NZ Nursing STATE EXAM 202 3 QUESTIONS WITH 100% CORRECT SOLUTIONS.
What does Ambulatory mean? Answer- Day surgery (max stay 23 hours)
What does inpatient surgical care mean? Answer- Admitted to hospital (min 24 hours)
Surgery classifications? Answer- Elective
Diagnostic
Acute
List 3 patient orientated goals post surgery? Answer- Return to normal physical function
Remain free from post op complications
Achieve emotional and physical comfort
What is included in a pre-op assessment? (5) Answer- Obtain history
Physical assessment
Determine patient understanding
Identify emotional state and coping skills
Check consent, pre anaesthetic form complete, other pre anaesthetic orders
What does atelectasis mean? Answer- Collapse or closure of lung resulting in reduced or absent gas exchange
List 5 ways to safely care for post op patients? Answer- Fluid balance input and output Pain management Assessing wound
Vital signs every five minutes
Checking IV site
What is meningitis? Answer- A serious disease in which there is inflammation of the meninges
Signs and symptoms of meningitis? Answer- Intense headache
Fever
Light sensitivity
Muscular rigidity
Main cause of meningitis? Answer- Bacterial: Streptococcus pneumoniae Viral: Enterovirus Signs of raised intercranial pressure? (4) Answer- Headache
Nausea
Increased bp
Confusion
What is the purpose of the nursing council? Answer- To protect the health and safety of members of the public by ensuring RNs are registered, fit to practise, and competent.
Signs of otitis? (Ear infection/inflammation) Answer- Ear pain
Fever
Difficulty hearing
What would you do if prescribed medication was not signed by the doctor? Answer- Do not give until a signature or verbal consent has been given with a witness
Signs of a patient on methamphetamine? (5) Answer- Dilated pupils
Agitation
Increased bp Loss of appetite
Paranoia
List 5 pieces of advice to give a patient following a total hip replacement? Answer- Place a pillow between legs when lying on side Avoid bending past 90 degrees
Avoid crossing legs
Sit on chairs higher than knee height Take short frequent walks
What is airway obstruction caused by? Answer- Tongue
Laryngospasm
Retained secretions
Insufficient anaesthetic reversal
Treatment for airway obstruction? Answer- Correct positioning
o2 therapy
Suctioning
Close monitoring
Viral signs
Anti emetics
Manifestations of atelectasis? Answer- Insidious onset
Early s&s: cough, sputum, low grade fever
Later s&s: respiratory distress, dyspnoea, tachycardia, pleural pain, cyanosis, anxiety
What is a pulmonary embolism? Answer- Occurs from a deep vein thrombosis, clot forms, travels to lungs or brain, life threatening Diagnosis of a pulmonary embolism? Answer- Chest X-ray Ecg Abg Ultra sound
Pulmonary angiography
How to prevent a pulmonary embolism? Answer- Pre op weight loss
Compression stockings
Early animation
Hydration
Meds
What causes a deep vein thrombosis? Answer- Occurs in leg veins due to inactivity,
body positioning, and pressure
Risk factors for DVTs? Answer- Elderly
Poor nutrition
Surgery over three hours
Limited mobility
Long haul flights
Diabetes
What is wound dehiscence? Answer- Disruption of previously joined wound edges due to an infection, too tight sutures, or injury to wound
Risk factors for wound dehiscence? Answer- Elderly
Poor nutrition
Diabetes
Abdominal surgery
Immunosuppressant
Smoking
Signs of wound inflammation? Answer- Redness
Warmth
Malaise ( general discomfort)
Tachycardia
Febrile
What are treatments for pain? Answer- Positioning
Analgesia
List some side effects of opioid use? Answer- Decreased bp
Decreased LOC
Vomitting
Respiratory depression
Constipation
What would you assume if someone's temperature was slightly lower post surgery? Answer- This could be normal due to lack of muscle movement to keep body warm What would you assume if someone's temperature was slightly higher post surgery? Answer- This could be normal due to inflammation being the 1st sign of healing
What would a temp above 38 4-5 days post op signify? Answer- Infection/sepsis
What is autologous blood collection? Answer- Providing blood for oneself
What fresh blood components are given in blood transfusions? Answer- Red cells- used to treat anaemia, severe bleeding. Platelets- to stop bleeding, used in ICU or cancer treatment
Fresh frozen plasma or cryoprecipitate- used for replacing clotting factors and rarely other blood proteins. Used in ICU or liver disease patients
Blood donations are always tested for? Answer- Infection
Hep B & C
HIV & AIDS Syphilis ABO group
Rh type
Blood group antibodies
What cell is carefully checked before a blood transfusion for incompatibility? Answer- Red blood cells
What is a blood crossmatch? Answer- When a sample of the patients blood is used along with the donors blood for a transfusion
List some risks for blood transfusions? Answer- Mild fever
Skin rash
Kidney failure
Dyspnoea
Minor virus infection
What type of burns are there? Answer- Thermal
Electrical
Caustic chemical injury Radiation exposure
Inhalation of noxious fumes
What occurs with a thermal burn? Answer- Proteins denature
Irreversible cellular damage occurs
Acute inflammatory response
What is a 1st degree burn + what occurs? Answer- Superficial partial thickness burn
Damage to epidermis
Triggers vasodilation
Increased capillary permeability Heals within a week
Give an example of a 1st degree burn? Answer- Sunburn
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