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NUR 437 Midterm Exam Questions with Complete Answers
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NUR 437 Midterm Exam Questions with Complete Answers
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NUR 437 Midterm Exam Questions withComplete Answers
Describe CURE. - Answer-C: Critical (Potentially life threatening, such as respiratory
distress and chest pain, ABCs)
U: Urgent (Safety needs and pain control, such as low blood sugar and pain medication)
R: Routine (Responsibilities such as assessments, vitals and scheduled medications)
E: Extras (Patient requests such as ice chips and warm blankets)
Describe the Five F's of prioritizing. - Answer-Fatal- failure to do could cause death or
injury (respiratory distress)
Fundamental- essential to profesional definition of job (assessments)
Frequent- must be done many times (vitals)
Fixed- must be done within a certain time frame (medications)
Facility- aspects of the job set as standards by the organization. (charting)
You are caring for a patient with chronic obstructive pulmonary disease (COPD). Which
intervention for airway management should you delegate to a nursing assistant (PCT)?
A. Assisting the patient to sit up on the side of the bed
B. Instructing the patient to cough effectively
C. Teaching the patient to use incentive spirometry
D. Auscultation of breath sounds every 4 hours - Answer-A (Assisting patients with
positioning and activities of daily living is within the educational preparation and scope
of practice of a nursing assistant. Teaching, instructing, and assessing patients all
require additional education and skills and are more appropriate for a licensed nurse.)
After change of shift, you are assigned to care for the following patients. Which patient
should you assess first?
A. A 60-year old patient on a ventilator for whom a sterile sputum specimen must be
sent to the lab
B. A 55-year old with COPD and a pulse oximetry reading from the previous shift of
90% saturation
C. A 70-year old with pneumonia who needs to be started on intravenous (IV) antibiotics
D. A 50-year old with asthma who complains of shortness of breath after using a
bronchodilator - Answer-D (The patient with asthma did not achieve relief from
shortness of breath after using the bronchodilator and is at risk for respiratory
complications. This patient's needs are urgent. The other patients need to be assessed
as soon as possible, but none of their situations are urgent. in COPD patients pulse
oximetry oxygen saturations of more than 90% are acceptable.)
Describe assessment and patient education regarding Coumadin (Warfarin) - Answer-
Assessment:
Monitor for signs of bleeding, such as hematuria, blood in the stool (black, tarry stools),
excessive bruising and excessive menstrual bleeding.
,Patient education:
Avoid contact sports, use a soft bristle toothbrush, report signs of bleeding to provider,
keep vitamin K consistent in diet, takes 5-7 days to take effect so we use heparin in
conjunction with Warfarin until it takes effect
Describe assessment and patient education regarding buprenorphine (Subutex) -
Answer-Assessment: Monitor for respiratory depression and therapeutic effect. This
medication is used to reduce the symptoms of narcotic withdrawal.
Patient education:
This medication is used to treat addiction to narcotic pain relievers. High risk for
addiction and dependence, do not dc abruptly. Do not take with any other CNS
depressants.
Given sublingually
What was Arne Ardings diagnosis? - Answer-Respiratory failure and sepsis
Which patient had opioid dependence? - Answer-Regina Fields
What was Kyle Miller's diagnosis? - Answer-Cellulitis
What was Harry Chester's diagnosis? - Answer-Pneumonia and COPD
What condition is potassium chloride used to treat? - Answer-Hypokalemia
The use of digital information and communication technologies, such as computers and
mobile devices, to access health care services remotely and manage your health care.
These may be technologies you use from home or that your doctor uses to improve or
support health care services. - Answer-Telehealth
List some examples of telehealth. - Answer--Use a mobile phone or other device to
upload food logs, medications, dosing and blood sugar levels for review by a nurse who
responds electronically.
-Watch a video on carbohydrate counting and download an app for it to your phone.
-Use an app to estimate, based on your diet and exercise level, how much insulin you
need.
-Use an online patient portal to see your test results, schedule appointments, request
prescription refills or email your doctor.
-Order testing supplies and medications online.
-Get a mobile retinal photoscreening at your doctor's office rather than scheduling an
appointment with a specialist.
-Get email, text or phone reminders when you need a flu shot, foot exam or other
preventive care.
What are some drawbacks to telehealth? - Answer--Treatment may not be coordinated
with your regular doctor.
-Essential information from your medical history may not be considered.
, -The computer-driven decision-making model may not be optimal if you have a complex
medical history.
-The virtual visit lacks an in-person evaluation, which may hamper accurate diagnosis.
-The service doesn't easily allow for shared doctor-patient decision-making about
treatments or making a plan B if an initial treatment doesn't work.
-also runs the risk of fragmenting health care Fragmented care may lead to gaps in
care, overuse of medical care, inappropriate use of medications, or unnecessary or
overlapping care.
What are the goals of telehealth? - Answer--Make health care accessible to people who
live in rural or isolated communities.
-Make services more readily available or convenient for people with limited mobility,
time or transportation options.
-Provide access to medical specialists.
-Improve communication and coordination of care among members of a health care
team and a patient.
-Provide support for self-management of health care.
What was Sam Sanders' diagnosis? - Answer-Acute appendicitis
What was Isabella's diagnosis? - Answer-Bronchiolitis R/O RSV
What was Ana's diagnosis? - Answer-DKA
What is one common side effect of albuterol? - Answer-Tachycardia
Why is Isabelle Capstone on phenobarbital? - Answer-She had a seizure because of
her VP shunt from hydrocephalus as a newborn. She is on phenobarbital to prevent
further seizures while she is in the hospital.
Assessment and patient education for morphine. - Answer-Assessment
-Assess pain level before and after administration.
-Monitor for respiratory depression.
-Assess bowel habits due to constipation.
Patient education
-Tell pt. about side effects (respiratory depression and constipation)
Patient education for Rhogam. - Answer-Rhₒ(D) immune globulin is a medication used
to prevent Rh isoimmunization in mothers who are Rh negative and to treat idiopathic
thrombocytopenic purpura in people who are Rh positive. It is often given both during
and following pregnancy. It may also be used when Rh negative people are given Rh
positive blood.
Refers to interpretations and inferences that influence actions in clinical practice. -
Answer-Clinical judgment
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