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NSG123/ NSG 123 Final Exam: (New 2024/
2025 Update) Med Surg 1 Review| Questions
and Verified Answers| 100% Correct|All
Units Covered| A Grade – Herzing
QUESTION
isotonic solution Answer:
- has the same concentration of solutes as blood
- no fluid shift
- given for FVD, blood loss, hypotension, hypovolemia*** Ex: 0.9% NaCl, lactated ringers, 5% dextrose in water
QUESTION
hypotonic solution Answer:
- has less concentration of solutes than blood
- fluid shifts INTO the cells
- given for NPO Ex: 0.45% NaCl, water, 2.5% dextrose in water
QUESTION
hypertonic solution Answer:
- has more concentration of solutes than blood
- fluid shifts OUT of the cells
- given for 3rd spacing, later stages of DKA Ex: 3% NaCl, 5% NaCl
QUESTION
IV insertion steps Answer:
- open and prepare sterile packages
- prepare extension tubing: clean connection port, attach 0.9% NS syringe to tubing and prime tubing, leave syringe attached
- apply tourniquet
- select vein to be used
- release tourniquet temporarily
- apply clean gloves
- clean site
- reapply tourniquet
- insert needle with bevel up
- check for blood return/flashback
- advance needle 1/4" and then loosen stylet
- using index finger, advance catheter off the needle into the vein
- stabilize catheter and release tourniquet
- connect extension tubing to catheter
- aspirate to assess blood return, then flush line with 0.9% NS
- secure catheter with tape/transparent dressing
- label dressing with date, time, initials, type and size of catheter used
QUESTION
osteoporosis Answer:
- rate of bone resorption is greater than rate of bone formation
- most common bone disease in the world
- bones become porous and brittle
QUESTION
risk factors for osteoporosis Answer:
- female
- small bone frame
- age
- take on empty stomach with full glass of water
- remain sitting upright for 30 minutes after taking
QUESTION
patient education for osteoporosis Answer:
- fall prevention is most important
- regular weigh bearing exercise
- balanced diet high in calcium and vitamin D
- prevent constipation
QUESTION
osteoarthritis Answer:
- non-inflammatory joint disease
- breakdown of joint cartilage
- formation of osteophytes
QUESTION
risk factors for osteoarthritis Answer:
- older age
- female
- obesity
- genetics
- occupations with laborious tasks (nursing)
QUESTION
symptoms of osteoarthritis Answer:
- stiffness
- functional impairment
- crepitus
- inflammation
QUESTION
diagnostic test for osteoarthritis Answer: x-rays
QUESTION
medications for osteoarthritis Answer:
- NSAIDs (first line treatment)
- topical Voltaren
- corticosteroids
- opioids
- Hyaluronic acid injections
- joint replacement surgery
QUESTION
gout Answer:
- inflammatory arthritis
- increased uric acid in the blood
QUESTION
symptoms of gout Answer:
QUESTION
buffer systems in the body Answer:
- chemical buffers (NaHCO3) - works within seconds
- respiratory - regulates CO2 - works within minutes
- metabolic - regulates HCO3 - may take days to regulate
QUESTION
risk factors for ABG imbalance Answer:
- burns
- trauma
- surgery
- abnormal loss of body fluids
- acute/chronic illness
QUESTION
symptoms of respiratory acidosis Answer:
- suddenly increased HR, BP, RR
- mental changes
- always due to respiratory problem
QUESTION
symptoms of respiratory alkalosis Answer:
- light headedness
- inability to concentrate
- seizures
- numbness/tingling
QUESTION
symptoms of metabolic acidosis Answer:
- increased RR and depth (Kussmaul res- pirations)
- headache
- confusion
- drowsiness
- commonly due to kidney injury
QUESTION
nursing interventions for metabolic acidosis Answer:
- administer sodium bicarbon- ate
- monitor potassium levels (hyperkalemia)
QUESTION
symptoms of metabolic alkalosis Answer:
- respiratory depression
- tachycardia
- hypokalemia
- commonly due to vomiting or gastric suction, long-term diuretics
QUESTION
treatment for metabolic alkalosis Answer: restore fluid volume with NaCl (allows ex- cretion of excess bicarbonate)
QUESTION
symptoms of fluid volume excess Answer:
- hypervolemia, water intoxication
- caused by heart failure, kidney failure, alcoholism, too much salt
- increased blood pressure
- bounding pulse
- shortness of breath
- crackles in lung sounds
- distended neck veins
- edema
QUESTION
nursing interventions for fluid volume excess Answer:
- low sodium diet (avoid ba- con, fast food, pickled foods)
- restrict fluids
- assess lung sounds
- diuretics (monitor K+ levels)
- monitor I&O
- daily weight
QUESTION
lab findings for fluid volume excess Answer:
- decreased BUN
- decreased creatinine
- decreased Hgb
- decreased Hct (report if < 30%)
- decreased urine specific gravity
QUESTION
normal Na+ range Answer: 135 - 145 mEq/L
QUESTION
normal K+ range Answer: 3.5- 5 mEq/L
QUESTION
normal Hgb range Answer: 12 - 18 g/dL
QUESTION
normal Hct range Answer: 38 - 48%
QUESTION
normal creatinine range Answer: 0.7-1.4 mg/dL
QUESTION
QUESTION
What are the "sick day" rules for diabetics? Answer:
- take insulin or oral medication as usual
- check blood glucose and urine ketones
- report elevated glucose levels/urine ketones to provider
- report nausea, vomiting, and diarrhea to provider
QUESTION
clinical signs of hyperglycemic hyperosmolar syndrome (HHS) Answer:
- mostly occurs in type 2 diabetics
- slower onset than DKA
- hyperglycemia (>650+)
- tachycardia
- shallow breaths
- polyuria
- glucose in urine
- hypotension
- normal pH
QUESTION
long-term complications of diabetes Answer:
- atherosclerosis
- peripheral vascular disease
- diabetic retinopathy
- nephropathy
- peripheral neuropathy
- sexual dysfunction
QUESTION
health recommendations for diabetics Answer:
- annual eye exam
- inspect and wash feet daily
- no lotion between toes
- avoid heating pads
- annual vaccines
- no sandals
QUESTION
rheumatoid arthritis Answer:
- progressive autoimmune disease
- inflammation of connective tissues (especially distal joints)
- cause is unknown
- affects females more than males
QUESTION
stages of rheumatoid arthritis Answer:
- synovitis (inflammation)
- pannus (granulation tissue, nodules form)
- fibrous (scar tissue)
QUESTION
risk factors for rheumatoid arthritis Answer:
- family history (first degree relatives)
- smoking
- pollution
- illness (bacterial or viral)
QUESTION
What will nurse monitor when patient is on DMARDs? Answer:
- liver enzymes (AST)
- kidney function (creatinine, BUN)
- CBC
QUESTION
treatments for rheumatoid arthritis Answer:
- disease modifying antirheumatic drugs (DMARDs)
- COX 2 inhibitors
- NSAIDs
- corticosteroids (persistent RA)
- immunosuppressants (advanced RA)
QUESTION
How can the nurse tell medications are working for rheumatoid arthritis? Answer:
- decreased pain
- increased motion
- decreased inflammation around the joint
QUESTION
patient education for rheumatoid arthritis Answer:
- keep joints moving
- low-stress exercise (swimming or cycling, no jumping or running)
- adequate sleep
- diet with high vitamins, protein, and iron (red meat, leafy vegetables)
- avoid caffeine
- avoid heavy meals at night
QUESTION
systemic lupus erythematosus (SLE) Answer:
- autoimmune disease affects every organ in the body
- B lymphocytes attack the body
- unknown cause
- periods of exacerbation and no symptoms
- affects females more than males
QUESTION
triggers for SLE Answer:
- smoking
- illness
- stress
- sunlight
QUESTION
Criteria for diagnosis of SLE Answer:
- malar rash (facial butterfly rash)
- discoid rash (scaly rash on arms, legs)
- lab test antinuclear antibodies (ANA)***
QUESTION
