Medications
Who to see first?
Nursing Interventions
Labs
Signs and Symptoms
100
Before giving nitroglycerin to a patient with chest pain, what should you check?
Blood pressure is critically important. Take vitals prior to administration to ensure safety parameters are met as nitroglycerin can significantly drop BP.
100
A) COPD patient with O2 sat 90% on RA
B) Patient with +pronator drift
C) Patient post op Day 1 with 100.9F temp
D) Patient with a broken shoulder complaining of 10/10 pain
Patient with +pronator drift. Need to r/o stroke, especially if new. FAST protocol.
100
First action when a patient is unresponsive?
Check for a pulse
100
What two lab values are monitored for patients with a diagnosis of sepsis?
WBC and lactate
100
Your patient has an indwelling foley catheter. In 3 hours, what would you expect the urine output to be?
90 mL
30mL/hr for adults is expected
200
You are educating your patient about Warfarin. You should instruct them to avoid what types of foods?
Foods rich in vitamin K, like green leafy vegetables.
200
A) A patient with a potassium level of 6.1 mEq/L and tall, peaked T-waves on EKG
B) A patient with stable angina who reports 4/10 chest pain that is improving with rest
C) A post-CVA patient with expressive aphasia trying to speak to you
D) A patient with Cushing's disease complaining of extreme fatigue and hunger
A patient with a potassium level of 6.1 mEq/L and tall, peaked T-waves on EKG. Hyperkalemia with EKG changes can cause life threatening arrhythmia.
200
You have an order to administer an IVPB antibiotic, but there are maintenance fluids running at 75mL/hr. What actions should you take?
Check compatibility and if compatible, hang!
200
What condition does an elevated BNP indicate?
CHF
200
Provide two examples of early signs of septic shock in adults.
Hypotension and tachycardia
300
You are with your nursing instructor in clinical. She gives you a labeled Metoprolol XR 50 mg tablet to give to her patient with a g-tube. Should you administer the medication? Why or why not?
No. It is an extended release medication. Extended release medications can not be crushed and should not be given via g-tube.
300
A) A patient 1 hour post-lumbar puncture complaining of a severe 10/10 headache
B) A post-op hysterectomy patient with 200 mL of bright red blood in JP drain over the last 8 hours
C) A patient with known history of asthma who just received a DuoNeb is now wheezing, using accessory muscles, and tripoding
D) A patient awaiting discharge education on insulin
A patient with history of asthma now wheezing and using accessory muscles to breathe to assess for acute respiratory distress. Think ABCs
300
Your patient is varicella+. What precautions should you initiate?
Airborne precautions.
300
Your patient has a high BUN and creatinine. What does this indicate?
Impaired renal function or AKI.
The higher the values, the less efficient the kidneys are working.
300
You are an RN in an outpatient primary care office. Your patient with asthma comes in with a white film around the mouth. What do you suspect it is and why did this happen?
Oral candidiasis. This can happen by not rinsing the mouth after using corticosteroid inhalers.
400
You are an outpatient RN calling your patient regarding an upcoming CT scan with contrast. You instruct your non insulin dependent diabetic patient and inform them to stop taking what medication before the scan?
Metformin - this medication increases the risk of lactic acidosis and should be stopped 48 hours before and after contrast if possible.
400
A) A 60-year-old diabetic with a foot ulcer and purulent foul-smelling drainage
B) A patient post-op Day 2 from bowel surgery with HR 110 and BP 88/50
C) A patient with multiple sclerosis requesting immediate assistance with ambulation and PT/OT consult
D) A 40-year-old with anxiety reporting chest tightness. BP: 135/65, HR 98, O2 98% on RA, RR 18, no temp.
A patient post-op Day 2 from bowel surgery with HR 110 and BP 88/50. This patient is showing s/s of shock.
400
Your patient's sodium level is 114. What is a priority nursing intervention?
Initiate seizure precautions.
400
What acid-base imbalance would you expect to see on an ABG for a patient that is anxious and hyperventilating?
Respiratory alkalosis.
This is due to excessive loss of CO2.
400
Your patient's FSBS was 40. What signs and symptoms do you anticipate? Provide at least 3 examples.
sweating, confusion, irritability, shaking, seizure, etc.
500
What blood thinners do not need routine labs checked?
Xarelto and Eliquis
500
A) A patient on a PCA pump that is sleepy and RR 12
B) A CHF patient reporting 3+ leg edema and weight gain of 3 lbs overnight who has been noncompliant with medications
C) A COPD patient with O₂ sat of 89% and clubbing fingers
D) A post-op abdominal patient with a rigid, board-like abdomen
A post-op abdominal patient with a rigid, board-like abdomen to r/o peritonitis or internal bleeding
500
You tripped over your patient's chest tube and it fell out onto the floor. What should you do?
Apply a sterile occlusive dressing taped on 3 sides, call MD, monitor for s/s of pneumothorax.
500
What lab and test should be performed if there is a suspected PE?
d-dimer and CTPA
500
Your patient presents with intermittent dizziness and palpitations. You obtain an EKG and it shows this. What rhythm is this?
Atrial fibrillation.
There is not a P wave for every QRS. The rhythm is irregular.