MED-SURG (NR325) ADULT HEALTH II
FINAL EXAM 2025/2026 QUESTIONS AND
ANSWERS 100% PASS
Neurological Diagnostic Procedures - ANS -Cerebral angiography
-cerebral computed tomography (CT) scan
-Electroencephalography (EEG)
-Glasgow coma Scale (GCS)
-ICP monitoring
-spinal tap
-MRI
-Positron emission tomography (PET)
-single-photon emission computed tomography (SPECT)
-radiography (x-ray)
cerebral angiography - ANS *indications*: assesses bloodflow to/within brain, identifies
aneurysms, defines tumor vascularity, can be used to inject medications
*intraprocedure*
-catheter placed into artery (groin/neck), dye injected, x-rays taken
-catheter removed once pics are finished, closure device/pressure held over artery to control
bleeding by forming a thrombus and sealing the artery off.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Nursing considerations pre-cerebral angiography - ANS -weigh benefits before allowing preg
patient to continue
-instruct client: NPO 4-6 hrs before and void right before
-assess for allergies
-obtain hx of bleeding/anticoags
-assess BUN/creatinine to determine ability to excrete dye
-ensure they're wearing 0 jewelry
-mild relaxing sedative sometimes administered, vitals monitored during.
-client will feel warmth through face and taste something metallic as dye is injected
Nursing considerations post-cerebral angiography - ANS -closely monitor area to ensure
proper clotting
-restrict client's movements depending on procedure used to seal artery
-place ice pack on insertion site
*complications*
-risk for bleeding/hematoma @ site so
--check frequently
--if bleeding occurs, apply pressure & call HCP
-check extremity distal to puncture site for adequate circulation
Intracranial pressure - ANS -normal is 10-15 mmHg, elevation minimizes cerebral circulation
and can lead to brain death
-monitoring is done for ID/treatment of > ICP.
-patients with GCS scores 8 or lower are candidates
-*s/s increased ICP:*
-severe headache
-irritability
-dilated pupils
-slowness
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,-breathing alterations
-motor fxn deterioriateion
-abnormal posturing
Lumbar puncture (spinal tap) - ANS -small amount of CSF withdrawn from spinal canal and
analyzed for constituents
-used to detect presence of diseases (MS, syphilis, meningitis), reduce CSF pressure, administer
meds/chemo, instill medium/air for diagnostics
*possible complications*: brain herniation, bleeding that compresses spinal cord if PT on
anticoags.
Nursing considerations pre-lumbar tap - ANS -ensure all PT jewelry gone
-instruct PT to void before
-instruct PT to get in "cannonball" position to stretch spinal canal
-local anesthetic injected into area, needle is inserted to withdraw CSF, then removed
Nursing considerations post-lumbar tap procedure - ANS -monitor puncture site (client
should remain lying for several hrs to ensure site clots/decrease risk of post-lumbar headache
caused by CSF leakage)
-normal activities may be resumed after bedrest if stable
*complications*
-if clotting doesn't occur, CSF can leak, resulting in headache/infection
-prepare client for epidural blood patch to seal hole in dura if headache continues
Confusion Assessment Method - ANS 1) acute onset and fluctuating course
2) inattention
3) disorganized thinking
4) altered level of consciousness
-used to assess for delirium and confusion
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, Seizures - ANS -abrupt, abnormal electrical discharge of neurons in brain causing alteration
in LOC/motor/sensory ability and behavior
-most likely to occur 24 hrs after stroke due to increased ICP
Patient safety during seizure - ANS -protect client's privacy, keep head off floor and away
from furniture
-provide patent airway, be prepared to suction oral secretions
-turn to side to decrease aspiration risk
-loosen restrictive clothing
-don't try to insert anything in mouth
-document onset/duration of seizure & findings (LOC, apnea, cyanosis, etc) before, during, after
seizure
Patient safety after seizure - ANS -"postictal" phase
-maintain side position to prevent aspiration
-check vitals
-assess for injuries
-perform neuro checks
-allow PT to rest
-reorient/calm client
-determine if client experienced aura (can indicate seizure origin)
-try to determine possible trigger (fatigue maybe)
Seizure medication - ANS -antiepileptic drugs (AED'S) like *phenytoin*
-goal is to ctrl seizure activity with ONE medication
-therapeutic lvls determined via blood tests
-educate client to take med @ same time each day
-drug decline (tolerance) over time may lead to increase in seizures
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
FINAL EXAM 2025/2026 QUESTIONS AND
ANSWERS 100% PASS
Neurological Diagnostic Procedures - ANS -Cerebral angiography
-cerebral computed tomography (CT) scan
-Electroencephalography (EEG)
-Glasgow coma Scale (GCS)
-ICP monitoring
-spinal tap
-MRI
-Positron emission tomography (PET)
-single-photon emission computed tomography (SPECT)
-radiography (x-ray)
cerebral angiography - ANS *indications*: assesses bloodflow to/within brain, identifies
aneurysms, defines tumor vascularity, can be used to inject medications
*intraprocedure*
-catheter placed into artery (groin/neck), dye injected, x-rays taken
-catheter removed once pics are finished, closure device/pressure held over artery to control
bleeding by forming a thrombus and sealing the artery off.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Nursing considerations pre-cerebral angiography - ANS -weigh benefits before allowing preg
patient to continue
-instruct client: NPO 4-6 hrs before and void right before
-assess for allergies
-obtain hx of bleeding/anticoags
-assess BUN/creatinine to determine ability to excrete dye
-ensure they're wearing 0 jewelry
-mild relaxing sedative sometimes administered, vitals monitored during.
-client will feel warmth through face and taste something metallic as dye is injected
Nursing considerations post-cerebral angiography - ANS -closely monitor area to ensure
proper clotting
-restrict client's movements depending on procedure used to seal artery
-place ice pack on insertion site
*complications*
-risk for bleeding/hematoma @ site so
--check frequently
--if bleeding occurs, apply pressure & call HCP
-check extremity distal to puncture site for adequate circulation
Intracranial pressure - ANS -normal is 10-15 mmHg, elevation minimizes cerebral circulation
and can lead to brain death
-monitoring is done for ID/treatment of > ICP.
-patients with GCS scores 8 or lower are candidates
-*s/s increased ICP:*
-severe headache
-irritability
-dilated pupils
-slowness
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,-breathing alterations
-motor fxn deterioriateion
-abnormal posturing
Lumbar puncture (spinal tap) - ANS -small amount of CSF withdrawn from spinal canal and
analyzed for constituents
-used to detect presence of diseases (MS, syphilis, meningitis), reduce CSF pressure, administer
meds/chemo, instill medium/air for diagnostics
*possible complications*: brain herniation, bleeding that compresses spinal cord if PT on
anticoags.
Nursing considerations pre-lumbar tap - ANS -ensure all PT jewelry gone
-instruct PT to void before
-instruct PT to get in "cannonball" position to stretch spinal canal
-local anesthetic injected into area, needle is inserted to withdraw CSF, then removed
Nursing considerations post-lumbar tap procedure - ANS -monitor puncture site (client
should remain lying for several hrs to ensure site clots/decrease risk of post-lumbar headache
caused by CSF leakage)
-normal activities may be resumed after bedrest if stable
*complications*
-if clotting doesn't occur, CSF can leak, resulting in headache/infection
-prepare client for epidural blood patch to seal hole in dura if headache continues
Confusion Assessment Method - ANS 1) acute onset and fluctuating course
2) inattention
3) disorganized thinking
4) altered level of consciousness
-used to assess for delirium and confusion
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, Seizures - ANS -abrupt, abnormal electrical discharge of neurons in brain causing alteration
in LOC/motor/sensory ability and behavior
-most likely to occur 24 hrs after stroke due to increased ICP
Patient safety during seizure - ANS -protect client's privacy, keep head off floor and away
from furniture
-provide patent airway, be prepared to suction oral secretions
-turn to side to decrease aspiration risk
-loosen restrictive clothing
-don't try to insert anything in mouth
-document onset/duration of seizure & findings (LOC, apnea, cyanosis, etc) before, during, after
seizure
Patient safety after seizure - ANS -"postictal" phase
-maintain side position to prevent aspiration
-check vitals
-assess for injuries
-perform neuro checks
-allow PT to rest
-reorient/calm client
-determine if client experienced aura (can indicate seizure origin)
-try to determine possible trigger (fatigue maybe)
Seizure medication - ANS -antiepileptic drugs (AED'S) like *phenytoin*
-goal is to ctrl seizure activity with ONE medication
-therapeutic lvls determined via blood tests
-educate client to take med @ same time each day
-drug decline (tolerance) over time may lead to increase in seizures
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
