NR 325 MED SURG (ELABORATED QUESTIONS AND CORRECT ANSWERS) 2023/2024

NR 325 MED SURG (ELABORATED QUESTIONS AND CORRECT ANSWERS) 2023/2024 Which sided stroke has impaired speech/language aphasia; impaired right/left discrimination; slow performance/cautious,; depression/anxiety; impaired comprehension. - CORRECT ANSWER-Left-Sided Which sided stroke has spatial perception deficits; denying/minimizing; rapid performance/short attention; impulsiveness; impaired judgment; impaired time. - CORRECT ANSWER-Right-sided _____ are the confirming diagnostic studies for stroke. - CORRECT ANSWER-CT; CT angiogram; CT/MRI perfusion and diffusion imaging; MRI; Magnetic resonance angiography (MRA) _____ are the confirming laboratory studies for stroke. - CORRECT ANSWER-Prothrombin time, activated partial thromboplastin time; CBC (including platelets); Electrolyte panel with blood glucose; Lipid profile; Renal and hepatic studies Recombinant tissue plasminogen activator (tPA) is used to produce localized fibrinolysis by binding to the fibrin in the thrombi, and is the immediate treatment for _____ _____. - CORRECT ANSWER-Ischemic stroke Aspirin at a dose of 325 mg may be started within 24 to 48 hours after the onset of an _____ stroke. - CORRECT ANSWER-ischemic Anticoagulants and platelet inhibitors are contraindicated in patients with _____ strokes. - CORRECT ANSWER-hemorrhagic The main drug therapy for patients with _____ stroke is the management of hypertension. - CORRECT ANSWER-hemorrhagic The _____ _____ of a spinal cord injury (SCI) is initial physical disruption of the spinal cord. - CORRECT ANSWER-primary injury The _____ _____ of a spinal cord injury is from processes, such as ischemia, hypoxia, hemorrhage, edema - CORRECT ANSWER-secondary injury _____ _____ may occur shortly after acute SCI. It is characterized by loss of deep tendon and sphincter reflexes, loss of sensation, and flaccid paralysis below the level of injury. - CORRECT ANSWER-Spinal shock _____ _____ involvement results in total loss of sensory and motor function below the level of injury. - CORRECT ANSWER-Complete cord _____ _____ involvement results in a mixed loss of voluntary motor activity and sensation and leaves some tracts intact. - CORRECT ANSWER-Incomplete cord SCI at C1-C3 - CORRECT ANSWER-Often fatal; Movement in neck and above, loss of innervation to diaphragm, absence of independent respiratory function SCI at C4 - CORRECT ANSWER-Sensation and movement in neck and above; May be able to breathe without ventilator SCI at C5 - CORRECT ANSWER-Full neck, partial shoulder, back, biceps; Gross elbow, inability to roll over or use hands; ↓ Respiratory reserve SCI at C6 - CORRECT ANSWER-Shoulder and upper back abduction and rotation at shoulder; Full biceps to elbow flexion, wrist extension, weak grasp of thumb; ↓ Respiratory reserve SCI at C7-C8 - CORRECT ANSWER-All triceps to elbow extension, finger extensors and flexors; Good grasp with some decreased strength; ↓ Respiratory reserve SCI at T1-T6 - CORRECT ANSWER-Full innervation of upper extremities; Back, essential intrinsic muscles of hand; Full strength and dexterity of grasp; ↓ Trunk stability, decreased respiratory reserve SCI at T6-T12 - CORRECT ANSWER-Full, stable thoracic muscles and upper back; Functional intercostal muscles, resulting in ↑ respiratory reserve SCI at L1-L2 - CORRECT ANSWER-Varying control of legs and pelvis; Instability of lower back SCI at L3-L4 - CORRECT ANSWER-Quadriceps and hip flexors; Absence of hamstring function, flail ankles CT scan is the preferred imaging study to diagnose the location and degree of injury and the degree of _____ _____ _____. - CORRECT ANSWER-spinal canal compromise _____ is used to assess soft tissue injury, neurologic changes, unexplained neurologic deficits, or worsening neurologic condition in SCI. - CORRECT ANSWER-MRI Goals immediately after _____ include maintaining a patent airway, adequate ventilation/breathing, and adequate circulating blood volume (ABCs) and preventing extension of spinal cord damage (secondary injury). - CORRECT ANSWER-SCI _____ allows the patient to move and ambulate while cervical bones fuse - CORRECT ANSWER-Halo fixation device One of the physically demonstrable symptoms of meningitis is _____ _____. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed. - CORRECT ANSWER-Brudzinski's sign Positive _____ sign is involuntary flexing of hips and knees (an involuntary reaction to lessen the stretch on the inflamed meninges) - CORRECT ANSWER-Brudzinski's sign _____ _____ is a neuropsychiatric manifestation of liver disease. The pathogenesis is multifactorial. It includes the neurotoxic effects of ammonia, abnormal neurotransmission, astrocyte swelling, and inflammatory cytokines. - CORRECT ANSWER-Hepatic encephalopathy A characteristic manifestation of hepatic encephalopathy is _____, or flapping tremors, with the most common involving the arms and hands. - CORRECT ANSWER-asterixis If the common bile duct is obstructed due to _____, no bilirubin will reach the small intestine to be converted to urobilinogen. Thus the kidneys will excrete bilirubin, causing dark amber to brown urine. - CORRECT ANSWER-cholelithiasis Complications of _____ and cholecystitis include gangrenous cholecystitis, subphrenic abscess, pancreatitis, cholangitis (inflammation of biliary ducts), biliary cirrhosis, fistulas, and rupture of the gallbladder, which can cause bile peritonitis. - CORRECT ANSWER-cholelithiasis Manifestations of _____ vary from indigestion to moderate to severe pain, fever, chills, and jaundice. - CORRECT ANSWER-cholecystitis When a stone is lodged in the ducts or when stones are moving through the ducts, spasms may result in response to the stone. This sometimes causes severe pain, which is termed _____ _____. - CORRECT ANSWER-biliary colic _____ results in the replacement of liver tissue by fibrosis (scar tissue) and regenerative nodules that occur from the liver's attempt to repair itself - CORRECT ANSWER-cirrhos