MED SURG NSG 233 EXAM| NSG 233 MED
SURG III EXAM 2 ACTUAL EXAM WITH Q&A
NEWLY MODIFIED EXAM TESTED AND
APPROVED!!!
What is an important patient teaching point for a young woman who is taking
Phenytoin? -- ANSWER--Oral contraceptives are less effective when taking this
medication. Therefore, you should use other forms of contraception in addition
to oral contraceptives if you choose to be sexually active.
What are the side effects of Phenytoin and what are some patient teaching
points? -- ANSWER--S/E: nausea, vomiting, drowsiness, lethargy, and ataxia.
Pt teaching: maintain good oral hygiene to prevent gum disease! Also, use
contraception, oral contraceptives are less effective when taking Phenytoin.
What is Propofol and what is it used for? -- ANSWER--It is an IV anesthetic
(sedative/hypnotic).
Used for induction and maintenance of general anesthesia. It provides smooth
hypnosis in less than one minute.
It blocks the perception of pain by producing amnesia, euphoria, and hypnosis.
Page 1 of 40
,However, it does not provide analgesia.
What is the cardinal behavioral sign of a frontal lobe traumatic brain injury? --
ANSWER--Bizarre or irrational behavior.
What is the cardinal neurologic sign of a temporal lobe traumatic brain injury? -
ANSWER--Amnesia or disorientation.
What are some nursing interventions for a TBI? -- ANSWER--- Maintain a
patent airway.
- monitor neurologic function (neuro checks).
- monitor vitals (look for Cushing's triad).
- POSITION HOB AT 30 DEGREES WITH THE NECK IN A
NEUTRAL POSITION TO PROTECT C-SPINE.
- assess motor function.
- monitor for fluid and electrolyte imbalances, especially sodium.
- promote adequate nutrition.
- maintain thermoregulation.
- maintain skin integrity.
- early administration of anticonvulsants.
- maintain cerebral perfusion pressure.
Page 2 of 40
,What can hyponatremia cause? What precautions do we need to place our
patient on because of this? -- ANSWER--Seizures!
Seizure precautions.
What should cerebral perfusion pressure be maintained at? -- ANSWER--Above
50 mmHg.
What are three common symptoms for a patient coming out of a coma? --
ANSWER--1. agitation.
2. restlessness.
3. incontinence.
May also experience lethargy and stupor.
What do unilaterally dilated and poorly responding pupils indicate? --
ANSWER--The development of a hematoma, with subsequent pressure on the
third cranial nerve due to shifting of the brain.
What is the medication Phenytoin (Dilantin) used for? -- ANSWER--Used to
control seizures!
Page 3 of 40
, Upon discharge, which s/s would you teach the patient to return to the
emergency department if they begin experiencing? -- ANSWER--- decreased
LOC.
- worsening headache.
- Dizziness.
- Seizures.
- Abnormal pupil response.
- vomiting.
- irritability.
- slurred speech.
- weakness or numbness of the extremities.
What are the three cardinal signs of brain death? -- ANSWER--1. coma.
2. absence of reflexes.
3. apnea.
What GCS score indicates a severe traumatic brain injury? -- ANSWER--A
score of 3-8.
What are the three signs of the Cushing's Triad and what do they indicate? --
ANSWER--1. Bradycardia (decreased heart rate).
2. Widening pulse pressure (SBP is rising).
3. Irregular respirations.
Page 4 of 40
SURG III EXAM 2 ACTUAL EXAM WITH Q&A
NEWLY MODIFIED EXAM TESTED AND
APPROVED!!!
What is an important patient teaching point for a young woman who is taking
Phenytoin? -- ANSWER--Oral contraceptives are less effective when taking this
medication. Therefore, you should use other forms of contraception in addition
to oral contraceptives if you choose to be sexually active.
What are the side effects of Phenytoin and what are some patient teaching
points? -- ANSWER--S/E: nausea, vomiting, drowsiness, lethargy, and ataxia.
Pt teaching: maintain good oral hygiene to prevent gum disease! Also, use
contraception, oral contraceptives are less effective when taking Phenytoin.
What is Propofol and what is it used for? -- ANSWER--It is an IV anesthetic
(sedative/hypnotic).
Used for induction and maintenance of general anesthesia. It provides smooth
hypnosis in less than one minute.
It blocks the perception of pain by producing amnesia, euphoria, and hypnosis.
Page 1 of 40
,However, it does not provide analgesia.
What is the cardinal behavioral sign of a frontal lobe traumatic brain injury? --
ANSWER--Bizarre or irrational behavior.
What is the cardinal neurologic sign of a temporal lobe traumatic brain injury? -
ANSWER--Amnesia or disorientation.
What are some nursing interventions for a TBI? -- ANSWER--- Maintain a
patent airway.
- monitor neurologic function (neuro checks).
- monitor vitals (look for Cushing's triad).
- POSITION HOB AT 30 DEGREES WITH THE NECK IN A
NEUTRAL POSITION TO PROTECT C-SPINE.
- assess motor function.
- monitor for fluid and electrolyte imbalances, especially sodium.
- promote adequate nutrition.
- maintain thermoregulation.
- maintain skin integrity.
- early administration of anticonvulsants.
- maintain cerebral perfusion pressure.
Page 2 of 40
,What can hyponatremia cause? What precautions do we need to place our
patient on because of this? -- ANSWER--Seizures!
Seizure precautions.
What should cerebral perfusion pressure be maintained at? -- ANSWER--Above
50 mmHg.
What are three common symptoms for a patient coming out of a coma? --
ANSWER--1. agitation.
2. restlessness.
3. incontinence.
May also experience lethargy and stupor.
What do unilaterally dilated and poorly responding pupils indicate? --
ANSWER--The development of a hematoma, with subsequent pressure on the
third cranial nerve due to shifting of the brain.
What is the medication Phenytoin (Dilantin) used for? -- ANSWER--Used to
control seizures!
Page 3 of 40
, Upon discharge, which s/s would you teach the patient to return to the
emergency department if they begin experiencing? -- ANSWER--- decreased
LOC.
- worsening headache.
- Dizziness.
- Seizures.
- Abnormal pupil response.
- vomiting.
- irritability.
- slurred speech.
- weakness or numbness of the extremities.
What are the three cardinal signs of brain death? -- ANSWER--1. coma.
2. absence of reflexes.
3. apnea.
What GCS score indicates a severe traumatic brain injury? -- ANSWER--A
score of 3-8.
What are the three signs of the Cushing's Triad and what do they indicate? --
ANSWER--1. Bradycardia (decreased heart rate).
2. Widening pulse pressure (SBP is rising).
3. Irregular respirations.
Page 4 of 40
