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Adriana Orozco

Professor Brewster
Focus Exam 1 Analysis
1. Question #1: I couldnt determine the differences between anthrax that is inhaled
and skin anthrax. With skin anthrax, it is not necessary to have contact precautions
unless the nurse has cuts and abrasions that may come into contact. Remediation: I will
review skin anthrax in my med-surg book p.g 454.
2. Question #2: I was confused with this question because I thought the patient
would be advised to not use any type of lotion or soap because they have chemicals that
can be abrasive. Remediation: Look at the key word mild soap which makes it ok to
use. I will go over mastectomy patient care in my med-surg book p.g 1680.
3. Question #3: I understood that this medication was a diuretic, so I was thinking of
low potassium levels, however; this is a K sparing diuretic which means I have to look
out for signs of hyperkalemia instead. Remediation: Go over Aldactone in my drug guide
book p.g 1057
4. Question #4, question #8, question #23: Dietary precautions is content where I
lack knowledge. Especially when it is a select all question, I end up having to guess
because I dont remember all the drugs indications and precautions. Its something I
really need to work on. Remediation: I will go over COPD dietary precautions to help pt
keep up with their nutritional status in my med-surg book p.g 633. I will go over burn
patient diet in p.g 543. I will review epoetin alfa in p.g 871.
5. Question #6: I couldnt remember the normal CVP of the atrium and central
veins. The normal is 7-12. During HF the heart and arteries have to work harder to pump
the blood which causes an increase in the CVP. Remediation: Go over normal CVP
values in my med-surg book p.g 743.
6. Question #7: Once I read the rationale to this question it makes a lot of sense.
Because the pt is at risk for hemorrhaging, the way to assess the site of bleeding is to
check the moisture on pts neck and shoulders because the way they are positioned. The
blood would move down and out toward the gauze because of gravity. Remediation: I
have to picture myself assessing the patient.
7. Question #11, question #13: I also struggle remembering signs and symptoms
that are dangerous for a specific drug. Remediation: I will try to remember the drug and
think of the effects it would cause if they had too much. For example, if the pt has
hypothyroidism, I will recall the signs and symptoms of hyperthyroidism to recognize
symptoms that may indicate a dosage too high.
8. Question #14: Im not aware much about Glargine insulin, but not I understand it
cannot be mixed with another insulin. Remediation: Go over Lantus insulin in my drug
book p.g 792.
9. Question #15: I never knew the pH of the eye. But I could have guessed this
question better if I associated it with the normal pH of the body 7.35-7.45. Remediation: I
will go over emergency nursing procedure in my med-surg book p.g 756-758.
10. Question #16: The reason I got this wrong was because I thought the pt would be
infectious before the scabs showed up. Remediation: I will go over pt management with
small pox in my med-surg book p.g 338.

11. Question #19: I understand the concept now after reading the rationale. You
would not put saline in the ear because this can cause the insect to expand which
makes the ear further impacted. Instead, it must be killed and then removed, this can be
done with lidocaine. Remediation: Remember the basic mechanics of water and take the
procedure step by step in my head.
12. Question #20: I wasnt sure what the disease process the picture was showing,
so I guessed it was infections and airborne. However, this is a picture of scabies that is
transmitted through direct skin contact and inanimate objects. Remediation: Go over
what scabies looks like and nursing precautions in my med-surg book p.g 448.
13. Question #37: I understand the patho of GERD, but I didnt know that chewing
gum will help them because it produces saliva. Remediation: I will go over measures to
ease discomfort for GERD pts in my med-surg book p.g 1323.
14. Question 28#: I understand a glucose level of 400 is very dangerous, but I
thought the very first action I would do is to stop the PN. But this question is asking the
best thing I should do, not the first. In this case, its very important to contact the HCP.
Remediation: Re-read the stem of the question and look at the key words.
15. Question #30: I didnt know that taking Zyloprim and drinking coffee can increase
the uric acid in the body. Remediation: I will review Zyloprim in my drug book p.g 372.
16. Question #31: I couldnt remember anything about transcutaneous electrical
nerve stimulation. Remediation: I will go over TENS and pt care in my med-surg book
p.g 379.
17. Question #32: The key word in this question is the word priority. Its important to
know the sodium of this pt, but because of the extremely high level of K, the physician
should be contacted first because of the risk of cardiac dysrhythmias. Remediation: Reread the stem of the question and highlight the key words.
18. Question #37: I couldnt remember the class of drug Cogentin was. It is an
anticholinergic, so I would have to look out for those effects. Remediation: Go over
Cogentin and its affects in my drug guide book in p.g 334.
19. Question #38: This question was very intimidating to me because I couldnt
remember what half of the drugs were. Cyclobenzaprine is a MAO inhibitor.
Remediation: I need to go over MAO and their drug interaction precautions in my drug
guide book in p.g 284.
20. Question #40: Reading the rationale for this questions really helps me
understand the answer. Because the pt is still young and has had an orchidectomy, he
may feel as if he lost his role performance because he is no longer fertile. Remediation:
Understand that question is asking for a direct cause from the surgery, not associated.
21. Question #46: Because the brain tumor and radiation are being treated on the
head, dysphagia would not be a side effect, this usually occurs when the radiation is on
the lungs. Remediation: Go over radiation therapy in my med-surg book in p.g 539-543.
22. Question #47: I thought the nurse would have to wear a mask. But what is more
important is that the medication is drawn up in a biological safety cabinet. Remediation: I
will go over chemotherapy precautions in my med-surg book in p.g 285.
23. Question #53: I understand the claudication causes pain, but I didnt know how a
nurse would assess the degree of the condition. Remediation: I will review
characteristics of intermittent claudication in my med-surg book in p.g 1308.

24. Question #54: I thought levels would be drawn at its peak to look at the
therapeutic levels in the pts body. However, reading the rationale, I understand that it
should be taken before the next dose is given to provide safety to the pt from dig toxicity.
Remediation: Go over digoxin toxin levels in my drug guide in p.g 1447.
25. Question #58: I dont know why I missed this question. I understand a blunt chest
injury. I remember the signs, and as it progresses, its harder for the pt to breathe which
would also cause cyanosis. Remediation: Use process of elimination and think through
the disease process.
26. Question #63: I simply didnt remember the signs of a ruptured peptic ulcer.
Remediation: When there is a question I dont know, I should think about the anatomical
structure and its location to help me with my process of elimination.
27. Question #64: I didnt think the pt was supposed to lay flat after a craniotomy.
However, reading the rationale, it makes sense because the reduces the pressure.
Remediation: Review pt care with craniotomy in my med-surg book in p.g 1060.
28. Question #67: I understood the question as one og the very first signs to see
during CRF. I thought it would be restless, instead its the fluid overload. I thought this
would be a later sign. Remediation: I have to review early signs and symptoms of CRF in
my med-surg book in p.g 797.
29. Question #69: I thought nurses arent allowed to reposition the NG tube. I also
didnt know what a Billroth procedure was. Remediation: I will review Billroth procedure
in my med-surg book in p.g 637.
30. Question #71: This pt is not supposed to have a high sodium diet. Reading the
rationale, I learned something new. Canned drinks have a higher sodium content level,
which should be avoided for pts with hypertension. Remediation: Review food items that
are high in sodium and in foods in my med-surg book in p.g 1512.
31. Question #74: DKA breathes also known as Kussmaul breathes. Because the pt
is in acidosis, the body is going to try to compensate by taking deep rapid breaths to get
more O2 in. Remediation: When theres a question Im not sure of, I need to think of the
pathophysiology and how the body tries to compensate.
32. Question #77: I didnt think this question through. If I did, I would have realized,
that with cardiogenic shock, the pt will also have an increase in CVP. Remediation:
Review mechanics and clinical manifestations of cardiogenic shock in my med-surg
book in p.g 1174.
33. Question #80: I forgot the PT time for a pt who is on Coumadin. Remediation: I
will review PT times for those on anticoagulants in my med surg book in p.g 1333
34. Question #81: I missed this question because I simply lacked knowledge on the
signs of dig toxicity. Remediation: I have to review these symptoms, especially because
its a popular drug. I will go over it in my drug book in p.g 624.
35. Question #83: I missed this question because I didnt read the full question. I
thought it was asking the position of the pt during the procedure not after. Remediation: I
have to slow down and read the whole question, and highlight the key words.
36. Question #84: Again, I missed the key word in this question is early. Decorticate
is a late sign of ICP. Remediation: Slow down and re-read the question for clarification.
37. Question #85: I thought osmolarity would cause a complication putting the
diabetic pt in high level of glucose. However, reading the rationale, I understand that
high levels of sodium can cause the pt to become severely dehydrated. Remediation: I

will review head injury complications for pts with diabetes in my med-surg book in p.g
1059.
38. Question #86: I dont know much about Crutchfield tongs, so I thought checking
the pin site was the safest answer. Remediation: I need to review nursing care for pts
with Crutchfield tongs in my med-surg book in p.g 1958.
39. Question #91: I couldnt remember if I was supposed to use the mg or mL to
calculate the drip rate. Remediation: I read the rationale and know that its always
supposed to the mL that gets calculated.
40. Question #94: I dont know why I thought the cultures would be in the blood,
when this test is always used to check the sputum. Remediation: I have to review
pyrazinamide and TB tests in my med-surg book in p.g 1963.
41. Question #95: I knew that adverse effects of heparin has to do with bleeding, but
I for some reason I thought petechiae would be a normal finding when someone is taking
heparin. Remediation: I will go over patient care and adverse effects of heparin in my
drug guide book in p.g 819.
42. Question #99: This pt is at risk for bleeding, so I have to pick those precautions
that protect the pt from bleeding. I was confusing thrombocytopenia with other conditions
that include a low WBC. Remediation: I will go over the difference between
thrombocytopenia and neutropenia in my med-surg book in p.g 427 and 550.