N343 Fall 2024 Final Road Map PDF

**N343 Fall 2024** **Final Road Map** ***(Multiple-choice, select-all-that-apply, matching, short answer)*** **Bone Disorders (14 questions)** **[Content/Knowledge level-based questions on: ]** - Types of fractures (matching) Spiral: Child abuse Greenstick: football player getting hit Comm...

**N343 Fall 2024** **Final Road Map** ***(Multiple-choice, select-all-that-apply, matching, short answer)*** **Bone Disorders (14 questions)** **[Content/Knowledge level-based questions on: ]** - Types of fractures (matching) Spiral: Child abuse Greenstick: football player getting hit Communited: shattered: hfhfhfh - Osteoporosis - Osteomyelitis - Gout: [Application Level **based questions on:**] - Compartment Syndrome - Osteomyelitis - Rhabdomyolysishghgh - DVT - Case study/short answer on a post-op ORIF patient with one-sided lower extremity pain and redness (10 points) - What complication is occurring in your patient (based on assessment data we give)? (1 point) - What must the nurse address prior to calling the provider? List 3 interventions. (3 points) - Use SBAR to write report to your provider (6 points) ***Comprehensive Content (approximately 40 questions multiple-choice, select-all-that-apply, T/F,& matching)*** **Perioperative Care (5 questions)** **[Content/Knowledge level-based questions on:]** - Patient Education- pre op, post op (inpatient stay), and discharge instructions - Smoking cessation, concerning signs/symptoms prior to surgery, when to start discharge teaching - Prevention and management of common post op complications - pneumonia, DVTs - Use of IV med and oral meds in pain management -- choosing appropriate medications based on patient symptoms/orders - Informed consent -- when to send a patient to surgery vs have a surgeon visit them preoperatively **Sleep (6 questions)** **[Content/Knowledge level-based questions on:]** - Sleep apnea: signs and symptoms, treatments (CPAP and non-CPAP interventions) - Sleep deprivation: signs/symptoms - Sleep hygiene: best practices for improving sleep, factors/habits that impede sleep - BONUS question: HR changes in age/fitness levels: **Nutrition (4 questions)** **[Content/Knowledge level-based questions on:]** - Nursing considerations for patient on parenteral and enteral feedings - Patient safety concerns - PPN vs TPN vs tube feeds - Metabolic Syndrome - Lab values, diagnostic studies (fasting glucose, vital signs) - Labs that link to nutritional status: Signs & symptoms of low albumin levels [Application Level **based questions on:**] - **Refeeding syndrome** **Skin (4 questions)** **[Content/Knowledge level-based questions on:]** - Sunscreen guidance and recommendations - Wound healing: how smoking impacts healing - Role of the skin in general - Signs/symptoms of atopic dermatitis **Fluid and Electrolytes (6 questions)** **[Content/Knowledge level-based questions on:]** - Difference between hypo/hyper/isotonic fluids - Types of IV Fluids (reference last two pages ***Electrolyte Quick Reference Guide in D2L)*** - Clinical Manifestations and Causes for hypo/hyper (reference ***Electrolyte Quick Reference Guide in D2L)*** - Treatment for hyperkalemia [Application Level **based questions on:**] - Causes of fluid deficit and excess (reference *Fluid Imbalance Study Guide* in D2L) - Deficit=loss of fluid - Excess= extra fluid think: perfusion or filtration issue **Renal (5 questions)** **[Content/Knowledge level-based questions on:]** - Labs that link to kidney function and expected lab findings in CKD - Causes of the types of AKI - Clinical manifestations of each phase for AKI - Stages of CKD - Causes of uric acid kidney stones [Application Level **based questions on:**] - Medications for chronic kidney disease that are outlined in PowerPoint - Contraindications for medications - Assessment data prior to med administration ie: lab results and /or physical assessment **GU (2 questions)** **[Content/Knowledge level-based questions on:]** - Incontinence -- difference between the types; treatment options or nursing considerations, nursing interventions (select-all-that-apply) **GI (10 questions)** **[Content/Knowledge level-based questions on:]** - Lower vs Upper GI bleeds: assessment findings with fluid volume deficit (select all that apply), priority intervention in a patient with a new GI bleed - Crohn's, Ulcerative Colitis - Fistulas - GI bleed - GERD: medications/treatments (H2 blockers and PPIs -- how they work) [Application Level **based questions on:**] - Peritonitis: treatments (priority) - Peptic ulcer disease: medications to avoid, risk factors/causes - Case study/short answer applying ADPIE to a patient with abdominal pain (10 points) - Given patient description, answer the following: - What GI problem do you suspect? (1 point) - Which lab value would you expect to be elevated at this time? (1 point) - What diagnostic studies could be done to determine the cause of this pain? (1 point) - What do you predict for interventions/treatments for this patient? (6 points) - If this goes untreated, what do you anticipate occurring in this patient? (1 point) Which assessment finding would indicate that a patient with a cast is developing compartment syndrome? **Select all that apply. One, some, or all responses may be correct.** *Exactly!* - Paralysis of the extremity - Reduced peripheral pulses - Itching under the cast - Numbness and tingling of the extremity - Pain that is accelerating despite pain medication Practice Questions- Pro Prac 1. Sodium polysystene (Kayexalate) is ordered for a patient with hyperkalemia. What should the nurse assess before admistering this medication? Answer: Bowel sounds 2. A 33 yr old female client is in her first trimester of pregnancy and complains that she needs to urinate more frequently and is concerned about having a UTI. Which of the following statements would be appropriate for the nurse to make? Answer: Are you having any pain when you urinate 3. To prevent recurrence of uric acid kidney stones the nurse teaches the patient to avoid eating? Answer: Sardines and liver 4. For a client with a nursing diagnosis of excess fluid volume the nurse is alert to which of the following signs and symptoms? Answer: Hypertension 5. Which inference would the nurse use to explain the lab report for the patient with CKD who has a hemoglobin of 8.0? Answer: Decreased levels of erythropoietin & lowered production of hemoglobin 6. The nurse should be alert for which manifestations in a patient receiving a loop diuretic? Answer: Weak, irregular pulse and poor muscle tone 7. In planning nursing interventios to increase bladder control in the patient with urinary intontinence, the nurse includes (select all that apply) - Teaching the patient biofeedback mechanisms to train the pelvic floor muscles - Developing a fluid modification plan, focusing on decreasing intake before bedtime - Teaching the patient to use kegel exercises 8. Which response will the nurse make when a patient with AKI who is experiencing hypokalemia asks Why is IV insulin being prescribed? - IV glucose is given concurrently to precent hypocalcemia - Insulin helps potassium move into the cells, which lowers your blood potassium level 9. During the oliguric phase of AKI, the nurse monitors the patient for? (select all that apply) - ECG changes - Pulmonary edema 10. The typical fluid replacement for the patient with a fluid volume DEFICIT is: Answer: Lactated ringer solution (LR) 11. When a patient who has had a progressive chronic CKD, for several years os started on hemodialysis which information about diet will the nurse include in patient teaching? Answer: More protein will be allowed because of the removal of urea and creatinine during dialysis 12. A client is taking an IV diuretic for fluid volume excess. Which of the folliwng assessments should the nurse report to the physician? Answer: decrease in potassium level below 3.5 13. Which information will the nurse monitor to determine the effectiveness of prescribed calcium carbonate (Caltrate) for a patient with CKD? Answer: Phosphate Level 14. A client with AKD has a serum potassium level of 7.0. The nurse would plan which actions as a priority? Select all that apply Answers: Review the clients medications to determine whether they contain potassium, place the client on a cardiac monitor, and notify the primary health care provider 15. I am ready for holiday break: answers are yes or no 16. Which of the following information is provided by the clients bed partner with sleep apnea? Answer: frequent snoring 17. The device that is used to treat sleep apnea is called a CPAP: Answer is true 18. The assistive nursing personnel reports the HR of sleeping 23 yr old who is following a tonsillectomy is 56. States that this HR is 10 beats per minute slower than when she took it earlier in the evening. The nurse knows that this is considered??? (BONUS QUESTION) Answer: Normal, they will continue to monitor the vital signs as ordered 19. The nurse knows that which of the following habits may interfere with a clients sleep? Answer: exercising before bedtime 20. Which of the following symptoms should the nurse assess with a client who is deprived of sleep? Answer: confusion and irritability 21. Which interventions would the nurse include in the plan of care for patient with sleep apnea? Answer: Avoid alcoholic beverages 3-4 hrs before bed, refer patients who are overweight to a weight loss program 22. To lessen the postop complication of DVT the nurse would: Answer: apply SCDS and remind client to exercise the legs and feet 23. My pre op patient is expected to have surgery in the next 60 min. When speaking with them they have questions. Because of time it is appropriate to send them to surgery instead of having them speak to the surgeon about the procedure: answer if FALSE 24. My patient is experiencing pain 9/10. Current vital signs are 107, 150/87, 24, 95%, and 37.9/ m. I know they take extended release oxycontin BID, Given their current pain score I know it is safe to administer fentanyl. Answer is TRUE 25. During preop, the nurse advices the client who smokes on an important health promotion measure to take before surgery that is to: answer is stop smoking at once to prevent major complications 26. Preop assessment data that should be reported to the surgeon include: answer is having a sore throat and fever 27. Match the ostomy with the expected output -Thick paste like, can sometimes be formed: Colostomy -Thin and watery: ileostomy 28\) Which assessment should the nurse perform FIRST for a patient who just vomited bright red blood? Answer: take the BP and pulse 29\) During a Chrons flare the patient should adhere to a low fiber diet and slow includes the amount of fiber in their diet as tolerated or directed by their provider. Answer is TRUE 30\) How should the nurse explain Nexium to a patient with recurring heartburn? Answer: It treats gastroesophageal reflux disease by decreasing stomach acid production 31\) After change of shift report, which patient should the nurse assess FIRST? Answer: 30 yr old female with severe abdominal pain and vomiting 32: The nurse is teaching