Exam 4: NUR242/ NUR 242 | Question and verified Answers| Latest 2025/ 2026 Update | Medical – Surgical Nursing Concepts | 100% Correct | GRADED A – Galen

Exam 4: NUR242/ NUR 242 | Question and verified Answers| Latest 2025/ 2026 Update | Medical – Surgical Nursing Concepts | 100% Correct | GRADED A – Galen Question: Normal BP Answer: Systolic 120 / Diastolic 80 Question: Pre-HTN Answer: Systolic =120-139 / Diastolic=80-89 Question: Stage 1 HTN Answer: Systolic=140-159 / Diastolic=90-99 Question: Stage 2 HTN Answer: Systolic=160 / Diastolic=100 Question: Malignant HTN Answer: Extremely high BP 180/110 Question: S/S of Malignant HTN Answer: initially asymptomatic, headache upon awakening, blurred vision, dizziness, chest pain, difficult breathing, numbness in face and legs, tinnitus, flushed face, epistaxis Question: HTN Crisis Answer: acute and life threatening; accelerated HTN requires ER treatment because organ damage can occur quickly Question: Pharmacological interventions for HTN Answer: ACE Inhibitors, Diuretics, Calcium Channel Blockers, ARBs, and Beta Blockers Question: What symptom should you report right away with ACE Inhibitors? Answer: Dry nagging cough- discontinue immediately and teach about orthostatic HTN in elderly Question: What is an example of an ACE inhibitor drug? Answer: Lisinopril, Enalapril Question: What is an example of a Calcium Channel Blocker? Answer: Verapamil, Amlodopine Question: What is an example of an ARB? Answer: Losartan, Valsartan Question: What is an example of a Beta Blocker? Answer: Metoprolol, Atenolol Question: Pt. teaching for Raynauds disease Answer: Stop smoking, avoid cold and stress, wear warm clothing, take vasodilators as prescribed Question: Pt. teaching for Burgers Disease Answer: Use vasodilators as prescribed, smoking cessation, avoid injury to upper and lower extremities, can cause gangrene Question: S/S of Peripheral Arterial Disease (PAD) Answer: Leg pain, burning, cramping muscle discomfort when walking that stops at rest. As the disease persists the pt can walk shorter distances Question: Post-OP Care for Femoral Artery Bypass graft? Answer: warmth, redness and edema are expected. Monitor for possible occlusion and continuous aching pain (first sign of occlusion) Throbbing pain is due to increased blood flow to the area. Question: Notify the physician immediately if they experience what S/S after a femoral artery graft? Answer: Cold, pale, cyanotic skin or decreased pulse Question: Amputation complications: Answer: infection, phantom limb pain, flexion contractions Question: Amputation Post-OP care: Answer: -DO NOT elevate limb on pillow (can cause flexion contractures) -1st 24 hours elevate the foot of the bed to decrease edema then keep the bed flat -24-48 hours- place the pt. in prone position to stretch muscles and prevent hip flexion contractures Question: Pt with a DVT is at high risk for? Answer: PE Question: DVT S/S Answer: -calf/groin tenderness -sudden unilateral swelling -positive Homans sign Question: DVT Risk Factors Answer: -venous stasis from varicose veins -heart failure -immobility -use of birth control -ulcerative colitis -prolonged bedrest Question: DVT interventions: Answer: -SCDs -Compression hose -Elevate extremities -IV continuous Heparin Question: When a pt. is on IV continuous Heparin, what lab values do you monitor? Answer: aPTT Values Question: What is the normal aPTT range? Answer: 30-40 seconds 1.5-3 times normal control levels Call the MD if 70 seconds Question: Normal PT level: Answer: 11-12.5 seconds -1.5-2.5 times normal control level when on Coumadin Question: Normal PTT level: Answer: 60-70 seconds -1.5-2.5 times the normal control on Heparin Question: Normal INR level: Answer: 0.9-1.2 seconds Miserable therapeutic level is 2-3 times the normal Question: Normal total cholesterol level: Answer: 140-199 Question: Normal LDL level: Answer: 130 Question: Normal HDL level: Answer: 30-70 Question: Normal triglyceride level: Answer: 200 Question: Where do you listen for the Aortic sound? Answer: 2nd Intercostal space, RSB Question: Where do you listen for the Pulmonic sound? Answer: 2nd intercostal space, LSB Question: Where do you listen for Erbs Point? Answer: 3rd intercostal space, LSB Question: Where do you listen to the Tricuspid? Answer: 4th intercostal space, LSB Question: Where do you listen to the Mitral sound? Answer: 5th intercostal space, mid-clavicular line Question: What is the only sound heard on the RSB? Answer: Aortic Question: Pre-OP teaching for Cardiac Cath Answer: -Might experience palpitations when the catheter is passed through the left ventricle -Feel heat or hot flash when the dye is injected -Urge to cough when the dye is injected to the RIGHT side of the heart Question: Post-OP for Pacemaker Answer: -Report fever, redness, swelling or drainage to MD -Keep ID card in wallet or wear medical alert bracelet -Know rate of pacemaker -Avoid tight clothing Question: What symptoms do you report to the MD if you have a pacemaker? Answer: -SOB -Dizziness -Chest Pain -Fainting -Weight gain -Hiccups (Check pulse at time of incident for any of these) Question: S/S of RIGHT sided heart failure Answer: -Dependent edema -JVD -Abdominal distention -Hepatomegaly -Splenomegaly -Anorexia/nausea -Weight gain -Nocturnal diuresis -Swelling of fingers/hands Question: What lab values are used to confirm heart failure? Answer: BNP Question: S/S of Pulmonary Edema: Answer: -Severe dyspnea or orthopnea -Pallor -Tachycardia -Tachypnea -Expectoration of blood tinged frothy sputum -Wheezing/ crackles in the lungs -Anxiety -Nasal flaring -Use of accessory muscles Question: S/S of Bradycardia: Answer: -Confusion -Syncope (fainting) -Dizziness -Weakness -Hypotension -SOB -Angina Question: Bradycardia treatment: Answer: Atropine, epi, dopamine, IV fluids, O2 S/S of V-Tach: Answer: -Angina -Syncope (fainting) -Light headedness -Dizziness -SOB Question: V-Tach Treatment: Answer: -O2 -Confirm with 12 lead EKG -Mag Sulfate -Lidocaine -Amiodarone Question: S/S of V-Fib: Answer: -fainting/loss of consciousness -no pulse -no breathing -no BP or heart sounds Within minutes pupils become fixed and dilated, skin cold and mottled Question: V-Fib treatment: Answer: -DEFIBRILATION IS PRIORITY! -Do CPR until defib is available -Vasopressin, Epi, Amiodarone, lidocaine, mag sulfate, O2 Question: What seizure lasts longer than 5 minutes or repeated seizures over 30 minutes? Answer: Status Epilepticus (Medical Emergency) Question: What medication do you give a pt in status epileptics? Answer: IV push lorazepam or diazepam Question: What is the priority for a pt in tonic clonic seizure? Answer: Keep pt safe and patent airway Question: S/S of MS: Answer: -Dysarthria -Dysphagia -Fatigue -Muscle weakness and spasticity -Decreased visual and hearing acuity -Tremors -Paresthesia -Ataxia -Abnormal reflexes -Memory changes -Confusion -Blurred vision Question: MS pt. teaching: Answer: -wear eye patch and alternate to relieve diplopia -teach bladder care and self-cath -Reduce stress -Continue social activities -Drink 2L of H2O daily -CAM therapies -Marijuana where legal Question: What is Parkinsons disease? Answer: PROGRESSIVE neurodegenerative disease that affects motor ability Question: 4 Cardinal symptoms of Parkinsons? Answer: -Tremors in hands and fingers at rest (pill rolling)-increased with fatigue -Bradykinesia or akinesia (slow or no movement) -Rigidity -Postural instability Question: Parkinsons interventions: Answer: -Give anti-parkinsonian meds to INCREASE DOPAMINE - Avoid rushing the pt during ADLs -Plan activités around time when they have the most energy -Promote independence with safety measures Question: What type of diet should a person with Parkinsons eat? Answer: High calorie, high protein, high fiber soft diet Question: You should encourage a pt with Parkinsons to do what when ambulating? Answer: Lift their feet when walking and proper posture Question: Reversible Ischemic Neurologic Deficit (RIND) treatment: Answer: -Anticoagulant therapy- clopidogrel (Plavix) -Educate pt on bleeding precautions Question: Risk factors for CVA: Answer: -Smoking -Substance abuse -Obesity -Sedentary lifestyle -Birth control -Heavy ETOH use -use of PPA (antihistamines) Question: Treatment for acute ischemic stroke? Answer: Fibrinolytic therapy An early intervention that is the standard of practice to improve blood flow to the brain Question: what is rtPA (retavase) used for? Answer: To break down fibrin. Only given within 3-4.5 hours from the time the pt was last seen normal Question: Low back pain prevention: Answer: -no high heels -Proper body mechanics -exercise Question: What medications are given for migraines? Answer: Triptan drugs- should not be taken with SSRI antidepressants Question: Care of hearing aids: Answer: -Keep dry -Wash ear mold with mild soap and water -Clean debris from holes with toothpick -Avoid hair spray Question: Pt education for Meziere's Disease: Answer: -Move head slowly to prevent worsening vertigo -Smoking cessation -Avoid food/fluids with high sodium -Avoid caffeine -Avoid food with MSG Question: Primary open angle glaucoma: expected outcomes Answer: -Prevent blindness by early detection -Lifelong treatment -Close monitoring with follow up Question: How to instill eye drops? Answer: -Do not skip any doses -When using more than one wait 10-15 minutes in between to prevent diluting the other drug Question: How to admin eye ointment? Answer: From nose outward Question: S/S of age-related macular degeneration Answer: -Decline in central vision -Blurred vision -happens faster in smokers Question: Pt education after cataract surgery: Answer: -avoid eye straining -use an eye shield while sleeping -provide written time schedule for all eye drops -eye itching is common, avoid rubbing eyes Question: S/S of Retinal Detachment: Answer: -flashes of light -floaters or black spots -increase in blurred vision -sense of a curtain being pulled over eyes -loss of part of the visual field Question: Pt education for Osteoporosis: Answer: -Encourage exercise that strengthens abdominal and back muscles -Boniva only needs to be taken every third month Question: Risk factors for Osteoarthritis (DJD) Answer: -trauma -aging -obesity -genetic changes -smoking Question: Osteoarthritis goal: Answer: prevent or decrease modifiable risk factors Question: S/S of RA: Answer: -inflammation -tenderness -stiffness of the joints -moderate to severe pain with morning stiffness that lasts longer than 30 minutes -joint deformities -spongy, soft feeling joints Question: S/S of compartment syndrome: Answer: -initially the pt will have paresthesia -unrelieved or increased pain in the limb -pain with passive movement -tissue that is distal to the involved area becomes pale, dusky, or edematous Question: What medication is used to treat gout? Answer: Allopurinol Question: What medication should not be used in older adults due to toxic metabolites that can cause seizures and other complications? Answer: Meperidine (Demerol) Question: S/S of osteomyelitis: Answer: -Constant pain not relieved even with movement -Will be on antibiotics for at least 6 weeks -Fever usually 101 Question: S/S of fat embolism: Answer: -Assess for restlessness -call the MD immediately if so Question: Pt who have had a long bone fracture are at risk for _______ which is the #1 complication. Answer: Fat embolism Question: What medication do you give a pt who develops an "ACE cough" Answer: ARBs (Losartan, Valsartan) Question: Expected finding for a pt with Burgers disease? Answer: Intermittent claudication, ischemic pain in the digits at rest Question: S/S of intermittent claudication: Answer: -Burning -Cramping/burning when walking that stops at rest Question: What medication do you hold when a pt is experiencing bradycardia? Answer: Beta Blockers Question: If a pt is asymptomatic with bradycardia, what is the recommended drug treatment? Answer: None Question: If a pt is symptomatic with bradycardia what medication is given? Answer: IV atropine Question: What assessment is priority for a pt with V-tach? Answer: ABC's and LOC Question: What position should you place a pt in who is having a seizure? Answer: On their side to keep the airway patent Question: Pt education for MS, what to avoid? Answer: -Extreme temps -People with infections -Stress Question: What assessment needs to be done hourly for the first 24 hours on a patient how had an acute ischemic stroke? Answer: Neuro assessment Question: Assessment for pt with anterior cervical discectomy: Answer: -Monitor for Respiratory difficulty -Pts ability to swallow -Hoarsness and ability to cough (can indicate laryngeal nerve damage) Question: How should the patient be positioned after taking risedronate (Actonel)? Answer: Sitting upright for 30-60 minutes Question: How should allopurinol be taken? Answer: -With food with a full glass of water -Increase fluids to prevent renal dysfunction (for GOUT) Question: A patient with claudication, what pulse is decreased in blood flow more noted? Answer: Posterior tibial Question: A pt with intermittent claudication says "i have pain in my calf and ankle, is this a sign of the above"? Answer: Yes