Medical-Surgical RN A Prophecy Relias Questions And Solutions, Exams of Nursing

Download Medical-Surgical RN A Prophecy Relias Questions And Solutions and more Exams Nursing in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) Medical-Surgical RN A Prophecy Relias 1.2 milligrams is equal to how many micrograms? - solution-1200 mcg Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? - solution-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? - solution-Deflate the balloon, advance the catheter further, then reinflate the balloon Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response? - solution-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? - solution-broth, jello, soft fruit no skin, 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? - solution-Report to the post-surgical unit. What is a proton pump inhibitor, such as pantoprazole (Protonix) used for? - solution- 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? - solution-Patient lift (e.g., Hoyer) Which tool should you use to assess pain in you 80-year-old patient with severe dementia? - solution-PAINAD scale 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 Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) in report that he lives at home with family members. What should you do? - solution-Notify the charge nurse and social worker of your concerns. Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) 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? - solution-No action is necessary because no PHI was displayed. Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) Your new patient understands very limited English. How should you communicate with them when completing the admission assessment? - solution-Use 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? - solution- Obtain 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? - solution- Perform 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? - solution-Severe abdominal pain or rebound tenderness What is the EARLIEST sign indicating increased intracranial pressure (ICP)? - solution-Level of consciousness In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - solution-Paresthesia 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? - solution-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? - solution-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? - solution-Non-rebreather mask Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? - solution-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? - solution- Vomiting and diarrhea Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) Upon entering your patient's room, you note that they are having a seizure. What is your FIRST action? - solution-Position the patient on their side to maintain the airway. Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? - solution-Vitamin K Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) 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? - solution-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? - solution-Encourage the patient to cough and deep breathe. What patient population is the pneumococcal vaccine, PPSV23 indicated for? - solution-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? - solution-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? - solution-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? - solution-"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? - solution-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? - solution-Clarify the order with the provider. When would sucralfate (Carafate) 4 times daily be scheduled for? - solution-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? - solution-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? - Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) solution-risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) 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? - solution-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? - solution-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? - solution-Congestive 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? - solution-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? - solution- Hand 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? - solution- Phenazopyridine (Pyridium) Your patient is taking digoxin (Lanoxin) and has a potassium level of 3.0. How might this affect the patient? - solution-Increase 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? - solution-"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? - solution-Neglect 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? - solution-Verify 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? - solution-320 units Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) What diagnostic finding would support a diagnosis of deep vein thrombosis? - solution-Positive 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? - solution- Urinalysis 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? - solution- Acknowledge 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? - solution-He could be aspirating. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - solution-Left lower quadrant Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - solution-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? - solution-18 mL/hr Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - solution- Initiate droplet precautions What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? - solution-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? - solution-Stop the tranfusion. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - solution-Bright red urine What condition (not medication related) might cause an elevation in the patients PT/INR level? - solution-Liver disease Your patient admitted for small bowel obstruction has been vomiting for the Medical-Surgical RN A Prophecy Relias Questions And solutions( With Complete answers) last 3 days. What electrolyte imbalance would you expect to be associated with this patient? - solution-Hypokalemia