NURS319 Final Exam Study Guide, Exams of Nursing

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NURS319 Final Exam STUDY GUIDE WITH

OVER 1 00 QUESTIONS AND VERIFIED

ANSWERS LATEST UPDATE 2024/

FREQUENTLY TESTED QUESTIONS ALREADY

GRADED A

How is diabetes diagnosed? - ANSWER>>-A1C of 7 or >

• fasting plasma glucose > or = 126 mg/dL
• 2 hour plasma glucose level > or = to 200 mg/dL
• pt w/ polyuria, polydipsia, polyphagia, and unexplained weight loss or random plasma glucose > 200 will be treated what are the manifestations of diabetes? - ANSWER>>-polyuria, polydipsia, polyphagia
• hyperglycemia
• unexplained weight loss what is diabetes the leading cause of? - ANSWER>>-End-stage renal disease
• Adult blindness
• Non-traumatic lower limb amputations what are the complications of diabetes? - ANSWER>>-heart disease
• hypertension
• stroke what should nutrition education be for someone with diabetes? - ANSWER>>-eat at regular intervals
• should carb count
• coordinate diet with activity
• weight loss (if applicable)
• fruits and vegetables

what is the exercise education with pt with DM? - ANSWER>>-consistent exercise

• walking 30 min/day for 5 days/week
• have snack before exercise, check BGM, keep simple carb on hand
• best done 1hr after meals or have 10-15g snack before what is the nursing intervention for a patient with hyperglycemia? - ANSWER>>-continue med regimen
• check BGM fx
• increase fluids
• call provider
• check urine for ketones what are the manifestations for hyperglycemia? - ANSWER>>-hot dry skin
• fruity breath what are the manifestations for hypoglycemia? - ANSWER>>-shakiness
• confusion
• profuse sweating
• palpitations
• headache what is the rule of 15 for hypoglycemia? - ANSWER>>-15g of simple carb (4-6oz of juice or soft drink)
• recheck in 15 min
• if sustained give another 15g
• recheck in 15min
• repeat 2-3 doses, if unchanged call HCP what is the emergency intervention for a pt with hypoglycemia? - ANSWER>>-give 20-50 mL of 50% dextrose IV
• if no IV access & pt is unconscious give 1mg of glucagon IM or subQ what is a rapid acting insulin? - ANSWER>>aspart, lispro, gluisine

What is the onset for rapid acting insulin? - ANSWER>>10-30 minutes what is the peak for rapid acting insulin? - ANSWER>>30 min to 3 hr what is the duration for rapid acting insulin? - ANSWER>>3-5 hours what are the short acting insulins? - ANSWER>>regular What is the onset of short acting insulin? - ANSWER>>30 minutes to 1 hour what is the peak of short acting insulin? - ANSWER>>2-5 hr what is the duration of short acting insulin? - ANSWER>>5-8 hours what is intermediate acting insulin? - ANSWER>>NPH what is the onset of intermediate acting insulin? - ANSWER>>1.5-4 hours What is the peak of intermediate acting insulin? - ANSWER>>4-12 hr what is the duration for intermediate acting insulin? - ANSWER>>12-18hr what are the long acting insulins? - ANSWER>>degludec, glargine, detemir What is the onset of long acting insulin? - ANSWER>>0.8-4 hours what is the duration of long acting insulin? - ANSWER>>16-24 hours what is the nursing management for a pt on insulin? - ANSWER>>-always have a meal available before administration

• teach-back (pt can draw up and administer, learn doses and sliding scale, choose the proper site, knows s/s of hyper/hypoglycemia)
• home health nurse if necessary what are the complications of thyroidectomoy? - ANSWER>>-hypothyroidism
• damage or accidental removal of parathyroid (hypocalcemia)
• hemorrhage
• infection what is the nursing care for a pt post op thyroidectomoy? - ANSWER>>-fx assessment for hemorrhage or tracheal compression
• place in semi-fowlers with head supported with pillows (NO NECK EXTENSION)

• monitor VS and Ca
• coughing and deep breathing, analgesia what should the nurse be aware of in her pt post op for thyroidectomy? - ANSWER>>-can the patient communicate?
• yes/no question, whiteboard, head signals What is the most common cause of hyperthyroidism? - ANSWER>>-Graves disease how is hyperthyroidism treated? - ANSWER>>-thyroidectomy
• drugs
• nutrition what are manifestations of hyperthyroidism? - ANSWER>>-tremor
• exophthalmos what are the main points for levothyroxine (synthroid)? - ANSWER>>-take an hour before breakfast-can go to hyperthyroidism
• can get tremor (adjust dose)
• peaks in 1-3 weeks who is most at risk for hypothyroidism? - ANSWER>>-women what is pt education for hypothyroidism? - ANSWER>>-thyroid replacement
• monitor bloodwork
• nutrition therapy to promote weight loss what are the manifestations of hypothyroidism? - ANSWER>>-fatigue
• lethargy
• irritability
• weight gain what are the manifestations of cushing? - ANSWER>>-buffalo hump
• moon face who is at risk for cushing? - ANSWER>>-long-term corticosteroid users

How is Addison's disease treated? - ANSWER>>-Hydrocortisone what to know about hydrocortisone? - ANSWER>>-take early morning w/ food

• taper off if stopping
• take w/ vitamin D
• low impact exercise what should be inspected in the physical skin assessment? - ANSWER>>-color
• pigment
• bruising
• lesions
• discoloration what should be palpated in skin assessment? - ANSWER>>-temperature
• turgor
• moisture
• texture what is a macule lesion? - ANSWER>>-freckles, mole
• flat discoloration what is a papule lesion? - ANSWER>>-wart, elevated mole, basal cell carcinoma
• elevated solid lesion what is a plaque lesion? - ANSWER>>-psoriasis
• elevated solid lesion what is a pustule lesion? - ANSWER>>-acne, impetigo
• elevated lesion w/ purulent fluid what is a vesicle lesion? - ANSWER>>-varicella, shingles, 2nd degree burn
• superficial collection of serous fluid

what is a wheal lesion? - ANSWER>>-inspect bite, hives, angioedema

• firm, edematous, irregular shape how is skin cancer diagnosed? - ANSWER>>A: asymmetry B: border C: color D: diameter E: evolving What do basal cell carcinomas look like? - ANSWER>>-pearly borders, depressed center, slightly red or elevated
• treated by surgery depending on the location what is the prognosis for basal cell carcinomas? - ANSWER>>-least likely to metastasize, 90% cure rate
• least deadly what is the prognosis for melanoma? - ANSWER>>-poor prognosis unless treated early
• rapid metastasis
• survival rate has correlation on depth of invasion what does melanoma look like? - ANSWER>>- irregularly shaped
• rough borders
• varied colors with red, white, blue tones What can melanoma arise from? - ANSWER>>-environmental factors
• genetics what to know about HSV1? - ANSWER>>-recurrent and lifelong
• treat w/ antiviral rx (acyclovir), soothing moist compress
• no vaccine What is the treatment for herpes zoster? - ANSWER>>-silvadene (if ruptured vesicles
• wet cold compress
• analgesics (gabapentin)
• vaccine (age 65 and above)

• antiviral treatment is shingles unilateral or bilateral? - ANSWER>>unilateral what is the patient education for scabies? - ANSWER>>-treat close family and sexual partners
• treat environment w/ plastic for 5 days
• can have itching up to 4 weeks after
• treated with 5% topical lotion (apply overnight and 2nd application is a week later)
• treated w/ antibiotics if secondary infection
• launder clothes w/ bleach what are the skin gerontological considerations? - ANSWER>>-decreased fat in the skin
• less protection, more wrinkles
• dry skin, less sweating
• bruising
• less awareness to pain, touch, temp, vibration what are the gerontological considerations for hair? - ANSWER>>-gray or white, dry or coarse what are the gerontological considerations for nails? - ANSWER>>-thick brittle nails w/ diminished growth what is tinea pedis? - ANSWER>>athlete's foot what is impetigo? - ANSWER>>Contagious bacterial infection marked by clusters of small blisters what is psoriasis? - ANSWER>>dry skin, reddness what is candidasis? - ANSWER>>fungal infectioon (thrush) What is tinea corporis? - ANSWER>>ringworm What is uriticaria? - ANSWER>>hives what is the discharge criteria from the PACU to the floor? - ANSWER>>-pt is at baseline and can be aroused
• stable vitals
• no excessive bleeding or drainage

• no respiratory depression
• o2 sats < 90%
• pain is controlled or at an acceptable level
• report given to floor what is the patient education for PE? - ANSWER>>-deep breathing and coughing
• incentive spirometer
• early ambulation
• fx repositioning q 1-2hr what are nursing actions for PE? - ANSWER>>-d-dimer
• CT scan
• heparin and lovenox what is a normal pH? - ANSWER>>7.35-7. what is a normal CO2? - ANSWER>>35- 45 what is a normal bicarb? - ANSWER>>22- 26 what needs to be done before a pt has an x-ray? - ANSWER>>-remove metals
• pregnancy test what needs to be done before a pt has a ct scan? - ANSWER>>-BUN and creatinine
• allergies (shellfish, contrast dye)
• tell pt about warm flushed feeling what needs to be done before MRI? - ANSWER>>-remove metals
• report surgical staples, rods, or screws what is the pt education for ultrasound? - ANSWER>>-noninvasive, not painful
• short time, no fasting or sedation required what are notable findings on cardiac assessment? - ANSWER>>-cardiac issues in the past
• OTC meds

• Chest pain or SOB during activity
• pillows needed to sleep (orthopnea)
• sodium restriction what are MI manifestations? - ANSWER>>-anxiety/impending feeling of doom
• chest pain
• nausea/dizziness
• cool clammy skin
• tachycardia/heart palpitations
• SOB what is patient education for nitroglycerin? - ANSWER>>-take SL NTG q5 min for a max of 3 doses
• if pain is unchanged call 911
• can take 5-10 minutes before activity what is the goal for respiratory function? - ANSWER>>adequate gas exchange what are absent breath sounds? - ANSWER>>none what are coarse crackles? - ANSWER>>-loud low-pitched sounds
• heard on inspiration, expiration, or both what are fine crackles? - ANSWER>>-short high pitched sounds at end of inspiration what is pleural friction rub? - ANSWER>>-two surfaces rubbing together, grating sounds
• inspiration, expiration, or both what is stridor? - ANSWER>>-upper airway obstruction
• choking what is wheezing? - ANSWER>>-high pitched squeaking
• inspiration, expiration what are the manifestations of COPD? - ANSWER>>-chronic dyspnea

• chronic cough
• chest heaviness
• wheezing
• fatigue
• weight loss what is occupational lung disease caused by? - ANSWER>>-asbestos what is patient teaching for pt with occupational lung disease? - ANSWER>>-proper PPE
• OSHA
• limit exposure what should the nurse assess for in pt with a tracheostomoy? - ANSWER>>-body image (do they accept it, participate in care, change gauze)
• can they communicate (yes/no ?, head shake, white board) what is the pt education for aspiration? - ANSWER>>-recovery position
• keep HOB elevated during meals
• O2, abx, cardiopulmonary support
• head tilt chin lift what is the pt education for atelectasis? - ANSWER>>-deep breathing and coughing
• incentive spirometer
• oxygen how to use incentive spirometer? - ANSWER>>-expand lungs and breath more deeply and fully
• lips around mouthpiece and inhale deeply to watch piston rise what is the gerontological consideration for influenza? - ANSWER>>-encourage vaccination
• pneumonia is the complication what are the HTN risk factors? - ANSWER>>-age
• alcohol

- DM

• elevated serum lipids
• ethnicity
• excess dietary sodium
• gender
• obesity
• sedentary lifestyle
• socioeconomic status
• stress
• tobacco use what are lifestyle modifications for HTN? - ANSWER>>-manage BP
• control diet (cholesterol, blood sugar)
• get active, eat better, lose weight
• stop smoking What is the DASH diet? - ANSWER>>-dietary approach to stop hypertension
• fruits, vegetables, fat-free or low-fat milk, whole grains, fish, poultry, beans, seeds, and nuts
• NO FATTY MEAT what activity should a HTN pt do? - ANSWER>>-aerobic exercise for 30 min/day or 150 min/week what is the treatment for HTN crisis? - ANSWER>>-sodium nitroprusside
• labetalol
• reassess q3-5 min, check neuro, recheck BP
• EKG, bloodwork, drugs what are the educational points after RGYB? - ANSWER>>-dumping syndrome is a complication so avoid sugar
• 6 small meal, no liquids at the same time

• avoid drinking w/ straw (gulping)
• 15mL q10-15min, increase to 90mL q30 min
• multivitamins= Ca, D, B12, high protein, low carb what is the patient teaching for chronic constipation? - ANSWER>>-high fiber diet (fruit w/ skin, wheat bread, asparagus, beans)
• stool softeners, laxatives (enemas are not first line tx)
• fx repositioning, privacy
• drink fluids
• exercise what is hep A caused by? - ANSWER>>-contaminated food, milk, water, shellfish what is hep A education? - ANSWER>>-hand-washing
• vaccine what is CKD causes? - ANSWER>>-age >
• CVD
• DM
• ethnic minority
• exposure to nephrotoxic drugs
• family hx of CKD
• HTN what are post-op complications for TURP? - ANSWER>>-hemorrhage
• bladder spasms
• urinary incontinence
• infection what to do for a hemorrhage after TURP? - ANSWER>>-CBI
• remove clotted blood from bladder

• check for bleeding in cath what is the lupus pt ed? - ANSWER>>-pain management
• heat therapy
• conserve energy
• SPF 15 or >
• avoid stress, infections, drying soaps, powders, chemicals how is RA dianosed? - ANSWER>>- + RF
• synovial fluid
• xray
• H&P what is pt ed for RA? - ANSWER>>-afternoon nap
• PT and OT
• avoid and manage stress
• heat and cold
• assistive devices what are the risk factors for OA? - ANSWER>>-drugs
• inflammation
• joint instability
• mechanical stress (sports, repetitive movements)
• neurological disorders
• skeletal deformities
• trauma how do you maintain placement/patency for NG tube? - ANSWER>>- xray confirmation and gastric residual
• check skin for breakdown

• flush between meds