Medical-Surgical RN A Prophecy Relias exam with answers, Exams of General Surgery

Download Medical-Surgical RN A Prophecy Relias exam with answers and more Exams General Surgery in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias exam with answers 1.2 milligrams is equal to how many micrograms? - ANSWER: ✔✔1200 mcg What lab values are expected to be in a patient with end stage renal disease on hemodialysis - ANSWER: ✔✔BUN 32, CREATNINE 8.32 dietary teaching for a patient with chronic renal failure should include choices that are: - ANSWER: ✔✔Low potassium, low protein, moderate fat 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 What are the most common causes of acute onset pancreatitis? - ANSWER: ✔✔Alcoholism and gallstones What medication is contraindicated In a patient with A hemorrhagic CVA? - ANSWER: ✔✔heparin Your patient appears dusky colored and you cannot palpate a pulse. What is the 1st thing you should do? - ANSWER: ✔✔Initiate a code per facility protocol and begin CPR A patient with diabetes who is receiving peritoneal dialysis Is at risk for which of the following? - ANSWER: ✔✔hyperglycemia 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, clear liquids 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 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: ✔✔Hold wayfaring (coumadin) for the next 48 hours Stat CT of head 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 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 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? - ANSWER: ✔✔Non-rebreather mask Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? - ANSWER: ✔✔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? - ANSWER: ✔✔Vomiting and diarrhea 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 A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? - ANSWER: ✔✔Vitamin K 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? - ANSWER: ✔✔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? - ANSWER: ✔✔Encourage the patient to cough and deep breathe. What patient population is the pneumococcal vaccine, PPSV23 indicated for? - ANSWER: ✔✔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? - ANSWER: ✔✔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? - ANSWER: ✔✔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? - ANSWER: ✔✔"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? - ANSWER: ✔✔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? - ANSWER: ✔✔Clarify the order with the provider. When would sucralfate (Carafate) 4 times daily be scheduled for? - ANSWER: ✔✔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? - ANSWER: ✔✔PRBCs 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: ✔✔chlorpromazine