PPE
You are a nurse working in the triage area of the Emergency Department. A patient reports a cough with blood-streaked sputum for almost two months with night sweats and an unintended 20-lb weight loss. You suspect tuberculosis (TB). What type of precautions would be appropriate? a) Contact b) Droplet c) Airborne d) Contact & Droplet
The correct answer is C, Airborne Isolation Precautions. A surgical type face mask should be placed on the patient and he should be moved to a negative-pressure room as soon as possible. If an AIIR is not immediately available, you should be promptly placed in a private room while awaiting the AIIR. Staff caring for the patient must wear appropriate respiratory protection such as an N95 respirator or PAPR.
Describe Wood's light exam and what does it identify.
What is a black light test or UV test in which the skin is viewed under UV light through a special glass (Wood's glass) to identify superficial infections of the skin.
The RN should assess vs and lung sounds before the transfusion and again when?
What is, after the first 15 minutes and every 30 minutes to 1 hour (per facility policy) until 1 hour after the transfusion is complete.
Convert 2 g to mg.
What is 2000 mg.
2g = 2000 mg (multiply by 1000 or move decimal point 3 places to right).
The order is to give 1.25 mg of Xanax. What you have available is 0.5 mg tablets. How many tablets will you give?
What is 2.5 tabs.
A previously healthy 35 year-old woman is admitted to your medical unit with fever, cough, and body aches for two days. She tests positive for seasonal influenza. What type of precautions would be appropriate? a) Contact b) Droplet c) Airborne d) Standard
The correct answer is B, Droplet Precautions. These precautions need to be instituted before lab confirmation of illness. Some facilities have enhanced or extended Droplet Precautions, but all should be based on the Droplet Precautions concepts we covered in this module. This includes health care personnel wearing a surgical-type face mask when coming into close contact with the patient, use of a private room and limiting movement within the facility.
A pt. has acute cellulitis of the LLE. The RN expects to note which finding?
1. Inflammation of the epidermis.
2. Skin infection of the dermis and underlying hypodermis.
3. Acute superficial infection of the upper layers of the skin.
4. Epidermal and lymphatic infection caused by Staphylococcus.
What is 2. Skin infection of the dermis and underlying hypodermis.
The RN checks the blood bag tag, label and blood requisition form to ensure that ___________ and _________ are compatible.
What is ABO and Rh types.
Convert 250 mL to Liters.
What is 250 mL = 0.25 L (divide by 1000 or move decimal point 3 places to left).
The doctor orders 600 mg of Tylenol. What is available is 750 mg/2.5 mL. Calculate how many mL(s) the nurse will administer.
What is 2 mL.
A 75 year-old male patient presents with his daughter who tells you he’s had a large draining wound on his hip that’s difficult to keep covered and draining onto his linens. You confirm this and suggest to the nurse the patient be placed into: a) Contact Precautions b) Standard Precautions c) Droplet Precautions d) Airborne Isolation Precautions
The correct answer is A, Contact Precautions. Contact Precautions should be considered when a patient has a draining, wound. It should also be considered for patients with uncontrollable diarrhea and other instances when the environment may become contaminated.
A person calls the ED after direct contact with poison ivy. The person tells the RN that nothing is visible on the skin and asks what to do. The RN should respond:
1. "Come to the ED."
2. "Apply calamine lotion immediately to the exposed skin."
3. "Take a shower immediately, lathering and rinsing several times."
4. "It is not necessary to do anything if you cannot see anything on your skin."
What is 3. "Take a shower immediately, lathering and rinsing several times."
Identify 6 complications of a blood transfusion.
Transfusion reaction, circulatory overload, septicemia, iron overload, disease transmission, hypocalcemia, hyperkalemia and citrate toxicity.
Pt. consumed 4 oz OJ, 8 oz milk and 12 oz coffee. How many mL did this pt. consume?
What is 720 mL.
4+8+12=24
24x30=720mL
A dose of Epinephrine 1.4 mg is needed. Available is 1 mg/1 mL. How many mL(s) will the nurse administer? (Round to the tenth)
What is 1.4mL
In the ED a pt. c/o uncontrolled diarrhea with unknown etiology with no other presenting symptoms. What type of isolation would they need?
What is contact.
The RN assess a pt. with psoriasis after the pt. has used a new topical tx for 2 months. The RN identifies which characterisitcs as improvement of the psoriasis condition. Select all that apply:
1. Presence of striae.
2. Palpable radial pulses.
3. Absence of ecchymosis on the extremities.
4. Thinner reddish papules and a decrease in thier number.
5. Scarce amount of silvery-white scaly patches on the arms.
What is
4. Thinner reddish papules and a decrease in thier number.
and
5. Scarce amount of silvery-white scaly patches on the arms.
To avoid the risk of septicemia during a blood transfusion, one unit of blood should not exceed _______hours of administration.
What is 4 hours for PRBCs.
Pt. stated they consumed 2 Tablespoons of cough medicine. How many mL is this?
What is 30mL.
1 Tablespoon=15 mL.
Dexamethasone 4 mg/1 mL is available. The MD orders 6000 mcg. How much will the nurse give? (Round to the tenth)
What is 1.5 mL
If a pt. is in isolation with droplet precautions, can they go outside thier room to the radiology department and explain.
What is yes. If on Droplet Precautions, the patient should wear a surgical?type face mask and follow cough etiquette when outside of their room.
The RN is on vacation and during a local mountain hike, she witnessed a person suffer from a snakebite. Which is the first priority intervention:
1. Immobilize the affected extremity.
2. Remove jewelry and constrictive clothing from the victim.
3. Place the extremity in a position so that it is below the level of the heart.
4. Move the victim to a safe area away from the snake and encourage the victim to rest.
What is 4. Move the victim to a safe area away from the snake and encourage the victim to rest.
A pt. is receiving a unit of PRBCs suddenly c/o chills, backache and itchy skin. The RN notes a chest and neck rash. What actions should the RN take?
What is stop the blood, take down blood tubing and replace with NS@KVO, check vs, notify provider and blood bank, stay with pt. and assess s/sx and monitor vs q 5 minutes, prepare emergency meds and CPR PRN, obtain pt. urine and other specimens as indicated to the lab, return blood bag and tubing including all transfusion docs to lab and document occurance, actions taken and pt. response.
What is the fluid balance for this pt. in mL? Pt. consumed 1 pint gatorade, 1 gallon water, 2 teaspoons meds, and 4 ounces OJ. UOP = 2 gallons.
What is -3182 mL.
1 pint = 473 mL
1 gallon = 3785 mL
2 teaspoons = 10 mL
4 ounces = 120 mL
UOP = 7570 mL minus Intake of 4388= -3182 mL
The order states: Give Inapsine 4.5 mg IV every 12 hours. Available for this dose is Inapsine 5 mg/2 mL. How many mL(s) will the nurse give for one dose? (Round to the tenth)
What is 1.8 mL