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LPN-RN SUMMER BRIDGE 2024 EXAM 1 WITH ACTUAL SOLUTIONS
"The unique function of the nurse is to assist with the individual, sick or well, in the performance of those activities contributing to health or recovery ( or peaceful to death) that he would
preform unaided if he had the necessary strength, will, or knowledge, - CORRECT ANSWER
Definition of Nursing for International Council of Nurses?" "nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human
response, and advocacy in the care of individuals, families, communities, and populations -
CORRECT ANSWER Definition of Nursing for American Nurses Association?"
"give us expectations of what a nurse is - CORRECT ANSWER What do these definations
provide nurses?" "LPN's cannot -hang blood -chemotherapy treatments -IV push medications
-pronounce time of death - CORRECT ANSWER What's the difference between an RN and a
LPN?"
"tells us how we have to act as a nurse ( accountable, competent, informed, judgment, advocate)
- CORRECT ANSWER ANA Code of Ethics are"
"what you can and can't do as a nurse - CORRECT ANSWER ANA Standards of clinical practice
tells us..."
"education, health screenings before someone gets sick, health promotion, teachings -
CORRECT ANSWER Promotion"
"avoidance of disease and infection ( vaccines) - CORRECT ANSWER Prevention"
"activities foster a return to health for those ill ( ROM) - CORRECT ANSWER Restoration"
"providing respectful care to those that are terminally ill, comfort - CORRECT ANSWER End of
Life Care"
""bedside" , hands on - CORRECT ANSWER Direct Care"
""triage" administration, care conference, plan of care, build policies - CORRECT ANSWER
Indirect Care" "Economy- when the economy is good, promotion/prevention is easy, people go to the doctor, when it is bad people are really sick when they go Healthcare- nursing shortage, higher patient -staff ratio Collective bargaining- insurance, unions Women's Movement- single moms is nice to work part time as a nurse to stay at home with kids
Overall Consumers- clients, patient - CORRECT ANSWER What influences the care provided?"
"private or personal standards of right or wrong - CORRECT ANSWER Morals"
"stufy of moral principles + standards, formal process to make decisions - CORRECT ANSWER
Ethics"
"application of ethics in healthcare look at doing good for overall good - CORRECT ANSWER
Bioethics"
"subset of bioethics, refers to nursing practice - CORRECT ANSWER Nursing Ethics"
"influence decision making, ideals, beliefs, customs - CORRECT ANSWER Values"
"mental disposition towards object or person, what a person thinks or feels - CORRECT
ANSWER Attitudes"
"idea that one accepts is true but may be based on faith - CORRECT ANSWER Beliefs"
"observe and consider, awareness of total situation, look at values, cultural issues, interpersonal
relationships, environmental surroundings - CORRECT ANSWER Contextual Awareness"
"creditable sources, apply stands of good reasoning (ask yourself- does this help the patient) -
CORRECT ANSWER Inquiry"
"Purpose - obtain data and identify problems Subjective - information from patient
Objective- signs, labs, assessment, diagnostic tests - CORRECT ANSWER * Assessment*"
"NANDA- nursing diagnosis for nursing- contains problem and( etiology --> cause of problem)
-see where problems are at and interperating data collected - CORRECT ANSWER
Diagnosis"
"has signs and symptoms , 3 parts 1.) problem 2.)cause 3.) s/s - CORRECT ANSWER Types of
Nursing Diagnosis ( Actual)"
"has risk factors, no s/s - CORRECT ANSWER Types of Nursing Diagnosis ( Risk)"
"any condition that requires intervention - CORRECT ANSWER Types of Nursing Diagnosis
( Health Problem)"
"assess problems and go to who we need for what we want ( - CORRECT ANSWER Types of
Nursing Diagnosis ( Collaborative Problems)" "PES format 1.) problem - s/s, NANDA 2.) Etiology- cause of problem
3.) Signs and symptoms- subjective & objective data - CORRECT ANSWER What is the format
for diagnostic statement?" "formal- critical thinking, desired outcomes "planned" informal-discover something else as you are working on your formal plan
- prioritize nursing diagnosis -plan outcomes ( goal)
-plan interventions - CORRECT ANSWER Planning"
"Initial Planning- first contact with patient and assessment Ongoing Planning- make changes
Discharge Planning- starts at admission - CORRECT ANSWER Types of Planning"
"Outcome! - CORRECT ANSWER The first component of "plan" is ______"
"motivates, achieve it , improves & maintains health status of patient - CORRECT ANSWER
What are the purpose of outcomes?" "S-pecic M-easurable A-ttainable R-ealistic
T-imely - CORRECT ANSWER SMART ( Planning Phase)"
"Client Will verb- describe, feel , smell Performance criteria- how, what when, amount
Target Time- at discharge, 2 weeks, end of stay - CORRECT ANSWER Components of
Outcomes?"
"*putting planned interventions in action in order to meet goal, carry out nursing order -
CORRECT ANSWER * Implementation*"
"-evaluate all steps and look at the effectiveness of the care plan - CORRECT ANSWER
Evaluation" "Ongoing- carrying out plan Intermittent - specified times
Terminal- progress at time of discharge - CORRECT ANSWER Types of Evaluation"
"Self talk; can be positive or negative - CORRECT ANSWER Intrapersonal Communication"
"between 2 or more people - CORRECT ANSWER Interpersonal Communication"
"with many people at the same time - CORRECT ANSWER Group"
"unique form form of group communication - CORRECT ANSWER Public Speaking"
"personal distance with patients - CORRECT ANSWER What distance do we provide with
patients?"
"failure to follow up or check on a patient ( did not do vitals or assess patient) - CORRECT
ANSWER Negligence/ Neglect"
"legally accountable for actions - CORRECT ANSWER Vicarious Liability"
"1.) Duty- care for patient 2.) Breech of duty- didn't do what you were suppose to 3.)Causation-injury or death related to breech of duty
3.) Damages- money patient gets - CORRECT ANSWER Malpractice ( 4 elements) KNOW"
"1.) Cognitive - understanding 2.) Affective- attitude or feeling
3.)Psychomotor - motor skills ( demonstrate injections) - CORRECT ANSWER **** Blooms
Domain of Learning ****" "-what -when -who was taught -how the topic was taught -was the client receptive
-confirmation of learning obtained - CORRECT ANSWER **** What does documenting of
teaching need to include? ****" "maintain venous access, administer fluids or electrolyte replacement, deliver TPN, administer
blood - CORRECT ANSWER What is the purpose of Intravenous therapy?"
"every 4 hours - CORRECT ANSWER What is the MINIMUM time to assess and IV site and
dressing integrity?"
"smaller - CORRECT ANSWER For needles, the larger the number, the _______ the needle"
"** Distal to proximal/caution hands*
-area where it lays flat and can not be manipulated easy - CORRECT ANSWER When having a
patient with a peripheral vein accessed, how do you pick a injection site?" "-inserted by an MD or surgen -tunnled ( goes through vein, longterm -nontunneled- right where it is inserted, can have for one month
-implanted ports- can stay in place for a year
-hemodialysis - CORRECT ANSWER Central Venous Access ( CVAD)"
"Chest X-Ray ( complications - lung puncture --> pnemothorax) - CORRECT ANSWER How
do you confirm placement of a CVAD?"
"inserted into subclavian or internal jugular, acess with huber needle, sterile acess - CORRECT
ANSWER Implanted Ports"
"implanted ports - CORRECT ANSWER Which vascular access devices has the LEAST risk for
infection?" "infection of site s/s - pain, redness, swelling, fever, increased WBC, foul smelling nursing interventions- stop infusion, D/C IV, monitor vitals, blood cultures order, ABX ordered,
confusion - CORRECT ANSWER Site Infection + Sepsis"
"blockage of blood supply by air bubbles s/s- decreased BP, dizziness, itchy skin, chest pain, anxiety, dyspena, irregular heart rhythm, confusion nursing intervention- call for rapid response, trendelenburg on Left side*, administer
oxygen, monitor vitals - CORRECT ANSWER Air Embolism"
"1 to 2 minutes - CORRECT ANSWER IV push meds are typically given over ____ minutes"
"10 mLs - CORRECT ANSWER PICC lines need flushed with how many mLs?"
"waste 10 mLs before collecting blood sample, and flush post sampling with 20 mLs - CORRECT
ANSWER A person with a PICC dressing needs a blood draw, what do you do?"
"right patient type of solution rate/infusion of administration
specifc drug in solution - CORRECT ANSWER What do you need to check before administering
IV's?"
- Volume of fluid to be infused ( the ordering prescriber may order "cefazolin 1 gram IVPB every 4 hours, but the complete order once profiled by pharmacy will include the volume of solution the cefazolin is in) -Specific site of IV -Specific type of solution -Specific dose of drug in IV solution"
"Contact the provider to obtain clarification of the order - CORRECT ANSWER It's 6am and the
admitting provider has ordered 0.9% NSS to infuse at 250mL/hr for your patient admitted with dehydration. What should the RN do? -Hold the IV until provider does rounds to confirm order -Initiate the infusion of NSS 0.9% at 252mL/hr -Contact the provider to obtain clarification of the order -Infuse 1L of NSS0.9% at 250mL/hr -Start the infusion of NSS 0.9% at a lower rate of 125mL/hr and clarify with provider when they do morning rounds in an hour"
"-Check the compatibility of cefazolin with the infusion of D5 0.45% saline - CORRECT
ANSWER Your client has a continuous infusion of D5 0.45% saline at 125mL/hr. You have a new
order to administer cefazolin IVPB. What must the RN do first prior to administering the cefazolin? -Prepare the correct dose of cefazolin in 100mL of normal saline -Check the compatibility of cefazolin with the infusion of D5 0.45% saline -Scan the patient's ID armband -Stop the infusion of D5 0.45% saline while the cefazolin infuses"
"Hypertonic - CORRECT ANSWER Which IV solution will help correct acid-base and electrolyte
imbalance by moving water out of the cells and into the blood stream? Hypotonic Isotonic Hypertonic TPN (total parental nutrition)"
"fluid within cells - CORRECT ANSWER Intracellular Fluid"
"fluid outside the cell - CORRECT ANSWER Extracellular Fluid"
"fluid surrounding the cell - CORRECT ANSWER Intersittal Fluid"
"fluid in blood vessels - CORRECT ANSWER Vascular Fluid"
"high to low concentrations to reach equilibrium - CORRECT ANSWER Diffusion is moving
from"
"Sodium - CORRECT ANSWER What is the most abundant ion in ECF?"
"Potassium - CORRECT ANSWER What is the most abundant ion in ICF?"
"passive movement of water through a permeable membrane * need hydrostatic pressure*
( kidney and renal failure and can increase hydrostatic pressure) - CORRECT ANSWER
Filtration"
"ATP - CORRECT ANSWER What has to be in place for osmosis to happen?"
"water moves from less concentration to more concentration - CORRECT ANSWER Osmosis"
"-secreted with sodium is low -causes kidneys to retain sodium -water follows salt
-causes increase in blood volume and blood pressure - CORRECT ANSWER Aldosterone"
"-causes kidneys to reabsorb water to increase blood volume
-increases blood pressure - CORRECT ANSWER Antiduretic Hormone"
"decreases blood volume and BP - CORRECT ANSWER Natriuretic peptide"
"VS- decrease BP, tachycardia, confusion, headache, concentrated urine, weakness, fatigue, fever
- CORRECT ANSWER Dehydration Symptoms?"
"increased BP, edema, SOB, crackles in lungs, JVD, confusion, headache - CORRECT ANSWER
Fluid Overload symptoms?"
"ions are atoms or molecules with an electrical charge - CORRECT ANSWER What is an
electrolyte?"
beans, lentils, salmon, sellfish - CORRECT ANSWER Normal range for phosphate?dietary?"
"-3.5-5.5 mEq/L
-avocado, bananas, spinach, sweet potato, chocolate - CORRECT ANSWER Normal range of
Potassium? dietary?"
"-cardiac arrrhythiams, V-Fib, irritability, anxiety, abdominal cramps - CORRECT ANSWER
Hyperkalemia?"
"-bradycardia, irregular weak pulse, decreased GI function - CORRECT ANSWER
Hypokalemia?" "135-145 mEq/L
-salt, celery, beets, milk, processed/packaged foods, soup - CORRECT ANSWER Normal range
for Sodium? dietary?" “observing, comparing, contrasting, and evaluating the clients condition. ( looking at condition -->
vital signs, medications, call physican) - CORRECT ANSWER Clinical Judgment"
"reflective thinking process involving collecting and analyzing data, making sure it is accurate,
determine what action to take. - CORRECT ANSWER Critical Thinking"
"consider an issue and attempt to find a satisfactory solution to achieve best outcomes -
CORRECT ANSWER Problem-Solving"
"regualtes nursing practice in each state, approves nursing education, defines nursing practices, establishes criteria for differences between LPN and RN, determines scope of practice and
establishes roles - CORRECT ANSWER State Boards of Nursing"
"defines practice of professional nursing, approve nurse education programs, establishes criteria that allow a person to be a licensed as a RN or LPN, develop rules and regulations, enforce rules
CORRECT ANSWER Nurse Practice Act"
"Personal -set values that you reflect on that hope lead to good life Professional- preform as you move forward in profession and set what you learn ( caring,
competence, diversity, truth, hollistic care) - CORRECT ANSWER Personal Values VS
Professional Values" "put aside your own values, to provide nonjudgmental care ( help patient make best decision for
themselves) - CORRECT ANSWER Value Neutrality"
"-be aware of and sensitive to issues -assume responsibility for your own moral actions -function as a team member -support the patient and family member -support patients who are not being allowed to decide -use and participate in institutional ethics committees -advocate for your client
-continually strive to improve your ethical decision making - CORRECT ANSWER *Nurse's
Ethical Obligations* NEED TO KNOW"
"statement of clients health status that nurses can identify, prevent, or treat independently -
CORRECT ANSWER Types of Nursing Diagnosis ( Nurse Diagnosis)"
"reactions to disease, injury, other stressors, can be a problem or a strength, psychological,
physiological, spiritual, religions, developmental - CORRECT ANSWER Types of Nursing
Diagnosis ( Human Responses )"
"disease, injury, * we treat human responses to medical diagnosis* - CORRECT ANSWER
Types of Nursing Diagnosis ( Medical Diagnosis)" "independent interventions - w/o an order dependent interventions- need an order Interdependent interventions- carried out w/ other health care team members ( PT, OT, Speech)
CORRECT ANSWER Interventions <-- second part of Planning Phase"
"Nursing interventions " The what" --> chocolate cake Rationale "The Why" --> like cake Nursing Order "The How" --> the recipe for the cake
Write Nurse Will - CORRECT ANSWER Planning Phase: Nursing Interventions"
"-client centered -goal directed, focused on problem solving
-strengthens therapeutic relationships - CORRECT ANSWER Goals for Therapeutic
Communication" "to have a great deal of self -awareness and self- understanding ( check yourself before you go to
work and focus on your patients ) - CORRECT ANSWER * KNOW* Therapeutic use of self
requires the nurse....."
"normal saline solution - CORRECT ANSWER A patient presents with weakness, dizziness and
a blood pressure of 78/32. He reports he hasn't eaten in 3 days. Which IV infusion can the RN anticipate being ordered initially? Total parental nutrition (TPN) Normal Saline Solution 0.45% Saline solution D5W 0.45% Saline Solution"
"Indication for the use of Morphine - CORRECT ANSWER Your patient is ordered Morphine
sulfate 2mg IVP every 2 hours. What is missing from this order? How fast to push the Morphine The volume of Morphine to be given Indication for the use of Morphine Site to administer the Morphine in ** think it through: all prn orders must indicate"
"-Start with more distal site - CORRECT ANSWER Your client needs a peripheral IV for
antibiotic therapy. What does the nurse need to consider prior to insertion of the IV/saline lock? -Start with more proximal site -Start with more distal site -Insert in site where client prefers -Use the client's dominant hand"
"-Maintain the prescribed intravenous flow rate - CORRECT ANSWER What is the nurses
responsibility regarding the infusion of IV solutions? -Adjust the IV infusion flow rate depending on the patient's blood pressure -Discontinue the IV infusion once the patient is tolerating PO fluids -Maintain the prescribed intravenous flow rate -Change or discontinue the IV solution once the patient's serum osmolality has reaches 280mOm/kg"
"-Phlebitis - CORRECT ANSWER Your client complains of pain and burning at the IV insertion
site after the first dose of antibiotic has been infused. You note erythema, warmth, and swelling around the insertion site. What is likely complication? -Infiltration -Phlebitis -Air embolism -Circulatory overload" "9-10.5 mg/dL
dark leafy greens, low fat milk, cheese, yogurt, broccali, green beans, almonds, canned fish -
CORRECT ANSWER Normal range for calcium? dietary?"
"-increased thirst, increased urination, belly pain, nausea, bone pain, muscle weakness,
confusion ( think about how you feel if you drink too much of a milkshake) - CORRECT
ANSWER Hypercalcemia?"
