NUR 437 Midterm Exam Questions with
Complete Answers
Telehealth and patients - Answer--Use of digital information and communication
technologies to access health services remotely
-Ex: appointment online, pt health portal, text/email reminders, refills online
-Drawbacks: may not be coordinated with regular doctor, essential hx might not be
considered, lack of in person evaluation, fragmented care (gaps in care, overuse of
medical care and meds, overlapping care
-goals: accessibility, readily available, access to specialist, improved communication,
provide support for self care management
CIWA - Answer--alcohol withdrawal
-score less then 10 does not need extra meds for withdrawal
-score greater than 15 usually indicated risk for severe withdrawal
CAM tool - Answer--Confusion Assessment Method
-for ALOC
-finish assessment then call provider
Afib - Answer--results in loss of effective atrial contraction
-BIG risk for clots
-IRREGULAR rhythm
-treatment: anticoagulants (watch INR/PTT), beta blockers, amioderone, digoxin,
cardizem, electro cardioversion NOT dfib
FHR normal - Answer--110-160 BPM
-accelerations means baby is healthy fetal/placental exchange
-FHR brady: can cause unteroplacental insufficiency, umbilical cord prolapse, maternal
hypotension --> D/c oxytocin, O2 10L/min via nonrebreather and tocolytic med
-FHR Tachy:
greateer than 160 for 10 min or more
-can cause maternal infection, can be due to cocaine, dehydration
-interventions: antipyretics, 02, fluid bolus
TOCO - Answer--contraction monitor
-placed on the top (fundus)
FHR - Answer--placed near the pubic bone
-lower abdomen
FHR monitoring tests - Answer-non-stress test
-during 3rd trimester
, -noninvasive procedure that monitors response of FHR to fetal movement
-doppler for FHR (lower), TOCO for uterine contractions (top)
-reactive: good showed accelerations
-Non-reactive: bad did not show accelerations
Five F's of Prioritization - Answer-Fatal - failure to do could cause death or injury
(respiratory distress)
Fundamental - essential to professional definition of job (assessments)
Frequent - must be done many times (vitals)
Fixed - Must be done within a certain time frame (meds)
facility - aspects of the job set as standards (charting)
Delegation "never share your teacup" - Answer-T - Teaching
E - evaluation
A - assessment A- Advanced intervention
C - collaboration
U - unstable patients
P- planning
Priority ranking of patients - Answer-First level
-patients immediate survival or safety and demand immediate nursing interventions
(ABCs)
Second Level
-concerns as mental status changes, acute pain, acute elimination, abnormal pathology,
risk for infection (diabetic needing insulin)
Third level
-those That do not fit into the above two categories such as monitoring for med adverse,
lack of pt knowledge, long term problems
CURE - Answer-C - critical (potentially life threatening)
U - Urgent (safety needs and pain control; pain meds, low BG)
R - Routine responsibilities (vitals, scheduled meds, assessments)
-Extra - Pt requests
Admin of blood products - Answer--obtain consent
-type and cross match
-obtain from blood bank
-needs to be double verified with a nurse
-blood band verify
-250 mL of 0.9% normal saline
-Y blood tubing, saline first them Blood
-admin within 30 min and transfuse within 4 hours
PRBCs - Answer--used for tx of anemia/Hgb 7-8
Complete Answers
Telehealth and patients - Answer--Use of digital information and communication
technologies to access health services remotely
-Ex: appointment online, pt health portal, text/email reminders, refills online
-Drawbacks: may not be coordinated with regular doctor, essential hx might not be
considered, lack of in person evaluation, fragmented care (gaps in care, overuse of
medical care and meds, overlapping care
-goals: accessibility, readily available, access to specialist, improved communication,
provide support for self care management
CIWA - Answer--alcohol withdrawal
-score less then 10 does not need extra meds for withdrawal
-score greater than 15 usually indicated risk for severe withdrawal
CAM tool - Answer--Confusion Assessment Method
-for ALOC
-finish assessment then call provider
Afib - Answer--results in loss of effective atrial contraction
-BIG risk for clots
-IRREGULAR rhythm
-treatment: anticoagulants (watch INR/PTT), beta blockers, amioderone, digoxin,
cardizem, electro cardioversion NOT dfib
FHR normal - Answer--110-160 BPM
-accelerations means baby is healthy fetal/placental exchange
-FHR brady: can cause unteroplacental insufficiency, umbilical cord prolapse, maternal
hypotension --> D/c oxytocin, O2 10L/min via nonrebreather and tocolytic med
-FHR Tachy:
greateer than 160 for 10 min or more
-can cause maternal infection, can be due to cocaine, dehydration
-interventions: antipyretics, 02, fluid bolus
TOCO - Answer--contraction monitor
-placed on the top (fundus)
FHR - Answer--placed near the pubic bone
-lower abdomen
FHR monitoring tests - Answer-non-stress test
-during 3rd trimester
, -noninvasive procedure that monitors response of FHR to fetal movement
-doppler for FHR (lower), TOCO for uterine contractions (top)
-reactive: good showed accelerations
-Non-reactive: bad did not show accelerations
Five F's of Prioritization - Answer-Fatal - failure to do could cause death or injury
(respiratory distress)
Fundamental - essential to professional definition of job (assessments)
Frequent - must be done many times (vitals)
Fixed - Must be done within a certain time frame (meds)
facility - aspects of the job set as standards (charting)
Delegation "never share your teacup" - Answer-T - Teaching
E - evaluation
A - assessment A- Advanced intervention
C - collaboration
U - unstable patients
P- planning
Priority ranking of patients - Answer-First level
-patients immediate survival or safety and demand immediate nursing interventions
(ABCs)
Second Level
-concerns as mental status changes, acute pain, acute elimination, abnormal pathology,
risk for infection (diabetic needing insulin)
Third level
-those That do not fit into the above two categories such as monitoring for med adverse,
lack of pt knowledge, long term problems
CURE - Answer-C - critical (potentially life threatening)
U - Urgent (safety needs and pain control; pain meds, low BG)
R - Routine responsibilities (vitals, scheduled meds, assessments)
-Extra - Pt requests
Admin of blood products - Answer--obtain consent
-type and cross match
-obtain from blood bank
-needs to be double verified with a nurse
-blood band verify
-250 mL of 0.9% normal saline
-Y blood tubing, saline first them Blood
-admin within 30 min and transfuse within 4 hours
PRBCs - Answer--used for tx of anemia/Hgb 7-8
