NUR 265 – Med-Surg Comprehensive Practice Exam
(Version 2) | 150 Questions with Rationales |
Cardiovascular, Respiratory, Endocrine, Renal, GI,
Neuro, Pharmacology
-clean skin with mild soap and pat dry and apply lotion
Lupus: medical management - ANSWER//-
hydroxychloroquine(anti-malarial) decreases absorption of
UV light Scleroderma - ANSWER//inflammatory,
autoimmune connective tissue disease Scleroderma:
Hallmark Sign - ANSWER//Hard, leather-like edematous
skin Late: esophageal dismotility Scleroderma: Assess -
ANSWER//Swallow safety--esophageal dysmotility
(ASPIRATION) O2 circulation skin Scleroderma:
Interventions - ANSWER//aspiration precautions (keep
HOB at 60 degrees during meals and after) skin protection
measures small frequent meals--avoid caffeine and
alcohol -avoid spices, caffeine and pepper fibromyalgia:
S/sx - ANSWER//extreme fatigure GI symptoms dysuria
blurred vision forgetfulness fibromyalgia: Assess -
ANSWER//pain level extreme fatigue GI symptoms
Fibromyalgia: Interventions - ANSWER//NSAIDS
Nuerontin (gabapentin) Lyrica (pregabalin) SNRI and
tricyclic antidepressants (amitriptyline) promote sleep and
low impact exercise (stretching, walking, swimming,
rowing, water exercise) Lyme Disease: Hallmark sign -
ANSWER//stage 1: "bulls eye rash" and flu-like symptoms
Stage 2: facial paralysis, carditis, meningitis Lyme Disease:
Assess - ANSWER//Skin history of tick bites Lyme
Disease: Interventions - ANSWER//prevention! Insect
repellant with DEET early stage--doxycycline antibiotics
ORAL late stage--Iv antibiotics (ceftriaxone) avoid tall
grass wear light colored clothing have pets wear tick
collars Allergic Reaction Priority - ANSWER//STOP THE
INFUSION/ELIMINATE the trigger, then STOP the
immune response Give Epi maintain airway Latex allergy:
risks - ANSWER//-frequent use of latex condoms -
,healthcare workers -allergy to avocados, bananas, and
some nuts Anaphylactic shock - ANSWER//AIRWAY--give
epi IV or IM STAT and intubate if needed BREATHING--
apply O2; mechanically ventilate CIRCULATION--monitor
for distributive shock; give fluids Epinephrine Auto-injector
teaching - ANSWER//always carry 2 devices inject by
"stabbing" into top of thigh with pants on (AVOID pockets)
call 911 immediately--patient still needs to be monitored
keep epi in cool dark place. Immunocompromised Patient
- ANSWER//-Do not drink anything that has been sitting
out -take temp at least once per day -clean toothbrush
once weekly in diswasher or bleach solution -do not eat
raw foods; salad, cottage cheese -do not scoop litter
boxes -no plants or soil exposure -antibacterial soap -
AVOID reptiles HIV: Assess - ANSWER//CD4 count
ELISA test once per year for at risk patients HIV:
Interventions - ANSWER//PREVENTION: -condoms -PreP
(truvada) must take 4 consecutive days in a row before
protected; cant miss more than one dose in a row -needle
safety -post exposure prophylaxis-start cART within 24-36
hours of exposure HIV: Nutrition - ANSWER//high calorie
high protein low fat small frequent meals thrush--treat with
anitfungal HIV tx: HAART/cART - ANSWER//DOES NOT
CURE Does not prevent secondary/opportunistic
infections MUST TAKE 90% of the time --otherwise
resistance will occur HIV: complications --- AIDS -
ANSWER//CD4 count less than 200mmhg most likely to
experience opportunistic infections --I.e Pneumocystic
jiroveci pneumonia (ASSESS AIRWAY!!) consult pallative
care/hospice candida albicans - ANSWER//-Hallmark sign-
- white patches in the mouth -"food doesnt taste right" -If
patient wants a coke they can have it! They just have to
rinse mouth out with water (fungus loves sugar)
tuberculosis - ANSWER//hallmark sign-- night sweats,
high fever, cough -airborne isolation -do not trust TB skin
test in client with HIV Fungal pneumonia -
ANSWER//ABC's monitor ABG--if hypoxemia present
, antifungal drugs IV External Radiation - ANSWER//-teach
client to leave markings in place -use sunscreen -wash
skin with mild soap and use lotion frequently Breast
Cancer: Risks - ANSWER//-BRCA 1&2 genes
(preventative mastectomy) -women age 65-80 -elevated
estrogen levels -alcohol consumption -history of child after
30 years of age -early menstruation or late menopause
Breast cancer: Assess - ANSWER//screening history:
mammography every year starting at 45*** -self exam
frequency (same time of the month)*** -breast appearance
(dimpling, orange peel appearance) -breast ultrasound if
have dense breast tissue; if cant get good mammography
image*** Breast Cancer: interventions - ANSWER//pre
and post lumpectomy/mastectomy **prophylactic
mastectomy is patient with BRCA 1 and 2 gene -then
external radiation -chemo -symptom management Lung
Cancer: Risks - ANSWER//-environmental exposure -
radon, environmental tobacco smoke, asbestos -genetic -
inhalant exposure Lung Cancer: Warning signs -
ANSWER//-hoarse voice** -persistant cough** -blood-
tinged sputum** -chest pain Lung Cancer: Assess -
ANSWER//-respiratory -smoking history -screening history
(chest CT)--typically only for high risk patients; (smoking
for 20 years; may get routine CT) Lung cancer:
Interventions - ANSWER//VAT with wedge resection
chemo external radiation Colorectal cancer: risks -
ANSWER//-over the age of 50 -genetic -history of IBD -
smoking -alcohol consumption -high fat diet of red meat
Colorectal Cancer: screening - ANSWER//-fecal occult
blood test yearly*** -sigmoidoscopy OR double contrast
barium enem OR colonoscopy every 5 YEARS**
Colorectal: s/sx - ANSWER//-rectal bleeding -anemia -
changes in tool consistency -mahogany (dark) colored or
bright red stools colorectal cancer: Assess - ANSWER//-
stool output -changes to stool -blood in stool *new onset
constipation can suggest advanced disease colorectal
cancer: interventions - ANSWER//-screen -surgical
(Version 2) | 150 Questions with Rationales |
Cardiovascular, Respiratory, Endocrine, Renal, GI,
Neuro, Pharmacology
-clean skin with mild soap and pat dry and apply lotion
Lupus: medical management - ANSWER//-
hydroxychloroquine(anti-malarial) decreases absorption of
UV light Scleroderma - ANSWER//inflammatory,
autoimmune connective tissue disease Scleroderma:
Hallmark Sign - ANSWER//Hard, leather-like edematous
skin Late: esophageal dismotility Scleroderma: Assess -
ANSWER//Swallow safety--esophageal dysmotility
(ASPIRATION) O2 circulation skin Scleroderma:
Interventions - ANSWER//aspiration precautions (keep
HOB at 60 degrees during meals and after) skin protection
measures small frequent meals--avoid caffeine and
alcohol -avoid spices, caffeine and pepper fibromyalgia:
S/sx - ANSWER//extreme fatigure GI symptoms dysuria
blurred vision forgetfulness fibromyalgia: Assess -
ANSWER//pain level extreme fatigue GI symptoms
Fibromyalgia: Interventions - ANSWER//NSAIDS
Nuerontin (gabapentin) Lyrica (pregabalin) SNRI and
tricyclic antidepressants (amitriptyline) promote sleep and
low impact exercise (stretching, walking, swimming,
rowing, water exercise) Lyme Disease: Hallmark sign -
ANSWER//stage 1: "bulls eye rash" and flu-like symptoms
Stage 2: facial paralysis, carditis, meningitis Lyme Disease:
Assess - ANSWER//Skin history of tick bites Lyme
Disease: Interventions - ANSWER//prevention! Insect
repellant with DEET early stage--doxycycline antibiotics
ORAL late stage--Iv antibiotics (ceftriaxone) avoid tall
grass wear light colored clothing have pets wear tick
collars Allergic Reaction Priority - ANSWER//STOP THE
INFUSION/ELIMINATE the trigger, then STOP the
immune response Give Epi maintain airway Latex allergy:
risks - ANSWER//-frequent use of latex condoms -
,healthcare workers -allergy to avocados, bananas, and
some nuts Anaphylactic shock - ANSWER//AIRWAY--give
epi IV or IM STAT and intubate if needed BREATHING--
apply O2; mechanically ventilate CIRCULATION--monitor
for distributive shock; give fluids Epinephrine Auto-injector
teaching - ANSWER//always carry 2 devices inject by
"stabbing" into top of thigh with pants on (AVOID pockets)
call 911 immediately--patient still needs to be monitored
keep epi in cool dark place. Immunocompromised Patient
- ANSWER//-Do not drink anything that has been sitting
out -take temp at least once per day -clean toothbrush
once weekly in diswasher or bleach solution -do not eat
raw foods; salad, cottage cheese -do not scoop litter
boxes -no plants or soil exposure -antibacterial soap -
AVOID reptiles HIV: Assess - ANSWER//CD4 count
ELISA test once per year for at risk patients HIV:
Interventions - ANSWER//PREVENTION: -condoms -PreP
(truvada) must take 4 consecutive days in a row before
protected; cant miss more than one dose in a row -needle
safety -post exposure prophylaxis-start cART within 24-36
hours of exposure HIV: Nutrition - ANSWER//high calorie
high protein low fat small frequent meals thrush--treat with
anitfungal HIV tx: HAART/cART - ANSWER//DOES NOT
CURE Does not prevent secondary/opportunistic
infections MUST TAKE 90% of the time --otherwise
resistance will occur HIV: complications --- AIDS -
ANSWER//CD4 count less than 200mmhg most likely to
experience opportunistic infections --I.e Pneumocystic
jiroveci pneumonia (ASSESS AIRWAY!!) consult pallative
care/hospice candida albicans - ANSWER//-Hallmark sign-
- white patches in the mouth -"food doesnt taste right" -If
patient wants a coke they can have it! They just have to
rinse mouth out with water (fungus loves sugar)
tuberculosis - ANSWER//hallmark sign-- night sweats,
high fever, cough -airborne isolation -do not trust TB skin
test in client with HIV Fungal pneumonia -
ANSWER//ABC's monitor ABG--if hypoxemia present
, antifungal drugs IV External Radiation - ANSWER//-teach
client to leave markings in place -use sunscreen -wash
skin with mild soap and use lotion frequently Breast
Cancer: Risks - ANSWER//-BRCA 1&2 genes
(preventative mastectomy) -women age 65-80 -elevated
estrogen levels -alcohol consumption -history of child after
30 years of age -early menstruation or late menopause
Breast cancer: Assess - ANSWER//screening history:
mammography every year starting at 45*** -self exam
frequency (same time of the month)*** -breast appearance
(dimpling, orange peel appearance) -breast ultrasound if
have dense breast tissue; if cant get good mammography
image*** Breast Cancer: interventions - ANSWER//pre
and post lumpectomy/mastectomy **prophylactic
mastectomy is patient with BRCA 1 and 2 gene -then
external radiation -chemo -symptom management Lung
Cancer: Risks - ANSWER//-environmental exposure -
radon, environmental tobacco smoke, asbestos -genetic -
inhalant exposure Lung Cancer: Warning signs -
ANSWER//-hoarse voice** -persistant cough** -blood-
tinged sputum** -chest pain Lung Cancer: Assess -
ANSWER//-respiratory -smoking history -screening history
(chest CT)--typically only for high risk patients; (smoking
for 20 years; may get routine CT) Lung cancer:
Interventions - ANSWER//VAT with wedge resection
chemo external radiation Colorectal cancer: risks -
ANSWER//-over the age of 50 -genetic -history of IBD -
smoking -alcohol consumption -high fat diet of red meat
Colorectal Cancer: screening - ANSWER//-fecal occult
blood test yearly*** -sigmoidoscopy OR double contrast
barium enem OR colonoscopy every 5 YEARS**
Colorectal: s/sx - ANSWER//-rectal bleeding -anemia -
changes in tool consistency -mahogany (dark) colored or
bright red stools colorectal cancer: Assess - ANSWER//-
stool output -changes to stool -blood in stool *new onset
constipation can suggest advanced disease colorectal
cancer: interventions - ANSWER//-screen -surgical
