CNUR 203 UPDATED EXAM SCRIPT QUESTIONS AND
SOLUTIONS GRADED A+
✔✔What are prevention measures for post-op respiratory complications? - ✔✔DB
&C/incentive spirometry
Splinting incisions while coughing
Change positions q1-2h
Early ambulation
Adequate fluid intake
Adequate pain control
✔✔Post-op syncope may indicate........ - ✔✔Decrsd CO, fluid deficit, decreased cerebral
perfusion, orthotic hypotension
✔✔What is emergence delirium? - ✔✔State of dissociation of consciousness where the
patient is incoherent, inconsolable, irritable and uncooperative upon waking from
anesthesia
✔✔What can cause emergence delirium? - ✔✔Hypoxia, anesthetic meds, bladder
distension, sensory and cognitive impairment, elyte abnormalities
✔✔What is the first thing a nurse should rule out with emergence delirium? - ✔✔Rule
out hypoxia - then check dermatomes if regional anesthetic was used
✔✔For how long might a pot-op patient have hypothermia? - ✔✔Up to 12 hours. ( as
low as 35.0)
✔✔What is an acceptable post-op temperature in the first 24-48 hours an why? - ✔✔Up
to 38.0 due to inflammatory response to surgical stress
✔✔What temperature from the third day and out should alert the nurse of infection
brewing...? - ✔✔37.7 and higher
✔✔What are the signs of paralytic ileus? - ✔✔Distended abdomen, abdominal
discomfort, vomiting, no passage of flatus or stool, decreased or assent bowel sounds
✔✔What is the treatment for paralytic ileus? - ✔✔- Bowel rest (NPO, possible NG tube if
severe nausea, vomiting)
- correct underlying issues (narcotics, electrolytes, infections, surgery, etc)
- Encourage walking!!
✔✔Where is the costovertebral angle? - ✔✔Lower border of the 12th rib, and the
transverse processes of the upper lumbar vertebrae
, ✔✔What indicates kidney inflammation? - ✔✔Sharp pain at the cost-vertebral angle or
paraphrenic area
✔✔How do you assess for costo-vertebral angle tenderness? - ✔✔Indirect percussion.
✔✔What is the most common causative pathogen for UTIs? - ✔✔E. coli
✔✔What is a complicated UTI? - ✔✔as a result of structural or functional abnormalities
(stones, or catheters or neurological diseases, DM or recurrent infections)
✔✔What is the upper urinary tract? - ✔✔kidneys and ureters
✔✔What is the lower urinary tract? - ✔✔bladder, urethra, pelvic floor
✔✔What is cystitis? - ✔✔inflammation of the bladder
✔✔What is pyelonephritis? - ✔✔infection of the kidney
✔✔What are the 3 most common way the urethra is contaminated? - ✔✔Insufficient
peri-care, foreign body insertion, sexual inter course ( urethra is normally sterile!!!)
✔✔What is a rare cause of UTI? - ✔✔Bacteria enter UT from bloodstream or lymph
✔✔What is urinary stasis? - ✔✔Lack of urine from bladder
✔✔How do DM and HIV predispose patients for UTIs? - ✔✔Compromised immune
response
✔✔What are functional disorders that can lead to UTIs? - ✔✔Constipation or voiding
dysfunction
✔✔What is dysuria? - ✔✔painful or difficult urination
✔✔What are clinical manifestations of lower UTI's related to emptying? - ✔✔Dysuria,
hesitancy, post-void dribbling, urinary retention, intermittency
✔✔What are clinical manifestations of lower UTIs related to storage? - ✔✔Incontinence,
nocturia, urgency, urinary frequency, nocturnal enuresis
✔✔What are other/general clinical manifestations of lower tract UTIs? - ✔✔Suprapubic
discomfort or pressure, cloudy urine, foul-smelling urine, U/A + for nitrites, WBCs &
leukocyte eterase
SOLUTIONS GRADED A+
✔✔What are prevention measures for post-op respiratory complications? - ✔✔DB
&C/incentive spirometry
Splinting incisions while coughing
Change positions q1-2h
Early ambulation
Adequate fluid intake
Adequate pain control
✔✔Post-op syncope may indicate........ - ✔✔Decrsd CO, fluid deficit, decreased cerebral
perfusion, orthotic hypotension
✔✔What is emergence delirium? - ✔✔State of dissociation of consciousness where the
patient is incoherent, inconsolable, irritable and uncooperative upon waking from
anesthesia
✔✔What can cause emergence delirium? - ✔✔Hypoxia, anesthetic meds, bladder
distension, sensory and cognitive impairment, elyte abnormalities
✔✔What is the first thing a nurse should rule out with emergence delirium? - ✔✔Rule
out hypoxia - then check dermatomes if regional anesthetic was used
✔✔For how long might a pot-op patient have hypothermia? - ✔✔Up to 12 hours. ( as
low as 35.0)
✔✔What is an acceptable post-op temperature in the first 24-48 hours an why? - ✔✔Up
to 38.0 due to inflammatory response to surgical stress
✔✔What temperature from the third day and out should alert the nurse of infection
brewing...? - ✔✔37.7 and higher
✔✔What are the signs of paralytic ileus? - ✔✔Distended abdomen, abdominal
discomfort, vomiting, no passage of flatus or stool, decreased or assent bowel sounds
✔✔What is the treatment for paralytic ileus? - ✔✔- Bowel rest (NPO, possible NG tube if
severe nausea, vomiting)
- correct underlying issues (narcotics, electrolytes, infections, surgery, etc)
- Encourage walking!!
✔✔Where is the costovertebral angle? - ✔✔Lower border of the 12th rib, and the
transverse processes of the upper lumbar vertebrae
, ✔✔What indicates kidney inflammation? - ✔✔Sharp pain at the cost-vertebral angle or
paraphrenic area
✔✔How do you assess for costo-vertebral angle tenderness? - ✔✔Indirect percussion.
✔✔What is the most common causative pathogen for UTIs? - ✔✔E. coli
✔✔What is a complicated UTI? - ✔✔as a result of structural or functional abnormalities
(stones, or catheters or neurological diseases, DM or recurrent infections)
✔✔What is the upper urinary tract? - ✔✔kidneys and ureters
✔✔What is the lower urinary tract? - ✔✔bladder, urethra, pelvic floor
✔✔What is cystitis? - ✔✔inflammation of the bladder
✔✔What is pyelonephritis? - ✔✔infection of the kidney
✔✔What are the 3 most common way the urethra is contaminated? - ✔✔Insufficient
peri-care, foreign body insertion, sexual inter course ( urethra is normally sterile!!!)
✔✔What is a rare cause of UTI? - ✔✔Bacteria enter UT from bloodstream or lymph
✔✔What is urinary stasis? - ✔✔Lack of urine from bladder
✔✔How do DM and HIV predispose patients for UTIs? - ✔✔Compromised immune
response
✔✔What are functional disorders that can lead to UTIs? - ✔✔Constipation or voiding
dysfunction
✔✔What is dysuria? - ✔✔painful or difficult urination
✔✔What are clinical manifestations of lower UTI's related to emptying? - ✔✔Dysuria,
hesitancy, post-void dribbling, urinary retention, intermittency
✔✔What are clinical manifestations of lower UTIs related to storage? - ✔✔Incontinence,
nocturia, urgency, urinary frequency, nocturnal enuresis
✔✔What are other/general clinical manifestations of lower tract UTIs? - ✔✔Suprapubic
discomfort or pressure, cloudy urine, foul-smelling urine, U/A + for nitrites, WBCs &
leukocyte eterase
