Medical Surgical Nursing
Final Exam Review
General Information
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There will be 100 questions on the final exam
Cumulative Final
Approximately…
o 7 questions on patient care concepts, cultural concepts and disease transmission
o 11 questions on fluid and electrolyte & integumentary system
o 11 questions on Cardiovascular system
o 7 questions on the hematology and Immune systems
o 14 questions on the respiratory system
o 7 questions on the skeletal-muscle system
o 7 questions on the sensory system
o 7 questions on the urinary system
o 7 questions on the reproductive system
o 7 questions on the endocrine system
o 8 questions on diabetes mellitus
o 7 questions on the nervous system
o 7 questions on the gastro-intestinal system
Study suggestions:
o Study Small group questions
o Study from the list of following questions
Study Questions
Patient care concepts, cultural concepts and disease transmission
1. What is VRE and what type of isolation is used
2. What is MRSA, its common reservoir and type of isolation used
3. Define standard precaution, airborne precaution, droplet precaution and contact precaution
(what protective clothing is worm with each)
4. What is a nosocomial infection? Which is most common?
5. What are the stages of infection
6. Differentiate between local and systemic infections
7. What is a normal WBC count, and what does and deviation from normal indicate?
8. What do erythrocyte sedimentation rate and C-reactive protein indicate?
9. What are the classic S&S of inflammation
10. Define the nursing process
Fluid and electrolyte & integumentary system
1. Know the definition for osmosis, diffusion, active transport & Filtration*
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What are hyper and hypotonic solutions
What are the nursing interventions for a client with fluid volume excess
What are the S&S of fluid volume excess (esp vital signs)
What are the nursing interventions for a client with fluid volume deficit
What are the S&S of fluid volume deficit (esp. vital signs)*
What is a normal serum sodium level?
What are the S&S and treatment for a client with hyponatremia?
What are the S&S and treatment for a client with hypernatremia?*
What is a normal serum potassium level?
What are the S&S and treatment for a client with Hypokalemia?
What are the S&S and treatment for a client with Hyperkalemia?*
What are the S&S and treatment for a client with hypocalcemia
What are the S&S and treatment for a client with Hypercalcemia
What are Chvostek’s and Throusseau’s sign and what do they indicate?*
Identify common skin lesions (by definition)
Where are pressure sores most likely to develop?
How do you stage pressure sores?
How do you prevent a pressure sore
What is slough, eschar and granulation tissue
Cardiovascular system
1. Describe the blood flow through the heart and body
2. Identify where oxygen and deoxygenated blood is
3. What are S1 and S2
4. What is cardiac output
5. What is the normal conduction system of the heart? What is the pacemaker of the heart?
6. How are arteries, veins and capillaries similar and different?
7. Define cyanosis? What does it indicate?
8. How do you measure edema?
9. What is the definition of coronary heart disease?
10. Differentiate between arteriosclerosis & atherosclerosis
11. Define ischemia?
12. What are the S&S of angina pectoris.
13. What are the actions of nitrates
14. What are the actions of beta-blockers
15. What are the actions of calcium channel blockers
16. What are the actions of ACE inhibitors
17. How does an myocardial infarction differ from angina
18. What are the S&S of right sided heart failure
19. What are the S&S of left sided heart failure
20. What are the S&S of a DVT
Hematology and Immune systems
1. What is plasma
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What are erythrocytes and what are their function
What is the function of hemoglobin
What is Hemostasis
What is hemolysis
What are the actions of neutrophils and monocytes
What cells are involved with specific immune response
Where are white blood cells produced
What causes a person to be jaundice (describe jaundice)
What is a normal RBC count (what causes it to change)
What is a normal Hbg level (what does an increase or decrease level indicate
What is a normal Hct level (what does an increase or decrease level indicate)
What does a PT or PTT measure
Differentiate between the different types of anemia
Respiratory system
1. What is cilia
2. What keeps the alveoli open
3. What is the function of the pleural membranes
4. What is the functional unit of the respiratory system
5. How do you perform the Heimlich maneuver and when do you perform it?
6. What are barrel chest, kyphosis, lordosis,
7. How do you correctly auscultate the lungs
8. What are normal breath sounds
9. What are adventitious breath sounds and what do they indicate?
10. What is hypoxia and what are the S&S
11. How do you obtain a sputum specimen
12. Differentiate between hemoptysis and hematemesis
13. What does a pulse oximeter measure
14. What is a CT scan and what nursing consideration are there for a patient having a CT scan
15. What is a MRI and what nursing consideration are there for a patient having an MRI
16. What is the side effect of oxygen administration?
17. What is the purpose of incentive spirometry? How is it used?
18. Define the nursing diagnosis of ineffective airway clearance, Ineffective breathing patterns and
impaired gas exchange
19. What diseases are considered COPD (differentiate between them)
20. What is the #1 risk factor for COPD
21. What is pneumonia (definition)?
22. What are the S&S of pneumonia in an elderly patient
23. What is the early S&S of lung cancer?
24. What is chest physiotherapy?
Skeletal-muscle system
1. What minerals are vital for bone remodeling?
2. What is necessary for positive bone remodeling?
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Differentiate between ligaments and tendons
How does the S/M system change in the elderly
What is ROM?
Define Crepitus
Define flexion, extension abduction and adduction
What is the common nursing interventions for a sprain or strain
How do you use crutches going up stairs?
What is the correct emergency treatment for an open/compound fracture?
What instruction should a nurse give to a client with a new cast?
What position is best to prevent contractures in a patient with a new above the knee
amputation?
13. What would be a priority nursing diagnosis for a client with osteoporosis
14. What is a priority nursing diagnosis for a client with osteoarthritis?
Sensory system
1. What are the S&S of conjunctivitis and how is it normally treated
2. What is a Snellen eye chart and what does 20/40 vision mean?
3. Define PERRLA
4. What is the emergency treatment for a client with chemical burns to the eye?
5. What is the emergency treatment for a client with an object protruding from the eye (impaled
into the eye)
6. What is the correct procedure for instiliting eye drops
7. What is the correct procedure for irrigating the eye
8. Define cataracts and glaucoma
9. How are cataracts and glaucoma treated
10. Define Otitis media?
11. What is myringotomy? When is it performed
12. What is the standard nursing care that is provided post-op ear surgery
13. What teaching do you give a patient (and parent) after tubes are placed in their ear?
14. What does the nurse need to assist in preventing after eye surgery
Urinary system
1. What is the functional unit of the kidney
2. Describe urine flow from formation to excretion
3. What is BUN and what does and increase level indicate?
4. How does Creatinine clearance change with real dysfunction?
5. What is the number one carcinogen associated with cancer of the urinary system
6. What are the variables of a normal urinalysis
7. How do you obtain an sterile urine specimen
8. What does specific gravity of urine measure? (What does and increase or decrease level mean?)
9. 1 oz = how many mL
10. What are the S&S of dehydration?
11. What nursing interventions would you implement for a patient with pyelonephritis?
12. What are the S&S of nephritic syndrome (labs!)
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13. What are the nursing interventions for a client with renal calculi
14. What is the purpose of dialysis?
Reproductive system
1. What causes endometriosis (pathophysiology)
2. What are the complications of endometriosis?
3. How is endometriosis treated?
4. What is the primary cause of PID
5. What is the most common location for breast cancer
6. What is the number one cause of cervical cancer
7. How are the advantages and disadvantages of a vaginal hysterectomy
8. What is the common treatment of orchitis
9. What are the S&S of prostatitis
10. How is phimosis usually treated
11. What are the complications associated with cryptorchidism?
12. How is gonorrhea treated
13. What are the S&S of syphilis?
14. How are genital herpes treated
Endocrine system
1. What are the glands of the endocrine system
2. What is negative feedback
3. What function does the hypothalamus play in the endocrine system
4. What hormones are secreted by the pituitary gland and what is their action
5. What is the action of Calcitonin
6. What is the action of parathyroid hormone
7. What hormones does the adrenal medulla secrete?
8. What hormones does the adrenal cortex secrete?
9. What is the hormonal imbalance for Cushing & Addison’s disease, DI & SIADH
10. What are the priority nrs dx for Cushing & Addison’s disease, DI & SIADH
11. What are the S&S for Cushing & Addison’s disease, DI & SIADH
12. What are the medical interventions for Cushing & Addison’s disease, DI & SIADH
13. What are the S&S for hyper and hypothyroidism
14. What hormonal imbalance causes goiter?
Diabetes mellitus
1. How do you mix regular and intermediate acting insulin
2. What is the onset peak and duration of regular insulin
3. What is the onset peak and duration of intermediate acting insulin
4. What are oral hypoglycemic medications? Who can take them and who can’t
5. When is a sliding scale usually used
6. What cells secrete insulin
7. What is the action of insulin
8. What are the S&S of hyperglycemia
9. What are the S&S of hypoglycemia (be able to distinguish hyper from hypo)
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What is a glycosylated hemoglobin test? What are normal ranges and what does it indicate?
What is a normal fasting blood glucose level
What is the difference between type 1 diabetes and type 2 diabetes?
What affect does alcohol consumption have a blood glucose levels?
What affect does exercise have on blood glucose levels?
Nervous system
1. What organs make up the CNS and PNS
2. What are the divisions of the PNS
3. What is the functional unit of the nervous system?
4. What is the primary function of the brain stem, cerebellum and cerebrum?
5. What are the pyramidal tracts?
6. What are the levels of consciousness
7. What vital signs are associated with increased intracranial pressure
8. What are the nursing interventions associated with a lumbar puncture?
9. What are the medications are often prescribe to a patient with increased ICP?
10. What is the appropriate nursing action for a client having a tonic clonic seizure?
11. What is the primary risk factor for a stroke?
12. Identify appropriate nursing interventions for a client with aphasia
13. What are isometric exercises?
Gastro-intestinal system
1. How do you measure the length of an NGT?
2. How much fluid is flushed before and after medication administration?
3. What is Stomatitis?
4. What are the nursing interventions for a client with GERD’s
5. Where is bile produced?
6. Where is extra bile stored?
7. What is the function of bile?
8. What controls the rate of stomach emptying?
9. By what means does food move through the esophagus?
10. What are the risk factors for PED?
11. What is the medication of choice in treating PUD?
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