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You want to assess for jugular vein distention (JVD). What position would be BEST? -
ANSWERS-Position patient on their back with head of bed at 30 to 45 degrees.
Your patient with triple cardiac bypass surgery is post-op day 3. Chest tubes have been
removed. They suddenly report palpitations. Their blood pressure is 130/76 and heart
rate is 140 bpm. What would you do NEXT? -ANSWERS-Perform a bedside EKG
Your patient has a history of renal insufficiency. What class of analgesics would MOST
likely be contraindicated for them? -ANSWERS-Nonsteroidal anti-inflammatory
medications
Your patient with cardiac bypass surgery is post-op day 2. The nursing assistant reports
that your patient has a temp of 101.3°F and blood pressure of 82/56. Their urine output
has decreased to less than 30 mL in the past 4 hours. You suspect a post-surgery
complication. After calling the physician you receive orders for STAT CBC, CMP, and
coagulation test. What results would you expect to see after these labs are completed?
-ANSWERS-WBC greater than 19,000
What is an adequate amount of urine output? -ANSWERS-30 mL/hr
Your patient has left ventricular failure. What clinical manifestations would you expect to
see? -ANSWERS-Dyspnea, distant heart sounds, bilateral crackles
You are caring for your patient with an order for furosemide 80 mg BID. What would be
your MOST appropriate action? -ANSWERS-Call provider to clarify the order.
, Your patient is in cardiac arrest. Chest compressions are being performed.
Capnography indicates the end-tidal CO2 is 18 mmg. What do the capnography results
indicate about the chest compressions? -ANSWERS-No changes. These are high
quality compressions.
What is required before making a report of elder abuse? -ANSWERS-Suspicion of
abuse
You receive your patient with pneumonia from the ED. Antibiotics and steroids have
been initiated by the provider. The patient reports abdominal pain and has a large loose
bowel movement. They inform you this is their third bowel movement in the last two
hours. What would you do FIRST? -ANSWERS-Initiate enteric contact isolation
precautions for possible C. diff
Your patient has developed sepsis from an indwelling urinary catheter. What would be
your PRIORITY intervention? -ANSWERS-Remove catheter.
Your patient is in third degree heart block. What treatment would you MOST likely
expect to be implemented? -ANSWERS-Pacemaker
What are 2 nursing interventions to prevent venous thromboembolism? -ANSWERS-•
Adequate hydration and early mobilization.
• Hemodynamic monitoring and early mobilization. (Wrong)
• Adequate hydration and encouraging a steady amount of green leafy vegetables in
diet.
• Hemodynamic monitoring and encouraging a steady amount of green leafy vegetables
in diet.
Your patient is post left pneumonectomy. They have a chest tube in place for drainage.
What would be a PRIORITY in your care? -ANSWERS-Encourage patient to cough and
deep breathe