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100

A patient with a pacemaker is admitted to your Med Surg Floor. which order should the you immediately question the provider about?

MRI STAT!

100

 Sara presents to the floor with oliguria, Cola colored urine, edema in her face, and BP 140/90. She's upset because she was just here almost two weeks ago with strep throat. What could she be experiencing?

Acute Glomerulonephritis 

100

Your patient is 3 days post op after a corneal transplant. Upon your assessment you notice increased erythema in both eyes and the patient reports increased eye pain. What should you do first?

Notify the HCP due to possible infection

100

Your patient is presenting to the ED after a weekend of bar hopping with vomiting, boring left upper quadrant pain, and abd distention. What initial order from the provider should you anticipate?

NPO 🚫🍔

100

A patient with HIV is presenting with wasting syndrome. Which diet should the nurse recommend for this patient?

High calorie and High protein!

200

You're the nurse caring for a patient with a recent diagnosis of Psoriasis.They ask you "what is used to manage something like this?"

Tar prep,corticosteroids,UV light therapy adalimumab/Humira (immunosuppressants)

200

Congrats New Grad! You're 6 hours in your first 12 hour shift when the Charge nurse randomly asks you.."describe stage 4 renal failure and the GFR!"

GFR: 15-29 mL/Min 

Severely Reduced kidney function:Jaundice present

200

You're a Peds nurse providing education to the patient's family about external skeletal fixator care at home. What response by the dad would require further teaching?

"If looks like its healing funny i'll just fix it with my screw driver."

200

Your a nurse providing an seminar on detecting cancer early in young adults. Someone in the audience asks you when should testicular exam be performed?

Once a month after a warm shower or bath. 

200
Your patient with SLE has elevated BUN, creatinine labs, and proteinuria. What does this indicate?

 Lupus Nephritis 

300

Your patient has a venous ulcer on their left ankle, what characteristics about this wound would you expect to see in the documentation?

Brown pigment, pink bed, uneven edges, granulation tissue present

300

You're the ICU nurse for Carl who just had a right pneumonectomy. Which action by the UAP requires immediate action by you? 

Turning Carl from his back to his left side( good lung down)

300

You're in the ED at the nursing station when the LPN runs up to you reporting that your patient with ICP is projectile vomiting with a severe headache. What is the priority intervention?

Raising the HOB to 30 degrees

300

You are administering your morning meds on the oncology unit. When preparing to admin doxorubicin you notice tissue loss around the patient's IV site. Which intervention should be next?

Stop the infusion immediately

300

You have just received a new patient from PACU following a parathyroidectomy. What s/s of hypocalcemia should you mt for?

Tetany, paresthesia, positive trousseau and chvostek's sign

400

You're the charge nurse in the ED, a patient comes in with a temp of 104F, petechiae, and splinter hemorrhages. What disease process is this?

Infective Endocarditis 

400

The RT just drew ABG's which lab values would indicate your patient is in hypercapnic RF and what's the intervention?

PaCO2: 55, Apply BiPAP

400

Frank fell on the floor at walmart at 3:30pm. He is presenting to the ED at 4pm with left sided paralysis, dysphagia, and reported a headache of 10/10 on a drawing board. What is the priority intervention?

SBAR the provider for a thrombolytic order STAT. 
400

A 63 yr old female patient is in the OB GYN office with diagnoses of a prolapsed uterus. She refuses surgery due to her desire to travel now that she and her husband are retired. What treatment should you suggest?

Pessary ring

400

You're doing an assessment on a patient that is post-adrenalectomy. You notice the patient is tachycardic, has a temp of 102.F, and the dressing has moderate amounts of purulent drainage. What is the priority action? 

Report this to the provider! Infection

500

You're looking at the chart and these labs are elevated Myoglobin, Troponin, and CK-MB. What is going on and what do you do? 

Myocardial infarction! MONA- morphine, oxygen, nitroglycerin, and aspirin. 

500

Your just got back from lunch and are now doing rounds. You notice the water seal is bubbling on one of your patient's chest tube. What actions should you perform next?

clamp the tube for a second, if the bubbling stops its coming from the pt, so then unclamp and check the dressing for air leaks.

500

You're a nurse on the rapid response team that was called to room 4 where the RN reports the client had been seizing for 3 minutes. Which two interventions need to be performed immediately? 

IV push diazepam & long acting phenytoin

500

You're providing discharge teaching to a patient with Cirrhosis that recently developed esophageal varices. Which statement by the pt would indicate a need for further teaching?

I can't wait to eat a whole plate of nachos from Woodys after i'm discharged!

500

You're providing discharge teaching to a client prescribed hydroxychloroquine(DMARD) to manage SLE. What should be included in the teaching?

eye exam every 6-8 months