Download RELIAS MEDICAL SURGICAL RN FORM A 2022-2023 and more Study notes Nursing in PDF only on Docsity!
RELIAS MEDICAL SURGICAL RN FORM A 2022-
100 % Questions & Answers
1.2 milligrams is equal to how many micrograms? - ANSWER-1200 mcg Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? - ANSWER-Compress the drain, then plug the bulb to establish suction Your male patient complains of discomfort while inflating the balloon during insertion of an indwelling urinary catheter. What would be the MOST appropriate action? - ANSWER-Deflate the balloon, advance the catheter further, then reinflate the balloon Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response? - ANSWER-Respect his wishes and notify the provider Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? - ANSWER-broth, jello, soft fruit no skin, You were hired to work the medical unit and when you arrive at work the charge nurse has assigned you to the post-surgical unit since they are understaffed. Which is the MOST appropriate action? - ANSWER-Report to the post-surgical unit. What is a proton pump inhibitor, such as pantoprazole (Protonix) used for? - ANSWER- Acid Reduction Which adaptive equipment would be MOST appropriate to use for a severely contracted patient who is unable to bear weight when transferring from the bed to the chair? - ANSWER-Patient lift (e.g., Hoyer) Which tool should you use to assess pain in you 80-year-old patient with severe dementia? - ANSWER-PAINAD scale Your patient is admitted from the ED with failure to thrive and advanced dementia. You note he is extremely underweight, appears unbathed for some time, and has a stage 4 pressure injury to his coccyx. You were told in report that he lives at home with family members. What should you do? - ANSWER-Notify the charge nurse and social worker of your concerns. Your 85-year-old patient with atrial fibrillation fell at home 3 days ago. You notice she has been having several episodes of acute confusion since being admitted to your unit.
What is the MOST important order you should anticipate from the provider? - ANSWER- Stat CT of head Your patient has a temp of 102.3 F, HR 122, and has had 15 mL of urine from the indwelling urinary catheter in the last 2 hours. What is your patient MOST likely experiencing. - ANSWER-Sepsis What type of personal protective equipment (PPE) is applied prior to entering a room for a patient with C. diff? - ANSWER-Gown and gloves Your patient continues to pull at their IV site located in their left forearm despite verbal reminders and increased observation. The nursing assistant recommends using soft mitt restraints on the patient. What is your recommendation? - ANSWER-Request an order for soft mitts as they are the least restrictive Your patient was admitted for a hypertensive crisis and has a history of HTN, Parkinson's disease, depression, and alcohol use. On his second hospitalized day, you notice he is more anxious and restless than his baseline. What would be your FIRST nursing intervention? - ANSWER-Ask the patient when his last drink of alcohol was. What is the BEST indication of an acute neurological problem? - ANSWER- Change in level of consciousness While in a supine position your patient states, "I'm tired and cannot catch my breath." Physical assessment reveals jugular vein distention and a third heart sound (S3). These symptoms are indicative of what condition? - ANSWER- Heart failure Your new admission presents with a cough, unintentional weight loss, frequent night sweats, and bloody sputum. What type of isolation precautions should you initiate, if any? - ANSWER-Airborne precautions Patients with diabetes are at high risk for complications from damage to what body areas? - ANSWER-Nerve and kidney damage If your patient with a known history of diabetes is displaying symptoms of diaphoresis, cool skin, lethargy, and shakiness. What is your first action? - ANSWER-Check the patient's blood glucose level. Your patient tells you, "I hope I don't die, but if I do I don't want to be brought back.? You notice on her chart and wrist band that she is a full code. What would be the MOST appropriate action? - ANSWER-Discuss code status with the patient and follow up with provider to ensure the medical record reflects her wishes.
Upon entering your patient's room, you note that they are having a seizure. What is your FIRST action? - ANSWER-Position the patient on their side to maintain the airway. Your 18-year-old female patient was admitted with dehydration secondary to anorexia nervosa. During your assessment you note she has a flat affect and says, "I just want to die. I'm tired of my life." What should be your FIRST intervention? - ANSWER-Stay with the patient and ask fi she has a plan to carry out this wish. Your patient has a non-productive cough and presence of secretions in his tracheostomy. Prior to suctioning the patient, what should you do FIRST? - ANSWER- Hyperoxygenate patient. Your patient takes 5 mg of warfarn (Coumadin/Jantoven) daily and reports having black colored stool today. What do you most likely suspect? - ANSWER-Gastrointestinal bleeding Your new patient was admitted with blunt force trauma to the abdomen following a motor vehicle accident (MVA). A NG tube is in place for decompression; however, you note during the assessment that the stomach is rigid and hard during palpation. What condition do you suspect? - ANSWER-Hemorrhage Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? - ANSWER-Impaired gas exchange You have a patient going for dialysis. Their medications include lisinopril (Prinivil), ondansetron (Zofran), famotidine (Pepcid), and atorvastatin (Lipitor). Which medication would you possibly hold and seek clarification? - ANSWER-famotidine (Pepcid) What is an early symptom that the patient is developing a complication of heart failure?
- ANSWER-Edema in the legs and feet Black and tarry colored stools are CLASSIC symptoms of what condition? - ANSWER- Bleeding gastric ulcer You have 4 patients who have high priority needs. One needs to go to surgery, one needs STAT lab draws from a PICC line, another has chest pain rated 8/10, and another needs toileting. Which patient should you tend to FIRST? - ANSWER-The patient with chest pain
Your patient with Hepatitis C exhibits signs of jaundice and a distended abdomen. What procedure would you anticipate being performed by the provider at the bedside for this patient? - ANSWER-Paracentesis What is clubbing of the fingers MOST likely associated with? - ANSWER- Chronic oxygen deficiency
Your 68-year-old patient is a Type 1 diabetic with a history of schizophrenia and exhibits signs and symptoms of tardive dyskinesia. What long-term medication is associated with signs and symptoms of tardive dyskinesia? - ANSWER-risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine
Your 80-year-old patient is being discharged home post CVA. She lives alone, yet still requires assistance with ADLs. What referral is MOST appropriate to ensure her needs are met? - ANSWER-Case Manager Central Telemetry calls and tells you your patient is experiencing bradycardia. What is the first thing you should do after entering the room? - ANSWER-Assess the patient and take vital signs. Your patient is currently under 1:1 observation for suicide precautions. He states he needs to have a bowel movement and would like some privacy to use the bathroom. What is the MOST appropriate response? - ANSWER-"I must be within an arms' length view of you at all times for your safety, including while using the bathroom." A female patient requests a female nurse to provide care for her based on her religious beliefs. What is the MOST appropriate action to take? - ANSWER- Accommodate her request if possible. Your patient is a 40-year-old female with a recent history of hair loss, extremely dry skin, a nd a 20-point weight loss in the last 3 weeks. She also exhibits occasional episodes of tremors in her upper extremities. What condition do these symptoms MOST likely indicate? - ANSWER- Hyperthyroidism Insulin lispro (Humalog) is orders via sliding scale a.c. for your patient with diabetes. When is the best time to administer insulin lispro (Humalog)? - ANSWER-15 min before the meal arrives Which of the following would be used as part of the preop procedure to prevent infection? - ANSWER-Prophylactic antibiotics Two days after surgery, your 72-year-old patient is showing signs of agitation and confusion, which is not his baseline. The severity fluctuates throughout the day. His medications include hydromorphone (Dilaudid), amlodipine (Norvasc), alprazolam (Xanax), and carbidopa-levodopa (Sinemet). What condition do you MOST likely suspect? - ANSWER-Delirium What is the proper technique when suctioning a tracheostomy? - ANSWER- Suction in a circular motion while the catheter is being pulled out. Your new patient admitted for cholecystitis expresses she has a history of anxiety disorder. She is feeling panicked and does not think she can handle staying in the hospital for her surgery. What action is MOST appropriate for you to take? - ANSWER- Sit calmly next to her and offer her compassion and a sense of security.
The provider orders Heparin 4 units/kg SQ. Your patient weighs 176 pounds. How many units should you administer? - ANSWER-320 units
What diagnostic finding would support a diagnosis of deep vein thrombosis? - ANSWER-Positive D-dimer You are caring for a combative 85-year-old male with a history of dementia, CHF, UTI, and anemia. The family states he appears to be more confused than his baseline. What tests do you expect the provider to order? - ANSWER- Urinalysis with cultures, CBC A patient has recently been diagnosed with terminal cancer. Her responses are caustic and abrasive. What is the BEST way to respond? - ANSWER- Acknowledge her feelings, understanding this is expected in the grieving process. You notice your patient who recently had a stroke is coughing intermittently during meals. What is the MOST likely cause of this? - ANSWER-He could be aspirating. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - ANSWER-Left lower quadrant Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - ANSWER-Using sterile technique when inserting the catheter The provider orders a Heparin infusion of 900 units/hr. Your IV medication on hand has 25,000 units of Heparin in 500 mL of D5W. How many mL/hr will you infuse? - ANSWER-18 mL/hr Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - ANSWER- Initiate droplet precautions What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? - ANSWER-Statin Fifteen minutes after starting a blood transfusion, the patient complains of lower back pain, shortness of breath, and chills. What is your FIRST action?
- ANSWER-Stop the tranfusion. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - ANSWER-Bright red urine What condition (not medication related) might cause an elevation in the patients PT/INR level? - ANSWER-Liver disease Your patient admitted for small bowel obstruction has been vomiting for the
Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? - ANSWER- 0.125mg As you are walking down the hallway you overhear your colleague discussing her personal family issues with a patient. What would be the MOST appropriate response? - ANSWER-Remind her later of her responsibility for establishing and maintaining professional boundaries with patients. Your patient, who has soft wrist restraints for safety (non-violent), is working with the occupational therapist at the bedside. The nursing assistant enters and says, "The patient is not allowed to have his restraints untied." How do you respond? - ANSWER- "Restraints can be temporarily off while directly working with staff. Let me know when the therapy session is finished and I will re-apply them." Your patient suddenly develops signs and symptoms of shortness of breath, restlessness, tachypnea, hemoptysis, and decreased oxygen saturations despite being on 2L/min of O2 by nasal cannula. What do you expect is happening? - ANSWER- Pulmonary embolism The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - ANSWER-Prednisone Your patient with CHF states, "I can still eat the same food, I just have to weight myself everyday." Based on this statement, which nursing diagnosis would be appropriate? - ANSWER-Knowledge Deficit patient arrives on unit. you do an assessment and notice lice in her hair. what is your first action? - ANSWER-Secure a private room Patient presents dusky pallor and pulseless. First action - ANSWER-Initiate facility code procedure
