Download Hematology and Urology Conditions and more Exams Health sciences in PDF only on Docsity!
NSG123/ NSG 123 Exam 3: (New 2024/ 2025
Update) Med Surg 1 Review| Questions and
Verified Answers| 100% Correct|All Units
Covered| A Grade – Herzing
QUESTION
qualitative platelet defects Answer:
- number of platelets may be normal, but their function is not normal
- ask about OTC medications such as aspirin or NSAIDs
QUESTION
thrombocytopenia (quantitative platelet defect) Answer: low platelet count
QUESTION
signs and symptoms of thrombocytopenia Answer:
- bruising
- petechiae (platelets <20,000)
- excessive bleeding (platelets <5,000)
- nasal and gingival bleeding
QUESTION
What is the medication treatment for thrombocytopenia?
Answer: corticosteroids
QUESTION
Thalassemia Answer:
- inherited defect
- unable to produce hemoglobin
- type of hemolytic anemia
QUESTION
Patient education for thalassemia Answer:
- many medications exacerbate the dis- ease
- it is important to review all medications with prescriber
- stem cell transplants and blood transfusions may be used for treatment
QUESTION
iron deficiency anemia Answer:
- anemia caused by inadequate iron intake
- most common type of anemia
- type of hypoproliferative anemia
QUESTION
Risk factors for iron deficiency anemia Answer:
- living in developing country (low iron intake)
- premenopausal women
- vegetarians
- medications
QUESTION
nursing considerations for blood transfusion Answer:
- assess for signs of fluid volume overload
- lung sounds
- O2 saturation
- skin color
- respiratory rate
- JVD
- confusion
QUESTION
signs and symptoms of hemolytic reaction Answer:
- back pain
- chest pain
- hypotension
- tachycardia
- dyspnea
QUESTION
signs and symptoms of peripheral artery disease (PAD) Answer:
- intermittent clau- dication (pain when walking, relieved with rest)
- cool, pale skin
- loss of hair
- ulcerations
- brittle nails
- atrophy
- weak pulses in affected leg
QUESTION
causes of PAD Answer:
- nicotine
- hypertension
- diabetes
- obesity
- stress
- sedentary lifestyle
- age
- gender
- family history
QUESTION
foot care for PAD Answer:
- avoid restrictive clothing/socks/shoes
- wash feet daily
- dry thoroughly
- apply moisturizer
QUESTION
PAD post operative care Answer:
- assess every 15 minutes
- monitor pedal pulses
- check leg/foot color
- assess capillary refill
QUESTION
Correct technique for obtaining blood pressure Answer:
- select correct BP cuff size
- measure BP right after you wake up or before going to bed
- try to measure BP at the same time every day
- rest for 5 minutes
- sit with feet flat on floor and back straight
- place arm at the level of your heart
- stay still and do not move
QUESTION
Hypertensive emergency Answer: a situation where blood pressure is very elevated and there is evidence of actual or probable target organ damage
QUESTION
Hypertensive urgency Answer: a situation where blood pressure is very elevated but there is no evidence of target organ damage
QUESTION
Treatment for hypertensive emergency Answer:
- reduce BP 20 - 25% in first hour
- gradually reduce BP to normal over a few days
- IV vasodilators (sodium nitroprusside), Enalapril, Nitroglycerin
QUESTION
Treatment for hypertensive urgency Answer:
- oral medications (Labetalol, Captopril, Clonidine)
- normalize BP within 24 - 48 hours
QUESTION
Heart failure Answer:
- signs and symptoms of fluid volume overload and/or inadequate tissue perfusion
- problem with ventricles filling with blood (diastolic)
- problem with ventricles contracting & ejecting blood out (systolic)
QUESTION
ejection fraction Answer:
- measurement of blood volume the ventricle ejects with each contraction (normal is 55 - 65%)
- systolic failure will have a lower ejection fraction
- diastolic failure will have a normal ejection fraction
QUESTION
left-sided heart failure symptoms Answer:
- blood backs up to the lungs
- respiratory symptoms
- pulmonary congestion/crackles
- cough
- pink, frothy sputum
- low O2 saturation
- dyspnea
- fatigue
Answer:
- ACE inhibitors - slows progression of heart failure (may cause cough)
- Beta blockers - relaxes the heart (caution with asthma)
- ARB - alternative to ACE inhibitors
- Neprilysin inhibitor (Entresto) - removes BNP from blood
- diuretics - decrease fluid volume
- digitalis (Digoxin) - improves contractility (monitor for toxicity)
QUESTION
signs and symptoms of digitalis (DIgoxin) toxicity Answer:
- vision problems***
- nausea
- bradycardia
- anorexia
- confusion
QUESTION
How does the nurse know medications are effective for heart failure? Answer:
- increased energy
- decreased edema
- less shortness of breath
- increased activity tolerance
- able to walk further
QUESTION
Nursing assessment for heart failure Answer:
- mental status
- pink, frothy sputum
- heart sounds - S3 typical
- crackles or wheezes in lungs
- daily weights
- fluid volume overload signs
QUESTION
patient education for heart failure Answer:
- no more than 2L of fluid per day
- smoking cessation
- DASH diet (low sodium <2g per day)
- exercise
- monitor for signs of fluid volume excess
- daily weight (notify doctor if more than 2 - 3lbs/day or 5lbs/week)
QUESTION
What is ITP? Answer:
- idiopathic thrombocytopenic purpura (immune thrombocytope- nia)
- low platelet count due to body's development of antiplatelet antibodies
QUESTION
Causes of ITP Answer:
- autoimmune disorders
- viral infections
- medications (Cephalosporins, Sulfa)
QUESTION
Diagnostic tests for ITP Answer:
- infection introduced through urethra
- prostate cancer***
- female
- multiple sex partners
- lack of fluid intake
- multiple sexual encounters per day
- long term use of catheters
- diabetes
- ureterovesical reflux
- menopause
QUESTION
signs and symptoms of UTI Answer:
- burning with urination
- nocturia
- urinary frequency
- incontinence
- hematuria
- dysuria
QUESTION
signs and symptoms of pyelonephritis Answer:
- flank pain
- high fever
- pyuria (pus in the urine)
- very dark urine (tea colored)
- chills
- fatigue
- dysuria
- urinary frequency
- nausea and vomiting
- headache
QUESTION
goal of UTI management Answer:
- prevent complications like urosepsis
- prevent spread of infection to kidneys
QUESTION
nursing intervention for UTIs Answer:
- relieve pain
- application of heat
- increase fluid intake
- avoid bladder irritants (coffee, tea, citrus, alcohol)
QUESTION
types of urinary stones Answer:
- uric acid (meat, alcohol, red wine)
- cystine (common in bladder, genetic - ask about family hx)
- calcium oxalate (plants)
- calcium phosphate (medications)
- struvite
QUESTION
risk factors for urinary stones Answer:
- dehydration
- genetics
- diet (proteins = uric acid and plants = calcium oxalate)
treatments for kidney stones Answer:
- opioids, NSAIDs
- hot packs
- increased fluid intake
- strain the urine to check for passage of stones
- nutrition changes
- lithotripsy or ureteroscopy
- surgical removal
QUESTION
What nutrition changes are needed for kidney stones? Answer:
- calcium stones - restrict calcium intake
- uric acid stones - avoid organ meats, alcohol, soft drinks
- oxalate stones - avoid strawberries, rhubarb, chocolate, spinach, peanuts
QUESTION
Patient education for kidney stones Answer:
- signs and symptoms to report (UTI, hematuria, urinary retention)
- strain the urine
- fluid intake
- dietary education
QUESTION
diagnostic tests for prostate issues Answer:
- digital exam
- PSA lab study
- ultrasonography
QUESTION
signs and symptoms of BPH Answer:
- urinary frequency
- nocturia
- weak urinary stream
- urinary hesitancy
- urinary retention
- UTIs
QUESTION
How can a nurse tell if medications are working for BPH? Answer: patient will report urinary flow is easier and urinary stream is better (DO NOT select option about size of prostate)
QUESTION
If a patient with BPH has not urinated in 8 hours, what will the nurse do? Answer: place a REGULAR Foley catheter
QUESTION
patient education for a TURP (transurethral resection of prostate) before the procedure Answer:
- procedure is done under general anesthesia
- a large Foley will be in place after surgery
- there will be a lot of pain and discomfort
- output will be red and bloody at first because the prostate is very vascular
first line treatment for erectile dysfunction Answer: ORAL medications (DO NOT select any other answer)
QUESTION
patient education for erectile dysfunction Answer:
- contraindicated with nitrate use, but cardiac disease patients can take ED medication
- medication works better with a source of stimulation
- do not take more than 1 pill
QUESTION
Hypertension Answer:
- most common chronic disease in adults in US
- systolic of greater than 140mmHg
- diastolic of greater than 90mmHg
- based on average of at least 2 BP readings 1 - 4 weeks apart
- cannot be diagnosed with only 1 high BP reading
QUESTION
What is the treatment for pre-hypertension? Answer:
- diet and lifestyle changes FIRST
- if not effective, then medications will be given
QUESTION
Essential hypertension (primary hypertension) Answer:
high blood pressure with no verifiable physical cause, which makes up the majority of high blood pressure cases
QUESTION
Secondary hypertension Answer: hypertension is a secondary symptom of a primary disease like sleep apnea or pregnancy
QUESTION
manifestations of hypertension Answer:
- retinal and other eye changes
- renal damage
- myocardial infarction
- cardiac hypertrophy
- stroke
- headaches
- nosebleeds
- dizziness
- fatigue
QUESTION
Risk factors for hypertension Answer:
- smoking
- obesity
- physical inactivity
- microalbumin or GFR < 60mL/min
- family history
- diabetes
- African Americans
