Medical-Surgical Nursing Prophecy Relias Test: Questions and Answers, Exams of Public Health

Download Medical-Surgical Nursing Prophecy Relias Test: Questions and Answers and more Exams Public Health in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 1 Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 1 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. The provider orders and IV infusion of D5W 1000 mL to infuse over the next 6 hours. How many mLs per hour should the IV pump be set to? - 167 mL/hr You are assigned a new admission and note a Braden score of 11 after completing your assessment. Which interventions would be MOST appropriate based on your assessment? - Turn q 2hours, request nutrition consult, request low airloss mattress. Your patient may have tuberculosis TB) and is placed in airborne precautions. What test would you expect to be ordered? - Acid-fast bacilli sputum Your patient starts to complain of difficulty breathing while laying down, and states that he has been coughing up pink sputum. While performing your assessment, you notice jugular vein distention and coarse crackles in both lungs on auscultation. What diagnosis do you suspect? - You received a patient post op transurethral resection of the prostate (TURP). Which of the following symptoms would cause you the MOST concern? - Hemorrhage and hypotension Your patient with C. diff (Clostridioides difficile) has a family member about to leave the room. What education about performing hand hygiene should you give? - Hand hygiene with soap and water Congestive heart failure Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 2 Y r e - 1 Medical-Surgical RN A Prophecy Relias Test, Questions our patient has sy ason. What is an a & Answers Latest Update 2023 usion for religious o you ensure on during insertion riate action? mptomatic anemia but is refusing a blood transf ppropriate response? Respect his wishes and notify the provider rams? ) drain in place. How d .2 milligrams is equal to how many micro g 1200 mcg op patient has a Jackson-Pratt (J P ain function? Your posteffective dr - Y o - Y o - Y n t h - W - W c c - W d - Y Compress the drain, then plug the bulb to establish suction he ballo appro p our male patient complains of discomfort while inflating t f an indwelling urinary catheter. What would be the MOS T Deflate the balloon, advance the catheter further, then reinflate the balloon to be arge Which is y bed to the vere mentia. our patient is admitted with diverticulitis. What type of diet do you expect rdered for the patient? broth, jello, soft fruit no skin , edical unit and when you arrive at work the c h post-surgical unit since they are understaffed. ou were hired to work the m urse has assigned you to the e MOST appropriate action? Report to the post-surgical unit . such as pantoprazole (Protonix) used for? d be MOST appropriate to use for a severel to bear weight when transferring from the sess pain in you 80-year-old patient with se e ED with failure to thrive and advanced de hat is a proton pump inhibitor , Acid Reduction quipment woul t who is unable hich adaptive e ontracted patien hair? Patient lift (e.g., Hoyer) e to as from th hich tool should you u s ementia? PAINAD scale dmitted Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 5 - 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? - 18 mL/hr Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - Initiate droplet precautions What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? - 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? - Stop the tranfusion. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - Bright red urine What condition (not medication related) might cause an elevation in the patients PT/INR level? - Liver disease 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? - Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? Hypokalemia Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 6 - 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? - 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? - "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? Pulmonary embolism The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - 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? - patient arrives on unit. you do an assessment and notice lice in her hair. what is your first action? - Secure a private room Patient presents dusky pallor and pulseless. First action - Initiate facility code procedure Knowledge Deficit Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 st age 4 pressure injury to his coccyx. You were told in report that he lives at home w ith family members. What should you do? - Y s h u - Y i n e x - W f o - Y v s o - Y P n n - W - W P s y Notify the charge nurse and social worker of your concerns . 3 days ago. You notice e being admitted to your te from the provider? mL of urine from the patient MOST likely prior to entering a room left forearm despite stant recommends using ion? our 85-year-old patient with atrial fibrillation fell at home e has been having several episodes of acute confusion sinc nit. What is the MOST important order you should anticipa Stat CT of head temp of 102.3 F, HR 122, and has had 15 y catheter in the last 2 hours. What is your onal protective equipment (PPE) is applied C. diff? our patient has a dwelling urinar periencing. Sepsis hat type of pers r a patient with Gown and gloves ues to pull at their IV site located in their nd increased observation. The nursing ass i on the patient. What is your recommendat our patient conti n erbal reminders a ft mitt restraints Request an order for soft mitts as they are the least restrictive istory of HTN, d hospitalized day, you would be your FIRST ? nnot catch my breath." heart sound (S3). These ht loss, frequent night should you initiate, if 2 our patient was admitted for a hypertensive crisis and has a h arkinson's disease, depression, and alcohol use. On his secon otice he is more anxious and restless than his baseline. What ursing intervention? Ask the patient when his last drink of alcohol was . al problem hat is the BEST indication of an acute neurologi c Change in level of consciousness Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 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. 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 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 Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? - Gown and gloves Your patient recently had a G-tube placed and intermittent enteral feedings have been initiated. What symptoms may indicate intolerance to the feedings? - Vomiting and diarrhea 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. 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? -. 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. Your patient takes 5 mg of warfarn (Coumadin/Jantoven) daily and reports having black colored stool today. What do you most likely suspect? - 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? - Hemorrhage Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? - 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? - famotidine (Pepcid) Stay with the patient and ask fi she has a plan to carry out this wish Impaired gas exchange 6 Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 What is an early symptom that the patient is developing a complication of heartfailure? - Black and tarry colored stools are CLASSIC symptoms of what condition? - 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? - 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? - Paracentesis What is clubbing of the fingers MOST likely associated with? - Chronic oxygen deficiency A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? - Vitamin K Edema in the legs and feet The patient with chest pain 7 Medical-Surgical RN A Prophecy Relias Test, Questions & Answers Latest Update 2023 To reduce the risk of infection and phlebitis in an adult patient with a peripheral IV, what is the MINIMUM duration the catheter should remain in place before ROUTINE replacement? - 72 hours You are caring for a patient post lobectomy with a chest tube in place for drainage. What is a priority in care for this patient? - Encourage the patient to cough and deep breathe. What patient population is the pneumococcal vaccine, PPSV23 indicated for? - Adults aged 65 years and older Your patient with stave IV terminal lung cancer continues to experience increasing pain as each day passes. What would you anticipate the provider ordering for this patient? - Palliative care consult The provider gives you a telephone order to explain a surgical procedure to your patient and obtain surgical consent. How should you respond? - Inform the provider that explaining the procedure is outside the nurse's scope of practice. The patient has diltiazem HCl (Cardizem CD) ordered and is requesting the capsule be mixed into her morning yogurt. How should you respond? - "Sorry, it is a slow-release medication that cannot be opened or crushed." Your 72-year-old male patient is admitted for colon cancer related complications and has a history of CHF, stroke, and a recent knee replacement. Based on your patient's risk assessment, you determine he is at risk for venous thromboembolism (VTE). What is an appropriate VTE prophylaxis order for this patient? - Enoxaparin (Lovenox) once daily and intermittent pneumatic compressions (IPC) 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. When would sucralfate (Carafate) 4 times daily be scheduled for? - 1 hour before meals and at bedtime Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18. What blood product do you expect to administer?