NUR 239 FINAL EXAM QUESTIONS AND
ANSWERS | NUR 239 FINAL STUDY GUIDE &
PRACTICE TEST 2026/2027
1 of 212
Term
What are the clinical manifestations of Parkinson's?
Give this one a go later!
,-Caused by single mutation on chromosome 7
-This mutation causes a change in a membrane bound protein (CFTR) preventing the
passage of chloride ions across
-In 70 to 80% of cases this protein is completely missing
-CF is a genetic disorder and is not contagious
-CF is a recessive disorder that can only appear when the child receives the
mutated gene from both parents
-If both parents have the recessive allele there is a 25% chance that the child will
have CF
-If inherit one allele from one parent, they will be a carrier
-Environmental exposure has no impact
Clinical Manifestations:
-Higher than normal level of salt in sweat.
-A persistent productive cough
-Wheezing
-Breathlessness
-Exercise intolerance
-Repeated lung infections
-Inflamed nasal passages or a stuffy nose
-Foul-smelling, greasy stools
-Poor weight gain and growth
-Intestinal blockage, particularly in newborns (meconium ileus)
-S
Faem
veilrye Hciostnosrtiyp: aYtoi ou nh a v e a 50% chance of inheriting it from your parents and a 50%
chance of getting it if your parents are carriers. It can also result from spontaneous
N
geunrseinmguItm
atpiolin
caattiocnosn:ception.
DnNvA
-E irobnlo
moednttaels:tTfhoisr iC
s FsToRmg
eethnie
nganyd
ousw
areeatbtoersnt c
waitnh,byeoduocnaennfoort faacmqiulyiraet trhisisk.
-Monitor respiratory status- chest physiotherapy respiratory treatments
-CRlinskicfaolrmreap
niefe
ate
stadtiroenssp:iratory infections- ABX, mucolytic agents, enzyme agents to
b
-Frleaat,kld
igohwtnbrtohw
icnk m
spuoctuss
-9Fr0e%ckhlainvge ilnoss
armopf ipt sa na cn rde agtri oc i nf u an rcet aio n - supplemental vitamins, minerals, pancreatic
-eTninz ym beusmps on iris
-MPeaay-sdizeevd elo bp
um dpiasboente/us nmdeel rl i tsuksi nd u e to loss of pancreatic function- insulin therapy
-BProongend oesifso-rv
mairtie
abs le. Life expectancy to 40s and beyond
-TEunm d-osrtaogneodpistiecanser-vleung transplantation
-LPeroamrniisninggdriseasb eialirtciehs using gene therapy
-Larger than normal head size
-Short stature
-Changes in Eyesight
,Nursing interventions:
-Go to NF clinic annually for a check up
-Diphenhydramine for itching
-Yearly eye check-up
-Annual monitoring of BP
-Treatment and screening for depression and anxiety
-Methylphenidate to help with learning disabilities
-Women with NF need to avoid high-dose progesterone
-Pain medicine
-Surgery for severe symptoms, such as: removing tumors and inserting hearing
implants
-To diagnosis, at least 2 S/S must be present
-Emphasize importance of support groups
-Excess leads to Cushing syndrome - moon face, fat redistribution causing "buffalo
hump", thin fragile skin with striae, edema, muscle wasting
-Secondary Diabetes Mellitus
-Bone resorption with pathological fractures
-CNS-mood swings, depression, euphoria
-GI-nausea, vomiting, peptic ulcer, increased appetite
-Fluid & Electrolyte - sodium & water retention with edema, potassium/calcium loss
-Aldosterone causes sodium, water retention
(mineralocorticoid hormone secreted by adrenal cortex, regulates pH, blood
volume, blood pressure)
-Increased susceptibility to infection, decreased healing
-Children - growth suppression (may "catch up" when taken off steroids)
What are the general nursing implications of corticosteroids?
-Primary adrenal insufficiency = Addison's disease, secondary adrenal insufficiency
caused by long-term use
-Long-term therapy- will have decreased adrenal function - (can cause atrophy of
adrenal cortex)
-Must taper off steroid therapy gradually
-Requires increased steroid dose with stressors- surgery (may change from oral to
parenteral)
-Dosage/route varies with condition being treated
-Short-term or long-term
-ADT (alternate daily therapy) better for long-term use- less AE
, -Wide base of support, unsteady gait, lack of fluid movements, resting
tremors, involuntary movements, changes in posture and muscle tone, slow
movements (no paralysis)
-Rolls fingers like rolling a marble in hand (pill rolling)
-Bradykinesia- Slow to start walking, difficulty stopping and turning
-Freeze in place, "feet are glued to floor" especially at doorways
-Lean forward to maintain center of gravity
-Small shuffling steps
-Cardinal signs: tremor, rigidity, bradykinesia of movement
-Tremor is most noticeable sign of PD aka "pill-rolling"
-Most debilitating symptom of PD is difficulty initiating walking and difficulty
turning
-When walking they lean forward, take small shuffling steps without swinging
their arms, have difficulty changing their stride
-High Risk for falls
-PD progression includes fluctuation in motor function, neuropsychiatric
disorders, sleep disorders, facial expressions become stiff and mask-like
-Basal ganglia also influences autonomic NS symptoms such as excessive,
uncontrolled sweating, sebaceous gland secretions, salivation
-In late stages, lacrimation, dysphagia, orthostatic hypotension, thermal
regulation, constipation, urinary incontinence
-Cognitive dysfunction may also be clinical manifestation in 20 - 30 % of cases
Don't know?
2 of 212
Term
What are the lifestyle modifications to treat hypertension?
Give this one a go later!
ANSWERS | NUR 239 FINAL STUDY GUIDE &
PRACTICE TEST 2026/2027
1 of 212
Term
What are the clinical manifestations of Parkinson's?
Give this one a go later!
,-Caused by single mutation on chromosome 7
-This mutation causes a change in a membrane bound protein (CFTR) preventing the
passage of chloride ions across
-In 70 to 80% of cases this protein is completely missing
-CF is a genetic disorder and is not contagious
-CF is a recessive disorder that can only appear when the child receives the
mutated gene from both parents
-If both parents have the recessive allele there is a 25% chance that the child will
have CF
-If inherit one allele from one parent, they will be a carrier
-Environmental exposure has no impact
Clinical Manifestations:
-Higher than normal level of salt in sweat.
-A persistent productive cough
-Wheezing
-Breathlessness
-Exercise intolerance
-Repeated lung infections
-Inflamed nasal passages or a stuffy nose
-Foul-smelling, greasy stools
-Poor weight gain and growth
-Intestinal blockage, particularly in newborns (meconium ileus)
-S
Faem
veilrye Hciostnosrtiyp: aYtoi ou nh a v e a 50% chance of inheriting it from your parents and a 50%
chance of getting it if your parents are carriers. It can also result from spontaneous
N
geunrseinmguItm
atpiolin
caattiocnosn:ception.
DnNvA
-E irobnlo
moednttaels:tTfhoisr iC
s FsToRmg
eethnie
nganyd
ousw
areeatbtoersnt c
waitnh,byeoduocnaennfoort faacmqiulyiraet trhisisk.
-Monitor respiratory status- chest physiotherapy respiratory treatments
-CRlinskicfaolrmreap
niefe
ate
stadtiroenssp:iratory infections- ABX, mucolytic agents, enzyme agents to
b
-Frleaat,kld
igohwtnbrtohw
icnk m
spuoctuss
-9Fr0e%ckhlainvge ilnoss
armopf ipt sa na cn rde agtri oc i nf u an rcet aio n - supplemental vitamins, minerals, pancreatic
-eTninz ym beusmps on iris
-MPeaay-sdizeevd elo bp
um dpiasboente/us nmdeel rl i tsuksi nd u e to loss of pancreatic function- insulin therapy
-BProongend oesifso-rv
mairtie
abs le. Life expectancy to 40s and beyond
-TEunm d-osrtaogneodpistiecanser-vleung transplantation
-LPeroamrniisninggdriseasb eialirtciehs using gene therapy
-Larger than normal head size
-Short stature
-Changes in Eyesight
,Nursing interventions:
-Go to NF clinic annually for a check up
-Diphenhydramine for itching
-Yearly eye check-up
-Annual monitoring of BP
-Treatment and screening for depression and anxiety
-Methylphenidate to help with learning disabilities
-Women with NF need to avoid high-dose progesterone
-Pain medicine
-Surgery for severe symptoms, such as: removing tumors and inserting hearing
implants
-To diagnosis, at least 2 S/S must be present
-Emphasize importance of support groups
-Excess leads to Cushing syndrome - moon face, fat redistribution causing "buffalo
hump", thin fragile skin with striae, edema, muscle wasting
-Secondary Diabetes Mellitus
-Bone resorption with pathological fractures
-CNS-mood swings, depression, euphoria
-GI-nausea, vomiting, peptic ulcer, increased appetite
-Fluid & Electrolyte - sodium & water retention with edema, potassium/calcium loss
-Aldosterone causes sodium, water retention
(mineralocorticoid hormone secreted by adrenal cortex, regulates pH, blood
volume, blood pressure)
-Increased susceptibility to infection, decreased healing
-Children - growth suppression (may "catch up" when taken off steroids)
What are the general nursing implications of corticosteroids?
-Primary adrenal insufficiency = Addison's disease, secondary adrenal insufficiency
caused by long-term use
-Long-term therapy- will have decreased adrenal function - (can cause atrophy of
adrenal cortex)
-Must taper off steroid therapy gradually
-Requires increased steroid dose with stressors- surgery (may change from oral to
parenteral)
-Dosage/route varies with condition being treated
-Short-term or long-term
-ADT (alternate daily therapy) better for long-term use- less AE
, -Wide base of support, unsteady gait, lack of fluid movements, resting
tremors, involuntary movements, changes in posture and muscle tone, slow
movements (no paralysis)
-Rolls fingers like rolling a marble in hand (pill rolling)
-Bradykinesia- Slow to start walking, difficulty stopping and turning
-Freeze in place, "feet are glued to floor" especially at doorways
-Lean forward to maintain center of gravity
-Small shuffling steps
-Cardinal signs: tremor, rigidity, bradykinesia of movement
-Tremor is most noticeable sign of PD aka "pill-rolling"
-Most debilitating symptom of PD is difficulty initiating walking and difficulty
turning
-When walking they lean forward, take small shuffling steps without swinging
their arms, have difficulty changing their stride
-High Risk for falls
-PD progression includes fluctuation in motor function, neuropsychiatric
disorders, sleep disorders, facial expressions become stiff and mask-like
-Basal ganglia also influences autonomic NS symptoms such as excessive,
uncontrolled sweating, sebaceous gland secretions, salivation
-In late stages, lacrimation, dysphagia, orthostatic hypotension, thermal
regulation, constipation, urinary incontinence
-Cognitive dysfunction may also be clinical manifestation in 20 - 30 % of cases
Don't know?
2 of 212
Term
What are the lifestyle modifications to treat hypertension?
Give this one a go later!
