Exam Review
- The nurse is rounding on a patient diagnosed with heart failure (HF). The patient is receiving 1 liter of 0.9% sodium chloride at 150 ml/hr with two hours left on the infusion. The nurse observes that the patient has a moist cough, distended neck veins, and dyspnea. What actions should the nurse take? Select all that apply by choosing the three highest priority nursing actions for this patient.(SATA)A)Check the patient's temperatureB)Assess the pulse oximetry readingC)Auscultate the lungsD)Contact the providerE)Change the fluids to 0.45% sodium chlorideF)Administer furosemide as ordered
- The nurse is caring for a patient with a chest tube that is connected to a water seal drainage system. The nurse observes the chest tube is disconnected from the chest tube drainage system. Which of the following actions should the nurse take first?A)Assess how the chest tube became disconnected from the drainage systemB)Place the end of the chest tube into a container of sterile waterC)Apply an occlusive dressing to the chest tube insertion siteD)Auscultate the lung sounds
- The nurse is preparing medications for a patient who is being intubated. The provider orders succinylcholine 60 mg IV and etomidate 15 mg IV. Using the images of the vials below (also in attachments), calculate the amount of succinylcholine that you will draw into the syringe in milliliters and write it in the first blank here ▾ Succinylcholine: 3 mL. Next, calculate the amount of etomidate that you will draw into the syringe in milliliters and write it in the second blank here ▾ Etomidate: 7.5 mL. Last, in the third blank, write the name of the medication that you will give first here▾ Medication given first: Etomidate.Dropdown 1:Option 1: Succinylcholine: 3 mLOption 2: Etomidate: 7.5 mLOption 3: Medication given first: EtomidateDropdown 2:Option 1: Succinylcholine: 3 mLOption 2: Etomidate: 7.5 mLOption 3: Medication given first: EtomidateDropdown 3:Option 1: Succinylcholine: 3 mLOption 2: Etomidate: 7.5 mLOption 3: Medication given first: Etomidate
- When entering the room of a patient who has a chest tube attached to a water-seal drainage system, the nurse observes the chest tube is lying on the floor. Which of the following actions should the nurse take first?A)Reinsert the tube into the chest tube insertion siteB)Insert the end of the chest tube in a container of sterile waterC)Auscultate the lung sounds in bilateral lung fieldsD)Apply a sterile dressing to the chest tube insertion site
Exam Review
- The nurse is caring for a patient on mechanical ventilation. Which of the following must the nurse implement to prevent ventilator-associated pneumonia (VAP)? Drag and Drop Directions: Click and drag the correct answer choices from the Possible Answers box on the left to the Correct Answers box on the right. More than one answer may be chosen.(SATA)A)Provide oral care every 12 hoursB)Monitor ETT cuff pressureC)Insert a nasogastric tubeD)Administer high doses of sedationE)Maintain head of the bed to at least 30 degrees
- A patient has returned to the cardiac step-down unit following a percutaneous intervention (PCI). The nurse observes that the patient has bleeding at the right-sided femoral sheath site. What is the nurses' first action?A)Perform a sterile dressing changeB)Call a rapid responseC)Assess the patient's pain levelD)Apply pressure to the right femoral site
- An ICU nurse is at the nurse's station when they suddenly hear their patient's ventilator alarming. Which actions should the nurse take when responding to ventilator alarms? Select all that apply.(SATA)A)Immediately silence the alarm so the patient can restB)Check the ventilator tubing connectionsC)Assess the client's respiratory statusD)Adjust the ventilator settings to stop the alarmE)Call the respiratory therapist
- A patient is hospitalized with a second episode of pulmonary embolism (PE) despite anticoagulation therapy. What is the nurse's best action?A)Teach the patient to use a soft bristled toothbrushB)Instruct the patient to eliminate vitamin K from the dietC)Perform a medication reconciliationD)Refer the patient to a chronic illness support group
Exam Review
- A nurse provides care to a client with COPD, what symptoms does the nurse anticipate? Directions for drag and drop: Click and drag the possible answers from the left box to the right to indicate your answers.(SATA)A)Increased urine outputB)Sudden onset of shortness of breathC)Chest pain that worsens with deep breathingD)Muscle weaknessE)HypotensionF)Decreased heart rateG)Coughing up blood
- A nurse is planning care for a patient with a flail chest. Which of the following interventions are appropriate for this patient? Select all that apply. Directions for Drag and Drop: Click and drag the correct possible answers from the left box to the right to indicate your answer.(SATA)A)Administering high-flow oxygen therapyB)Administering analgesics for pain reliefC)Encouraging deep breathing and coughing exercisesD)Prepare for the need for intubationE)Encouraging the patient to lie flat on their back
- A nurse is caring for a patient with a diagnosis of myocardial infarction (MI), who reports chest pain 8/10. The nurse administers a sublingual nitroglycerin tablet as prescribed. After 5 minutes, the chest pain is 6/10. What action does the nurse take first?A)Check the blood pressureB)Start a nitroglycerin IV infusionC)Administer another nitroglycerin tabletD)Increase the flow rate of the oxygen to 3L via NC
- A patient with a medical history of COPD is admitted with pneumonia with a right-sided pleural effusion. At 1130 the patient returns to the unit after a thoracentesis. Which assessment finding is the highest priority?A)Respiratory rate of 28B)Pain 10/10 at the procedural siteC)Blood pressure 102/56D)O2 saturation 93% on 2L/NC
Exam Review
- A postoperative client is receiving intravenous heparin for a pulmonary embolism. The nurse observes frank red blood in the client's foley catheter bag. Which medication will the nurse prepare to administer?A)GemfibrozilB)Vitamin KC)Protamine sulfateD)Thromboplastin
- The critical care nurse is assessing a patient for readiness to be weaned from the ventilator. Which of the following indicates that the patient is most likely to have successful weaning from the ventilator?A)The patient is alert and oriented x 2B)The rapid shallow breathing index (RSBI) is 40C)The systolic blood pressure is less than 200 mmHgD)The pulse oximetry is at least 85% on the ventilator
- The nurse is monitoring the central venous pressure (CVP) of a patient with heart failure. The nurse observes that the reading is 12 mmHg. What is the nurse's best action?A)Call the provider to report that the reading is low and the patient needs 0.9% sodium chlorideB)Document the finding as within normal limitsC)Call the provider to report that the reading is high and the patient may need a furosemideD)Document the finding as abnormal
- A nurse is caring for a patient who was admitted for COPD exacerbation. Which of the following manifestations most likely suggestive of the development of respiratory distress? Select all that apply.A)TachycardiaB)DyspneaC)Muscle TremorsD)DiaphoreticE)Unable to speak in full sentencesF)Nausea
Exam Review
- The ED nurse is assessing a 48-year-old female (sex at birth) client who has a history of diabetes. Which of the following signs and symptoms would cause the nurse to expect that the client may be experiencing a myocardial infarction? Select all that apply.A)NauseaB)Increased urinary outputC)Excessive thirstD)HeartburnE)Palpitations
- The nurse is developing the plan of care to include prevention of foot drop for a patient on a mechanical ventilator who is sedated. What intervention should the nurse include in the plan of care?A)Perform passive range of motion (ROM) every 8 hoursB)Massage the feet every 2 hoursC)Elevate bilateral lower legs with pillowsD)Place orthopedic splints on the patient's feet
- The nurse assigned a patient who was diagnosed with a pulmonary embolism. Which of the following potential complication during the treatment for pulmonary embolism should the nurse monitor for?A)HyperglycemiaB)HemorrhageC)Septic shockD)Urinary retention
- The nurse is caring for a client who presents to the emergency department with chest pain, nausea, and diaphoresis. The client's blood pressure is 168/94. The nurse observes the following cardiac rhythm (see the 6-second rhythm strip below and in the attachment). What is the priority medication for this client?A)Adenosine 6 mg IVB)Nitroglycerin 0.4 mg sublingualC)Metoprolol 5 mg IVD)Ondansetron 4 mg sublingual
Exam Review
- The nurse is caring for a patient and observes the following rhythm on the monitor (see image below or in the attachment for a 6-second rhythm strip). The patient has a blood pressure of 98/56 mmHg and complains of dizziness and chest pain. What intervention should the nurse expect to implement first?A)Administer dopamine 5 mog/kg/minB)Administer atropine 0.5 mg IVC)Administer amiodarone 150 mg IVD)Prepare the patient for cardioversion
- The nurse is assessing the level of sedation for a patient who is intubated and receiving mechanical ventilation. The nurse observes that the patient's RASS (see RASS tool below or in the attachment) is +2. What is the nurse's best action?A)Place restraints on the patientB)Instruct the patient to be calmC)Call the providerD)Increase the rate of the patient's sedative drip
- The nurse is caring for a patient and observes the following rhythm on the monitor (see image below or in the attachment for a 6-second rhythm strip). The patient is alert and oriented x3, has a blood pressure of 105/56 mmHg, and denies chest pain. What action should the nurse take first?A)Prepare the patient for a transvenous pacemakerB)Prepare the patient for cardioversionC)Document that the patient is in normal sinus rhythmD)Contact the provider
- An ICU nurse is caring for a patient who is at risk for ICU delirium. What is the best method for the nurse to assess this patient for delirium?A)Assess the Level of Consciousness (LOC)B)Richmond Agitation and Sedation Scale (RASS)C)Glasgow Coma Scale for the ICU (GCS)D)Confusion Assessment Method for the ICU (CAM-ICU)