NSG 219 (Medical / Surgical Nursing)-
Final Exam with Complete Solutions
What can be delegated to a CNA (UAP)? - ANSWER-Vital signs
Bathing
Ambulating patients
Feeding
Changing bed linens/briefs
Keeping patient clean and dry
Turning and repositioning
Collecting urine, reporting I&O
What can be delegated to a LPN? - ANSWER-Dressing changes
They can be assigned only the most stable patients
They can't do assessments or patient teaching/discharge teaching
Administering PO meds
Suctioning as long as patient is stable
Remember the 5 Rights of Delegation when delegating patients to CNA or LPN -
ANSWER-Right task
Right circumstance
Right person
Right communication
Right supervision
What would indicate need for stool culture? - ANSWER-If a patient is suspected of
having C Diff
To check for cancer, Chron's disease, ulcerative colitis, severe constipation/bloating, or
if mucus and blood is present in bowel movements
How to prepare patient undergoing a paracentesis? - ANSWER-Explain the procedure
and answer patient questions
Take vitals, including weight before procedure
Ask patient to void before procedure to avoid bladder injury
Monitor vital signs during procedure
Measure and document the drainage
Weigh patient after procedure and document
Know how to calculate I&O - ANSWER-Add up all fluid intake (oral fluids, food, IV fluids)
and compare to sum of all output (urine, insensible losses - sweat, fluid in feces, vapors
from respiratory tract)
, Characteristics to assess in patient with malnutrition - ANSWER-BMI (<18.5 =
underweight)
Brittle/coarse hair and nails
Excess lethargy, tiredness, or weakness
Increased susceptibility to infections
Dry skin
What can effect older adults related to malnutrition? - ANSWER-Low BMI
Decreased appetite
Greater risk for dehydration, poor oral hygiene, cognitive impairment, and depression
Parenteral Nutrition Management - ANSWER-Monitor and document daily weights
Monitor serum electrolytes and glucose daily
Monitor I&O
Assess IV site for signs of infection (redness, edema, drainage, pain)
Change IV tubing q/24 hrs or facility protocol
Parenteral Nutrition Complications - ANSWER-Fever
Clotting problems
Excess triglycerides
Multi organ failure
Fat overlaod syndrome
(RESPOND TO ANY OF THESE SIGNS BY DISCONTINUING PN AND NOTIFYING
HCP!)
Self-management after gastric bypass surgery - ANSWER-Emphasize need to
decrease overall fat intake
Keep a food journal
Be physically active/eat healthy foods
Cover wounds during shower/bath
Follow up visits are very important
Report S/S of anastomotic leaks (increasing back/shoulder pain, abdominal pain,
restlessness, tachycardia, and oliguria)
Coaching techniques to use with obese patient in a Behavioral Modification program -
ANSWER-Talk to patient about their current health status and personal goals they have
Ask how they feel in general
Open ended questions ("Tell me more, How does that make you feel?")
Encourage and teach about healthier eating options
Keep a weight journal
Encourage consistent exercise
Set realistic goals
Post-op nursing care/management after weight loss surgery - ANSWER-Keep skin
clean and dry
Final Exam with Complete Solutions
What can be delegated to a CNA (UAP)? - ANSWER-Vital signs
Bathing
Ambulating patients
Feeding
Changing bed linens/briefs
Keeping patient clean and dry
Turning and repositioning
Collecting urine, reporting I&O
What can be delegated to a LPN? - ANSWER-Dressing changes
They can be assigned only the most stable patients
They can't do assessments or patient teaching/discharge teaching
Administering PO meds
Suctioning as long as patient is stable
Remember the 5 Rights of Delegation when delegating patients to CNA or LPN -
ANSWER-Right task
Right circumstance
Right person
Right communication
Right supervision
What would indicate need for stool culture? - ANSWER-If a patient is suspected of
having C Diff
To check for cancer, Chron's disease, ulcerative colitis, severe constipation/bloating, or
if mucus and blood is present in bowel movements
How to prepare patient undergoing a paracentesis? - ANSWER-Explain the procedure
and answer patient questions
Take vitals, including weight before procedure
Ask patient to void before procedure to avoid bladder injury
Monitor vital signs during procedure
Measure and document the drainage
Weigh patient after procedure and document
Know how to calculate I&O - ANSWER-Add up all fluid intake (oral fluids, food, IV fluids)
and compare to sum of all output (urine, insensible losses - sweat, fluid in feces, vapors
from respiratory tract)
, Characteristics to assess in patient with malnutrition - ANSWER-BMI (<18.5 =
underweight)
Brittle/coarse hair and nails
Excess lethargy, tiredness, or weakness
Increased susceptibility to infections
Dry skin
What can effect older adults related to malnutrition? - ANSWER-Low BMI
Decreased appetite
Greater risk for dehydration, poor oral hygiene, cognitive impairment, and depression
Parenteral Nutrition Management - ANSWER-Monitor and document daily weights
Monitor serum electrolytes and glucose daily
Monitor I&O
Assess IV site for signs of infection (redness, edema, drainage, pain)
Change IV tubing q/24 hrs or facility protocol
Parenteral Nutrition Complications - ANSWER-Fever
Clotting problems
Excess triglycerides
Multi organ failure
Fat overlaod syndrome
(RESPOND TO ANY OF THESE SIGNS BY DISCONTINUING PN AND NOTIFYING
HCP!)
Self-management after gastric bypass surgery - ANSWER-Emphasize need to
decrease overall fat intake
Keep a food journal
Be physically active/eat healthy foods
Cover wounds during shower/bath
Follow up visits are very important
Report S/S of anastomotic leaks (increasing back/shoulder pain, abdominal pain,
restlessness, tachycardia, and oliguria)
Coaching techniques to use with obese patient in a Behavioral Modification program -
ANSWER-Talk to patient about their current health status and personal goals they have
Ask how they feel in general
Open ended questions ("Tell me more, How does that make you feel?")
Encourage and teach about healthier eating options
Keep a weight journal
Encourage consistent exercise
Set realistic goals
Post-op nursing care/management after weight loss surgery - ANSWER-Keep skin
clean and dry
