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NUR242 / NUR 242 Exam 1, 2, 3 & 4 Galen
Exam + Study Notes + Study Guide Questions
Medical-Surgical Nursing Concepts
TABLE OF CONTENTS
NUR 242 Exam 1 + Study Notes + Study Guide…………………… 02
NUR 242 Exam 2 + Study Notes + Study Guide…………………… 87
NUR 242 Exam 3 + Study Notes + Study Guide…………………… 165
NUR 242 Exam 4 + Study Notes + Study Guide…………………… 255
NUR242 / NUR 242 Exam 1 Medical-Surgical Nursing Concepts Guarantee passing score of 90% or higher
Consist of 50 Questions with Answers
- Patricia is an RN working at a rehabilitation center and witnesses a nurse aid struggling to lift and reposition an elderly, bed ridden patient. She explains to the nurse aide that there is a No Lift Policy in place in the establishment. What does this policy entail : Answer The concept of a no-lift policy is a pledge from adminis- trators that proper equipment, adequately maintained and in sufficient numbers, will be available to care providers to reduce the risks associated with manual patient handling
- Immobility effects multiple body systems. What are some interventions that you can implement to decrease these effects? Select all that apply.
A. Utilizing waffle mattress to reduce the need for repositioning B. Teds/SCDs C. Rubbing reddened areas
: Answer Wound care nurse, Dietician, Physical therapist. OT can also be included, however they deal more with fine motor skills.
- An 85 year old woman is admitted to the hospital. When doing the initial assessment, what are some factors that you know put her at risk for pressure injuries : Answer -if the pt is immobile -if the pt is incontinent
-if the pt has comorbidities such as diabetes or PVD -if the pt is malnourished or dehydrated -if the pt suffers from decreased sensory perception
- The nurse notices a localized red area that is nonblanchable on the the patient's coccyx. What stage pressure injury is this recognized as : Answer Stage 1
Stage 1 pressure injury means the skin is intact with a localized area of nonblanch- able erythema (fancy word for redness).
- A pt asks you why what he eats has anything to do with wound healing. What is your response : Answer Successful healing of pressure injuries depends on adequate intake of calories protein, vitamins, minerals and water.
- After receiving shift report, the night nurse looks at the lab values for a patient with cellulitis. What abnormal lab values might you see : Answer -WBC - elevated -Creatinine- elevated -Bicarbonate- low -Albumin- low -Calcium- low
- Your pt verbalizes a pain of 2/10 and requests their dose of morphine. How would you educate your pt : Answer Morphine is an opioid analgesic used for moderate to severe pain.
- What is the most common side effect of analgesic use and how can we prevent it : Answer Constipation.
A high fiber diet, plenty of fluids, and stool softeners are prophylactic measures.
- The patient is undergoing surgery to fix a cleft palate. What type of surgery is this considered : Answer Constructive
- A biopsy is what type of procedure : Answer Diagnostic
- This type of surgery prolongs life but does not cure the underlying dis- ease: : Answer: Palliative
- A patient has received 10 mg of Morphine via IV 20 minutes ago and is noticeably groggy. The physician requests you witness the signature of his informed consent. How would you, as a patient advocate, proceed : Answer Informed consent should be received before patient is given any preop analgesics to ensure a clear state of mind.
Side note: A nurse is not responsible for clarification of risks or procedure explana- tion.
A nurse can witness signature.
- Pneumonia and Atelectasis are serious concerns post op. What are some things that we can encourage the patient to do to prevent these complica- tions : Answer Incentive spirometry, coughing, and deep breathing
- After surgery, Pt A verbalizes they do not want to cough because it is uncomfortable. What are some things the nurse can do to minimize dis- comfort : Answer Analgesic administration and educating on splinting incision site when coughing.
- Why is it important for a pt to ambulate and wear SCDs or TED stockings after a procedure : Answer To reduce the risk of DVT
- A pt's health history states that they are on corticosteroids. The PACU nurse
with : Answer B-12 Deficiency
- What signs and symptoms might you suspect a patient exhibit if they were iron deficient? Select all that apply.
a. weakness b. palor c. tachypnea d. fatigue e. beefy red tongue : Answer:
A, B, and D
- When caring for a patient with Sickle Cell Anemia, what are some nursing interventions you'll need to implement : Answer - Avoid extreme temperatures
- Keep room warm
- Encourage fluid intake -Encourage ROM
- Pain management
- Match the following infections with the precaution type
A. Standard B. Droplet
C. Airborne
1. MRSA. 5. Measles 2. TB 6. Varicella 3. Influenza 7. Pneumonia 4. Pediculosis 8. Meningitis : Answer: A, C, B, A, C, C, B, B
- A pt is receiving a blood transfusion and breaks out in hives. What is the nurses first step : Answer Immediately stop the the transfusion and start normal saline
- How often should the nurse monitor patient's vital signs when they are receive a blood transfusion : Answer Vital sings must be checked after 15 minutes, 30 minutes, and one hour followed by every hour after.
- The nurse preceptor is discussing antipsychotic medications with a stu- dent nurse. The nurse preceptor correctly explains that antipsychotic medica- tions work by: blocking the actions of dopamine.
- The nurse is caring for a client who has an antipsychotic medication prescribed. When assessing the client for neuroleptic malignant syndrome (NMS) the nurse should assess the client for: muscle rigidity.
- The nurse has attended a continuing education conference about the use of antipsychotics with older adults. Which of the following statements by the nurse would
supplements is commonly used to treat mild depression : Answer - Serum sodium of 130 mEq/L
- The nurse is caring for a client who has been prescribed estrogen re- placement medication for treatment of menopausal symptoms. The nurse recognizes that estrogen medications are contraindicated in clients who have a history of: breast cancer
- The nurse is teaching a client who has been prescribed an oral bisphos- phonate. Which statement by the client indicates that teaching was effective?- : "I will take this medication with a full glass of water."
- The nurse preceptor is observing a newly-hired nurse administer pre- scribed sildenafil to a client. It would require immediate intervention by the nurse preceptor if the newly-hired nurse was observed administering this medication to a client with a history of: myocardial infarction (MI).
- The nurse is teaching a client who has benign prostate hyperplasia (BPH) about ways to minimize symptoms such as urinary retention. The nurse should teach the client to avoid: anticholinergics.
- The nurse preceptor is observing a newly-hired nurse administer pre- scribed opioid analgesic to a client. It would require immediateintervention by the nurse preceptor if the newly-hired nurse was observed administering this medication to a client who has: ncreased intracranial pressure (ICP).
- Patient at risk for pressure injury - understanding of illness and compli- ance with treatment: -s/s to report to primary care doctor -drug therapy plan (correct time and dosing)
- ambulation or positioning schedule
- dressing changes/skin care
- nutrition modifications (24-hr diet recall)
- Patient at risk for pressure injury - nutritional needs: - change in muscle mass
- lackluster nails, sparse hair
- recent weight loss or more than 5% of usual weight
- impaired oral intake
- difficulty swallowing
- generalized edema
- Complications of Immobility: Contractors, foot drop, muscle atrophy DVT Constipation Decreased cardiac output Disorientation renal calculi, UTI Pneumonia pressure ulcers
- Prevention of pressure ulcers Early identification of high risk patients (Braden scale): Mental status change and decreased sensory perception impaired physical immobility, requires assistance with turning and positioning or patients who can not verbalize discomfort nutritional status: serum albumin < 3.5 and prealbumin levels < 19.5 Consult dietitian Incontinence and excessive moisture
- Informed consent: Surgeon is responsible before sedation is given and surgery is performed nurses role is to CLARIFY facts and CLARIFY the consent has been signed an "X" is permitted in patients that cannot write but MUST be witnessed
treatment for pain involves the use of battery-operated device capable of delivering small electrical currents through up to the painful areas
NUR242 / NUR 242 Exam 1 Galen
Study Notes + Study Guide Questions Medical-Surgical Nursing Concepts
Table of Contents
NUR 242 Exam 1 Study Notes………………………………… 01
NUR 242 Exam 1 Study Guide Questions……………………
Study Notes
- Four Major subgroups of Late Adulthood: 65 - 74 young old 75 - 84 middle old 85 - 99 old old 100 and older elite old
- Lifestyle and Practice to Promote Wellness older adults: Yearly flu vaccine pneumococcal vaccine Shingles vaccine tetanus and booster every 10 years
- Depression older adults: Most common mental health/behavioral health prob- lem among older adults. Use Geriatric Depression Scale form Mood disorder having cognitive, affective, physical manifestations Primary (lack of neurotransmitters) Secondary or situational
- Dementia older adults: slowly progresses generally chronic intellectual impairment Most common Alzheimer's Multi-infarct dementia, the second most common resulting from a vascular disorder
- Delirium older adults: Acute and fluctuating onset results from an unfamiliar place Symptoms - inattentiveness, disorganized thinking, and altered level of conscious- ness
- Nurse's role in Rehab: Advocate for the patient and family Create therapeutic rehab milieu provide whole person patient-centered care Collaborate with healthcare team for patient outcome and develop care plan Communicate with effectively with all members of the health care team, patient and family Evaluate effe ctivene ss of plan of care for the patient and family
Use Braden scale - skin break down risk
- Safe Patient Handing and Mobility (SPHM): -Maintain a wide, stable base with your feet -Put the bed at the correct height - waist level while providing direct care and hip level when moving patients
- Keep the patient or work directly in front of you to prevent your spine from rotating
- Keep the patient as close to your body as possible to prevent reaching
- walker - assisted and cane - assisted procedure: - Apply a transfer belt around patients waist
- guide patient to a standing position
- remind patient to place both hands on the walker
- ensure that the patient's body is well balanced
- walker teaching: - lift the walker
- move the walker about 2 feet forward and set it down on all legs -while resting on the walker, take small steps
- check balance
- repeat sequence
- cane teaching: - be sure cane is at the height of the patients wrist when the arm is placed at his or her side
- remind patient to place his or her strong hand on cane
- ensure that the patient's body is well balanced