Exam 4: NUR 265 Advanced Med-Surg Exam Study Guide with complete solutions| Latest 2025/2026 – Galen.

Exam 4: NUR 265 Advanced Med-Surg Exam
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Study Guide with complete solutions – Galen.
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John brown is burned over 90% of his body and is barely
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breathing. He is intubated and IV fluids were started at the scene
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*mass casualty example i,- i,- i,-i,- i,- BLACK: EMERGENT i,-




Mr. Miller, the van driver has a deep and long bleeding laceration
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on his forehead, is complaining of severe chest pain radiating
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down his left arm, SOA, nausea, and a headache
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*mass casualty example i,- i,- i,-i,- i,- RED: EMERGENT i,-




Patty Miller is complaining of severe pain in her right leg (her
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femur bone is protruding through her skin) and bleeding, and her
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right arm as well as her neck is hurting
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*mass casualty example i,- i,- i,-i,- i,- YELLOW: URGENT i,-




Sam Miller who did not have a seat belt on is complaining of
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chest and back pain. He has what appears to be ribs protruding
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,through his right chest wall. He has no breath sounds on that side
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when assessed. i,- i,-




*mass casualty example i,- i,- i,-i,- i,- RED: EMERGENT i,-




Tom Smith was back in the third seat and was hanging half way
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out of the vehicle and unconcious. When he arrived, blood was
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coming out of his LEFT ear, legs mangled, and a gaping hole in
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his abdomen with blood everywhere
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*mass casualty example i,- i,- i,-i,- i,- BLACK: NON-URGENT i,-




Mrs. Tipton has no visible injuries. You are able to assess her
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orientation. She has a blank stare on her face. You ask her
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questions and give her commands, and no response is given. She
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is not moaning or making any noise, only staring straight ahead.
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*mass caualty example i,- i,- i,-i,- i,- YELLOW: URGENT i,-




Mr. Gulliver believes his leg is broken. He tells you that he is in a
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great deal of pain and is unable to stand on his leg. The fire
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department had to remove him from the bus because he was i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-



pinned behind the steering wheel. The airbag inflated but there
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were no visible injuries caused by the airbag that can be seen.
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,*mass casualty examplei,- i,- i,-i,- i,- GREEN: NON-URGENT i,-




Non urgent
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Lupus: Hallmark sign i,- i,- i,-i,- i,- butterfly rash on face i,- i,- i,-




Lupus: Indication of flarei,- i,- i,- i,-i,- i,- Fever and fatigue i,- i,- i,-




*also assess BUN function
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*c reactive protein remains normal
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Lupus: Interventions i,- i,-i,- i,- -Falls precautions i,-




-treat pain with tylenol and NSAIDS (monitor kidney function)
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-AVOID SUNLIGHT i,-




-REPORT FLARE IMMEDIATELY i,- i,-




-clean skin with mild soap and pat dry and apply lotion
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Lupus: medical management i,- -hydroxychloroquine(anti- i,- i,-i,- i,-



malarial) decreases absorption of UV light
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, Scleroderma i,-i,- i,- inflammatory, autoimmune connective tissue i,- i,- i,- i,-



disease


Scleroderma: Hallmark Sign i,- i,- i,-i,- i,- Hard, leather-like edematous skin
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Late: esophageal dismotility
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Scleroderma: Assess i,- i,-i,- i,- Swallow safety--esophageal dysmotility
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(ASPIRATION)
O2
circulation
skin


Scleroderma: Interventions aspiration precautions (keep HOB
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at 60 degrees during meals and after)
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skin protection measures
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small frequent meals--avoid caffeine and alcohol
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-avoid spices, caffeine and pepper
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fibromyalgia: S/sx i,- i,-i,- i,- extreme fatigure i,-




GI symptoms
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dysuria