NSG233 / NSG 233 Final Exam 2024-
2025 |Medical-Surgical Nursing
III|BRAND NEW EXAM QUESTIONS
AND VERIFIED CORRECT DETAILED
ANSWER|ALL GRADED A+
Herzing|LATEST UPDATE
Diffusing anger in the ED - ANSWER-✔Self safety is PRIORITY
gunfire- protect self
separate feuding individuals
Heat Stroke ** - ANSWER-✔Priority action: Lower body temperature; O2, fluids,
cool towel, cool bath (NO ICE BATH) elevate feet
SATA: +HR, +temp, confusion, headache, anxiety, cramps, gooseflesh, HOT,DRY skin,
NO sweating
Abnormal labs: +BUN, + creatinine + myoglobinuria
-sodium, - potassium
Meds: Thorazine- reduce shiver
Monitor: vitals, ECG, LOC, urine output
BUN - ANSWER-✔10-20
Creatinine - ANSWER-✔0.6-1.2
Potassium - ANSWER-✔3.5-5.0
Sodium - ANSWER-✔135-145
, Alcoholic- first assessment - ANSWER-✔Priority: look for head injury, hypoglycemia
(which mimics intoxication), and other health problems.
Actions: detoxification, recovery, rehab
Ask if patient if they have gone through withdrawal before and had seizures
when was there last drink?
Benzos: sedative
Let them sleep if they calm-
not calm- benzo's
Non-fatal drowning ** - ANSWER-✔Priority: manage hypoxia, acidosis and
hypothermia > airway, oxygen
Management: CPR, core temp (rectal) rewarming procedures during CPR, trach/PEEP,
O2
Risks: ARDS> hypoxia, hypercarbia and respiratory acidosis can occur
Hypothermia> metabolic acidosis
NGT> decompress stomach and prevent aspirating gastric contents.
Monitor: ECG, ICP, serial chest xray, I/O
Labs: serum electrolytes
Highest risk: <5 yo, >85 yo
Freshwater: loss of surfactant- inability to expand lungs
Saltwater: pulmonary edema
Observe pt for 23 + hours
Serum Electrolytes - ANSWER-✔* Mg+ 1.5-2.5
* Phos 2.5-4.5
* K+ 3.5-5
* Ca 8.5-10.9
* Chl 95-105
Bite Priority - ANSWER-✔Animal: rabies prophylaxis
Snakebite: lie down, removing constrictive items, providing warmth, cleansing the
wound, covering the wound with a light sterile dressing, and immobilizing the
injured body part below the level of the heart.
CABs (Circulation, Airway Breathing)
NO: Ice, incision and suction, or a tourniquet
Tetanus and analgesia should be given as necessary.
Meds: FabAV or CroFAb: no limit on how much to give
S&S: necrosis, edema, ecchymosis
Tick: remove with tweezers, straight up pull, (try to get close to skin as possible)
S&S: bulls eye rash
Poisoning in the house - ANSWER-✔Carbon Monoxide: 100% O2
Atmospheric/hyperbaric chamber
Ingested Poison: ABC, Call poison control, try to describe what was ingested
Charcoal: most effective, Do not use if heavy metals were ingested. Corrosives: give
water/milk
, Cathartics: sorbitol: give w/ 1st dose of charcoal
syrup ipecac: Induces vomiting, only give to alert patients-and NO patients who
ingested a corrosive agent
Gastric emptying: intubate before lavage ( if -LOC/-gag reflex) with in 1 hour of
ingestion.
MODS- OD
01.04.03 ** - ANSWER-✔Find out what Patient OD'd on. Give antidote if there is one
Treatment goals for a patient with a drug overdose are to support the respiratory
and cardiovascular functions, to enhance clearance of the agent, and to provide for
safety of the patient and staff.
Abuse- interpersonal violence - ANSWER-✔Priority: ask questions IN PRIVATE,
separate from person who is abusive/neglectful
referral to shelter
adults are free to accept or refuse help
safety plans should be explored
Mandatory report: children and elderly abuse - only need to suspect abuse, do not
need to prove it
PTSD- rape and stabbing 01.04.06?? - ANSWER-✔Keep patient comfortable
Offer therapeutic communication -listen
Avoid triggers
Chest-Blunt trauma complications ** - ANSWER-✔Flail chest: paradoxical chest
movement, hypoxemia, resp acidosis
Pulmonary contusion: abnormal accumulation of fluid,
SATA: - lung sounds, cough, frank blood, mucus, chest pain, atelectasis, -BP, resp
acidosis
Monitor: fluid intake, fluid replacement and pain
Managment: airway, O2, treat pain, bronchoscopy
Meds: morphine
Medical Management• ABC-oxygen, possible endotracheal intubation, ventilatory
support• Replace fluid volume• Restore negative intrapleural pressure if needed•
Needle decompression• Chest tube if needed• Hemothorax• Pneumothorax• Hemo-
pneumothorax
Crush injuries and trauma - ANSWER-✔Hypovolemic shock
Spinal Cord Injury
Fractures
Acute Kidney Injury
Priority: ABC's
SATA: Rhabdomyolysis: Triad: muscle cramps, muscle weakness, dark urine
Labs: CK levels, serum lactic acid levels Compartment syndrome: elevate extremity,
fasciotomy.
proper alignment of extremities, check peripheral pulses
Meds: pain, cephalosporins, penicillin
