Advanced Med-Surg Principles Jersey College Exam 1
Questions and Answers with Explanations Latest
Exam
What during labor increases the risk of neonate aquiring acute encephalitis? -
answeractive herpes simplex virus-2
How do you administer meds? - answerstarting with the lowest dose and titrating up
slowly
What is pain is associated with? - answeractual or potential tissue damage
When pain stimulates the sympathetic nervous system, what does it result in? - answer-
increase in BP
- increase in HR
- increase in RR
Where are catecholamines released from? - answeradrenal medulla
Where are steroid hormones (cortisol & aldosterone) released from? - answeradrenal
cortex
What does unrelieved pain lead to? - answer- increases glucagon production
- decreases insulin secretion
- depress immune function
- can lead to addictive behaviors
What initiates inflammation, contributes to tissue sweeling, and pain? -
answerProstaglandins
What can nerve root injury lead to? - answerallodynia (pain that is associated with non-
noxious stimuli)
What is needed for renal blood flow? - answerProstaglandin
Pain is? - answerwhatever the patient says it is
What is the single most reliable indicator of pain? - answerthe patient's self-report
How do NSAID's preimarily produce pain relief? - answerby preventing prostaglandin
formation
,What does acetaminphen not have? - answerany inflammatory properties
What do you manage nociceptive pain with? - answer- local anesthetics
- non-opioids
- opioids
What does 0 on the 0 - 10 numeric pain rating scale indicate? - answerno pain
What does the Wong-Baker FACES pain scale consist of? - answercartoon faces that
the patient (ages 3 and up) selects to report thier pain level
What does the visual analog 10cm scale represent? - answerno 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? - answerverbal
descriptor scale
What does a comprehensive pain assessment consist of? - answer- duration (when it
started/lasted)
- type (intensity/assoc factors/influencing fators)
- location
What patients do we avoid the rectal route for med administration? -
answerthrombocytopenic
What type of effect do topical agents produce? - answerlocal
What type of effect do transdermal agents produce? - answerdrug absorption into the
systemic circulation
What would help reduce complications related to pain for patients? - answerprovide a
PCA
How do we administer around the clock pain relief for post-op and chronic pain? -
answerprovide analgesics, never wait for chronic pain to reoccur
What is provided for mild to moderate pain? - answeraspirin or acetaminaphen
What is provided for moderate pain? - answerNSAID's
What is provided for severe pain? - answermorphine
Why would you wake patients who have chronic pain or who have moderate to severe
pain folowing surgery? - answerto administer prescribed analgcsics
What can excessive use of acetaminophen cause? - answerhepatoxicity
,What does of acetaminophen could lead to hepatoxicity? - answer4,000 mg/day
What can NSAID's meds result in? - answer- 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? - answeracute renal failure
What undesirable effects do opioids produce? - answer- constipation
- nausea
- pupil constriction
- respiratory distress
Physical dependence and tolerance are not the same as what? - answeraddiction
Why do you never apply heat over a transdermal patch? - answerit could increase
absorption and result in lethal complications
How should you manage neuropathic pain? - answerwith adjuvant meds such as
antidepressants or anticonvulsants
What should not be used in a clincial practice that it would violate the nurse-patient
relationship? - answerplacebos
What are some non-pharmacologic pain management strategies? - answer- physical
modalities
- mind-body methods
- biologic and energy-based therapies
What are the clinical manifestations of hyponatremia? - answer- headaches
- seizures
- lethargy
- tachycardia
- decreased BP
- thready pulse
- hyperactive bowel sounds
- abdominal cramps
What are signs of hypoxia? - answer- restlessness
- confusion
- pallor
- tachycardia
- tachypnea
What can vagal stimulation be caused by? - answer- 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? - answera cataract
What are some risk reductions for catarats? - answer- 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? -
answer- marked by pain
- decreasing vision
- eyelid redness
- eyelid edema
- yellowish/green discharge from the eye
Viral conjunctivitis is? - answerhighly contageous
What are S/S of viral conjunctivitis? - answer- marked by conjunctival hyperemia
- lid edema
- ptosis
- foreign body sensation
- watery discharge
What cranial nerve has nerve fibers from the right and left eye that cross over before
sending impulses to the occipital lobe? - answerCranial nerve II (optic nerve)
What increases the risk for retinal artery or vein occlusion and loss of vision? - answer-
diabetes
- glaucoma
- aging
- HTN
- atherosclerosis
What results in blurred distant vision - answermyopia (nearsightedness)
What results in blurred near vision? - answerhyperopia (farsightedness)
What safety mesaures are used when interacting with visually impaired patients? -
answer- keeping objects close by
- identifying where objects are
- not distracting their safety animal
- using the clock method when ambulating
Questions and Answers with Explanations Latest
Exam
What during labor increases the risk of neonate aquiring acute encephalitis? -
answeractive herpes simplex virus-2
How do you administer meds? - answerstarting with the lowest dose and titrating up
slowly
What is pain is associated with? - answeractual or potential tissue damage
When pain stimulates the sympathetic nervous system, what does it result in? - answer-
increase in BP
- increase in HR
- increase in RR
Where are catecholamines released from? - answeradrenal medulla
Where are steroid hormones (cortisol & aldosterone) released from? - answeradrenal
cortex
What does unrelieved pain lead to? - answer- increases glucagon production
- decreases insulin secretion
- depress immune function
- can lead to addictive behaviors
What initiates inflammation, contributes to tissue sweeling, and pain? -
answerProstaglandins
What can nerve root injury lead to? - answerallodynia (pain that is associated with non-
noxious stimuli)
What is needed for renal blood flow? - answerProstaglandin
Pain is? - answerwhatever the patient says it is
What is the single most reliable indicator of pain? - answerthe patient's self-report
How do NSAID's preimarily produce pain relief? - answerby preventing prostaglandin
formation
,What does acetaminphen not have? - answerany inflammatory properties
What do you manage nociceptive pain with? - answer- local anesthetics
- non-opioids
- opioids
What does 0 on the 0 - 10 numeric pain rating scale indicate? - answerno pain
What does the Wong-Baker FACES pain scale consist of? - answercartoon faces that
the patient (ages 3 and up) selects to report thier pain level
What does the visual analog 10cm scale represent? - answerno 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? - answerverbal
descriptor scale
What does a comprehensive pain assessment consist of? - answer- duration (when it
started/lasted)
- type (intensity/assoc factors/influencing fators)
- location
What patients do we avoid the rectal route for med administration? -
answerthrombocytopenic
What type of effect do topical agents produce? - answerlocal
What type of effect do transdermal agents produce? - answerdrug absorption into the
systemic circulation
What would help reduce complications related to pain for patients? - answerprovide a
PCA
How do we administer around the clock pain relief for post-op and chronic pain? -
answerprovide analgesics, never wait for chronic pain to reoccur
What is provided for mild to moderate pain? - answeraspirin or acetaminaphen
What is provided for moderate pain? - answerNSAID's
What is provided for severe pain? - answermorphine
Why would you wake patients who have chronic pain or who have moderate to severe
pain folowing surgery? - answerto administer prescribed analgcsics
What can excessive use of acetaminophen cause? - answerhepatoxicity
,What does of acetaminophen could lead to hepatoxicity? - answer4,000 mg/day
What can NSAID's meds result in? - answer- 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? - answeracute renal failure
What undesirable effects do opioids produce? - answer- constipation
- nausea
- pupil constriction
- respiratory distress
Physical dependence and tolerance are not the same as what? - answeraddiction
Why do you never apply heat over a transdermal patch? - answerit could increase
absorption and result in lethal complications
How should you manage neuropathic pain? - answerwith adjuvant meds such as
antidepressants or anticonvulsants
What should not be used in a clincial practice that it would violate the nurse-patient
relationship? - answerplacebos
What are some non-pharmacologic pain management strategies? - answer- physical
modalities
- mind-body methods
- biologic and energy-based therapies
What are the clinical manifestations of hyponatremia? - answer- headaches
- seizures
- lethargy
- tachycardia
- decreased BP
- thready pulse
- hyperactive bowel sounds
- abdominal cramps
What are signs of hypoxia? - answer- restlessness
- confusion
- pallor
- tachycardia
- tachypnea
What can vagal stimulation be caused by? - answer- 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? - answera cataract
What are some risk reductions for catarats? - answer- 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? -
answer- marked by pain
- decreasing vision
- eyelid redness
- eyelid edema
- yellowish/green discharge from the eye
Viral conjunctivitis is? - answerhighly contageous
What are S/S of viral conjunctivitis? - answer- marked by conjunctival hyperemia
- lid edema
- ptosis
- foreign body sensation
- watery discharge
What cranial nerve has nerve fibers from the right and left eye that cross over before
sending impulses to the occipital lobe? - answerCranial nerve II (optic nerve)
What increases the risk for retinal artery or vein occlusion and loss of vision? - answer-
diabetes
- glaucoma
- aging
- HTN
- atherosclerosis
What results in blurred distant vision - answermyopia (nearsightedness)
What results in blurred near vision? - answerhyperopia (farsightedness)
What safety mesaures are used when interacting with visually impaired patients? -
answer- keeping objects close by
- identifying where objects are
- not distracting their safety animal
- using the clock method when ambulating
