Medical-Surgical RN A Prophecy Relias (Latest 2024/2025) DownLoad to Score A, Exams of Nursing

Download Medical-Surgical RN A Prophecy Relias (Latest 2024/2025) DownLoad to Score A and more Exams Nursing in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias 1.2 milligrams is equal to how many micrograms? - CORRECT ANSWER: 1200 mcg 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? - CORRECT ANSWER: Accommodate her request if possible. A patient has recently been diagnosed with terminal cancer. Her responses are caustic and abrasive. What is the BEST way to respond? - CORRECT ANSWER: Acknowledge her feelings, understanding this is expected in the grieving process. A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? - CORRECT ANSWER: Vitamin K A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - CORRECT ANSWER: Left lower quadrant A patient with peritonitis presents with tachycardia, hypotension, and dehydration. What other assessment finding would you anticipate as part of your physical assessment? - CORRECT ANSWER: Severe abdominal pain or rebound tenderness An older adult patient arrives on the unit looking emaciated, disheveled, and with soiled clothes. The patient claims that his daughter cares for him at home. What would you suspect? - CORRECT ANSWER: Neglect 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? - CORRECT ANSWER: Remind her later of her responsibility for establishing and maintaining professional boundaries with patients. Black and tarry colored stools are CLASSIC symptoms of what condition? - CORRECT ANSWER: Bleeding gastric ulcer Central Telemetry calls and tells you your patient is experiencing bradycardia. What is the first thing you should do after entering the room? - CORRECT ANSWER: Assess the patient and take vital signs. Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? - CORRECT ANSWER: 0.125mg Fifteen minutes after starting a blood transfusion, the patient complains of lower back pain, shortness of breath, and chills. What is your FIRST action? - CORRECT ANSWER: Stop the tranfusion. If your patient with a known history of diabetes is displaying symptoms of diaphoresis, cool skin, lethargy, and shakiness. What is your first action? - CORRECT ANSWER: Check the patient's blood glucose level. In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - CORRECT ANSWER: Paresthesia and paralysis 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)? - CORRECT ANSWER: 15 min before the meal arrives patient arrives on unit. you do an assessment and notice lice in her hair. what is your first action? - CORRECT ANSWER: Secure a private room Patient presents dusky pallor and pulseless. First action - CORRECT ANSWER: Initiate facility code procedure Patients with diabetes are at high risk for complications from damage to what body areas? - CORRECT ANSWER: Nerve and kidney damage The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - CORRECT ANSWER: Prednisone What type of personal protective equipment (PPE) is applied prior to entering a room for a patient with C. diff? - CORRECT ANSWER: Gown and gloves When would sucralfate (Carafate) 4 times daily be scheduled for? - CORRECT ANSWER: 1 hour before meals and at bedtime 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? - CORRECT ANSWER: Patient lift (e.g., Hoyer) Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - CORRECT ANSWER: Using sterile technique when inserting the catheter Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? - CORRECT ANSWER: Impaired gas exchange Which of the following would be used as part of the preop procedure to prevent infection? - CORRECT ANSWER: Prophylactic antibiotics Which tool should you use to assess pain in you 80-year-old patient with severe dementia? - CORRECT ANSWER: PAINAD scale 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? - CORRECT ANSWER: Heart failure 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? - CORRECT ANSWER: Turn q 2hours, request nutrition consult, request low airloss mattress. 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? - CORRECT ANSWER: Urinalysis with cultures, CBC 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? - CORRECT ANSWER: Encourage the patient to cough and deep breathe. 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? - CORRECT ANSWER: Obtain capillary blood glucose level. 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? - CORRECT ANSWER: Hold digoxin (Lanoxin) and call the provider You are preparing to hang 1 unit PRBC's to administer to your patient. The patient states, "I don't take blood products." What is the MOST appropriate response? - CORRECT ANSWER: "You have the right to refuse the blood transfusion. I will inform the provider of your decision." 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? - CORRECT ANSWER: The patient with chest pain 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? - CORRECT ANSWER: famotidine (Pepcid) You just left your patient's room with her husband at bedside. You then receive a phone call from someone states that she is your patient's mother and demands updates about your patient. What should you do NEXT? - CORRECT ANSWER: Verify your patient's consent to release information to her mother. You notice your patient who recently had a stroke is coughing intermittently during meals. What is the MOST likely cause of this? - CORRECT ANSWER: He could be aspirating. You receive a provider's order that is not consistent with evidence-based practice. What is your FIRST step? - CORRECT ANSWER: Clarify the order with the provider. You received a patient post op transurethral resection of the prostate (TURP). Which of the following symptoms would cause you the MOST concern? - CORRECT ANSWER: Hemorrhage and hypotension You received a report on a patient that sustained a right hemisphere CVA 48 hours ago. What do you expect the patient to exhibit? - CORRECT ANSWER: Left sided weakness of the leg, arm, and face. 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? - CORRECT ANSWER: Report to the post-surgical unit. 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? - CORRECT ANSWER: Stay with the patient and ask fi she has a plan to carry out this wish. 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? - CORRECT ANSWER: risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine 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. - CORRECT ANSWER: Sepsis Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - CORRECT ANSWER: Initiate droplet precautions Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response? - CORRECT ANSWER: Respect his wishes and notify the provider 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? - CORRECT ANSWER: Perform a bladder scan 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? - CORRECT ANSWER: Hyperthyroidism 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? - CORRECT ANSWER: Notify the charge nurse and social worker of your concerns. Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? - CORRECT ANSWER: broth, jello, soft fruit no skin, 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? - CORRECT ANSWER: "I must be within an arms' length view of you at all times for your safety, including while using the bathroom." Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? - CORRECT ANSWER: Gown and gloves Your patient is taking digoxin (Lanoxin) and has a potassium level of 3.0. How might this affect the patient? - CORRECT ANSWER: Increase risk of digoxin toxicity Your patient may have tuberculosis TB) and is placed in airborne precautions. What test would you expect to be ordered? - CORRECT ANSWER: Acid-fast bacilli sputum Your patient recently had a G-tube placed and intermittent enteral feedings have been initiated. What symptoms may indicate intolerance to the feedings? - CORRECT ANSWER: Vomiting and diarrhea 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? - CORRECT ANSWER: Congestive heart failure 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? - CORRECT ANSWER: Pulmonary embolism Your patient takes 5 mg of warfarn (Coumadin/Jantoven) daily and reports having black colored stool today. What do you most likely suspect? - CORRECT ANSWER: Gastrointestinal bleeding 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? - CORRECT ANSWER: Discuss code status with the patient and follow up with provider to ensure the medical record reflects her wishes. 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? - CORRECT ANSWER: Ask the patient when his last drink of alcohol was. 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? - CORRECT ANSWER: Hand hygiene with soap and water 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? - CORRECT ANSWER: Knowledge Deficit 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? - CORRECT ANSWER: Paracentesis 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? - CORRECT ANSWER: Palliative care consult 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? - CORRECT 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."