COMPLEX MED SURG EXAM 2026 STUDY
GUIDE WITH PRACTICE QUESTIONS
◉ Internal radiation precautions. Answer: this type of radiation puts
others at risk, no children under 16 or pregnant women, no sick
contacts
◉ Internal radiation s/s. Answer: skin integrity, alopeia, erythema,
shredding of skin (desquamation), stomatitis , dry mouth, change or
loss of taste, decreased salivation, anorexia, N/V, dysphagia,
thrombocytopenia (low platelets), anemia, leukopenia
◉ Nursing interventions for radiation. Answer: place pt in private
room away from other clients , keep door closed, place sign on door,
wear dosimeter film badge, limit visitors maintain a distance of 6 ft.
from the source, wear lead apron
◉ External chemo precautions. Answer: does not pose a risk to
others
◉ External chemo s/s. Answer: can alter taste (red meat), severe
fatigue, skin integrity, may cause anemia and thrombocytopenia,
skin: blanching, erythema, desquamation, sloughing, hemorrhage,
mouth: mucostitis, dry mouth, difficulty swallowing, gastroenteritis
,◉ Nursing interventions for external radiation. Answer: provide a
well balanced diet that does not contain red meat, help client
manage fatigue by scheduling activities w/rest periods in between
and using energy saving measures, monitor for radiation injury to
skin and mucous membranes and implement a skin care regimen,
monitor CBS
◉ Care after transplant. Answer: assess I/O's at least every hour,
urine appearance, v/s q 15 minutes until stable, labs (renal/H&H),
daily weight, surgical site care, immunosuppressive med, possible
diuretics, nutrition, monitor for s/s of infection, IV fluids, urinary
catheter care, sodium restriction, teach pt s/s of infection,
compliance w/medications is critical, teach pt s/s of rejection and
what to monitor at home, decreased urine output, edema; weight
gain, fatigue, s/s of electrolyte imbalance, psychosocial/emotional
impact, avoid trauma to area of transplant
◉ Osteomylitis. Answer: infection of the bone, develops in one of the
three ways: extension of soft tissue infection, direct bone
contamination, hematogenous (blood borne) spread from other sites
◉ Osteomyelitis risk factors. Answer: elderly; obese; poor nutrition,
impaired immune system; chronic disease
, ◉ Osteomyelitis s/s. Answer: bone pain (pulsating pain), fever,
leukocyosis; increased ESR, may progress to sepsis, chronic
osteomyelitis has less severe manifestations, diagnostics: x-rays,
MRI, wound and blood cultures
◉ Treatment s/s. Answer: prevention is the goal, difficult to treat,
long course antibiotics therapy: IV antibiotics followed by oral
antibiotics: penicillinase-resistant semisyntheti penicillin (nafcillin,
oxacillin) or a cephlasporin until culture results are known, may
require debridement, hyperbaric oxygen treatment in chronic cases,
surgically implanted antibiotics at home, vitamin C for healing
◉ Benign bone tumors. Answer: more common than malignant
primary tumors, osteochondroma is the most common, other:
enchondroma, bone cysts, osteoid osteoma, osteoclastomas (giant
cell tumors)
◉ Malignant bone tumors. Answer: primary malignant
musculoskeletal tumors are relatively rare, osteosarcoma is most
common and most often fatal malignant bone tumor,
chondosarcoma, ewing's sarcoma, bone marrow elements: multiple
myeloma, soft tissue: liposarcoma, fibrosarcoma,
rhabdomyosarcoma
◉ Fat embolism syndrome. Answer: fat globules released when the
bone was fractured travel and may occlude blood vessels, onset w/in
12-72 hours of injury, risk factors: long bone fractures, pelvic or hip
GUIDE WITH PRACTICE QUESTIONS
◉ Internal radiation precautions. Answer: this type of radiation puts
others at risk, no children under 16 or pregnant women, no sick
contacts
◉ Internal radiation s/s. Answer: skin integrity, alopeia, erythema,
shredding of skin (desquamation), stomatitis , dry mouth, change or
loss of taste, decreased salivation, anorexia, N/V, dysphagia,
thrombocytopenia (low platelets), anemia, leukopenia
◉ Nursing interventions for radiation. Answer: place pt in private
room away from other clients , keep door closed, place sign on door,
wear dosimeter film badge, limit visitors maintain a distance of 6 ft.
from the source, wear lead apron
◉ External chemo precautions. Answer: does not pose a risk to
others
◉ External chemo s/s. Answer: can alter taste (red meat), severe
fatigue, skin integrity, may cause anemia and thrombocytopenia,
skin: blanching, erythema, desquamation, sloughing, hemorrhage,
mouth: mucostitis, dry mouth, difficulty swallowing, gastroenteritis
,◉ Nursing interventions for external radiation. Answer: provide a
well balanced diet that does not contain red meat, help client
manage fatigue by scheduling activities w/rest periods in between
and using energy saving measures, monitor for radiation injury to
skin and mucous membranes and implement a skin care regimen,
monitor CBS
◉ Care after transplant. Answer: assess I/O's at least every hour,
urine appearance, v/s q 15 minutes until stable, labs (renal/H&H),
daily weight, surgical site care, immunosuppressive med, possible
diuretics, nutrition, monitor for s/s of infection, IV fluids, urinary
catheter care, sodium restriction, teach pt s/s of infection,
compliance w/medications is critical, teach pt s/s of rejection and
what to monitor at home, decreased urine output, edema; weight
gain, fatigue, s/s of electrolyte imbalance, psychosocial/emotional
impact, avoid trauma to area of transplant
◉ Osteomylitis. Answer: infection of the bone, develops in one of the
three ways: extension of soft tissue infection, direct bone
contamination, hematogenous (blood borne) spread from other sites
◉ Osteomyelitis risk factors. Answer: elderly; obese; poor nutrition,
impaired immune system; chronic disease
, ◉ Osteomyelitis s/s. Answer: bone pain (pulsating pain), fever,
leukocyosis; increased ESR, may progress to sepsis, chronic
osteomyelitis has less severe manifestations, diagnostics: x-rays,
MRI, wound and blood cultures
◉ Treatment s/s. Answer: prevention is the goal, difficult to treat,
long course antibiotics therapy: IV antibiotics followed by oral
antibiotics: penicillinase-resistant semisyntheti penicillin (nafcillin,
oxacillin) or a cephlasporin until culture results are known, may
require debridement, hyperbaric oxygen treatment in chronic cases,
surgically implanted antibiotics at home, vitamin C for healing
◉ Benign bone tumors. Answer: more common than malignant
primary tumors, osteochondroma is the most common, other:
enchondroma, bone cysts, osteoid osteoma, osteoclastomas (giant
cell tumors)
◉ Malignant bone tumors. Answer: primary malignant
musculoskeletal tumors are relatively rare, osteosarcoma is most
common and most often fatal malignant bone tumor,
chondosarcoma, ewing's sarcoma, bone marrow elements: multiple
myeloma, soft tissue: liposarcoma, fibrosarcoma,
rhabdomyosarcoma
◉ Fat embolism syndrome. Answer: fat globules released when the
bone was fractured travel and may occlude blood vessels, onset w/in
12-72 hours of injury, risk factors: long bone fractures, pelvic or hip
