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RELIAS PROGRESSIVE CARE RN EXAM
LATEST AND COMPLETE VERSION
WITH VERIFIED SOLUTIONS ALREADY
GRADED A+
"A 78 year old male is admitted from the ED for syncope with ground level fall. You note his heart rate is 50 and the patient is confused. His daughter states she thinks he has dementia but he has not been diagnosed yet. Blood pressure is stable. What order do you anticipate? - CORRECT ANSWER=> Stat head CT" "A patient with an upper GI bleed has a hgb of 6.1 g/dL. Which of the following orders should you do FIRST? - CORRECT ANSWER=> Prepare to administer 2 units PRBCs" "Which of the following should be checked before administering digoxin? - CORRECT ANSWER=> Apical pulse" "A patient with a history of acute seizure activity of unknown etiology is admitted to the PCU from the ED. Which of the following orders would you expect to receive from the admitting provider? - CORRECT ANSWER=> Levetiracetam (Keppra) 500 mg IV every 12 hours and seizure precautions" "You are caring for a patient post left pneumonectomy with a chest tube in place for drainage. Which of the following is a priority in caring for this patient? - CORRECT ANSWER=> Encourage the patient to cough and deep breathe" "You are caring for a patient with an order for "furosemide 80 mg BID". Which of the following actions is the MOST appropriate? - CORRECT ANSWER=> Call the provider to clarify the order" "You are caring for a patient with a Do Not Resuscitate (DNR) order. The patient goes into cardiac arrest and the patient's daughter states "Do whatever you can to save my dad." Which of the following is the BEST response? - CORRECT ANSWER=> Follow the patient's wishes and honor the DNR"
"You are educating your patient about reducing sodium intake. You know that the patient understands when they make the statement: - CORRECT ANSWER=> "I will avoid canned food because it's salty"" "The trough for vancomycin is measured: - CORRECT ANSWER=> Immediately before the next scheduled dose" "You are delegating wound care to a LPN. The LPN states that she has never performed this type of wound care before. Which of the following components of delegation have you neglected? - CORRECT ANSWER=> Competency" "You are caring for a patient in third degree heart block. Which of the following treatment options will MOST likely be implemented? - CORRECT ANSWER=> Pacemaker" "You are assigned a patient who recently traveled outside of the United States. He has a fever of 101.9 F and excessive diarrhea. You suspect he may have been exposed to Ebola. What type of PPE would you expect to use? - CORRECT ANSWER=> High level PPE" "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=> 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"
"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" "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/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 angioplasty. 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 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 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)" "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" "You receive your patient with pneumonia from the ED. Antibiotics and steroids have been initiated by the provider. The patient reports abdominal pain and has a large loose bowel movement. They inform you this is their third bowel movement in the last two hours. What would you do FIRST? - CORRECT ANSWER=> Initiate enteric contact isolation precautions for possible C. diff" "Your patient has developed sepsis from an indwelling urinary catheter. What would be your PRIORITY intervention? - CORRECT ANSWER=> Remove catheter." "Your patient is in third degree heart block. What treatment would you MOST likely expect to be implemented? - CORRECT ANSWER=> Pacemaker" "What are 2 nursing interventions to prevent venous thromboembolism? - CORRECT ANSWER=>
- Adequate hydration and early mobilization.
- Hemodynamic monitoring and early mobilization. (Wrong)
- Adequate hydration and encouraging a steady amount of green leafy vegetables in diet.
- Hemodynamic monitoring and encouraging a steady amount of green leafy vegetables in diet." "Your patient is post left pneumonectomy. They have a chest tube in place for drainage. What would be a PRIORITY in your care? - CORRECT ANSWER=> Encourage patient to cough and deep breathe" "What is the reversal agent for benzodiazepines? - CORRECT ANSWER=> Flumazenil (Romazicon)"
"You are administering 1 unit of packed red blood cells (PRBC) to your patient. They develop shortness of breath, tachycardia, and distended jugular veins in the first 15 minutes of PRBC administration. What type of transfusion reaction are they likely experiencing? - CORRECT ANSWER=> • Transfusion related hemolytic reaction (Wrong)
- Septic transfusion reaction
- Transfusion related fluid overload
- Anaphylaxis" "When should the trough for vancomycin (Firvanq®) be measured? - CORRECT ANSWER=> Immediately before the next scheduled dose" "What are PRIMARY goals in diabetic ketoacidosis therapy? - CORRECT ANSWER=> Correct fluid deficit and replace potassium." "Your patient is receiving an amiodarone (Pacerone®) drip. When would you reduce the dose from 1 mg/mL to 0.5 mg/mL? - CORRECT ANSWER=> After 6 hours" "You walk into your patient's room. You notice that the chest tube collection chamber has been knocked over onto its side. There appears to be drainage dispersed throughout the chambers. What would you do NEXT? - CORRECT ANSWER=> Replace chamber with a new one." "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'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" ACLS Protocol: first medication administration - CORRECT ANSWER=> Epinephrine" "How long do you apply direct pressure to the site of an arterial catheter/sheath? - CORRECT ANSWER=> At least 5 minutes" "Possible blood transfusion reactions? - CORRECT ANSWER=> Urticaria, Fever, chills, Dyspnea, Respiratory distress, Hypotension, Hypothermia" "What do you do if your patient has a blood transfusion reaction? - CORRECT ANSWER=> -Stop transfusion immediately -Continue NS -Examine blood bag and send back to BB -monitor VS q15 mins -Send post transfusion blood sample to lab" "CVA symptoms - CORRECT ANSWER=> Confusion, one-sided weakness and facial drooping" "What do you do If your patient expresses chest pain and dyspnea - CORRECT ANSWER=> Contact rapid response" "Hypoglycemia symptoms - CORRECT ANSWER=> - Tachycardia
- Moist clammy skin
- Vertigo (dizzy)
- Tremors" "What do bilateral rales indicate onset and/or worsening? - CORRECT ANSWER=> Heart Failure (HF)" "Hypertension symptoms - CORRECT ANSWER=> -headache (usually in occipital region and occurs upon waking up) -dizziness -weakness -epistaxis -tinnitus -blurred vision -seizures" "What do you do if you think your patient is hyper/hypoglycemic? - CORRECT ANSWER=> Obtain a STAT blood glucose" "Pain assessment tools - CORRECT ANSWER=> -Wong-Baker FACES -Beyer Oucher pain scale -CRIES pain scale -FLACC scale -COMFORT scale" "myocardial infarction - CORRECT ANSWER=> the occlusion of one or more coronary arteries caused by plaque buildup (heart attack)" "post angioplasty care - CORRECT ANSWER=> Patients should be kept lying flat for several hours after the procedure so that any serious bleeding can be avoided and that the artery can heal" "What is needed for a patient in restraints? - CORRECT ANSWER=> monitor every 2 hours and reevaluate as needed" "What are early indications of heart failure - CORRECT ANSWER=> Shortness of breath with activity or when lying down. Fatigue and weakness. Swelling in the legs, ankles and feet. Rapid or irregular heartbeat." "What are lab indicators of renal function? - CORRECT ANSWER=> A creatinine level of greater than 1.2 for women and greater than 1.4 for men"
"Naloxone (Narcan) - CORRECT ANSWER=> opiate antagonist, reverses opioid induced respiratory depression" "Oxygen - CORRECT ANSWER=> Keep above 94% on RA" "Treatment for infiltration with a known vesicant? - CORRECT ANSWER=> Stop infusion and disconnect IV tubing" "Finding associated with MI, S-T segment elevation - CORRECT ANSWER=> a total blockage of the involved coronary artery and that the heart muscle is currently dying" "ECG rhythm strip interpretation: atrial fibrillation - CORRECT ANSWER=> " "ECG rhythm strip interpretation: sinus rhythm with multifocal PVC couplet - CORRECT ANSWER=> " "ECG rhythm strip interpretation: narrow complex tachycardia), first action - CORRECT ANSWER=> vagal maneuvers: hold breath and bear down" "ECG rhythm strip interpretation and action: ventricular fibrillation - CORRECT ANSWER=> shock at 200 joules, biphasic" "ECG rhythm strip interpretation: ventricular tachycardia - CORRECT ANSWER=> " "Normal range for BUN? - CORRECT ANSWER=> 6-20" "Normal range for Creatinine? - CORRECT ANSWER=> 0.6-1.2" "Normal range for glucose? - CORRECT ANSWER=> 70-100 mg/dL" "Normal range for magnesium? - CORRECT ANSWER=> 1.5-2.5" "Normal range for Sodium? - CORRECT ANSWER=> 135-145" "normal range for calcium? ** - CORRECT ANSWER=> 9-11"
"Catheter-associated urinary tract infection (CAUTI) prevention bundle? - CORRECT ANSWER=> Reassess need for catheter" "Catheter-associated bloodstream infection (CLABSI) prevention bundle - CORRECT ANSWER=> Reassess need for central line" "Do you wash your hands with a patient with C. Diff or can you just foam? - CORRECT ANSWER=> Must wash hands" "What are patient identifiers? - CORRECT ANSWER=> Name, date of birth and MRN" "How to help prevent Ventilator-associated pneumonia (VAP)? - CORRECT ANSWER=> Elevate HOB" "What is the purpose of oxygen post MI? - CORRECT ANSWER=> Improve myocardial perfusion" "What to include in Heart failure discharge teaching? - CORRECT ANSWER=> Monitoring weight and instructions if symptoms worsen." "How does a Demand pacemaker function? - CORRECT ANSWER=> Sensing and pacing when heart rate drops below preset threshold" “Which of the following medications is MOST commonly indicated for patients with CHF? - CORRECT ANSWER=> Ace inhibitors" "A patient was involved in a motor vehicle accident and CAT scan results reveal a right sided SDH. What would be an expected neurological assessment finding in this patient? - CORRECT ANSWER=> Dilated right pupil" "What is the most common symptom of SIADH? - CORRECT ANSWER=> Fluid retention" "Upon arrival to the unit, you receive report on four PCU patients. Which patient should you attend to FIRST? - CORRECT ANSWER=> A patient complaining of shortness of breathe on continuous BiPAP with a BP of 189/109"
