RELIAS ED RN A, EXAM QUESTIONS AND 100% CORRECT ANSWERS| 2024/25 UPDATE, Exams of Nursing

Download RELIAS ED RN A, EXAM QUESTIONS AND 100% CORRECT ANSWERS| 2024/25 UPDATE and more Exams Nursing in PDF only on Docsity! RELIAS ED RN A, EXAM QUESTIONS AND 100% CORRECT ANSWERS| 2024/25 UPDATE What is the current recommended dose of intravenous or intraosseous epinephrine in adult patients with cardiac arrest? 10 mg every 10 minutes 1 mg every 3-5 minutes 1 mg every 7 minutes 0.1 mg every 2 minutes ✔✔ 1 mg every 3-5 minutes A patient with a traumatic brain injury (TBI) is MOST likely to suffer from what condition? Diabetes mellitus Cerebral palsy Diabetes Insipidus Myxedema coma ✔✔ Diabetes Insipidus A patient presents after sustaining a roll-over motor vehicle accident. They are complaining of pain around the mid-upper back. On your initial triage assessment, you find that patient has preserved motor function below L5 but is suffering from a loss of sensory function. The assessment findings are consistent with: Posterior cord syndrome Central cord syndrome Anterior cord syndrome Autonomic syndrome ✔✔ Posterior cord syndrome A patient arrives with acute onset of central chest pain. The patient is tachycardic and tachypneic and appears very anxious and restless. What would be the MOST important initial intervention for this patient? Obtain electrocardiogram Administer nitroglycerin Administer oxygen Obtain venous blood gas ✔✔ IDK, but its not administer nitroglycerin or obtain electrocardiogram!! A patient who is 27 weeks pregnant presents with painless bright red vaginal bleeding. What condition correlates with the presenting symptoms? Abruptio placenta Placenta Previa Ectopic pregnancy Premature rupture of membranes (PROM) ✔✔ Placenta Previa What is a common assessment finding in a patient with a tension pneumothorax? Petechial chest rash Distended neck veins Equal chest wall expansion Abruptio placenta Ruptured ectopic pregnancy ✔✔ Ruptured ectopic pregnancy A patient with a history of chronic alcohol use is brought in with possible esophageal varices. What medication is used to stop upper gastrointestinal (GI) bleeding in patients with this condition? Octreotide (Sandostatin®) Acetaminophen (Tylenol®) Warfarin (Jantoven®) Ibuprofen (Motrin®) ✔✔ Octreotide (Sandostatin) A patient has sustained multiple traumatic injuries after a fall from a height. What is considered an important component of the primary survey assessment? Complete set of vital signs Neurological assessment Head to toe assessment Patients allergy history ✔✔ Neurological Assessment What do you anticipate is the BEST indicator of adequate hydration in an adult patient with 30% body surface area burn during initial fluid resuscitation? Blood pressure of 110/60 mm Hg Urine output of 0.5 mL/kg/hr Central venous pressure of 25 mm Hg Urine output of 0.2 mL/kg/hr ✔✔ Urine output 0.5mL/kg/hr What staff member would you ask to accompany you when transporting an intubated patient to imaging for a CT? Lift team Respiratory therapist Physician's assistant Nursing assistant ✔✔ RT An elderly patient is brought in with new onset of confusion and gradual onset of headache in the last 48hours. The patient states that they had a fall 3 days ago. Based on the history and presenting complaints, what diagnostic test do you anticipate the provider to order? MRI of the brain Complete Blood Count Finger stick blood sugar CT scan of the brain ✔✔ CT scan of the brain A patient arrives with suspected appendicitis. What action, if observed, would require additional training for the unlicensed assistive personnel (UAP)? The UAP offers the patient a ginger ale. The UAP allows the patient to move to a position of comfort. Paresthesia of the foot Capillary refill pf toes <2 sec ✔✔ Paresthesia of the foot You are assisting a novice nurse with a blood draw. You observe the nurse draw the blood, place the specimen tubes in a biohazard bag, and leave the room with the unlabeled specimen tubes. What would you do NEXT? Don't confront the nurse, go redraw the labs and label at the bedside. Do nothing because they can label them anywhere. Report them to your supervisor. Re-educate the nurse, then redraw thexabs, use patient identifiers and label at the bedside. ✔✔ Re-educate What is the critical goal time from arrival to the ED to CT brain scan based on the American Heart Association stroke recommendations? 10 minutes 25 minutes 45 minutes 60 minutes ✔✔ 25min A patient presents with sudden onset of aphasia and left-sided weakness for the last 25 minutes. What action would be taken NEXT? Triage them to the screening area Complete a thorough triage evaluation, initiate the appropriate stroke resources Register the patient prior to triage, and collect smoking and drug use history Activate your department's code stroke protocol ✔✔ Activate your deptartment's code stroke protocol Your patient's chest tube dressing has accidentally come off and you are preparing to place a new one. You have a slit drain sponge, 4 x 4 gauzes, tape, scissors, and antiseptic swabs. What else do you need? Kelly clamp Petrolatum gauze Tube connector Chest drainage system ✔✔ Petrolatum gauze What type of medication is used in the emergency care setting to help manage the symptoms of alcohol withdrawal? Benzodiazepines Valproic acid Electrolytes Thiamine ✔✔ Benzos A patient presents to the lobby stating she thinks she is in active labor. Your facility doesn't have a labor and delivery unit. What is the NEXT action you would take? Tell the patient she needs to go to the nearest hospital with a labor and delivery unit. Have an ED provider perform a medical screening exam to determine if she is in active labor. Call the nearest hospital with a labor and delivery unit to see if they will accept the patient. Get a wheelchair for the patient and inform her that there will be a 3 hour wait time. ✔✔ presentation? 1 2 3 4 ✔✔ 1 A patient presents with an episode of hypertensive crisis, a blood pressure of 220/118, and the provider has put in the order for nitroprusside. What demonstrates that the treatment has been effective? Systolic blood pressure reaches 160 mm Hg Systolic blood pressure reaches 210 mm Hg Patients states that he no longer has chest pain Oxygen saturation increased from 94% to 99% ✔✔ SBP reaches 160 You want to implement the new evidence-based practice guidelines in managing patients to prevent falling on your unit. What provides the STRONGEST evidence for interventions? Systematic reviews Retrospective study Single randomized control trial Observational study ✔✔ Systematic reviews A patient is brought in after being struck by lightning during a heavy thunderstorm. What would be the PRIORITY intervention for this patient upon arrival? Measuring urine output Monitoring cardiac rhythm Cleaning of the burn wounds Obtaining chest x-ray ✔✔ Monitoring cardiac rhythm A patient presents with a history of acute urinary retention. An indwelling catheter is placed and the patient is sent for an ultrasound scan. The imaging confirms benign prostatic hyperplasia as the cause of urinary retention. What medication do you anticipate the provider to order? Tamsulosin (Flomax®) Vasopressin Phenylephrine (Omidria®) Methoxamine (Vasoxy|®) ✔✔ Flomax The life-threatening and rare complication of hypothyroidism is known as: Pheochromocytoma Adrenal crisis Thyroid Since the patient was not harmed, do not report the incident. Tell only the patient about the incident and have them decide what to do. ✔✔ Inform the charge nurse about what happened and document it. Your patient has just had a paracentesis during which 5 liters of fluid were removed. Which assessment is the PRIORITY? Palpate for tenderness Blood pressure Observation of puncture site Signs of infection ✔✔ Blood pressure What symptom is commonly seen in patients with alcohol withdrawal? Tachycardia Hypotension Bradycardia Hypothermia ✔✔ Tachycardia A patient's family has decided to withdraw life-sustaining treatment. When communicating with the family of the patient, what reassurance would you provide? Life support is essential in the patient's quality of life. Efforts will be made to make the patient comfortable. That the patient lived a full and complete life. Substantial amounts of pain medication will be provided. ✔✔ Efforts with be made to make the patient comfortable. During cardiogenic shock what temporary intervention might be ordered to improve perfusion until definitive treatment is provided? Coronary artery bypass notropic iffusion Percutaneous intervention Continuous renal replacement therapy ✔✔ Inotropic infusion You accidentally administered epinephrine 1:1000 intravenous push for a patient suffering from a severe anaphylactic reaction. You recognize this as a near-miss event and report this: Internally, per policy through the defined incident reporting system Externally, to the state board of nursing through the website Externally, to state board of pharmacy through the website Since it was a near miss reporting is not necessary ✔✔ Internally, per policy through the defined incident reporting system. You are administering haloperidol (Haldol®) to a patient with acute symptoms of Schizophrenia. What changes in the electrocardiogram (ECG) are possible as a result of this medication? Depressed T wave O Prolonged QT interval Prolonged PR interval Elevated ST segment ✔✔ Prolonged QT interval A patient is brought in with possible foreign body obstruction and respiratory distress. The provider suctions the patient and unsuccessfully tries to insert an endotracheal tube (ETT). What type of procedure would you anticipate NEXT? Placement of laryngeal mask Tracheostomy Bronchoscopy Chest tube insertion ✔✔ Trach A patient is complaining of a burning sensation in both eyes with pain, redness, swelling, and purulent discharge. The visual assessment using the Snellen chart reveals no changes in vision. You anticipate that the patient has signs and symptoms of: Iritis Conjuntivitis Retinal detachment Glaucoma ✔✔ Conjuntivitis A patient presents with possible organophosphate toxicity. What would you expect to find upon assessment? Diaphoresi s Tachycardi a Constipati on Hot and dry skin ✔✔ Diaphoresis What is the appropriate intervention for patients with Acute Respiratory Distress Syndrome (ARDS)? Increasing fluid volume Mechanical ventilation Bag mask valve (BMV) ventilation Administering sedatives ✔✔ Mechanical ventilation A patient with a history of advanced-stage leukemia presents with a history of increasing shortness of breath in the last 4 days. The patient is anemic and has multiple bruises on their extremities. What is the MOST likely cause of bruising? Anemia Thrombocytopeni a Fever Blood tinged sputum ✔✔ Pursed lip breathing A patient presents with a 5-day history of runny nose, headache, and productive cough. The patient is unable to speak full sentences, reports having a history of moderate to severe COPD, and has a Sp02 reading of 89%. What intervention do you anticipate implementing FIRST for this patient? • Provide oxygen Obtain venous blood gas (VBG) Obtain vital signs Obtain ECG ✔✔ Provide Oxygen A patient with dementia has a family member with MPOA, who is unable to be reached. The provider needs a consent signed and allows the patient to sign. What is the MOST appropriate action you would take? • Report the provider to their supervisor. Do nothing as the form has already been signed. Call the ethics committee. Report the provider to the Medical Board. ✔✔ Report the provider to their supervisor Under what circumstances can the hospital transfer an unstable patient to another facility and maintain compliance with the Emergency Medical Treatment and Active Labor Act (EMTALA)? The patient has no health insurance coverage. The receiving facility is conducting research on specific disease condition. The necessary treatment is not available at the current hospital. The family members are requesting to transfer the patient near to them. ✔✔ The necessary treatment is not available at the current hospital. A 35-year-old patient complains of night sweats, low-grade fever, weight loss, and a productive cough with pink-tinged sputum for 3-4 weeks. They have been staying at a local shelter since they lost their job 6 months ago. What diagnosis is most likely? Tuberculosis Influenza COVID 19 Liver cancer ✔✔ TB Which of the following wounds has the highest risk for developing osteomyelitis? Closed fracture of tibia resulting from trauma Contusion and bruising to the head from a fall A confused patient is trying to grasp at their IV with their right hand. Which is the LEAST restrictive measure to maintain patient safety? 2-point restraint on right arm and left leg Safety "mitt" for both hands 2-point restraints on upper limbs Safety "mitt" for right hand only ✔✔ Safety "mitt" for right hand only A patient is frustrated at the length of time they have been waiting to be triaged. They start to yell obscenities and threaten you with violence. Why would this incident be reported to your supervisor? The patient is responsible for their actions even though they are ill You have the right to personal safety at work As no physical injury actually occurred, no further action is necessary This type of behavior is expected and accepted in the ED ✔✔ You have a right to personal safety at work A patient who is 8 weeks pregnant presents to triage with vaginal bleeding and lower abdominal pain. RhoGAM will be given for which situation? Father is negative Father is positive Mother is positive Mother is Rh negative ✔✔ Mother is Rh negative An adult patient who is 70 kg has a full-thickness burn over 30% of their body surface area. What is the anticipated fluid replacement for a patient in the first 8 hours is based on the Parkland formula? 4200 mL 4800 mL 6300 mL 8400 mL ✔✔ 4200 mL