NSG 4800/ NSG4800 Comprehensive Exam 1 – Professional Nursing Practice 2026/2027 | Galen | Latest Questions & Verified Answers

NSG 4800/ NSG4800 Comprehensive Exam 1 – Professional Nursing Practice 2026/2027 | Galen | Latest Questions & Verified Answers Q: What would you determine to be a significant drop in blood pressure? Answer A drop of 20 "points" from where it was originally can be concerning Q: What is in a UAP scope of practice? Answer Assist with ADLS, Vitals after the first set is assessed by RN and patient is stable, cleaning up patients Q: LPN Scope of practice Answer 1. monitoring RN findings 2. reinforcing education 3. routine procedures (catheterization) 4. most med administraions 5. ostomy care 6. tube patency and enterl feeding 7. specific assessments (like lung, bowel, neurovascular checks) Q: What can LPNS not do Answer - can't administer some meds - can't initiate assessments - can't do initial patient education - can't start blood transfusions Q: What are the rules around using medical interpreter? Answer Should always be used Can not use family as interpreter Can not use Google translate Q: What is Rho(D) or RhoGAM? Why is it used? What does it do? Answer It's commonly given to Rh-negative pregnant mothers who are expecting a Rh-positive baby. RhoGAM contains a type of antibody called an immunoglobulin that stops the mother's body from making Rh antibodies against the baby's blood. Q: when do you give Rhogam When at 28 wks and within 72 hours after birth of an Rh + infant or abortion. Answer also, given if bleeding occurs during pregnancy or after an amniocentesis (the sampling of amniotic fluid using a hollow needle inserted into the uterus, to screen for developmental abnormalities in a fetus.). Q: What interventions help to decrease a high fetal heart rate in labor? Answer Okay as long as patient is in labor means baby is well oxygenated Can give medications that can pass through placenta Q: Normal Fetal heart range for third trimester baby Answer 110-160 Q: Normal vital signs for infant (0- 12 months ) Answer HR- 100-180 Bp- 72-104 / 37-56 RR- 30-53 Q: Normal vital signs for toddler (1-2 years) Answer HR 98-140 RR- 22-47 BP- 86-106 / 42-63 Q: Normal Vital signs for Preschooler ( 3-5 years) Answer HR- 80-120 RR-20-28 BP- 89-112 / 46-72 Q: Normal vital signs for school age ( 6-9 years ) Answer HR- 75-118 RR- 18-25 BP- 97-115 / 57-76 Q: infant appropriate toys Answer Explores with their hands mouth and eyes. enjoy toys that they can touch and squeeze. Crib gyms, activity mats, squeaky toys, soft dolls or stuffed animals Q: toddler appropriate toys Answer -parallel play -push/pull toys -thick crayons -finger paints -blocks 4-5 year old appropriate toys Answer nontoxic art suppulys Play toys like money or phones teddy bears or dolls outdoor toys such as trycicles 6-9 year old age appropriate toys Answer Arts and craft kits Puppets jump ropes miniature dolls and action figures 10-14 year old appropriate play Answer Handheld electronic games board games Sports equipment model kits musical insturments One month milestones Answer can turn head from side to side when prone, lifts head momentarily from bed weight gain of 5-7 oz weekly for first 6 mos height gain of 1 inch monthly for first 6 mos head circumference increases 6/10 of an inch monthly for first 6 mos two month milestones Answer Calms down when spoken to or picked up Looks at your face Seems happy to see you when you walk up to her Smiles when you talk to or smile at her Makes sounds other than crying Reacts to loud sounds Watches you as you move Looks at a toy for several seconds Holds head up when on tummy Moves both arms and both legs Opens hands briefly four month milestones Answer Smiles on his own to get your attention Chuckles (not yet a full laugh) when you try to make him laugh Looks at you, moves, or makes sounds to get or keep your attention Makes sounds like "oooo", "aahh" (cooing) Makes sounds back when you talk to him Turns head towards the sound of your voice If hungry, opens mouth when he sees breast or bottle Looks at her hands with interests Holds head steady without support when you are holding him Holds a toy when you put it in his hand Uses his arm to swing at toys Brings hands to mouth Pushes up onto elbows/forearms when on tummy Six month milestones Knows familiar people Likes to look at self in a mirror Laughs Takes turns making sounds with you Blows "raspberries" (sticks tongue out and blows) Makes squealing noises Puts things in her mouth to explore them Reaches to grab a toy she wants Closes lips to show she doesn't want more food Rolls from tummy to back Pushes up with straight arms when on tummy Leans on hands to support herself when sittin nine month milestones is shy, clingy, or fearful around strangers Shows several facial expressions, like happy, sad, angry, and surprised Looks when you call her name Reacts when you leave (looks, reaches for you, or cries) Smiles or laughs when you play peek-a-boo Makes a lot of different sounds like "mamamama" and "bababababa" Lifts arms up to be picked up Looks for objects when dropped out of sight (like his spoon or toy) Bangs two things together Movement/Physical Development Milestones Gets to a sitting position by herself Moves things from one hand to her other hand Uses fingers to "rake" food towards himself Sits without support 12 month mile stones Plays games with you, like pat-a-cake Waves "bye-bye" Calls a parent "mama" or "dada" or another special name Understands "no" (pauses briefly or stops when you say it) Puts something in a container, like a block in a cup Looks for things he sees you hide, like a toy under a blanket Pulls up to stand Walks, holding on to furniture Drinks from a cup without a lid, as you hold it Picks things up between thumb and pointer finger, like small bits of food Hepititis B vaccines is given at birth What vaccines are given at two months (Dose 1) Polio Pneumococcal Hib Dtap Rotavirus Hep B (2nd dose) What vaccines are given at four months (Dose 2) Polio Pneumococcal Hib Dtap Rotavirus What vaccines are given at six months (Dose 3) Polio Pneumococcal Hib Dtap Rotavirus What vaccines are given at twelve months Pneumococcal Hib MMR (first) Chicken Pox (first) Hep A (First, doses have to be operated by six months) Vaccines given at four to six years Dtap Polio MMR Chicken pox Flu shots Shouldn't be given to immunocompromised or patients under six months old VEAL CHOP MINE V- Variable C- Cord Comphression M- Maternal Repositioning E- Early Decels H- Head Compression I- Identify Labor Progress A- Accelerations O - OK N- Nothing L-Late Decels P - Placenta E- Execute interventions What are signs of kidney transplant rejection? Acute: (1 wk-2yrs post op), oliguria, anuria, increased temp (37.8C), increased BP, flank tenderness, lethargy, decreased specific gravity, fluid retention. Chronic: (over months to yrs), gradual increase in BUN/creatinine, imbalances in electrolytes, fatigue. how do you apply compression stockings? Hold the top of the stocking and roll it down to the heel. Put your foot into the stocking as far as you can. ... Pull the stocking up. ... After the top of the stocking is in place, smooth out any wrinkles. Do not let the stockings bunch up or wrinkle How do you care for a NG tube to suction? Take Xray before hooking up Check PH to make sure its In the stomach (1.5-3.5) Make sure tube is the same length and document it How to care for a tracheostomy maintain a open airway maintaining pt comfort admin oxygen provide transport Signs of problems with tracheostomy leeding at the tracheostomy site or from the windpipe. Having a hard time breathing through the tube. Pain or a change in comfort level. A change in skin color or swelling around the tracheostomy. What are interventions in the care of a patient receiving internal radiation? Patient should have their own personal bathroom no one else can use it People can wear lead aprons If something falls out of patient use tongs and seal in raidoactice container What teaching do you provide for the patient receiving external radiation? Skin over target area will be marked, do no wash off these marks. Wash skin over affected area with mild soap and water, gently pat dry. Do not apply lotions, powders, ointments to irradiated skin. 1. The maximum amount of hours someone can spend at the bedside of a radiation therapy patient is ---2 Hours! Who is a red tag Immideate emergency chest pain, severe respiratory distress limb amputation, acute neurological deficits. Who is a black tag Dead or dying with or without medical intervention Who is a yellow tag triage Urgent but not immediate Multiple fractures (Closed) Who is a green tag triage Minimal injuries could be urgent care worthy Hyperkalemia S/S (3.5-5) M.U.R.D.E.R. M - Muscle weakness U - Urine, oliguria, anuria R- Respiratory distress D - Decreased cardiac contractility E - ECG changes peaked T waves R - Reflexes, hyperreflexia, or areflexia (flaccid) Hypokalemia S/S (3.5-5) Fatigue, Anorexia, N/V, Muscle weakness, Decreased GI motility, Dysrhythmias, Paresthesia, Flat T waves on ECG Hyponatremia S/S (135-145) Nausea Muscle cramps Confusion Muscular twitching, coma Seizures Headache Hypernatremia S/S (135-145) You are 'fried' or S.A.L.T. F - Fever (low grade), flushed skin R - Restless (irritable) I - Increased fluid retention and increased BP E - Edema (peripheral and pitting) D - Decreased urinary output, dry mouth S = Skin flushed A = Agitation L = Low-grade fever T = Thirst Hypocalcemia signs and symptoms (9-11) Numbness and tingling of fingers and circumoral (around mouth) region, hyperactive reflexes, positive Trousseau's sign (carpopedal spasm with hypoxia), positive Chvostek's sign (contraction of facial muscles when facial nerve is tapped), tetany, muscle cramps, and pathological fractures (chronic hypocalcemia) Hypercalcemia S/S (9-11) Muscle weakness, Constipation, Anorexia, N/V, Polyuria, Polydipsia, Neurosis, Dysrhythmias, What is epiglottitis - a serious obstructive inflammatory process; there is absence of a cough, presence of dyspahgia , drooling, and rapid progression to severe resp. distress - NEVER USE A TONGUE DEPRESSOR Do not assess throat prepare to intubate What is impetigo? Contagious bacterial infection marked by clusters of small blisters Red base may develop into a yellow crust (Stops being contagious after lesions crust over or 48 hours after antibiotics) What is sickle cell A group of disorders that cause red blood cells to become misshapen and break down. What could prevent a patient from having a sickle cell crisis Avoid alcohol and smoking Stay in low altitudes Stay away from crowds Stay hydrated Low stress What is peptic ulcer disease A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum Interventions for Peptic ulcer disease Stop Nsaids Avoid Alcohol What are signs/symptoms of meningitis Chills and fever, severe headache, nausea and vomiting, nuchal rigidity, photophobia, Stiff Neck What is the difference between bacterial/viral Meningitis Viral meningitis: temporary, flu-like symptoms, headache, and stiff neck. Bacterial meningitis: possibility of varying degrees of brain damage, including hearing loss and mental retardation. Can be fatal if not treated in time. What do you do if a low pressure alarm sounds on a ventilator Low pressure alarms are usually caused by a leak or disconnect. Start at the patient and work your way towards the vent checking for loose connections. What do you do if a High pressure alarm sounds on a ventilator high-pressure alarm indicates increased resistance to airflow, which could be caused by secretions or mucus in the airways. Suctioning is the appropriate intervention to clear the airways of excess secretions, reducing airway resistance and preventing the high-pressure alarm What are standard precautions They are used during every patient interaction. Includes: hand hygiene, use of PPE, respiratory hygiene, safe injection practices, and disinfection of soiled surfaces and equipment. What are droplet precautions? Droplets are generated by a person coughing, sneezing, or talking and can invade the the hosts nasal mucosa, conjunctiva, or mouth. Examples: flu, pneumonia, meningitis. Hand washing, PPE, face mask while in the room. What are airborne precautions? Used when an individual has a suspected or known infection that is transmitted via the airborne route. Examples: TB, chickenpox. Hand washing, PPE, N95 (filter) face mask before entering the room. What are contact precautions? Used when patients have diarrhea, draining wounds / sores, vomiting, draining body fluids. The pathogen can invade the body by direct contact or contact with an infected object. Examples: HIV, ebola hepatitis Hand washing, PPE, gown & gloves How would you move patients in a fire? Patients in immediate danger should be moved first this includes unstable patients Implement a safe place for patients to be What is PASS in fire safety? Pull, Aim, Squeeze, Sweep What is "RACE" in fire safety? rescue, alarm, contain, extinguish What is primary prevention Health promotion and illness prevention' immunizations are a form of primary prevention. What is secondary prevention? treating or controlling a disease or condition after it occurs regular exams and screening tests to detect disease in its earliest stages (e.g. mammograms to detect breast cancer) daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokes. What is tertiary prevention? Rehabilitative therapies and monitoring of health to prevent complications or further illness, injury, or disability screening of patients with diabetes for diabetic retinopathy to prevent progression to blindness What are HDLS high density lipoproteins (good cholesterol) What are LDLS low density lipoproteins (bad cholesterol) Should HDLS or LDLS be higher to determine heart health HDLS What are bronchovesicular breath sounds Bronchovesicular breath sounds are medium in loudness and pitch and can be heard next to the sternum between the scapulae Vesicular breath sounds Normal breath sounds made by air moving in and out of the alveoli. What is histrionic personality disorder a chronic, enduring psychiatric condition characterized by a consistent pattern of pervasive attention-seeking behaviors and exaggerated emotional displays. The condition is usually life long and treatment-resistant, with onset typically in late adolescence or early adulthood. How to treat histrionic personality disorder Therapy is very effective in treating this disorder. Psychodynamic therapy, talk therapy, behavioral therapy, and other types of therapy can help you learn how to gain control over your disorder. What is confabulation? making up lies to fills gaps in memory loss. (saying you were somewhere you weren't) Why is it important not to feed the dysphagia patient shortly before bed? Because they could aspirate or pocket food and choke How do you properly perform post-mortem care? This includes bathing the body, removing any lines such as IV, oxygen, or tubes, and cleaning up any body fluid that leaks out after a patient passes. What is the Parkland Formula? Fluids for first 24hrs = 4 (pt weight in kg x %BSA) 50% over 8hrs 50% over next 16hrs What is warfrin? • an anticoagulant or blood thinner, used to prevent the formation of blood clots in the blood vessels, and their migration elsewhere in the body. Inhibits the vitamin-k dependant synthesis of biologically active forms of the calcium dependant clotting factors, II, VII, IX and X When would warfarin be used? to prevent and treat venous thrombosis and thromboembolic events, as well as conditions such as myocardial infarction and atrial fibrillation What Lab values do you monitor for Warfarin INR and PT INR and PT levels 1.1 before warfarin INR of 2.0 to 3.0 after 25-35 PTT doubles if on heparin What reverses Warfarin Vitamin K what reverse heparin protamine sulfate Why do we watch kidney function carefully with antibiotics? Because these can easily become nephrotoxic