NUR 324 Final Exam: Alternative Therapies, Wound Healing, Sensory Deprivation, Exams of Nursing

Download NUR 324 Final Exam: Alternative Therapies, Wound Healing, Sensory Deprivation and more Exams Nursing in PDF only on Docsity! nur 324 fundamentals final exam questions and answers pH normal range - correct answer 7.35-7.45 PaCO2 normal range - correct answer 35-45 acid, lungs HCO3 normal range - correct answer 22-26 base, kidneys PaO2 normal range - correct answer 80-100 lungs SaO2 normal range - correct answer 95-100% base excess normal range - correct answer -2 - +2 assesses how well the buffers are working. < -2: excessive acids > +2: excessive bicarbonate nur 324 fundamentals final exam questions and answers compensated ABG values - correct answer -pH: 7.35-7.45 -PaCO2 and/or HCO3 abnormal -original problem: closer to 7.35 (acidosis); closer to 7.45 (alkalosis) partially compensated ABG values - correct answer -abnormal pH -PaCO2 OR HCO3 abnormal (source of imbalance: whichever value makes sense for the pH) -other abnormal is the one trying to compensate uncompensated ABG values - correct answer -abnormal pH -either PaCO2 or HCO3 abnormal (source of imbalance) -other one will be normal allopathic therapies - correct answer western conventional therapies complimentary therapies - correct answer in addition to allopathic treatment; neither is more important than the other nur 324 fundamentals final exam questions and answers acupressure - correct answer -manipulative and body-based method -digital pressure to relieve pain chiropractic medicine - correct answer -manipulative and body-based method -manipulating spinal column craniosacral therapy - correct answer -manipulative and body-based method -assesses craniosacral motion massage therapy - correct answer -manipulative and body-based method -manipulation of soft tissue mind-body interventions (4) - correct answer -biofeedback -guided imagery -meditation -yoga nur 324 fundamentals final exam questions and answers biofeedback - correct answer -mind-body intervention -use of instruments to provide information about autonomic responses guided imagery - correct answer -mind-body intervention -concentration on an image to treat pathological conditions meditation - correct answer -mind-body intervention -self guided practice for relaxation using breathing yoga - correct answer -mind-body intervention -focus on muscles, posture, breathing, and consciousness to enhance mental and physical wellbeing movement therapies (2) - correct answer -dance therapy -pilates nur 324 fundamentals final exam questions and answers dance therapy - correct answer -movement therapy -expression of the body/mind to treat social, emotional, cognitive, or physical problems pilates - correct answer -movement therapy -body movement to strengthen, lengthen, and improve voluntary control of muscles whole medical systems (4) - correct answer -Ayurvedic medicine -homeopathic medicine -naturopathic medicine -traditional chinese medicine Ayurvedic medicine - correct answer -whole medical system -from india; incorporates numerous therapies homeopathic medicine - correct answer -whole medical system -treat a disease by giving a small amount of a naturally occurring substance to trigger a response nur 324 fundamentals final exam questions and answers -reduces RR in asthmatic and cancer patients -what is a mind-body therapy that uses the conscious mind to create mental images to stimulate physical changes in the body, improve perceived well-being, and/or enhance self-awareness? -clinical application? - correct answer -imagery or visualization -pain control what are the limitations to imagery/visualization? - correct answer known side effects -anxiety/fear with PTSD and social anxiety disorders -COPD/asthma can experience airway constriction what is a mind-body technique that uses electromechanical instruments to teach self-regulation and voluntary self-control over thoughts, feelings, and physiological responses? - correct answer biofeedback acupuncture regulates/realigns vital energy, aka ______, which flows through channels in the form of a system of pathways called _______. - correct answer qi; meridians nur 324 fundamentals final exam questions and answers how does acupuncture work? - correct answer modifies the body's pain response and how pain is processed by central neural pathways and cerebral function what is it called when the practitioner places open palms on or close to the patient's body, using long downward strokes to touch or maintain the hands a few inches from the body? - correct answer therapeutic touch what are the 5 phases of therapeutic touch? - correct answer 1) centering 2) assessing 3) unruffling 4) treating 5) evaluating what does chiropractic therapy treat? - correct answer -acute pain and disability -enhances conventional treatment of pediatric asthma what are the contraindications for chiropractic therapy? - correct answer -bone infections nur 324 fundamentals final exam questions and answers -fractures -dislocations -osteoporosis in traditional chinese medicine, what is viewed as the cause of disease? - correct answer disruption of vital energy (qi) what CAM drugs are not regulated by the FDA? - correct answer -chinese herbs companies are allowed to sell herbs as dietary supplements as long as what? - correct answer as long as no health claims are written on their labels what are 2 things to remember with natural products? - correct answer -natural does not mean safe -can interact with prescription and OTC medicines use and potential drug interactions: aloe - correct answer -wound healing -loop diuretics nur 324 fundamentals final exam questions and answers what 3 things are necessary for effective hand washing? - correct answer soap, water, friction what are some nonpharmacological ways to promote sleep? - correct answer -warm milk -avoid caffeine, alcohol, and exercise right before -reading what are the steps to performing oral care on an unconscious patient? - correct answer 1) HOB 30-45 degrees 2) turn to side-lying position if possible 3) use oral swabs and suction equipment what are safety considerations for restrained patients? - correct answer -make sure 2 fingers fit underneath the restraint -tie restraint to bed frame not rail! -need MD order every 24 hr -use least restrictive measures first -every 2 hours: turn, offer hydration and elimination, assess circulation nur 324 fundamentals final exam questions and answers what is included in a clear liquid diet? - correct answer coffee, juice, broth, jello, popsicles what is included in a full liquid diet? - correct answer soup, milk, yogurt, coffee with creamer where should you start an IV on a limb? where do you go after a failed attempt? - correct answer -always start distal and move proximally up the limb; never go proximal to distal -might have to move to another extremity what is it called when a microorganism invades the host but does not cause infection? why does this happen? - correct answer -colonization -organism enters body but the body fights it off so infection does not occur what is the chain of infection? - correct answer infectious agent -> reservoir -> portal of exit -> mode of transmission -> portal of entry -> host -> infectious agent again nur 324 fundamentals final exam questions and answers another name for normal flora? - correct answer resident flora what are transient flora? - correct answer passed between people and cause infection what does the ability of microorganisms to cause disease depends on? (4) - correct answer dose, virulence, ability to enter and survive in the host, host resistance a _______ is someone who shows no symptoms of illness but who have pathogens in or on their bodies that can be transferred to others. - correct answer carrier what are 5 factors that make a host more susceptible? - correct answer 1) age (young, old) 2) nutritional status 3) chronic disease (COPD, AIDS, cancer) 4) smoking 5) trauma nur 324 fundamentals final exam questions and answers what is the difference between asepsis and aseptic technique? - correct answer -asepsis: absence of pathogenic microorganisms -aseptic technique: effort to keep the person as free from microorganisms as possible what's another name for medical asepsis? what does this include? - correct answer -clean technique -reducing the number of organisms present and preventing the transfer of organisms -hand washing, changing linens, using clean supplies, collecting fecal specimen what's another name for surgical asepsis? what does this include? when is this used? - correct answer -sterile technique -to eliminate ALL microorganisms from an object/area -surgery, protective isolation, entry into sterile areas of the body -sterile fields what can contaminate a sterile object or field? - correct answer when touched by something unsterile, out nur 324 fundamentals final exam questions and answers of visual range, below the waist, prolonged air exposure, when wet (surface) -edges of sterile field and container are considered unsterile when can you use alcohol rubs? when must you wash your hands? - correct answer only use hand sanitizer when hands aren't visibly soiled. otherwise must wash hands what is the difference between cleaning, disinfecting, and sterilizing? - correct answer -cleaning: removal of soil from object/surface -disinfection: process of killing all pathogenic organisms except their spores sterilization: process of eliminating and destroying all microorganisms, including spores and viruses what is the order of donning personal protective equipment? - correct answer 1) gown 2) mask 3) eyewear 4) gloves nur 324 fundamentals final exam questions and answers what do contact precautions include? - correct answer -MRSA, shigella, herpes simplex, scabies, varicella zoster, VRE -private room/cohort clients -gloves -gowns -client's own room equipment (make sure to cover glucose meter when used) when are droplet precautions needed? what do these include? - correct answer -for diseases spread by droplets > 5 microns (diphtheria, rubella, pneumonia, scarlet fever, pertussis, mumps) -private/cohort room -regular mask when are airborne precautions used? what is needed? - correct answer -diseases transmitted by droplets < 5 microns (measles, chicken pox, varicella zoster, TB) -private room with negative pressure -N95 respirator mask nur 324 fundamentals final exam questions and answers -auscultate over stomach and push air into tube (listen for air); chest xray what diet additions are necessary for those with ostomies? - correct answer sufficient fluid intake to help stool pass through ostomy how to attain an expectorated specimen? - correct answer 1) best in morning prior to oral care or eating 2) have them rinse mouth and spit the water out 3) they can hold the basin if able 4) deep breathe 3-4 breaths, then hold breath and cough 5) have them spit stuff directly into container 6) cover and send to lab within 30 minutes how to attain a suctioned sputum specimen? - correct answer 1) best in morning before oral care or eating 2) sterile technique 3) lubricate catheter with NS 4) insert, once they begin coughing suction for 5-10 seconds nur 324 fundamentals final exam questions and answers 5) let them rest for 1-2 min and repeat 6) apply O2 as indicated 7) cover and send to lab within 30 minutes 6 rights of medication administration - correct answer 1) patient 2) medicine 3) dose 4) route 5) time 6) documentation NG tube medication administration - correct answer 1) put in Fowler's and stop feedings 2) take 60mL syringe and aspirate: <250 mL, return and give meds. >250 mL hold meds and contact provider but make sure to return the fluid 3) flush with 30mL water/saline before and after each med (unless fluid restrictions, then as little as 5 mL) how many times to check the MAR before giving meds? - correct answer 3 times when pulling from drawer, when calculating/drawing up dose, at bedside before giving nur 324 fundamentals final exam questions and answers what is the "6th vital sign?" - correct answer pain what is a transition diet? - correct answer progresses from one form to another (like clear-full-regular) as their GI motility returns (like after surgery) what is proprioception? - correct answer awareness of the position of body parts immobility effects on cardiovascular system - correct answer -orthostatic hypotension (decreased fluid volume and CO) -increased cardiac workload (increased O2 consumption, decreased cardiac efficiency) -thrombus formation (damage to vessel wall, altered blood flow, altered blood constituents) immobility effects on respiratory function - correct answer -decreased respiratory movement, can cause atelectasis -stasis of secretions, can cause hypostatic pneumonia -hypoventilation, increased O2 demand nur 324 fundamentals final exam questions and answers how often should you change a patient's position? - correct answer q 2 hr how many people are needed for log rolling and where do they stand? - correct answer at least 3. one holding head straight, at least 1 pulling them onto bed, one holding feet still. keep entire spinal column straight what side do you transfer patients to with partial weight bearing ability? - correct answer toward their stronger side which side do you stand on with patient's who have an affected side? - correct answer stand on their affected side age related changes to skin and implications - correct answer 1) reduced elasticity, collagen, and thinning underlying muscle (easy to tear) 2) polypharmacy (interferes with wound healing) 3) decreased inflammatory response (slow epithelialization and healing) 4) decreased SQ tissue over bony prominences (greater chance of breakdown) nur 324 fundamentals final exam questions and answers 5) often reduced nutritional intake 6 risk factors for pressure ulcer development - correct answer 1) impaired sensory perception 2) impaired mobility 3) altered LOC 4) shear 5) friction 6) moisture what is shear force? - correct answer exerted parallel to the skin from gravity pushing them down (like in the bed) and the friction of the bed what is the braden scale range? what does it mean? - correct answer 6-23, the lower they are, higher the risk for developing an ulcer 5 things to assess a pressure ulcer for - correct answer 1) depth/stage 2) type and % of tissue in wound bed 3) dimensions (l x w x d) 4) exudate (amount, color, consistency, odor) nur 324 fundamentals final exam questions and answers 5) condition of surrounding skin (redness, warmth, swelling) how does the stage of a healing ulcer change in its description? - correct answer whatever it is originally staged as, it will forever be referred to as. then described by its appearance wound base tissue types - correct answer 1) granulation: red, moist, healing 2) slough: yellow/white stringy attached to wound bed. must be removed for healing 3) eschar: black/brown necrotic tissue. must be removed for healing 4) exudate: describe amount, color, consistency, and odor stage 1 pressure ulcer - correct answer -nonblanchable redness of intact skin, localized stage 2 pressure ulcer - correct answer -partial thickness skin loss or blister -abrasion, blister, shallow crater nur 324 fundamentals final exam questions and answers -redness and swelling partial thickness wound healing: epithelial proliferation and migration - correct answer second step -epithelial cells begin to regenerate -proliferation occurs at edges and migrate across moist surface partial thickness wound healing: reestablishment of epidermal layers - correct answer third and last step -new epithelium undergoes reestablishment and slowly regains normal thickness what are the 4 stages of full thickness wound healing? - correct answer 1) hemostasis 2) inflammation 3) proliferation 4) remodeling full thickness wound healing: hemostasis - correct answer first step nur 324 fundamentals final exam questions and answers -to control blood loss, establish bacterial control, and seal the injury -injured vessels constrict -platelets gather -clots form fibrin matrix: framework for cellular repair full thickness wound healing: inflammatory phase - correct answer second step -begins within minutes and lasts about 3 days -leukocytes arrive within a few hours and start to "clean" -in clean wound: controls bleeding and establishes a clean wound bed full thickness wound healing: proliferative phase - correct answer third step -3-24 days long -wound fills with granulation tissue; begins to contract and resurface -epithelial cells migrate from edges -vascular bed is reestablished and fills with replacement tissue full thickness wound healing: remodeling stage - correct answer fourth/final step nur 324 fundamentals final exam questions and answers -can take up to a year or more -collagen scar reorganizes and gain strength for months what is the difference between dehiscence and evisceration? - correct answer -dehiscence: partial or total separation of wound layers -evisceration: total separation of layers and protrusion of visceral organs what is an abrasion? - correct answer -superficial -little bleeding -partial-thickness wound what are nutritional requirements for wound healing? - correct answer -at least 1500 kcals/day -1.25-1.5 g protein/kg of body weight what's the best measure of nutritional status? - correct answer prealbumin level 15-36 nur 324 fundamentals final exam questions and answers when can you clamp a chest tube? - correct answer only when assessing for a leak. otherwise can cause tension pneumothorax important things to remember about supplemental oxygen - correct answer -considered a medicine. need an order, use 6 rights -flammable -make sure patient has enough in tank before ambulating/transporting -humidify with rates at or greater than 4L at what rate does oxygen need to be humidified? - correct answer 4 L or above oxygen flow rates per minute - correct answer 1) nasal cannula: up to 6L 2) simple face mask: at least 5L 3) partial rebreather: 6-10 L 4) nonrebreather mask: minimum of 10L 5) venturi mask: 4-12 L nur 324 fundamentals final exam questions and answers what amount of oxygen can COPD patients have? - correct answer no more than 2L/min unless a different order syringe size, needle gauge and length, max amount, location, and angle: intradermal injection - correct answer 1 mL tuberculin 25-27 G 1/2"-5/8" 0.1 mL ventral surface of forearm between dermis and epidermis 5-15* angle syringe size, needle gauge and length, max amount, location, and angle: SQ injection - correct answer 1 mL tuberculin/100u insulin 28-31 G 5/16-1/2" 1 mL or less multiple sites 45* (1 in.) - 90* (2 in.) nur 324 fundamentals final exam questions and answers syringe size, needle gauge and length, max amount, location, and angle: IM injection - correct answer 2-5 mL 21-25G 1-1.5" 2-5 mL ventrogluteal, deltoid, vastus lateralis 90* aspirate unless vaccine landmarks: intradermal forearm - correct answer 3-4 fingerbreadths below antecubital fossa, hands-breadth above wrist; pull skin taut landmarks: SQ upper arm - correct answer hands-breadth below acromium process, hands-breadth above antecubital fossa in posterior aspect of upper arm landmarks: SQ abdomen - correct answer 2" away from umbilicus below costal margins, between iliac spines (heparin). Insulin: on sides in fat pads; same angles as above nur 324 fundamentals final exam questions and answers -orogastric tube colostomy irrigations - correct answer -never use an enema set -use special cone tipped irrigator foods not to eat with an ostomy - correct answer stringy meats, mushrooms, popcorn, fruits with seeds, seafood normal adult urine output (day and hour) - correct answer 1200-1500 mL/day at least 30 mL/hour; normally 1 mL/kg/hour what does the RAAS do? - correct answer salt retention (and thus water), increases BP and vascular fluid volume renin, angiotensin, aldosterone 6 types of incontinence? - correct answer 1) reflex: damage to spinal cord, loss of voluntary control nur 324 fundamentals final exam questions and answers 2) overflow: bladder is too full and pressure exceeds sphincter 3) transient: caused by medical conditions that are often reversible (confusion, excessive output) 4) stress: weakness of sphincter/muscle (coughing, laughing) 5) urge: involuntary r/t strong and sudden urge 6) functional: immobility, dexterity, cognitive impairments) main caution point with peritoneal dialysis? - correct answer if the dialysate is left in the peritoneal cavity for too long, hyperglycemia can occur r/t glucose level of solution why does alcohol cause dehydration? - correct answer it inhibits ADH release, causing increased water loss in the urine difference between polyuria and diuresis? - correct answer -polyuria: excessive output of urine -diuresis: increased urine formation what 3 medicines can change the color of the urine? - correct answer -pyridium: orange/rust nur 324 fundamentals final exam questions and answers -amitriptyline: green/blue -levodopa: brown/black what is pyelonephritits? s/s? - correct answer -infection in the upper urinary tract (kidneys) -flank pain, tenderness, fever, chills what are the 2 main neuro controllers of sleep? - correct answer -hypothalamus -reticular activating system what are the 2 types of sensory nerve fibers for pain? - correct answer 1) fast A-delta: myelinated, sharp, localized, distinct 2) slow C: unmyelinated, poorly localized, burning, persistent acute/transient pain - correct answer protective, identifiable, short duration chronic episode pain - correct answer sporadically occurring over an extended duration nur 324 fundamentals final exam questions and answers when is parenteral nutrition used? why does the percentage of glucose matter? - correct answer -unable to digest or absorb enteral nutrition or are in highly stressed states (sepsis, head injury, burns, infection) -<10%: peripheral ->10%: central -always use filter peptic ulcer causes (3)? food and medicine practices to do and avoid? - correct answer -H. pylori, stress, acid overproduction -avoid caffeine, spicy foods -avoid aspirin and NSAIDs -consume small and frequent meals 2 types of inflammatory bowel disease? food types to increase/decrease? - correct answer -Crohn's, idiopathic ulcerative colitis -fiber increase -fat reduction -avoid large meals, lactose, sorbitol nur 324 fundamentals final exam questions and answers diet changes for diverticulitis - correct answer -acute infection: low to moderate residue diet -chronic: high fiber type 2 diabetes dietary levels: saturated fat, cholesterol, protein - correct answer -sat. fat: <7% -cholesterol: <200 mg intake -protein: 15-20% of diet diabetes dietary goals (glucose, LDLs, BP) - correct answer -normal to near-normal glucose levels - <100mg LDLs - <130/85 mmHg BP -avoid hypoglycemia CV diseases dietary changes (saturated and trans fats; cholesterol) - correct answer -trans: <1% -sat.: <7% -cholesterol: < 300mg/day nur 324 fundamentals final exam questions and answers what 3 major parts of the brain control senses? - correct answer 1) cerebral cortex 2) brain stem 3) cerebellum what part of the brain is responsible for thought, memory, reasoning, sensation, and voluntary movement? - correct answer cerebral cortex what are the 4 lobes of the cerebral cortex? - correct answer 1) frontal 2) parietal 3) temporal 4) occipital what are 8 responsibilities of the hypothalamus? - correct answer 1) respiratory center 2) temperature 3) appetite 4) sex drive 5) HR 6) BP 7) sleep nur 324 fundamentals final exam questions and answers 2) elimination of patterns 3) restrictive environments a score of less than ___ on the mini mental exam indicates _______ - correct answer 21 (out of 30 points) cognitive impairment glasgow coma scale range? what does it assess? - correct answer 3 (comatose)- 15 (awake and alert) LOC what is aphasia? what are the 3 kinds? - correct answer -difficulty producing or understanding language 1) expressive/Broca's: inability to produce meaningful speech 2) receptive/Wernicke's: inability to understand written or spoken language 3) global: both expressive and receptive the goal of surgical assessment is to establish what is _________ for the patient - correct answer normal nur 324 fundamentals final exam questions and answers during surgery, who reviews the pre-op assessment, establishes/implements a plan of care, and verifies sponge/instrument counts? - correct answer circulating nurse (must be RN) what are the 5 risk factors of surgery? - correct answer 1) blood clots 2) atelectasis 3) pressure ulcers 4) infection 5) pain what are prerenal, renal, and postrenal factors/conditions? - correct answer -pre: decreased blood flow to and through the kidneys -renal: disease conditions of the renal tissue -post: obstruction in the lower urinary tract that prevents urine flow what's the difference between side effects and adverse effects? - correct answer -side: predictable and often unavoidable produced by usual dosage nur 324 fundamentals final exam questions and answers -adverse: unintended, undesirable, and often unpredictable severe responses what are 5 examples of complete protein foods? - correct answer 1) fish 2) chicken 3) soybeans 4) turkey 5) cheese what are the 4 dysphagia diet levels? - correct answer 1) puree 2) mechanically altered 3) advanced 4) regular diet what tonicity is dextrose? - correct answer starts as isotonic but becomes hypotonic what do you administer for malignant hyperthermia? - correct answer dantrolene sodium