Medical-Surgical RN A Prophecy Relias 2023, Exams of Nursing

Download Medical-Surgical RN A Prophecy Relias 2023 and more Exams Nursing in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias 2023 1.2 milligrams is equal to how many micrograms? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - Vitamin K A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - Assess the patient and take vital signs. Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? - Ans - 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? - Ans - 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? - Ans - Check the patient's blood glucose level. In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - Ans - 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)? - Ans - 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? - Ans - Secure a private room Patient presents dusky pallor and pulseless. First action - Ans - Initiate facility code procedure Patients with diabetes are at high risk for complications from damage to what body areas? - Ans - Nerve and kidney damage The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - Ans - Prednisone The patient has diltiazem HCl (Cardizem CD) ordered and is requesting the capsule be mixed into her morning yogurt. How should you respond? - Ans - "Sorry, it is a slow-release medication that cannot be opened or crushed." The provider gives you a telephone order to explain a surgical procedure to your patient and obtain surgical consent. How should you respond? - Ans - Inform the provider that explaining the procedure is outside the nurse's scope of practice. 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? - Ans - 18 mL/hr The provider orders and IV infusion of D5W 1000 mL to infuse over the next 6 hours. How many mLs per hour should the IV pump be set to? - Ans - 167 mL/hr The provider orders Heparin 4 units/kg SQ. Your patient weighs 176 pounds. How many units should you administer? - Ans - 320 units 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? - Ans - 72 hours Two days after surgery, your 72-year-old patient is showing signs of agitation and confusion, which is not his baseline. The severity fluctuates throughout the day. His medications include hydromorphone (Dilaudid), amlodipine (Norvasc), alprazolam (Xanax), and carbidopa-levodopa (Sinemet). What condition do you MOST likely suspect? - Ans - Delirium Upon entering your patient's room, you note that they are having a seizure. What is your FIRST action? - Ans - Position the patient on their side to maintain the airway. updates about your patient. What should you do NEXT? - Ans - 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? - Ans - He could be aspirating. You receive a provider's order that is not consistent with evidence-based practice. What is your FIRST step? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine 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? - Ans - Enoxaparin (Lovenox) once daily and intermittent pneumatic compressions (IPC) 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? - Ans - Case Manager 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? - Ans - Stat CT of head 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? - Ans - No action is necessary because no PHI was displayed. Your male patient complains of discomfort while inflating the balloon during insertion of an indwelling urinary catheter. What would be the MOST appropriate action? - Ans - Deflate the balloon, advance the catheter further, then reinflate the balloon 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? - Ans - Airborne precautions Your new patient admitted for cholecystitis expresses she has a history of anxiety disorder. She is feeling panicked and does not think she can handle staying in the hospital for her surgery. What action is MOST appropriate for you to take? - Ans - Sit calmly next to her and offer her compassion and a sense of security. Your new patient understands very limited English. How should you communicate with them when completing the admission assessment? - Ans - Use the organization's interpreter services. 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? - Ans - Hemorrhage 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? - Ans - Hypokalemia 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? - Ans - Request an order for soft mitts as they are the least restrictive Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - Ans - Bright red urine 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? - Ans - Phenazopyridine (Pyridium) Your patient has a non-productive cough and presence of secretions in his tracheostomy. Prior to suctioning the patient, what should you do FIRST? - Ans - Hyperoxygenate patient. 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. - Ans - Sepsis Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - Ans - Initiate droplet precautions Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - "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? - Ans - Gown and gloves Your patient is taking digoxin (Lanoxin) and has a potassium level of 3.0. How might this affect the patient? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - 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? - Ans - Pulmonary embolism