NSG 223 Exam 4: (Latest 2026/2027 Update) Stroke, Eye Disorders, Meningitis,
Cancer & End-of-Life Care | Q&A | Grade A | 100% Correct (Verified Answers)
– Nursing Program
Subject: NSG 223 – Medical-Surgical Nursing / Advanced Concepts
Source: NSG 223 Exam 4 Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What are the modifiable risk factors of stroke?
Correct Answer: Bad = high fat, processed — don't eat the BLT (hypertension, high cholesterol,
diabetes, smoking, atrial fibrillation, obesity, sedentary lifestyle).
1. Hypertension is most important modifiable risk factor (control BP to <130/80).
2. Smoking cessation reduces stroke risk by 50% within 1 year.
3. Statins (atorvastatin) reduce LDL and stroke risk; antithrombotics for AFib.
2. What are kitten steroids (alkylating agents) and what should the patient know about them?
Correct Answer: Alkylating agents (cisplatin, oxaliplatin): avoid cold environment and cold
foods/drinks (causes cold hypersensitivity, dysesthesias).
1. Oxaliplatin causes acute cold-induced neuropathy (throat/larynx spasm, paresthesias, jaw
pain).
2. Avoid cold drinks, handling cold objects, going outside in cold weather without
gloves/pashmina.
3. Symptoms usually resolve within days after infusion; neuropathy cumulative with repeated
doses.
3. What is a cataract and what are discharge teaching instructions? (Select all that apply)
Correct Answer: An eye shield is usually worn at night for the first week to avoid injury — this is the
only correct answer. The shield should be worn AT NIGHT for a week.
1. Post-cataract surgery: eye shield at night to prevent rubbing/shielding injury; glasses during
day for vision.
2. Avoid bending lifting >10 lb, straining, swimming (2 weeks).
3. Report increased pain, vision loss, flashes/floaters (retinal detachment).
4. What are the non-modifiable risk factors of stroke?
Correct Answer: Gender (male), age, race (African American), family history, prior stroke/TIA.
1. Age over 55 years doubles stroke risk every decade.
2. African Americans have twice the stroke risk of Caucasians.
3. Family history of stroke increases risk by 30%.
, 5. What are the symptoms of meningitis?
Correct Answer: Positive Kernig sign — when the patient is lying with the thigh flexed on the
abdomen, the leg cannot be completely extended (pain with knee extension). Also Brudzinski sign
(flexion of neck causes flexion of hips/knees).
1. Meningitis triad: fever, nuchal rigidity (stiff neck), altered mental status.
2. Kernig and Brudzinski signs indicate meningeal irritation.
3. Photophobia, severe headache, vomiting, seizures.
6. What is the difference between palliative care and hospice?
Correct Answer: All hospice care is palliative care, but not all palliative care is hospice care. Palliative
care can be given alongside curative treatment; hospice is for end-of-life (prognosis ≤6 months) and no
curative intent.
1. Palliative care: symptom management at any stage of serious illness, concurrent with disease-
modifying therapy.
2. Hospice: comfort-focused care; forego curative treatments; interdisciplinary team (nurse,
chaplain, social worker, volunteer).
3. Both aim to improve quality of life for patient and family.
7. What is the first-line treatment for ischemic stroke and what is contraindication?
Correct Answer: tPA (alteplase) — do not give with platelets below 100,000 (bleeding risk).
1. tPA given within 3-4.5 hours of symptom onset (door-to-needle <60 min).
2. Absolute contraindications: active bleeding, recent intracranial surgery/hemorrhage,
uncontrolled hypertension (>185/110).
3. Platelet count <100,000 increases intracerebral hemorrhage risk; hold tPA.
8. What is primary cancer prevention?
Correct Answer: Use of immunization to reduce risk of cancer. Example: HPV and HBV vaccines
(prevent infection that can lead to cancer).
1. HPV vaccine (Gardasil-9) prevents cervical, anal, oropharyngeal, penile cancer.
2. HBV vaccine prevents hepatitis B → cirrhosis → hepatocellular carcinoma.
3. Other primary prevention: smoking cessation, healthy diet, sun protection, avoiding
carcinogens.
9. What is secondary cancer prevention?
Correct Answer: Screening and early detection activities (mammography, colonoscopy, Pap smear,
PSA).
1. Detect cancer at early, treatable stage before symptoms develop.
2. Colonoscopy every 10 years (if normal/low risk) starting age 45-50.
3. Mammogram annually starting age 40-45; Pap smear q3-5 years.
Cancer & End-of-Life Care | Q&A | Grade A | 100% Correct (Verified Answers)
– Nursing Program
Subject: NSG 223 – Medical-Surgical Nursing / Advanced Concepts
Source: NSG 223 Exam 4 Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What are the modifiable risk factors of stroke?
Correct Answer: Bad = high fat, processed — don't eat the BLT (hypertension, high cholesterol,
diabetes, smoking, atrial fibrillation, obesity, sedentary lifestyle).
1. Hypertension is most important modifiable risk factor (control BP to <130/80).
2. Smoking cessation reduces stroke risk by 50% within 1 year.
3. Statins (atorvastatin) reduce LDL and stroke risk; antithrombotics for AFib.
2. What are kitten steroids (alkylating agents) and what should the patient know about them?
Correct Answer: Alkylating agents (cisplatin, oxaliplatin): avoid cold environment and cold
foods/drinks (causes cold hypersensitivity, dysesthesias).
1. Oxaliplatin causes acute cold-induced neuropathy (throat/larynx spasm, paresthesias, jaw
pain).
2. Avoid cold drinks, handling cold objects, going outside in cold weather without
gloves/pashmina.
3. Symptoms usually resolve within days after infusion; neuropathy cumulative with repeated
doses.
3. What is a cataract and what are discharge teaching instructions? (Select all that apply)
Correct Answer: An eye shield is usually worn at night for the first week to avoid injury — this is the
only correct answer. The shield should be worn AT NIGHT for a week.
1. Post-cataract surgery: eye shield at night to prevent rubbing/shielding injury; glasses during
day for vision.
2. Avoid bending lifting >10 lb, straining, swimming (2 weeks).
3. Report increased pain, vision loss, flashes/floaters (retinal detachment).
4. What are the non-modifiable risk factors of stroke?
Correct Answer: Gender (male), age, race (African American), family history, prior stroke/TIA.
1. Age over 55 years doubles stroke risk every decade.
2. African Americans have twice the stroke risk of Caucasians.
3. Family history of stroke increases risk by 30%.
, 5. What are the symptoms of meningitis?
Correct Answer: Positive Kernig sign — when the patient is lying with the thigh flexed on the
abdomen, the leg cannot be completely extended (pain with knee extension). Also Brudzinski sign
(flexion of neck causes flexion of hips/knees).
1. Meningitis triad: fever, nuchal rigidity (stiff neck), altered mental status.
2. Kernig and Brudzinski signs indicate meningeal irritation.
3. Photophobia, severe headache, vomiting, seizures.
6. What is the difference between palliative care and hospice?
Correct Answer: All hospice care is palliative care, but not all palliative care is hospice care. Palliative
care can be given alongside curative treatment; hospice is for end-of-life (prognosis ≤6 months) and no
curative intent.
1. Palliative care: symptom management at any stage of serious illness, concurrent with disease-
modifying therapy.
2. Hospice: comfort-focused care; forego curative treatments; interdisciplinary team (nurse,
chaplain, social worker, volunteer).
3. Both aim to improve quality of life for patient and family.
7. What is the first-line treatment for ischemic stroke and what is contraindication?
Correct Answer: tPA (alteplase) — do not give with platelets below 100,000 (bleeding risk).
1. tPA given within 3-4.5 hours of symptom onset (door-to-needle <60 min).
2. Absolute contraindications: active bleeding, recent intracranial surgery/hemorrhage,
uncontrolled hypertension (>185/110).
3. Platelet count <100,000 increases intracerebral hemorrhage risk; hold tPA.
8. What is primary cancer prevention?
Correct Answer: Use of immunization to reduce risk of cancer. Example: HPV and HBV vaccines
(prevent infection that can lead to cancer).
1. HPV vaccine (Gardasil-9) prevents cervical, anal, oropharyngeal, penile cancer.
2. HBV vaccine prevents hepatitis B → cirrhosis → hepatocellular carcinoma.
3. Other primary prevention: smoking cessation, healthy diet, sun protection, avoiding
carcinogens.
9. What is secondary cancer prevention?
Correct Answer: Screening and early detection activities (mammography, colonoscopy, Pap smear,
PSA).
1. Detect cancer at early, treatable stage before symptoms develop.
2. Colonoscopy every 10 years (if normal/low risk) starting age 45-50.
3. Mammogram annually starting age 40-45; Pap smear q3-5 years.
