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PROGRESSIVE CARE RN CERTIFICATION QUIZ PROGRESSIVE CARE RN CERTIFICATION QUIZ
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Which of the following medications is MOST commonly indicated for patients with CHF?
You are caring for a patient with a chest tube that has become dislodged. Which of the following would you do FIRST? - ANSWER-Cover the insertion site immediately with Vaseline gauze A 78 year old male is admitted from the ED for syncope with ground level fall. You note his heart rate is 50 and the patient is confused. His daughter states she thinks he has dementia but he has not been diagnosed yet. Blood pressure is stable. What order do you anticipate? - ANSWER-Stat head CT A patient with an upper GI bleed has a hgb of 6.1 g/dL. Which of the following orders should you do FIRST? - ANSWER-Prepare to administer 2 units PRBCs Which of the following should be checked before administering digoxin? - ANSWER- Apical pulse A patient with a history of acute seizure activity of unknown etiology is admitted to the PCU from the ED. Which of the following orders would you expect to receive from the admitting provider? - ANSWER-Levetiracetam (Keppra) 500 mg IV every 12 hours and seizure precautions You are caring for a patient post left pneumonectomy with a chest tube in place for drainage. Which of the following is a priority in caring for this patient? - ANSWER- Encourage the patient to cough and deep breathe You are caring for a patient with an order for "furosemide 80 mg BID". Which of the following actions is the MOST appropriate? - ANSWER-Call the provider to clarify the order You are caring for a patient with a Do Not Resuscitate (DNR) order. The patient goes into cardiac arrest and the patient's daughter states "Do whatever you can to save my dad." Which of the following is the BEST response? - ANSWER-Follow the patient's wishes and honor the DNR You are educating your patient about reducing sodium intake. You know that the patient understands when they make the statement: - ANSWER-"I will avoid canned food because it's salty" The trough for vancomycin is measured: - ANSWER-Immediately before the next scheduled dose You are delegating wound care to a LPN. The LPN states that she has never performed this type of wound care before. Which of the following components of delegation have you neglected? - ANSWER-Competency
You are transfusing PRBCs into a patient with a hgb of 7.7 g/dL. Fifteen minutes into the transfusion, the patient complains of lower back pain, shortness of breath, and chills. Which of the following would you do FIRST? - ANSWER-Stop the transfusion You receive a patient from the emergency department with a fever, cough for 3 weeks, night chills, and fatigue. During the admission assessment the patient reports recent travel out of the country. What should be your FIRST action? - ANSWER-Notify the provider, apply a mask to the patient, and transfer to a negative pressure room Unstable angina is characterized by which of the following? - ANSWER-Chest pain, usually while at rest The patient's lab test results indicate a BNP of 2,000 upon arrival to the ED. The patient has been transferred to PCU. What treatment plan would you anticipate from the attending provider? - ANSWER-Furosemide 40 mg IV BID Which of the following has been found to be linked to a diagnosis of endocarditis? - ANSWER-Recent invasive dental procedures Your patient is post-op day 3 after triple bypass surgery. Chest tubes have been removed. The patient suddenly complains of palpitations. His blood pressure is 130/ and heart rate is 140 bpm. What would you do NEXT? - ANSWER-Immediately perform a bedside EKG What abnormal heart sound would you expect to hear in a patient with mitral stenosis? - ANSWER-Diastolic murmur You are performing auscultation on your patient and note an absence of breath sounds in the right lower lobe. Which of the following would you suspect? - ANSWER- Pneumothorax Which of the following are primary goals in diabetic ketoacidosis therapy? - ANSWER- Correct fluid deficit and replace potassium You receive an 84 year old patient from the ED with pneumonia. Antibiotics and steroids have already been initiated by the provider. The patient complains of abdominal pain and has a large, loose bowel movement and notifies you this is the third one. What should you do FIRST? - ANSWER-Initiate contact isolation precautions for possible C. difficile You have completed a blood transfusion and are unsure of how to dispose of the empty bag. What should you do? - ANSWER-Locate the MSDS book to find policy and procedures Which of the following is an early indication of a stroke? - ANSWER-Ptosis
Which of the following are clinical manifestations typically seen in a patient with left ventricular failure? - ANSWER-Dyspnea/distant heart sounds/bilateral crackles??? A patient is admitted to the PCU with COPD exacerbation. Which of the following assessment findings would you expect to find knowing that the patient has been taking prednisone 40 mg PO once daily for 18 years? - ANSWER-Hyperglycemia A 16 year old patient was admitted to the unit for asthma exacerbation. The patient has a suicide attempt the previous shift and states "I want to die because I am being bullied at school." Which of the following is the MOST important action? - ANSWER-Place the patient on suicide precautions to prevent a second suicide attempt The provider has written an order for diltiazem 125 mg in 100 mL D5W at 10 mg/hour. The vial of diltiazem contains 5mg/mL. Which of the following is the correct volume to add to the bag of D5W? - ANSWER-25 mL The provider has ordered a 24-hour urine collection for your patient. The patient voids 275 cc, 2 hours after the order is given. This specimen should be: - ANSWER- Discarded, then begin collection with the next void What acid-base imbalance would you expect to see in a patient with an acute kidney injury? - ANSWER-Metabolic acidosis Your 28 year old patient is being discharged on warfarin 5 mg every evening after being diagnosed with atrial fibrillation. Which of the following statements indicates a need for further teaching? - ANSWER-"I cant wait to get back to riding on my horse." You are caring for an 80 year old male with advanced COPD with an oxygen saturation level of 80%. Which of the following would you do to promote adequate oxygen exchange? - ANSWER-Use a high-flow venturi mask to deliver oxygen as ordered You are caring for a patient that has returned from the cath lab post angioplasty. Upon assessment, you note a large hematoma at the sheath site. Which of the following would you do immediateley? - ANSWER-Apply manual pressure to the site and call for help Which of the following findings assist in the diagnosis of deep vein thrombosis? - ANSWER-Positive D-dimer The patient is presenting with a blood pressure of 90/60, a creatinine of 3.0 and decreased urinary output. What is a possible cause for these findings? - ANSWER- Acute kidney injury