MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2, Exams of Nursing

Download MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2 and more Exams Nursing in PDF only on Docsity! MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2025 BEST GRADED A+ 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? - CORRECT ANSWERS Stat CT of head 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 ANSWERS Sepsis What type of personal protective equipment (PPE) is applied prior to entering a room for a patient with C. diff? - CORRECT ANSWERS Gown and gloves Your patient continues to pull at their IV site located in their left forearm despite verbal reminders and increased observation. The nursing assistant recommends using soft mitt restraints on the patient. What is your recommendation? - CORRECT ANSWERS Request an order for soft mitts as they are the least restrictive 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 ANSWERS Ask the patient when his last drink of alcohol was. What is the BEST indication of an acute neurological problem? - CORRECT ANSWERS Change 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 ANSWERS Heart 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 ANSWERS Airborne precautions Patients with diabetes are at high risk for complications from damage to what body areas? - CORRECT ANSWERS Nerve and kidney damage MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2025 BEST GRADED A+ 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 ANSWERS Check 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 ANSWERS Discuss 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 ANSWERS No 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 ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Severe abdominal pain or rebound tenderness What is the EARLIEST sign indicating increased intracranial pressure (ICP)? - CORRECT ANSWERS Level of consciousness In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - CORRECT ANSWERS Paresthesia and paralysis MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2025 BEST GRADED A+ Your patient takes 5 mg of warfarn (Coumadin/Jantoven) daily and reports having black colored stool today. What do you most likely suspect? - CORRECT ANSWERS 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? - CORRECT ANSWERS Hemorrhage Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? - CORRECT ANSWERS 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? - CORRECT ANSWERS famotidine (Pepcid) What is an early symptom that the patient is developing a complication of heart failure? - CORRECT ANSWERS Edema in the legs and feet Black and tarry colored stools are CLASSIC symptoms of what condition? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Paracentesis What is clubbing of the fingers MOST likely associated with? - CORRECT ANSWERS Chronic oxygen deficiency MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2025 BEST GRADED A+ A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Encourage the patient to cough and deep breathe. What patient population is the pneumococcal vaccine, PPSV23 indicated for? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS "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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Clarify the order with the provider. MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2025 BEST GRADED A+ When would sucralfate (Carafate) 4 times daily be scheduled for? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine Your 80-year-old patient is being discharged home post CVA. She lives alone, yet still requires assistance with ADLs. What referral is MOST appropriate to ensure her needs are met? - CORRECT ANSWERS Case Manager Central Telemetry calls and tells you your patient is experiencing bradycardia. What is the first thing you should do after entering the room? - CORRECT ANSWERS Assess the patient and take vital signs. 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 ANSWERS "I must be within an arms' length view of you at all times for your safety, including while using the bathroom." 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 ANSWERS Accommodate her request if possible. 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 ANSWERS Hyperthyroidism MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2025 BEST GRADED A+ 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 ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS He could be aspirating. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - CORRECT ANSWERS Left lower quadrant Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - CORRECT ANSWERS 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? - CORRECT ANSWERS 18 mL/hr Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - CORRECT ANSWERS Initiate droplet precautions What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? - CORRECT ANSWERS 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? - CORRECT ANSWERS Stop the tranfusion. MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2025 BEST GRADED A+ Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - CORRECT ANSWERS Bright red urine What condition (not medication related) might cause an elevation in the patients PT/INR level? - CORRECT ANSWERS 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? - CORRECT ANSWERS Hypokalemia Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS "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 ANSWERS Pulmonary embolism The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - CORRECT ANSWERS 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? - CORRECT ANSWERS Knowledge Deficit MEDICAL-SURGICAL RN A PROPHECY RELIAS QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2024/2025 BEST GRADED A+ patient arrives on unit. you do an assessment and notice lice in her hair. what is your first action? - CORRECT ANSWERS Secure a private room Patient presents dusky pallor and pulseless. First action - CORRECT ANSWERS Initiate facility code procedure