NUR 230 Exam 4 (2026/2027):Obstetrics
& Pediatrics Nursing Comprehensive
Review (High- Yield Concepts & Practice
Questions For OB/Peds Success.
What medications can cause renal failure?
Antibiotics, NSAID's, and Contrast Dyes
What is the desired normal output for patients?
0.5mL/kg/hr
What causes glomerulonephritis?
Strep infection
How is nephrotic syndrome treated?
Similar to kidney failure but diet should be HIGH in protein, and steroid therapy is also effective
What is the most common cause of a prerenal AKI?
Hypovolemia
What are some common causes of intrarenal AKI?
Shock, Acute Tubular Necrosis (ATN), Burns, Contrast Dyes, Medications, and Rhabdomyolysis
What are some common causes of postrenal AKI?
Stones, Prostate, and Tumors
What abnormal lab values will occur in renal failure?
Decreased sodium, increased potassium, increased magnesium, increased phosphate, and
decreased calcium
What are some symptoms of hypocalcemia?
Trousseau's sign (arm), Tetany (muscle spasms), Chvostek sign (face), and decreased bone
density
Are patient with kidney disease usually alkalotic or acidotic?
Metabolic Acidosis
How do you treat AKI?
Treat the cause; Maintain fluid balance: weigh, assess for edema, strict I&O
How do you maintain pH in kidney failure?
Give bicarb
Why does nocturia and polyuria occur in the beginning stages of CRF?
D/t being unable to concentrate urine
What lab values are elevated in CRF?
BUN, Creat, Potassium, Magnesium, Phosphorus, PTH, and Uric Acid
What lab values are decreased in CRF?
Hgb/Hct, Calcium, Albumin, pH, Bicarb/Co2/Anion Gap, adn Creatinine Clearance
T/F Hyperlipidemia can be a complication of ESRD?
TRUE!
T/F Epotein alpha can cause HTN
1|P age
,TRUE! Check BP
Why should you be careful when giving an ARB or ACE to renal failure patients?
Can cause elevation of potassium
What foods should be avoided due to high phosphorus?
Dairy (milk & cheese), Sodas, Nuts, and Peas
What foods should be avoided due to high potassium?
Avocado, Bananas, Kiwi, Dried Fruit
Can a renal patient eat potatoes and vegetables?
Yes, but the potato needs to be boiled and peeled, and the vegetables need to be boiled (this
reduces the potassium content)
What does the acronym AEIOU stand for? What is it for?
To know whether a patient needs dialysis; A-Acidosis, E-Electrolyte imbalance, I-Intoxicants, O-
Overload, U-Uremia
What medications should be held prior to dialysis treatments?
ALL MEDS!
How long should invasive procedures be avoided post dialysis? Why?
4-6 hours d/t heparin use
When does Hyperacute renal rejection occur? What is th treatment?
Within first 48 hours of transplant; Remove the kidney
When does Acute renal rejection occur?
Within 6 weeks post-op; Increase doses of immunosuppressive drugs
When does Chronic renal rejection occur?
Months to years later; Treat symptoms until dialysis is required
What are the 2 main functions of the pancreas?
Glucose & Digestion
What are the s/s of pancreatitis?
Hypotension, Tachycardia, Fever, Pain radiating to back, and GI distention/possible ileus
What respiratory complications can occur due to pancreatitis?
Effusion, Atelectasis, and ARDS
T/F Turner's Sign & Cullen's sign are caused by renal disease?
FALSE! It is a sign of pancreatitis
What lab changes occur in pancreatitis?
Elevated glucose, Elevated WBC, Low albumin, Hypocalcemia, and possible DIC
What are some s/s of Hypocalcemia?
Tetany (muscle spasms), seizures, numbness/tingling around mouth/lips, Trousseau's (arm), and
Chvostek (cheek)
What is the nursing care for pancreatitis?
NPO, NGT, Antiemetics, and medications to decrease gastric secretions (watch for peritonitis,
and ileus), Electrolyte replacement (Calcium gluconate), and I/O
What type of diet should be given to a patient with pancreatitis?
Small, frequent meals that are low fat, and high carbs; No ETOH or caffeine, and enzyme
replacements should be given with meals
What are some s/s of chronic pancreatitis?
Steatorrhea, Fat malabsorption, Weight loss, and Diabetes
What proteins does the liver metabolize?
Albumin, prothrombin, fibrinogen, and vitamin K
2|P age
,What are the clinical manifestations of Hepatitis?
Fatigue, N/V, Anorexia, RUQ Pain, Myalgia, Irritability, Fever, Bleeding, Pruritis, Light-colored
stool, Brown Urine, Elevated LFT's
How is Hepatitis A transmitted? What is the Incubation/Illness Period?
Fecal-Oral Route; Incubation: 15-50 days; Illness: 4-8 weeks
How is Hepatitis B & C transmitted? What is the Incubation?
Blood/Sexual Contact; Incubation: 1-6 months
What stage of Hepatitis causes no symptoms or mild symptoms (mostly GI)?
Preicteric
What stage of Hepatitis causes sickness and jaundice?
Icteric
What stage of Hepatitis is known as the recovery stage?
Posticteric
What type of diet should be followed in Hepatitis patients?
High calorie, Eat in the morning (n/v occur at night), Fat and Protein modifications, and Monitor
weight
What medications can cause drug-induced Hepatitis?
Tylenol, Antituberculars, NSAIDs, Statins, and Terbinafine (Lamisil)
What complications occur in Cirrhosis?
Inability to detoxify substances, produce essential proteins, regulate glucose/bilirubin
metabolism, and regulate fluid volume
What is elevated blood pressure in the portal vein? What disorder causes it? What 2
complications occur due to this pressure elevation?
Portal Hypertension; Cirrhosis; Varices & Ascites
What are some s/s of cirrhosis?
Firm, enlarged liver, abdominal pain, steatorrhea, ascites, varices, pleural effusion, decreased
potassium, jaundice, splenomegaly, and vitamin deficiencies
What disorder causes hemorrhoids, Caput Medusa, Spider angiomas, Palmar erythema,
and neuropathy?
Cirrhosis
What type of diet should be followed with cirrhosis?
Sodium restriction, high calorie, modify protein, fat may not be tolerated, and intake of vitamins
especially A, B complex, C, D, and K
How is cirrhosis managed?
Lactulose; Avoid ETOH, narcotics, sedatives, and Tylenol; Potassium-sparing diuretics;
Antacids; Albumin, and Vitamin K
T/F Albumin and a low-sodium diet are 2 ways to treat ascites?
TRUE! Along with diuretics, paracentesis, TIPS, and other shunts
Why does ascites reoccur so frequently?
Due to renin-angiotensin aldosterone causing sodium & water retention, so it will keep
reaccumulating
How often should a patient with cirrhosis undergo an endoscopy to screen for varices?
Every 2 years
What medications are used for treating bleeding esophageal varices?
Octreotide, vasopressin & nitrates combo, vitamin K, and IV pantoprazole
What are the clinical manifestations of Hepatic Encephalopathy?
3|P age
, Changes in LOC, Asterixis (liver flap), Constructional apraxia, and breath odor (fetor hepaticus)
T/F Protein helps lowers ammonia levels
FALSE! Protein INCREASES ammonia levels
T/F Glucose can help stop protein breakdown
TRUE!
What is the Triad of Death?
hypothermia, acidosis, coagulopathy
What is the primary survey in ED care?
Airway, Breathing, Circulation, Disability (Alert, Voice, Pain, or Unresponsive), and Exposure
(Hypothermia)
What is the secondary survey in ED care?
Complete health history, H2T, Pain, Monitoring, Splinting, Diagnostics, Wound care,
Comfort/emotional support, and Referrals
What 2 portions of Maslow's Hierarchy of Needs are prioritized in ED?
Safety & Physiological
When should a spine injury be assumed during a trauma? What type of maneuver should
be used if patient has to be moved?
ALWAYS; Log roll the patient until the spine is cleared
What are some examples of intraabdominal injuries?
Penetrating (gunshots, stabbings, impalement), and Blunt Trauma (MVC's, Falls, Blows, and
Explosions)
How are brown recluse bites best treated?
Clean with soap & water, administer a tetanus vaccine, and hyperbaric chamber for 2-3 months
to increase wound healing
How are black widow bites best treated?
Clean with soap & water; Analgesic, Tetanus vaccines, Benzodiazepines (for muscle spasms),
and antivenin (if HTN or dyspnea)
When should antivenin be used for spider bites?
For black widow spiders, but only if dyspnea or HTN are occuring
What should you NOT do to treat snake bites?
Apply ice, tourniquet, perform incision/suction, drink alcohol, or take medications that impair
coags (NSAIDS)
When a snake bite arrives in the ED what are the do's?
Identify where/when, sequence of events, call local poison control, obtains vitals, measure
circumference of body part bitten , place 2 large bore IV's. and pain management
When is antivenin most effective?
Within 4 hours and no greater than 12 hours
Why should someone receiving antivenin be continuously monitored? What emergency
equipment is needed and why?
The patient has the risk of becoming unstable very quickly, they need to be monitored at all
times & resus equip should be on standby
How often should a body part be measured after a snake bite? Why?
Every 15 minutes during infusion & every 30-60 min post infusion for the next 48 hours; to
detect compartment syndrome
What are some alkaline corrosive agents that are ingested? Should you induce vomiting if
ingested?
4|P age
& Pediatrics Nursing Comprehensive
Review (High- Yield Concepts & Practice
Questions For OB/Peds Success.
What medications can cause renal failure?
Antibiotics, NSAID's, and Contrast Dyes
What is the desired normal output for patients?
0.5mL/kg/hr
What causes glomerulonephritis?
Strep infection
How is nephrotic syndrome treated?
Similar to kidney failure but diet should be HIGH in protein, and steroid therapy is also effective
What is the most common cause of a prerenal AKI?
Hypovolemia
What are some common causes of intrarenal AKI?
Shock, Acute Tubular Necrosis (ATN), Burns, Contrast Dyes, Medications, and Rhabdomyolysis
What are some common causes of postrenal AKI?
Stones, Prostate, and Tumors
What abnormal lab values will occur in renal failure?
Decreased sodium, increased potassium, increased magnesium, increased phosphate, and
decreased calcium
What are some symptoms of hypocalcemia?
Trousseau's sign (arm), Tetany (muscle spasms), Chvostek sign (face), and decreased bone
density
Are patient with kidney disease usually alkalotic or acidotic?
Metabolic Acidosis
How do you treat AKI?
Treat the cause; Maintain fluid balance: weigh, assess for edema, strict I&O
How do you maintain pH in kidney failure?
Give bicarb
Why does nocturia and polyuria occur in the beginning stages of CRF?
D/t being unable to concentrate urine
What lab values are elevated in CRF?
BUN, Creat, Potassium, Magnesium, Phosphorus, PTH, and Uric Acid
What lab values are decreased in CRF?
Hgb/Hct, Calcium, Albumin, pH, Bicarb/Co2/Anion Gap, adn Creatinine Clearance
T/F Hyperlipidemia can be a complication of ESRD?
TRUE!
T/F Epotein alpha can cause HTN
1|P age
,TRUE! Check BP
Why should you be careful when giving an ARB or ACE to renal failure patients?
Can cause elevation of potassium
What foods should be avoided due to high phosphorus?
Dairy (milk & cheese), Sodas, Nuts, and Peas
What foods should be avoided due to high potassium?
Avocado, Bananas, Kiwi, Dried Fruit
Can a renal patient eat potatoes and vegetables?
Yes, but the potato needs to be boiled and peeled, and the vegetables need to be boiled (this
reduces the potassium content)
What does the acronym AEIOU stand for? What is it for?
To know whether a patient needs dialysis; A-Acidosis, E-Electrolyte imbalance, I-Intoxicants, O-
Overload, U-Uremia
What medications should be held prior to dialysis treatments?
ALL MEDS!
How long should invasive procedures be avoided post dialysis? Why?
4-6 hours d/t heparin use
When does Hyperacute renal rejection occur? What is th treatment?
Within first 48 hours of transplant; Remove the kidney
When does Acute renal rejection occur?
Within 6 weeks post-op; Increase doses of immunosuppressive drugs
When does Chronic renal rejection occur?
Months to years later; Treat symptoms until dialysis is required
What are the 2 main functions of the pancreas?
Glucose & Digestion
What are the s/s of pancreatitis?
Hypotension, Tachycardia, Fever, Pain radiating to back, and GI distention/possible ileus
What respiratory complications can occur due to pancreatitis?
Effusion, Atelectasis, and ARDS
T/F Turner's Sign & Cullen's sign are caused by renal disease?
FALSE! It is a sign of pancreatitis
What lab changes occur in pancreatitis?
Elevated glucose, Elevated WBC, Low albumin, Hypocalcemia, and possible DIC
What are some s/s of Hypocalcemia?
Tetany (muscle spasms), seizures, numbness/tingling around mouth/lips, Trousseau's (arm), and
Chvostek (cheek)
What is the nursing care for pancreatitis?
NPO, NGT, Antiemetics, and medications to decrease gastric secretions (watch for peritonitis,
and ileus), Electrolyte replacement (Calcium gluconate), and I/O
What type of diet should be given to a patient with pancreatitis?
Small, frequent meals that are low fat, and high carbs; No ETOH or caffeine, and enzyme
replacements should be given with meals
What are some s/s of chronic pancreatitis?
Steatorrhea, Fat malabsorption, Weight loss, and Diabetes
What proteins does the liver metabolize?
Albumin, prothrombin, fibrinogen, and vitamin K
2|P age
,What are the clinical manifestations of Hepatitis?
Fatigue, N/V, Anorexia, RUQ Pain, Myalgia, Irritability, Fever, Bleeding, Pruritis, Light-colored
stool, Brown Urine, Elevated LFT's
How is Hepatitis A transmitted? What is the Incubation/Illness Period?
Fecal-Oral Route; Incubation: 15-50 days; Illness: 4-8 weeks
How is Hepatitis B & C transmitted? What is the Incubation?
Blood/Sexual Contact; Incubation: 1-6 months
What stage of Hepatitis causes no symptoms or mild symptoms (mostly GI)?
Preicteric
What stage of Hepatitis causes sickness and jaundice?
Icteric
What stage of Hepatitis is known as the recovery stage?
Posticteric
What type of diet should be followed in Hepatitis patients?
High calorie, Eat in the morning (n/v occur at night), Fat and Protein modifications, and Monitor
weight
What medications can cause drug-induced Hepatitis?
Tylenol, Antituberculars, NSAIDs, Statins, and Terbinafine (Lamisil)
What complications occur in Cirrhosis?
Inability to detoxify substances, produce essential proteins, regulate glucose/bilirubin
metabolism, and regulate fluid volume
What is elevated blood pressure in the portal vein? What disorder causes it? What 2
complications occur due to this pressure elevation?
Portal Hypertension; Cirrhosis; Varices & Ascites
What are some s/s of cirrhosis?
Firm, enlarged liver, abdominal pain, steatorrhea, ascites, varices, pleural effusion, decreased
potassium, jaundice, splenomegaly, and vitamin deficiencies
What disorder causes hemorrhoids, Caput Medusa, Spider angiomas, Palmar erythema,
and neuropathy?
Cirrhosis
What type of diet should be followed with cirrhosis?
Sodium restriction, high calorie, modify protein, fat may not be tolerated, and intake of vitamins
especially A, B complex, C, D, and K
How is cirrhosis managed?
Lactulose; Avoid ETOH, narcotics, sedatives, and Tylenol; Potassium-sparing diuretics;
Antacids; Albumin, and Vitamin K
T/F Albumin and a low-sodium diet are 2 ways to treat ascites?
TRUE! Along with diuretics, paracentesis, TIPS, and other shunts
Why does ascites reoccur so frequently?
Due to renin-angiotensin aldosterone causing sodium & water retention, so it will keep
reaccumulating
How often should a patient with cirrhosis undergo an endoscopy to screen for varices?
Every 2 years
What medications are used for treating bleeding esophageal varices?
Octreotide, vasopressin & nitrates combo, vitamin K, and IV pantoprazole
What are the clinical manifestations of Hepatic Encephalopathy?
3|P age
, Changes in LOC, Asterixis (liver flap), Constructional apraxia, and breath odor (fetor hepaticus)
T/F Protein helps lowers ammonia levels
FALSE! Protein INCREASES ammonia levels
T/F Glucose can help stop protein breakdown
TRUE!
What is the Triad of Death?
hypothermia, acidosis, coagulopathy
What is the primary survey in ED care?
Airway, Breathing, Circulation, Disability (Alert, Voice, Pain, or Unresponsive), and Exposure
(Hypothermia)
What is the secondary survey in ED care?
Complete health history, H2T, Pain, Monitoring, Splinting, Diagnostics, Wound care,
Comfort/emotional support, and Referrals
What 2 portions of Maslow's Hierarchy of Needs are prioritized in ED?
Safety & Physiological
When should a spine injury be assumed during a trauma? What type of maneuver should
be used if patient has to be moved?
ALWAYS; Log roll the patient until the spine is cleared
What are some examples of intraabdominal injuries?
Penetrating (gunshots, stabbings, impalement), and Blunt Trauma (MVC's, Falls, Blows, and
Explosions)
How are brown recluse bites best treated?
Clean with soap & water, administer a tetanus vaccine, and hyperbaric chamber for 2-3 months
to increase wound healing
How are black widow bites best treated?
Clean with soap & water; Analgesic, Tetanus vaccines, Benzodiazepines (for muscle spasms),
and antivenin (if HTN or dyspnea)
When should antivenin be used for spider bites?
For black widow spiders, but only if dyspnea or HTN are occuring
What should you NOT do to treat snake bites?
Apply ice, tourniquet, perform incision/suction, drink alcohol, or take medications that impair
coags (NSAIDS)
When a snake bite arrives in the ED what are the do's?
Identify where/when, sequence of events, call local poison control, obtains vitals, measure
circumference of body part bitten , place 2 large bore IV's. and pain management
When is antivenin most effective?
Within 4 hours and no greater than 12 hours
Why should someone receiving antivenin be continuously monitored? What emergency
equipment is needed and why?
The patient has the risk of becoming unstable very quickly, they need to be monitored at all
times & resus equip should be on standby
How often should a body part be measured after a snake bite? Why?
Every 15 minutes during infusion & every 30-60 min post infusion for the next 48 hours; to
detect compartment syndrome
What are some alkaline corrosive agents that are ingested? Should you induce vomiting if
ingested?
4|P age
