aged cheeses, smoked meats, fermented deli meats, pickles, beer, wine, nuts (think tyramine)
6. A patient is trying to see what things trigger their migraines. What education can the nurse provide?: Keep a food diary and determine what foods may make the migraine occur.
7. A patient tells the nurse that they see flashing lights before their headache starts. What is this called?: Aura
8. A aura may happen with and .: Migraines, Seizures
9. S/S of Migraines: Photophobia, N,V,head pain, phonophobia
10. A patient tells their spouse who is a nurse they are having a migraine. What would the nurse tell them to do?: Go into a cool dark room and rest while sitting up.

11. A nurse is setting up a room for a patient coming in for a seizure. What things should be included in the room?: Working suction and o2, padded bed side rails, placement of an IV when patient arrives.
12. What should you never place in a patients mouth when they are having a seizure?: Tongue blade
13. What is the term for a seizure lasting more than 5 minutes or having multiples in a 30 min period?: Status Epilepticus
14. What can you give to stop a seizure?: IV benzo
15. A patient states to the nurse before leaving the doctors office his provider will place him on phenytoin. What education should the nurse give?: Do not stop the medication- if so a seizure may occur.
16. A patient with a seizure disorder suddenly freezes up and drops without twitching. What type of seizure is this called?: Tonic

17. A patient with a seizure disorder suddenly freezes up for a few seconds and starts to vigorously twitch. What type of seizure is the patient having?: Tonic Clonic

18. A person starts to have brief twitches of their left arm while in line to check out at the store. What type of seizure is this?: Myoclonic
19. A patient suddenly looses muscle tone and drops to the floor. What type of seizure is this?: Atonic
20. A nurse starts to see the patient in a room starting to have a seizure. What is her next move?: Place patient on left side, lower bed, support head, no restraining them, timing the episode and calling for help.
21. After a seizure is done, what actions should the nurse take?: Assess vitals, reorient patient, clean them up if they peed or pooped, call provider.
22. A teen with a seizure disorder is cleared by the provider to take his drivers license test. What must her report to the DMV?: That he has a seizure disorder
23. A female patient was recently diagnosed with a seizure disorder and is taking a oral contraceptive. What education must the nurse give?: She should

switch off the pill as seizure prevention medications can cause the pill to not work.

24. S/S of Parkinsons include:: bradykinesia, muscle rigidity, mask like face, postal instability, resting tremors, cogwheel rigidity, lead pipe rigidity, shuffling gait
25. What are some concerns regarding Parkinsons disease?: Safety- fall pre- cautions needed Aspiration- may need assistance or observation while eating
26. Who is at risk for developing MS?: Females ages 20 - 40
27. S/S of MS:: based on area affected, fatigue, double vision, HA, trigeminal neuralgia, dysarthria, ataxia, incontinence, nystagmus.
28. MS treatment: steroids and the S/S
29. What is a hallmark manifestation of guillan barre?: Ascending paralysis
30. What is a concern we can have with guillan barre?: Will eventually reach its way to diaphragm and cause respiratory compromise and need for mechanical

ventilation

31. When can one get Gillian barre?: After a virus or vaccine
32. What is trigeminal neuralgia?: Pain of the CN 5, causes pain in the face.
33. What is one medication we can give to a patient experiencing spasms of the face from trigeminal neuralgia?: Baclofen
34. What are the highest priorities during the post-op period?: Patent airway and oxygen saturation
35. At what level of the body will a patient have autonomic dysreflexia?: Above a T6 fracture
36. A patient with a T1 fracture starts to have a headache and flushing of the skin. his most recent vitals are BP 170/90, HR is 50. What are interventions to assist with these manifestations?: Sit them up and look for a cause such as a full bladder and solve it

37. What are some preoperative priorities?: Confirm consent is signed, verify any allergies, educate patient on what to expect during and after the procedure, ensure patient has been NPO for 6-8 hrs, baseline vitals, confirm the most recent labs, medications, pregnancy test.
38. What can UAPs not do?: Assess, evaluate, or teach. No unstable patients, no meds, no invasive procedures.
39. A patient who had a stroke has his meal on the floor. No modified barium swallow has been done yet. The UAP asks to go feed the patient. Should the nurse intervene?: Yes- the patient could aspiration without having the proper diet and feeding precautions established
40. Parts of the Glasgow Coma Scale are:: Eye opening response, motor re- sponse, verbal response.
41. If a patient has a GCS score of 8, what are they most likely in?: Coma

42. If a patient has a GCS score of 3, what is happening?: They dead
43. Decorticate posturing: characterized by upper extremities flexed at the elbows and held closely to the body and lower extremities that are externally rotated and extended. occurs when the brainstem is not inhibited by the motor function of the cerebral cortex.
44. Decerebrate posturing: posturing in which the neck is extended with jaw clenched; arms are pronated, extended, and close to the sides; legs are extended straight out; more ominous sign of brain stem damage. Most Severe.
45. What are priorities when patient is in the OR?: Safety and Infection Control
46. What is evisceration?: protrusion of visceral organs through a wound opening
47. What is dehiscence?: A separation of the wound incision
48. A patient tells the nurse that when he went to cough her felt a popping sensation. Part of his intestines is out. What does the nurse do next?: Call for

help, place a sterile moistened gauze over the area, patient will go to OR.

49. How do we know a JP drain is working?: The bulb is squeezed and collapsed for suction
50. Who should the nurse place a consult in for a patient who had a stroke and needs a swallow eval?: Speech Therapist
51. A nurse notices a patient with a head injury has clear fluid draining from his ear. What is the nurses next action?: Assess it for presence of CSF with halo sign and glucose concentration
52. What interventions should the nurse do for a patient with increased ICP?: - Provide a low stimuli, quiet room with patient sitting up with head in neutral position.
53. A nurse sees that a patient with an ICP of 24 is going for an lumbar punc- ture. What is the nurses next action?: Call the provider to have the procedure cancelled as increased ICP is contraindicated for a lumbar puncture.

54. What medication can be given to reduce increased ICP?: Mannitol through a filter needle
55. What are early s/s of increased ICP: LOC change, vision changes
56. What are late s/s of increased ICP?: vomiting, blown pupils, Cushing triad
57. What are parts of Cushing Triad?: bradycardia, widen pulse pressure, Cheyne stoke respiration
58. Aphasia: inability to speak or understand language
59. Agnosia: the inability to recognize familiar objects or faces
60. Proprioception: The ability to tell where one's body is in space.
61. What type of paralysis does myasthenia gravis cause?: Descending paraly- sis
62. What are the s/s of myasthenia gravis?: Ptosis, diplopia, extremity weakness worse with exercise, respiratory difficulty

63. A patient has myasthenia gravis. What education should the patient be given based on medication?: Take meds before activity, up to 1 hr before
64. Too much Ach=: cholinergic crisis
65. Too little Ach=: myasthenia crisis
66. What medication do we give to correct a myasthenia crisis?: endrophonium
67. What medication do we give to correct a cholinergic crisis?: Atropine
68. What is bells palsy often confused with?: Stroke
69. What type of CT should we give a stroke patient and why?: W/O contrast as we need the scan quickly
70. How to we diagnose myasthenia gravis?: Tensillion test
71. What is a hemorrhagic stroke?: A stroke caused by bleeding into the brain from trauma or ruptured blood vessel
72. S/S one is having hemorrhagic stroke?: Headache

73. What actions should be taken with a patient with a hemorrhagic stroke?: - Control BP
74. What is a precursor to an ischemic stroke?: transient ischemic attack
75. What is a cause of an ischemic stroke?: A fib
76. What is TPA used to treat?: Ischemic strokes
77. What is important to know before starting a patient on TPA?: When stroke symptoms first started, if patient has Afib
78. A patient says that his parents had a history of TIAs and died of stroke. The patient already has hypertension. What type of factor is the history of TIAs?: Non modifiable
79. What is conscious sedation made of?: Benzodiazepine and Opioid
80. What is an effect of conscious sedation?: Amnesia

81. What are manifestations of Alzheimers?: loss of memory, judgment, and visuospatial perception; change in personality; increasing cognitive impairment, wandering
82. What are some interventions to help a patient with Alzheimers?: Use vali- dation, routine, exercise and rest, educate family.
83. s/s of neurogenic shock: low BP
84. S/S of spinal shock: decreased DTRs
85. What are some important post op interventions to prevent complications?- : Early ambulation, Ted hose, leg exercises, spirometry, sit up, fluids
86. A patient has a PCA pump. What education should be given?: Do not let family push the pump button, will only give certain amounts of medication per hour.
87. What precaution do we put a patient with meningitis?: Droplet
88. S/S meningitis: nuchal rigidity, HA, photophobia, kerning and brudunzski sign

89. Malignant hyperthermia. When does it occur?: Within 30 mins of anesthesia administration to days post op.
90. treatment of malignant hyperthermia: call for help, give dantrolene, cooling blankets
91. S/S of Bell's Palsy: inability to wrinkle forehead
92. What is the role of the nurse when it comes to consent?: Witness the consent being signed
93. Who gets the consent from the patient for surgery?: Surgeon
94. What is time out?: occurs just before the start of the surgical procedure to recheck the patient's identity, the surgical procedure to be performed, and the site of the surgery.
95. How long do you do a surgical scrub?: 3 - 5 mins
96. What is a sponge count?: done to prevent retained surgical items. Occurs

during and before surgery

97. What must be done before the patient goes to surgery?: Surgical checklist
98. How does OR affect older adults?: Anesthesia is unable to be excreted well Delirium Greater healing period Falls