Advanced Med-Surg Principles Jersey College
Exam question with answers
What during labor increases the risk of neonate aquiring acute encephalitis? - -
active herpes simplex virus-2
-How do you administer meds? - -starting with the lowest dose and titrating up
slowly
-What is pain is associated with? - -actual or potential tissue damage
-When pain stimulates the sympathetic nervous system, what does it result in? - --
increase in BP
- increase in HR
- increase in RR
-Where are catecholamines released from? - -adrenal medulla
-Where are steroid hormones (cortisol & aldosterone) released from? - -adrenal
cortex
-What does unrelieved pain lead to? - -- increases glucagon production
- decreases insulin secretion
- depress immune function
- can lead to addictive behaviors
-What initiates inflammation, contributes to tissue sweeling, and pain? - -
Prostaglandins
-What can nerve root injury lead to? - -allodynia (pain that is associated with non-
noxious stimuli)
-What is needed for renal blood flow? - -Prostaglandin
-Pain is? - -whatever the patient says it is
-What is the single most reliable indicator of pain? - -the patient's self-report
-How do NSAID's preimarily produce pain relief? - -by preventing prostaglandin
formation
-What does acetaminphen not have? - -any inflammatory properties
-What do you manage nociceptive pain with? - -- local anesthetics
- non-opioids
- opioids
-What does 0 on the 0 - 10 numeric pain rating scale indicate? - -no pain
,-What does the Wong-Baker FACES pain scale consist of? - -cartoon faces that the
patient (ages 3 and up) selects to report thier pain level
-What does the visual analog 10cm scale represent? - -no pain to the worst pain,
the patient marks a spot somewhere in between indicating their pain level
-What pain scale helps indiviuals describe the intensity of pain? - -verbal descriptor
scale
-What does a comprehensive pain assessment consist of? - -- duration (when it
started/lasted)
- type (intensity/assoc factors/influencing fators)
- location
-What patients do we avoid the rectal route for med administration? - -
thrombocytopenic
-What type of effect do topical agents produce? - -local
-What type of effect do transdermal agents produce? - -drug absorption into the
systemic circulation
-What would help reduce complications related to pain for patients? - -provide a
PCA
-How do we administer around the clock pain relief for post-op and chronic pain? - -
provide analgesics, never wait for chronic pain to reoccur
-What is provided for mild to moderate pain? - -aspirin or acetaminaphen
-What is provided for moderate pain? - -NSAID's
-What is provided for severe pain? - -morphine
-Why would you wake patients who have chronic pain or who have moderate to
severe pain folowing surgery? - -to administer prescribed analgcsics
-What can excessive use of acetaminophen cause? - -hepatoxicity
-What does of acetaminophen could lead to hepatoxicity? - -4,000 mg/day
-What can NSAID's meds result in? - -- gastric ulcers
- contribute to CV events (MI or stroke)
-What can the use of NSAID's lead to in patients with volume depletion or who take
it for chronic pain? - -acute renal failure
-What undesirable effects do opioids produce? - -- constipation
- nausea
- pupil constriction
, - respiratory distress
-Physical dependence and tolerance are not the same as what? - -addiction
-Why do you never apply heat over a transdermal patch? - -it could increase
absorption and result in lethal complications
-How should you manage neuropathic pain? - -with adjuvant meds such as
antidepressants or anticonvulsants
-What should not be used in a clincial practice that it would violate the nurse-
patient relationship? - -placebos
-What are some non-pharmacologic pain management strategies? - -- physical
modalities
- mind-body methods
- biologic and energy-based therapies
-What are the clinical manifestations of hyponatremia? - -- headaches
- seizures
- lethargy
- tachycardia
- decreased BP
- thready pulse
- hyperactive bowel sounds
- abdominal cramps
-What are signs of hypoxia? - -- restlessness
- confusion
- pallor
- tachycardia
- tachypnea
-What can vagal stimulation be caused by? - -- vomiting
- suctioning
- severe pain
all resulting in bradycardia
-What is a loss of transparency of the eye lens, results in blurry vision, decreased
visual acuity, and sensitivity to glare? - -a cataract
-What are some risk reductions for catarats? - -- reducing weight
- smoking cessation
- optimizing blood sugars
- using sunglasses when outdoors
-What are S/S of an endopthalmitis (infection) that can occur after catarat surgery?
- -- marked by pain
- decreasing vision
- eyelid redness
Exam question with answers
What during labor increases the risk of neonate aquiring acute encephalitis? - -
active herpes simplex virus-2
-How do you administer meds? - -starting with the lowest dose and titrating up
slowly
-What is pain is associated with? - -actual or potential tissue damage
-When pain stimulates the sympathetic nervous system, what does it result in? - --
increase in BP
- increase in HR
- increase in RR
-Where are catecholamines released from? - -adrenal medulla
-Where are steroid hormones (cortisol & aldosterone) released from? - -adrenal
cortex
-What does unrelieved pain lead to? - -- increases glucagon production
- decreases insulin secretion
- depress immune function
- can lead to addictive behaviors
-What initiates inflammation, contributes to tissue sweeling, and pain? - -
Prostaglandins
-What can nerve root injury lead to? - -allodynia (pain that is associated with non-
noxious stimuli)
-What is needed for renal blood flow? - -Prostaglandin
-Pain is? - -whatever the patient says it is
-What is the single most reliable indicator of pain? - -the patient's self-report
-How do NSAID's preimarily produce pain relief? - -by preventing prostaglandin
formation
-What does acetaminphen not have? - -any inflammatory properties
-What do you manage nociceptive pain with? - -- local anesthetics
- non-opioids
- opioids
-What does 0 on the 0 - 10 numeric pain rating scale indicate? - -no pain
,-What does the Wong-Baker FACES pain scale consist of? - -cartoon faces that the
patient (ages 3 and up) selects to report thier pain level
-What does the visual analog 10cm scale represent? - -no pain to the worst pain,
the patient marks a spot somewhere in between indicating their pain level
-What pain scale helps indiviuals describe the intensity of pain? - -verbal descriptor
scale
-What does a comprehensive pain assessment consist of? - -- duration (when it
started/lasted)
- type (intensity/assoc factors/influencing fators)
- location
-What patients do we avoid the rectal route for med administration? - -
thrombocytopenic
-What type of effect do topical agents produce? - -local
-What type of effect do transdermal agents produce? - -drug absorption into the
systemic circulation
-What would help reduce complications related to pain for patients? - -provide a
PCA
-How do we administer around the clock pain relief for post-op and chronic pain? - -
provide analgesics, never wait for chronic pain to reoccur
-What is provided for mild to moderate pain? - -aspirin or acetaminaphen
-What is provided for moderate pain? - -NSAID's
-What is provided for severe pain? - -morphine
-Why would you wake patients who have chronic pain or who have moderate to
severe pain folowing surgery? - -to administer prescribed analgcsics
-What can excessive use of acetaminophen cause? - -hepatoxicity
-What does of acetaminophen could lead to hepatoxicity? - -4,000 mg/day
-What can NSAID's meds result in? - -- gastric ulcers
- contribute to CV events (MI or stroke)
-What can the use of NSAID's lead to in patients with volume depletion or who take
it for chronic pain? - -acute renal failure
-What undesirable effects do opioids produce? - -- constipation
- nausea
- pupil constriction
, - respiratory distress
-Physical dependence and tolerance are not the same as what? - -addiction
-Why do you never apply heat over a transdermal patch? - -it could increase
absorption and result in lethal complications
-How should you manage neuropathic pain? - -with adjuvant meds such as
antidepressants or anticonvulsants
-What should not be used in a clincial practice that it would violate the nurse-
patient relationship? - -placebos
-What are some non-pharmacologic pain management strategies? - -- physical
modalities
- mind-body methods
- biologic and energy-based therapies
-What are the clinical manifestations of hyponatremia? - -- headaches
- seizures
- lethargy
- tachycardia
- decreased BP
- thready pulse
- hyperactive bowel sounds
- abdominal cramps
-What are signs of hypoxia? - -- restlessness
- confusion
- pallor
- tachycardia
- tachypnea
-What can vagal stimulation be caused by? - -- vomiting
- suctioning
- severe pain
all resulting in bradycardia
-What is a loss of transparency of the eye lens, results in blurry vision, decreased
visual acuity, and sensitivity to glare? - -a cataract
-What are some risk reductions for catarats? - -- reducing weight
- smoking cessation
- optimizing blood sugars
- using sunglasses when outdoors
-What are S/S of an endopthalmitis (infection) that can occur after catarat surgery?
- -- marked by pain
- decreasing vision
- eyelid redness
