Medical-Surgical RN A Prophecy Relias Medical-Surgical RN A Prophecy Relias Medical-Surgic, Exams of Nursing

Download Medical-Surgical RN A Prophecy Relias Medical-Surgical RN A Prophecy Relias Medical-Surgic and more Exams Nursing in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias Medical- Surgical RN A Prophecy Relias Medical-Surgical RN A Prophecy Relias (Latest 2024/2025) Which adaptive equipment would be most appropriate to use for a severely contracted patient who is unable to bear weight when transferring from bed to chair - Correct Answer Patient Lift example hoyer What lab values are expected to be in a patient with end stage renal disease on hemodialysis - Correct AnswerBUN 32, CREATNINE 8.32 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? You're? - Correct AnswerHold wayfaring (coumadin) for the next 48 hours Your new admission presents with a cough, unintentional weight loss, frequent knot sweats, and bloody sputum. What type of isolation precautions should you initiate, if any? - Correct AnswerAirborne precautions Upon entering your patient's room you note that they are having a seizure. What is your 1st action? - Correct AnswerPosition the patient on their side to maintain the airway You find your coworker looking through your patient's medical record.. She States how is Mr. Smith doing? He is my best friend's dad. We are so worried about him. What is the best course of action? - Correct AnswerTell her you cannot give her information and report her actions to your manager. Your male patient complaints of discomfort while inflating the balloon during insertion of a endwelling urinary catheter. What would be the most appropriate action? - Correct AnswerDeflate the balloon, advance the catheter further, then reinflate the balloon. Your patient takes regular insulin and NPH twice A-day for glucose control. What times should the patient be taught to be alert for signs of hypoglycemia? - Correct AnswerIs late afternoon and early morning What is a proton pump inhibitor, such as pantoprazole (protonix) used for? - Correct AnswerReduce gastric acid secretion Your patient has a non productive cough and presence of secretions in his tracheostomy. Prior to sectioning the patient, what should you do 1st? - Correct AnswerHyperoxygenate patient dietary teaching for a patient with chronic renal failure should include choices that are: - Correct AnswerLow potassium, low protein, moderate fat Which of the following nursing diagnosis is most important for a patient with chronic obstructive pulmonary disease(COPD) - Correct AnswerImpaired gas exchange 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 AnswerNotify the charge nurse and social worker of your concerns. You have a patient going for dialysis. There are medications include Lisinopril(prinivil), ondansetron (zofran), famotidine(pepcid) and atorvastatin(lipitor). Which medication would you possibly hold and seek clarification? - Correct AnswerLISINOPRIL(PRINIVIL) What is the best indication of an acute neurological problem? - Correct AnswerChange in level of consciousness Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? - Correct AnswerClear liquids Which tool should you use to assess pain in your 80 year old patient with severe dementia? - Correct Answer? You are ordered to give Digoxin(lanoxin). Your patience vital signs are BP 130/75, temp 97.9F, HR 52, RR 16, o2 sat 100% on room air. What should you do next? - Correct AnswerHOLD DIGOXIN AND CALL PROVIDER 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 AnswerDiscuss code status with the patient and follow up with the provider to ensure the medical record reflects her wishes What are the most common causes of acute onset pancreatitis? - Correct AnswerAlcoholism and gallstones Your 18 year old female patient was admitted with dehydration secondary to anorexia nervosa. During your assessment you note she has a flat effect and says" I just want to die, I'm tired of my life ". What should be your 1st intervention? - Correct AnswerStay with the patient and ask if she has a plan to carry out this wish A patient with diabetes who is receiving peritoneal dialysis Is at risk for which of the following? - Correct Answer? To reduce the risk of infection and phlebotomy in an adult patient with a peripherL IV, What is the minimum duration the catheter should remain in place before routine replacement. - Correct Answer72 hours Your patient was admitted for a hypertensive crisis and has a history of HTN. Parkinson disease, depression and alcohol use. On his 2nd hospitalized day, you notice he is more anxious and restless than his baseline. What would be your 1st nursing intervention? - Correct AnswerAsk the patient when his last drink of alcohol was Black and tarry Colored stools are classic symptoms of what condition? - Correct AnswerBleeding gastric ulcer In addition to pain, pallor, and pulselssness, a neurovascular assessment Also includes checking for - Correct AnswerParasthesia and paralysis After scrolling through your social media, you notice a coworker posted a photo with a patient from your unit. What is the most appropriate action to take? - Correct AnswerReport the situation to the hospital compliance officer. Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18. What blood product do you expect to administer? - Correct AnswerPRBCs What medication is contraindicated In a patient with A hemorrhagic CVA? - Correct AnswerHeparin Your patient appears dusky colored and you cannot palpate a pulse. What is the 1st thing you should do? - Correct AnswerInitiate a code per facility protocol and begin CPR Your 68 year old patient is a is a Type one diabetic with a history of schizophrenia And exhibit signs and symptoms of tardiness dyskinesia. Is what long term medication is associated with signs and symptoms of tardive dyskinesia? - Correct AnswerChlorpromazine(thorazine) 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 AnswerLift sided weakness of the leg, arm, and face and face You have 4 patients who have high priority needs. One needs to go to surgery, 1 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 1st? - Correct AnswerThe patient with chest pain Your coworker posted photos on social media from a birthday party they had for her in the unit break room. What should be your next course of action? - Correct AnswerNo action is necessary because no PHI was displayed. Is your patient with stage IV Terminal lung cancer continues to experience increasing pain as each day passes. What would you anticipate the provider ordering for this patient? - Correct AnswerPalliative care consult 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 prophylaxis order for this patient? - Correct AnswerEnoxaparin(Lovenox) once daily and intermittent pneumatic compressions(IPC) 1.2 Milligrams is equal to how many micrograms - Correct Answer1200 mcg Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? - Correct AnswerGown and gloves You are caring for a patient with history of diabetes mellitus. You walk into the room and find the patient lethargic and diaphoretic. What is your 1st action? - Correct AnswerObtain capillary blood glucose level Your patient has symptomatic anemia but is refusing a blood transfusion for religious reasons. What is an appropriate response? - Correct AnswerRespect his wishes and notify the provider Your patient has a temp of 102.3 F, HR 122, and has had 15ml of urine from the indwelling urinary catheter in the last 2 hours. What is your patient most likely experiencing? - Correct Answer? Patients with diabetes are at a high risk for complications for damage in what body areas? - Correct AnswerNerve and kidney damage Your patient is 4 hours post open appendectomy Anne has not voided yet. You note his lower abdomen is distended. What should you do next? - Correct AnswerPerform a bladder scan What is the BEST indication of an acute neurological problem? - Correct AnswerChange 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? - Correct AnswerHeart 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? - Correct AnswerAirborne precautions Patients with diabetes are at high risk for complications from damage to what body areas? - Correct AnswerNerve 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? - Correct AnswerCheck 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? - Correct AnswerDiscuss code status with the patient and follow up with provider to ensure the medical record reflects her wishes. Your coworker posted photos on social media from a birthday party they had for her in the unit breakroom. What should be your NEXT course of action? - Correct AnswerNo action is necessary because no PHI was displayed. Your new patient understands very limited English. How should you communicate with them when completing the admission assessment? - Correct AnswerUse the organization's interpreter services. 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 AnswerObtain capillary blood glucose level. 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 AnswerPerform a bladder scan A patient with peritonitis presents with tachycardia, hypotension, and dehydration. What other assessment finding would you anticipate as part of your physical assessment? - Correct AnswerSevere abdominal pain or rebound tenderness What is the EARLIEST sign indicating increased intracranial pressure (ICP)? - Correct AnswerLevel of consciousness In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - Correct AnswerParesthesia and paralysis 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 AnswerLeft 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? - Correct AnswerHold 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? - Correct AnswerNon-rebreather mask Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? - Correct AnswerGown 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? - Correct AnswerVomiting and diarrhea Upon entering your patient's room, you note that they are having a seizure. What is your FIRST action? - Correct AnswerPosition 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? - Correct AnswerStay 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? - Correct AnswerHyperoxygenate patient. Your patient takes 5 mg of warfarn (Coumadin/Jantoven) daily and reports having black colored stool today. What do you most likely suspect? - Correct AnswerGastrointestinal 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? - Correct AnswerHemorrhage Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? - Correct AnswerImpaired 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? - Correct Answerfamotidine (Pepcid) What is an early symptom that the patient is developing a complication of heart failure? - Correct AnswerEdema in the legs and feet Black and tarry colored stools are CLASSIC symptoms of what condition? - Correct AnswerBleeding 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? - Correct AnswerThe 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? - Correct AnswerParacentesis What is clubbing of the fingers MOST likely associated with? - Correct AnswerChronic oxygen deficiency A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? - Correct AnswerVitamin 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? - Correct Answer72 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? - Correct AnswerEncourage the patient to cough and deep breathe. Your patient may have tuberculosis TB) and is placed in airborne precautions. What test would you expect to be ordered? - Correct AnswerAcid-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? - Correct AnswerCongestive heart failure You received a patient post op transurethral resection of the prostate (TURP). Which of the following symptoms would cause you the MOST concern? - Correct AnswerHemorrhage 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? - Correct AnswerHand hygiene with soap and water Your patient has a diagnosis of urinary tract infection (UTI) and is currently taking medication that has recently made her urine reddish-orange. Which of the following medications would cause this side effect? - Correct AnswerPhenazopyridine (Pyridium) Your patient is taking digoxin (Lanoxin) and has a potassium level of 3.0. How might this affect the patient? - Correct AnswerIncrease risk of digoxin toxicity 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." 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 AnswerNeglect 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 AnswerVerify your patient's consent to release information to her mother. The provider orders Heparin 4 units/kg SQ. Your patient weighs 176 pounds. How many units should you administer? - Correct Answer320 units What diagnostic finding would support a diagnosis of deep vein thrombosis? - Correct AnswerPositive 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? - Correct AnswerUrinalysis 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? - Correct AnswerAcknowledge 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? - Correct AnswerHe could be aspirating. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - Correct AnswerLeft lower quadrant Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - Correct AnswerUsing 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? - Correct Answer18 mL/hr Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - Correct AnswerInitiate droplet precautions What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? - Correct AnswerStatin 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 AnswerStop the tranfusion. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - Correct AnswerBright red urine What condition (not medication related) might cause an elevation in the patients PT/INR level? - Correct AnswerLiver 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? - Correct AnswerHypokalemia Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? - Correct Answer0.125mg 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? - Correct AnswerRemind 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? - 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." 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 AnswerPulmonary embolism The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - Correct AnswerPrednisone 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 AnswerKnowledge Deficit patient arrives on unit. you do an assessment and notice lice in her hair. what is your first action? - Correct AnswerSecure a private room Patient presents dusky pallor and pulseless. First action - Correct AnswerInitiate facility code procedure