State exam - flashcards

1: What system helps regulate blood pressure when it drops?

The RAAS system — renin is released by the kidneys, activating angiotensin I (from angiotensinogen), which is converted to angiotensin II by ACE, leading to vasoconstriction and increased blood volume.

2: How is cardiac output regulated?

By heart rate and stroke volume; increased by sympathetic stimulation and venous return, decreased by parasympathetic activity and hypertension.

3: What do the P, Q, RS, and T waves represent on an ECG?

P = atrial depolarisation

Q = represents the normal left-to-right depolarisation

RS = ventricular depolarisation

T = ventricular repolarisation.

4: What are two main types of heart failure?

Systolic (contraction issue) and diastolic (filling issue).

5: What are key symptoms of left-sided heart failure?

Dyspnoea, orthopnoea, crackles, fatigue, nocturia, and pulmonary congestion.

6: What are key symptoms of right-sided heart failure?

Peripheral oedema, ascites, hepatomegaly, jugular vein distension, weight gain.

7: What lab test confirms heart failure?

Elevated B-type natriuretic peptide (BNP) from ventricular stretch.

8: What is the first-line management for heart failure?

High Fowler’s position, oxygen, fluid and salt restriction, diuretics, ACE inhibitors, and daily weight monitoring.

9: What enzyme confirms myocardial infarction?

Troponin T — released from damaged cardiac muscle.

10: What are ECG changes in a myocardial infarction?

Peaked T waves, ST elevation, inverted T waves, and pathologic Q waves

11: Differentiate stable vs unstable angina.

Stable occurs with exertion and is relieved by rest or GTN; unstable occurs at rest, lasts longer, and may not respond to GTN.

12: What are risk factors for myocardial infarction?

Hypertension, hyperlipidaemia, diabetes, smoking, obesity, stress, and family history.

13: What medication is used to prevent angina pain?

Glyceryl trinitrate (GTN) — causes vasodilation to improve coronary blood flow.

14: What is an aortic dissection?

A tear in the aortic wall causing internal bleeding; treated by lowering BP with beta-blockers or surgery.

15: What are symptoms of DVT?

Redness, swelling, warmth, pain, and tenderness in the affected limb.

16: What is the main risk with a DVT?

Pulmonary embolism due to dislodgement of a clot.

17: What are the four main types of shock?

Cardiogenic, hypovolemic, distributive, and obstructive.

18: What are early signs of hypovolemic shock?

Tachycardia, cool clammy skin, low BP, anxiety, and decreased urine output.

19: What is the best position for hypovolemic shock?

Modified Trendelenburg (legs elevated, head flat).

20: What is the key treatment for anaphylactic shock?

Intramuscular adrenaline, airway support, and oxygen therapy.

21: What defines sepsis?

A systemic inflammatory response to infection causing tissue hypoperfusion and organ dysfunction.

22: What are warm-phase symptoms of sepsis?

Fever, flushed skin, tachycardia, and high cardiac output.

23: What are cold-phase symptoms of sepsis?

Hypotension unresponsive to fluids, clammy skin, low urine output, confusion.

24: What is the primary treatment priority in sepsis?

Obtain cultures, give IV antibiotics and fluids within 1 hour of suspicion.

25: What are complications of septic shock?

Multi-organ failure, stroke, and death

26: What causes asthma pathophysiologically?

Inflammatory response → bronchoconstriction → mucosal swelling → excess mucus → narrowed airways.

27: What are common asthma triggers?

Allergens, infections, stress, cold air, exercise, smoke.

28: What is the main short-term treatment for asthma?

Beta-2 agonists (salbutamol) for bronchodilation.

29: What is the main long-term management for asthma?

Inhaled corticosteroids to reduce inflammation.

30: What is emphysema?

Loss of alveolar elasticity leading to air trapping and reduced oxygen exchange.

31: What are key symptoms of emphysema?

Dyspnoea, barrel chest, pursed-lip breathing, fatigue, and cyanosis.

32: What is the main cause of COPD?

Long-term exposure to irritants, especially smoking.

33: How is pneumonia diagnosed?

Chest X-ray showing consolidation, sputum culture, and elevated WBC.

34: What are symptoms of pneumonia?

Fever, productive cough, dyspnoea, chest pain, fatigue, crackles.

35: What are complications of pneumonia?

Pleural effusion, sepsis, and respiratory failure.

36: What is bronchitis?

Inflammation of bronchial tubes, causing cough with sputum, often post-viral.

37: What are key treatments for acute bronchitis?

Rest, fluids, bronchodilator if needed, avoid smoking.

38: What causes pulmonary embolism?

A thrombus lodges in the pulmonary artery, blocking blood flow.

39: What are classic signs of PE?

Sudden dyspnoea, chest pain, tachycardia, anxiety, cough with blood.

40: What is the first nursing action for a suspected PE?

Elevate head of bed, give oxygen, and notify medical team.

41: What is a pneumothorax?

Air in the pleural space causing lung collapse.

42: What are symptoms of pneumothorax?

Sudden dyspnoea, chest pain, absent breath sounds on one side.

43: What is the emergency treatment for an open pneumothorax?

Apply a three-sided occlusive dressing and prepare for chest tube insertion.

44: What is pleural effusion?

Accumulation of fluid in pleural space, treated by thoracentesis.

45: What is flail chest?

Multiple rib fractures causing paradoxical chest movement; treat with oxygen, pain relief, and possible intubation

46: What is a stroke?

A sudden interruption of blood flow to the brain causing cell death due to ischaemia or haemorrhage.

47: What are the two main types of stroke?

Ischaemic (caused by blockage) and haemorrhagic (caused by vessel rupture).

48: What is a transient ischaemic attack (TIA)?

A short, reversible episode of neurological dysfunction caused by temporary reduced blood flow — warning of future stroke.

49: What are early signs of a stroke?

Facial droop, arm weakness, slurred speech — “FAST” acronym.

50: What diagnostic test confirms stroke type?

CT scan — identifies haemorrhage before treatment begins.

51: What medication dissolves clots in ischaemic stroke?

tPA (tissue plasminogen activator) — must be given within 3 hours and not for haemorrhagic strokes.

52: What are nursing priorities during stroke management?

Maintain airway, monitor neuro status, control BP, prevent aspiration, and support mobility.

53: What complications can occur post-stroke?

Dysphagia, aspiration pneumonia, mobility issues, pressure injuries, and depression.

54: What is cerebral palsy (CP)?

A group of non-progressive disorders affecting movement and posture due to early brain injury.

55: What are common types of CP?

Spastic, dyskinetic, ataxic, and mixed types.

56: What are hallmark symptoms of spastic CP?

Stiff movements, hypertonia, and delayed milestones.

57: What therapy helps children with CP improve mobility?

Physical and occupational therapy, and medications like baclofen for spasticity.

58: What are common coexisting conditions with CP?

Vision or hearing impairments, epilepsy, learning difficulties, and feeding issues.

59: What causes epilepsy?

Abnormal electrical activity in the brain leading to recurrent seizures.

60: What are the main seizure types?

Generalised (both hemispheres) and focal (localised to one area).

61: What are nursing actions during a seizure?

Keep airway clear, protect from injury, do not restrain, and time the event.

62: What medication class controls seizures?

Antiepileptic drugs such as sodium valproate or carbamazepine.

63: What is SUDEP?

Sudden Unexpected Death in Epilepsy — rare but serious complication.

64: What is meningitis?

Inflammation of the meninges of the brain and spinal cord caused by bacterial or viral infection.

65: What are key symptoms of meningitis?

Fever, headache, stiff neck, photophobia, vomiting, and rash.

66: What diagnostic test confirms meningitis?

Lumbar puncture to analyse cerebrospinal fluid (CSF).

67: What treatment is used for bacterial meningitis?

IV antibiotics and corticosteroids to reduce inflammation.

68: What is increased intracranial pressure (ICP)?

Raised pressure inside the skull that can compress brain tissue and reduce perfusion.

69: What are symptoms of increased ICP?

Headache, vomiting, blurred vision, bradycardia, and decreased consciousness.

70: How is increased ICP managed?

Elevate head of bed, restrict fluids, give mannitol or hypertonic saline, and avoid Valsalva manoeuvre.

71: What is Guillain-Barré syndrome?

An autoimmune disorder where the immune system attacks peripheral nerves, causing ascending paralysis.

72: What are key symptoms of Guillain-Barré?

Progressive weakness starting in legs, loss of reflexes, and possible respiratory failure.

73: What nursing care is required for Guillain-Barré?

Monitor respiratory function, provide airway management, prevent pressure injuries, and support mobility.

74: What is multiple sclerosis (MS)?

A chronic autoimmune disease causing demyelination of CNS nerve fibres, leading to disrupted nerve transmission.

75: What are early symptoms of MS?

Vision changes, fatigue, muscle weakness, and balance problems.

76: What type of MS has relapses and remissions?

Relapsing-remitting MS.

77: How is MS treated?

Corticosteroids for relapses and disease-modifying agents (e.g., interferon beta) to slow progression.

78: What complications can MS lead to?

Paralysis, depression, bladder dysfunction, and cognitive changes.

79: What is neurogenic shock?

Loss of sympathetic tone after spinal injury causing hypotension and bradycardia.

80: How is neurogenic shock treated?

Stabilise spine, give IV fluids, vasopressors, and atropine for bradycardia

81: What is GORD?

Gastro-oesophageal reflux disease — stomach acid flows back into the oesophagus, causing heartburn.

82: What are treatments for GORD?

Lifestyle changes (avoid caffeine, alcohol, and lying flat), antacids, and proton pump inhibitors.

83: What is appendicitis?

Inflammation of the appendix causing pain starting near the umbilicus then shifting to the right lower quadrant.

84: What are complications of untreated appendicitis?

Perforation and peritonitis.

85: What is diarrhoea?

Frequent loose stools due to increased motility or poor absorption; risk of dehydration and electrolyte imbalance.

86: What is constipation?

Hard, infrequent stools due to slow transit or low fibre/fluid intake.

87: What are treatments for constipation?

Increase fluids and fibre, encourage activity, and use stool softeners or laxatives if needed.

88: What are causes of vomiting?

GI irritation, CNS issues, medications, or infections.

89: What are complications of vomiting?

Dehydration, electrolyte imbalance, aspiration, and metabolic alkalosis.

90: What is a peptic ulcer?

A break in the gastric or duodenal mucosa caused by H. pylori or NSAID use.

91: What are symptoms of a peptic ulcer?

Epigastric pain, nausea, bloating, and melena (dark stools).

92: How are peptic ulcers treated?

Antibiotics for H. pylori, PPIs, and avoiding NSAIDs.

93: What is inflammatory bowel disease (IBD)?

Chronic inflammation of the GI tract, including Crohn’s disease and ulcerative colitis.

94: What are symptoms of IBD?

Abdominal pain, diarrhoea, weight loss, and blood in stool.

95: How is IBD managed?

Corticosteroids, immunosuppressants, biologics, and dietary management.

96: What is paralytic ileus?

Cessation of bowel movement after surgery or obstruction, causing distension and vomiting.

97: What is the nursing management for paralytic ileus?

Monitor bowel sounds, maintain NPO, and prepare for possible NG tube insertion.

98: What are potential complications of ileus?

Bowel obstruction, perforation, and peritonitis.

99: What is the purpose of a nasogastric tube?

Decompression, feeding, or medication delivery via the stomach.

100: What is essential nursing care for NG tubes?

Confirm placement, flush before/after feeds, monitor for aspiration, and maintain hygiene