Med-Surg II - Blueprint Exam 1 Questions With Complete
Solutions
*Angiography* (page 1340) Correct Answers • Is an x-ray
study of any blood vessel. The procedure involves injecting a
radiopaque substance into the femoral, brachial, or arterial
artery.
• X-ray films are then taken of the brain's blood vessels to detect
abnormalities
• Be alert for any signs of allergy to the drug injected for the test
• If severe anaphylaxis occurs in a client, it usually occurs
immediately
• Before the procedure, obtain a baseline neurologic assessment.
• A possibility exists that a thrombus can become dislodged,
causing an embolus. An embolus could travel to the heart, lung,
or brain.
• During the procedure, observe for Sx of muscular weakness,
twitching in the face or extremities, and respiratory difficulties.
if any of these occur, notify the healthcare provider immediately
• After the procedure, a sandbag or a specialized pressure device
is applied to the insertion site to reduce edema and prevent
bleeding and hematoma formation
• Check the are for bleeding every 15 to 30 minutes for several
hours
• Observe, the leg's color, temperature, and pedal pulse if the
femoral artery was used as the infection site
• Because of the radiopaque dye used, encourage intake of
fluids, unless contraindicated
• If you cannot find a pulse distal to the injection site, or if active
bleeding occurs, notify the healthcare provider immediately.
,*Antihypertensives* (page 1343) Correct Answers *Beta-
Blockers*:
• Propranolol (Inderal)
• Atenolol (Tenormin)
• Nadolol (Corgard)
• Metoprolol tartrate (Lopressor)
*Calcium Channel Blockers*:
• Verapamil (Calan)
• Diltiazem (Cardizem)
*Assisting in a cerebral arteriography* (page 1340) Correct
Answers • *Before the procedure*: obtain a baseline neurologic
assessment. A possibility exists that a thrombus can become
dislodged causing an embolus that could travel to the heart,
lung, or brain.
• During the procedure: observe for symptoms of muscular
weakness twitching in the face or extremities, and respiratory
difficulties.
• *After the procedure*:
o sandbag or specialized pressure device applied to insertion site
to reduce edema, prevent bleeding and hematoma formation.
o Check area for bleeding every 15-30 for several hours
o Observe leg's color, temp, and pedal pulse if the femoral artery
was used.
o Because of the radiopaque dye used, encourage intake of
fluids, unless contraindicated.
*Autonomic dysreflexia* (page 1351) Correct Answers
*Immediate treatment*:
• Elevate head or have client sit up, if possible
• Notify provider
,• Loosen constrictive clothing or devices
• Check for causes of pressure such as blocked urinary catheter
• Monitor BP every 2 to 5 minutes
• Treatment involves elimination of triggering stimulus
o In cases of severe hypertension, antihypertensive meds are
used
*Autonomic dysreflexia* (page 1351) Correct Answers *S/Sx
of Autonomic dysreflexia*:
• Sudden, significant increase in blood pressure (systolic and
diastolic) of 20 to 40 mmHg above baseline
• Sudden onset of a pounding headache
• Bradycardia, arrhythmias
• Profuse sweating (diaphoresis), goosebumps (piloerection),
and flushing above the level of injury
• Blurred vision, or spots in the visual field
• Nasal congestion
• Apprehension, anxiety
*Autonomic dysreflexia* (page 1351) Correct Answers *Teach
client & family preventive measures*:
• Preventing constipation & visually inspecting catheters to
ensure that it remains patent.
*Autonomic dysreflexia* (page 1351) Correct Answers
*Triggers include*:
• Distended bowel or bladder
• Fecal impaction
• Urinary tract infection
• Constrictive clothing, shoes or device
• Noxious stimuli such as pain, pressure or strong smells
, *Autonomic dysreflexia* (page 1351) Correct Answers •
(autonomic hyperreflexia) an exaggerated response to stimuli
below the level of the lesion in the clients with lesions at or
above T6, medical emergency that requires prompt treatment.
o Physical event or occurrences may trigger or be the precursor
to autonomic dysreflexia.
*Cephalgia* (page 1342) Correct Answers • Cephalgia
(Headache) is one of the most common symptoms of a
neurologic disorder. It also associated with many other diseases
and disorders.
• A headache is not a disease itself, but rather it is a symptom of
an underlying disorder.
• Headaches often appear with conditions such as:
o eye strain, sinusitis, muscle strain, ligament strain, cervical
degenerative changes, emotional tension, stress, brain tumors,
hypertension, and increased intracranial pressure.
• Cluster headaches receive their name because they tend to
occur in groups or clusters, often at night.
o Seem to result from vascular disturbances
o Severely disabling
o More common in men than in women
o Occurs suddenly and severely, often affecting only one side
and involving the eye, neck, and face on that side.
Eye may appear to bulge and other symptoms of vasodilation
are seen, such as edema, lacrimation (tear formation), rhinorrhea
(runny nose), diaphoresis (sweating), and flushing of the
affected side. Pupils constrict, and the face and head are
sensitive to external touch.
Solutions
*Angiography* (page 1340) Correct Answers • Is an x-ray
study of any blood vessel. The procedure involves injecting a
radiopaque substance into the femoral, brachial, or arterial
artery.
• X-ray films are then taken of the brain's blood vessels to detect
abnormalities
• Be alert for any signs of allergy to the drug injected for the test
• If severe anaphylaxis occurs in a client, it usually occurs
immediately
• Before the procedure, obtain a baseline neurologic assessment.
• A possibility exists that a thrombus can become dislodged,
causing an embolus. An embolus could travel to the heart, lung,
or brain.
• During the procedure, observe for Sx of muscular weakness,
twitching in the face or extremities, and respiratory difficulties.
if any of these occur, notify the healthcare provider immediately
• After the procedure, a sandbag or a specialized pressure device
is applied to the insertion site to reduce edema and prevent
bleeding and hematoma formation
• Check the are for bleeding every 15 to 30 minutes for several
hours
• Observe, the leg's color, temperature, and pedal pulse if the
femoral artery was used as the infection site
• Because of the radiopaque dye used, encourage intake of
fluids, unless contraindicated
• If you cannot find a pulse distal to the injection site, or if active
bleeding occurs, notify the healthcare provider immediately.
,*Antihypertensives* (page 1343) Correct Answers *Beta-
Blockers*:
• Propranolol (Inderal)
• Atenolol (Tenormin)
• Nadolol (Corgard)
• Metoprolol tartrate (Lopressor)
*Calcium Channel Blockers*:
• Verapamil (Calan)
• Diltiazem (Cardizem)
*Assisting in a cerebral arteriography* (page 1340) Correct
Answers • *Before the procedure*: obtain a baseline neurologic
assessment. A possibility exists that a thrombus can become
dislodged causing an embolus that could travel to the heart,
lung, or brain.
• During the procedure: observe for symptoms of muscular
weakness twitching in the face or extremities, and respiratory
difficulties.
• *After the procedure*:
o sandbag or specialized pressure device applied to insertion site
to reduce edema, prevent bleeding and hematoma formation.
o Check area for bleeding every 15-30 for several hours
o Observe leg's color, temp, and pedal pulse if the femoral artery
was used.
o Because of the radiopaque dye used, encourage intake of
fluids, unless contraindicated.
*Autonomic dysreflexia* (page 1351) Correct Answers
*Immediate treatment*:
• Elevate head or have client sit up, if possible
• Notify provider
,• Loosen constrictive clothing or devices
• Check for causes of pressure such as blocked urinary catheter
• Monitor BP every 2 to 5 minutes
• Treatment involves elimination of triggering stimulus
o In cases of severe hypertension, antihypertensive meds are
used
*Autonomic dysreflexia* (page 1351) Correct Answers *S/Sx
of Autonomic dysreflexia*:
• Sudden, significant increase in blood pressure (systolic and
diastolic) of 20 to 40 mmHg above baseline
• Sudden onset of a pounding headache
• Bradycardia, arrhythmias
• Profuse sweating (diaphoresis), goosebumps (piloerection),
and flushing above the level of injury
• Blurred vision, or spots in the visual field
• Nasal congestion
• Apprehension, anxiety
*Autonomic dysreflexia* (page 1351) Correct Answers *Teach
client & family preventive measures*:
• Preventing constipation & visually inspecting catheters to
ensure that it remains patent.
*Autonomic dysreflexia* (page 1351) Correct Answers
*Triggers include*:
• Distended bowel or bladder
• Fecal impaction
• Urinary tract infection
• Constrictive clothing, shoes or device
• Noxious stimuli such as pain, pressure or strong smells
, *Autonomic dysreflexia* (page 1351) Correct Answers •
(autonomic hyperreflexia) an exaggerated response to stimuli
below the level of the lesion in the clients with lesions at or
above T6, medical emergency that requires prompt treatment.
o Physical event or occurrences may trigger or be the precursor
to autonomic dysreflexia.
*Cephalgia* (page 1342) Correct Answers • Cephalgia
(Headache) is one of the most common symptoms of a
neurologic disorder. It also associated with many other diseases
and disorders.
• A headache is not a disease itself, but rather it is a symptom of
an underlying disorder.
• Headaches often appear with conditions such as:
o eye strain, sinusitis, muscle strain, ligament strain, cervical
degenerative changes, emotional tension, stress, brain tumors,
hypertension, and increased intracranial pressure.
• Cluster headaches receive their name because they tend to
occur in groups or clusters, often at night.
o Seem to result from vascular disturbances
o Severely disabling
o More common in men than in women
o Occurs suddenly and severely, often affecting only one side
and involving the eye, neck, and face on that side.
Eye may appear to bulge and other symptoms of vasodilation
are seen, such as edema, lacrimation (tear formation), rhinorrhea
(runny nose), diaphoresis (sweating), and flushing of the
affected side. Pupils constrict, and the face and head are
sensitive to external touch.
