ScribeAmerica Final Exam Verified Solutions 2024/2025, Exams of Nursing

Download ScribeAmerica Final Exam Verified Solutions 2024/2025 and more Exams Nursing in PDF only on Docsity! ScribeAmerica Final Exam A patient is seen in the emergency department complaining of dysuria and tells you that she is 23 weeks pregnant. Your doctor diagnoses her with a UTI. Which of the following would be the best diagnosis? - ✔acute urinary tract infection in pregnancy, 2nd trimester A patient cut his left foot on a piece of glass two hours ago and is seen in the emergency department to have sutures placed. The doctor tells you there is no tendon injury and circulatory, sensory and motor is intact. What is the best diagnosis for his complaint? - ✔Uncomplicated laceration of the left foot - initial encounter What does AMS stand for? - ✔altered mental status What does GCS stand for? - ✔glasgow coma scale What does DNR stand for? - ✔do not resuscitate What does AAA stand for? - ✔abdominal aortic aneurysm What does PE stand for in the diagnosis section of the chart? - ✔pulmonary embolism What does DP stand for in "DP pulse"? - ✔dorsalis pedis What does DVT stand for? - ✔deep vein thrombosis What does NTG stand for? - ✔nitroglycerin What does URI stand for? - ✔upper respiratory infection What does CHF stand for? - ✔congestive heart failure What does s/p stand for? - ✔status post What does GERD stand for? - ✔gastroesophageal reflux disease What does EOMI stand for? - ✔extraocular movements intact What does DOE stand for? - ✔dyspnea on exertion What does LBBB stand for? - ✔left bundle branch block What does CVA stand for? - ✔costovertebral angle What does CSF stand for? - ✔cerebrospinal fluid What does PTX stand for? - ✔pneumothorax What does COPD stand for? - ✔chronic obstructive pulmonary disease What does PNA stand for? - ✔pneumonia What does CBC stand for? - ✔complete blood count What does IDDM stand for? - ✔insulin dependent diabetes mellitus What does TIA stand for? - ✔transient ischemic attack A 43 y/o male presents to the ED with vomiting that began 5 hours ago. He has a history of Type II DM and is s/p right BKA. On objective evaluation it is found that he is hyperglycemic and has elevated ketones and so he will be admitted for DKA. Match the details to the correct section of the chart. 5 hours ago, DKA, vomiting, admit, Type II DM, right BKA, hyperglycemia & elevated ketones, Onset: Disposition: ED Course: CC: PMHx: Diagnosis: PSHx: - ✔Onset: 5 hours ago Disposition: admit ED Course: hyperglycemia and elevated ketones CC: vomiting PMHx: Type II DM Diagnosis: DKA PSHx: right BKA Match the following description to the appropriate team member. Unit Secretary, ED tech, Scribe, Mid-level Provider, charge nurse, RT, ED nurse ________: Documents the patient's visits on behalf of the physician ________: Answers phone calls, pages other specialists/ doctors, and organizes the patient's paperwork What condition correctly describes "Fertilized egg developed outside the uterus"? - ✔ectopic pregnancy A patient recently went on a boat trip 2 days ago and developed dizziness which has continued to persist since onset. She describes her dizziness as a room spinning and reports that it is accompanied by tinnitus, nausea, and vomiting. Physical exam is positive for Romberg's and Heat CT is negative. Based on this information which is the most likely final diagnosis for the patient? CVA Syncope Bell's Palsy BVP - ✔BPV What condition correctly describes "An immune response that leads to rash, itching, swelling, or difficulty breathing"? - ✔allergic reaction What condition describes "translocation of a thrombus leading to dyspnea and hypoxia"? - ✔PE Which of the following are not valid DDx for a patient with CC of HA? a. Syncope b. Hemorrhagic CVA c. Migraine d. Vertigo e. Bell's palsy f. Hypertensive HA - ✔Syncope Bell's palsy Vertigo What FHx/ SHx information is usually asked for pediatric parents? a. Immunization status b. History of cardiac disease c. Second hand smoke exposure d. Current occupation - ✔Immunization status Second hand smoke exposure A 45 year old male presents to the ED with a ripping, tearing pain to his central chest radiating strait to his back with associated nausea and begun 1 hours ago. What emergency conditions from the following list may explain the patients symptoms? a. AAA and Aortic dissection b. Aortic Dissection and MI c. AAA, Aortic Dissection, and MI d. Mi and AAA - ✔MI and Aortic Dissection A female patient has been pregnant four times in the past, is currently pregnant, and has two children at home. Calculate the G, P, and A. - ✔5,2,2 You are writing an HPI for a very complex patient who has had multiple recent hospital admissions and several significant complaints; what is the best way to organize the information in your HPI? - ✔Chronological order For chest pain patients, administering this medication can prevent onset of MI my thinning out the blood and improving blood flow to the heart. Because of this, it is important in the HPI if the patient has received this medication, and if so who gave the medication and what was the dosage of the medication. What medication is important for meeting this core measure? a. Epi pen b. ASA c. NSAIDS d. Acetaminophen e. Insulin f. Coumadin - ✔ASA Which of the following are considered to be cardiac risk factors for CP patients? a. None of the above b. Tobacco use c. DM d. CAD e. FHx of CAD <55 f. PSHx CABG, angioplasty, and stent ? g. HTN h. HLD - ✔Tobacco use DM CAD Family hx of CAD <55 y/o PSHx of CABG, angioplasty, and stent HTN HLD T/F. All symptoms documented in the HPI are also documented in the ROS. - ✔True A patient states she has had a productive cough for 4 days, and yesterday she developed a fever. Would her fever be considered an associates symptom for her productive cough? Why or why not? a. No, because the fever started later and not on the same day b. Yes, because the fever causes sputum production c. Yes, because fever started soon after the cough - ✔Yes, because fever started soon after the cough Match location with the corresponding DDx Pancreatic disease, gall bladder disease, appendicitis, diverticulitis LUQ - LLQ - RLQ - RUQ - - ✔LLQ: diverticulitis RLQ: appendicitis LUQ: pancreatic disease RUQ: gall bladder disease T/F. All symptoms documented in the ROS are also documented in the HPI - ✔False Match the following HPI detail with the corresponding DDx PTX, GERD, CAD/MI 1. Burning chest pain 2. Chest pains when taking in a deep breath 3. Sharp, stabbing pains that alternately becomes a dull heavy pressure like an elephant sitting on the chest, but regardless of quality, pain is always brought on by exertion - ✔PTX: chest pains when taking in a deep breath CAD/ MI: sharp, stabbing pains that alternately becomes a dull heavy pressure like an elephant sitting on the chest, but regardless of quality, pain is always brought on my exertion GERD: burning chest pain How would you document GPA for a patient who has previously been pregnant four times in the past, has three children at home, and is not currently pregnant? - ✔4,3,1 What is the medical term for "coughing up blood"? - ✔hemoptysis What is the medical term for painful urination? - ✔dysuria What medical term describes "blood present in vomit"? - ✔hematemesis What is the medical term for "bright red blood in stools"? - ✔hematochezia What medical term describes "noticeable blood in the urine"? - ✔hematuria e. ACS f. Acute MI g. Costochondritis h. A-fib with RVR i. Pleuritis j. CVA k. PE - ✔DKA Sepsis PTX ACS Acute MI A-fib with RVR CVA PE Match each critical care dx with it's associated procedure Cardioversion, CPAP/BiPAP, central line placement, chest tube, intubation, CPR cardiac rest- sepsis- respiratory failure- acute exacerbation- abnormal heart rhythm- PTX- - ✔PTX: chest tube Sepsis: central line placement Cardiac arrest: CPR Respiratory failure: Intubation Acute exacerbation CHF/ COPD (severe): CPAP/ BiPAP Abnormal heart rhythm: cardioversion Which of these procedures qualify as critical care procedures and would indicate that critical care time must be documented on a patient? a. Sedation b. CPAP/ BiPAP c. Central line placement d. LP e. Arthrocentesis f. CPR g. Chest tube h. Cardioversion i. Intubation - ✔CPAP/ BiPAP Central line placement CPR Chest tube Intubation Cardioversion Which of the following would need to go into a consult note for a patient that will be admitted to the hospital for treatment of bacterial meningitis? a. Mode of transportation b. Time period for f/u c. Name of the accepting physician d. Location in the hospital e. Condition at time of admission f. Reason for refusal g. Mental capacity h. Timing of admission i. Consultation note with accepting physician - ✔Name of the accepting physician Location in the hospital Condition at time of admission Timing of admission consultation note with accepting physician What term describes "the patient destination is home"? - ✔discharge What abreviation describes the scenario in which a patient declines a hospital stay and decided to go home instead? - ✔AMA A 13 y/o male patient was riding his bike earlier today and accidentally fell off after traveling on an uneven patch of sidewalk. He landed on to his outstretched right hand and subsequently experienced localized pains and swelling to his right wrist. An x-ray of the right wrist shows a distal radial fracture. Now that results are back, the physician will be ready to discharge the patient home. Which of the following would need to go into this patient's disposition note? a. Pt mental capacity b. Discussion of R/B/A c. F/U with specialist or PCP d. Specific conditions for return to the ED e. Condition at time of disposition f. Time period for f/u g. Timing of disposition h. Mode of transportation i. patient mental capacity - ✔F/u with specialist or PCP Condition at time of disposition Timing of disposition Time period for f/u Specific conditions for return to the ED What do you need to make sure to document for ever admitted patient? a. Prescriptions b. A consultation note indicating the admitting physician c. A work excuse d. Discharge paperwork - ✔A consultation note indicating the admitting physician An ED technician informs the provider that they have just finished applying a splint and sling for the patient with the wrist fracture. What PE finding is important for your provider to assess and include in the procedure note before the patient can be discharged home? - ✔CSMT You've just caught up on all you're charting. What are some things you can do to increase you providers efficiency? a. Accompanying your provider on reevals b. Taking blood samples to labs c. Preparing charts for pts that are assigned to your provider d. Tracking results e. Start interviewing upcoming pts on their CC and PHx f. Preparing for dispositions - ✔Preparing charts for patients that are assigned to your provider Tracking results Accompanying your provider on reevals Preparing for dispositions Consent should be documented any time a procedure is preformed, but there are maybe certain situations in which consent is unobtainable. In that case, consent is precluded by clinical urgency. During which of the following procedures would consent usually be unobtainable? - ✔CPR You are starting your shift and you physician immediately picks up 3 patients... - ✔PNA, Appendicitis, UTI What does ETT stand for? - ✔endotracheal tube Select terms you might find on an x-ray interpretation? a. Infiltrate b. No ST changes c. Normal QRS d. Pneumothorax - ✔Infiltrate Pneumothorax Match the oxygen administration route to the corresponding definition c. CT A/P with PO contrast d. CT chest with IV contrast e. CT A/P dry f. CT chest with PO contrast - ✔Ct A/P with IV contrast dye Which of the following diseases may be diagnosed using CXR? a. Asthma b. Heart function c. CHF d. PTX e. PE f. Rib fracture g. PNA - ✔Rib fracture PTX PNA CHF Which of the following tests would likely be immediately ordered for a Cardiac Workup in the ED? a. Troponin b. CXR c. EKG d. Aspirin e. Cardiac Stent f. CBC and BMP - ✔CBC and BMP Troponin CXR EKG Your physician tells you the patient had a wood's lamp exam to look for fluorescein uptake. In which organ system would you document this physical exam finding? - ✔Eyes Match the normal grading scale with the corresponding PE finding 15, 5/5, 2+ Strength - GCS - Reflexes - - ✔Reflexes: 2+ Strength: 5/5 GCS: 15 A 23 y/o female is brought in by EMS for a motor vehicle crash. Your physician verbalized outlaid that the patient appears to be on a backboard and her cervical spine is stabilized with a hand collar. The patient also appears to be lethargic with obvious lacerations above her right eyebrow, left hand, and left thigh. Match the following exam findings with he appropriate organ system. Integumentary, Neck, neurological, back - C-collar - Back boarded - Lacerations to the right eyebrow, left hand, and left thigh - Patient lethargic - ✔Neck: patient with a c-collar Back: patient back-boarded Integumentary: lacerations to the right eyebrow, left hand, and left thigh Neurological: patient lethargic Which of the following would belong in a psychiatric exam? a. Glasgow Coma Scale b. Reflexes c. Cerebellar exam d. Sensory exam e. Affect f. Cranial nerve exam - ✔Affect You see the physician check the patients pulses I four places; the right wrist, the top of the right foot, the back of the right foot, and the left neck. The doctor states "The pulses are fine." Match the location with the appropriate pulse that you would document in the physical exam. Neck, Back of foot. Wrist, Top of foot - 2+radial pulse - 2+carotid - 2+DPP - 2+PTP - ✔Neck: 2+ carotid Back of foot: 2+ PTP Wrist: 2+ radial pulse Top of foot: 2+ DPP