MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 B, Exams of Nursing

Download MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 B and more Exams Nursing in PDF only on Docsity! MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 BEST EXAM SOLUTION TOP RANKED A+ Your patient continues to pull at their IV site located in their left forearm despite verbal reminders and increased observation. The nursing assistant recommends using soft mitt restraints on the patient. What is your recommendation? - CORRECT ANSWERS Request an order for soft mitts as they are the least restrictive Your patient was admitted for a hypertensive crisis and has a history of HTN, Parkinson's disease, depression, and alcohol use. On his second hospitalized day, you notice he is more anxious and restless than his baseline. What would be your FIRST nursing intervention? - CORRECT ANSWERS Ask the patient when his last drink of alcohol was. What is the BEST indication of an acute neurological problem? - CORRECT ANSWERS Change in level of consciousness While in a supine position your patient states, "I'm tired and cannot catch my breath." Physical assessment reveals jugular vein distention and a third heart sound (S3). These symptoms are indicative of what condition? - CORRECT ANSWERS Heart failure Your new admission presents with a cough, unintentional weight loss, frequent night sweats, and bloody sputum. What type of isolation precautions should you initiate, if any? - CORRECT ANSWERS Airborne precautions Patients with diabetes are at high risk for complications from damage to what body areas? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Discuss code status with the patient and follow up with provider to ensure the medical record reflects her wishes. MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 BEST EXAM SOLUTION TOP RANKED A+ 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Severe abdominal pain or rebound tenderness What is the EARLIEST sign indicating increased intracranial pressure (ICP)? - CORRECT ANSWERS Level of consciousness In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - CORRECT ANSWERS Paresthesia and paralysis You received a report on a patient that sustained a right hemisphere CVA 48 hours ago. What do you expect the patient to exhibit? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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%. MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 BEST EXAM SOLUTION TOP RANKED A+ Your patient with stave IV terminal lung cancer continues to experience increasing pain as each day passes. What would you anticipate the provider ordering for this patient? - CORRECT ANSWERS Palliative care consult The provider gives you a telephone order to explain a surgical procedure to your patient and obtain surgical consent. How should you respond? - CORRECT ANSWERS Inform the provider that explaining the procedure is outside the nurse's scope of practice. The patient has diltiazem HCl (Cardizem CD) ordered and is requesting the capsule be mixed into her morning yogurt. How should you respond? - CORRECT ANSWERS "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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Clarify the order with the provider. When would sucralfate (Carafate) 4 times daily be scheduled for? - CORRECT ANSWERS 1 hour before meals and at bedtime Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18. What blood product do you expect to administer? - CORRECT ANSWERS 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? - CORRECT ANSWERS risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 BEST EXAM SOLUTION TOP RANKED A+ 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS "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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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)? - CORRECT ANSWERS 15 min before the meal arrives 1.2 milligrams is equal to how many micrograms? - CORRECT ANSWERS 1200 mcg Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? - CORRECT ANSWERS 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? - CORRECT ANSWERS Deflate the balloon, advance the catheter further, then reinflate the balloon MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 BEST EXAM SOLUTION TOP RANKED A+ Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Report to the post-surgical unit. What is a proton pump inhibitor, such as pantoprazole (Protonix) used for? - CORRECT ANSWERS 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? - CORRECT ANSWERS Patient lift (e.g., Hoyer) Which tool should you use to assess pain in you 80-year-old patient with severe dementia? - CORRECT ANSWERS PAINAD scale Your patient is admitted from the ED with failure to thrive and advanced dementia. You note he is extremely underweight, appears unbathed for some time, and has a stage 4 pressure injury to his coccyx. You were told in report that he lives at home with family members. What should you do? - CORRECT ANSWERS Notify the charge nurse and social worker of your concerns. 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 admitted to your unit. What is the MOST important order you should anticipate from the provider? - CORRECT ANSWERS Stat CT of head 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. - CORRECT ANSWERS Sepsis MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 BEST EXAM SOLUTION TOP RANKED A+ 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? - CORRECT ANSWERS Urinalysis with cultures, CBC A patient has recently been diagnosed with terminal cancer. Her responses are caustic and abrasive. What is the BEST way to respond? - CORRECT ANSWERS 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? - CORRECT ANSWERS He could be aspirating. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - CORRECT ANSWERS Left lower quadrant Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - CORRECT ANSWERS 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? - CORRECT ANSWERS 18 mL/hr Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - CORRECT ANSWERS Initiate droplet precautions What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? - CORRECT ANSWERS 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? - CORRECT ANSWERS Stop the tranfusion. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - CORRECT ANSWERS Bright red urine MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 BEST EXAM SOLUTION TOP RANKED A+ What condition (not medication related) might cause an elevation in the patients PT/INR level? - CORRECT ANSWERS Liver disease 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? - CORRECT ANSWERS Hypokalemia Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? - CORRECT ANSWERS 0.125mg 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? - CORRECT ANSWERS Remind her later of her responsibility for establishing and maintaining professional boundaries with patients. Your patient, who has soft wrist restraints for safety (non-violent), is working with the occupational therapist at the bedside. The nursing assistant enters and says, "The patient is not allowed to have his restraints untied." How do you respond? - CORRECT ANSWERS "Restraints can be temporarily off while directly working with staff. Let me know when the therapy session is finished and I will re-apply them." Your patient suddenly develops signs and symptoms of shortness of breath, restlessness, tachypnea, hemoptysis, and decreased oxygen saturations despite being on 2L/min of O2 by nasal cannula. What do you expect is happening? - CORRECT ANSWERS Pulmonary embolism The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - CORRECT ANSWERS Prednisone 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? - CORRECT ANSWERS Knowledge Deficit patient arrives on unit. you do an assessment and notice lice in her hair. what is your first action? - CORRECT ANSWERS Secure a private room MEDICAL-SURGICAL RN A PROPHECY RELIAS EXAM QUESTIONS AND ANSWERS LATEST UPDATE 2024/2025 BEST EXAM SOLUTION TOP RANKED A+ Patient presents dusky pallor and pulseless. First action - CORRECT ANSWERS Initiate facility code procedure