NURS 440 Practicum

Cardiology

100

A) Initiate a heparin infusion B) Give atropine IV push C) Prepare for immediate cardioversion D) Prepare the patient for AV node ablation

A patient who has experienced atrial fibrillation for the past 3 days is admitted to the cardiac care unit. In addition to administering an antidysrhythmia medication, the healthcare provider should anticipate which of these orders?

200

A) BUN and creatinine B) Sodium, potassium, and calcium C) Hemoglobin and hematocrit D) PT and INR

When caring for a patient with a cardiac dysrhythmia, which laboratory value is a priority for the healthcare provider to monitor?

300

A) When there is impairment in cardiac output. B) When the dysrhythmia becomes chronic. C) If the heart rate is 50 to 60 beats per minute. D) After the heart rate reaches a rate faster than 100 beats per minute

Risks and benefits are balanced when giving an antidysrhythmic drug to a treat a cardiac dysrhythmia. When does the need for the drug outweigh the risks?

400

Select all that apply. A) Defibrillation B) Administration of IV crystalloid C) Administration of epinephrine D) Cardiopulmonary resuscitation (CPR) E) Administration of vasoconstrictors F) Synchronized cardioversion

While caring for a patient who is experiencing a postoperative hemorrhage, the healthcare provider notes the rhythm observed on the electrocardiogram (EKG) does not produce a pulse. Which actions should the healthcare provider initiate to resolve this patient’s problem?

500

Select all that apply. A) Hypotension B) Dizziness C) Headache D) Pulse deficit E) Chest pain

A patient who has a diagnosis of atrial fibrillation has a heart rate of 152 beats per minute. The healthcare provider should assess for which of these problems related to the dysrhythmia?

Peds/OB

100

A) Check that the baby is up-to-date with immunizations B) Call for assistance because the baby is in respiratory distress C) Weigh the baby to assess weight gain D) Assure the mother these are normal symptoms of a cold

A mother brings her 2-month-old infant to the clinic. She tells the healthcare provider the baby has been irritable with a runny nose for the past 4 days. The healthcare provider assesses the baby and notes nasal flaring and intercostal retractions. What is the most appropriate action by the healthcare provider at this time?

200

A) Obtain an order for an antibiotic B) Call for immediate assistance C) Inspect the child’s throat for a foreign object D) Ask the mother if the child has any allergies

A mother brings her 2-month-old child in to the urgent care clinic reporting that shortly after the child developed a fever, his voice became muffled, and he began drooling. Inspiratory stridor is present. The priority action of the healthcare provider is to:

300

A) Monitoring elimination B) Encouraging rest C) Promoting mobility D) Assessing pain

A child is admitted to the pediatric unit with a diagnosis of pertussis. Which of the following is the priority when planning care for the child?

400

A) Document this as a normal finding B) Assess the degree of cervical dilation C) Assist the woman to lay on her left side D) Administer oxygen by nasal cannula

When evaluating the fetal heart rate (FHR) pattern for a woman in active labor, the healthcare provider notes periodic decelerations in the FHR with the following characteristics: Gradual decrease in FHR Onset just prior to the uterine contraction 120 beats/minute at the peak of the uterine contraction Waveform inversely mirrors uterine contraction What is the healthcare provider’s priority action?

500

A) Abruptio placentae B) Threatened abortion C) Placenta previa D) Preterm labor

A woman is admitted to the obstetric unit at 30 weeks gestation with a sudden onset of vaginal bleeding that is bright red in color. Her uterus is soft and her pain report is 0 on a 0 - 10 pain scale. The fetal heart rate is 140 beats/minute. The healthcare provider correctly identifies these assessment findings are related to which of the following problems?

Pulm

100

A) Increased crackles auscultation bilaterally B) A high pressure alarm sounds C) Decreased breath sounds on the left side of the chest D) Low pressure alarm sounds

The healthcare provider is caring for a patient on a ventilator with an endotracheal tube in place. What assessment data indicate the tube has migrated too far down the trachea?

200

A) Obtain an arterial blood gas immediately B) Raise the head of the bed to a 45 degree angle C) Notify the health care provider of the patient’s status D) Administer 100%, percent oxygen per nasal cannula

A patient is dyspneic with a respiratory rate of 26 breaths per minute. What is the healthcare provider’s first action?

300

A) Asymmetrical chest expansion B) Circumoral cyanosis C) Hypoxemia unresponsive to supplemental oxygen D) Pink, frothy sputum

The healthcare provider’s assessment of the patient includes rapid, shallow respirations, respiratory alkalosis, and inspiratory crackles. Which additional assessment finding would confirm a diagnosis of acute respiratory distress syndrome (ARDS)?

400

A) Perform a complete respiratory assessment B) Apply ice to the patient’s calf C) Elevate the extremity D) Massage the patient’s calf

The healthcare provider is caring for a patient recovering from a broken femur. When assessing the unaffected leg, edema is noted and the patient complains of calf pain. Which of the following interventions should be included in the plan of care?

500

A) Provide oral care and suctioning to the patient B) Maintain intubation for no more than 72 hours C) Give prophylactic antibiotics D) Discourage patient visitors

In order to prevent ventilator associated/ acquired pneumonia (VAP) in an intubated patient, the healthcare provider should:

Other

100

A) Dry mouth B) Bradycardia C) Urinary retention D)Paresthesia

The healthcare provider is performing an assessment on a patient who is taking propranolol (Inderal) for supraventricular tachycardia. Which assessment finding is an indication the patient is experiencing an adverse effect of this drug?

200

A) Dyspnea, malaise, and hypotension B) Bruising, fatigue, and bone pain C) Paresthesia, facial rash, and abdominal pain D) Bradycardia, hypotension, and palpitations

A patient has recently been diagnosed with leukemia. Which of the following symptoms would a health care professional expect to see given this diagnosis?

300

A) Cool and pale skin B) Increased systolic blood pressure C) Poor skin turgor D) Bradycardia

After falling from a 10ft ladder, a patient is brought to the emergency department. The patient is alert, reports back pain, and difficulty moving the lower extremities. Which additional observation is an indication the patient may be experiencing neurogenic shock?

400

A) Distribution B) Metabolism C) Excretion D) Absorption

A patient is admitted to the medical unit with a diagnosis of hepatitis. When preparing to administer intravenous medications, the healthcare provider understands that the patient’s diagnosis primarily impacts which phase of pharmacokinetics?

500

A) Serotonin B) Glutamate C) Norepinephrine D) Dopamine

A patient who is diagnosed with Parkinson disease (PD) states, “I can’t tie my shoelaces anymore.” The healthcare provider recognizes that this patient’s problem is due to a deficiency in which of these neurotransmitters?

Education

100

A) “Every morning I will perform arm and shoulder stretches.” B) “Each day I’ll take my pulse and record it in a log.” C) “I’ll have to get rid of my microwave oven.” D) “I won’t be able to use my electric blanket anymore.”

A patient is being discharged after the insertion of a permanent pacemaker. Which statement made by the patient indicates an understanding regarding appropriate self-care?

200

A) “Since the vaccine is the live virus, I can expect to be ill for 4-7 days after receiving my shot.” B) “Influenza vaccines are a cure for the flu.” C) “The vaccine is an inactivated virus, but may cause some mild cold-like symptoms.” D) “If I have already had the vaccine last year, it is not recommended that I get it again this year.”

The healthcare provider understands that teaching has been effective when the patient verbalizes the following regarding influenza vaccinations:

300

A) Mycoplasma B) Human papillomavirus C) Influenza D) Streptococcus pneumoniae

The healthcare provider is conducting teaching during a health fair about the causes of pneumonia. The healthcare provider demonstrates understanding of the causes when she states that community acquired pneumonia (CAP) can be caused by all of the following except:

400

A) The vaccine is not recommended for older adults. B) The vaccine effectiveness depends on the characteristics of the individual and how close the vaccine matches the current strain. C) The vaccine can reduce the incidence of influenza by 60% D) The vaccine does not protect against other viruses.

The healthcare provider understands that further teaching on the Influenza vaccine is needed when the patient states:

500

A) “I should use the enteric-coated aspirin to reduce the risk of bleeding.” B) “I will call the clinic if I experience a ringing sound in my ears.” C) “I can stop taking my anti-lipid medication now that I’m taking aspirin.” D) “If I experience stomach upset I can take the aspirin with an antacid.”

A patient with a history of transient ischemic attacks (TIA) is prescribed low dose aspirin daily. Which of the following statements made by the patient indicates the teaching about this medication has been successful?