Medical-Surgical RN A Prophecy Relias Test Latest Update 2024/2025, Exams of Nursing

Download Medical-Surgical RN A Prophecy Relias Test Latest Update 2024/2025 and more Exams Nursing in PDF only on Docsity! 1 Medical- Surgical RN A Prophecy Relias Test Latest Update 2024/2025 2 Medical-Surgical RN A Prophecy Relias Test 1.2 milligrams is equal to how many micrograms? - 1200 mcg Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? - 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? - 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? - 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? - 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? - Report to the post-surgical unit. What is a proton pump inhibitor, such as pantoprazole (Protonix) used for? - 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? - Patient lift (e.g., Hoyer) 5 Patients with diabetes are at high risk for complications from damage to what body areas? - Nerve 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? - 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? - 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? - 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? - 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? - 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? - 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? - Severe abdominal pain or rebound tenderness 6 What is the EARLIEST sign indicating increased intracranial pressure (ICP)? - Level of consciousness In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - Paresthesia and paralysis - 7 You received a report on a patient that sustained a right hemisphere CVA 48 hours ago. What do you expect the patient to exhibit? - 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? - 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? - Non-rebreather mask Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? - 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? - Vomiting and diarrhea Upon entering your patient's room, you note that they are having a seizure. What is your FIRST action? - Position 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? - Stay 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? - 10 The patient has diltiazem HCl (Cardizem CD) ordered and is requesting the capsule be mixed into her morning yogurt. How should you respond? - "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? - 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? - Clarify the order with the provider. When would sucralfate (Carafate) 4 times daily be scheduled for? 1 hour before meals and at bedtime 11 Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18. What blood product do you expect to administer? 12 - 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? - 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? - 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? - 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? - "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? - 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? - Hyperthyroidism 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)? - 15 min before the meal arrives 15 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? - Hand hygiene with soap and water 16 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? - Phenazopyridine (Pyridium) Your patient is taking digoxin (Lanoxin) and has a potassium level of 3.0. How might this affect the patient? - 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? - "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? - 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? - 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? - 320 units What diagnostic finding would support a diagnosis of deep vein thrombosis? - 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? - Urinalysis with cultures, CBC 17 A patient has recently been diagnosed with terminal cancer. Her responses are caustic and abrasive. What is the BEST way to respond? - 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? - He could be aspirating. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - Left lower quadrant Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - 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? - 18 mL/hr Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - Initiate droplet precautions What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? - 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? - Stop the tranfusion. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - Bright red urine What condition (not medication related) might cause an elevation in the patients PT/INR level?