NUR 351 Final Exam Study Guide
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Questions and Answers

What medication class is used to reduce blood pressure and may cause dizziness and hypotension?

  • Beta-blockers
  • Calcium channel blockers
  • ACE inhibitors (correct)
  • Diuretics

Which of the following is a primary goal of cardiac rehabilitation?

  • To decrease heart rate permanently
  • To assist patients in returning to optimal health and wellness (correct)
  • To improve only physical strength
  • To provide medication management only

What is a common cranial nerve deficit observed in stroke patients that can increase the risk for aspiration?

  • Visual impairment
  • Dysphagia (correct)
  • Ataxia
  • Memory loss

What strategy should be utilized to aid a stroke patient with aphasia in communication?

<p>Be patient and encourage communication as able (D)</p> Signup and view all the answers

Which of the following is a significant risk associated with cerebellum damage in stroke patients?

<p>Impaired gait and risk for falls (B)</p> Signup and view all the answers

What does the 'S' in the SBAR method of communication stand for?

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

Which condition is a risk factor for patient falls?

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

Which intervention is most appropriate for managing symptoms in a dying patient?

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

What is the first step in creating a teaching plan for discharge?

<p>Assessing the patient’s readiness to learn (B)</p> Signup and view all the answers

Which method can be used to evaluate the teaching-learning process effectively?

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

Which level of prevention focuses on preventing disease before it occurs?

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

What barriers may impact a patient's readiness to learn?

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

Which of the following reinforces behaviors that assist with health promotion?

<p>Self-monitoring for signs and symptoms of illness (C)</p> Signup and view all the answers

Which of the following is an example of primary prevention?

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

What is the purpose of tertiary prevention?

<p>Re-establish baseline health after a disease (D)</p> Signup and view all the answers

Which symptom might indicate the presence of an infection?

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

What is the immediate action to take when managing anaphylaxis?

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

When caring for a postoperative patient, what should be assessed at the surgical site?

<p>Color and amount of drainage (C)</p> Signup and view all the answers

What should be done before administering any medication to a patient?

<p>Inquire about the patient's allergies (B)</p> Signup and view all the answers

What is a primary lifestyle change recommended for managing hypertension?

<p>Limit sodium intake (B)</p> Signup and view all the answers

Which of the following describes a method to manage postoperative pain non-pharmacologically?

<p>Resting in a comfortable position (C)</p> Signup and view all the answers

What is a sign that may indicate the necessity for assessing NG tube placement?

<p>Unusual bowel sounds (D)</p> Signup and view all the answers

Which symptom is commonly associated with a myocardial infarction (MI)?

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

What is a key distinction between stable and unstable angina that should be addressed in patient education?

<p>Stable angina is usually relieved by rest (B)</p> Signup and view all the answers

What is the purpose of cardiac catheterization?

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

Why might a patient undergo Percutaneous Transluminal Coronary Angioplasty (PTCA)?

<p>To remove blockage in the coronary artery (A)</p> Signup and view all the answers

Which medication class is commonly prescribed to decrease cardiac workload after a myocardial infarction?

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

Which of the following is NOT considered a modifiable risk factor for coronary artery disease (CAD)?

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

What should post-cardiac catheterization patients be monitored for at the insertion site?

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

What initial action should be taken before assessing a patient's suction?

<p>Turn off the suction (C)</p> Signup and view all the answers

What is a potential treatment for sinus bradycardia when the patient is symptomatic?

<p>Administration of Atropine (C)</p> Signup and view all the answers

Which rhythm is characterized by visible QRS complexes followed by 'fibs'?

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

What treatment option is appropriate when a patient presents with Ventricular Tachycardia and has a pulse?

<p>Valsalva maneuver and antiarrhythmic medication (C)</p> Signup and view all the answers

What is the recommended course of action for a patient in Ventricular Fibrillation?

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

What medication may be ordered for a patient with Atrial Fibrillation at risk for stroke?

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

Which of the following is a characteristic feature of Ventricular Tachycardia on an EKG strip?

<p>Visible QRS in a regular pattern (B)</p> Signup and view all the answers

What is the first step in managing a patient with Ventricular Tachycardia if there is no pulse?

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

What is a key indicator that a lung infection may be present?

<p>Greenish sputum with a foul odor (B)</p> Signup and view all the answers

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

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

What diagnostic test is most commonly used to identify consolidation in pneumonia?

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

Which population is at the highest risk for community-acquired pneumonia?

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

What is a recommended treatment for pneumonia?

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

The use of a chest tube is primarily to facilitate which function?

<p>Expel air and fluid from the pleural space (D)</p> Signup and view all the answers

Which of the following conditions poses the highest risk for hospital-acquired pneumonia?

<p>Current hospital admission with antibiotic therapy (D)</p> Signup and view all the answers

What is a potential risk associated with hyperkalemia?

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

Flashcards

Components of SBAR

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

Patient safety risks

Factors like impaired mobility, orthostatic hypotension, or cognitive decline can increase a patient's risk of falls, infections, and other safety concerns.

Dying patient care

Focuses on pain management, symptom control, and creating a peaceful environment to support patients facing end-of-life situations.

Patient readiness to learn

Assessing a patient's motivation, willingness to learn, and ability to grasp information before discharge.

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Barriers to learning

Factors like a patient's cognitive abilities, emotional state, cultural or religious beliefs, or lack of motivation can hinder their willingness to learn.

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Teaching-learning process

Methods like direct observation, return demonstrations, and the 'teach-back' method are used to evaluate a patient's understanding and reinforce health promotion behaviors.

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Primary prevention

Focuses on preventing disease and risk factors before they occur, by educating individuals about healthy habits and lifestyles.

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Secondary prevention

Aims to detect and treat diseases or conditions early, when they are often more treatable, such as through screenings.

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Tertiary prevention

Stopping disease progression and restoring health.

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Signs of infection

Symptoms indicating possible infection, like fever, malaise, and elevated WBCs.

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Anaphylaxis signs

Allergic reaction symptoms such as wheezing, rash, and itching.

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Anaphylaxis treatment

IM epinephrine to constrict blood vessels and improve BP, monitoring airway.

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Post-op infection assessment

Checking surgical site for redness, warmth, swelling, drainage, and odor.

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NG tube placement check

Listening for bowel sounds to check for proper NG tube positioning.

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Sinus Bradycardia

A slow heart rhythm originating from the sinoatrial (SA) node, that is generally 60 bpm or less.

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Sinus Tachycardia

A fast heart rhythm originating from the sinoatrial (SA) node, that is generally above 100 bpm.

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Atrial Fibrillation (A Fib)

An irregular and often rapid heart rhythm originating in the atria. Visible QRS, with 'fibs' between

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Ventricular Tachycardia (V Tach)

A rapid heart rhythm originating in the ventricles. Visible wide QRS, often upside down 'V' shape.

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Ventricular Fibrillation (V Fib)

A life-threatening irregular heart rhythm originating in the ventricles. No visible QRS, just 'fibs'.

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Lethal Arrhythmia

A potentially fatal heart rhythm problem, often requiring immediate intervention.

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Normal Sinus Rhythm (NSR)

A heart rhythm originating in the sinoatrial (SA) node within a normal range of heart rate (60-100 bpm).

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Cardioversion

A procedure that uses electrical shocks to restore a normal heart rhythm from abnormal heart rhythms.

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Hypertension Education

Includes limiting sodium intake, lifestyle changes, smoking cessation, exercise, fluid monitoring, controlling modifiable risk factors, and taking medications as prescribed.

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Diuretic Use

Diuretics are medications used to reduce fluid retention and lower blood pressure. They can impact potassium levels. Furosemide lowers potassium, while Spironolactone increases potassium.

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MI Presenting Symptoms

Chest pain, neck/jaw/shoulder pain, fatigue, shortness of breath, abdominal pain. Women may experience vague symptoms.

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Angina Education

Explain the difference between stable and unstable angina. Encourage rest and activity balance, smoking cessation, and proper nitroglycerin use.

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Cardiac Catheterization

A diagnostic procedure used to identify coronary artery disease. It can also be used to remove plaque or thrombus, and insert stents to maintain vessel patency.

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Post-Catheterization Care

Monitor for signs of infection at the insertion site, such as pain, warmth, or swelling of the extremity.

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PTCA Intervention

A procedure used to remove blockages in coronary arteries. A balloon-tipped catheter is inserted through an artery to inflate and open the vessel.

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Modifiable CAD Risk Factors

Factors that can be changed to decrease the risk of Coronary Artery Disease, including stress reduction, smoking cessation, a healthy diet, weight management, and exercise.

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What is the purpose of cardiac rehab?

Cardiac rehabilitation helps patients recover from heart problems and regain their overall health and well-being after a heart event. It is a personalized program that focuses on strengthening individuals and enhancing their quality of life.

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Orthostatic hypotension

A condition that occurs when blood pressure drops significantly when standing up, leading to dizziness, lightheadedness, and an increased risk of falls.

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Cranial Nerve VIII Deficits

Damage to the eighth cranial nerve, responsible for balance and hearing, can lead to Ataxia, a condition that affects coordination and gait, increasing the risk of falls.

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Aphasia

A communication disorder that affects the ability to speak and understand language, often caused by a stroke.

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Ataxia - Balance/Gait Disturbance

A condition where balance and coordination are impaired, often leading to unsteady gait and a high risk of falls. Common in stroke patients.

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What does greenish sputum indicate?

Greenish sputum, accompanied by a foul odor and symptoms like cough and fever, suggests a possible lung infection.

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What are low flow oxygen delivery devices?

Low flow oxygen devices, such as nasal cannula and face masks, deliver oxygen at a lower rate than high flow devices.

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Types of pneumonia

Pneumonia can be classified as community-acquired, hospital-acquired, or healthcare-associated, depending on the location and risk factors.

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What are some pneumonia risk factors?

Older adults, smokers, those with chronic respiratory diseases, immune system dysfunction, and prolonged immobility are at higher risk of pneumonia.

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What is hyperkalemia?

Hyperkalemia refers to a high potassium level in the blood (above 5.3 mEq/L) and poses a risk of heart arrhythmias.

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What is hypokalemia?

Hypokalemia means low potassium levels in the blood (below 3.5 mEq/L), and if corrected too rapidly, can lead to brain herniation.

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What does a chest tube do?

A chest tube helps to expel air or fluid from the pleural space, allowing the lung to re-expand and restore negative intrapleural pressure.

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What's the rationale for chest tube insertion?

Inserting a chest tube into the pleural space helps to improve gas exchange by restoring negative intrapleural pressure and allowing the lung to re-expand.

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Study Notes

NUR 351 Final Exam Study Guide

  • Test Format: 100 questions total, including 18 psych/mental health, 9 pediatrics, and 73 medical-surgical questions.

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

  • SBAR Method: Component method of communication (Situation, Background, Assessment, Recommendation).
  • Prioritize Patients: Identify patients at risk for falls, infections, etc., understanding why (impaired mobility, orthostatic hypotension).
  • Dying Patient Interventions: Focus on pain management, symptom control, and maintaining a calm, quiet, and peaceful environment.
  • Patient Teaching Plan: Assess patient readiness to learn, identify barriers impacting learning (like acceptance of information, cognitive abilities, or emotional state), and evaluate the teaching process using direct observation, return demonstration method etc.

Week 5: Immunity & Perioperative Nursing

  • Infection Signs: Malaise, fatigue, warm/flushed skin, fever, elevated WBC, tachycardia, purulent drainage.
  • Anaphylaxis Management: Wheezing (possibly stridor), pruritus (rash), urticaria (itching) treat with IM epinephrine ASAP.
  • Important Postoperative Interventions: Monitor for signs of infection at surgical site including redness, warmth, swelling, increased drainage, or odor. Encourage pain management, including pain medication, or non-pharmacological comfort measures. Assess & monitor NG tube placement by auscultating bowel sounds & assessing for proper placement.

Week 6: Dysrhythmias & Hypertension

  • Rhythm Interpretation: Review rhythm strips for sinus rhythms (bradycardia HR <60, tachycardia HR > 100) and abnormal rhythms.
  • Sinus Bradycardia Treatment: Avoid valsalva maneuver; if symptomatic, administer atropine; treat underlying causes.
  • Sinus Tachycardia Treatment: Identify and treat the underlying cause. Beta-blockers might be used.
  • Atrial/Ventricular Rhythms: Understand the associated rhythms, and their treatment.

Week 7: Myocardial Infarction (MI)

  • MI Symptoms: Chest pain, neck/jaw/shoulder pain, fatigue, shortness of breath, abdominal pain (women may experience vague symptoms).
  • Angina Education: Explain the difference between stable and unstable angina.

Week 8: Neuro/Stroke

  • Elderly Stroke Assessments: Understand that some symptoms of stroke may mask or mimic aging effects (e.g. slower processing, weakness as normal aging changes).
  • Cranial Nerve Deficits: Deficits in cranial nerves IX, X, XI, and XII indicate risk for dysphagia (risk for aspiration). Cranial nerve deficits in VIII indicate a risk for ataxia and possible gait impairments. Deficits in cranial nerve II indicate possible risk for falls due to visual field loss. Patients presenting with cerebellar damage may also be at increased risk of falls.
  • Stroke Patient Care: Focus on airway management (use of HOB elevation, supportive measures, etc.), patient communication strategies, and fall prevention.
  • Pneumonia Risk Factors: Elderly patients, smokers, chronic respiratory diseases, immune-compromised individuals (HIV/AIDS), prolonged immobility.
  • Bronchoscopy: Procedure for visualization of respiratory tract.
  • Sputum Analysis: Analysis to detect abnormal cells.

Week 12: Fluids & Electrolytes, Acid-Base, Acute Renal Failure

  • Electrolyte Imbalances: Treat the underlying cause, monitor for symptoms (especially in the central nervous and cardiovascular systems). Be aware of potassium and sodium levels and their effects on the heart and brain.
  • Fluid Volume Overload: Monitor I & O, weight. Monitor for edema, elevated heart rate (tachycardia), and respiratory complaints (tachypnea, crackles).
  • Acute Kidney Injury (AKI): Recognize the symptoms, including reduced urine output and associated factors.
  • Treatment of Pneumonia: Implement thin secretion therapies, antibiotics (Ensure full completion of course of antibiotics), supplemental oxygen therapy, Bronchodilators.

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

  • Peptic Ulcer Symptoms: Common symptom is epigastric pain, and symptoms commonly happen after meals.
  • Peptic Ulcer Complications: Most common complications are GI bleeds/hemorrhage.
  • H. Pylori Treatment: Use prescribed antibiotics to treat bacterial infections.

Week 14: Sepsis & Shock

  • Sepsis Bundle Interventions: Implement interventions within 1 hour of recognizing sepsis to improve chances of survival.
  • Fluid Resuscitation: Use crystalloids like lactated Ringer’s at the rate of 30 mL/kg.
  • DIC (Disseminated Intravascular Coagulation): Monitor and treat patients to prevent worsening conditions.
  • Sepsis Symptoms: Compensatory mechanisms for shock/sepsis like decreased urine excretion, tachycardia (increased heart rate), and vasoconstriction (reduced blood flow in extremeities) are common symptoms.

Additional Information

  • Know Meds: Identify which class medications belong in. Examples given for different categories of medications.
  • Mental Health: Review Mental Status Exam (MSE) sections and relevant terms. Understand bipolar disorder characteristics/interventions and suicide assessment and management.
  • Pediatric Topics: Review specific assessment findings, patient care interventions, and complications for the respiratory, and other related topics.
  • Immunization Schedule: Understand the schedule, contraindications, and possible reactions for immunizations.

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Description

Prepare for the NUR 351 final exam with this comprehensive study guide covering key topics in medical-surgical nursing, health promotion, and patient teaching. The exam consists of a diverse set of questions, including psych/mental health, pediatrics, and various nursing interventions. Focus on critical components such as SBAR communication and patient prioritization to excel in your nursing journey.

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