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NSG123/ NSG 123 Exam 1: (New 2024/ 2025
Update) Med Surg 1 Review| Questions and
Verified Answers| 100% Correct|All Units
Covered| A Grade – Herzing
QUESTION
What is the nurse's role for informed consent? Answer:
- clarify facts presented by the physician
- witness signature
QUESTION
If a patient cannot explain the procedure, what should the nurse do? Answer: have the doctor return and explain the procedure again
QUESTION
If a patient is supposed to be NPO but reports eating breakfast, what should the nurse do? Answer:
- ask what the patient ate and when it was eaten
- after assessment of patient, call provider to discuss
QUESTION
circulating nurse roles Answer:
- manages patient care in the OR
- protects the patient's safety and health needs
- performs all security checks (correct surgery, correct limb)
QUESTION
types of anesthesia Answer: Unconscious:
- general (inhalation or IV, unable to maintain airway function, requires LMA or intubation)
- moderate sedation (IV, patient able to maintain airway)
- monitored anesthesia care Conscious:
- local (injected at site of surgery)
- epidural (in the dura around the spinal cord)
- spinal (in the subarachnoid space of the spinal cord)
QUESTION
adverse effects of anesthesia Answer:
- allergic reactions
- drug toxicity or reactions
- malignant hyperthermia
- cardiac dysrhythmias
- CNS changes
- oversedation (especially in elderly)
- undersedation
- trauma (laryngeal, oral, nerve, skin)
- hypotension
- thrombosis
QUESTION
malignant hyperthermia
Answer:
- assess ABCs, skin color, LOC, ability to respond to commands
- obtain vital signs at least every 15 minutes
- administer postoperative analgesia
- transfer report
QUESTION
responsibilities of nurse with hospitalized postoperative patient Answer:
- ABCs
- hemodynamic (BP, vitals, ambulation)
- wound care (observe the wound, lift up gown)
- pain level
- mental status
QUESTION
indications of hypovolemic shock Answer:
- pale, clammy
- BP decrease
- HR and RR increase
- decrease in pulse pressure (systolic - diastolic = PP)
- cyanosis
- rapid, weak, thready pulse
- concentrated urine
QUESTION
considerations for elderly postoperative patients Answer:
- increased confusion and delirium
- monitor hydration
- hypoxia
- hypotension
QUESTION
What should a nurse do if there is blood seen on a dressing 1 hour after a patient returns from the OR? Answer:
- reinforce the dressing
- if bleeding comes through the reinforcement, then call the doctor
QUESTION
Penrose drain Answer:
- a flat, thin, rubber tube inserted into a wound to allow for fluid to flow from the wound
- it has an open end that drains onto a dressing
- sterile safety pin used to stop drain from slipping back into the wound
- physician order indicates how much of tube to be cut off during drain care
QUESTION
closed drainage systems Answer:
- Jackson-Pratt (emptied when about half full, release suction before removal)
- Hemovac (usually removed by doctors because they are sutured in place)
QUESTION
Coordinator of care transitions Answer:
- nurse navigator: ensures smooth transition through the hospital
- case manager: assesses needs of patient before going home from the hospital
Answer:
- health history (heart disease, kidney disease, clotting disorders, COPD, asthma, sleep apnea, diabetes)
- previous surgeries (previous general anesthesia reaction)
- meds (anticoagulants, hypertensive drugs, diabetic drugs, antidepressants)
- allergies (latex, avocado, eggs, chestnuts)
- nutrition (special diets, height and weight)
- dentition (dentures, crowns, bridges, loose teeth)
- drug/alcohol use (alcohol can cause issues with anesthesia)
- lab work (CBC, WBC, H&H, electrolytes, BUN)
- immune function (lupus, diabetes)
- psychosocial factors (is pt ready for changes after surgery)
- spiritual beliefs (important to know before surgery)
QUESTION
Normal BUN levels Answer: 5 - 20 mg/dL decreased = malnutrition, overhydration increased = starvation, severe dehydration
QUESTION
Normal creatinine levels Answer: 0.4 - 1.5 mg/dL decreased = severe malnutrition increased = dehydration
QUESTION
Normal WBC levels Answer: Adults: 4,500 - 11,000/microliter Infants & children: 6,000 - 17,500/microliter Newborns: 9,000 - 35,000/microliter
QUESTION
Normal hemoglobin levels Answer: 12 - 18 g/dL decreased = anemia
QUESTION
Normal hematocrit levels Answer: 40 - 50% decreased = anemia increased = dehydration
QUESTION
Surgical considerations for elderly patients Answer:
- cardiac reserves are lower
- kidney and liver functions are depressed
- GI activity is reduced
- decreased subcutaneous fat (risk for hypothermia)
- may need more time for explanations
Answer:
- shortness of breath
- tachycardia
- expiratory wheezing
- use of accessory muscles
- hypoxemia
QUESTION
What lab is used for asthma diagnosis? Answer:
QUESTION
status asthmaticus Answer:
- emergency situation
- "silent chest"
- absence of wheezing after patient had been wheezing
- RR > 30/min
- HR > 120/min
QUESTION
treatment for status asthmaticus Answer:
- short-acting bronchodilator (nebulizer)
- oxygen
- IV corticosteroids
- IV magnesium
QUESTION
asthma treatment
Answer:
- short-acting bronchodilator/rescue inhaler (Albuterol)
- low-dose inhaled corticosteroid (ICS)
- low-dose ICS and long-acting bronchodilator OR medium-dose ICS
QUESTION
What is immediate treatment for a patient with an asthma attack?*** Answer: short-acting bronchodilator in a nebulizer
QUESTION
Correct order of steps to administer 2 inhalers Answer:
- give bronchodilator first
- wait 5 minutes
- give steroid inhaler second
- rinse patient's mouth to avoid infection
QUESTION
aerosol metered dose Inhaler steps Answer:
- Shake well immediately before each use.
- Remove the cap from the mouthpiece.
- Exhale to the end of a normal breath.
- With the inhaler in the upright position, place the mouthpiece just inside the mouth, and use the lips to form a tight seal or hold the mouthpiece approximately two finger widths from the open mouth.
- While pressing down on the inhaler, take a SLOW, DEEP breath for 3 to 5 seconds, hold the breath for approximately 10 seconds, and exhale slowly.
- Wait 3 to 5 minutes before taking a second inhalation of the drug.
- Rinse the mouth with water after each use.
TB skin test results Answer: Mantoux test: 0 - 4mm: not significant 5 - 10mm: significant for at risk patients
10mm: significant for patients with slightly impaired or normal immune system
QUESTION
risk factors for tuberculosis Answer:
- contact with an infected person
- compromised immune system
- immigrant from country with high TB rate
- environment (prison, long term care, travel, homelessness)
QUESTION
tuberculosis signs and symptoms Answer:
- dry cough that becomes productive
- high fever
- crackles
- fatigue
- loss of appetite
- bloody purulent sputum
QUESTION
drugs used to treat TB Answer:
- Isoniazid (INH)
- Rifampin
- Pyrazinamide (PZA)
QUESTION
Health care acquired pneumonia Answer:
- develops in individuals receiving treatment from a health care facility
- ex: patient going to dialysis or visit from a home healthcare nurse
QUESTION
Clinical classification of pneumonia Answer:
- community-acquired: S&S within 48 hours of admission
- healthcare acquired: S&S after receiving treatment at a healthcare facility (dialysis, home health nurse)
- hospital-acquired: S&S after being in hospital for 48 hours
- ventilator-associated: S&S after being intubated
- aspiration: S&S after aspiration of food
QUESTION
signs and symptoms of pneumonia Answer:
- fever
- chills
- dyspnea
- productive cough
- yellow, green, rust colored sputum
- crackles in lungs
- malaise
- lack of appetite
QUESTION
QUESTION
pneumonia vaccines Answer:
- PCV13: >65, >19 with immunocompromise
- PPSV23: >65, >19 who smoke/have asthma
QUESTION
risk factors for COPD Answer:
- cigarettes smoking
- occupational dust
- air pollution
- frequent respiratory infections
- asthma
- alpha-antitrypsin deficiency (genetic)
QUESTION
signs and symptoms of COPD Answer:
- shortness of breath
- chronic cough
- lots of sputum
- easily fatigued
- barrel chest
- digital clubbing
- use of accessory muscles
- weight loss
- sit forward
QUESTION
classification of COPD severity
Answer:
- Mild: FEV >80%
- Moderate: FEV 50 - 80%
- Severe: FEV 30 - 50%
- Very severe: FEV <30% (forced expiratory volume)
QUESTION
management of COPD Answer:
- smoking cessation
- bronchodilators (short & long acting)
- corticosteroids
QUESTION
How does a nurse know COPD medications are working? Answer:
- O2 level increases
- expiration rate has increased
- decreased SOB
- more activity tolerance
QUESTION
Oxygen therapy for COPD Answer:
- PaO2 >60mmHg = O2 sat 90%
- increase O2 if PaO2 is <60mmHg
- safety concerns for home O
QUESTION
- decreases respiratory rate
- improves aeration
- preserves energy
- lessens fatigue
QUESTION
Medical-surgical nurse Answer:
- single largest specialty in the US
- primarily in the hospital setting
- primarily cares for acutely ill adults
QUESTION
Roles of the medical surgical nurse Answer:
- administer medications
- educate patients and families
- admit and discharge patients
- complete treatments
- manage IV fluids
QUESTION
Nursing education programs for advanced practice Answer:
- nurse researcher
- nurse administrator
- nurse informatics specialist
- nurse educator
QUESTION
Social policy statement
Answer:
- contract of nursing with society and society's contract with nursing
- What does society expect from nursing - stay up to date with nursing practice, continuing education
- What does nursing expect from society - provide facilities, allow nursing to grow
QUESTION
What organization is responsible for developing standards of practice and code of ethics? Answer: American Nursing Association
QUESTION
Standards of Practice Answer:
- basic competencies in delivering care
- expectations for nurses
- set up based on nursing process (ADPIE)
- ex: practices ethically, practices in a healthy manner
QUESTION
Nurse Practice Act Answer:
- laws in each state that regulate the practice of nursing
- sets scope of practice in each state
- sets requirements for nursing school curriculum
QUESTION
Code of ethics for nurses
