Progressive Care RN Exam Preparation: Key Questions and Answers for 2024, Exams of Nursing

Download Progressive Care RN Exam Preparation: Key Questions and Answers for 2024 and more Exams Nursing in PDF only on Docsity! Progressive Care RN A 2024 Exam Best Studying Material with All Questions from Actual Past Exam and 100% Correct Answers Your patient is on anticoagulant medication. You are discharging them and provide patient education. Which statement by your patient indicates an understanding of the education? ----------- Correct Answer ---------- I will not take ibuprofen (Motrin®) every day Your non-verbal patient is alert. What type of pain assessment would be appropriate? -- --------- Correct Answer ---------- • Visual pain scale • Verbal descriptive scale • Vital signs assessment to approximate pain • Behavioral pain scale (Wrong) You receive a patient from the emergency department with a fever, cough for 3 weeks, night chills, and fatigue. During the admission assessment the patient reports recent travel out of the country. What should be your FIRST action? --------- Correct Answer ---- ----- Notify the provider, apply a mask to the patient, and transfer to a negative pressure room Unstable angina is characterized by which of the following? --------- Correct Answer ------ --- Chest pain, usually while at rest The patient's lab test results indicate a BNP of 2,000 upon arrival to the ED. The patient has been transferred to PCU. What treatment plan would you anticipate from the attending provider? --------- Correct Answer --------- Furosemide 40 mg IV BID Which of the following has been found to be linked to a diagnosis of endocarditis? ------- -- Correct Answer --------- Recent invasive dental procedures Your patient is post-op day 3 after triple bypass surgery. Chest tubes have been removed. The patient suddenly complains of palpitations. His blood pressure is 130/76 and heart rate is 140 bpm. What would you do NEXT? --------- Correct Answer --------- Immediately perform a bedside EKG What abnormal heart sound would you expect to hear in a patient with mitral stenosis? - -------- Correct Answer --------- Diastolic murmur You are performing auscultation on your patient and note an absence of breath sounds in the right lower lobe. Which of the following would you suspect? --------- Correct Answer --------- Pneumothorax Which of the following are primary goals in diabetic ketoacidosis therapy? --------- Correct Answer --------- Correct fluid deficit and replace potassium You receive an 84 year old patient from the ED with pneumonia. Antibiotics and steroids have already been initiated by the provider. The patient complains of abdominal pain and has a large, loose bowel movement and notifies you this is the third one. What should you do FIRST? --------- Correct Answer --------- Initiate contact isolation precautions for possible C. difficile You have completed a blood transfusion and are unsure of how to dispose of the empty bag. What should you do? --------- Correct Answer --------- Locate the MSDS book to find policy and procedures Your patient has returned from the cath lab post angioplasty. Upon assessment you note a large hematoma at the sheath site. What would be your immediate action? -------- --- Correct Answer ---------- Apply manual pressure to the site and call for help. Your patient has new onset seizures. They ask you what they should know about taking levetiracetam (Keppra®). What would be your BEST response? ----------- Correct Answer ---------- Common side effects are fatigue and depression Your patient with cardiac bypass surgery is post-op day 2. The nursing assistant reports that your patient has a temp of 101.3°F and blood pressure of 82/56. Their urine output has decreased to less than 30 mL in the past 4 hours. You suspect a post-surgery complication. After calling the physician you receive orders for STAT CBC, CMP, and coagulation test. What results would you expect to see after these labs are completed? ----------- Correct Answer ---------- WBC greater than 19,000 What is an adequate amount of urine output? ----------- Correct Answer ---------- 30 mL/hr Your patient has left ventricular failure. What clinical manifestations would you expect to see? ----------- Correct Answer ---------- Dyspnea, distant heart sounds, bilateral crackles You are caring for your patient with an order for furosemide (Lasix®) 80 mg BID. What would be your MOST appropriate action? ----------- Correct Answer ---------- Call provider to clarify the order. Your patient is in cardiac arrest. Chest compressions are being performed. Capnography indicates the end-tidal CO2 is 18 mmg. What do the capnography results indicate about the chest compressions? ----------- Correct Answer ---------- No changes. These are high quality compressions. What is required before making a report of elder abuse? ----------- Correct Answer -------- -- Suspicion of abuse Your patient is experiencing left-sided weakness from a meningioma. What would be the MOST likely treatment for their brain tumor? ----------- Correct Answer ---------- Surgical resection Your coworker mistakenly gives 2 units of insulin to a patient. The patient is stabilized and the provider is informed. What would be your NEXT step? ----------- Correct Answer ---------- Create an incident report Your patient had an IVC filter placed 2 days ago. They start to complain of sharp pain in the chest, shortness of breath, anxiety, and heart palpitations. What would you do NEXT? ----------- Correct Answer ---------- Notify provider and prepare for a CT scan. What ethical principle is the foundation of end-of-life care? ----------- Correct Answer ----- ----- Patient autonomy What is the importance of proper cuff inflation for tracheostomy tubes? ----------- Correct Answer ---------- • To decrease the flow of supplemental oxygen. (Wrong) • To facilitate mechanical ventilation. • To prepare the patient for extubation. • To allow the patient to speak. What are the MOST common causes of acute onset pancreatitis? ----------- Correct Answer ---------- Alcoholism and gallstones Your patient has an upper GI bleed. They have a hemoglobin of 6.1 g/dL. What order would you perform FIRST? ----------- Correct Answer ---------- Prepare to administer 2 units PRBCs. Your patient is on the midday schedule for hemodialysis. They have 100 mg metoprolol XL (Toprol®) ordered for this morning. Their blood pressure is 150/98. What would be your MOST appropriate action? ----------- Correct Answer ---------- Hold the metoprolol because of the upcoming dialysis. What would be your BEST method for dressing a venous stasis ulcer? ----------- Correct Answer ---------- Use gauze wrap covered by a compression bandage What would you check before administering digoxin (Lanoxin®)? ----------- Correct Answer ---------- Apical pulse What is the FIRST step of the PDSA quality improvement cycle? ----------- Correct Answer ---------- Plan Your patient has left ventricular heart failure and chest pain. The transport team is ready to take them to their echocardiogram. What would be your nursing PRIORITY for safe transportation? ----------- Correct Answer ---------- Accompany patient to their destination Your patient has a new onset of atrial fibrillation with a blood pressure of 80/60. What treatment would be MOST appropriate? ----------- Correct Answer ---------- Electrical cardioversion A patient is status post video-assisted thorascopic surgery (VATS) with lobectomy. You are preparing to admit them. What equipment should be placed in their room prior to their arrival? ----------- Correct Answer ---------- High flow oxygen Which statement by your patient would concern you the MOST that they are seriously considering suicide? ----------- Correct Answer ---------- I have 10 pills set aside if things get really bad. Your patient has advanced COPD with an oxygen saturation level of 80%. What would you do to promote adequate gas exchange? ----------- Correct Answer ---------- Use a venturi mask to delivery oxygen as ordered What is an early hemodynamic change associated with stroke? ----------- Correct Answer ---------- • Bradycardia • Widened pulse pressure • Hypotension (Wrong) • Hypertension Your patient has mitral stenosis. What abnormal heart sound would you expect to hear? ----------- Correct Answer ---------- Diastolic murmur Your patient is admitted from the ED for syncope for a ground level fall. You note their heart rate is 50 and they are confused. Their child states they think your patient has dementia but has not been diagnosed yet. Patient's blood pressure is stable. What order do you expect? ----------- Correct Answer ---------- Stat head CT Your patient is newly diagnosed with asthma. What would be your MAIN goal when providing patient education? ----------- Correct Answer ---------- Self-management for symptom control You are performing auscultation on your patient. You note an absence of breath sounds in the right lower lobe. What would you suspect? ----------- Correct Answer ---------- Pneumothorax You complete a mental status assessment on your patient. You notice they are oriented some of the time but not all of the time as their attention drifts when you ask them questions. What would be an appropriate screening tool based on your assessment findings? ----------- Correct Answer ---------- Confusion Assessment Method (CAM) You want to assess for jugular vein distention (JVD). What position would be BEST? ---- ------- Correct Answer ---------- Position patient on their back with head of bed at 30 to 45 degrees. Your patient with triple cardiac bypass surgery is post-op day 3. Chest tubes have been removed. They suddenly report palpitations. Their blood pressure is 130/76 and heart rate is 140 bpm. What would you do NEXT? ----------- Correct Answer ---------- Perform a bedside EKG Your patient has a history of renal insufficiency. What class of analgesics would MOST likely be contraindicated for them? ----------- Correct Answer ---------- Nonsteroidal anti- inflammatory medications Your patient is acutely ill. What route of medication administration would likely be LEAST effective? ----------- Correct Answer ---------- Intramuscular You are working with the code team to resuscitate a patient in ventricular fibrillation. Chest compressions are ongoing and the patient has been shocked twice. What emergency medication, if any, would you administer at this juncture? ----------- Correct Answer ---------- Epinephrine (Adrenaline) 1 mg IV Your patient reports nausea, vomiting, and diarrhea. Their blood pressure is 89/55, heart rate 122 bpm, and temperature 100.8°F. What condition do you expect? ----------- Correct Answer ---------- Hypovolemic shock Your patient was diagnosed with atrial fibrillation. They are being discharged on anticoagulant therapy every evening. Which patient statement indicates a need for further teaching? ----------- Correct Answer ---------- I cannot wait to get back to riding my horse. Your patient's epicardial wires were pulled 30 minutes ago. They now report acute chest pain. What would you do NEXT? ----------- Correct Answer ---------- Call cardio-thoracic surgeon and report symptoms. You enter your patient's room. You notice the telemetry box and the IV catheter on the bed. You last saw your patient 1 hour ago. Who would you notify immediately? ----------- Correct Answer ---------- Charge nurse A patient is status post video-assisted thorascopic surgery (VATS) with lobectomy. You are preparing to admit them. What equipment should be placed in their room prior to their arrival? ----------- Correct Answer ---------- • Trach collar • High flow oxygen (Wrong) • Incentive spirometer • Sterile suctioning catheter Which of the following medications is MOST commonly indicated for patients with CHF? --------- Correct Answer --------- Ace inhibitors Which of the following patients would you see FIRST? --------- Correct Answer --------- A 57 year old male complaining of worsening chest tightness You enter a patient's room and notice the telemetry box on the bed and the IV on the floor connected to running IV fluids. You last saw the patient 1 hour ago. Who should be notified immediately? --------- Correct Answer --------- Charge nurse A patient is admitted for a NSTEMI and ST depression is noted in leads II, III, and AVF. Two hours after admission you notice the patient now has ST elevation in each of those leads. What should you do NEXT? --------- Correct Answer --------- Initiate STEMI team or Administer O2 and morphine 2mg IV??? An 18 year old female is admitted from PACU after a cholecystectomy. She has a 22 gauge peripheral IV in her left hand and is due to void. She had morphine 8 mg and Zofran 4 mg in recovery, and is complaining of nausea. She has Phenergan 50 mg IV every 6 hours/PRN. What should you do first? --------- Correct Answer --------- Start a new IV line in the antecubital region or obtain an order for Phenergan IM A patient is on strict I&Os with an indwelling urinary catheter. 4 hours into your shift you notice that there is a total of 50 mL of urine in the bag. You notify the provider because you recognize that adequate urine output should be: --------- Correct Answer --------- 30 mL/hr A co-worker administered a narcotic earlier in the shift, but failed to get a witness for the portion of medication that was wasted. The co-worker asks that you sign off as the witness. What is the BEST response? --------- Correct Answer --------- Refuse to witness the waste and ask the co-worker to notify the charge nurse You are caring for a patient taking warfarin for atrial fibrillation. The lab calls reporting that the patient has an INR of 6.4. What medication do you anticipate being ordered by the provider? --------- Correct Answer --------- Vitamin K You are caring for a patient complaining of chest pain. Which of the following troponin I levels requires provider notification? --------- Correct Answer --------- 0.07 ng/mL or 0.5 ng/mL??? A patient with new onset seizures is most likely to have which of the following in their room? --------- Correct Answer --------- Padded side rails and suction at the bedside You are transfusing PRBCs into a patient with a hgb of 7.7 g/dL. Fifteen minutes into the transfusion, the patient complains of lower back pain, shortness of breath, and chills. Which of the following would you do FIRST? --------- Correct Answer --------- Stop the transfusion Which of the following is an early indication of a stroke? --------- Correct Answer --------- Ptosis Which of the following are clinical manifestations typically seen in a patient with left ventricular failure? --------- Correct Answer --------- Dyspnea/peripheral edema/JVD or Dyspnea/distant heart sounds/bilateral crackles??? A patient is admitted to the PCU with COPD exacerbation. Which of the following assessment findings would you expect to find knowing that the patient has been taking prednisone 40 mg PO once daily for 18 years? --------- Correct Answer --------- Hyperglycemia A 16 year old patient was admitted to the unit for asthma exacerbation. The patient has a suicide attempt the previous shift and states "I want to die because I am being bullied at school." Which of the following is the MOST important action? --------- Correct Answer --------- Place the patient on suicide precautions to prevent a second suicide attempt The provider has written an order for diltiazem 125 mg in 100 mL D5W at 10 mg/hour. The vial of diltiazem contains 5mg/mL. Which of the following is the correct volume to add to the bag of D5W? --------- Correct Answer --------- 25 mL The provider has ordered a 24-hour urine collection for your patient. The patient voids 275 cc, 2 hours after the order is given. This specimen should be: --------- Correct Answer --------- Discarded, then begin collection with the next void What acid-base imbalance would you expect to see in a patient with an acute kidney injury? --------- Correct Answer --------- Metabolic acidosis Your 28 year old patient is being discharged on warfarin 5 mg every evening after being diagnosed with atrial fibrillation. Which of the following statements indicates a need for further teaching? --------- Correct Answer --------- "I cant wait to get back to riding on my horse." You are caring for an 80 year old male with advanced COPD with an oxygen saturation level of 80%. Which of the following would you do to promote adequate oxygen exchange? --------- Correct Answer --------- Use a high-flow venturi mask to deliver oxygen as ordered You are caring for a patient that has returned from the cath lab post antioplasty. Upon assessment, you note a large hematoma at the sheath site. Which of the following would you do immediateley? --------- Correct Answer --------- Apply manual pressure to the site and call for help Which of the following findings assist in the diagnosis of deep vein thrombosis? --------- Correct Answer --------- Positive D-dimer The patient is presenting with a blood pressure of 90/60, a creatinine of 3.0 and decreased urinary output. What is a possible cause for these findings? --------- Correct Answer --------- Acute kidney injury You admit a patient to the PCU that was rear-ended in a motor vehicle accident. As they sit up in bed you notice bruising to the right flank area. What immediate action should be taken? --------- Correct Answer --------- Notify the provider of assessment findings and possible retroperitoneal bleeding A patient is admitted with a diagnosis of "rule out GI bleed." Which of the following lab values supports confirmation of this diagnosis? --------- Correct Answer --------- Hgb of 5.2 You are taking care of a patient who is scheduled for ablation to treat atrial fibrillation. While obtaining consent , the patient asks multiple questions about the procedure. What is the BEST response? --------- Correct Answer --------- Request the provider come and discuss the procedure with the patient Your patient has an IVC filter placed two days ago and starts to complain of sharp pain in the chest, shortness of breath, anxiety, and heart palpitations. What should you do NEXT? --------- Correct Answer --------- Notify the provider and prepare for a CT scan What is the MOST important intervention for a patient with non-blanching redness and intact skin to their coccyx? --------- Correct Answer --------- Turning the patient every two hours, alternating from side to side What is the most common cause of acute onset pancreatitis? --------- Correct Answer --- ------ Alcoholism and galstones Then nursing assistant reports that your post-op day 2 CABG patient has a temp of 101.3 and BP of 82/56. The patient's output has decreased to < 30 cc in the past 4 hours. You suspect a post surgical complication. After calling the doctor, you receive the orders for STAT CBC, CMP, and coagulation test. Which of the following results would you expect to see after these labs are completed? --------- Correct Answer --------- WBC greater than 19,000 Your patient is receiving an amiodarone drip. You should reduce the dose from 1 mg/mL to 0.5 mg/mL after: --------- Correct Answer --------- 6 hours Your patient was admitted for a hypertensive crisis and has a history of HTN, Parkinson's Disease, CAD, and depression. The patient reports drinking 3-4 alcoholic drinks/night. This is your third day caring for this patient and you suddenly notice that he is more anxious and restless than his baseline. What would be your INITIAL nursing intervention? --------- Correct Answer --------- Check CIWA score