MEDICAL SURGICAL RN A PROPHECY RELIAS, Exams of Nursing

Download MEDICAL SURGICAL RN A PROPHECY RELIAS and more Exams Nursing in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias 1 / 13 1. 1.2 milligrams is equal to how many micrograms? 1200 mcg 2. Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? 3. Your male patient complains of discomfort while in- flating the balloon during insertion of an indwelling urinary catheter. What would be the MOST appropri- ate action? 4. Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response? 5. Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? 6. 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? 7. What is a proton pump inhibitor, such as pantopra- zole (Protonix) used for? 8. Which adaptive equipment would be MOST appropri- ate to use for a severely contracted patient who is unable to bear weight when transferring from the bed to the chair? 9. Which tool should you use to assess pain in you 80- year-old patient with severe dementia? 10. Your patient is admitted from the ED with failure to thrive and advanced dementia. You note he is extremely underweight, appears unbathed for some Compress the drain, then plug the bulb to estab- lish suction Deflate the bal- loon, advance the catheter further, then reinflate the balloon Respect his wish- es and notify the provider broth, jello, soft fruit no skin, Report to the post- surgical unit. Acid Reduction Patient lift (e.g., Hoyer) PAINAD scale Notify the charge nurse and social worker of your time, and has a stage 4 pressure injury to his coccyx. concerns. Medical-Surgical RN A Prophecy Relias 2 / 13 You were told in report that he lives at home with family members. What should you do? 11. 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 ad- mitted to your unit. What is the MOST important order you should anticipate from the provider? 12. 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. 13. What type of personal protective equipment (PPE) is applied prior to entering a room for a patient with C. diff? 14. Your patient continues to pull at their IV site located in their left forearm despite verbal reminders and increased observation. The nursing assistant recom- mends using soft mitt restraints on the patient. What is your recommendation? 15. Your patient was admitted for a hypertensive crisis and has a history of HTN, Parkinson's disease, de- pression, and alcohol use. On his second hospital- ized day, you notice he is more anxious and restless than his baseline. What would be your FIRST nursing intervention? 16. What is the BEST indication of an acute neurological problem? 17. While in a supine position your patient states, "I'm tired and cannot catch my breath." Physical assess- ment reveals jugular vein distention and a third heart sound (S3). These symptoms are indicative of what condition? Stat CT of head Sepsis Gown and gloves Request an order for soft mitts as they are the least restrictive Ask the patient when his last drink of alcohol was. Change in level of consciousness Heart failure Medical-Surgical RN A Prophecy Relias 5 / 13 says, "I just want to die. I'm tired of my life." What should be your FIRST intervention? 36. Your patient has a non-productive cough and pres- ence of secretions in his tracheostomy. Prior to suc- tioning the patient, what should you do FIRST? 37. Your patient takes 5 mg of warfarn (Coumadin/Jan- toven) daily and reports having black colored stool today. What do you most likely suspect? 38. Your new patient was admitted with blunt force trau- ma to the abdomen following a motor vehicle acci- dent (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 con- dition do you suspect? 39. Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pul- monary disease (COPD)? 40. You have a patient going for dialysis. Their med- ications include lisinopril (Prinivil), ondansetron (Zofran), famotidine (Pepcid), and atorvastatin (Lipi- tor). Which medication would you possibly hold and seek clarification? 41. What is an early symptom that the patient is develop- ing a complication of heart failure? 42. Black and tarry colored stools are CLASSIC symp- toms of what condition? 43. 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 rat- ed 8/10, and another needs toileting. Which patient should you tend to FIRST? has a plan to carry out this wish. Hyperoxygenate patient. Gastrointestinal bleeding Hemorrhage Impaired gas ex- change famotidine (Pep- cid) Edema in the legs and feet Bleeding gastric ulcer The patient with chest pain Medical-Surgical RN A Prophecy Relias 6 / 13 44. Your patient with Hepatitis C exhibits signs of jaun- dice and a distended abdomen. What procedure would you anticipate being performed by the provider at the bedside for this patient? 45. What is clubbing of the fingers MOST likely associat- ed with? 46. A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate ad- ministering? 47. 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? 48. 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? 49. What patient population is the pneumococcal vac- cine, PPSV23 indicated for? 50. Your patient with stave IV terminal lung cancer con- tinues to experience increasing pain as each day passes. What would you anticipate the provider order- ing for this patient? 51. The provider gives you a telephone order to explain a surgical procedure to your patient and obtain sur- gical consent. How should you respond? 52. The patient has diltiazem HCl (Cardizem CD) ordered and is requesting the capsule be mixed into her morn- ing yogurt. How should you respond? Paracentesis Chronic oxygen deficiency Vitamin K 72 hours Encourage the pa- tient to cough and deep breathe. Adults aged 65 years and older Palliative care consult Inform the provider that ex- plaining the proce- dure is outside the nurse's scope of practice. "Sorry, it is a slow-release med- ication that can- Medical-Surgical RN A Prophecy Relias 7 / 13 53. 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? 54. You receive a provider's order that is not consistent with evidence-based practice. What is your FIRST step? 55. When would sucralfate (Carafate) 4 times daily be scheduled for? 56. Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18. What blood product do you expect to administer? 57. Your 68-year-old patient is a Type 1 diabetic with a his- tory of schizophrenia and exhibits signs and symp- toms of tardive dyskinesia. What long-term medica- tion is associated with signs and symptoms of tardive dyskinesia? 58. Your 80-year-old patient is being discharged home post CVA. She lives alone, yet still requires assis- tance with ADLs. What referral is MOST appropriate to ensure her needs are met? not be opened or crushed." Enoxaparin (Lovenox) once daily and intermittent pneumatic compressions (IPC) Clarify the order with the provider. 1 hour before meals and at bed- time PRBCs risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine Case Manager Medical-Surgical RN A Prophecy Relias 10 / 13 Your patient has a diagnosis of urinary tract infection (UTI) and is currently taking medication that has re- cently made her urine reddish-orange. Which of the following medications would cause this side effect? 75. Your patient is taking digoxin (Lanoxin) and has a potassium level of 3.0. How might this affect the pa- tient? Phenazopyridine (Pyridium) Increase risk of digoxin toxicity 76. You are preparing to hang 1 unit PRBC's to administer "You have the to your patient. The patient states, "I don't take blood products." What is the MOST appropriate response? 77. An older adult patient arrives on the unit looking ema- ciated, disheveled, and with soiled clothes. The pa- tient claims that his daughter cares for him at home. What would you suspect? 78. You just left your patient's room with her husband at bedside. You then receive a phone call from some- one states that she is your patient's mother and de- mands updates about your patient. What should you do NEXT? 79. The provider orders Heparin 4 units/kg SQ. Your pa- tient weighs 176 pounds. How many units should you administer? 80. What diagnostic finding would support a diagnosis of deep vein thrombosis? right to refuse the blood transfusion. I will inform the provider of your decision." Neglect Verify your pa- tient's consent to release informa- tion to her mother. 320 units Positive D-dimer 81. You are caring for a combative 85-year-old male with a Urinalysis with cul- 82. 8 2 . history of dementia, CHF, UTI, and anemia. The family states he appears to be more confused than his base- line. What tests do you expect the provider to order? tures, CBC Medical-Surgical RN A Prophecy Relias 11 / 13 A patient has recently been diagnosed with terminal Acknowledge her cancer. Her responses are caustic and abrasive. What feelings, under- is the BEST way to respond? 83. You notice your patient who recently had a stroke is coughing intermittently during meals. What is the MOST likely cause of this? 84. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? 85. Which of the following is MOST important in pre- venting a catheter associated urinary tract infection (CAUTI)? standing this is expected in the grieving process. He could be aspi- rating. Left lower quad- rant Using sterile tech- nique when insert- ing the catheter 86. The provider orders a Heparin infusion of 900 units/hr. 18 mL/hr Your IV medication on hand has 25,000 units of He- parin in 500 mL of D5W. How many mL/hr will you infuse? 87. Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which ac- tions should you take FIRST? 88. What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? 89. Fifteen minutes after starting a blood transfusion, the patient complains of lower back pain, shortness of breath, and chills. What is your FIRST action? 90. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? 91. What condition (not medication related) might cause an elevation in the patients PT/INR level? Initiate droplet precautions Statin Stop the tranfu- sion. Bright red urine Liver disease Medical-Surgical RN A Prophecy Relias 12 / 13 92. 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? 93. Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? 94. 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? 95. Your patient, who has soft wrist restraints for safety (non- violent), is working with the occupational thera- pist at the bedside. The nursing assistant enters and says, "The patient is not allowed to have his restraints untied." How do you respond? 96. Your patient suddenly develops signs and symptoms of shortness of breath, restlessness, tachypnea, he- moptysis, and decreased oxygen saturations despite being on 2L/min of O2 by nasal cannula. What do you expect is happening? 97. The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? 98. 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? Hypokalemia 0.125mg Remind her lat- er of her respon- sibility for estab- lishing and main- taining profession- al boundaries with patients. "Restraints can be temporarily off while directly working with staff. Let me know when the therapy ses- sion is finished and I will re-apply them." Pulmonary em- bolism Prednisone Knowledge Deficit