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Medical Surgical-telemetry RN A Accurate &
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You are to obtain informed consent for a Spanish-speaking patient scheduled for surgery. You do not speak Spanish and are having difficulty communicating with your patient. Which of the following resources would be most appropriate to utilize in order to obtain consent? Correct Answer✔✔
The hospitals language interpreter
You're reviewing the discharge medication list of a patient diagnosed with gastric ulcer. Which of the following medication should you question? Correct Answer✔✔
Acetylsalicylic acid ( Bauer buffered aspirin)
When taking care of a patient with pancreatitis, which of the following lab should be reviewed? Correct Answer✔✔
Lipase and amylase
You're caring for a 12 hour postoperative parathyroidectomy patient. Which assessment finding would indicate an emergency? Correct Answer✔✔
Laryngeal strider
Which of the following actions would be considered a violation of Hyppa? Correct Answer✔✔
Looking through the chart of a coworker admitted to your unit
Sinus tachycardia
You are taking care of a patient who is admitted for left flank pain with a kidney stone of 1.5 cm. He asks you about the procedure what would be the most therapeutic response?
Due to the size of the kidney stone it is an appropriate treatment?
NOT:Print reading materials about the subject and give it to the patient
The nurse is taking care of a patient who is terminally ill and has a DNR on file. Their patient has a sudden cardiac arrest and family wants CPR initiated. How should you respond? Correct Answer✔✔
Honor the patient's wishes
Not normal sinus rhythm into a flutter
Correct answer is ventricular fibrillation
Your patient began deteriorating rapidly after complaining of shortness of breath. And ABG was drawn and the results are pH? Correct Answer✔✔ HCO3 - 23. These values indicate the patient is experiencing:
Your inserting a urinary catheter into a male patient. As you inflate a balloon, the patient complains of discomfort what is the best action? Correct Answer✔✔
Aspirate the fluid, advance the catheter farther, then re-inflate the balloon
When assessing a patient, you notice crepitus on the right upper shoulder. You notify the physician and anticipate which diagnosis? Correct Answer✔✔
Subcutaneous emphysema
Wheat bread
A postoperative laparoscopic appendectomy patient is receiving morphine PCA for pain findings with alert you to the potential of a narcotic overdose? Correct Answer✔✔
A respiratory rate of 8 breaths per minute
Your patient was admitted with severe dehydration. Which of the following orders would you question
KCI 40 mEq IV push STAT
What is the first sign of increased intracranial pressure? Correct Answer✔✔
Change in LOC
A patient suddenly complains of new onset of chest pain. The doctor is suspecting a possible? Correct Answer✔✔... What is most likely to be ordered? Correct Answer✔✔
Morphine Duramorph, oxygen, nitrates,
Aceticsalicylic acid, bayer buffered aspirin
The Glasgow, scale ranges from:
3 to 15
You deserve the nurse aid removing her gloves and immediately using alcohol hand sanitizer in a room with a patient who has C-Diff. What education should you provide to the nurse aide
And washing with soap and water is mandatory because alcohol based hand sanitizers do not kill C-diff
Heart rate
80
Which of the following assessment findings should you report immediately to the physician for a patient who just had a bronchoscopy and biopsy? Correct Answer✔✔
Sputum with streaks of blood
NOT: increased salivation
Your patient was just returned from surgery with a Jackson-Pratt JP drain in place which of the following is the best nursing action? Correct Answer✔✔
Compress the drain, then plug the bulb to establish suction
Patient is admitted for shortness of breath. Do you notice the spouse adjusting the oxygen on the wall and she states "she always takes care of my husband" what would be an appropriate response? Correct Answer✔✔
Educate the spouse on oxygen use as a medical device in the hospital
Deposition has ordered for your patience to begin a 24 hour urine collection. Your patient voids for the first time two hours after the orders received. What should be done with this urine sample? Correct Answer✔✔
Discarded, then begin the 24 hour collection
Which of the following lab values would you expect to see in a patient diagnosed with? Correct Answer✔✔....
Lipase - 196
Which of the following issues should be reported up the chain of command
A coworker arriving to work under the influence of alcohol
You're providing discharge instructions to a CHF patient.
Increase shortness of breath
Which of the following electrolyte value should be Addressed immediately by the nurse
Potassium 2.5 mEq/L
Which of the following medication may cause urine discoloration
Rifampin
Calculate the 12 hour intake for a patient that has received the following during your shift: normal saline 750 ML, 24 ounces of sprite, Levaquin 50 ML, 650 ML urine in Foley catheter
1520
When caring for a patient experiencing a tonic clonic seizure, the most appropriate nursing intervention is:
Protecting the patient's head and extremities from contact with surrounding objects
You went to the room of a 58-year-old female. You find that the patient's cardiac monitor shows asystolye, what should be your first action? Correct Answer✔✔
Assess the patient
Not: start CPR
Didn't nurse ask you about the typical signs and symptoms of myocardial infarction
Women could have pain in their arm, neck, back or jaw
While performing the narcotic count at the end of the shift, my coworker admits to something, coworker to sign for the ways that you did not witness
Refused to sign for the waste
Cardiac strip
Sinus rhythm with PAC
You're preparing your patient for discharge need to provide dietary education related to his diagnosis what should you instruct the patient to avoid? Correct Answer✔✔
Canned meats
Your patient complains of not being able to urinate since 0500. It is now 1900. What should be your next step? Correct Answer✔✔
Perform a bladder scan
The doctor ordered Lasix 40 mg IV push, 100mg/10 mL
4ml
Your post-op patient has nausea, hypoactive bowel sounds, and repeated vomiting of dark brown emesis despite antiemetics. What order do you anticipate from the provider? Correct Answer✔✔
Rehydration
Labs
NG tube
NOT: Obtain MRI of the abdomen
What is the cardiac rhythm? Correct Answer✔✔
NOT: Sinus rhythm with first-degree AV block
You hear an alarm at the central monitor and see one of your patients with this rhythm. What would you do FIRST? Correct Answer✔✔
Check patient status and lead placement
NOT: Call a code blue
Your patient with cancer has a left upper arm PICC line. They report pain in their left arm, shoulder, and tingling in their left hand. Upon assessment you note the left arm is significantly larger than the right arm. The left arm is red and warm to the touch. What do you suspect? Correct Answer✔✔
Thrombosis (Blood Clot)
Air Embolism
NOT: Infiltration
Furosemide (Lasix®) IV should be pushed no faster than 10 mg/min to avoid what? Correct Answer✔✔
Tinnitus
-Ringing, buzzing or other unexplained noise in the ears
Other:
Pancreatitis
Dehydration
Electrolyte Imbalance
Increased blood glucose
Decreased urination
Dry mouth
Thirst
Nausea; vomiting
Weakness; Drowsiness; Confusion; muscle pain or cramps; or rapid or pounding heartbeats
NOT: Dizziness
Your patient presents with CHF and has a potassium level of 5.8. What diuretic do you anticipate being ordered by the provider? Correct Answer✔✔
bumetanide (Bumex)
NOT: Spironolactone (Aldactone)
You are caring for your 80-year-old patient admitted for pneumonia. They have a history of heart failure, cataracts, arthritis, and anxiety. They are receiving scheduled furosemide (Lasix®) and IV antibiotics. What are they at the HIGHEST risk for? Correct Answer✔✔
Remove the mouthpiece cover by squeezing gently at both sides, then pulling out
Hold the inhaler facing away from you, and release a test spray
Shake it again for 5 seconds and release a second test spray
TO USE YOUR INHALER:
Step 1: Shake your inhaler well for 5 seconds. Remove the mouthpiece cover by squeezing gently at both sides, then pulling out. Check the mouthpiece for foreign objects.
Step 2: Breathe out fully (exhale). Hold the inhaler up to your mouth. Place the white mouthpiece fully into your mouth and close your lips around it. Make sure that the inhaler is upright and that the opening of the mouthpiece is pointing toward the back of your throat.
Step 3: Breathe in (inhale) deeply and slowly through your mouth. Press down firmly and fully on the top of the counter on the inhaler to release the medicine.
Step 4: Continue to breathe in (inhale) and then hold your breath for about 10 seconds, or for as long as it is comfortable. Before you breathe out (exhale), release your finger from the top of the counter. Keep your inhaler upright and remove it from your mouth.
Step 5: Shake your inhaler again for 5 seconds and repeat steps 2 to 4.
After using your SYMBICORT inhaler:
Put the cover back on
Rinse your mouth with water and spit it out
Don’t swallow the water
Reading the actuation counter
The actuation counter on top of the inhaler helps to monitor the amount of medication remaining and helps you know when to refill your prescription. The arrow points to the number of inhalations, or puffs remaining. Here’s how to read it:
After you have primed the inhaler for the first time, the counter will read either 120 or 60, depending on which size was provided to you
Each time you release a puff from the inhaler, the counter will count down
When the arrow gets close to 20, you will notice the beginning of the yellow zone, indicating that it is time to call for a refill
Discard the inhaler when the arrow points to the red zone and reads zero (0), or 3 months after it is taken out of its pouch, whichever comes first
Your inhaler may not feel empty and may continue to operate, but you will not get the right amount of medicine if you keep using it
How to clean your SYMBICORT inhaler
You should clean the white mouthpiece of the SYMBICORT inhaler every 7 days
Remove the gray mouthpiece cover by squeezing gently at both sides, then pulling out
Use a clean, dry cloth to wipe the inside and outside of the white mouthpiece
When you are finished cleaning the mouthpiece, place the cover back over the mouthpiece
