Advanced Med-Surg Principles Jersey College Mid-Term Questions With Updated Answers
Ch 39: What is used to control edema following an arthoscopy? - ans --- compression
- elevation
- joint extension
Ch 39: What are two complicants following an arthoscopy? - ans --- infection
- bleeding
Ch 39: What is lab value elevated in liver disease or bone disorders? - ans --alkaline phosphate
Ch 39: What is nephrotoxic and contraindicated in a pt who has an allergy to iodine, shellfish, or seafood, who may be pregnant, or has elevated creatinine levels? - ans --
contrast medium
Ch 39: What is important to intruct on during a bone scan using an isotope? - ans --
hydration is used to eliminate the isotope
Ch 39: What diagnostic test is used to help distinguish muscle from nerve disorders by directly stimulating muscle cells? - ans --electromyography
Ch 39: What two interventions do you do for the diagnostic test electromyography? - ans --- check for use of anticoagulants prior to it (bleeding in the muscle could occur)
- apply warm compress to relieve discomfort following the test
Ch 39: What two complications do diagnostic procedures that disrupt skin surfaces cause? - ans --increased risk of:
- infection
- bleeding
Ch 39: What decreases serum calcium levels? - ans --calcitonin
Ch 39: What increases serum calcium levels? - ans --parathyroid hormone Ch 39: When phophorus levels rise the calcium levels do what? - ans --- decrease
- pt can present with S/S of hypocalcemia
Ch 39: What holds articulating bones together and an injury can impair movement? - ans --ligaments
Ch 39: What connects muscle to bone and an injury can impair movement? - ans --
tendons
Ch 39: What can helo support bone formation? - ans --- weight bearing exercises
- sex hormones
- calcitonin
- calcium intake
Ch 39: Adults over 50 require how much Vit D daily to help prevent osteoporosis? - ans --800 - 1000 IU
Ch 39: What is important to instruct pts on consuming in regards to helping to prevent osteoporosis? - ans --- 1,200 mg of calcium daily
- 600 IU Vit D daily (with intake of low-fat milk, yogart, and cheese)
Ch 39: What can increase bone resorption and could lead to osteoporosis? - ans --- excessive cortisol production
- excessive thyroid hormone production
Ch 39: What stimulates osteoblastic (bone formation) activity and inhibits osteoclastic (bone resorption) activity? - ans --estrogen
Ch 39: Compromised estrogen levels in menopause can increase the risk of? - ans --
osteoporosis
Ch 39: What two things can result in a loss in height? - ans --- vertebral fractures
- loss vertebral cratilage
Ch 40: Because external fixators increase the risk for osteomyelitis you should do what for the pt? - ans --perform pin site care using the aseptic technique (use chlorhexidine 2 mg/mL solution unless contraindicated)
Ch 40: How do you properly clean/perfom pin care for a pt? - ans --clean with a circular motion from the inner to the outer region and cleaning each site separately
Ch 40: What is used to help reduce complication related to pain? - ans --PCA (pt controlled analgesia) Ch 40: What can occur following some fractures due to the loss of blood to the bone so pts must be closely monitored for increased pain and a decrease in mobility? - ans --
avascular necrosis
Ch 40: What are three complications that can arise following fractures? - ans --- hypovolemic shock (hemorrhage)
- fat embolism (in long bones)
- compartment syndrome
Ch 40: How do you prevent hip dislocation following a total hip arthroplasty? - ans --- abducting the legs
- prevent internal rotation of the legs
- turn to the unaffected side while maintaining abduction
- avoid flexing the hip more than 90 degrees
- keep legs in a neutral position
- keep the HOB < 60 degress
- avoid crossing the legs
Ch 40: What instructions do you give a pt following a total hip arthroplasty to do to prevent dislocation for a minimum of 4 mos? - ans --- use a raised toilet seat
- avoid crossing the legs
- no bending at the waist
- sit with hips higher than the knees
Ch 40: What are signs of hip dislocation? - ans --- limb shortening
- acute groin pain
- external or internal rotation
- limb deformity
- crepitus (cracking or grating sound)
- reduced mobility
Ch 40: What will help reduce pain by limiting fluid accumulation and hematoma? - ans --
surgical drains
Ch 40: What would you instruct a pt to do to help prevent disuse from immobilzation? - ans --isometric exercises (squats, planking, calf raises, etc)
Ch 40: What two complicants can pressure on the back or side of the knee increase the risk for in a pt? - ans --- peroneal nerve damage
- foot drop
Ch 40: What should you do if a pt has footdrop? - ans --a neurovascular assessment (this is a priority)
Ch 40: What complications can immobility increae the risk for? - ans --- pneumonia
- decubiti (pressure-induced ulcer)
Ch 39: What is used to control edema following an arthoscopy? - ans --- compression
- elevation
- joint extension
Ch 39: What are two complicants following an arthoscopy? - ans --- infection
- bleeding
Ch 39: What is lab value elevated in liver disease or bone disorders? - ans --alkaline phosphate
Ch 39: What is nephrotoxic and contraindicated in a pt who has an allergy to iodine, shellfish, or seafood, who may be pregnant, or has elevated creatinine levels? - ans --
contrast medium
Ch 39: What is important to intruct on during a bone scan using an isotope? - ans --
hydration is used to eliminate the isotope
Ch 39: What diagnostic test is used to help distinguish muscle from nerve disorders by directly stimulating muscle cells? - ans --electromyography
Ch 39: What two interventions do you do for the diagnostic test electromyography? - ans --- check for use of anticoagulants prior to it (bleeding in the muscle could occur)
- apply warm compress to relieve discomfort following the test
Ch 39: What two complications do diagnostic procedures that disrupt skin surfaces cause? - ans --increased risk of:
- infection
- bleeding
Ch 39: What decreases serum calcium levels? - ans --calcitonin
Ch 39: What increases serum calcium levels? - ans --parathyroid hormone Ch 39: When phophorus levels rise the calcium levels do what? - ans --- decrease
- pt can present with S/S of hypocalcemia
Ch 39: What holds articulating bones together and an injury can impair movement? - ans --ligaments
Ch 39: What connects muscle to bone and an injury can impair movement? - ans --
tendons
Ch 39: What can helo support bone formation? - ans --- weight bearing exercises
- sex hormones
- calcitonin
- calcium intake
Ch 39: Adults over 50 require how much Vit D daily to help prevent osteoporosis? - ans --800 - 1000 IU
Ch 39: What is important to instruct pts on consuming in regards to helping to prevent osteoporosis? - ans --- 1,200 mg of calcium daily
- 600 IU Vit D daily (with intake of low-fat milk, yogart, and cheese)
Ch 39: What can increase bone resorption and could lead to osteoporosis? - ans --- excessive cortisol production
- excessive thyroid hormone production
Ch 39: What stimulates osteoblastic (bone formation) activity and inhibits osteoclastic (bone resorption) activity? - ans --estrogen
Ch 39: Compromised estrogen levels in menopause can increase the risk of? - ans --
osteoporosis
Ch 39: What two things can result in a loss in height? - ans --- vertebral fractures
- loss vertebral cratilage
Ch 40: Because external fixators increase the risk for osteomyelitis you should do what for the pt? - ans --perform pin site care using the aseptic technique (use chlorhexidine 2 mg/mL solution unless contraindicated)
Ch 40: How do you properly clean/perfom pin care for a pt? - ans --clean with a circular motion from the inner to the outer region and cleaning each site separately
Ch 40: What is used to help reduce complication related to pain? - ans --PCA (pt controlled analgesia) Ch 40: What can occur following some fractures due to the loss of blood to the bone so pts must be closely monitored for increased pain and a decrease in mobility? - ans --
avascular necrosis
Ch 40: What are three complications that can arise following fractures? - ans --- hypovolemic shock (hemorrhage)
- fat embolism (in long bones)
- compartment syndrome
Ch 40: How do you prevent hip dislocation following a total hip arthroplasty? - ans --- abducting the legs
- prevent internal rotation of the legs
- turn to the unaffected side while maintaining abduction
- avoid flexing the hip more than 90 degrees
- keep legs in a neutral position
- keep the HOB < 60 degress
- avoid crossing the legs
Ch 40: What instructions do you give a pt following a total hip arthroplasty to do to prevent dislocation for a minimum of 4 mos? - ans --- use a raised toilet seat
- avoid crossing the legs
- no bending at the waist
- sit with hips higher than the knees
Ch 40: What are signs of hip dislocation? - ans --- limb shortening
- acute groin pain
- external or internal rotation
- limb deformity
- crepitus (cracking or grating sound)
- reduced mobility
Ch 40: What will help reduce pain by limiting fluid accumulation and hematoma? - ans --
surgical drains
Ch 40: What would you instruct a pt to do to help prevent disuse from immobilzation? - ans --isometric exercises (squats, planking, calf raises, etc)
Ch 40: What two complicants can pressure on the back or side of the knee increase the risk for in a pt? - ans --- peroneal nerve damage
- foot drop
Ch 40: What should you do if a pt has footdrop? - ans --a neurovascular assessment (this is a priority)
Ch 40: What complications can immobility increae the risk for? - ans --- pneumonia
- decubiti (pressure-induced ulcer)
