Exam 3: NSG223/ NSG 223 (Latest 2024/ 2025 Update) Med Surg 2 Exam| Questions and Verified Answers| 100% Correct| Grade A- Herzing
Exam 3: NSG223/ NSG 223 (Latest 2024/
2025 Update) Med Surg 2 Exam| Questions
and Verified Answers| 100% Correct| Grade
A- Herzing
Q: What are some dietary recommendations for a patient with cushing’s syndrome?
Answer:
-Increase potassium, calcium and protein.
-Restrict fluid and sodium intake.
Q: What is acromegaly?
Answer:
hypersecretion of GH during adulthood
Q: What is gigantism?
Answer:
hypersecretion of GH in children
Q: What is contraindicated with ketoconazole?
Answer:
Antacids, because it decreases absorption.
Q: How should ketoconazole taken?
Answer:
Fruit juice, acidic drinks to increase absorption.
Q: How should octreotide be administered?
Answer:
IM
Q: The nurse is caring for a client completing a fluid deprivation test. Which result should the
nurse expect to confirm?
Answer:
unchanged urine osmolarity
Q: The nurse is caring for a pt with SIADH knows that effective management of this disease
includes?
Answer:
CLOSELY MONITOR FLUID BALANCE
-I&Os and daily weights
Q: The nurse is preparing to administer desmopressin to a client with diabetes insipidus. What
would contraindicate med admin?
Answer:
Creatinine clearance less then 50ml!!!
(40mL)
Q: What are signs and symptoms of a fracture? SATA
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The nurse is assessing a client with addison’s disease. Which assessment findings would the nurse expect? SATA
Muscle weakness
Dark pigmentation
Hyperkalemia
Hyponatremia
What kind of diet should a patient with addison’s disease be on?
Diet high in sodium and fluids, low in potassium.
A pt presents to the ED in addisonian crisis. Which IV fluid should the nurse anticipate to administer stat?
5% dextrose in normal saline
What are contraindications for patients with addison’s disease on hydrocortisone treatment?
Live vaccines (MMR, varicella)
How should hydrocortisone be administered? PT teaching Q
At 9am with breakfast (At the same time with a meal)
The nurse is caring for a patient with possible cushing’s syndrome. What are some suspected findings upon assessment?
HIRSUTISM, weight gain, buffalo hump, bruising
What are some dietary recommendations for a patient with cushing’s syndrome?
-Increase potassium, calcium and protein.
-Restrict fluid and sodium intake.
What is acromegaly?
hypersecretion of GH during adulthood
What is gigantism?
hypersecretion of GH in children
What is contraindicated with ketoconazole?
Antacids, because it decreases absorption.
How should ketoconazole taken?
Fruit juice, acidic drinks to increase absorption.
How should octreotide be administered?
IM
The nurse is caring for a client completing a fluid deprivation test. Which result should the nurse expect to confirm?
unchanged urine osmolarity
The nurse is caring for a pt with SIADH knows that effective management of this disease includes?
CLOSELY MONITOR FLUID BALANCE
-I&Os and daily weights
The nurse is preparing to administer desmopressin to a client with diabetes insipidus. What would contraindicate med admin?
Creatinine clearance less then 50ml!!!
(40mL)
What are signs and symptoms of a fracture? SATA
-Crepitus
-Pain
-Bruising
-Swelling
What are some precautions to take with an open (leg) fracture?
Immobilize the leg prior to moving pt to safer spot
Discharge education for pts with fractures:
-Takes 6-8 weeks to heal
-Bone ossification 2-3 weeks
-Immobilized with splint cast for 6-8 weeks
What assessment is most critical in the early detection of compartment syndrome for a pt with a leg cast?
Pain assessment
What is important nursing care for patients with a cast or splint?
Assess for reports of burning (hotspots)can indicate a developing pressure ulcer.
How can the nurse teach a pt with a cast how to prevent disuse syndrome?
Tense and contract muscles without moving any underlying bone. Every hour while awake! (isometric)
Nurse detects redness and serous drainage at site of external fixation device. What should the nurse do next?
Notify the healthcare provider
What is important to know about a PCA pump?
Patients must be able to know how to use the
pump, and most of all able to push the pain
button
What should we assess for in pts on PCA pumps?
Respiratory depression
Why should Meperidine be avoided in the elderly?
Causes agitation, seizures and hallucinations
How is a patient with a fractured clavicle treated?
Sling, ice and pain meds
A pts hip is crushed in a MVA, the nurse understands that in addition to hemorrhage, what is a serious problem?
Shock
How is the peroneal nerve assessed?
pt will not be able to dorsiflex great toe and will have diminished sensation in the wen space
How do you care for a patient with a rib fracture?
-Give regularly scheduled analgesics or NSAIDS
-Chst binders to immobilize the fracture are not used
When would a below the knee amputation be necessary?
Damage to distal tibia or surrounding tissure
When would an above the knee amputation be necessary?
Gangrene, uncontrolled diabetes, arterial insufficiency
what is an elastic dressing?
Compression bandage to prevent swelling
What do you do if the elastic dressing comes off with a new amputation?
Immediately put it back on
A pt had an amputation of the left leg and is having self-esteem problems. As the nurse what is important?
Encourage communication and expression of feelings
When does a PCA pump medication (Morphine) peak?
10-20 minutes
Nurse is assessing a client with possible diagnosis of MS. What assessment findings support this diagnosis? SATA
weakness, pain, numbness, ataxia, fatigue
Nurse is teaching a prevent muscle spasticity. What recommendations should be made for them?
Daily stretching exercises
What is ataxia ?
Impaired coordination during voluntary movement
What is MS?
demyelinating disease of the CNS
What should be avoided in patients who have MS?
Hot baths bc of burns that can occur due to decreased sensation, cold temperatures bc it can increase spasticity.
— Avoid strenuous activity
What is the medication of choice for treating spasticity in MS?
Baclofen
A pt comes in with vision changes, muscle weakness, dysphagia and ptosis but no ataxia. Which condition do they most likely have?
myasthenia gravis (MG)
What does MG affect?
the myoneural junction
The nurse understands that a positive Tensilon Test confirms which autoimmune disorder?
Myasthenia Gravis
What is affected in severe cases of MG?
Breathing and limb movement
What is plasmapheresis used to treat?
Treat MG exacerbations for a few weeks
Is there a cure for MG?
NO
What is a thymectomy?
Removal of the thymus gland
Who is a candidate for a thymectomy?
pts younger than 60 years with MG diagnosis within past 3 years (42 yr old w 5 yr histx)
What should be avoided in a pt who has a cholinergic or myasthenic crisis?
Sedatives and tranquilizers bc they are ventilated (can cause resp and cardiac depression)
A nurse is preparing to administer neostigmine for a client with MG. What effects does this med have?SATA
improved skeletal muscle tone and strength ; increase in tone of GI smooth muscle; increase salivary gland production; increase tone and contractility of bladder muscles
–relaxes bronchial muscles; ; decreased HR
What is GBS and when does it often occur?
Acute attack of the myelin sheath, often follows a viral infection
What findings support a diagnosis of GBS? SATA
Ascending muscle weakness, diminished lower extr. reflexes, areflexia, symmetrical weakness (TOES TO NOSE)
–Viral inf 2 weeks prior
How is GBS treated?
Lovenox (Given subq in Abdomen)
–Sequential compression boots to prevent VTE
–Anticoagulant therapy
What medications should be avoided in fibromyalgia?
Opiates (HYDROCODONE)
What can treat fibromyalgia?
NSAIDS (ibuprofen) , flexeril, amitriptyline
What is a nursing diagnosis for for GBS?
Impaired gas exchange due to weakness of intercostal muscles