NUR 351 Final Exam Study Guide
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Questions and Answers

Which component of the SBAR method represents the patient's current status?

  • Assessment (correct)
  • Background
  • Recommendation
  • Situation
  • What is a key factor that may increase a patient's risk for falls?

  • Adequate hydration
  • Impaired mobility (correct)
  • High dietary fiber intake
  • Regular exercise
  • Which of the following is considered an essential nursing intervention for a patient who is dying?

  • Pain management (correct)
  • Providing aggressive treatments
  • Frequent medical assessments
  • Isolation from family members
  • What best describes a patient who is demonstrating readiness to learn?

    <p>Asks questions and seeks more information (A)</p> Signup and view all the answers

    Identifying barriers to learning does NOT include which of the following factors?

    <p>Noncompliance with treatment (B)</p> Signup and view all the answers

    Which method is NOT typically used to evaluate the teaching-learning process?

    <p>Asking the patient to wait for a follow-up visit (C)</p> Signup and view all the answers

    Which level of prevention focuses on preventing the onset of disease?

    <p>Primary prevention (B)</p> Signup and view all the answers

    Which behavior is NOT an example of health promotion?

    <p>Ignoring prescribed medication schedules (A)</p> Signup and view all the answers

    What is the primary focus of tertiary prevention in healthcare?

    <p>Stopping disease progression and restoring baseline health (C)</p> Signup and view all the answers

    Which of the following is an example of secondary prevention?

    <p>Mammogram screening (C)</p> Signup and view all the answers

    What immediate action should be taken when managing anaphylaxis?

    <p>Administer IM Epinephrine (B)</p> Signup and view all the answers

    Which symptom is NOT typically associated with an allergic reaction?

    <p>Fever (C)</p> Signup and view all the answers

    When caring for a postoperative patient, what should the nurse primarily assess for at the surgical site?

    <p>Signs of potential infection (C)</p> Signup and view all the answers

    What is a typical non-pharmacologic measure to alleviate pain in postoperative patients?

    <p>Massage (A)</p> Signup and view all the answers

    What is a key indicator that an allergic reaction might be worsening?

    <p>Angioedema or throat swelling (D)</p> Signup and view all the answers

    What should be included in patient education to prevent allergic reactions?

    <p>Identifying triggers and notifying providers (B)</p> Signup and view all the answers

    What initial action should be taken before assessing a patient with suction devices in use?

    <p>Turn off the suction to prevent noise interference (A)</p> Signup and view all the answers

    What is a characteristic feature observed in a sinus rhythm?

    <p>Regular P waves followed by QRS complexes (A)</p> Signup and view all the answers

    Which medication is appropriate for treating symptomatic sinus bradycardia?

    <p>Atropine (B)</p> Signup and view all the answers

    What should be the main concern when managing a patient with ventricular fibrillation?

    <p>Immediate CPR and defibrillation (C)</p> Signup and view all the answers

    In the case of ventricular tachycardia with a pulse present, what is a recommended intervention?

    <p>Instruct the patient to perform the Valsalva maneuver (D)</p> Signup and view all the answers

    What defines atrial fibrillation on an ECG rhythm strip?

    <p>Visible QRS complexes with intermittent ‘fibs’ (A)</p> Signup and view all the answers

    Which of the following is NOT a treatment for ventricular tachycardia?

    <p>Giving anticoagulants to prevent stroke (A)</p> Signup and view all the answers

    The mnemonic 'unstable gets the CABLE' is associated with which cardiac condition?

    <p>Ventricular fibrillation (C)</p> Signup and view all the answers

    What precautions should be taken for a patient experiencing dysphagia?

    <p>Elevate the head of the bed (HOB) and limit eating distractions. (B)</p> Signup and view all the answers

    What potential side effect should a nurse monitor for in a patient taking Verapamil?

    <p>Bradycardia (D)</p> Signup and view all the answers

    What is a primary nursing responsibility before a bronchoscopy procedure?

    <p>Ensure the patient is NPO for at least 8 hours. (B)</p> Signup and view all the answers

    What is a common complication to monitor for during the recovery phase after bronchoscopy?

    <p>Subcutaneous crepitus around the face and neck. (C)</p> Signup and view all the answers

    What is the correct procedure for collecting a sputum culture?

    <p>Instructing the patient to rinse their mouth before collecting the sample. (A)</p> Signup and view all the answers

    Which demographic is particularly at risk for respiratory illnesses due to changes in chest wall compliance?

    <p>Elderly patients with osteoporosis and kyphosis (C)</p> Signup and view all the answers

    What does sputum analysis primarily check for?

    <p>Microorganisms and abnormal cell growth (A)</p> Signup and view all the answers

    What should patients limit to manage hypertension effectively?

    <p>Sodium intake (D)</p> Signup and view all the answers

    Which of the following is NOT a recommended aspiration precaution for patients with dysphagia?

    <p>Encourage fast eating to avoid fatigue (B)</p> Signup and view all the answers

    Which symptom is NOT commonly associated with a myocardial infarction (MI)?

    <p>Runny nose (D)</p> Signup and view all the answers

    What is a primary rationale for cardiac catheterization?

    <p>To diagnose coronary artery disease (D)</p> Signup and view all the answers

    What does Percutaneous Transluminal Coronary Angioplasty (PTCA) involve?

    <p>Balloon inflation to open blocked coronary arteries (A)</p> Signup and view all the answers

    Which of these is considered a modifiable risk factor for coronary artery disease (CAD)?

    <p>Smoking (A)</p> Signup and view all the answers

    What medication class is commonly prescribed post-myocardial infarction to decrease cardiac workload?

    <p>Beta blockers (B)</p> Signup and view all the answers

    What should be monitored post-cardiac catheterization to prevent complications?

    <p>Signs of infection at the insertion site (D)</p> Signup and view all the answers

    Which is NOT a recommendation for lifestyle changes to manage hypertension?

    <p>Increasing sodium intake (C)</p> Signup and view all the answers

    What is the most appropriate action to take immediately after a specimen is collected to prevent microorganism growth?

    <p>Send the specimen to the lab immediately (C)</p> Signup and view all the answers

    Which sputum characteristics indicate a possible lung infection?

    <p>Greenish and foul smelling (C)</p> Signup and view all the answers

    Which of the following is considered a high flow oxygen delivery device?

    <p>Venturi mask (D)</p> Signup and view all the answers

    What is a significant risk factor for hospital-acquired pneumonia?

    <p>Recent antibiotic therapy (C)</p> Signup and view all the answers

    In the treatment of pneumonia, what is the purpose of increasing fluid intake?

    <p>To thin secretions (C)</p> Signup and view all the answers

    What is the main goal of inserting a chest tube?

    <p>To allow expulsion of air and/or fluid (C)</p> Signup and view all the answers

    Which of the following is a symptom that may indicate hyperkalemia?

    <p>Risk for arrhythmias (C)</p> Signup and view all the answers

    What could be a potential risk if hypokalemia is corrected too quickly?

    <p>Brain herniation (A)</p> Signup and view all the answers

    Flashcards

    Components of SBAR

    SBAR stands for Situation, Background, Assessment, Recommendation. It's a communication method used to clearly and concisely share patient information.

    Patient Safety Risk Factors

    Factors that increase the likelihood of a patient experiencing a fall, infection, or other safety event; Examples include impaired mobility or orthostatic hypotension.

    Dying Patient Interventions

    Nursing interventions for patients who are dying, focusing on comfort, symptom management, and a supportive environment.

    Patient Readiness to Learn

    A patient's willingness and ability to absorb and retain information about their health conditions and treatment.

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    Barriers to Learning

    Factors that hinder a patient's ability to learn, such as cognitive limitations, emotional distress, or cultural beliefs.

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    Health Promotion Behaviors

    Actions a patient takes to maintain or improve their health, such as monitoring symptoms, taking medication, and adhering to appointments.

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    Levels of Prevention (Primary)

    Strategies to prevent disease or injury from occurring in the first place. Examples are health education and immunizations.

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    Levels of Prevention (Secondary)

    Strategies to detect and treat diseases or injuries early, before they become severe. Examples are screenings for cancer or high blood pressure.

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    Primary Prevention of Disease

    Measures taken to prevent disease from ever occurring.

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    Secondary Prevention of Disease

    Early detection of disease to allow for treatment; catch it early.

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    Tertiary Prevention of Disease

    Stopping disease progression and getting back to normal.

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    Signs of Infection

    Symptoms like fever, pain, redness, swelling, and drainage.

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    Anaphylaxis Symptoms

    Severe allergic reaction with symptoms like difficulty breathing, rash, and itching.

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    Anaphylaxis Treatment

    Epinephrine (IM) injection to constrict blood vessels and improve heart function.

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    Postoperative Infection Assessment

    Checking for signs of infection around a surgical or insertion site.

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    Postoperative Pain Management

    Assessment, monitoring, and treatment of postoperative pain, encompassing both medication and non-pharmacologic methods.

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    Sinus Bradycardia

    Slow heart rhythm originating from the sinoatrial (SA) node.

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    Sinus Tachycardia

    Fast heart rhythm originating from the sinoatrial (SA) node.

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    Atrial Fibrillation (A Fib)

    Irregular, rapid heart rhythm originating in the atria.

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    Ventricular Tachycardia (V Tach)

    Rapid, irregular heart rhythm originating in the ventricles.

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    Ventricular Fibrillation (V Fib)

    Uncoordinated heart rhythm originating in the ventricles.

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    Lethal Arrhythmia

    A heart rhythm that can lead to cardiac arrest.

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    Sinus Rhythm

    Normal heartbeat originating from the SA node.

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    Treatment for Lethal Arrhythmia (no pulse)

    Immediate CPR and defibrillation.

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    MI Presenting Symptoms

    Chest pain, neck/jaw/shoulder pain, fatigue, shortness of breath, abdominal pain; women may have vague symptoms.

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    Dysphagia

    Difficulty swallowing, often associated with aspiration risk. Nursing interventions include positioning the patient upright, limiting distractions during meals, offering small frequent meals, and using thickened liquids.

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    Angina Patient Education

    Explain stable vs. unstable angina, balance rest and activity, recommend smoking cessation, and teaching nitroglycerin use (how, when).

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    Aspiration Precautions

    Specific procedures implemented to prevent food or liquids from entering the airway. This might include elevating the head of the bed, limiting distractions during meals, providing small frequent meals, and ensuring the patient rests between bites.

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    Cardiac Catheterization Rationale

    Diagnose coronary artery disease (CAD) and potentially remove blockages (plaque/thrombus), inserting stents.

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    Verapamil

    A calcium channel blocker used to treat hypertension. It can cause hypotension, bradycardia, and dizziness as a side effect.

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    Bronchoscopy

    A procedure that involves visualizing the respiratory tract directly using a flexible tube with a camera. This enables tissue analysis and biopsies.

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    PTCA Procedure

    Balloon catheter inserted into a blocked coronary artery and inflated to open it, potentially using stents for long-term patency.

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    Greenish Sputum

    Sputum that is green, has a foul odor, and is accompanied by cough and fever is a possible sign of a lung infection.

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    Bronchoscopy - Pre-Procedure

    Nursing interventions prior to a bronchoscopy include ensuring the patient is NPO for at least 8 hours.

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    CAD Risk Factor Education

    Stress management, smoking cessation, diet improvement, weight management, and exercise to address modifiable CAD factors.

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    Low Flow Oxygen Devices

    Devices like nasal cannulas and face masks that deliver oxygen at relatively low flow rates.

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    Post-MI Medications for Cardiac Workload

    Beta blockers (e.g., Metoprolol) to lower heart rate and workload, and ACE inhibitors (e.g., Lisinopril) to lower blood pressure.

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    Chest Tube Rationale

    Chest tubes are inserted to expel air or fluid from the pleural space, allowing the lung to re-expand and improve gas exchange.

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    Bronchoscopy - Post Procedure

    Nursing care after a bronchoscopy involves monitoring for hypoxia and bleeding, and ensuring the gag reflex returns before allowing the patient to eat or drink.

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    Sputum Analysis

    A laboratory test that examines mucus coughed up from the lungs to identify microorganisms or abnormal cell growth.

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    High Potassium Levels/Medication

    Spironolactone can cause high potassium; monitor closely.

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    Hyperkalemia Symptoms

    High potassium levels in the blood can cause heart rhythm abnormalities (arrhythmias).

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    Low Potassium Levels/Medication

    Furosemide can cause low potassium; monitor closely.

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    Sputum Culture Collection

    Collecting and testing the sputum to check for infections. Prior to the collection, the patient should rinse their mouth to minimize contamination.

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    Hypokalemia Symptoms

    Low potassium levels can lead to neurological issues, including possible brain herniation if corrected too quickly.

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    Community-Acquired Pneumonia

    Pneumonia contracted outside of a healthcare setting, primarily affecting elderly or smokers.

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    Hospital-Acquired Pneumonia

    Pneumonia acquired during a hospital stay, often affecting patients with risk factors like antibiotic therapy, immunosuppression, or chronic diseases.

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    Healthcare-Associated Pneumonia

    Pneumonia acquired outside of a hospital, but related to recent hospital discharge or healthcare exposure.

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    Study Notes

    NUR 351 Final Exam Study Guide

    • Test Questions Blueprint: 100 questions total, broken down into Psych/Mental Health (18), Pediatrics (9), and Medical-Surgical (73).

    Week 3-4: Foundations of Medical-Surgical Nursing & Health Promotion/Teaching/Learning

    • SBAR Communication: Components include Situation, Background, Assessment, and Recommendation. An example would detail the patient's current status, relevant medical history, assessment findings, and a suggested plan of action.
    • Patient Risk Factors: Identify factors like impaired mobility or orthostatic hypotension that increase the risk of falls and infections in patients.
    • Dying Patient Interventions: Prioritize pain management, symptom control, creating a calm environment, and maintaining patient comfort.
    • Patient Readiness to Learn: Assess for barriers like cognitive abilities, emotional state, and motivation. Consider cultural and religious beliefs influencing treatment consent. Evaluate teaching-learning through observation, demonstration, and the teach-back method.

    Week 5: Immunity & Perioperative Nursing

    • Signs of Infection: Malaise, fatigue, warm skin, fever, elevated white blood cell (WBC) count, tachycardia, and purulent drainage.
    • Anaphylaxis Management: Key symptoms include wheezing (potentially stridor), pruritus, urticaria. Administer epinephrine (IM) ASAP.
    • Infection: Treat non-specific issues with supportive care, pain management, fever management.

    Week 6: Dysrhythmias & Hypertension

    • Sinus Rhythms: Assess heart rate (HR) – bradycardia (below 60 bpm), tachycardia(above 100 bpm). The normal sinus rhythm (NSR) is between 60-100 bpm. Treat underlying causes if needed.
    • Atrial Rhythms: Specific rhythms requiring particular management.
    • Ventricular Rhythms: Dangerous rhythms. Immediate intervention is necessary, such as CPR and defibrillation.

    Week 7: Myocardial Infarction

    • Presenting Symptoms: Chest pain, neck/jaw pain, fatigue, shortness of breath, abdominal pain. Women may display vague symptoms.

    Week 8: Neuro/Stroke

    • Cranial Nerve Deficits: (IX, X, XI, XII): Assess for swallowing difficulties (dysphagia), risk of aspiration.
    • Cerebellar Damage Considerations: Assess for risk of falls.
    • Stroke Patient Care: Assess for aphasia, ataxia, and dysphagia and incorporate measures to manage each.

    Week 10: Adult Respiratory System

    • Risk Factors for Respiratory Illness: Smoking and osteoporosis-related chest wall compliance issues.
    • Bronchoscopy Care: Pre-procedure (NPO), post-procedure (monitor for hypoxia, bleeding, gag reflex).
    • Sputum Culture: Collect samples to identify microorganisms.
    • Respiratory issues: Assess oxygen requirements. Use appropriate oxygen delivery devices (e.g., nasal cannula, face masks)

    Week 12: Fluid & Electrolyte Balance, Acid-Base, and Acute Renal Failure

    • Electrolyte Imbalances: Monitor electrolytes for critically ill patients. Risks associated with hyperkalemia (K+ > 5.3) and hypokalemia (K+ < 3.5).
    • Dehydration: Look for tachycardia, dry mucous membranes, decreased urine output, and weight loss in assessing patients.
    • Fluid Overload: Look for edema, weight gain, crackles in lungs, and tachycardia in assessing patients.
    • Treatment for Acute Kidney Injury (AKI): Awareness of the stages that include initiating, oliguric, and diuretic phases, and their management.

    Week 13: Acute Pancreatitis, Peptic Ulcer Disease, and Upper GI Bleed

    • Peptic Ulcer Disease (PUD): Primary symptom is pain. Other symptoms can include nausea, vomiting, hiccups, and/or abdominal distention.
    • Treatment: Administer H2 antagonists to reduce acid production or antibiotics if PUD is caused by the infection of Helicobacter Pylori.

    Week 14: Sepsis and Shock, DIC

    • Sepsis Bundle: Interventions should be initiated within 1 hour, including fluid resuscitation and antibiotic administration.
    • Disseminated Intravascular Coagulation (DIC): A complication of sepsis.

    Week 15, 16, and 17 (Other potential topics/requirements)

    • Mental Status Exam/MSE: Review the components and relevant terminology
    • Mood Disorders (Depression/Bipolar): Relevant characteristics and interventions for patients with these disorders
    • Suicide Risk Assessment: Identify risk factors, safety planning.
    • Substance Use Disorders: Understand appropriate assessment and treatment for individuals with substance use disorders.
    • Eating Disorders: Understand the key components for anorexia and bulimia.

    Week 16 and 17 (Potential topics/requirements)

    • Pharmacology Review: Match medications to their drug class, including side effects and clinical considerations. Focus on understanding the pharmacology related to specific conditions covered in respective weeks of the course.

    Other Critical Topics

    • Patient safety across all topics.
    • Priority Setting, identifying what needs to be addressed immediately versus what can be addressed later.

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    Prepare for your NUR 351 final exam with this comprehensive study guide. It covers essential topics such as SBAR communication, patient risk factors, interventions for dying patients, and assessing patient readiness to learn. Use this resource to reinforce your knowledge and excel in your nursing studies.

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