Medical-Surgical (Med-
Surg) Proctored Exam
2023-2026 with NGN – 100
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Med-Surg Proctored
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,Priority intervention for Diabetic ketoacidosis: - ANSWER -administer insulin
administer IV fluids
Diabetes foot care stuff to know: - ANSWER --wash feet daily w/mild soap & warm water
-test water temp 1st
-nails cut straight across
-no barefoot
-lotion, but not between toes
-use socks made of cotton only
Glaucoma s/s: - ANSWER --headache
-eye pain
-loss of peripheral vision
-elevated IOP (above 21)
-decreased or blurred vision
-halos around lights
-nonreactive pupils to lights
-photophobia
Hypothyroidism client teaching: - ANSWER --no heating blankets
-encourage warm liquids
-cough & deep breath
-increase activity level gradually, allow time for rest
-TSH monitoring
-treatment starts slow
-take meds 1-2 hrs before breakfast
,-lifelong tx, w/ongoing thyroid assessment
Wound care following an open cholecystectomy: - ANSWER --hospitalized for 2-3 days
-T tube may be in place (drainage is initially bloody then brown-green bile)
-report drainage exceeding 1000 mL/day
-keep drainage bag at level of gallbladder
-clamp tube 1-2 hr before & after meals
-expect more than 400 mL of drainage in the 1st 24 hr initially, w/gradual decrease
-report nausea & pain (indicates obstruction of t-tube)
Automated external defibrillator steps: - ANSWER -1. turn it on & place pads on client
2. make sure no one is touching client
3. hit analyze
4. if shock is needed, AED will do it
Nonpharm interventions for total knee replacement postop client complaining of pain but refusing
pain meds: - ANSWER -cold or ice therapy
Priority assessment for hypokalemia: - ANSWER -pts taking digoxin
ineffective respirations or diminished breath sounds
Side effects of long-term NSAID use: - ANSWER --tinnitus
-vertigo
-decreased hearing
-GI bleeds/ulceration
-bleeding
Acute hemolytic transfusion reaction s/s: - ANSWER --chills
-fever
-low back pain
, -tachycardia
-flushing
-hypotension
-chest tightening/pain
-tachypnea
-nausea
-anxiety
-hemoglobinuria
Febrile transfusion reaction s/s: - ANSWER --chills
-fever
-flushing
-headache
-anxiety
Mild allergic transfusion reaction s/s: - ANSWER --itching
-urticaria
-flushing
give benadryl
Anaphylactic transfusion reaction s/s: - ANSWER --wheezing
-dyspnea
-chest tightness
-cyanosis
-hypotension
Treatment for circulatory overload: - ANSWER --O2 therapy
-vital sign monitoring
-slow the rate of infusion
-admin diuretics as prescribed