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NSG 4100 final exam Problem Solving Exam Questions and With Distinction level Marking scheme updated 2024/2025
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NSG 4100 final exam Problem Solving Exam Questions and With Distinction level Marking scheme updated 2024/2025 Expected outcomes for patents with a complete spinal cord injury - correct answer signifies loss of both sensory and voluntary motor communication from brain to peripherally, resulting ...

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  • October 24, 2024
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  • 2024/2025
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NSG 4100 final exam Problem Solving Exam
Questions and With Distinction level Marking scheme
updated 2024/2025

Expected outcomes for patents with a complete spinal cord injury - correct answer
signifies loss of both sensory and voluntary motor communication from brain to
peripherally, resulting in paraplegia or tetraplegia


Expected outcomes for patients with an incomplete spinal cord lesion - correct answer
denotes the ability of the spinal cord to relay messages to and from the brain
- sensory and motor function is preserved below the lesion


Expected outcomes for patient with central cord lesions - correct answer motor deficits
in upper extremities compared to lower
- sensory loss in upper extremities, bowel and bladder dysfunction is variable or
completely preserved


Expected outcomes for patient with an anterior cord lesion - correct answer - loss of
pain, temp, and motor function below level of lesions
- light touch, position, and vibration sensation remain intact


Expected outcomes for patient with a lateral cord injury - correct answer ipsilateral
paralysis or paresis together with ipsilateral loss of touch, pressure, vibration, and
contralateral loss of pain and temp


What is Guillain-Barre syndrome? - correct answer is an autoimmune attack on the
peripheral nerve myelin, that results in acute rapid segmental demyelination on
peripheral nerves and some cranial nerves, producing ascending weakness with
dyskinesia (inability to execute voluntary movements), hyporeflexia, and paresthesias
(sensation of numbness tingling, or a "pins and needles" sensation


Interventions for pts with Guillain-barre syndrome to maintain respiratory function -
correct answer - maximize IS and chest physiotherapy

,- changes in vital capacity and negative inspiratory force is key early prevention to RF
- Assist fam and ot in potential of mechanical ventilation discussion upon admission
- suction to maintain clear airway


Interventions for pts with Guillain-barre syndrome to enhance physical mobility - correct
answer - supportive paralyzed extremity in functional positioning and passive ROM
x2/day
- VTE prevention - anticoagulants, ROM exercise, anti-embolism stockings, sequential
compression, adequate hydration
- reduce pressure injuries
- assess lab results for indications of malnutrition and dehydration


Interventions for pts with Guillain-barre syndrome to provide adequate nutrition -
correct answer - administer fluids and parenteral nutrition
- assess return of gag reflex and bowel sounds - before oral nutrition


Interventions for pts with Guillain-barre syndrome to reduce fatigue - correct answer -
help identify activities that are demanding, assess amount of sleep, and healthy eating
to maintain strength


Interventions for pts with Guillain-barre syndrome to monitor and manage potential
complications - correct answer - dysrhythmias
- transient htn
- orthostatic hypotension
- VTE
- urinary retention
- Respiratory Failure: breathlessness, accessory muscle use, tachycardia, weak cough,
changes in respiratory status


What are the 3 phases of burns? - correct answer - emergent/resuscitative phase
- acute/intermediate phase

,- rehabilitative state


How long does the emergency phase last? - correct answer from onset of injury to
completion of fluid resuscitation


What are the main priorities of the emergent phase - correct answer - Primary surgery
of ABCDE
- prevention of shock
- prevention of respiratory distress
- detection and tx of concomitant
- wound assessment
- initial care


What on the scene care will be provided in the emergent care phase? - correct answer
- airway potency and breathing must be assessed during the initial minute of emergency
- immediate therapy is directed toward establishing a patent airway and giving
humidified 100% oxygen
- Insert ET tube and initiate mechanical ventilation if burn pt has severe respiratory
distress or airway edema and qualified personnel is available
- Restrict fluids and food b/c N/V is likely to occur and we want to prevent aspiration


What procedures are done at the burn scene - correct answer - extinguish the flames
or remove from source: stop, drop, and roll; stop, sit, pat; disconnect electrical source
before approaching
- cool burn: soak with cool water; never ice or longer than 20 min because it can lead to
hypothermia
- remove restrictive objects: remove affected, non adherent clothing immediately
- cover wound: minimize bacterial contamination, maintain body temp, decrease pain;
clean-dry cloth in emergency, no ointments; no meds or materials
- irrigate chemical burns: irrigate immediately and continuously with copies amount of
water

, Medical management for pt with mild pulmonary injury - correct answer - 100%
humidified oxygen
- pt is encouraged to cough to remove expectorates or suction prn


Medical management for pt with severe pulmonary injury - correct answer remove
secretion by bronchial suctioning and administration of bronchodilators


Parkland formula - correct answer 4ml x TBSA (%) x body weight (kg); 50% given in
first eight hours; 50% given in next 16 hours.
- it is used from starting point of time of injury NOT when pt arrived to ED


Fluid resuscitation for emergent care - correct answer - used when TBSA is >20% -->
LR
- peripherally IV initially
- for larger wounds, use central venous access- due to large volumes required
- 1st. Calculate TBSA
- 2nd. Use parkland formula to determine total fluids to be given in 24 hrs
- 3rd. Find the rate of fluids to be given


How to find the rate of fluids to be given - correct answer - for the first 8hrs, you divide
the total half fluids given by 8
- for the last 16hrs, you divide the total half fluids given by 16


Nursing management for pts in emergent burn care - correct answer - insertion of
indwelling cathether
- monitor temp: hypothermia develops rapidly
- NG tube inserted and low intermittent suction for burns greater than 20% or 25%
TBSA
- increased BP and HR: not good indicators due to inflammatory response
- monitor circulation
- to assess BP. - apply clean dressing under cuff to protect from contamination

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