rn intense remedial packet questions

8/19/2019 RN Intense Remedial Packet Questions

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Hurst Review Services 1

Fluid and Electrolytes

1. What is fluid volume excess?

2.

What is another term for fluid volume excess?

3. How can heart failure cause hypervolemia (or fluid volume excess)?

4. How can renal failure cause fluid volume excess?

5. How can IV fluids with sodium induce hypervolemia?

6. Alka-Seltzer contains a lot of which electrolyte?

7. How can Alka-Seltzer cause hypervolemia?

8. Fleets enemas contain a lot of which electrolyte?

9.

How can a fleet enema cause hypervolemia?

10. What is the normal action of aldosterone?

11. How can aldosterone cause hypervolemia?

12. What is the name of the disease a client can have that will induce hypervolemia due to toomuch aldosterone?

13. What hormone works the opposite of aldosterone?


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Hurst Review Services

14. How does ANP correct FVE?

15. What is the normal action of ADH, and what does ADH stand for?

16. How can ADH cause hypervolemia?

17. Where is ADH stored?

18. What will the effects be on the body if a client is producing too much ADH? What is the

name of this disease?

19.

What will the effects be on the body if the client does not have enough ADH? What is thename of this disease?

20. What happens to the veins of the client who is hypervolemic?

21. Why does the hypervolemic client develop edema?

22.

Define CVP. Where is CVP measured?

23. What is normal CVP?

24. If a client is hypervolemic, what will happen to the CVP?

25. If a client is hypovolemic, what will happen to the CVP?

26. If a client is hypervolemic, what are the lung sounds like and why?


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27. Why does the client who is hypervolemic develop polyuria?

28. What happens to the blood pressure and pulse with hypervolemia? Explain why.

29. What happens to the weight in hypervolemia? Why?

30. What type of diet is prescribed for the hypervolemic client? Explain why.

31. If a hypervolemic client is placed on a high-sodium diet, what will happen?

32. Why would you do daily weights on the hypervolemic client?

33. Explain why diuretics are given to the hypervolemic client.

34. Furosemide(Lasix) is a common diuretic. What is the major electrolyte imbalance thatyou are worried about with this drug?

35.

What is the major electrolyte imbalance to watch for with thiazide diuretics?

36. Spironolactone (Aldactone) is a potassium-sparing diuretic. What is the major electrolyte

imbalance you watch for with this drug?

37. How does bed rest cause diuresis?

38. Why is it so important to give IV fluids very slowly to the elderly?

39. What is another name for fluid volume deficit?


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40. Define fluid volume deficit.

41. How can GI losses affect your vascular space?

42. What is third spacing?

43. How can ascites induce hypovolemia?

44. How can burns induce hypovolemia?

45. Why will the diabetic client develop polyuria?

46. The person with polyuria will eventually develop what life threatening complication?

47. What three changes will you see in the urine output that will indicate the body is

compensating?

48. How does hypovolemia affect the weight?

49. During hypovolemia, what happens to the blood pressure and pulse and why?

50. During hypovolemia, what happens to the CVP? Explain why.

51. During hypovolemia, what happens to the veins? Explain why.


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52. Why do the extremities of a client who is hypovolemic become cool?

53. What is going to happen to the urine specific gravity if a client is hypovolemic?

54. What is the treatment for mild fluid volume deficit?

55. What is the treatment for severe FVD?

56. What safety precautions are needed for the FVD client and why?

IV Fluids

57. How do isotonic solutions work?

58. Why is an isotonic solution contraindicated in a client with hypertension?

59.

What complications do we worry about when administrating isotonic solutions?

60. How do hypotonic solutions work? Give examples.

61. When would a hypotonic solution be used?

62. Why would I worry about FVD in the client receiving a hypotonic solution?

63. How do hypertonic solutions work? Give an example.

64. When would a hypertonic solution be used?


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65. Why would I worry about FVE in the client receiving a hypertonic solution?

Magnesium and Calcium:

Hypermagnesemia:

66. How do we get rid of excess magnesium from our body?

67. Renal failure can cause hypermagnesemia. Explain why.

68. Magnesium acts like a _______________________.

69.

If a client has hypermagnesemia, what will happen to their DTR’s, muscle tone,respirations, and level of consciousness?

70. Could the client with hypermagnesemia have a life-threatening arrhythmia?

71. Why does the client who has hypermagnesemia develop flushing and warmth?

72. What effect will this flushing and warmth from hypermagnesemia have on the blood

pressure?

73. Why would a client with hypermagnesemia require a ventilator?

74.

Why would a client with hypermagnesemia be dialyzed?

75. Why is calcium gluconate given to someone who has hypermagnesemia?


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Hypercalcemia:

76. Hyperparathyroidism can induce hypercalcemia. Explain how.

77. What is the normal action of parathormone?

78. How do thiazide diuretics cause hypercalcemia?

79. How does immobilization (bed rest) cause hypercalcemia?

80. If a client has too much calcium in the blood, what kind of muscle tone will the client have?

81. What will the client’s DTRs be like?

82. How will it affect the client’s LOC, pulse, and respirations? Could the client have an

arrhythmia?

83.

Could the client have a kidney stone? Why?

84. Why is it so important to get the client walking or weight-bearing with hypercalcemia?

85. Why is it so important to increase fluids in hypercalcemia?

86. Calcium has an inverse relationship with what other electrolyte?


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87. What do steroids do to your serum calcium level?

88. How does vitamin D help calcium?

89. What drug will return calcium to the bones? What disease is this drug used for?

Hypomagnesemia:

90. How can diarrhea induce hypomagnesemia?

91.

Why are alcoholics prone to hypomagnesemia?

92. If you have a client with hypomagnesemia, what will the client’s muscles be like?

93. Could the client have a seizure?

94.

Why do we worry about the client’s airway?

95. Why does the client with hypomagnesemia have a positive Chvostek’s and Trousseau’s,

and what will happen to the DTRs?

96. Could the client with hypomagnesemia have arrhythmias?

97.

Describe the level of consciousness of the client with hypomagnesemia.

98. Would the client with hypomagnesemia have problems swallowing?

99. Why is it so important to check for renal failure prior to giving IV magnesium?


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100. Why are seizure precautions necessary when caring for a client with hypomagnesemia?

101. Why is it so important to discontinue the mag-sulfate infusion if a client begins to have

flushing and sweating?

Hypocalcemia:

102. How does hypoparathyroidism affect the serum calcium levels?

103.

How could a radical neck dissection/thyroidectomy affect the serum calcium level?

104. List symptoms of hypocalcemia and explain why the client has these symptoms.

105.

Why do we give the hypocalcemic client vitamin D?

106. If a client has hyperphosphatemia, what other electrolyte imbalance will be present?

107. How will phosphate binders increase calcium levels?

108.

Why do we give the hypocalcemic client calcium carbonate and calcium gluconate?


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109. When you are giving someone IV calcium, what is the most important thing you need to

remember to do? Explain why.

Sodium:

Hypernatremia:

110. If you have a client who is very dehydrated, what will happen to their serum sodium level?

Explain why.

111.

If you have a client who is dehydrated, what will happen to their H&H? Explain why.

112. Why does the client who is hypernatremic have dry sticky mucous membranes and why arethey thirsty?

113. There is one organ in the body that really does not like it when sodium is out of balance.What is it?

114. Why is it so important when you are trying to lower someone’s serum sodium level that youdilute the client with IV fluid gradually?

115. If you have a client who is becoming dehydrated, what will begin to happen to their sodiumlevel? And what should you do before the client becomes hypernatremic?

116.

Why is it so important to ensure proper water replacement with tube feedings?


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Hyponatremia:

117. If a client is hyponatremic, what is their blood like? Concentrated or dilute? Why?

118. How can D5W make someone’s serum sodium go down?

119. How can drinking too much water make your serum sodium go down?

120. When you have a hyponatremic client, it is important that you restrict water. Explain why.

121. What IV fluids are used to treat hyponatremia? What nursing alerts are necessary when

administering these fluids?

Potassium:

Hyperkalemia:

122. What organs must be working properly to help maintain the normal potassium level in your

blood?

123. How can renal failure cause hyperkalemia?

124. How can spironolactone cause hyperkalemia?

125. What are the major symptoms of hyperkalemia?


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126. When a client with a potassium imbalance has an arrhythmia, they are very dangerous.

Why? What type of arrhythmias will the client have?

127. When you have a hyperkalemic client, why do we dialyze them?

128. Why do we give the hyperkalemic client calcium gluconate?

129. Why do we give the hyperkalemic client glucose and insulin?

130. How does sodium polystyrene sulfonate (Kayexalate) work?

131. When you give sodium polystyrene sulfonate (Kayexalate), you can expect the serum potassium level to go down; therefore, what will happen to the serum sodium level? Explain

Hypokalemia:

132. How can vomiting induce hypokalemia?

133. What are the S/S of hypokalemia?

134. Why is it so important that you monitor the digoxin client closely for hypokalemia or other

electrolyte imbalances?

135. How does spironolactone (Aldactone) help hypokalemia?


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136. Why is it so important to asses urine output before starting IV potassium?

137.

What are some foods high in potassium?

138. What is the major side effect of oral potassium supplements?


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Acid Base

1. What are the major acid/base chemicals? Are they acids or bases? What organs control eachchemical?

2. What does the pH tell you?

3. What organ does not like it when the pH is messed up?

4. In respiratory acidosis or alkalosis, what are the problem organs?

5. In respiratory acidosis or alkalosis, who is going to compensate?

6. In metabolic acidosis or alkalosis, what are the problem organs?

7. In metabolic acidosis or alkalosis, who is going to compensate?

8. When you think of the lungs, what chemical needs to pop into your mind?

9. When you think of the kidneys, what chemicals needs to pop into your mind?

10. Can CO2 be a chemical that makes you sick and be a chemical that makes you compensate?

11. Can bicarb and hydrogen be chemicals that make you sick and be chemicals that make youcompensate?


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12. What is the only way you can have a buildup of CO2 in your blood?

13. What is the only way to lower CO2 in the blood?

Respiratory Acidosis:

14. In respiratory acidosis, which organs are not working right? Who is going to compensate?

How does the compensation work?

15. In respiratory acidosis, what has happened to the CO2 level in your blood? What caused theincrease? Give examples.

16. In respiratory acidosis, how is the client breathing? And how does this affect the CO2 level

in the blood?

17. What is going to happen to the bicarb level in respiratory acidosis?

18. Why does it do this?

19. When someone gets very acidotic, what happens to their level of consciousness?

20. When a client has a high CO2 level in their blood, what is going to happen to the oxygen

level in their blood?

21. What are the early signs of hypoxia?


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22. When you have a client in respiratory acidosis, what is the primary thing that has to be

fixed? Explain some ways this can be fixed.

Respiratory Alkalosis:

23. When someone is in respiratory alkalosis, what organs are going to compensate? With whatchemicals are they going to compensate? Explain the compensation.

24. When someone is in respiratory alkalosis, how do they have to be breathing?

25.

How does their breathing cause alkalosis?

26. What has happened to the pH in respiratory alkalosis?

27. What is the bicarb level going to do in respiratory alkalosis?

28. When someone is hysterical, why can they go into respiratory alkalosis?

29. What is the immediate treatment for respiratory alkalosis?

30. If you have a client who is on the ventilator, and the respiratory rate is set too high, will the

client go into respiratory acidosis or respiratory alkalosis? Explain why.

31. How will sedation affect respiratory alkalosis?

Metabolic Acidosis:

32. In metabolic acidosis, what are the problem organs? What chemicals are altered?


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33. What happens to the pH and why?

34. Which organs are going to compensate? With what chemical will they compensate?

35. If you have a client who is in acidosis, do you want that client to retain CO2 to compensate,

or do you want this client to lose more CO2?

36. CO2 is a what?

37. If you have a client in metabolic acidosis, what is going to happen to their respiratory rateand why?

38. How can a DKA client go into metabolic acidosis?

39. How can an anorexic or bulimic client go into metabolic acidosis?

40. What are ketones and how do they affect the blood?

41. How can diarrhea induce metabolic acidosis?

42. In any type of metabolic acidosis, what is going to happen to the serum potassium level?Therefore, what is the major electrolyte imbalance they will have, and what is the major side

effect they will have?


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Metabolic Alkalosis:

43. In metabolic alkalosis, which organ has the problem? Therefore, what chemicals are going

to be altered?

44. In metabolic alkalosis, which organs are going to compensate? What chemical are they

going to compensate with? Explain compensation.

45. How can vomiting or NG tube suction induce metabolic alkalosis?

46. Explain why antacids can cause metabolic alkalosis.

47. Why do we have to worry about hypokalemia in the alkalotic client? What life threatening

complication can occur?

48. Treatment for metabolic alkalosis is directed toward what?


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Burns

1. If someone has been burned, fluid seeps out into the tissue, why?

2. When the fluid seeps into the tissue, what happened to the blood pressure and the pulse?Explain why.

3. Why does the cardiac output decrease when the fluid seeps out into the tissue?

4. During this phase (when the fluid is seeping into the tissue), is this client in a fluid volume

deficit or fluid volume excess?

5. When a client is in a fluid volume deficit, why does their urine output decrease?

6. After a major burn, when fluid is seeping out into the tissue, why is it important that ADH

and aldosterone are secreted?

7. What is the treatment for carbon monoxide poisoning? Explain why.

8. When a client has any type of upper body burns, why do we have to worry about theairway?

9.

What are the s/s of airway injury in the burn client?


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10. Explain the Rule of Nines.

11. Using the Parkland formula, what percent volume of fluid is given the 1st 8 hours, 2nd 8

hours, and 3rd 8 hours?

12. What measurement is the best to way evaluate fluid volume status in the burn client?

13.

How will an IV with albumin help fight shock? What are the risks with albuminadministration?

14. Explain the difference between the tetanus toxoid and the tetanus immune globulin.

15. What is the purpose of the escharotomy?

16. What electrolyte do we worry about with burns?

17. Why do clients with burns take a GI protectant medication, like an antacid or proton-pumpinhibitor?

18. What is the purpose of measuring gastric residual?

19. Why are multiple antibiotics used when treating burns?

20. When a client has an electrical injury, they are at a high risk for what arrhythmia?


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21. How long is the client at risk for a life-threatening arrhythmias?

22. Why can a client with an electrical burn have kidney failure?


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Oncology

1. At what age should yearly mammograms start?

2. Why do testicular exams need to be done monthly?

3. Explain nursing assignments for radiation clients.

4. When a client has a radiation implant, why do we put them on a low fiber diet?

5. Why does this client have a foley catheter?

6. Why do we want to keep the client with a radiation implant on bed rest?

7. When a client has a radiation implant, there is a chance it will become dislodged. What

would you do?

8. Explain the nursing care for the markings that a client will have when they are receiving

external radiation therapy.

9. List basic side effects of chemotherapy.

10. What is a vesicant?


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11. What do you do if a vesicant infiltrates?

12. What is the danger of a vesicant infiltrating?

13. List 6 general ways to prevent infection in the client receiving chemotherapy.

14. What is one of the major complications post-hysterectomy and why?

15. When a client has had an abdominal hysterectomy, what is the position to avoid? Explain

why.

16. Explain the post op care for a client who has had a mastectomy.

17. Why is it so important that the mastectomy client elevate her arm on the affected side?

18.

Why is it important that the client exercise the affected side after a mastectomy?


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19. List discharge teaching precautions for the mastectomy client.

20.

When a client has a bronchoscopy, they are NPO until what returns?

21. What are some complications of a bronchoscopy that you need to watch for?

22. Explain the procedure to obtain a sputum specimen.

23. When a client has had a pneumonectomy, what is the nursing care as far as positioning andwhy?

24. Why does the client who has had a total laryngectomy need to have a tracheostomy?

25.

Why does the client who had a total laryngectomy need to be positioned in Fowler’s

position?

26. Why does the laryngectomy client need to have NG feedings?

27. Why is it important that the laryngectomy client have frequent mouth care?

28. Explain suctioning.


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29. Why are Ulcerative Colitis and Crohn’s disease considered to be risk factors for colon

cancer?

30. Explain, in your own words, an ileal conduit.

31. What is the major symptom of bladder cancer?

32. Why is it important that hourly outputs be monitored after a client has had an ileal conduit?

33. Is mucous in the urine normal after an ileal conduit?

34. Why is it important that the ileal conduit client change their appliance in the morning?

35. Explain the pathophysiology behind urinary retention with an enlarged prostate (benign prostatic hypertrophy), BPH.

36. What are the symptoms of BPH? Why do they get these symptoms?

37. What is the major lab work assessed when prostate cancer is suspected?

38. Why does the client not have an incision with a TURP?

39. What is the most common complication of a TURP?


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40. When a client has had a TURP, why do they not have to worry about impotency and

infertility?

41.

Explain how a three-way catheter works and why the prostatectomy client has to have it.

42. How do Kegel exercises help prostatectomy clients?

43. Why is it important that the prostatectomy client avoid sitting, driving, strenuous exercise,

and lifting?

44. Why does the prostatectomy client have to take Colace?

45. What is one of the risk factors of stomach cancer?

46. When a client has had a fresh GI surgery, such as gastrectomy, is it okay for the nurse to

manipulate the NG tube?

47. What are the two major complications of a gastrectomy?

48. What are the S/S of GI tract obstruction?


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Endocrine

1. List the major symptoms of hyperthyroidism.

2. What is another name for hyperthyroidism?

3. Why does the client develop the symptoms of hyperthyroidism?

4. What happens to the workload of the heart in hyperthyroidism?

5. What do you have to have in your diet to make thyroid hormones?

6. Explain how the antithyroid drugs work.

7. Give examples of the antithyroid drugs:

8. Why do we give iodine compounds preoperatively?

9. Why do you have to give iodine compounds in milk or juice and use a straw?

10. Why would the hyperthyroid client be put on beta blockers? How does this help the client?

11. How does radioactive iodine work?

12. What is one of the major complications of radioactive iodine?


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13. When a client has had a thyroidectomy, why is it so important for them to support theirneck?

14.

How do you want a thyroidectomy client to be positioned? Explain why.

15. Why do we check for bleeding behind the neck with a thyroidectomy client?

16. Why do we keep a trach set at the bedside with a thyroidectomy client?

17. How do you assess for recurrent laryngeal nerve damage in the thyroidectomy client?

18. Why do we have to assess for parathyroid removal in the thyroidectomy client?

19. How do you assess for parathyroid removal?

20. What is another name for hypothyroidism?

21. When someone is hypothyroid, what has happened to their thyroid hormone levels?

22. What are the S/S of hypothyroidism?

23. What is cretinism?


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24. How do you treat hypothyroidism?

25. When a client has started on drug therapy for hypothyroidism, is it temporary or permanent?

26. When somebody is hyperparathyroid, what is the major electrolyte imbalance they have?

27. Why do you have to worry about the bones of a client with hyperparathyroidism?

28. Why does the hyperparathyroid client have kidney stones?

29. What is the major electrolyte imbalance a hypoparathyroid client will have?

30. What type of symptoms will this client exhibit?

31. Why does the hypoparathyroid client need a quiet environment?

32. Why does the hypoparathyroid client need a trach tray at the bedside?

33. Why is it important that the hypoparathyroid client have a diet that is limited in phosphorus?


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34. When a client has a Pheochromocytoma, what is the major problem they have?

35. What happens to this client’s blood pressure and pulse?

36. What is the major diagnostic test for Pheochromocytoma? Explain.

37. What are the four major actions of glucocorticoids?

38. When you hear the word mineralocorticoids, what is the major word you need to think of?

39. How does aldosterone work?

40. What is another name for glucocorticoids, mineralocorticoids, or sex hormones?

41. Why do steroids drive your blood sugar up?

42. If a client is making too much aldosterone, what is going to happen to the vascular space?Explain why.

43. Explain briefly the basic pathophysiology of Addison’s disease.

44. What is the major electrolyte imbalance a client with Addison’s disease will have?


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45. What are the S/S of hyperkalemia?

46.

Could the Addison’s disease client also have a life-threatening arrhythmia? If so, why?

47. Does the Addison’s disease client have too many steroids in their blood or not enough

steroids in their blood?

48. Why does the Addison’s disease client have trouble with shock?

49. Why does the Addison’s disease client need more sodium in their diet?

50. Why is I&O such an important nursing intervention with the Addison’s disease client?

51. Is the Addison’s disease client in a fluid volume deficit or a fluid volume excess?

52. What happens to the Addison’s disease client’s blood pressure?

53. When a client has Cushing’s syndrome, explain briefly, in your own words, what the client

will look like?


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54. Why does the Cushing’s syndrome client experience the following?

a. Growth arrest

b. Thin extremities and skin

c. Increased risk for infection

d.

Hyperglycemia

e. Psychosis to depression (changes in mood)

55. Is the Cushing’s syndrome client in a fluid volume deficit or excess?

56. Why does the Cushing’s syndrome client develop high blood pressure and heart failure?

57. When a client has Cushing’s syndrome, their serum potassium level goes down. Why?

58. Why does the Cushing’s syndrome client need more calcium in their diet?

59. Does the Cushing’s syndrome client need to be on a low-sodium diet or a high-sodium diet?

Explain.

60. Why does the Cushing’s syndrome client have ketones and glucose in their urine?

61. Why does the Cushing’s syndrome client not have protein in their urine? Is it normal to have

protein in the urine?

62. In the diabetic client, why does the glucose build up in their blood?

63. In the diabetic client, why does the body start breaking down protein and fat?


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64. Anytime you break down fat, you are going to get production of what?

65. Ketones are what?

66. What is the major acid base imbalance the diabetic client can develop and explain why.

67. Why does the diabetic develop the following symptoms?

a. Polyuria

b. Weight loss

c. Polydypsia

d. Polyphagia

68. Explain how oral hypoglycemic agents work and give examples.

69. Why will an oral hypoglycemic agent not work in a Type I diabetic?

70.

Why does a Type II diabetic have problems with wounds that will not heal or repeatedvaginal infections?

71. What is the common treatment for Type II diabetics?

72. In the treatment of a diabetic, why do we have to limit the protein in the diet?

73. Why are diabetics prone to coronary artery disease?


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74. How can a high-fiber diet benefit a diabetic client?

75. When the diabetic client exercises, why do they have to worry about hypoglycemia and how

can they prevent it?

76. Why is it important that a diabetic client exercise when their blood sugar is at its highest?

77. How does the primary healthcare provider determine the insulin dose? What would it be fora 175 pound client? Round to nearest whole number.

78. What is the only type of insulin that can be given IV?

79. How often is a long acting insulin like Glargine given?

80. What two assessments indicate that the insulin dose is adjusted properly?

81. What insulin types are used in a Basal/Bolus dosing?

82. When is the Basal insulin given? When is the Bolus insulin given?

83. What is the significance of a HbAlc of 8%?

84. What type of insulin is used in an insulin pump?


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85. Explain how the Basal/Bolus method is similar to the body’s natural response to insulinneeds?

86.

When insulin is at its peak, that means the insulin is working really hard; therefore, what isgoing to happen to the blood sugar at the peak time?

87. How can hypoglycemia be prevented?

88. Why is rotating injection sites important for the client on insulin?

89.

What is going to happen to anybody’s blood sugar when they are sick or stressed?

90. When a diabetic client is sick, their blood sugar is going to go up; therefore, what do theyneed to do with the dose of their insulin?

91. What major complication can occur in a Type I diabetic when the blood sugar is

uncontrolled?

92.

What are some general S/S of hypoglycemia, and what is the immediate nursing action?

93. After giving a simple sugar to the hypoglycemic client, what would the nurse do next?

94. Why is hypoglycemia considered to be more dangerous than hyperglycemia?

95. If you walk into a diabetic client’s room and find the client unconscious, do you treat theclient as hypoglycemic or hyperglycemic?

96. Why is it so important that a diabetic client eat regularly and take their insulin regularly?


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97. Explain the basic pathophysiology behind diabetic ketoacidosis.

98. When a client has diabetic ketoacidosis, why is it important that we measure the blood sugar

and the potassium hourly?

99. When you give a client insulin, what do you expect it to do to the client’s blood sugar?

Why?

100. When you give a client insulin, what do you expect it to do to the client’s serum potassiumlevel? Explain why.

101. Why is it so important that we monitor the diabetic ketoacidotic client’s EKG so closely?

102. Why are we measuring hourly output on the diabetic ketoacidosis client?

103. When a client has oliguria and anuria, what do you really have to start worrying about andwhy?

104. Explain diabetic foot care thoroughly.


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Cardiac

1. Describe preload and afterload.

2. What is cardiac output?

3. If your cardiac output is decreased, do you perfuse as well as you normally do?

4. What conditions can affect your cardiac output?

5. If you are taking care of a client with decreased cardiac output, what is going to happen to

their level of consciousness?

6. Could they start complaining of chest pain?

7. Why does a client’s (whose cardiac output is low) skin feel cool and clammy?

8. When you are taking care of a client who has decreased cardiac output, why do they get

short of breath and have wet lung sounds?

9. When you are taking care of a client who has decreased cardiac output, why do their

peripheral pulses diminish?

10. What is going to happen to urine output when you have a client who has decreased cardiac

output?


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11. When you have a client with decreased cardiac output, why does their blood pressure drop?

12. How will bradycardia affect cardiac output?

13. How can tachycardia (i.e., heart rate> 150) affect cardiac output?

14. When someone has had an MI, how can this affect cardiac output and why?

15.

If my blood pressure is really high, how will this affect cardiac output and why?

16. Draw a picture of my square heart and include the lungs and the aorta and trace the normal

blood flow through the heart.

17. What is chronic stable angina?

18. Explain the pain a client has with angina.

19. Why is nitroglycerine given?


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20. When you give somebody nitroglycerine, more ________________ is going to get to the

heart muscle?

21. How do you teach a client to take their nitroglycerine?

22. Why could nitroglycerine sublingual have a burning sensation?

23. What is a common and expected side effect of nitroglycerine?

24. When you give somebody nitroglycerine, are they going to vasoconstrict or vasodilate?

Therefore, what is going to happen to their blood pressure?

25. Why do clients with angina need beta blockers? List several examples.

26. What is the purpose of aspirin for the angina client?

27.

Why is it so important that the angina client avoid isometric exercise, overeating, caffeine,or any drugs that increase the heart rate and avoid cold weather?

28. Why is it so important that the angina client rest frequently?

29.

Is it okay for a client with angina to take their nitroglycerine prophylactically?

30. Before they take their nitroglycerine, should the client sit down or stand up? Explain.


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31. Why is it so important that you ask the client if they are allergic to iodine before they go for

a heart catheterization?

32. Any time you have a client who is injected with iodine-based dye, what is the common

complaint the client will have?

33. In post-cardiac catheterization, you have to watch the puncture site closely. What are we

watching it for?

34.

When a client has had a heart cath, you have a pertinent nursing assessment you need to dodistal to the insertion site. Explain.

35. With a MI (myocardial infarction), why does the client have necrosis?

36. Will rest or nitroglycerine relieve MI pain?

37. Explain how MI pain feels.

38. Why does an MI client get cold, clammy, and their blood pressure drop?

39. Which biomarker would be appropriate if the client has delayed treatment post MI?

40. Is a negative myoglobin a good thing or a bad thing?


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41. When a client is having a MI, what arrhythmia is a very high risk?

42. When a client goes into V-fib, what is the priority nursing action?

43. What antiarrhythmics are used when the V-Fib is resistant to defibrillation?

44. What drugs are used for chest pain when the MI client arrives to the ED?

45. How do thrombolytics work? Give me three examples of common thrombolytics.

46. What is the major complications of a thrombolytic?

47. Before you give a thrombolytic, you are supposed to get a good history. What did I tell you

to focus on (what type of disease or illness)?

48. After someone has received a thrombolytic, why is it so important that we decrease puncturesites?

49. What is angioplasty and what is the major complication of angioplasty?

50. If you increase preload, what do you do to the workload of the heart?


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51. List some ways preload can be increased.

52. List some ways preload can be decreased.

53. Explain afterload in your own words.

54. If you increase afterload, what do you do to the cardiac output?

55. If cardiac output is decreasing, that means the blood is not moving forward. If blood is not

moving forward, then it has got to go backwards, so therefore where is it going to wind up?

56. What are the major symptoms of left-sided heart failure and explain why.

57. Why does a client with left-sided failure have restlessness and tachycardia?

58.

Why does a client with left-sided failure have nocturnal dyspnea?

59. Why does the client with left-sided failure basically have pulmonary symptoms?

60. What are the major symptoms of right-sided failure?

61. When a client is in right-sided failure, is the blood backing up into the arterial system or the

venous system?


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62. What does a Swan Ganz catheter measure inside the heart?

63. What does this catheter measurement tell you?

64. What is an A-line?

65. Why is it so important that the distal circulation be checked when a client has an A-line?

Explain your checks that you are going to do (nursing assessment).

66. If an A-line is accidentally pulled out, what is the first thing that needs to be done?

67. When a client has an A-line, pressure has to be kept in the infusion bag. Why? What wouldhappen if you didn’t keep the pressure on the inf usion bag?

68. Why does the client in heart failure develop cardiomegaly?

69. Which two medication groups are the standard for heart failure?

70. Explain how digoxin (Lanoxin) works.

71. Why do we use digoxin (Lanoxin) with caution in the elderly?


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72. When you start a client on an ACE, ARB or digoxin expect their cardiac output to increase;

therefore, what should happen to their:

a. Level of consciousness?

b. Lung sounds?

c.

Urine output?

d. Skin?

e. Peripheral pulses?

f. Blood pressure?

73. Why does a heart failure client need Furosemide (Lasix)?

74.

When a client goes on a low-sodium diet and bed rest, what might happen to them?

75. Why do we give diuretics in the morning?

76. What is your natural pacemaker?

77. What do artificial pacemakers do?

78. Can the electrical part of your heart be working and the pumping mechanism not?

79.

Explain the difference between a demand and a fixed-rate pacemaker.


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80. You really need to get worried about a pacemaker malfunctioning when the rate of the

pacemaker does what?

81. Why is it so important that we immobilize the arm on the affected side after pacemaker

insertion?

82. Why does the pacemaker client need to check their pulse every day?

83. Why does the pacemaker client have to avoid electromagnetic fields? Give some examples

84. If a HF client notices their weight increasing, what could that put them at risk for?

85. What is pulmonary edema?

86.

How does a client develop pulmonary edema?

87. What time of day does pulmonary edema usually occur and why?

88. What are the major S/S of pulmonary edema?

89. Why is the client in pulmonary edema restless and anxious?


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90. Why is it so important that we hurry up and decrease the circulating volume in the

pulmonary edema client?

91. When a client is in pulmonary edema, why do we give them oxygen? How much do we give

them?

92. What is Natrecor and what precautions do we use when administering?

93.

When a client is in pulmonary edema, why is it important that you sit them up with theirlegs down?

94. What are the hallmark signs of cardiac tamponade?

95. Why are these hallmark signs occurring?

96.

What events put a client at risk for cardiac tamponade?

97. What is intermittent claudication?

98. When a client has an arterial problem, it means the oxygen/blood are having a hard time

getting to the tissue, so therefore different S/S develop. Explain the S/S.

99. Could a client with an arterial problem develop ischemia and necrosis in the affected

extremity? Explain.


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100. How will angioplasty help an arterial problem?

101.

When a client has a venous disorder, are they having trouble with oxygenation of theaffected extremity?

102. Do you elevate venous disorders or lower venous disorders (such as an affected extremity)?

103. Explain the pathophysiology behind a venous disorder.

104.

Why does a client with a venous disorder need Heparin?

105. How do TED hose help venous disorders?

106. When taking care of a client with a venous disorder, do you use warm moist heat or cold

wet packs?

107.

With DVT prevention is the key. We _____________ and _______________ the client.


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Psychiatric Nursing

1. Why is the client with depression irritable?

2. Why do we want to prevent isolation when a person is depressed?

3. Why as depression lifts does the suicide risk go up?

4. How do you respond to a client’s delusion of grandeur?

5. Why does the manic client like to dress seductively?

6. What is the reason a manic client likes to manipulate?

7.

Why do you not want to argue with or try to reason with the manic client?

8. What is an example of inappropriate affect in the schizophrenia client?

9. How does the nurse respond to the schizophrenia client’s neologism?

10. What is the most important thing to remember with a suicidal client?

11. If you use restraints for a suicidal client what must you do?


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12. What is most important in the treatment of paranoia?

13. Why does the highly anxious client need step-by-step instructions?

14. Why do we include time in the schedule for rituals with an obsessive compulsive disorderclient?

15. Why does the alcoholic have trouble with losing their magnesium and potassium?

16. Why would you observe the bulimic client for one hour after they have eaten a meal?

17. Explain the reason follow up is the key to successful treatment of a phobia?

18. How can the client with panic attacks learn to stop their anxiety?

19. Why do you warn a hallucinating client before you touch them?

20. Why do you give atropine pre procedure for electro-convulsive therapy?


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Renal

1. What is the major cause of glomerulonephritis?

2. When a client has glomerulonephritis, are they in a fluid volume deficit or a fluid volumeexcess?

3. When a client has glomerulonephritis. Why do they develop malaise and headache?

4.

When a client has glomerulonephritis, why does their urine output go down?

5. When a client has glomerulonephritis, why does their BUN and creatinine go up?

6. When a client has glomerulonephritis, why do they get protein in their urine?

7. Explain CVA tenderness.

8. In glomerulonephritis, why does the blood pressure go up?

9. And what will happen to the urine specific gravity?

10. With any type of kidney disease, it is common for the BUN to be elevated; therefore, why

do we limit the protein in the diet?


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11. If you add protein to the diet of anyone with renal disease, what will happen to their BUN?

12. Why does the glomerulonephritis client need rest?

13. When determining fluid replacement for a renal disease client (glomerulonephritis), youalways give them what they lost in a 24- hour period plus 500 mL. What is the purpose of

adding 500 mLs?

14. Once diuresis begins in glomerulonephritis, will the client be at risk for a fluid volumedeficit or fluid volume excess?

15. When a client has nephrotic syndrome, what is the major element that is leaking out in their

urine?

16. What will protein or albumin hold onto in the vascular space?

17. If a client does not have protein or albumin in their vascular space (blood), what is going to

happen to all the fluid that is supposed to stay in their vascular system?

18. How does this affect the vascular space?

19. Therefore, will the nephrotic syndrome client (in the acute stages) be in a fluid volume

deficit or fluid volume excess?

20. When a client has nephrotic syndrome, they develop total body edema, what is the proper

term for total body edema?


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21. When a client has nephrotic syndrome, it is common for them to be placed on prednisone.

Why?

22. Does the nephrotic syndrome client need a high-sodium diet or a low-sodium diet? Explain

why.

23. Does the nephrotic syndrome client need a high-protein diet or a low-protein diet? Explain

why.

24.

How can bradycardia cause renal failure?

25. How can hypovolemia cause renal failure?

26. How can shock cause renal failure?

27. How can decreased cardiac output cause renal failure?

28. How can glomerulonephritis, nephrotic syndrome, or diabetes cause renal failure?

29.

How can a kidney stone cause renal failure?

30. How can ureteral swelling cause renal failure?


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31. How can a tumor or an enlarged prostate cause renal failure?

32. When a client is in renal failure, why does their BUN and creatinine go up?

33. What happens to the specific gravity in renal failure?

34. Why can the renal failure client become anemic?

35.

Why does the renal failure client’s blood pressure go up?

36. Why is the renal failure client at risk for heart failure?

37. Why does the renal failure client develop anorexia, nausea, and vomiting?

38. Why does the renal failure client develop an itching frost?

39. Why does the renal failure client have to worry about osteoporosis?

40.

There are two phases of renal failure. The first phase is an oliguric phase, if a client isoliguric, what has happened to the urine output?

41. Why does the oliguric client go into a fluid volume excess?


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42. Why does the oliguric client develop hyperkalemia?

43. The second phase of renal failure is called the diuretic phase. When a client is diuresing,

what has happened to their urine output?

44. Why will a client who is diuresing go into a fluid volume deficit?

45. If a client goes into a fluid volume deficit, what will happen to their blood pressure?

46. What will happen to their heart rate? Explain why.

47. When a client is diuresing, their serum potassium level goes down (hypokalemia). Explainwhy.

48. If a client is allergic to Heparin, they cannot be hemodialyzed. Why?

49. Is hemodialysis done every day?

50. Does the client who is being hemodialyzed have to watch what they eat and drink in

between treatment? Why?

51. Explain the basic nursing care for a circulatory access (A-V shunt, fistula, or graft).

52. Why can’t a client who has an alternate circulatory access device have blood pressures or

venipunctures in that extremity?


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53. Explain in your own words what peritoneal dialysis is.

54.

When a client is having peritoneal dialysis, where is the fluid going into?

55. What would you do if you instilled 1,000 mL of fluid into the peritoneal dialysis client and

only 700 mL came back?

56.

What should the drainage of peritoneal dialysis look like?

57. What would be S/S of infection with peritoneal dialysis?

58. When a client has peritoneal dialysis for renal failure, why do they have to increase protein

and fiber in their diet?

59. When a client has peritoneal dialysis, why do they have a constant sweet taste and why do

they have anorexia?

60. What are the major signs of kidney stones?

61.

What is the number one thing you need to remember with kidney stones?

62. Why is the serum creatinine not affected by what we eat?


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63. What type of specimen do you need to test a creatinine level on a client?

64. Is the BUN affected by what we eat?


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Gastrointestinal

1. What are the two major functions of the pancreas?

2. What is the major cause of pancreatitis?

3. How can gallbladder disease cause pancreatitis?

4. List all of the symptoms of pancreatitis. (Explain WHY these occur)

a. Abdominal distention and ascites

b. Abdominal mass

c. Rigid board-like abdomen

d. Bruising

e. Fever

f.

Jaundice

g. Hypotension

5. Why do we give the pancreatitis client steroids?

6. Why do we give the pancreatitis client anti-cholinergic drugs?

7. Is it possible that a pancreatitis client might have to have insulin? Explain why.


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8. What are the dietary changes needed for the pancreatitis client?

9. What is cirrhosis?

10. When a client has cirrhosis, what happens to the blood pressure in their liver and what is the proper term for this?

11. Explain the S/S of cirrhosis and explain why the client develops each symptom.

12. Why does the cirrhosis client sometimes develop hepatic encephalopathy and coma?

13. Your client is going to have a liver biopsy. What clotting studies should be checked? Please

explain why.

14. Why is it so important that vital signs be checked pre-liver biopsy?

15. How is a client positioned during a liver biopsy?


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16. How is a client positioned post-liver biopsy? Explain why.

17.

Why does the client have to exhale and hold while the primary healthcare provider is puncturing into the liver?

18. Why are we worried about I & O and daily weights with the cirrhosis client?

19. Why is rest so important with a cirrhosis client?

20. Why are we worried about prevention of bleeding in the cirrhosis client?

21. Why do we measure the abdominal girth in the cirrhosis client and what will it tell us?

22. What is a paracentesis?

23. When a client is having a paracentesis, what position do you put them in?

24. Why is it so important that the paracentesis client void pre-procedure?

25.

Why is it so important to monitor the vital signs pre- and post-paracentesis?

26. During a paracentesis, could the client could go into a fluid volume deficit or a fluid volume

excess?


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27. Where is the first place that a cirrhosis client might develop jaundice?

28. When jaundice gets to the skin, what is one of the major nursing diagnoses?

29. Why do you have to avoid narcotics in any liver client?

30. When a client has a liver disease, what should be done with protein in the diet?

31. Why does the liver client need a low-sodium diet?

32. What chemical builds up in the blood that causes a client to go into a hepatic coma?

33. Why does the blood level of this chemical increase?

34. What are symptoms of a hepatic coma? Explain why the client develops these symptoms.

35. What is the major drug used in hepatic coma? Explain why.

36. If a client is in hepatic failure and eats protein, what is going to happen to the ammonia level

in their blood? Explain why.


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37. What are bleeding esophageal varices?

38.

Why does a client develop bleeding esophageal varices?

39. Why is oxygen important with a client who has bleeding esophageal varices?

40. Explain how Octreotide (Sandostatin) works.

41. What is one of the complications of giving Octreotide (Sandostatin)?

42. Why does the client with bleeding esophageal varices need a Sengstaken Blakemore tube?

43.

What is the nursing care associated with a Sengstaken Blakemore tube?

44. Explain symptoms of peptic ulcers.

45. What is the pre-procedure care of a gastroscopy? Explain what a client should expect if theyare going to have a gastroscopy.


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46. When a client has a gastroscopy, they have to be NPO until their gag reflex returns. Why?

47.

What would be a major sign of perforation post-gastroscopy?

48. Why do we give the peptic ulcer client antacids? What type of antacids would be the best-liquid or tablet?

49. Why do we give the client with peptic ulcer disease H-2 receptor antagonists? List some

examples.

50. Why do we give the peptic ulcer client sucralfate?

51. Why is it important that the peptic ulcer client decrease stress?

52.

Why is it important that the peptic ulcer client stop smoking?

53. Explain what you would teach a peptic ulcer client about diet.

54. What is the difference in a gastric ulcer and a duodenal ulcer?

55. What is a hiatal hernia?

56. What are the major symptoms of a hiatal hernia?


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57. What are the major nursing interventions for a client who has a hiatal hernia?

58. What is dumping syndrome?

59. What can cause a client to get dumping syndrome?

60. What are the symptoms of dumping syndrome?

61.

What are the major nursing interventions for a client who has dumping syndrome?

62. What is the difference in ulcerative colitis and Crohn’s disease?

63. What are the symptoms of ulcerative colitis and Crohn’s disease?

64. What is another name for Crohn’s disease?

65. When a client has ulcerative colitis or Crohn’s disease, do they need a high -fiber or low-

fiber diet? Why?

66.

Why does the client with ulcerative colitis or Crohn’s need to avoid cold foods andsmoking?

67. Why does the client with ulcerative colitis or Crohn’s disease need steroids?


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68. When a client has an ileostomy, what will the drainage be like?

69. Why would an ileostomy client need to avoid rough foods or high-fiber foods?

70. Why does the ileostomy client need Gatorade?

71. Why is the ileostomy client at risk for kidney stones?

72. When a client has an ileostomy, what electrolyte are they losing a lot of?

73. Explain the nursing care for a colostomy.

74. Why does a client develop appendicitis?

75. Explain the major symptoms of appendicitis?

76. Why do we avoid giving enemas to a client who has appendicitis?

77. When a client has had any abdominal surgery, what is the position of choice and why?

78. Why does a client who is receiving TPN need a central line?

79. Why do we discontinue TPN gradually?


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80. Why is it so important that we monitor daily weight in the client receiving TPN?

81. The TPN client may have to start taking insulin. Why?

82. When a client is on TPN we check their urine every day. What are some things you should be checking it for?

83. Why is it so important that we not mix TPN ahead of time?

84. Why does TPN need to be in a pump?

85. Why is it so important that home TPN clients emphasize hand washing?

86. How should you position your client for central line insertion?

87. Where does the central line go?

88. If air gets into the central line, what is going to happen? What position should you place the

client in?

89. After the central line has been inserted, we always get a chest x-ray. What two things are wechecking for in this chest x-ray?


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Respiratory

1. What is the purpose of a thoracentesis?

2. When a client is having a thoracentesis, where is the fluid being removed from?

3. What is the pleural space?

4. When the pleural space fills with fluid, what happens to the lungs?

5. Any time you are pulling fluid from a client’s body (thoracentesis, paracentesis, foley

catheter), are you putting the client at risk for going into a fluid volume deficit or a fluid

volume excess? Why?

6. There is a possibility with a thoracentesis that a pneumothorax could occur. Why?

7. What has happened when a client needs a chest tube?

8. Chest systems have a water seal. What is the purpose of the water seal and what wouldhappen if there was not water seal?

9.

When a client has chest tubes, hopefully the lungs will do what?


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10. What critical numbers would you report related to oxygenation and drainage in a closed

chest drainage system?

11. Why is the CDU kept below the level of the chest?

12. What do you do when:a. Tubing disconnects from chest tube?

b. CDU falls over and water leaks out?

c. When is bubbling normal?

d. When is bubbling a problem?

13. What should the nurse do if the water seal in the chest system is broken?

14. What life threatening complication can occur if you clamp a chest tube?

15. What is a hemothorax?

16. What is pneumothorax?

17. When blood, air or fluid accumulates in the pleural space, what is going to happen to the

lung?

18. What should you do if a client presents with a penetrating object to the chest?


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19. What is a tension pneumothorax?

20. With a mediastinal shift, what will happen to the trachea?

21. When a client has an open pneumothorax, you are supposed to put a piece of occlusivegauze over the area. How many sides are taped down? Why do we leave one side open?

22. When a client has a fractured sternum or ribs, why are the respirations so shallow? What

acid base imbalance will this put them at risk for?

23. With a fractured sternum or ribs, why do we give non-narcotic analgesics?

24. What is flail chest?

25. What is paradoxical chest wall movement?

26. Why does the client with flail chest develop paradoxical chest wall movement?

27. With a fractured sternum or ribs, why is the client put on a ventilator with PEEP?

28. What is PEEP?

29. What is CPAP?


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30. What is the major difference between the two (PEEP and CPAP)?

31. How can dehydration promote an embolus?

32. How can venous stasis promote a pulmonary embolus?

33. When a client has a pulmonary embolus, why does their pulse go up?

34.

When a client has a pulmonary embolus, describe their chest pain.

35. When a client has a pulmonary embolus, the blood pressure is going to go up in their lungs.

What effect will this have on the right side of the heart?

36. With a pulmonary embolus, the client will have fever and their WBC count will go up.

Why?

37. Why does the PO2 go down with a pulmonary embolus?

38. How will Heparin help the client who has developed a pulmonary embolus?

39. What are other common anticoagulant drugs?

40. What nursing interventions can help to prevent the development of a PE?


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Orthopedics

1. Why is it so important that fractures be immobilized as soon as possible?

2. What type of emboli do you worry about with a fracture?

3. What would you do if a client came in with an open fracture?

4. Explain a neurovascular check.

5. There are two parts to a neurovascular check.

a. What is the neuro component?

b. What is the vascular component?

6. List S/S of a fat embolus?

7.

What is compartment syndrome?

8. If you suspect compartment syndrome, what should you do first?


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9. Explain the why for these components of cast care.

a. Ice packs on sides

b. No indentations

c. Use palms for the first 24 hours.

d. Keep uncovered and dry.

e. Do not rest cast on hard surface or sharp edge.

f. Mark breakthrough bleeding circle area, date, and time site.

g. Cover cast close to the groin with plastic.

h.

Neurovascular checks with the 5 Ps

i. Elevate

10. What are the advantages of a fiberglass cast?

11. When a client with an orthopedic injury complains of pain, what is the first thing you shoulddo?

12. What are some purposes of traction?

13. Weights on traction should hang freely. Explain why.

14. What is skin traction? Give an example.

15. What type of assessment is very important when a client has skin traction? Explain why.


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16. What is skeletal traction? Explain. Give examples.

17. Explain how to do pin care.

18. When a client has a total hip replacement, there are some important things to rememberabout positioning. Explain why each of these is important:

a. Neutral rotation.

b. Limit flexion.

c.

Promote extension.

d. Abduction

19. Discuss the general nursing care for someone with a continuous passive motion (CPM)machine.

20.

What are some good exercises for the total hip replacement client?

21. Give examples of things a total hip replacement client should avoid specifically related toflexion.

22. Why is it important that we keep a tourniquet at the bedside with an amputation?

23. Why is elevation so important with an amputation (for the first 24 hours)?


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24. What can we do in the amputation client to prevent hip and knee contractures?

25. What is phantom pain?

26. Describe the nursing care with someone with phantom pain?


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Maternity

1. List presumptive, probable, and positive signs of pregnancy.

2. When teaching a pregnant client about exercise what heart rate do you tell her not to get

above when exercising? And why?

3. The client should be taught to be alert for what danger signs during pregnancy?

4. What signs of true labor would the nurse teach the client?

5. Why is an IV fluid bolus of 1000 ml NS or LR given prior to an epidural?

6. The nurse caring for a laboring client receiving Pitocin would discontinue the Pitocin if

what occurred?

7. When you assess tachycardia in a postpartum client, what should you think?

8. What should the nurse do when palpating the postpartum client’s fundus that is boggy? And

why?

9. The nurse teaching a group of pregnant clients about breast feeding would include what

important points?

10. What assessments are scored with the Apgar and when is it done?


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Complications of Maternity

1. What is the first sign of an ectopic pregnancy?

2. What are the two priorities in the treatment of Abruptio placenta?

3. List treatments for the client with Hyperemesis Gravidarum.

4. By definition, preeclampsia involves what assessment data?

5. Why do the face and hands of the preeclamptic client swell?

6. What are priority assessments for the client receiving magnesium sulfate?

7. The nurse caring for a client in preterm labor would observe for which side effects ofterbutaline (Brethine)?

8. Why is betamethasone (Celestone) given to the mom in preterm labor?

9. Why is it important to check FHT’s when membranes rupture, either artificially or

spontaneously?

10.

When are pregnant clients routinely assessed for GBS risk factors?


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Neuro

1. When performing an assessment on the neuro client, what is most important?

2.

What is the Glasgow Coma scale and when is it used?

3. Explain the 3 components of the Glasgow Coma scale.

4. Explain the Babinski and the difference for a child less than one year of age and anyone

greater than one year of age.

5. When a client is having a CT of the head, is it okay for them to talk?

6. Can a CT scan be done with contrast medium (dye)?

7. What type of client cannot tolerate an MRI scan?

8. Explain everything that you would teach a client about an MRI.

9. What is cerebral angiography?

10. When a client is having cerebral angiography, what artery do they go through?


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11. What other procedure do we use the femoral artery for?

12. Why is it so important that a client who is about to have cerebral angiography be well

hydrated?

13. Why is it so important that we assess the peripheral pulses before a cerebral angiography?

14.

When a client is having a cerebral angiography, it is not uncommon for them to complain ofa warmth in the face. Explain why.

15. Why is it so important that you ask a client who is about to have a cerebral angiography if

they have any allergies? What are you worried about?

16. Explain the post-procedure care for the cerebral angiography client and explain why.

17. Why is it so important that we watch for an embolus after cerebral angiography? Explain

what you would watch for specifically in your client.


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18. What is an EEG?

19.

What is the pre-procedure care for a client who is going to have an EEG?

20. If a client were about to have an EEG, what would you tell them about the procedure?

21.

What are some reasons for doing a lumbar puncture?

22. How do you position a client for a lumbar puncture?

23. Why do you put them in this position?

24. What should cerebrospinal fluid look like?

25. What is the post-procedure care of a lumbar puncture? Explain why.

26. What is the most common complication of a lumbar puncture?

27. How is this complication treated?


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28. What is life-threatening complication of a lumbar puncture?

29. What are the early signs of ICP?

30. What is Crushing’s Triad? What vital sign changes do you see?

31. Describe decorticate and decerebrate posturing. What do they mean, which is worse?

32. When a client is posturing, what happens to their caloric needs?

33. Why are osmotic diuretics used in the treatment of intracranial pressure? Explain exactlyhow they work.

34.

When a client is on an osmotic diuretic, they better have two organs that are working

perfectly. What are they?

35. Why are clients with increased intracranial pressure given steroids?

36. What would happen to the intracranial pressure if the temperature were to exceed 100.4F?

37. When taking care of a head injury client with increased intracranial pressure, why is it so

important that you space your nursing interventions?


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38. What is the purpose of a barbiturate induced coma?

39. Why is it so important to restrict the fluids in a head injury client?

40. If a client were to become bradycardic, what would happen to the cerebral perfusion?

Explain why.

41. If a client were to develop an increased blood pressure, what will happen to cardiac output?

Explain how this would affect cerebral perfusion.

42. What is a major risk when a client has an ICP monitoring device?

43. Why is it so important that we keep the connections tight on an ICP monitoring device and

also why is it so important to keep the dressings dry?

44. What is meningitis, what are the common S&S?

45.

Which isolation precautions should be adhered to for a client with bacterial meningitis?Which precautions for viral meningitis?


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46. Define what a seizure is, discuss the difference between a partial and generalized seizure.

47. What is status epilepticus?

48. Give an example of a long-acting anticonvulsant and a short-acting anticonvulsant used in

the treatment of seizures.

49. What is an open head injury?

50. What is a closed head injury?

51. Is the client most at risk for infection with an open or closed head injury?

52. When a client has a basal skull fracture, where is the fracture?

53.

What is Battle’s sign?

54. What are raccoon eyes?


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55. What is cerebrospinal rhinorrhea?

56. How do you tell CSF from other drainage?

57. Explain the S/S of a concussion.

58. If a client has been diagnosed with a concussion, what things should you teach before they

go home?

59. Is it okay for a concussion client to go home alone?

60. If a client has an epidural hematoma, explain the sequence of events that will occur and why

the client has these changes.

61. What is the treatment for an epidural hematoma?

62. Explain the treatment for a subdural hematoma.

63. When you have a head injury client, why is it so important that we keep the environment

quiet?

64. What is autonomic dysreflexia and what are the S&S?

65. How do you treat autonomic dysreflexia?


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Pediatrics

1. What is the order of obtaining vital signs in the pediatric client?

2. At what stage do children begin to use language to express thoughts?

3. Discuss nursing strategies that could be used to communicate with a child with

developmental disabilities.

4. Why might nebulized epinephrine be used to treat LTB? What should you observe for after

its use?

5. Why is it so important to recognize signs and symptoms of RSV quickly?

6. Why is the child with Cystic Fibrosis at risk for hyponatremia?

7. Why do we need to feed the pediatric client with heart failure when they are well rested,

when they wake up and are showing signs of hunger, and before they start crying?

8. Why should an infant with a cleft lip and palate be burped frequently?


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9. Why is the child, post tonsillectomy, positioned on their side, or head of bed elevated, or prone?

10.

Why would we want the child with Otitis Media to lie on the affected side?


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Management and Delegation

1. Why do you need to know med-surg core content first when delegating routine tasks toLPNs and unlicensed assistive personnel (UAPs)?

2. Why can UAPs only perform routine, simple, repetitive common activities on stable clients

in uncomplicated situations?

3. What types of assignment transfers both responsibility and accountability?

4. Why is the RN responsible for knowing the staff’s strengths and weaknesses in regards to

delegation?

5. What should the RN do when a weakness is identified in a staff member?

6. Why can the LPN not do any form of evaluation?

7. Why should the RN assess the newly admitted client first?

rn intense remedial packet questions

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