JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM WITH COMPLETE SOLUTIONS.
List four modifiable risk factors. (general health promotion) - (ANSWER)weight, smoking, sex
practices, diet
List three non-modifiable risk factors. (general health promotion) - (ANSWER)age, genetics, sex
*&^
What type of assessment should the nurse preform prior to initiating health teaching? - %$
(ANSWER)cultural assessment
Maslow's Hierarchy of Needs
--priorities?
--what order? - (ANSWER)physiological integrity
safety and security
belongingness and affection
esteem and self-respect
self-actualization
-- physiologic needs and life threatening issues are a priority
-- confirm that these needs are met in the order listed above
Organization that identifies health promotion and disease prevention goals and lists strategies
along with resources in an attempt to improve the nation's health - (ANSWER)Healthy People
2020
Organization that recommends ways to strengthen the practice of nursing in order to improve
health care. - (ANSWER)The Institute of Medicine's report on the Future of Nursing
The Joint Commission lists the top patient safety concerns and includes medication safety,
infection prevention, surgery-related mistakes, patient identification and improving staff
communication. What is this list called? - (ANSWER)The National Patient Safety Goals
This governs nursing practice and is a law that is put into place to protect the public - nurses
must follow and comply with their state's regulations - (ANSWER)Nurse Practice Acts
Institute that seeks to strengthen the knowledge, skills, and attitudes of nurses in providing
continuous quality improvement in health care - (ANSWER)QSEN - Quality and Safety
Education for Nurses Institute
What is pain? - (ANSWER)whatever the patient says it is
Pain is associated with __________________________________. - (ANSWER)actual or
potential tissue damage
,JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM WITH COMPLETE SOLUTIONS.
The single most reliable indicator of pain is _______. - (ANSWER)the patient's self report
Pain stimulates the sympathetic nervous system and could result in an increase in ___________,
___________, and ____________. - (ANSWER)blood pressure, heart rate, and respirations *&^
%$
physiologic effects of unrelieved pain (4) - (ANSWER)increases glucagon production
decreases insulin secretion
depresses immune function
can lead to addictive behaviors
initiate inflammation and contribute to tissue swelling and pain - (ANSWER)prostaglandins
______ primarily produce pain relief by preventing prostaglandin formation. -
(ANSWER)NSAIDS
_____________ does not have anti-inflammatory properties. - (ANSWER)Acetaminophen
______________ stimulates the inflammatory response and puts the patient at risk for pain. -
(ANSWER)tissue damage
manage nociceptive pain with? - (ANSWER)local anesthetics, non-opioids or opioids
pain that is associated with a noxious stimulus - (ANSWER)allodynia
________________ could lead to allodynia. - (ANSWER)nerve route injury
What does a comprehensive pain assessment include? - (ANSWER)timing:
onset - when it started
duration - where it started
frequency - how often/for how long
type - includes intensity, associated factors
influencing factors - what makes it better/worse
intensity - how bad does it hurt
quality - what does it feel like
,JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM WITH COMPLETE SOLUTIONS.
location - where does it hurt
effects on function/daily activities
10cm line that represents no pain to worst pain on each end of the line and the patient places a *&^
mark somewhere between the two ends depending on the severity of pain - (ANSWER)visual %$
analog scale
ranges from 0 to 10 with 0 representing no pain - (ANSWER)numeric rating scale
consists of cartoon faces that the patient selects to report their pain - (ANSWER)Wong-Baker
FACES Scale (ages 3+)
uses words to help individuals describe the intensity of their pain - (ANSWER)verbal descriptor
scale
should never be used by the provider to match the patient's facial expression - (ANSWER)Wong-
Baker FACES Scale
effect produced by topical analgesics - (ANSWER)produce a local effect
effect produced by transdermal route of analgesics - (ANSWER)produces drug absorption into
the systemic circulaiton
Provide ____________ to help reduce complications related to pain. Used in postoperative
patients as a preventative measure for pain. - (ANSWER)provide PCA (patient controlled
analgesia)
Provide administration of analgesics __(frequency)__ for chronic and postoperative pain, never
wait for chronic pain to reoccur. - (ANSWER)around the clock
given for mild to moderate pain - (ANSWER)aspirin or acetaminophen
given for moderate pain - (ANSWER)NSAIDS
given for severe pain - (ANSWER)opioid analgesics (Morphine)
Avoid which medication administration route for patients who are thrombocytopenic? -
(ANSWER)rectal route
, JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM WITH COMPLETE SOLUTIONS.
Use of this analgesic could result in hepatoxicity and should not exceed 4,000mg/day. -
(ANSWER)Acetaminophen
analgesic that could result in gastric ulcers or contribute to cardiovascular events such as MI or
stroke - (ANSWER)NSAIDS *&^
%$
analgesic that could lead to acute renal failure in patients with volume depletion or who take it
for chronic pain - (ANSWER)NSAIDS
needed for renal blood flow - (ANSWER)prostaglandin
undesirable side effects of opioids - (ANSWER)constipation, nausea, pupil constriction, and
respiratory depression
Never apply heat over transdermal patches. Why? - (ANSWER)could increase absorption and
result in lethal complications
adjuvant medications used to manage neuropathic pain - (ANSWER)antidepressants or
anticonvulsants
Vomiting can lead to what acid-base imbalance - (ANSWER)metabolic alkalosis
Diarrhea can lead to what acid-base imbalance - (ANSWER)metabolic acidosis
Mineral that helps to regulate muscle contraction and relaxation - (ANSWER)calcium
In the setting of hypoparathyroidism, provide a diet that is high in _______ and low in
__________. - (ANSWER)high in calcium and low in phosphorus
Chloride works with sodium to determine _______________. - (ANSWER)osmotic pressure
If chloride levels drop, bicarbonate is retained and results in
_______________________________. - (ANSWER)hypochloremic metabolic alkalosis
Changes in electrolytes impair _________________ resulting in ________ or ____________. -
(ANSWER)action potentials
weakness or excitability
Small shifts in intravascular volume in children increases their risk for __________________. -
(ANSWER)fluid volume deficit (FVD)
List four modifiable risk factors. (general health promotion) - (ANSWER)weight, smoking, sex
practices, diet
List three non-modifiable risk factors. (general health promotion) - (ANSWER)age, genetics, sex
*&^
What type of assessment should the nurse preform prior to initiating health teaching? - %$
(ANSWER)cultural assessment
Maslow's Hierarchy of Needs
--priorities?
--what order? - (ANSWER)physiological integrity
safety and security
belongingness and affection
esteem and self-respect
self-actualization
-- physiologic needs and life threatening issues are a priority
-- confirm that these needs are met in the order listed above
Organization that identifies health promotion and disease prevention goals and lists strategies
along with resources in an attempt to improve the nation's health - (ANSWER)Healthy People
2020
Organization that recommends ways to strengthen the practice of nursing in order to improve
health care. - (ANSWER)The Institute of Medicine's report on the Future of Nursing
The Joint Commission lists the top patient safety concerns and includes medication safety,
infection prevention, surgery-related mistakes, patient identification and improving staff
communication. What is this list called? - (ANSWER)The National Patient Safety Goals
This governs nursing practice and is a law that is put into place to protect the public - nurses
must follow and comply with their state's regulations - (ANSWER)Nurse Practice Acts
Institute that seeks to strengthen the knowledge, skills, and attitudes of nurses in providing
continuous quality improvement in health care - (ANSWER)QSEN - Quality and Safety
Education for Nurses Institute
What is pain? - (ANSWER)whatever the patient says it is
Pain is associated with __________________________________. - (ANSWER)actual or
potential tissue damage
,JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM WITH COMPLETE SOLUTIONS.
The single most reliable indicator of pain is _______. - (ANSWER)the patient's self report
Pain stimulates the sympathetic nervous system and could result in an increase in ___________,
___________, and ____________. - (ANSWER)blood pressure, heart rate, and respirations *&^
%$
physiologic effects of unrelieved pain (4) - (ANSWER)increases glucagon production
decreases insulin secretion
depresses immune function
can lead to addictive behaviors
initiate inflammation and contribute to tissue swelling and pain - (ANSWER)prostaglandins
______ primarily produce pain relief by preventing prostaglandin formation. -
(ANSWER)NSAIDS
_____________ does not have anti-inflammatory properties. - (ANSWER)Acetaminophen
______________ stimulates the inflammatory response and puts the patient at risk for pain. -
(ANSWER)tissue damage
manage nociceptive pain with? - (ANSWER)local anesthetics, non-opioids or opioids
pain that is associated with a noxious stimulus - (ANSWER)allodynia
________________ could lead to allodynia. - (ANSWER)nerve route injury
What does a comprehensive pain assessment include? - (ANSWER)timing:
onset - when it started
duration - where it started
frequency - how often/for how long
type - includes intensity, associated factors
influencing factors - what makes it better/worse
intensity - how bad does it hurt
quality - what does it feel like
,JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM WITH COMPLETE SOLUTIONS.
location - where does it hurt
effects on function/daily activities
10cm line that represents no pain to worst pain on each end of the line and the patient places a *&^
mark somewhere between the two ends depending on the severity of pain - (ANSWER)visual %$
analog scale
ranges from 0 to 10 with 0 representing no pain - (ANSWER)numeric rating scale
consists of cartoon faces that the patient selects to report their pain - (ANSWER)Wong-Baker
FACES Scale (ages 3+)
uses words to help individuals describe the intensity of their pain - (ANSWER)verbal descriptor
scale
should never be used by the provider to match the patient's facial expression - (ANSWER)Wong-
Baker FACES Scale
effect produced by topical analgesics - (ANSWER)produce a local effect
effect produced by transdermal route of analgesics - (ANSWER)produces drug absorption into
the systemic circulaiton
Provide ____________ to help reduce complications related to pain. Used in postoperative
patients as a preventative measure for pain. - (ANSWER)provide PCA (patient controlled
analgesia)
Provide administration of analgesics __(frequency)__ for chronic and postoperative pain, never
wait for chronic pain to reoccur. - (ANSWER)around the clock
given for mild to moderate pain - (ANSWER)aspirin or acetaminophen
given for moderate pain - (ANSWER)NSAIDS
given for severe pain - (ANSWER)opioid analgesics (Morphine)
Avoid which medication administration route for patients who are thrombocytopenic? -
(ANSWER)rectal route
, JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM WITH COMPLETE SOLUTIONS.
Use of this analgesic could result in hepatoxicity and should not exceed 4,000mg/day. -
(ANSWER)Acetaminophen
analgesic that could result in gastric ulcers or contribute to cardiovascular events such as MI or
stroke - (ANSWER)NSAIDS *&^
%$
analgesic that could lead to acute renal failure in patients with volume depletion or who take it
for chronic pain - (ANSWER)NSAIDS
needed for renal blood flow - (ANSWER)prostaglandin
undesirable side effects of opioids - (ANSWER)constipation, nausea, pupil constriction, and
respiratory depression
Never apply heat over transdermal patches. Why? - (ANSWER)could increase absorption and
result in lethal complications
adjuvant medications used to manage neuropathic pain - (ANSWER)antidepressants or
anticonvulsants
Vomiting can lead to what acid-base imbalance - (ANSWER)metabolic alkalosis
Diarrhea can lead to what acid-base imbalance - (ANSWER)metabolic acidosis
Mineral that helps to regulate muscle contraction and relaxation - (ANSWER)calcium
In the setting of hypoparathyroidism, provide a diet that is high in _______ and low in
__________. - (ANSWER)high in calcium and low in phosphorus
Chloride works with sodium to determine _______________. - (ANSWER)osmotic pressure
If chloride levels drop, bicarbonate is retained and results in
_______________________________. - (ANSWER)hypochloremic metabolic alkalosis
Changes in electrolytes impair _________________ resulting in ________ or ____________. -
(ANSWER)action potentials
weakness or excitability
Small shifts in intravascular volume in children increases their risk for __________________. -
(ANSWER)fluid volume deficit (FVD)