NSG 2016 FINAL EXAM BLUEPRINT AND KEY NURSING CONCEPTS QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NSG 2016 FINAL EXAM BLUEPRINT AND KEY NURSING CONCEPTS QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 What is Patient-Controlled Analgesia (PCA)? - Answers A treatment that allows clients to self-administer small amounts of pain medication at a continuous rate or via a button for a bolus dose. What defines chronic pain? - Answers Pain that is constant or recurring and lasts longer than 6 months. What are opioids commonly prescribed for? - Answers Relief of pain by activating opioid receptors in the brain, spinal cord, and central nervous system. What are the risks associated with opioid administration? - Answers Addiction, oversedation, respiratory depression, orthostatic hypotension, and syncope. What are subjective indicators of pain? - Answers Pain scale score, quantity, and quality of pain. What are objective indicators of pain? - Answers Grimacing, guarding, crying. What does the PQRST acronym stand for in pain assessment? - Answers A method for assessing pain that includes Provocation, Quality, Region, Severity, and Timing. Name three pain assessment scales mentioned in the notes. - Answers Numeric Rating Scale, Wong-Baker FACES Pain Rating Scale, FLACC scale. What is Cognitive Behavioral Therapy (CBT) used for in pain management? - Answers To help clients manage negative thoughts and maladaptive behaviors, reducing anxiety, stress, and chronic pain. Why are children at risk of being undertreated for pain? - Answers They may display pain differently and some are not verbally able to describe their pain. How does pain perception change with age? - Answers Pain tends to increase with age, often due to neuropathic conditions and joint issues. What should nurses assess in clients with cognitive impairment regarding pain? - Answers Look for behaviors such as guarding, grimacing, restlessness, and other behavioral changes. What is acute pain defined as? - Answers Pain that has an anticipated or predictable end and lasts less than 6 months. What is nociceptive pain? - Answers Pain felt in a tissue, organ, or damaged part of the body, or referred pain. What is neuropathic pain? - Answers Nerve pain that occurs without tissue damage. What are some care considerations for patients with neuropathy? - Answers Educate about foot care, inspect feet daily, wear closed-toe shoes, and avoid walking barefoot. What interventions should be taken for clients with vision impairment? - Answers Ensure access to corrective lenses, adequate lighting, large-print materials, and face the client when speaking. What is diabetic retinopathy and what are its effects? - Answers Diabetic retinopathy is damage to the blood vessels of the retina caused by diabetes mellitus, leading to blood leakage, impaired vision, and potential blindness. What are some symptoms of diabetic retinopathy? - Answers Symptoms include floaters and impaired vision in both eyes. How can clients slow the progression of diabetic retinopathy? - Answers Clients can slow the progression by maintaining good control of their blood glucose level, blood pressure, and cholesterol level. What are some interventions for clients with impaired speech? - Answers Interventions include allowing extra time for communication, exhibiting patience, encouraging the use of picture boards or writing tools, and promoting participation in speech therapy. What are common age-related changes in vision? - Answers Common age-related changes include far-sightedness, hearing loss, macular degeneration, and cataracts. What are cataracts and their effects on vision? - Answers Cataracts are the clouding of the lens of the eye, causing blurry, hazy, or less colorful vision, and can hinder activities like reading and driving. What causes cataracts? - Answers Cataracts can be caused by previous eye surgeries, chronic diseases like diabetes mellitus, and most commonly, older age. How can cataracts be treated? - Answers Cataracts can be surgically removed. What is glaucoma and how does it affect vision? - Answers Glaucoma is an increase in intraocular pressure due to fluid buildup, leading to compression of the optic nerve and loss of peripheral vision, which can progress to total blindness. Is vision loss due to glaucoma reversible? - Answers No, vision loss due to glaucoma is irreversible, but progression can be slowed or prevented with early detection and treatment. What is included in postmortem care? - Answers Postmortem care includes washing the body, accounting for the client's possessions, placing identification tags, and removing invasive devices according to healthcare policy. What must be documented when a client dies? - Answers The date and time of death, the name of anyone notified, the location of the client's belongings, and where the body is moved. What are the eligibility criteria for hospice care? - Answers Eligibility includes a life expectancy of 6 months, the client's agreement to palliative care, and signing a statement choosing hospice care over other treatment benefits. What considerations should clients and families discuss regarding hospice care? - Answers They should discuss the client's readiness to discontinue life-prolonging treatments and the rate of deterioration despite medical treatment. How is spirituality defined in the context of healthcare? - Answers Spirituality is more than religion; it involves acknowledging the client's viewpoint and providing holistic care that emphasizes dignity and purpose in life. What should be done to accommodate a client's religious beliefs in spiritual care? - Answers Accommodations may include contacting religious figures and other followers within the client's religious group. What type of spiritual care should be offered to clients without religious beliefs? - Answers Nonreligious spiritual care should be offered to clients who do not identify with any religious beliefs. What should be provided by spiritual leaders instead of nurses? - Answers In-depth spiritual counseling. What are common expected assessment findings at the end of life? - Answers Dyspnea, death rattle, Cheyne-Stokes respirations, pain, episodes of increased and decreased temperature, mottling, and hallucinations. What is mottling and what causes it? - Answers Mottling is a physical change of the skin marked by purple or reddish marbling, caused by the heart's inability to pump blood effectively, leading to decreased blood perfusion throughout the body. What is the definition of palliative care? - Answers Holistic care provided for clients experiencing a severe medical illness, particularly for those approaching end of life, aimed at improving the quality of life for the client, family, and caregivers. What physiological changes in the respiratory system occur as a client approaches the end of life? - Answers Common changes include dyspnea (shortness of breath), retention of secretions (death rattle), and Cheyne-Stokes respirations (irregular respiratory rate with quick breaths and periods of apnea). What is the dosage conversion for 1 mg in micrograms? - Answers 1 mg = 1,000 mcg. How many milliliters are in 1 ounce? - Answers 1 oz = 30 ml. What is the equivalent of 1 kilogram in pounds? - Answers 1 kg = 2.2 lb. What is the first step in medication administration safety? - Answers Triple check that you have all the rights of administration. What should be done if a medication administration error occurs? - Answers Report any errors immediately. What is the proper sequence for administering a metered dose inhaler (MDI)? - Answers Gather supplies, perform hand hygiene, verify client identification, check medication label against MAR, check pertinent findings, shake MDI, prime, and attach to spacer. What must be checked before administering medication? - Answers Check allergies and the medical record. What is the conversion for 1 tablespoon in milliliters? - Answers 1 Tbsp = 15 ml. What is the significance of Cheyne-Stokes respirations? - Answers It is an irregular respiratory pattern that indicates a client is approaching the end of life. What does the term 'death rattle' refer to? - Answers Retention of secretions in the respiratory tract leading to a gurgling sound during breathing. What is the purpose of palliative care? - Answers To lessen the client's distress at the end of life and improve quality of life. What should be done with the MDI before use? - Answers Shake well, prime if necessary, and check the counter. What is the conversion for 1 grain in milligrams? - Answers 1 gr = 60 mg. What is the importance of checking vital signs before medication administration? - Answers To ensure the medication is appropriate based on the client's current health status. What protective equipment should be used during medication administration if indicated? - Answers Nonsterile gloves and personal protective equipment (PPE). What is the first step in instructing a client to use a metered-dose inhaler (MDI)? - Answers Instruct the client to take a deep breath and exhale completely. How should a client position the MDI or spacer when using it? - Answers The mouthpiece should be inserted into their mouth with lips tightly closed around it and the canister in an upright position. What should the client do after depressing the canister of the MDI? - Answers Inhale slowly and deeply for 3 to 5 seconds. What should the client do after inhaling from the MDI? - Answers Hold their breath for 5 to 10 seconds, remove the MDI, and then exhale slowly using pursed lip breathing. What is the recommended wait time before repeating the MDI steps if prescribed for 2 puffs? - Answers Wait 30 seconds before repeating the steps. What should be ensured before leaving the room after medication administration? - Answers Ensure client safety. What is the purpose of evaluating the outcome of medication? - Answers To assess the effectiveness of the medication at the appropriate time frame. What are the routes of medication administration? - Answers Oral (PO), Subcutaneous (SubQ), Transdermal, Otic, Ophthalmic, Rectal, Sublingual, Intramuscular (IM), Intranasal, Topical, Inhalation, Intradermal, Buccal, Epidermal. What are the common injection sites for intramuscular (IM) administration? - Answers Deltoid, Ventrogluteal, Rectus femoris, Vastus lateralis. What is the difference between enteral and parenteral medication administration? - Answers Enteral is absorbed through the digestive tract, while parenteral is absorbed outside of the digestive tract. What is hyponatremia? - Answers A condition where sodium levels are below 135. What factors can place a client at risk for developing hyponatremia? - Answers Medications, chronic or severe vomiting or diarrhea, drinking excess amounts of water, excess alcohol intake, heart, kidney, and liver problems, severe burns. What is hypomagnesemia and what is its threshold? - Answers Hypomagnesemia is a condition where magnesium levels are under 1.5. What are some causes of hypomagnesemia? - Answers Medications, decreased intake, decreased absorption by intestines, increased excretion by gastrointestinal tract or kidneys, excessive alcohol use, diabetes mellitus type 2, undernutrition, severe burns. What is dehydration and how does it occur? - Answers Dehydration occurs from a loss of water or lack of water intake without a concomitant loss of sodium, leading to altered electrolyte-water balance. What are some causes of dehydration? - Answers Diarrhea, vomiting, excessive sweating, excessive urination, illnesses like diabetic ketoacidosis, fever, insufficient intake of water. What are the manifestations of dehydration? - Answers Increased thirst, dry mouth or tongue, fatigue, fever, dizziness, dark-colored urine, lack of urine or sweat. What is the Body Mass Index (BMI) formula? - Answers Weight (in kg) ÷ height (m²). What BMI ranges define underweight, normal, overweight, and obesity? - Answers Underweight: below 18.5, Normal: 18.5-24.9, Overweight: 25.0-29.9, Obesity: 30.0 and above. Why is it important to note that BMI does not account for muscle mass? - Answers Muscle weighs more than fat and may affect BMI calculations. How do you calculate BMI for a client who is 5 feet 4 inches and weighs 170 lb? - Answers Convert weight to kg (170 lb / 2.2046 = 77.11 kg), convert height to meters (64 in × 0.0254 = 1.63 m), then calculate BMI: 77.11 / (1.63)² = 29.17. What category does a BMI of 29.17 fall into? - Answers Overweight. What does NPO stand for in therapeutic diets? - Answers Nothing by mouth; no eating or drinking, often used before surgery or procedures. What is dysphagia? - Answers The inability to safely swallow food. What constitutes a regular diet? - Answers A diet consisting of healthy foods from all food groups, with no restrictions on sugar or sodium. What is a soft diet and when is it prescribed? - Answers A diet containing soft, easy to digest foods, prescribed for clients recovering from surgeries or those with swallowing difficulties. What types of foods are included in a soft diet? - Answers Bland foods such as well-cooked vegetables, low-fiber cereals, tender meats, and creamy peanut butter. What is a pureed diet? - Answers A diet consisting of soft and smooth foods that do not need to be chewed, suitable for clients with chewing or swallowing difficulties. What foods can be consumed on a pureed diet? - Answers Pudding, mashed potatoes, yogurt, baby food, pureed meats, and broths. What is a full liquid diet? - Answers A diet that includes only fluids and foods that are liquids at room temperature, such as ice cream and milkshakes. When might a full liquid diet be prescribed? - Answers After abdominal surgery, for clients experiencing dysphagia, or before certain procedures. What is a clear liquid diet? - Answers A diet consisting of clear liquids like broth, gelatin, and water, intended to be easily digestible. What should be avoided on a clear liquid diet for colon procedures? - Answers Liquids or gelatin with red coloring to prevent confusion with possible bleeding. What is the purpose of a heart-healthy diet? - Answers To improve or maintain cardiovascular health by controlling portions and limiting unhealthy fats. What are key components of a heart-healthy diet? - Answers Increasing fruits and vegetables, whole grains, low-fat proteins, and decreasing sodium intake. What is a renal diet? - Answers A diet for individuals with kidney disease that limits sodium, potassium, and phosphorus intake. What should be avoided in a renal diet? - Answers Potassium-rich foods such as dried beans, tomatoes, oranges, and spinach. What are some examples of foods allowed on a full liquid diet? - Answers Juices, pudding, milkshakes, strained soups, popsicles, and Jell-O. What is the significance of a clear liquid diet? - Answers It helps keep the body hydrated and decreases strain on the digestive system. What types of clients might require a soft diet? - Answers Clients recovering from surgeries on the jaw, mouth, or abdomen, or those taking certain medications. What is the recommended sodium intake for a heart-healthy diet? - Answers No more than 2,300 mg per day. What foods are typically included in a regular diet? - Answers Fruits, vegetables, grains, protein, and dairy sources. Why is it important for clients on a pureed diet to receive adequate nutrients? - Answers To ensure they get necessary protein, carbohydrates, fats, vitamins, and minerals despite food texture limitations. What types of foods should be avoided for high phosphorus content? - Answers Dairy, mushrooms, broccoli, beer, and whole wheat bread. What are the dietary recommendations for managing constipation? - Answers A high-fiber diet, staying well hydrated, exercise, bowel training, and medications to soften stools. What defines constipation in terms of bowel movements? - Answers Infrequent bowel movements, often defined as fewer than three per week, with hard, lumpy stools that are difficult to pass. Who is most at risk for developing constipation? - Answers Pregnant individuals, older adults, those with low fiber intake, certain medications, and GI disorders. What symptoms of constipation require medical attention? - Answers Fever, bleeding from the GI tract, abdominal pain, vomiting, low back pain, and weight loss. What is fecal impaction and when can it occur? - Answers Fecal impaction can occur if constipation is chronic, leading to an obstruction. What interventions can be used for advanced constipation? - Answers A warm mineral oil enema may be used to loosen stool for manual removal; surgery may be needed for complete obstruction. What is diarrhea and what are its characteristics? - Answers Diarrhea is characterized by frequent loose, watery stools and an urgent need to defecate. What are common risk factors for diarrhea? - Answers Infection, medication use, GI disorders, and diet. What complications can arise from persistent diarrhea? - Answers Dehydration and malabsorption, which can be life-threatening if severe. What are the primary interventions for managing diarrhea? - Answers Removing irritating factors and ensuring rehydration; over-the-counter medications may be used for acute cases. What is an ileostomy? - Answers A fecal diversion that uses the terminal end of the small intestine (ileum) for waste elimination. When is a permanent ileostomy created? - Answers When the entire colon, including the rectum and anus, must be removed or bypassed. What is included in ostomy care? - Answers Cleaning the stoma and surrounding skin and replacing the ostomy appliance every 3 days or when leaking. What is a colostomy? - Answers A fecal diversion using part of the colon to form a stoma through the abdominal wall. What is colostomy irrigation and when is it beneficial? - Answers A method to remove stool from the colon, especially beneficial for clients with permanent colostomies. What is the purpose of an enema? - Answers To introduce a solution through the anus into the rectum and sigmoid colon to eliminate solid waste. What equipment is needed for enema administration? - Answers Non-sterile gloves, facility-approved pain assessment tool, stethoscope, enema solutions, and various other supplies. What is the importance of hand hygiene in urinary catheter care? - Answers Good hand hygiene helps reduce the risk of infections such as UTIs and kidney infections. What are potential complications of urinary catheters? - Answers Urinary tract infections (UTIs), kidney infections, and skin complications. What is the role of probiotics in managing diarrhea? - Answers Probiotics help restore intestinal flora and re-create the usual GI environment if a GI infection is present. What should be done if a client has a urinary diversion? - Answers Perform good hand hygiene and monitor for signs of infection. What are the signs of dehydration due to diarrhea? - Answers Signs include dry mouth, decreased urine output, and dizziness. What is the first step in preparing for an enema administration? - Answers Position the client into the left Sims' position with the upper thigh flexed to the chest. What should be done to the enema solution before administration? - Answers Prepare and pour the enema solution into the bag or container and prime the tubing. How high should the enema bag be elevated during administration? - Answers No higher than 18 inches above the patient's anus. What is the purpose of lubricating the end of the enema tubing? - Answers To facilitate the insertion of the rectal tube into the anus. What should the patient be instructed to do before the insertion of the enema tubing? - Answers Take several slow deep breaths.