NUR 3066 Final Review questions with answers

NUR 3066 Final Review questions with
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answers

Components of the Mental Status Examination - CORRECT
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ANSWERS ✔✔A: Appearance |\ |\




B: Behavior
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C: Cognition
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T: Thought Processes
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Marijuana - CORRECT ANSWERS ✔✔reddened eyes, tachycardia,
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dry mouth, increased appetite, loss of
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coordination/balance


Cocaine - CORRECT ANSWERS ✔✔pupillary dilation, tachycardia
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or bradycardia, elevated or lowered BP, sweating, chills,
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nausea, vomiting, weight loss
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Heroin - CORRECT ANSWERS ✔✔pinpoint pupils, decrease blood
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pressure, pulse, respirations and temperature
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Hallucinogens - CORRECT ANSWERS ✔✔tachycardia, nausea,|\ |\ |\ |\ |\ |\


increased blood pressure, respirations or temperature, loss of
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appetite, dry mouth, paranoia, psychosis
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,Inhalants: - CORRECT ANSWERS ✔✔slurred speech, lack of
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coordination, dizziness, delusions |\ |\




Methamphetamines - CORRECT ANSWERS ✔✔pupillary dilation, |\ |\ |\ |\ |\ |\


tachycardia or bradycardia, elevated or decreased blood
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pressure, sweating or chills, nausea and vomiting, weight loss
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Temperature - CORRECT ANSWERS ✔✔Normal -Oral 96.4-99.1 F -
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Rectal 97.1-100.1 F
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Abnormal: Fever (hyperthermia): 100.4+F, Cold (hypothermia)
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<96.4 F |\




-Rectal temps are most accurate
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-Tympanic temp utilized in peds often due to ease
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Pulse Rate - CORRECT ANSWERS ✔✔Normal- 60-100 BPM
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Abnormal: Bradycardia <60, Tachycardia >100
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-Low pulse can be normal
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-Pediatrics run higher and have a different scale of normal
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-Doppler can be used if not palpable
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Pulse Force - CORRECT ANSWERS ✔✔2+
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0=absent, 1+=weak, thread, 3+=bounding |\ |\ |\




-Reflects strength of heart's stroke volume
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Respirations - CORRECT ANSWERS ✔✔Normal- 10-20/minutes
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, Abnormal: Bradypnea <10, Tachypnea>20 |\ |\ |\




-Distract patient to get accurate result |\ |\ |\ |\ |\




-Pediatric population differs |\ |\




-Con signal declining status
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-Count for 30 seconds and x2 (count for full minute if suspected
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abnormality)


Oxygen Saturation - CORRECT ANSWERS ✔✔Normal: >95% on
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room air |\




Abnormal: <95% on room air |\ |\ |\ |\




-Lung disease may cause lower normal reading
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-Move pulse oximeter around if getting odd reading - could be
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due to placement
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Blood Pressure - CORRECT ANSWERS ✔✔Systolic= maximum
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pressure during left ventricular contraction, TOP reading
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Diastolic= recoil/resting pressure between each contraction,
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BOTTOM reading |\




Pulse Pressure= difference between systolic and diastolic
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pressures and reflects stroke volume |\ |\ |\ |\




Causes of Abnormalities: medical diagnoses, medications, current
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state
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Performing Blood Pressure Reading - CORRECT ANSWERS |\ |\ |\ |\ |\ |\ |\


✔✔Ensure cuff is correct size |\ |\ |\ |\




Place around arm as directed (practice in lab)
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Inflate to maximum level
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