Review
1. Why can pancreatic cancer spread rapidly?
✅ Answer: Because of its location, it can invade nearby blood vessels and surrounding structures.
Rationale: The pancreas is close to major vessels, lymphatics, and abdominal structures, and pancreatic cancer is often detected after it has already advanced.
2. What is the primary risk factor for prostate cancer emphasized by your instructor?
✅ Answer: Increasing age, especially older adulthood.
Rationale: Prostate cancer risk increases substantially with age.
3. What are common cancer risk factors?
✅ Answer: Smoking, increasing age, obesity, certain alcohol exposures, genetics/family history, and some environmental exposures.
Rationale: Cancer risk can involve both modifiable factors, such as smoking, and nonmodifiable factors, such as age and genetics.
4. Where is it especially important to assess for melanoma in clients with darker skin?
✅ Answer: Palms, soles/plantar surfaces, and nail areas, as part of a complete skin exam.
Rationale: Acral melanoma occurs on areas such as the palms, soles, and nail beds and represents a larger proportion of melanoma cases among people with darker skin.
5. What is the most important modifiable intervention for decreasing lung-cancer risk?
✅ Answer: Smoking cessation.
Rationale: Tobacco smoking is the leading preventable risk factor for lung cancer. Appropriate high-risk adults may also qualify for low-dose CT screening.
🔥 Burns
6. What are the adult Rule of Nines percentages?
✅ Answer:
Head/neck = 9%
Each arm = 9%
Anterior trunk = 18%
Posterior trunk = 18%
Each leg = 18%
Perineum = 1%
Rationale: The Rule of Nines rapidly estimates the percentage of total body surface area (TBSA) affected by burns.
7. What percentage is the anterior surface of one adult arm?
✅ Answer: 4.5%
Rationale: The entire arm is 9%; anterior half = 4.5%, posterior half = 4.5%.
8. A flame burn is blistered, wet, and moist. What depth is it?
✅ Answer: Superficial partial-thickness (second-degree).
Rationale: These burns commonly appear red/pink, moist and blistered and are usually painful.
9. What is the priority assessment for a client with a major burn?
✅ Answer: Airway.
Rationale: Follow ABC — Airway, Breathing, Circulation. Airway edema from inhalation injury can become life-threatening.
10. What does black/sooty sputum following a burn suggest?
✅ Answer: Inhalation injury.
Rationale: Soot in sputum, hoarseness, facial burns, and respiratory changes can indicate airway involvement.
11. What IV fluid is commonly used for initial major-burn resuscitation?
✅ Answer: Lactated Ringer’s (LR).
Rationale: LR is commonly used as the crystalloid for initial burn resuscitation.
12. What adult urine output generally indicates adequate burn resuscitation?
✅ Answer: Approximately 0.5 mL/kg/hr, commonly at least around 30 mL/hr in many adults.
Rationale: Urine output is an important indicator of organ perfusion and the adequacy of fluid resuscitation.
🩹 Wounds & Skin
13. What does healthy granulation tissue look like?
✅ Answer: Red/pink, moist/soft tissue that can bleed easily.
Rationale: Granulation tissue contains newly forming capillaries and connective tissue and is a sign of healing.
14. What gloves should be worn to remove a contaminated/soiled dressing?
✅ Answer: Clean/nonsterile gloves.
Rationale: The old dressing is contaminated. After removal, perform hand hygiene and use sterile technique when required for the new dressing.
15. What is negative-pressure wound therapy (wound VAC) used for?
✅ Answer: To remove drainage and promote wound healing.
Rationale: Negative pressure removes exudate and supports formation of healthy granulation tissue.
16. What is dehiscence?
✅ Answer: Separation/opening of a surgical wound.
Rationale: The incision partially or completely separates without necessarily having organs protrude.
17. What is evisceration?
✅ Answer: Protrusion of internal organs/tissue through an opened surgical incision.
Rationale: Evisceration is a surgical emergency.
18. What should the nurse do for abdominal evisceration?
✅ Answer: Cover the exposed tissue with sterile gauze moistened with sterile normal saline and notify the surgeon/provider immediately. Do NOT push the organs back inside.
Rationale: Moist sterile gauze protects the exposed tissue from drying and contamination while emergency treatment is obtained.
19. Which vitamin is particularly important for wound healing?
✅ Answer: Vitamin C.
Rationale: Vitamin C is necessary for collagen synthesis and tissue repair. Protein and zinc are also important nutrients for healing.
20. What does contact dermatitis typically look like?
✅ Answer: Red, itchy, inflamed skin that may have vesicles/blisters.
Rationale: Contact with an irritant or allergen produces an inflammatory skin reaction.
21. What does psoriasis typically look like?
✅ Answer: Well-defined erythematous plaques with silvery-white scales.
Rationale: The rapid turnover of epidermal cells produces the characteristic scaling.
22. What treatment may be used for widespread psoriasis?
✅ Answer: Phototherapy; selected patients may receive photochemotherapy such as PUVA.
Rationale: Controlled ultraviolet exposure can slow excessive skin-cell proliferation.
23. A skin lesion grows from 5 mm to 10 mm, changes color, itches, and bleeds. What findings are concerning?
✅ Answer: Increase in size, change in color, and itching/bleeding.
Rationale: An evolving lesion—one changing in size, shape, color, or symptoms—requires evaluation.
24. What does ABCDE mean when assessing a suspicious pigmented lesion?
✅ Answer:
A = Asymmetry
B = Border irregularity
C = Color variation
D = Diameter
E = Evolving/changing
Rationale: ABCDE helps identify characteristics concerning for melanoma.
25. What interventions were included in your teacher’s keloid scenario?
✅ Answer: Silicone gel sheets, monitoring for infection, and an antihistamine PRN for itching.
Rationale: Silicone products can help flatten/manage some keloids; monitoring identifies complications, and antihistamines can help control itching.
👁 Eye Disorders
26. What are common manifestations of cataracts?
✅ Answer: Painless, progressively blurred/cloudy vision, glare and decreased visual acuity.
Rationale: Cataracts cause progressive clouding of the eye’s lens.
27. What are risk factors for cataracts emphasized in your lecture?
✅ Answer: Previous eye trauma and excessive UV exposure.
Rationale: Both trauma and chronic UV exposure can contribute to lens damage and cataract formation.
28. What causes increased IOP in primary open-angle glaucoma?
✅ Answer: Decreased outflow/drainage of aqueous humor.
Rationale: Impaired drainage contributes to increased intraocular pressure and progressive optic nerve damage.
⭐ Do not memorize “decreased aqueous humor.”
It’s decreased DRAINAGE/OUTFLOW.
29. What risk factor for glaucoma did your instructor emphasize?
✅ Answer: Severe nearsightedness (myopia).
Rationale: Myopia is associated with an increased risk of open-angle glaucoma.
30. What should the nurse ask when assessing a client with suspected retinal detachment?
✅ Answer: Ask about recent eye/head trauma or injury, along with onset and characteristics of visual symptoms.
Rationale: Trauma can precipitate retinal tears/detachment.
31. What are classic warning signs of retinal detachment?
✅ Answer: Flashes + floaters + curtain/shadow over vision.
Rationale: These sudden visual changes can indicate separation of the retina and require urgent ophthalmologic evaluation.
32. What postoperative restrictions should a client follow after retinal reattachment surgery?
✅ Answer: Follow prescribed positioning and activity restrictions and avoid activities such as heavy lifting or bending until cleared. Do not drive until medically cleared.
Rationale: Restrictions help protect the surgical repair.
33. What risk factor for AMD did your instructor emphasize?
✅ Answer: Light-colored/blue eyes or light pigmentation.
Rationale: Light iris pigmentation has been investigated as an AMD risk factor; however, older age and smoking are stronger established risk factors to remember clinically.
34. What is the Amsler grid used for?
✅ Answer: Detecting/monitoring central visual distortion, particularly with AMD.
Rationale: Macular disease can make straight grid lines appear wavy, blurred, distorted, or missing.
⭐ AMSLER = AMD
35. What does the Snellen chart measure?
✅ Answer: Distance visual acuity.
Rationale: It measures how clearly a person can see letters at a standardized distance.
36. What does tonometry measure?
✅ Answer: Intraocular pressure (IOP).
Rationale: Measuring IOP is part of glaucoma evaluation and monitoring.
37. What does a refraction test determine?
✅ Answer: Whether the client needs corrective lenses and what prescription is required.
Rationale: Refraction determines the lens power necessary to correct refractive errors.
38. Why does decreased tear production increase the risk of eye problems?
✅ Answer: Tears normally lubricate, clean and protect the eye.
Rationale: Reduced tears decrease natural cleansing and protection, contributing to dryness, irritation and increased susceptibility to surface problems.
39. What can a client with diabetic retinopathy experience?
✅ Answer: Floaters and blurred vision as disease progresses.
Rationale: Diabetes damages retinal blood vessels. Importantly, early diabetic retinopathy can be asymptomatic.
👂 Ear & Hearing
40. What medication class may be used to help manage Ménière’s disease?
✅ Answer: Diuretics.
Rationale: Diuretics, often combined with dietary measures such as sodium restriction, may help reduce frequency/severity of Ménière’s symptoms in some patients.
41. What is tinnitus?
✅ Answer: Perception of ringing, buzzing, or another sound without an external sound source.
Rationale: Persistent tinnitus can interfere with sleep, concentration, and emotional well-being.
42. What tinnitus assessment did your teacher specifically mention?
✅ Teacher-review answer: Assess whether side-to-side eye movement changes/worsens the tinnitus.
Rationale: Keep this as a teacher-specific test point. It is not a standard universal tinnitus assessment question I would generalize to every patient.
43. What type of diet/food may be easier immediately after cochlear implant surgery?
✅ Answer from your course review: Soft foods.
Rationale: Softer foods reduce vigorous chewing/jaw movement during early postoperative recovery.
44. How should the nurse communicate with a client who has hearing loss?
✅ Answer: Face the client directly, speak clearly, provide adequate lighting and decrease background noise.
Rationale: This improves access to facial cues and makes speech easier to understand. Avoid shouting.
👵 Older Adults
45. Which sensory changes/complications can occur with aging? — SATA
✅ Answers:
Reduced nutritional intake due to decreased taste/smell sensitivity
Reduced pain sensation related to decreased peripheral nerve functioning
Difficulty hearing high-frequency sounds
Rationale: Aging can decrease taste and smell sensitivity, alter peripheral sensation, and cause presbycusis, which characteristically affects high-frequency hearing.
🚨 NIGHT-BEFORE-EXAM MEMORY BOX
Pancreas → spreads/invades nearby structures
Prostate → AGE
Burn + black sputum → AIRWAY 🚨
Burn fluids → LR
Blisters + moist → superficial partial-thickness
Adult urine output → ~0.5 mL/kg/hr
Dehiscence → wound opens
Evisceration → organs protrude → moist sterile saline gauze → NEVER push back
Contact dermatitis → RED + ITCHY + VESICLES
Psoriasis → SILVERY SCALES
Cataract → CLOUDY + BLURRY + PAINLESS
Glaucoma → ↓ aqueous DRAINAGE → ↑ IOP
Retinal detachment → FLASHES + FLOATERS + CURTAIN 🚨
AMSLER → AMD 🎯
SNELLEN → ACUITY 👀
TONOMETRY → PRESSURE 💨
REFRACTION → GLASSES 👓
Ménière’s → DIURETIC
Tinnitus → RINGING
Presbycusis → HIGH-FREQUENCY hearing loss
You now have 45 questions with answers and rationales, which gives you more material than the 35 questions on your actual exam.