Medical-Surgical RN A Prophecy Relias Exam 2023 latest updated questions, Exams of Nursing

Download Medical-Surgical RN A Prophecy Relias Exam 2023 latest updated questions and more Exams Nursing in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias Exam 2023 latest updated questions 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 family members. What should you do? - answerNotify 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? - answerStat 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. - answerSepsis What type of personal protective equipment (PPE) is applied prior to entering a room for a patient with C. diff? - answerGown and gloves 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? - answerRequest 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? - 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 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 draws from a PICC line, another has chest pain rated 8/10, and another needs toileting. Which patient should you tend to FIRST? - answerThe patient with chest pain 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 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? - answerEnoxaparin (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? - answerClarify the order with the provider. When would sucralfate (Carafate) 4 times daily be scheduled for? - answer1 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? - answerPRBCs 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." 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 A patient has recently been diagnosed with terminal cancer. Her responses are caustic and abrasive. What is the BEST way to respond? - answerAcknowledge 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? - answerHe could be aspirating. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - answerLeft lower quadrant Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - answerUsing 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? - 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 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? - answerHypokalemia Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? - answer0.125mg 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? - answerRemind 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? - answer"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