*NURSING > QUESTIONS & ANSWERS > NCLEX MEDICAL SURGICAL NURSING Q&A: Respiratory, Renal, Cardiovascular, Gastrointestinal, Endocrine (All)

NCLEX MEDICAL SURGICAL NURSING Q&A: Respiratory, Renal, Cardiovascular, Gastrointestinal, Endocrine, Musculoskeletal, Neurosensory/Neurological, Hematology/Oncology, Reproductive Systems and Burns.

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MEDICAL SURGICAL NURSING Q&A 1. RESPIRATORY SYSTEM: 2. List 4 common symptoms of pneumonia the nurse might note on a physical exam. 3. State 4 nursing interventions for assisting the client t... o cough productively. 4. What symptoms of pneumonia might the nurse expect to see in an older client? 5. What should the O2 flow rate be for the client with COPD? 6. How does the nurse prevent hypoxia during suctioning? 7. During mechanical ventilation, what are three major nursing intervention? 8. When examining a client with emphysema, what physical findings is the nurse likely to see? 9. What is the most common risk factor associated with lung cancer? 10. Describe the pre-op nursing care for a client undergoing a laryngectomy. 11. List 5 nursing interventions after chest tube insertion. 12. What immediate action should the nurse take when a chest tube becomes disconnected from a bottle or a suction apparatus? What should the nurse do if a chest tube is accidentally removed from the client? 13. What instructions should be given to a client following radiation therapy? 14. What precautions are required for clients with TB when placed on respiratory isolation? 15. List 4 components of teaching for the client with tuberculosis. 2. RENAL SYSTEM: 1. Differentiate between acute renal failure and chronic renal failure. 2. During the oliguric phase of renal failure, protein should be severely restricted. What is the rationale for this restriction? 3. Identify 2 nursing interventions for the client on hemodialysis. 4. What is the highest priority nursing diagnosis for clients in any type of renal failure? 5. A client in renal failure asks why he is being given antacids. How should the nurse reply? 6. List 4 essential elements of a teaching plan for clients with frequent urinary tract infections. 7. What are the most important nursing interventions for clients with possible renal calculi? 8. What discharge instructions should be given to a client who has had urinary calculi? 9. Following transurethral resection of the prostate gland (TURP), hematuria should subside by what post-op day? 10. After the urinary catheter is removed in the TURP client, what are 3 priority nursing actions? 11. After kidney surgery, what are the primary assessments the nurse should make? 3. CARDIOVASCULAR SYSTEM: 1. How do clients experiencing angina describe that pain? 2. Develop a teaching plan for the client taking nitroglycerin. 3. List the parameters of blood pressure for diagnosing hypertension. 4. Differentiate between essential and secondary hypertension. 5. Develop a teaching plan for the client taking antihypertensive medications. 6. Describe intermittent claudication. 7. Describe the nurse’s discharge instructions to a client with venous peripheral vascular disease. 8. What is often the underlying cause of abdominal aortic aneurysm? 9. What lab values should be monitored daily for the client with thrombophlebitis who is undergoing anticoagulant therapy? 10. When do PVCs (premature ventricular contractions) present a grave danger? 11. Differentiate between the symptoms of left-sided cardiac failure and right-sided cardiac failure. 12. List 3 symptoms of digitalis toxicity. 13. What condition increases the likelihood of digitalis toxicity occurring? 14. What life style changes can the client who is at risk for hypertension initiate to reduce the likelihood of becoming hypertensive? 15. What immediate actions should the nurse implement when a client is having a myocardial infarction? 16. What symptoms should the nurse expect to find in the client with hypokalemia? 17. Bradycardia is defined as a heart rate below BPM. Tachycardia is defined as a heart rate above BPM. 18. What precautions should clients with valve disease take prior to invasive procedures or dental work? 4. GASTROINTESTINAL SYSTEM: 1. List 4 nursing interventions for the client with a hiatal hernia. 2. List 3 categories of medications used in the treatment of peptic ulcer disease. 3. List the symptoms of upper and lower gastrointestinal bleeding. 4. What bowel sound disruptions occur with an intestinal obstruction? 5. List 4 nursing interventions for post-op care of the client with a colostomy. 6. List the common clinical manifestations of jaundice. 7. What are the common food intolerances for clients with cholelithiasis? 8. List 5 symptoms indicative of colon cancer. 9. In a client with cirrhosis, it is imperative to prevent further bleeding and observe for bleeding tendencies. List 6 relevant nursing interventions. 10. What is the main side effect of lactulose, which is used to reduce ammonia levels in clients with cirrhosis? 11. List 4 groups who have a high risk of contracting hepatitis. 12. How should the nurse administer pancreatic enzymes? 5. ENDOCRINE SYSTEM: 1. What diagnostic test is used to determine thyroid activity? 2. What condition results from all treatments for hyperthyroidism? 3. State 3 symptoms of hyperthyroidism and 3 symptoms of hypothyroidism. 4. List 5 important teaching aspects for clients who are beginning corticosteroid therapy. 5. Describe the physical appearance of clients who are Cushinoid. 6. Which type of diabetic always requires insulin replacement? 7. What type of diabetic sometimes requires no medication? 8. List 5 symptoms of hyperglycemia. 9. List 5 symptoms of hypoglycemia. 10. Name the necessary elements to include in teaching the new diabetic. 11. In less than ten steps, describe the method for drawing up a mixed dose of insulin (regular with NPH). 12. Identify the peak action time of the following types of insulin: rapid-acting regular insulin, intermediate-acting, long-acting. 13. When preparing the diabetic for discharge, the nurse teaches the client the relationship between stress, exercise, bedtime snacking, and glucose balance. State the relationship between each of these. 14. When making rounds at night, the nurse notes that an insulin-dependent client is complaining of a headache, slight nausea, and minimal trembling. The client’s hand is cool and moist. What is the client most likely experiencing? 15. Identify 5 foot-care interventions that should be taught to the diabetic client. 6. MUSCULOSKELETAL SYSTEM: 1. Differentiate between rheumatoid arthritis and degenerative joint disease in terms of joint involvement. 2. Identify the categories of drugs commonly used to treat arthritis. 3. Identify pain relief interventions for clients with arthritis. 4. What measures should the nurse encourage female clients to take to prevent osteoporosis? 5. What are the common side effects of salicylates? 6. What is the priority nursing intervention used with clients taking NSAIDs? 7. List 3 of the most common joints that are replaced. 8. Describe post-op stump care (after amputation) for the 1st 48 hours. 9. Describe nursing care for the client who is experiencing phantom pain after amputation. 10. A nurse discovers that a client who is in traction for a long bone fracture has a slight fever, is short of breath, and is restless. What does the client most likely have? 11. What are the immediate nursing actions if fat embolization is suspected in a fracture/orthopedic client? 12. List 3 problems associated with immobility. 13. List 3 nursing interventions for the prevention of thromboembolism in immobilized clients with musculoskeletal problems. 7. NEUROSENSORY/NEUROLOGICAL SYSTEMS: 1. What are the classifications of the commonly prescribed eye drops for glaucoma? 2. Identify 2 types of hearing loss. 3. Write 4 nursing interventions for the care of the blind person and 4 nursing interventions for the care of the deaf person. 4. In your own words describe the Glasgow Coma Scale. 5. List 4 nursing diagnoses for the comatose client in order of priority. 6. State 4 independent nursing interventions to maintain adequate respirations, airway, and oxygenation in the unconscious client. 7. Who is at risk for cerebral vascular accidents? 8. Complications of immobility include the potential for thrombus development. State 3 nursing interventions to prevent thrombi. 9. List 4 rationales for the appearance of restlessness in the unconscious client. 10. What nursing interventions prevent corneal drying in a comatose client? 11. When a comatose client on IV hyperalimentation begin to receive tube feedings instead? 12. What is the most important principle in a bowel management program for a neurologic client? 13. Define cerebral vascular accident. 14. A client with a diagnosis of CVA presents with symptoms of aphasia, right hemiparesis, but no memory or hearing deficit. In what hemisphere has the client suffered a lesion? 15. What are the symptoms of spinal shock? 16. What are the symptoms of autonomic dysreflexia? 17. What is the most important indicator of increased ICP? 18. What vital sign changes are indicative of increased ICP? 19. A neighbor calls the neighborhood nurse stating that he was knocked hard to the floor by his very hyperactive dog. He is wondering what symptoms would indicate the need to visit an emergency room. What should the nurse tell him to do? 20. What activities and situations should be avoided that increase ICP? 21. How do Hyperosmotic agents (osmotic diuretics) used to treat intracranial pressure act? 22. Why should narcotics be avoided in clients with neurologic impairment? 23. Headache and vomiting are symptoms of many disorders. What characteristics of these symptoms would alert the nurse to refer a client to a neurologist? 24. How should the head of the bed be positioned for post-craniotomy clients with infratentorial lesions? 25. Is multiple sclerosis thought to occur because of an autoimmune process? 26. Is paralysis always a consequence of spinal cord injury? 27. What types of drugs are used in the treatment of myasthenia gravis? 8. HEMATOLOGY/ONCOLOGY: 1. List 3 potential causes of anemia. 2. Write 2 nursing diagnoses for the client suffering from anemia. 3. What is the only intravenous fluid compatible with blood products? 4. What actions should the nurse take if a hemolytic transfusion reaction occurs? 5. List 3 interventions for clients with a tendency to bleed. 6. Identify 2 sites, which should be assessed for infection in immunosuppressed clients. 7. Name 3 food sources of vitamin b12. 8. Describe care of invasive catheters and lines. 9. List 3 safety precautions for the administration of antineoplastic chemotherapy. 10. Describe the use of Leucovorin. 11. Describe the method of collecting the trough and peak blood levels of antibiotics. 12. What is the characteristic cell found in Hodgkin’s disease? 13. List 4 nursing interventions for care of the client with Hodgkin’s disease. 14. List 4 topics you would cover when teaching an immunosuppressed client about infection control. 9. REPRODUCTIVE SYSTEM: 1. What are the indications for a hysterectomy in the client who has fibromas? 2. List the symptoms and conditions associated with cystocele. 3. What are the most important nursing interventions for the postoperative client who has had a hysterectomy with an A&P repair? 4. Describe the priority nursing care for the client who has had radiation implants. 5. What screening tool is used to detect cervical cancer? What are the American Cancer Society’s recommendations for women ages 30 to 70 with three consecutive normal results? 6. Cite 2 nursing diagnoses for a client undergoing a hysterectomy for cervical cancer. 7. What are the 3 most important tools for early detection of breast cancer? How often should these tools be used? 8. Describe 3 nursing interventions to help decrease edema post mastectomy. 9. Name 3 priorities to include in a discharge plan for the client who has had a mastectomy. 10. What is the most common cause of nongonococcal urethritis? 11. What is the causative agent for syphilis? 12. Malodorous, frothy, greenish-yellow vaginal discharge is characteristic of which STD? 13. Which STD is characterized by remissions and exacerbations in both males and females? 14. Outline a teaching plan for the client with an STD. 10. BURNS: 1. List 4 categories of burns. 2. Burn depth is a measure of severity. Describe the characteristics of superficial partial-thickness, deep partial-thickness, and full-thickness burns. 3. Describe fluid management in the emergent phase, acute phase, and rehabilitation phase of the burned client. 4. Describe pain management of the burned client. 5. Outline admission care of the burned client. 6. Nutritional status is a major concern when caring for a burned client. List 3 specific dietary interventions used with burned clients. 7. Describe the method of extinguishing each of the following burns: thermal, chemical and electrical. 8. List 4 signs of an inhalation burn. 9. Why is the burned client allowed NO “free” water? - Describe an autograft. [Show More]

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