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Prophecy Progressive Care RN A V
Questions and Answers Latest Update.
Which of the following medications is MOST commonly indicated for patients with CHF? Ace inhibitors A patient was involved in a motor vehicle accident and CAT scan results reveal a right sided SDH. What would be an expected neurological assessment finding in this patient? Dilated right pupil What is the most common symptom of SIADH? Fluid retention Upon arrival to the unit, you receive report on four PCU patients. Which patient should you attend to FIRST? A patient complaining of shortness of breathe on continuous BiPAP with a BP of 189/ Of the following patients, which one would you see FIRST? A 30 year suicidal female that took an unknown number of alprazolam with an O2 saturation of 85% You are caring for a patient with new onset atrial fibrillation with a blood pressure of 80/60. Which of the following treatment options is MOST appropriate? Electrical cardioversion Which of the following supplemental medications is frequently ordered in conjunction with furosemide? Potassium Which of the following positions is the BEST way to assess for JVD? Position the patient on his/her back with the head of bed 30- 45
degrees
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? 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? 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? 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? 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: “I will avoid canned food because it’s salty” The trough for vancomycin is measured: 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? Competency You are caring for a patient in third degree heart block. Which of the following treatment options will MOST likely be implemented? Pacemaker
You are assigned a patient who recently traveled outside of the United States. He has a fever of 101.9 F and excessive diarrhea. You suspect he may have been exposed to Ebola. What type of PPE would you expect to use? High level PPE Which of the following patients would you see FIRST? A 57 year old male complaining of worsening chest tightness You enter a patient’s room and notice the telemetry box on the bed and the IV on the floor connected to running IV fluids. You last saw the patient 1 hour ago. Who should be notified immediately? Charge nurse A patient is admitted for a NSTEMI and ST depression is noted in leads II, III, and AVF. Two hours after admission you notice the patient now has ST elevation in each of those leads. What should you do NEXT? Initiate STEMI team An 18 year old female is admitted to PCU from PACU after a cholecystectomy. She has a 22 gauge peripheral IV in her left hand and is due to void. She had morphine 8mg and Zofran 4mg in recovery, and is complaining of nausea. She has Phenergan 50mg ordered IV every 6 hours/PRN. What should you do FIRST? Start a new IV in the antecubital region or obtain an order for Phenergan IM. A patient is on strict I&Os with an indwelling urinary catheter. 4 hours into your shift you notice that there is a total of 50 mL of urine in the bag. You notify the provider because you recognize that adequate urine output should be: 30 mL/hr
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? Furosemide 40 mg IV BID Which of the following has been found to be linked to a diagnosis of endocarditis? 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 130/76 and heart rate is 140 bpm. What would you do NEXT? Immediately perform a bedside EKG What abnormal heart sound would you expect to hear in a patient with mitral stenosis? 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? Pneumothorax Which of the following are primary goals in diabetic ketoacidosis therapy? 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? 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? Locate the MSDS book to find policy and procedures Which of the following is an early indication of a stroke? Ptosis Which of the following are clinical manifestations typically seen in a patient with left ventricular failure? Dyspnea/peripheral edema/JVD or 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? 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? 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? 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: Discarded, then begin collection with the next void
Hgb of 5. You are taking care of a patient who is scheduled for ablation to treat atrial fibrillation. While obtaining consent , the patient asks multiple questions about the procedure. What is the BEST response? Request the provider come and discuss the procedure with the patient Your patient has an IVC filter placed two days ago and starts to complain of sharp pain in the chest, shortness of breath, anxiety, and heart palpitations. What should you do NEXT? Notify the provider and prepare for a CT scan What is the MOST important intervention for a patient with non- blanching redness and intact skin to their coccyx? Turning the patient every two hours, alternating from side to side What is the most common cause of acute onset pancreatitis? Alcoholism and galstones Then nursing assistant reports that your post-op day 2 CABG patient has a temp of 101.3 and BP of 82/56. The patient’s output has decreased to < 30 cc in the past 4 hours. You suspect a post surgical complication. After calling the doctor, you receive the orders for STAT CBC, CMP, and coagulation test. Which of the following results would you expect to see after these labs are completed? WBC greater than 19, Your patient is receiving an amiodarone drip. You should reduce the dose from 1 mg/mL to 0.5 mg/mL after: 6 hours Your patient was admitted for a hypertensive crisis and has a history of HTN, Parkinson’s Disease, CAD, and depression. The patient reports drinking 3 - 4 alcoholic drinks/night. This is your third day caring for this patient and you suddenly notice that he is more
anxious and restless than his baseline. What would be your INITIAL nursing intervention? Check CIWA score
