MEDICAL SURGICAL RN FORM A &B EXAM 2023 QUESTIONS AND 100% CORRECT ANSWERS, Exams of Nursing

Download MEDICAL SURGICAL RN FORM A &B EXAM 2023 QUESTIONS AND 100% CORRECT ANSWERS and more Exams Nursing in PDF only on Docsity! MEDICAL SURGICAL RN FORM A &B EXAM 2023 QUESTIONS AND 100% CORRECT ANSWERS 1.2 milligrams is equal to how many micrograms? - answer1200 mcg Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? - answerCompress 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? - answerDeflate the balloon, advance the catheter further, then reinflate the balloon Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response? - answerRespect 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? - answerbroth, 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? - answerReport to the post-surgical unit. What is a proton pump inhibitor, such as pantoprazole (Protonix) used for? - answerAcid 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? - answerPatient lift (e.g., Hoyer) Which tool should you use to assess pain in you 80- year- old patient with severe dementia? - answerPAINAD 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 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? - answerAsk the patient when his last drink of alcohol was. What is the BEST indication of an acute neurological problem? - answerChange 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? - answerHeart 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? - answerAirborne precautions Patients with diabetes are at high risk for complications from damage to what body areas? - answerNerve 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? - answerCheck 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? - answerDiscuss code status with the A patient with peritonitis presents with tachycardia, hypotension, and dehydration. What other assessment finding would you anticipate as part of your physical assessment? - answerSevere abdominal pain or rebound tenderness What is the EARLIEST sign indicating increased intracranial pressure (ICP)? - answerLevel of consciousness In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - answerParesthesia 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? - answerLeft 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? - answerHold 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%. Which mode of oxygen delivery would MOST likely reverse these symptoms? - answerNon-rebreather mask Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? - answerGown and gloves Your patient recently had a G-tube placed and intermittent enteral feedings have been initiated. What symptoms may indicate intolerance to the feedings? - answerVomiting and diarrhea Upon entering your patient's room, you note that During your assessment you note she has a flat affect and says, "I just want to die. I'm tired of my life." What should be your FIRST intervention? - answerStay with the patient and ask fi she has a plan to carry out this wish. Your patient has a non-productive cough and presence of secretions in his tracheostomy. Prior to suctioning the patient, what should you do FIRST? - answerHyperoxygenate patient. Your patient takes 5 mg of warfarn (Coumadin/Jantoven) daily and reports having black colored stool today. What do you most likely suspect? - answerGastrointestinal bleeding Your new patient was admitted with blunt force trauma to the abdomen following a motor vehicle accident (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 condition do you suspect? - answerHemorrhage Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? - answerImpaired gas exchange You have a patient going for dialysis. Their medications include lisinopril (Prinivil), ondansetron (Zofran), famotidine (Pepcid), and atorvastatin (Lipitor). Which medication would you possibly hold and seek clarification? - answerfamotidine (Pepcid) What is an early symptom that the patient is developing a complication of heart failure? - answerEdema in the legs and feet Black and tarry colored stools are CLASSIC symptoms of what condition? - answerBleeding gastric ulcer You have 4 patients who have high priority needs. One needs to go to surgery, one needs STAT lab Your patient with Hepatitis C exhibits signs of jaundice and a distended abdomen. What procedure would you anticipate being performed by the provider at the bedside for this patient? - answerParacentesis What is clubbing of the fingers MOST likely associated with? - answerChronic oxygen deficiency A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? - answerVitamin K 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? - answer72 hours 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? - answerEncourage the patient to cough and deep breathe. What patient population is the pneumococcal vaccine, PPSV23 indicated for? - answerAdults aged 65 years and older 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? - answerPalliative 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? - answerInform 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? - answer"Sorry, it is a slow-release medication that 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? - answerrisperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine 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? - answerCase Manager Central Telemetry calls and tells you your patient is experiencing bradycardia. What is the first thing you should do after entering the room? - answerAssess 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? - answer"I must be within an arms' length view of you at all times for your safety, including while using the bathroom." The severity fluctuates throughout the day. His medications include hydromorphone (Dilaudid), amlodipine (Norvasc), alprazolam (Xanax), and carbidopa-levodopa (Sinemet). What condition do you MOST likely suspect? - answerDelirium What is the proper technique when suctioning a tracheostomy? - answerSuction in a circular motion while the catheter is being pulled out. Your new patient admitted for cholecystitis expresses she has a history of anxiety disorder. She is feeling panicked and does not think she can handle staying in the hospital for her surgery. What action is MOST appropriate for you to take? - answerSit calmly next to her and offer her compassion and a sense of security. The provider orders and IV infusion of D5W 1000 mL to infuse over the next 6 hours. How many mLs per hour should the IV pump be set to? - answer167 mL/hr You are assigned a new admission and note a Braden score of 11 after completing your assessment. Which interventions would be MOST appropriate based on your assessment? - answerTurn q 2hours, request nutrition consult, request low airloss mattress. Your patient may have tuberculosis TB) and is placed in airborne precautions. What test would you expect to be ordered? - answerAcid-fast bacilli sputum Your patient starts to complain of difficulty breathing while laying down, and states that he has been coughing up pink sputum. While performing your assessment, you notice jugular vein distention and coarse crackles in both lungs on auscultation. What diagnosis do you suspect? - answerCongestive heart failure You received a patient post op transurethral resection of the prostate (TURP). Which of the following symptoms would cause you the MOST concern? - answerHemorrhage and hypotension emaciated, disheveled, and with soiled clothes. The patient claims that his daughter cares for him at home. What would you suspect? - answerNeglect You just left your patient's room with her husband at bedside. You then receive a phone call from someone states that she is your patient's mother and demands updates about your patient. What should you do NEXT? - answerVerify your patient's consent to release information to her mother. The provider orders Heparin 4 units/kg SQ. Your patient weighs 176 pounds. How many units should you administer? - answer320 units What diagnostic finding would support a diagnosis of deep vein thrombosis? - answerPositive D-dimer 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? - answerUrinalysis with cultures, CBC mL/hr will you infuse? - answer18 mL/hr Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - answerInitiate droplet precautions What medication would you anticipate to be ordered for a patient who has a LDL > 200 mg/dL? - answerStatin Fifteen minutes after starting a blood transfusion, the patient complains of lower back pain, shortness of breath, and chills. What is your FIRST action? - answerStop the tranfusion. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - answerBright red urine What condition (not medication related) might cause an elevation in the patients PT/INR level? - answerLiver disease 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? - answerPulmonary embolism The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - answerPrednisone 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? - answerKnowledge Deficit patient arrives on unit. you do an assessment and notice lice in her hair. what is your first action? - answerSecure a private room - answer