NURS 152 Final Exam Study Guide: Key Concepts and Practice Questions, Exams of Nursing

Download NURS 152 Final Exam Study Guide: Key Concepts and Practice Questions and more Exams Nursing in PDF only on Docsity!

NURS 152 Final Exam With Questions And Accurate Answers

100% Pass Guaranteed

Type I Diabetes- ANSWER -Autoimmune disease -Beta cells destroyed by own body, NO INSULIN is produced. -Most often before age 15 -CANNOT use oral meds, ONLY INSULIN

Type 2 Diabetes- ANSWER Too little Insulin produced, or too little sensitivity to Insulin Genetic/heritage/lifestyle Maybe reversed with diet, exercise, weight loss May need to take Insulin shots Most common in adults 40 and over

Fast-acting Insulin- ANSWER Lispro (Humalog) Aspart (Novolog)

Short acting insulin - ANSWER Regular (Humulin R, Novolin R)

Intermediate acting Insulin - ANSWER NPH Can cause problems with hypoglycemia, If getting in the am, be sure to eat lunch, do not exercise (between lunch and dinner)

Long acting Insulin - ANSWER glargine (Lantus) No peak

Rapid acting Insulin onset - ANSWER 5-15 min POSES THE HIGHEST RISK FOR HYPOGLYCEMIA

Short acting Insulin onset - ANSWER 30 minutes ONLY Insulin given IV NTP- REGULAR goes RIGHT into the vein memory trick

Intermediate acting Insulin onset ANSWER 1-2 hours

Long acting Insulin onset ANSWER 30-60 minutes

Metformin (for type 2) S/E ANSWER GI upset N/V Weakness Metallic taste in mouth

Glipizide Glyburide (for type 2) ANSWER Stimulates pancreas to make more insulin

Hypoglycemia ANSWER Low blood glucose 70 mg/dL OR LESS 40 mg/dL OR LESS = Severe hypoglycemia

Hypoglycemia Causes - ANSWER Excessive insulin or oral hypoglycemic agent Inadequate food intake Physical activity Peaking of insulin

continuous IV insulin exercise diet

complications of diabetes - ANSWER -blindness,

• poor wound healing,
• amputations of the extremities -Retinopathy -Nephropathy -Neuropathy -PVD, CAD, CVD, TIA

Management of complications of Diabetes - ANSWER Manage all hypertension weight BG levels Inspect feet for cuts/sores proper shoes medications

A client is receiving short acting regular insulin and long acting insulin to control her diabetes. Which lab shows the clients overall control of diabetes? - ANSWER Hemoglobin A1C

A nurse is performing an emergency assessment of a client who appears to be in severe hypoglycemia. Which of the following symptoms are indicative of hypoglycemia? - ANSWER -Diaphoresis -Tachycardia -Anxiety

Left sided Heart Failure (LUNGS) - ANSWER Think —— -DROWNING -Dyspnea -Rales -Orthopnea -Weakness/fatigue -Nocturnal paroxysmal -Increased HR -Nagging cough (frothy, blood tinged) -Gaining weight (2-3 lbs per day) -Increased urine output

Right sided Heart Failure - ANSWER Think —— -SWELLING Hepatomegaly Splenomegaly -Swelling. Legs/hands. -Weight gain. Anorexia -Edema (pitting) -Large neck veins (JVD) -lethargy/fatigue -Irregular HR -Nocturia -Girth in abdomen = ASCITES

Atelectasis prevention - ANSWER Collapse or closure of lung resulting in reduced or absent gas exchange. Can occur after surgery. -PREVENTION = Deep breathing, Encourage coughing

Blood infections Pressure injury MRSA C-DIFF PREVENTION = Proper PPE/HAND HYGINE

Standard Precautions - ANSWER All hospitalized PT's regardless of diagnosis or infectious status -Hand hygiene before/after PT contact -Use of PPE, GLOVES -Proper disposal of sharps -Use aseptic technique -Clean equipment

Droplet Transmission - ANSWER Sneezing / coughing, whooping cough Pneumonia Influenza Bacterial meningitis COVID

Droplet Precautions - ANSWER SURGICAL MASK WITH EYE PROTECTION must be discarded in trash after leaving room GOWN GLOVES CLEAN EQUIPMENT Gel in, Gel out

Contact Transmission - ANSWER Germs that are spread by touching

MRSA

VRE

RSV

C-DIFF

Open wounds Contact Precautions - ANSWER WEAR GOWN & GLOVES (Remove gown & Gloves BEFORE Leaving the Room) Visitors Must check with RN before taking items in/out of room. CLEAN EQUIPMENT Gel in, Gel out Airborne Transmission - ANSWER Very small germ, spread through air TB Measles Chicken pox SARS COVID Airborne Precautions - ANSWER PT in NEGATIVE air pressure room (keep door shut) WEAR FITTED N-95 or higher mask (mask must Be discarded In trash after leaving room) CLEAN EQUIPMENT

Donning order of PPE - ANSWER 1. Hand sanitizer

2. Gown
3. mask
4. googles
5. gloves (over gown sleeves, if wearing)

Doffing order of PPE - ANSWER 1. Gloves

Basophil - ANSWER Normal = 0.5-1% Usually unaffected by infection

Penicillin - ANSWER ALLERGIES ARE COMMON BROAD SPECTRUM Penicillin, Amoxicillin USED FOR: UTI, meningitis, STI's, PNA, Intra-and infections. S/E: GI upset, n/v/d, hypotension, glossitis, phlebitis

A PT is allergic to penicillin and gets prescribed a drug in the same class, what do you do? - ANSWER Notify the provider

Tetracycline - ANSWER BROAD SPECTRUM Avoid in children, take on EMPTY stomach with FULL GLASS OF WATER, sit up 30 min after pill. USED FOR: STI's, skin (acne) S/E: GI distress, skin rashes, photosensitivity

Sulfamethoxazole - ANSWER Assess for allergies in SULFA drugs USED FOR: UTI, Otitis media S/E: Sulfa —— think SUNBURN Dry out body, crystalluria. hypoglycemia

Ciprofloxacin, Levofloxacin - ANSWER Fluoroquinolones USED FOR: Lower respiratory Bone/joint

UTI

STI

Opthalmic S/E: GI upset, dizziness, photosensitivity

Cephalexin, Ceftriaxone - ANSWER USED FOR: Otitis media, respiratory infections, UTI, bone infections S/E: Gi UPSET, n/v, heartburn, c-diff, seizures, nephrotoxicity

Broad Spectrum Antibiotic - ANSWER Effective against Gram-Positive & Gram- Negative or any antibiotic that works against a wide range of disease causing bacteria.

Adrenergic blockers (beta blockers) such as atenolol does what? - ANSWER -lowers BP -lowers HR

A nurse administers the medication diphenhydramine to a client, what would be expected side effects of the medication? - ANSWER -Increased HR -Dries everything up

What to take for blood clotting &cascade formation? - ANSWER Aspirin

You are teaching community members the s/s of TB. What would you include? - ANSWER -Low grade fever -Night sweats -Chest pain -Persistent cough

A nurse is caring for a PT taking albuterol, which of the following adverse effects should the nurse be aware of? -ANSWER- GI upset

Environmental hazards are found in home and community rugs/cords

What are individuals at risk for w/ Immobility- ANSWER Atrophy, fluid & electrolyte imbalance, Skin breakdown, Pressure injuries, Blood clots, kidney stones, UTI, Ineffective tissue perfusion Decreased circulation, Orthostatic hypotension, Contractures, Osteoporosis Diabetes due to sedentary lifestyle Atelectasis, constipation

What can make people immobile- ANSWER Injury Stroke Disease weight fracture/sprain Depression

RICE Acronym- ANSWER Rest Ice Compression Elevation

RACE. Acronym- ANSWER rescue, activate, confine, evacuate

Elements of Malpractice - ANSWER -DUTY - responsibility for PT

-BREACH OF DUTY - failure to act responsibly as a prudent person in this situation, not meeting standards of care. -CAUSATION- harm, failure to meet standards of care, causing harm. -DAMAGES OF HARM - injury is proved

Tasks that can be Delegated to a UAP - ANSWER -ADL's -bathing -grooming -dressing -toileting -ambulating (stable pt) -feeding (w/o swallowing precautions) -positioning -specimen collection -intake and output -Routine vital signs (on stable clients) Linen change

Communication with Alzheimer's - ANSWER Speak slowly Give one direction at time Don't ask complex or open ended questions "what do you want to wear" Ask simple, direct questions "would you like to wear brown or gray pants"? Face the client directly when speaking

Therapeutic communication - ANSWER -Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship. -*USE OPEN

Professional Boundaries Over involvement - ANSWER Includes boundary crossings, boundary violations and sexual assault, and inapprorpiate relationships with the partner or family of a person in a nurse's care (boundary violations).

Professional Boundaries Under involvement - ANSWER Patient abandonment Disinterest & neglect Detrimental to the PT & RN

Objective Data - ANSWER information that is seen, heard, felt, or smelled by an observer; signs

Subjective Data - ANSWER what the person says about himself or herself during history taking

Apical heart assessment - ANSWER Listen for a full 60 seconds @ MCL, 5th intercostal space. To be done before certain meds that decrease the HR.

Blood Pressure Parameters - ANSWER -Hypotension <90/60 mmHg -Normal <120/80 mmHg -Elevated 120-129/>80 mmHg -Stage 1. 130-139/80-89 mmHgterm- -Stage 2. 140/90 mmHg -Hypertensive Crisis. 180/

A client has been taking a new adrenergic blocker (beta blocker). Which of the following statements indicates that the client understands how to manage the side effects? SELECT One - Dizziness for a couple of weeks when changing positions will occur.

A client is admitted for dehydration due to heat related illness and they are showing

signs of fluid volume deficit. What are they experiencing? SELECT Hypotension

A client has been prescribed an Ace inhibitor captopril. The nurse would instruct the client about which side effects are associated with this medication? - ANSWER -Persistent dry cough -Dizziness

Pulse (BPM) Adult - ANSWER -Average 60-100 bpm -Bradycardia < 60 -Tachycardia > 100 -Older adult 40-

oxygen saturation (SpO2) - ANSWER Varies with health status ie: COPD Normal adult 92-100%

Respiration Rates - ANSWER Varies with age Normal adult 12- Older adult 16-

Temp Parameters - ANSWER -Oral 97.7- 99.5* F -Tympanic 98.2-100* F -Temporal artery 98.7- 100.5* F -Axillary 96.7- 98.5* F -Rectal 98.7- 100.5* F

What can affect medication Absorption? - ANSWER -The route of administration -Area of absorptive surface, functional integrity. -Vascularity

• Over bony prominence
• May be painful

Pressure Ulcer Stage 2 - ANSWER PARTIAL THICKNESS, SKIN LOSS WITH EXPOSED DERMIS.

• Shallow open ulcer -Red/pink wound bed -No slough

Stage 3 Pressure Ulcer - ANSWER FULL-THICKNESS, SKIN LOSS.

• Subcutaneous fat visible
• Slough may be present

Stage 4 Pressure Ulcer - ANSWER FULL-THICKNESS, SKIN & TISSUE LOSS.

• Exposed bone, muscle, tendon
• With or without slough & Escher visible

Unstageable Pressure Ulcer - ANSWER OBSCURED FULL-THICKNESS SKIN

Deep Tissue Pressure Ulcer - ANSWER PERSISTENT NON-BLANCHABLE -deep, red, maroon, or purple discoloration. -Intact skin -blood filled blister

What puts a patient at risk for Skin Breakdown? - ANSWER Motility, friction/shearing Malnutrition, poor skin hygiene Moisture & Incontinence

Appearance of existing pressure Injury, fractures, Increased body temp Aging skin, corticosteroid use, terminal illness

These can be classified as Restraints - ANSWER -Side rails -Geriatric chairs with attached tables -Appliances tied at the wrist, ankle, waist, or wheelchair -Chemical

Restraints types and uses - ANSWER -4 points = danger to self or others -MUST try other "distractions" first -NEVER use while PT is asleep -Used as a LAST resort -2 point = used in critical care to prevent pulling out lines.

Restraint Goals - ANSWER -Get PT out of restraints ASAP -Establish PT agreement -Only use as a LAST resort

Things to try BEFORE Restraints - ANSWER -Walking -Redirection/distraction -Activities (coloring, puzzles) -Remove cause of agitation Assess for pain

BMI (body mass index) - ANSWER -Underweight - Less than 18. -Normal - 18.5 - 24.