Vital Signs & Assessment
What is the normal adult heart rate range?
60–100 bpm
Name one of the 6 rights of medication administration.
Right patient / drug / dose / route / time / documentation
What law protects patient health information?
HIPPA
What is a common early sign of sepsis?
Fever (or hypothermia), tachycardia, or tachypnea
What is the most effective way to prevent infection spread?
Hand hygiene
A drop in BP when moving from lying to standing is called what?
Orthostatic hypotension
What is a high-alert medication that requires double-checking?
Insulin (also heparin, opioids acceptable)
Who is responsible for obtaining informed consent?
The provider (physician/NP/PA)
What specialist group is often called for sepsis work ups?
Infectious Disease
What device helps prevent falls in high-risk patients?
Bed alarm
What oxygen saturation is generally considered low and requires intervention?
Less than 92% (or per patient baseline/orders)
What should the nurse do first if unsure about a medication order?
Hold the medication and clarify the order
What is the correct action if a nurse makes a documentation error?
Correct it per policy (no erasing; single line, initial, correct entry)
What lab value is elevated in sepsis and indicates poor perfusion?
Lactate
What type of precautions are used for C. diff?
Contact precautions
What is the priority assessment if a patient reports sudden shortness of breath?
Assess airway, breathing, and oxygenation (respiratory status)
What is the priority assessment before giving an opioid?
Respiratory rate and level of consciousness
If a nurse is concerned about a patient’s condition and the provider does not respond, what should they do?
Follow the chain of command
What is the priority treatment for suspected sepsis?
IV fluids and broad-spectrum antibiotics
What is the priority action before ambulating a weak patient?
Assess strength and use assistive devices/gait belt
A patient has BP 88/50, HR 120, cool clammy skin—what type of condition is suspected?
Shock (likely hypovolemic or distributive depending on context)
A patient’s blood glucose is 55—what is the priority intervention?
Give fast-acting carbohydrates (e.g., juice/glucose) if conscious
A nursing student is asked to perform a skill they were not trained on—what should they do?
Refuse and notify instructor/supervisor (stay within scope)
What should be done before starting antibiotics in sepsis (if possible)?
What position helps prevent aspiration in a patient receiving tube feeding?
Head of bed elevated 30–45 degrees