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100
Exhibit pronation, supination, abduction, adduction, and opposition.
What is pronation = foot rolled inwards; supination = foot rolled outwards; abduction = taken away from the body; adduction = taken into the body; opposition is touching each finger to the thumb.
100
Manifestations of hypovolemic shock?
What is decreased BP & CO, rapid/thready pulse, cold/clammy skin, decreased LOC or altered mental status, chest pain/cardiac dysfunction, oliguria (at least 30mL/hour).
100
Six P's of compartment syndrome?
What is pain (unrelieved), pulselessness, paralysis, pallor, paresthesia, pressure!
100
What anticoagulant drug would you expect to use for a pregnant/lactating patient?
What is heparin! Warfarin is a teratogenic.
100
Side effects of cyclobenzaprine?
What is anticholinergic effects such as dry mouth, photophobia, urinary retention.
200
What does arterial insufficiency look like and what does poor venous return manifest as in an affected extremity?
What is arterial insufficiency = cool and pale; poor venous return = warm and cyanotic.
200
What precautions should the nurse take when moving a patient with a recent hip arthroplasty?
What is avoid hip flexion >90 degrees for 4-6 weeks (especially bending over!), avoid internal rotation or adduction (especially crossing the legs! - use abduction pillow in-between legs to avoid this).
200
The nurse is assessing a patient with a tibial cast on his lower left leg. The patient has been on morphine for the past two days but is suddenly crying out in pain and points out that the urine in his Foley bag "looks funky." What might the nurse anticipate doing and assessing?
What is bivalving the cast due to compartment syndrome. An important indicator of compartment syndrome is looking for myoglobinurea - characterized by a dark, reddish brown color, oliguria, and fluid and electrolyte abnormalities.
200
What would you expect to give a patient experiencing a platelet count below 100,000?
What is protamine sulfate - antidote for heparin, which is most likely cause of the heparin induced thrombocytopenia-like manifestation.
200
What special patient teaching might you include about methocarbamol?
What is it may turn urine brown, black, or dark green.
300
What is a Colle's fracture?
What is frac of the distal radius. If displaced, it puts patients at increased risk for vascular insufficiency and later, carpal tunnel.
300
What is compartment syndrome, when can it occur, and what bone injuries is it most commonly associated with?
What is swelling of myofascial compartment presses on vessels, nerves, and tendons, causing ischemia and possible tissue death. This is a medical emergency that can occur days after the injury - ischemia can happen 4-8 hours after onset. Most often occurs in distal humerus (Volkmann's) and proximal tibia fracs.
300
A patient hobbles into the dermatologist's office for her annual visit to get another prescription for her acne medication. As the nurse is getting her paperwork together in the exam room, the patient tells the nurse that she was standing on the kitchen counter yesterday looking for the donuts that her roommate had hidden from her when she fell off and broke her tibia. After hearing this, the nurse noticed that the patient had petechiae around her neck. The patient brushed if off and told the nurse that it was just itchy from the cervical collar she had to wear in the ED all day yesterday but the nurse had other thoughts. What was the petechiae indicative of?
What is Fatty Embolism Syndrome (FES) - long bone frac and petechiae.
300
In what type of surgery would you NOT give heparin?
What is eye, brain, spinal cord surgeries.
300
What is baclofen and what are its side effects?
What is baclofen is an antispastic drug. Side effects include drowsiness, dizziness, fatigue, n/v, constipation, urinary retention. Overdose can result in resp dep & coma.
400
What are the three top-priority risks associated with acute pelvic compartment syndrome?
What is FES, VTE, sepsis
400
You're a nurse at the hospital and work in the resource department. You're on a different floor than you were yesterday, and was told that your patient 65 year old patient, Ima Wolfe, just had her catheter removed at 6 this morning after her spinal surgery yesterday. Your report says that she was continent pre-op. You answer Ima's call light and walk her to the bathroom, noticing that she's peeing down her leg all the way there. What do you do?
What is call HCP IMMEDIATELY- this could be a nerve root compression, medical emergency.
400
A patient 4 years post op bariatric surgery came into the office this morning to receive a blood transfusion for his anemia due to being noncompliant with his vitamins and protein intake. His vitals were BP - 128/76, HR - 77, RR - 18, and temp - 98.8. You just gave him a unit 12 minutes ago and checked his vitals: BP 130/80, HR - 72, RR - 18, and temp 101.2. What medications would you anticipate?
What is acetaminophen and diphenhydramine - febrile, nonhemolytic reaction.
400
What should you assess when a patient is withdrawing from baclofen?
What is temp, LOC, muscle rigidity. Ask patient about visual hallucinations, paranoid ideation, and muscle spasticity.
500
What are the four main indications of a hip frac?
What is shortened limb, external rotation (supination), muscle spasm, and impaired circulation if displaced.
500
Name the stages of a healing bone and when they occur.
What is fracture hematoma (first 72 hours), granulation tissue (3-14 days after injury), callous formation (~ week 2), ossification (3 weeks - 6 mos after injury until completely healed/clinical union), consolidation (up to 1 year after injury), remodeling (the return to the pre-injured state - new bone deposited and excess tissue resorbed.)
500
After getting Ima Wolfe's continence issue addressed, you look at her dressing and notice a pale yellow discharge. What could you do next before calling the HCP?
What is dipstick the drainage to check for glucose, indicating that the discharge is CSF.
500
You are with an 90 year old patient receiving a unit of blood after she was diagnosed with leukemia. The patient has never had a transfusion before and is extremely nervous because she was a nurse in the 40s and witnessed patients contracting Hepatitis B and HIV from the infusions. After the infusion had been infusing for about 4 minutes, the patient told the nurse that she felt like she couldn't breathe and began to go into respiratory distress. What would the nurse anticipate doing to help this patient?
What is stop the transfusion, start saline, administer oxygen therapy, call HCP and blood bank, possible steroids and ventilatory support, recheck blood bags and tags, monitor VS and UO, send blood bag and tubing back to blood bank, collect urine and blood specimens, document. This was an example of a Transfusion-Related Acute Lung Injury (TRALI) reaction, not a panic attack. Assess lung and breath sounds!
500
Name some thrombolytic drugs and when they should be given.
What is altepase (tPA), reteplase, tenecteplase. These drugs are usually only given for acute MI, PE, or ISCHEMIC stroke. They are clot busters.