Medications
Who to see first?
Nursing Interventions
Labs
Signs and Symptoms
100
Before giving Nitroglcerine 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 Nitro can significantly drop BP.
100
A) COPD patient with O2 of 90% on RA
B) Patient with +pronator drift
C) Patient 1 day post op patient with 100.9F temp
D) Patient with a broken shoulder complaining of 10/10 pain
Patient with +pronator drift to r/o stroke, especially if new.
FAST protocol. Pronator drift part of neuro exam.
100
First action when a patient is unresponsive?
Check for a pulse
100
What lab value do we look at for sepsis?
lactate
100
You are suspecting your patient to be retaining urine. In 3 hours, what would you expect for output in the Foley catheter?
90ml.
30ml/hr for adults is expected.
200
What blood thinners do not need routine labs checked?
Xarelto and Eliquis
200
A) A patient with a potassium level of 6.1 mEq/L and tall, peaked T-waves on EKG
B) A patient with angina who reported 10/10 chest pain after walking and just given Nitro
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.
Hyperekalemia with EKG changes can cause life threatening arrhythmia.
200
You have an order to hand an IVPB antibiotic, but have maintenance fluids running at 75ml/hr. Now what?
Check compatibility and if compatible, hang!
200
What condition does an elevated BNP indicate
CHF
200
Example of early signs of septic shock in adults
Low BP and tachycardia
300
You are with your nursing instructor in clinical. She gives you a labeled 50 mg Metoprolol XR crushed to give to her gtube patient. Can you still administer?
No. It is an extended release medication. Extended release medications can not be crushed and should not be given.
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, just received DuoNeb, now wheezing, using accessory muscles, and tripping
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 Creatine. What does this indicate?
Impaired renal function or AKI.
The higher the values the less efficient the kidneys are working to clear.
300
You are a RN in an outpatient primary care. Your asthma patient comes in with white film around the mouth. What do you suspect it is and how may have this happen?
Oral candidiasis. This can happen by not washing your inhaler/spacer following long term corticosteroid inhalers.
400
You are an outpatient RN calling your patients for education regarding upcoming contrast CT scans. You call your non insulin dependent T2DM patient and inform them to stop taking what medication before the scan?
Metformin.
This runs the risk of lactic acidosis. Stop 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 is hyponatremic. What should you initiate was a RN.
Seizure precautions.
400
What state do you suspect an ABG to reveal in a patient that has anxiety and is hyperventilating
Respiratory alkalosis.
This is due to blowing off so much C02.
400
Your patients FSBS was 40. What s/s do you anticipate
sweating, confusion, irritability, shaking, seizure, etc.
500
You are educating your patient who is being discharged on Warfarin. You tell him to avoid these types of food, and give an example.
Foods rich in vitamin K, like green leafy vegetables.
500
A) A patient on a PCA pump that is sleepy and RR 10-12
B) A CHF patient reporting 3+ leg edema and weight gain of 3 lbs overnight 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 chest tube and it fell out of the patient. Now what?
Apply a sterile occlusive dressing taped on 3 sides, call MD, monitor for s/s of pneumothorax.
500
What lab and test get done if there is a suspected PE?
d dimer and CTA
500
Your patient presents with intermittently dizziness and palpitations. You take an EKG and it shows this. What is is?
Atrial fibrillation.
The QRS's do not march out, however there is a p for every QRS. Regularly irregular.