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TABLE OF CONTENTS
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
1. Cardiovascular Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Musculoskeletal, Trauma, and Orthopedic Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3. Eyes, Ears, Nose, and Throat (EENT) Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
4. Pulmonary Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
5. Gastrointestinal Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
6. Homeostasis, Metabolic and Endocrine Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
7. Neurology Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
8. Infectious Disease/Rheumatology/Immunology Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
9. Genitourinary/Renal Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
10. Resuscitation and Shock Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
11. Hematology/Oncology Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
12. Reproductive System Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
13. Dermatology Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
14. Patient Care Management Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
,vi Medical-Surgical Nursing Certification Examination Review ...
15. Organization and Personnel Management Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
16. Legal Issues and Quality Improvement Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
17. Wound Care Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
18. Perioperative Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
, CHAPTER 1 Cardiovascular Pearls
❍ What is the leading cause of death and disease in the United States?
Coronary artery disease (CAD), where arteries narrow from placques which partially or totally occlude the coronary
artery vasculature.
❍ What is the usual cause of an AMI (acute myocardial infarction)?
The coronary arteries develop a thrombus or blood clot formation at the site of a ruptured or narrow placque which
leads to acute symptoms of chest pain (angina), hypotension, and dysfunction of the heart. Treatment is directed
at reopening the artery and medical or surgical stabilization.
❍ What are the risk factors for coronary artery disease that cannot be modified?
Gender (males higher risk), family history of heart disease, and increasing age.
❍ A medsurg nurse is discharging a patient who was diagnosed and treated for a heart attack. What are the risk
factors for coronary artery disease than CAN be modified or treated to decrease this disease?
Diet (lower fat, salt), hypertension, obesity, diabetes, cigarette smoking, sedentary lifestyle, high levels of
triglycerides and low-density lipoprotein, and stress level (type A personality carries higher risks).
❍ What is the number one cause of preventable death in the United States?
Cigarette smoking. A medsurg nurse, who convinces or assists their patients to stop smoking, does a tremendous
service for the patient and their family.
❍ What is the most common symptom of aortic dissection?
Interscapular back pain. Classically is a sharp, tearing, severe pain.
❍ What side effect is expected with too rapid an infusion of procainamide?
Hypotension. Other side effects include: myocardial depression, QRS/QT prolongation, V-fib, and torsade de
pointes.
❍ What are the adverse drug effects of lidocaine?
Drowsiness, nausea, vertigo, confusion, ataxia, tinnitus, muscle twitching, respiratory depression, and psychosis.
ECG changes may be seen also.
1
Copyright © 2007 by The McGraw-Hill Companies, Inc. Click here for terms of use.
TABLE OF CONTENTS
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
1. Cardiovascular Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Musculoskeletal, Trauma, and Orthopedic Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3. Eyes, Ears, Nose, and Throat (EENT) Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
4. Pulmonary Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
5. Gastrointestinal Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
6. Homeostasis, Metabolic and Endocrine Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
7. Neurology Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
8. Infectious Disease/Rheumatology/Immunology Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
9. Genitourinary/Renal Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
10. Resuscitation and Shock Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
11. Hematology/Oncology Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
12. Reproductive System Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
13. Dermatology Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
14. Patient Care Management Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
,vi Medical-Surgical Nursing Certification Examination Review ...
15. Organization and Personnel Management Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
16. Legal Issues and Quality Improvement Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
17. Wound Care Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
18. Perioperative Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
, CHAPTER 1 Cardiovascular Pearls
❍ What is the leading cause of death and disease in the United States?
Coronary artery disease (CAD), where arteries narrow from placques which partially or totally occlude the coronary
artery vasculature.
❍ What is the usual cause of an AMI (acute myocardial infarction)?
The coronary arteries develop a thrombus or blood clot formation at the site of a ruptured or narrow placque which
leads to acute symptoms of chest pain (angina), hypotension, and dysfunction of the heart. Treatment is directed
at reopening the artery and medical or surgical stabilization.
❍ What are the risk factors for coronary artery disease that cannot be modified?
Gender (males higher risk), family history of heart disease, and increasing age.
❍ A medsurg nurse is discharging a patient who was diagnosed and treated for a heart attack. What are the risk
factors for coronary artery disease than CAN be modified or treated to decrease this disease?
Diet (lower fat, salt), hypertension, obesity, diabetes, cigarette smoking, sedentary lifestyle, high levels of
triglycerides and low-density lipoprotein, and stress level (type A personality carries higher risks).
❍ What is the number one cause of preventable death in the United States?
Cigarette smoking. A medsurg nurse, who convinces or assists their patients to stop smoking, does a tremendous
service for the patient and their family.
❍ What is the most common symptom of aortic dissection?
Interscapular back pain. Classically is a sharp, tearing, severe pain.
❍ What side effect is expected with too rapid an infusion of procainamide?
Hypotension. Other side effects include: myocardial depression, QRS/QT prolongation, V-fib, and torsade de
pointes.
❍ What are the adverse drug effects of lidocaine?
Drowsiness, nausea, vertigo, confusion, ataxia, tinnitus, muscle twitching, respiratory depression, and psychosis.
ECG changes may be seen also.
1
Copyright © 2007 by The McGraw-Hill Companies, Inc. Click here for terms of use.
