NURS 366 FINAL EXAM QUESTIONS
AND COMPLETE ANSWERS
Identify & manage patients with the following conditions: Parkinson's ANSW✅✅T: Tremor at rest
and gait changes. R: Rigidity (increased muscle tone) A: Akinesia, slowness in movement P: Postural
instability (propulsion forward uncontrolled). Management by maximizing neurologic function and
independence for as long as possible. Levodopa=medicine. Nutrition therapy: 6 small meals, high
fibre important. Surgery: Deep Brain Stimulator (DBS) most common
Identify & manage patients with the following conditions: Multiple Sclerosis
ANSW✅✅Autoimmune by activated T cells attack myelin sheaths. CMs: Blurred vision, muscle
weakness, coordination troubles, numbness and tingling, speech impairment, many more.
Progressive disability depends on the type. No definitive test, needs evidence of inflammatory
demyelinating lesions. Management: drug therapy, PT/OT/ST, adequate rest, maximize current
function, establish support system.
Identify & manage patients with the following conditions: ALS ANSW✅✅(aka Lou Gehrig's). Motor
neurons in brainstem and spinal cord deteriorate and die (death 2-5 years after dx). Cognitively
intact. Goals are to facilitate communication, prevent death from respiratory compromise, support
emotionally, discuss advance directives.
Identify the challenges of narcotic administration in the elderly. ANSW✅✅Respiratory depression
high risk Patients: Obstructive Sleep Apnea, morbidly obese.
Iatrogenic risk: Mixed opioids and other depressant meds.
Renal/Liver function decreases with age. Might not have same ability to excrete.
Identify abnormal vital signs and differing assessment findings with the older population.
ANSW✅✅Generalized
Describe signs and symptoms of pruritus, eczema, dermatitis, psoriasis vulgaris, acne vulgaris, skin
tears, pressure ulcers, sunburn, cellulitis, and herpes zoster (shingles). ANSW✅✅
Describe the principles in insulin therapy as they relate to diet, lifestyle, and sick day management.
ANSW✅✅- Sick day check ketones : easy to get ketoacidosis
- Blood sugars before meals, basal bolus dosing (sliding scale based on glucose)
,-Insulin right before meals
Discuss various methods of monitoring diabetes control and indications of each.
ANSW✅✅HgbA1C
Blood Glucose levels
CGM
Describe carb ratio, correction factors and be able to calculate each. ANSW✅✅
Understand when a nurse needs to communicate with other disciplines to ensure patient safety.
ANSW✅✅
Describe issues older adults face with polypharmacy. ANSW✅✅- Medication management ,
communicate with provider about all meds.
Know the difference between Isotonic, hypotonic and hypertonic IV fluids. ANSW✅✅Isotonic:
No fluid shift. Vascular expansion. Electrolyte replacement.
Hypotonic:
Shifts fluid out of vessels into cells.
Hypertonic:
Shifts fluid back into circulation.
Identify normal health and changes throughout the lifespan as well as management and education
for these changes. ANSW✅✅-ED
-Decreased testosterone production
-Increased prostate size
-Decrease sperm
-Smaller girth of penis
Education:
- ED resources
- DRE annually
, - Self-exam of prostate and breast monthly
Care of the post-op patient, identify and manage post-op complications. ANSW✅✅Most common
complications: Infection, PE, atelectasis, urinary retention, skin breakdown, constipation, pain, DVT.
Verbalize the differences between treatment, and potential complications from rheumatic
fever/rheumatic heart disease and Kawasaki disease. ANSW✅✅Rheumatic Fever: Self-limiting,
involves joints, skin, brain, heart, serous surfaces. Diagnosis based on 2 major (chorea, carditis,
polyarthesia, subcutaneous nodules, erythema margumentum) or 1 major and 2 minor
manifestations.
Rheumatic Heart Disease: Most serious complication of RF that leads to damage in cardiac valves
especially mitral.
Tx: Prevent/treat GABHS. Penicillin G PO. Prednisone, bed rest.
Kawasaki Disease:
Multisystem involvement with inflammation of arteries. Diagnosis based on fever for at least 5 days
and 4 criteria (eyes, lips, mouth, hands/feet, skin, cervical lymphadenopathy). Leads to coronary
artery aneurysm.
Tx: Based around prevention of thrombus and reduction of inflammation of coronary arteries. Meds:
IVIG and ASA.
Identify congenital heart defects visually by the cardiac blood flow. ANSW✅✅Increased
Pulmonary Blood Flow:
- Ventricular Septal Defect
-Atrial Septal Defect
-Patent Ductus Arteriosus
Decreased Pulmonary Blood Flow:
- Tetralogy of Fallot
- Pulmonary Atresia
Obstructive Defects:
- Left/Right sided heart obstructions (example: stenosis, coarctation of the aorta)
AND COMPLETE ANSWERS
Identify & manage patients with the following conditions: Parkinson's ANSW✅✅T: Tremor at rest
and gait changes. R: Rigidity (increased muscle tone) A: Akinesia, slowness in movement P: Postural
instability (propulsion forward uncontrolled). Management by maximizing neurologic function and
independence for as long as possible. Levodopa=medicine. Nutrition therapy: 6 small meals, high
fibre important. Surgery: Deep Brain Stimulator (DBS) most common
Identify & manage patients with the following conditions: Multiple Sclerosis
ANSW✅✅Autoimmune by activated T cells attack myelin sheaths. CMs: Blurred vision, muscle
weakness, coordination troubles, numbness and tingling, speech impairment, many more.
Progressive disability depends on the type. No definitive test, needs evidence of inflammatory
demyelinating lesions. Management: drug therapy, PT/OT/ST, adequate rest, maximize current
function, establish support system.
Identify & manage patients with the following conditions: ALS ANSW✅✅(aka Lou Gehrig's). Motor
neurons in brainstem and spinal cord deteriorate and die (death 2-5 years after dx). Cognitively
intact. Goals are to facilitate communication, prevent death from respiratory compromise, support
emotionally, discuss advance directives.
Identify the challenges of narcotic administration in the elderly. ANSW✅✅Respiratory depression
high risk Patients: Obstructive Sleep Apnea, morbidly obese.
Iatrogenic risk: Mixed opioids and other depressant meds.
Renal/Liver function decreases with age. Might not have same ability to excrete.
Identify abnormal vital signs and differing assessment findings with the older population.
ANSW✅✅Generalized
Describe signs and symptoms of pruritus, eczema, dermatitis, psoriasis vulgaris, acne vulgaris, skin
tears, pressure ulcers, sunburn, cellulitis, and herpes zoster (shingles). ANSW✅✅
Describe the principles in insulin therapy as they relate to diet, lifestyle, and sick day management.
ANSW✅✅- Sick day check ketones : easy to get ketoacidosis
- Blood sugars before meals, basal bolus dosing (sliding scale based on glucose)
,-Insulin right before meals
Discuss various methods of monitoring diabetes control and indications of each.
ANSW✅✅HgbA1C
Blood Glucose levels
CGM
Describe carb ratio, correction factors and be able to calculate each. ANSW✅✅
Understand when a nurse needs to communicate with other disciplines to ensure patient safety.
ANSW✅✅
Describe issues older adults face with polypharmacy. ANSW✅✅- Medication management ,
communicate with provider about all meds.
Know the difference between Isotonic, hypotonic and hypertonic IV fluids. ANSW✅✅Isotonic:
No fluid shift. Vascular expansion. Electrolyte replacement.
Hypotonic:
Shifts fluid out of vessels into cells.
Hypertonic:
Shifts fluid back into circulation.
Identify normal health and changes throughout the lifespan as well as management and education
for these changes. ANSW✅✅-ED
-Decreased testosterone production
-Increased prostate size
-Decrease sperm
-Smaller girth of penis
Education:
- ED resources
- DRE annually
, - Self-exam of prostate and breast monthly
Care of the post-op patient, identify and manage post-op complications. ANSW✅✅Most common
complications: Infection, PE, atelectasis, urinary retention, skin breakdown, constipation, pain, DVT.
Verbalize the differences between treatment, and potential complications from rheumatic
fever/rheumatic heart disease and Kawasaki disease. ANSW✅✅Rheumatic Fever: Self-limiting,
involves joints, skin, brain, heart, serous surfaces. Diagnosis based on 2 major (chorea, carditis,
polyarthesia, subcutaneous nodules, erythema margumentum) or 1 major and 2 minor
manifestations.
Rheumatic Heart Disease: Most serious complication of RF that leads to damage in cardiac valves
especially mitral.
Tx: Prevent/treat GABHS. Penicillin G PO. Prednisone, bed rest.
Kawasaki Disease:
Multisystem involvement with inflammation of arteries. Diagnosis based on fever for at least 5 days
and 4 criteria (eyes, lips, mouth, hands/feet, skin, cervical lymphadenopathy). Leads to coronary
artery aneurysm.
Tx: Based around prevention of thrombus and reduction of inflammation of coronary arteries. Meds:
IVIG and ASA.
Identify congenital heart defects visually by the cardiac blood flow. ANSW✅✅Increased
Pulmonary Blood Flow:
- Ventricular Septal Defect
-Atrial Septal Defect
-Patent Ductus Arteriosus
Decreased Pulmonary Blood Flow:
- Tetralogy of Fallot
- Pulmonary Atresia
Obstructive Defects:
- Left/Right sided heart obstructions (example: stenosis, coarctation of the aorta)
