Prophecy general ICU A V3 (Q&A) 2023., Exams of Nursing

Download Prophecy general ICU A V3 (Q&A) 2023. and more Exams Nursing in PDF only on Docsity! Prophecy general ICU A V3 (Q&A) 2023 One of your patients coded but is now stabilized and you are catching up on charting. The step-down unit calls to get report on your other patient who is to be transfered. The nurses near you do not appear busy. How should you prioritize your time? - ANSWERSGive report and ask the nurses to prepare the patient for transfer. Your patient was intubated but still has oral medications on their list of medications. How should you ensure they receive their medications? - ANSWERSAsk the provider to update the route of administration. What laboratory value should you monitor closely if your patient is vomiting coffee ground emesis? - ANSWERSHemoglobin What ECG finding is indicative of hyperkalema? - ANSWERSpeaked T wave You witness a patient that is not assigned to you fall out of bed and begin crying for help but you do not see the assigned nurse to assist the patient. What should you do first? - ANSWERSCheck on the patient's status and call for assistance. When assessing for fever in your intubated patient, placement of the thermometer in which area would be most accurate? - ANSWERSPulmonary artery or bladder Your patient has just completed IV potassium replacement. When should you collect their repeat potassium level? - ANSWERS30-60 min Your patient is receiving an antiarrhythmic agent. Which of the following assessment parameters is the MOST important for you to evaluate? - ANSWERSECG Your patient is undergoing a weaning trial from the ventilator. Fifteen minutes into the trial the patient's heart rate increases to 140 bpm and they start to grab at their oxygen and IV tubing. What should you do NEXT? - ANSWERSC. Stop weaning and rest the patient While assessing a patient just admitted to the hospital, he admits to drinking 12 cans of beer a day, with the last drink being right before admission. What is the expected onset of delirium tremens? - ANSWERSWithin 48-72 hours You have administered a pain medication that has a half-life of 120 minutes, onset of action 6 min, tmax of 15 minutes, and is mostly excreted in the uring. when can the patient expect the medication to start working - ANSWERS6 minutes A lethargic but oriented patient is being admitted for sepsis and their family member is in the waiting area. Their belonging include a ring, cell phone, and wallet. The patient asks if they can keep the ring on and phone at bedside. What is your BEST response? - ANSWERSIt is best if your family takes your belongings. What is a significant complication of imaging studies performed with iv contrast - ANSWERSAcute kidney injury What respiratory support would an alert patient with an acute COPD exacerbatiobn likely receive FIRST? - ANSWERSBipap Your intubated and unresponsive patient is scheduled for surgery in the morning. Who is the most appropriate person to make decisions for your patient? - ANSWERSThe healthcare POA When administering a titratable infusion what information must you check on the medication IV bag to confirm the correct dose is being administered? - ANSWERSConcentration Your patient has a known baseline heart rate of around 45. The ECG monitor keeps alarming when the heart rate decreases below 50. Their vital signs are stable. What would you do? - ANSWERSA. Adjust the alarm parameters How is dopamine usually administered in the icu when given intravenously - ANSWERSTitratable continous infusion Which of the following can be given through an enteral feeding tube? - ANSWERSImmediate release pills When donning an N-95 mask, how should you secure the nose? - ANSWERSFit the nose piece with both hands What type of medication is used in the critical care setting to help manage the symptoms of alcohol withdrawal? - ANSWERSBenzodiazepines While admitting a patient with a history of IV drug use, what precautions should you take? - ANSWERSCarefully inspect items for presence of sharps. Your patient is intubated and begins to cough up clear mucous inside their ETT. What should you do NEXT? - ANSWERSA. Instill normal saline to lavage ETT*WRONG* B. Sit the patient up to 30 degrees in bed *wrong* C. Inspect their oral cavity and suction mouth D. Provide 100% oxygenation and prepare to suction What is a complication of long term TPN? - ANSWERSLiver injury Which assessment establishes baseline hand perfusion before an ABG puncture or arterial line placement? - ANSWERSAllen Test You find the concentration of an IV medication bag that is hanging and infusing into your patient does not match the concentration in the order. What should you do NEXT? - ANSWERSStop the infusion Your patient has a right chest tube that was placed after thoracotomy. They report that is very painful when they cough and request cough medicing. What should you The provider has ordered 2 units of FFP to be transfused. Your patient's religious beliefs prevent them from accepting blood products. What is your BEST response? - ANSWERSInform the provider and discuss additional options. During cardiogenic shock what temporary intervention might be ordered to improve perfusion until definitive treatment is provided? - ANSWERSInotropic infusion While reviewing your patient's EHR prior to receiving report, you notice that their documented urine output for the past 24 hours is 600ml. What would be the MOST important action to take for this patient? - ANSWERSconfirm with the off-going nurse if this is a known situation. You are caring for a confused patient with edema who has large swollen wrist. You find that someone has taped their ID bracelet to the side of the bed. How should you secure their ID bracelet? - ANSWERSPlace a new ID bracelet on the patient's wrist while confirming perfusion to the hand You are caring for a patient with diabetic ketoacidosis with suspected sepsis. You have the following tasks to complete: Draw blood cultures, checkblood glucose, administer antibiotic, insert urinary catheter, and check urine for glucose. Which task should you complete FIRST? - ANSWERSDraw blood culture A code is initiated and the second nurse is observed not following ACLS protocol. What is the BEST actionsto take? - ANSWERSStop the nurse immediately and institute ACLS protocol During the first hour of tPA infusion, how frequently should you monitor blood pressure? - ANSWERSEvery 15 minutes Which of the following is a priority for the bedside nurse when a patient gets inpatient hemodialysis? - ANSWERSMaintaining adequate blood pressure What MUST you confirm before removing a cervical spine collar? - ANSWERSPresence of active order to remove Which of the following signs or symptoms indicates a patient might not be tolerating the extubation? - ANSWERSThe patient is coughing and has tachycardia Which age group is MORE likely to experence a "Blown" vein - ANSWERSolder adults What acid/base imbalance is MOST likely to be found in a patient with COPD - ANSWERSRespiratroy acidosis Which of the following should you do if your patient suddenly becomes diaphoretic, anxious, tachycardic, and has clammy skin? - ANSWERSCheck their glucose What information is MOST important for you to confirm in smart IV pump settings? - ANSWERSWeight Besides the white blood cells, what laboratroy value is used in the diagnosis of sepsis? - ANSWERSLactic acid Which medication is associated with increased delirium in critical care patients? - ANSWERSLorazepam ( ativan) What is an effective way to evaluate for cyanosis in a person of color - ANSWERSCheck inner eyelids What cardiac condition shows cardiomegaly on chest x-ray - ANSWERSSystolic heart failure Your patient begins to choke and a code blue is called. The provider is unsuccessful at removing the object and is unable to place the ETT. You would expect to prepare for what type of procedure - ANSWERSSurgical airway