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. Nitroglycerin can significantly lower BP and should always be checked prior to administration.
100
A) A patient with COPD with spO2 90% on room air
B) A patient with +pronator drift
C) A patient on post-op Day 1 with 100.9 F temp
D) Patient with a broken shoulder complaining of 10/10 pain
A patient with +pronator drift. Pronator drift is a warning sign of stroke and should be addressed immediately.
100
What is the first nursing action when a patient is found 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 minimum urine output to be?
90 mL
30mL/hr for adults is expected
200
You are educating your patient who is being discharged on warfarin. What types of food do you instruct him to avoid? Provide an example.
Foods that are rich in Vitamin K, such as leafy green vegetables. Excessive Vitamin K intake can decrease the effectiveness of warfarin and increase risk of clotting.
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 is typically indicated by an elevated BNP?
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 asks you to administer metoprolol succinate (Toprol XL) 50 mg tablet to her patient with a G-tube. Should you administer the medication? Why or why not?
No, because the medication is extended-release and cannot be crushed to administer via G-tube.
300
A) A patient 1 hour post-lumbar puncture complaining of a severe 8/10 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. Airway/breathing is the priority issue to address following the ABC framework.
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 (e.g., dehydration)
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. The patient has a history of type II diabetes. You should inform them to stop taking which oral antidiabetic 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 diabetic patient with a foot ulcer and purulent foul-smelling drainage
B) A patient on post-op Day 2 from bowel surgery with HR 110 and BP 86/50
C) A patient with multiple sclerosis requesting immediate assistance with ambulation and PT/OT consult
D) A patient with anxiety reporting chest tightness. HR 98, BP 135/70, spO2 95% on RA, RR 20
A patient post-op Day 2 from bowel surgery with HR 110 and BP 86/50. This patient is showing signs of sepsis/shock and should be addressed immediately.
400
Your patient's sodium level is 114. What is a priority nursing intervention to ensure patient safety?
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 caused by excess carbon dioxide elimination during hyperventilation.
400
Your patient's FSBS was 40. What signs and symptoms do you anticipate? Provide at least 5 examples.
Sweating, shakiness, dizziness, headache, lethargy, hunger, tachycardia, confusion, blurry vision, seizure, etc.
500
What are two anticoagulants that do not require routine lab checks?
Xarelto and Eliquis
500
A) A patient on a PCA pump who is drowsy with RR 12
B) A CHF patient who has been noncompliant with medications reporting +3 leg edema and weight gain of 3 lbs overnight
C) A COPD patient with spO2 of 89% and clubbed fingers
D) A post-op abdominal patient with a rigid, board-like abdomen and 10/10 pain
A post-op abdominal patient with a rigid, board-like abdomen and 10/10 pain. This patient is showing signs of peritonitis, a life-threatening complication that requires immediate intervention.
500
You tripped over your patient's chest tube and it falls out of the chest wall and onto the floor. What should you do?
Call for assistance, apply a sterile occlusive dressing taped on 3 sides, notify provider, and monitor for s/s of pneumothorax
500
What lab and test should be performed if there is a suspected pulmonary embolism?
d-dimer and chest CTA
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.