NUR 330 Final Exam Review Questions
and Solutions
Somatic tissue pain ✅bone fractures, abrasions, sunburn
Visceral tissue pain ✅appendicitis, pancreatitis (internal tissue)
Neuropathic pain ✅burning, numbing, shooting, stabbing pain, phantom limb pain
Breakthrough pain ✅temporary severe pain while having chronic pain
Three categories of drugs to treat pain ✅nonopioid, opioid, co-analgesic
Analgesic ceiling effect ✅occurs when a given pain drug no longer effectively controls
pain despite the administration of the highest safe dosages
Opioids side effects ✅respiratory depression, constipation, hypotension, sedation
Anecdote for opioids ✅naloxone (narcan)
Patient-controlled analgesia (PCA) ✅common for post op pain
Must be used by pt only
Physical dependence (addiction) ✅manifested by withdrawal syndrome when blood
levels drop abruptly; can occur with extended use of opioids
Why do we treat geriatric pt's more cautiously with pain ✅metabolize drugs more
slowly, risk of GI bleeds with nsaids, multiple drug use
How do we detect pain in pt's who are unable to self report ✅behavioral changes,
restlessness, agitation, facial expressions, changes in breathing
Factors that affect adherence ✅demographic variables, financial variables, illness
severity, health literacy
What happens to the cartilage in pt's with osteoarthritis ✅become dull, yellow, and
granular; soft and less elastic, less able to resist wear with heavy use
At what age does cartilage destruction begin? ✅begins between ages 20 and 30
,Risk factors for osteoarthritis ✅age, decreased estrogen at menopause, obesity,
anterior cruciate ligament injury, frequent kneeling and stooping
Osteoarthritis s/s ✅deep, aching joint pain, stiffness in the mornings and after
exercise, crepitus, grating of the joint, altered gait, decreased ROM, joint enlargement
Herberden's nodes and Bouchard's nodes ✅red, swollen, and tender; no significant
loss of function; visible deformities
Meds that treat mild-moderate joint pain ✅acetaminophen, capsaicin cream, topical
salicylates, hyaluronic acid
Meds that treat moderate-severe joint pain ✅NSAID, COX-2 inhibitor celecoxib
(Celebrex)
Nutritional supplements that help joint pain and purpose ✅glucosamine and
chondroitin sulfate; help relieve pain and improve mobility
Factors affecting learning ✅readiness, environment, teaching techniques
Learning readiness ✅patient's willingness to engage in the teaching-learning process
(emotional readiness) and experiential readiness to begin the challenge of learning
Healthy people 2020 goal ✅increase quality of years and eliminate health disparities
Adolescent teachings should focus on what? ✅focus on creating healthy habits early
to prevent negative results of risky behaviors
Young/middle aged adult teachings should focus on what? ✅focus on healthy
behaviors, pregnancy and family, cancer screenings, chronic illness, activities offered at
the workplace
Advantages of CVAD ✅immediate access
Reduced venipuncture
Decreased risk of extravasation
Disadvantages of cvads ✅increased risk of systemic infection
Invasive procedure
Peripherally inserted central catheter (PICC) ✅a device inserted into a peripheral vein
and designed and used for administration of sterile fluids, nutrition formulas, and
medications into central veins
Advantages of PICC ✅lower infection rate
, Fewer insertion related complications
Decreased cost
Complications of PICC ✅catheter occlusion and phlebitis
Advantages of implanted infusion port ✅good for long-term therapy
Low risk of infection
Cosmetic discretion
Valsalva maneuver ✅forcible exhalation against a closed glottis, resulting in increased
intrathoracic pressure
Hypovolemia ✅abnormal loss of normal body fluids, inadequate intake, or plasma-to-
interstitial fluid shift
Hypovolemia treatment ✅replace water and electrolytes with balanced IV solutions
Hypervolemia ✅excessive intake of fluids, abnormal retention fo fluids (HF), or
interstitial-to-plasma fluid shift
Hypervolemia treatment ✅remove fluid without changing electrolyte compositions or
osmolality of ECF
Types of isotonic solutions ✅D5W, normal saline, lactated ringers
Types of hypotonic solutions ✅1/2 normal saline
Types of hypertonic solutions ✅D5NS (5% dextrose in 0.9% nacl)
Hypernatremia causes ✅loss of sodium containing fluids or from water excess
S/s of hyponatremia ✅confusion, nausea, vomiting, seizures, coma
Nursing implementations for hyponatremia ✅fluid restriction and fluid replacement with
sodium containing solution
S/s of hypernatremia ✅thirst, lethargy, agitation, seizures, coma, impaired LOC
Nursing implementations for hypernatremia ✅treat underlying cause and give IV
solution 5% dextrose in water
Hypokalemia causes ✅abnormal losses of k+ through kidneys or GI tract, mg
deficiency, metabolic alkalosis
