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Nursing Scenarios: Patient Care and Diagnoses, Exams of Nursing

Sharda UniversityNursing

Answers to various nursing scenarios involving patient care, diagnoses, and symptoms. Topics include accommodating religious beliefs, identifying symptoms of different conditions, addressing professional boundaries, and administering medications. Students and healthcare professionals can use this document as a reference for understanding patient care and diagnosis in various clinical situations.

Typology: Exams

2023/2024

Available from 03/10/2024

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1) 1.2 milligrams is equal to how many micrograms? - Answer 1200 mcg
2) A female patient requests a female nurse to provide care for her based on her
religious beliefs. What is the MOST appropriate action to take? - Answer
Accommodate her request if possible.
3) A patient has recently been diagnosed with terminal cancer. Her responses are
caustic and abrasive. What is the BEST way to respond? - Answer Acknowledge
her feelings, understanding this is expected in the grieving process.
4) A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication
would you anticipate administering? - Answer Vitamin K
5) A patient with acute diverticulitis is MOST likely to complain of abdominal pain
with what quadrant? - Answer Left lower quadrant
6) A patient with peritonitis presents with tachycardia, hypotension, and
dehydration. What other assessment finding would you anticipate as part of your
physical assessment? - Answer Severe abdominal pain or rebound tenderness
7) An older adult patient arrives on the unit looking emaciated, disheveled, and with
soiled clothes. The patient claims that his daughter cares for him at home. What
would you suspect? - Answer Neglect
8) 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? - Answer Remind her later of her responsibility for establishing and
maintaining professional boundaries with patients.
9) Black and tarry colored stools are CLASSIC symptoms of what condition? -
Answer Bleeding gastric ulcer
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  1. 1.2 milligrams is equal to how many micrograms? - Answer 1200 mcg
  2. A female patient requests a female nurse to provide care for her based on her religious beliefs. What is the MOST appropriate action to take? - Answer Accommodate her request if possible.
  3. A patient has recently been diagnosed with terminal cancer. Her responses are caustic and abrasive. What is the BEST way to respond? - Answer Acknowledge her feelings, understanding this is expected in the grieving process.
  4. A patient on warfarin (Coumadin/Jantoven) has an INR of 6. Which medication would you anticipate administering? - Answer Vitamin K
  5. A patient with acute diverticulitis is MOST likely to complain of abdominal pain with what quadrant? - Answer Left lower quadrant
  6. A patient with peritonitis presents with tachycardia, hypotension, and dehydration. What other assessment finding would you anticipate as part of your physical assessment? - Answer Severe abdominal pain or rebound tenderness
  7. An older adult patient arrives on the unit looking emaciated, disheveled, and with soiled clothes. The patient claims that his daughter cares for him at home. What would you suspect? - Answer Neglect
  8. 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? - Answer Remind her later of her responsibility for establishing and maintaining professional boundaries with patients.
  9. Black and tarry colored stools are CLASSIC symptoms of what condition? - Answer Bleeding gastric ulcer
  1. Central Telemetry calls and tells you your patient is experiencing bradycardia. What is the first thing you should do after entering the room? - Answer Assess the patient and take vital signs.
  2. Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? - Answer 0.125mg
  3. Fifteen minutes after starting a blood transfusion, the patient complains of lower back pain, shortness of breath, and chills. What is your FIRST action? - Answer Stop the tranfusion.
  4. If your patient with a known history of diabetes is displaying symptoms of diaphoresis, cool skin, lethargy, and shakiness. What is your first action? - Answer Check the patient's blood glucose level.
  5. In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: - Answer Paresthesia and paralysis
  6. Insulin lispro (Humalog) is orders via sliding scale a.c. for your patient with diabetes. When is the best time to administer insulin lispro (Humalog)? - Answer 15 min before the meal arrives
  7. patient arrives on unit. you do an assessment and notice lice in her hair. what is your first action? - Answer Secure a private room
  8. Patient presents dusky pallor and pulseless. First action - Answer Initiate facility code procedure
  9. Patients with diabetes are at high risk for complications from damage to what body areas? - Answer Nerve and kidney damage
  10. The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? - Answer Prednisone
  1. Upon entering your patient's room, you note that they are having a seizure. What is your FIRST action? - Answer Position the patient on their side to maintain the airway.
  2. 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? - Answer Non-rebreather mask
  3. What condition (not medication related) might cause an elevation in the patients PT/INR level? - Answer Liver disease
  4. What diagnostic finding would support a diagnosis of deep vein thrombosis? - Answer Positive D-dimer
  5. What is a proton pump inhibitor, such as pantoprazole (Protonix) used for? - Answer Acid Reduction
  6. What is an early symptom that the patient is developing a complication of heart failure? - Answer Edema in the legs and feet
  7. What is clubbing of the fingers MOST likely associated with? - Answer Chronic oxygen deficiency
  8. What is the BEST indication of an acute neurological problem? - Answer Change in level of consciousness
  9. What is the EARLIEST sign indicating increased intracranial pressure (ICP)? - Answer Level of consciousness
  10. What is the proper technique when suctioning a tracheostomy? - Answer Suction in a circular motion while the catheter is being pulled out.
  1. What medication would you anticipate to be ordered for a patient who has a LDL

200 mg/dL? - Answer Statin

  1. What patient population is the pneumococcal vaccine, PPSV23 indicated for? - Answer Adults aged 65 years and older
  2. What type of personal protective equipment (PPE) is applied prior to entering a room for a patient with C. diff? - Answer Gown and gloves
  3. When would sucralfate (Carafate) 4 times daily be scheduled for? - Answer 1 hour before meals and at bedtime
  4. 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? - Answer Patient lift (e.g., Hoyer)
  5. Which of the following is MOST important in preventing a catheter associated urinary tract infection (CAUTI)? - Answer Using sterile technique when inserting the catheter
  6. Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? - Answer Impaired gas exchange
  7. Which of the following would be used as part of the preop procedure to prevent infection? - Answer Prophylactic antibiotics
  8. Which tool should you use to assess pain in you 80-year-old patient with severe dementia? - Answer PAINAD scale
  9. 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
  1. 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? - Answer The patient with chest pain
  2. 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? - Answer famotidine (Pepcid)
  3. 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? - Answer Verify your patient's consent to release information to her mother.
  4. You notice your patient who recently had a stroke is coughing intermittently during meals. What is the MOST likely cause of this? - Answer He could be aspirating.
  5. You receive a provider's order that is not consistent with evidence-based practice. What is your FIRST step? - Answer Clarify the order with the provider.
  6. You received a patient post op transurethral resection of the prostate (TURP). Which of the following symptoms would cause you the MOST concern? - Answer Hemorrhage and hypotension
  7. You received a report on a patient that sustained a right hemisphere CVA 48 hours ago. What do you expect the patient to exhibit? - Answer Left sided weakness of the leg, arm, and face.
  1. 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? - Answer Report to the post-surgical unit.
  2. Your 18-year-old female patient was admitted with dehydration secondary to anorexia nervosa. 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? - Answer Stay with the patient and ask fi she has a plan to carry out this wish.
  3. 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? - Answer risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone, lurasidone, chlorpromazine, fluphenazine, haloperidol, perphenazine
  4. 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? - Answer Enoxaparin (Lovenox) once daily and intermittent pneumatic compressions (IPC)
  5. 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? - Answer Case Manager

however, you note during the assessment that the stomach is rigid and hard during palpation. What condition do you suspect? - Answer Hemorrhage

  1. 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? - Answer Hypokalemia
  2. 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? - Answer Request an order for soft mitts as they are the least restrictive
  3. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? - Answer Bright red urine
  4. Your patient has a diagnosis of urinary tract infection (UTI) and is currently taking medication that has recently made her urine reddish-orange. Which of the following medications would cause this side effect? - Answer Phenazopyridine (Pyridium)
  5. Your patient has a non-productive cough and presence of secretions in his tracheostomy. Prior to suctioning the patient, what should you do FIRST? - Answer Hyperoxygenate patient.
  6. 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. - Answer Sepsis
  1. Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? - Answer Initiate droplet precautions
  2. Your patient has symptomatic anemia but is refusing a blood transfusion for religious reason. What is an appropriate response? - Answer Respect his wishes and notify the provider
  3. Your patient is 4 hours post open appendectomy and has not voided yet. You note his lower abdomen is distended. What should you do NEXT? - Answer Perform a bladder scan
  4. Your patient is a 40-year-old female with a recent history of hair loss, extremely dry skin, a nd a 20-point weight loss in the last 3 weeks. She also exhibits occasional episodes of tremors in her upper extremities. What condition do these symptoms MOST likely indicate? - Answer Hyperthyroidism
  5. 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? - Answer Notify the charge nurse and social worker of your concerns.
  6. Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? - Answer broth, jello, soft fruit no skin,
  7. 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
  1. 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? - Answer Discuss code status with the patient and follow up with provider to ensure the medical record reflects her wishes.
  2. 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? - Answer Ask the patient when his last drink of alcohol was.
  3. Your patient with C. diff (Clostridioides difficile) has a family member about to leave the room. What education about performing hand hygiene should you give? - Answer Hand hygiene with soap and water
  4. 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? - Answer Knowledge Deficit
  5. 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? - Answer Paracentesis
  6. 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? - Answer Palliative care consult
  7. 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."

  1. Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of
  1. What blood product do you expect to administer? - Answer PRBCs
  1. Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? - Answer Compress the drain, then plug the bulb to establish suction