(2023) Medical-Surgical RN A Prophecy Test, Relias Learning Answered, Exams of Medical Sciences

Download (2023) Medical-Surgical RN A Prophecy Test, Relias Learning Answered and more Exams Medical Sciences in PDF only on Docsity! MEDICAL-SURGICAL RN A PROPHECY TEST, RELIAS LEARNING ANSWERED 2023 Medical-Surgical RN A Prophecy Test / Relias Learning 1. 1.2 milligrams is equal to how many micrograms?: 1200 mcg 2. Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function?: Compress the drain, then plug the bulb to establish suction 3. Your male patient complains of discomfort while inflating the balloon during insertion of an indwelling urinary catheter. What would be the MOST appropriate action?: Deflate the balloon, advance the catheter further, then rein- flate the balloon 4. Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response?: Respect his wishes and notify the provider 5. Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient?: High Fiber 6. 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 un- derstaffed. Which is the MOST appropriate action?: Report to the post-surgical unit. 7. What is a proton pump inhibitor, such as pantoprazole (Protonix) used for?: Coat the lining of the stomach 8. Which adaptive equipment would be MOST appropriate to use for a severe- ly contracted patient who is unable to bear weight when transferring from the bed to the chair?: Patient lift (e.g., Hoyer) 23. Your new patient understands very limited English. How should you communicate with them when completing the admission assessment?: Use the organization's interpreter services. 24. You are caring for a patient with a history of diabetes mellitus. You walk into the room and find the patient lethargic and diaphoretic. What is your first action?: Obtain capillary blood glucose level. 25. Your patient is 4 hours post open appendectomy and has not voided yet. You note his lower abdomen is distended. What should you do NEXT?: Per- form a bladder scan 26. A patient with peritonitis presents with tachycardia, hypotension, and dehydration. What other assessment finding would you anticipate as part of your physical assessment?: Severe abdominal pain or rebound tenderness 27. What is the EARLIEST sign indicating increased intracranial pressure (ICP)?: Level of consciousness 28. In addition to pain, pallor, and pulselessness, a neurovascular assess- ment also includes checking for:: Paresthesia and paralysis 29. You received a report on a patient that sustained a right hemisphere CVA 48 hours ago. What do you expect the patient to exhibit?: Left sided weakness of the leg, arm, and face. 30. You are ordered to give digoxin (Lanoxin). Your patients vital signs are: BP 130/70, Temp 97.9F, HR 52, RR 16, O2 Sat 100% on room air. What should you do NEXT?: Hold digoxin (Lanoxin) and call the provider 31. Upon entry to your patient's room, you find her sitting in High Fowler's position and complaining of shortness of breath. Her respiratory rate is 34 breaths/min and O2 sat is 84%. Which mode of oxygen delivery would MOST likely reverse these symptoms?: Non-rebreather mask 32. Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room?: Gown and gloves 33. Your patient recently had a G-tube placed and intermittent enteral feed- ings have been initiated. What symptoms may indicate intolerance to the feedings?: Vomiting and diarrhea 34. Upon entering your patient's room, you note that they are having a seizure.What is your FIRST action?: Position the patient on their side to maintain the airway. 35. Your 18-year-old female patient was admitted with dehydration sec- ondary 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?: Stay with the patient and ask fi she has a plan to carry out this wish. 36. Your patient has a non-productive cough and presence of secretions in his tracheostomy. Prior to suctioning the patient, what should you do FIRST?: Hyperoxygenate patient. 37. Your patient takes 5 mg of warfarn (Coumadin/Jantoven) daily and re- ports having black colored stool today. What do you most likely suspect?: - Gastrointestinal bleeding 38. 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 decom- pression; however, you note during the assessment that the stomach is rigid and hard during palpation. What condition do you suspect?: Hemorrhage 39. Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)?: Impaired gas exchange 40. You have a patient going for dialysis. Their medications include lisinopril (Prinivil), ondansetron (Zofran), famotidine (Pepcid), and atorvastatin (Lip- itor). Which medication would you possibly hold and seek clarification?: - Lisinopril (Prinivil) 41. What is an early symptom that the patient is developing a complication of heart failure?: Edema in the legs and feet patient?: Enoxaparin (Lovenox) once daily and intermittent pneumatic compressions (IPC) 54. You receive a provider's order that is not consistent with evidence-based practice. What is your FIRST step?: Clarify the order with the provider. 55. When would sucralfate (Carafate) 4 times daily be scheduled for?: 1 hour before meals and at bedtime 56. Your patient's morning labs revealed a hemoglobin level of 6.3 and hema- tocrit of 18. What blood product do you expect to administer?: PRBCs 57. Your 68-year-old patient is a Type 1 diabetic with a history of schizophre- nia and exhibits signs and symptoms of tardive dyskinesia. What long-term medication is associated with signs and symptoms of tardive dyskinesia?: 58. Your 80-year-old patient is being discharged home post CVA. She lives alone, yet still requires assistance with ADLs. What referral is MOST appro- priate to ensure her needs are met?: Case Manager 59. Central Telemetry calls and tells you your patient is experiencing brady- cardia. What is the first thing you should do after entering the room?: Assess the patient and take vital signs. 60. 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?: "I must be within an arms' length view of you at all times for your safety, including while using the bathroom." 61. 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?: Ac- commodate her request if possible. 62. 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?: Hyperthyroidism 63. 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)?- : 15 min before the meal arrives 64. Which of the following would be used as part of the preop procedure to prevent infection?: Prophylactic antibiotics 65. 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), am- lodipine (Norvasc), alprazolam (Xanax), and carbidopa-levodopa (Sinemet). What condition do you MOST likely suspect?: Delirium 66. What is the proper technique when suctioning a tracheostomy?: Suction in a circular motion while the catheter is being pulled out. 67. 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?: Sit calmly next to her and offer her compassion and a sense of security. and demands updates about your patient. What should you do NEXT?: Verify your patient's consent to release information to her mother. 79. The provider orders Heparin 4 units/kg SQ. Your patient weighs 176 pounds. How many units should you administer?: 320 units 80. What diagnostic finding would support a diagnosis of deep vein throm- bosis?: Positive D-dimer 81. You are caring for a combative 85-year-old male with a history of demen- tia, 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?: Urinalysis with cultures, CBC 82. A patient has recently been diagnosed with terminal cancer. Her respons- es are caustic and abrasive. What is the BEST way to respond?: Acknowledge her feelings, understanding this is expected in the grieving process. 83. You notice your patient who recently had a stroke is coughing intermit- tently during meals. What is the MOST likely cause of this?: He could be aspirating. 84. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant?: Left lower quadrant 85. Which of the following is MOST important in preventing a catheter asso- ciated urinary tract infection (CAUTI)?: Using sterile technique when inserting the catheter 86. 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?: 18 mL/hr 87. Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST?: Initiate droplet precautions 88. What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL?: Statin 89. Fifteen minutes after starting a blood transfusion, the patient complains of lower back pain, shortness of breath, and chills. What is your FIRST action?: Stop the tranfusion. 90. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention?: Bright red urine 91. What condition (not medication related) might cause an elevation in the patients PT/INR level?: Liver disease 92. Your patient admitted for small bowel obstruction has been vomiting for the last 3 days. What electrolyte imbalance would you expect to be associated with this patient?: Hypokalemia 93. Digoxin (Lanoxin) 125 mcg is equivalent to how many mg?: 0.125mg 94. As you are walking down the hallway you overhear your colleague dis- cussing her personal family issues with a patient. What would be the MOST appropriate response?: Remind her later of her responsibility for establishing and maintaining professional boundaries with patients. 95. 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?: "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." 96. Your patient suddenly develops signs and symptoms of shortness of breath, restlessness, tachypnea, hemoptysis, and decreased oxygen satu- rations despite being on 2L/min of O2 by nasal cannula. What do you expect is happening?: Pulmonary embolism 97. The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency?: Prednisone