INP402 EpicCare Inpatient Clinic Exam | Questions with 100% Correct
Answers | Verified | Latest Update
Question 1: A 68-year-old male with a history of COPD and heart failure is admitted to the
inpatient medical unit with an exacerbation of dyspnea. The nurse reviews the EpicCare
Inpatient flowsheet and notes the p atient's SpO2 has dropp ed from 94% to 88% on a 2L
nasal cannula, and his respiratory rate has increased to 28 breaths/min. The p atient is using
accessory muscles and app ears anxious. Which action should the nurse p rioritize?
A. Increase the oxygen flow rate to 6L via nasal cannula and reassess in 15
minutes.
B. Administer the prescribed PRN albuterol nebulizer treatment and elevate the
head of the bed.
C. Apply a non-rebreather mask at 15L/min to rapidly correct the hypoxemia.
D. Call a rapid response team immediately and prepare for endotracheal
intubation.
CORRECT ANSWER: B. Administer the prescribed PRN albuterol nebulizer
treatment and elevate the head of the bed.
Rationale: The patient is experiencing a COPD exacerbation with increased
work of breathing. Elevating the head of the bed and administering a
bronchodilator are priority interventions to improve airway patency and
ventilation. High-flow oxygen (Options A and C) can suppress the hypoxic drive
in COPD patients, and a rapid response (Option D) is premature before trying
prescribed PRN interventions.
Question 2: A nurse is caring for a patient who is 12 hours post-operative
following a total thyroidectomy. The patient suddenly develops a muffled voice
and complains of a tingling sensation around the lips and fingertips. Upon
assessment, the nurse notes a positive Chvostek's sign. Which order should the
nurse anticipate implementing first?
A. Administer IV calcium gluconate as prescribed.
B. Prepare the patient for immediate surgical exploration of the neck.
C. Administer IV levothyroxine to correct the suspected hormonal deficit.
D. Document the findings and continue to monitor the patient's vital signs.
CORRECT ANSWER: A. Administer IV calcium gluconate as prescribed.
Rationale: The patient is exhibiting signs of acute hypocalcemia (tingling,
positive Chvostek's sign), a common complication of thyroidectomy due to
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,accidental removal or damage to the parathyroid glands. IV calcium gluconate is
the priority treatment to prevent laryngospasm and tetany. Surgical exploration
is for hematoma causing airway compromise, and levothyroxine treats
hypothyroidism, not acute hypocalcemia.
Question 3: A patient with a traumatic hemothorax has a chest tube connected
to a closed drainage system. The nurse observes continuous, vigorous bubbling
in the water seal chamber. Which interpretation and action are correct?
A. This is an expected finding indicating that the lung has fully re-expanded.
B. This indicates an air leak in the drainage system or the patient's pleural space;
the nurse should assess the connections.
C. This indicates that the suction regulator is set too high; the nurse should
decrease the wall suction.
D. This is a sign of a resolving pneumothorax; the nurse should clamp the chest
tube for 1 hour.
CORRECT ANSWER: B. This indicates an air leak in the drainage system or the
patient's pleural space; the nurse should assess the connections.
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Intermittent bubbling is expected and corresponds with the patient's respiratory
cycle (indicating air being evacuated). The nurse should systematically assess the
tubing connections and the insertion site to locate the leak. Clamping a chest
tube with an air leak is contraindicated as it can cause a tension pneumothorax.
Question 4: A 55-year-old patient is admitted to the ICU with severe sepsis
secondary to a urinary tract infection. The patient's blood pressure is 82/44
mmHg, heart rate is 122 bpm, and lactate is 4.5 mmol/L. The provider orders a
30 mL/kg IV fluid bolus of normal saline. What is the primary physiological goal
of this intervention?
A. To increase the oxygen-carrying capacity of the blood.
B. To decrease the systemic vascular resistance and reduce afterload.
C. To increase intravascular volume, improve tissue perfusion, and clear lactate.
D. To provide a source of calories for the hypermetabolic state of sepsis.
CORRECT ANSWER: C. To increase intravascular volume, improve tissue
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,perfusion, and clear lactate.
Rationale: In septic shock, profound vasodilation and capillary leak lead to
relative hypovolemia and inadequate tissue perfusion (evidenced by elevated
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, lactate). Rapid IV fluid resuscitation increases preload and intravascular volume
to restore cardiac output and tissue oxygenation.
Question 5: A patient with heart failure is receiving digoxin 0.25 mg IV daily.
Before administering the medication, the nurse reviews the patient's latest
laboratory results in the Epic EHR. Which laboratory value requires the nurse to
hold the medication and notify the provider?
A. Serum sodium of 138 mEq/L.
B. Serum potassium of 3.1 mEq/L.
C. Serum creatinine of 0.9 mg/dL.
D. Digoxin trough level of 1.2 ng/mL.
CORRECT ANSWER: B. Serum potassium of 3.1 mEq/L.
Rationale: Hypokalemia (normal 3.5-5.0 mEq/L) increases the risk of digoxin
toxicity by enhancing digoxin binding to the myocardium, which can precipitate
life-threatening dysrhythmias. The nurse should hold the digoxin and request a
potassium replacement order. The other values are within normal limits or
therapeutic ranges.
Question 6: A patient with a closed head injury is being monitored in the neuro-
ICU. The nurse notes that the patient's Glasgow Coma Scale (GCS) score has
decreased from 14 to 9 over the past two hours, and the right pupil is now 5 mm
and non-reactive, compared to the left pupil which is 3 mm and reactive. What
is the nurse's priority action?
A. Elevate the head of the bed to 45 degrees and apply a cold compress to the
forehead.
B. Perform a comprehensive neurological assessment and document the
findings in the flowsheet.
C. Notify the neurosurgery provider immediately and prepare the patient for an
emergent CT scan.
D. Administer a prescribed PRN dose of IV mannitol and recheck the pupils in 30
minutes.
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Answers | Verified | Latest Update
Question 1: A 68-year-old male with a history of COPD and heart failure is admitted to the
inpatient medical unit with an exacerbation of dyspnea. The nurse reviews the EpicCare
Inpatient flowsheet and notes the p atient's SpO2 has dropp ed from 94% to 88% on a 2L
nasal cannula, and his respiratory rate has increased to 28 breaths/min. The p atient is using
accessory muscles and app ears anxious. Which action should the nurse p rioritize?
A. Increase the oxygen flow rate to 6L via nasal cannula and reassess in 15
minutes.
B. Administer the prescribed PRN albuterol nebulizer treatment and elevate the
head of the bed.
C. Apply a non-rebreather mask at 15L/min to rapidly correct the hypoxemia.
D. Call a rapid response team immediately and prepare for endotracheal
intubation.
CORRECT ANSWER: B. Administer the prescribed PRN albuterol nebulizer
treatment and elevate the head of the bed.
Rationale: The patient is experiencing a COPD exacerbation with increased
work of breathing. Elevating the head of the bed and administering a
bronchodilator are priority interventions to improve airway patency and
ventilation. High-flow oxygen (Options A and C) can suppress the hypoxic drive
in COPD patients, and a rapid response (Option D) is premature before trying
prescribed PRN interventions.
Question 2: A nurse is caring for a patient who is 12 hours post-operative
following a total thyroidectomy. The patient suddenly develops a muffled voice
and complains of a tingling sensation around the lips and fingertips. Upon
assessment, the nurse notes a positive Chvostek's sign. Which order should the
nurse anticipate implementing first?
A. Administer IV calcium gluconate as prescribed.
B. Prepare the patient for immediate surgical exploration of the neck.
C. Administer IV levothyroxine to correct the suspected hormonal deficit.
D. Document the findings and continue to monitor the patient's vital signs.
CORRECT ANSWER: A. Administer IV calcium gluconate as prescribed.
Rationale: The patient is exhibiting signs of acute hypocalcemia (tingling,
positive Chvostek's sign), a common complication of thyroidectomy due to
Page 1 of 276
,accidental removal or damage to the parathyroid glands. IV calcium gluconate is
the priority treatment to prevent laryngospasm and tetany. Surgical exploration
is for hematoma causing airway compromise, and levothyroxine treats
hypothyroidism, not acute hypocalcemia.
Question 3: A patient with a traumatic hemothorax has a chest tube connected
to a closed drainage system. The nurse observes continuous, vigorous bubbling
in the water seal chamber. Which interpretation and action are correct?
A. This is an expected finding indicating that the lung has fully re-expanded.
B. This indicates an air leak in the drainage system or the patient's pleural space;
the nurse should assess the connections.
C. This indicates that the suction regulator is set too high; the nurse should
decrease the wall suction.
D. This is a sign of a resolving pneumothorax; the nurse should clamp the chest
tube for 1 hour.
CORRECT ANSWER: B. This indicates an air leak in the drainage system or the
patient's pleural space; the nurse should assess the connections.
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Intermittent bubbling is expected and corresponds with the patient's respiratory
cycle (indicating air being evacuated). The nurse should systematically assess the
tubing connections and the insertion site to locate the leak. Clamping a chest
tube with an air leak is contraindicated as it can cause a tension pneumothorax.
Question 4: A 55-year-old patient is admitted to the ICU with severe sepsis
secondary to a urinary tract infection. The patient's blood pressure is 82/44
mmHg, heart rate is 122 bpm, and lactate is 4.5 mmol/L. The provider orders a
30 mL/kg IV fluid bolus of normal saline. What is the primary physiological goal
of this intervention?
A. To increase the oxygen-carrying capacity of the blood.
B. To decrease the systemic vascular resistance and reduce afterload.
C. To increase intravascular volume, improve tissue perfusion, and clear lactate.
D. To provide a source of calories for the hypermetabolic state of sepsis.
CORRECT ANSWER: C. To increase intravascular volume, improve tissue
Page 2 of 276
,perfusion, and clear lactate.
Rationale: In septic shock, profound vasodilation and capillary leak lead to
relative hypovolemia and inadequate tissue perfusion (evidenced by elevated
Page 3 of 276
, lactate). Rapid IV fluid resuscitation increases preload and intravascular volume
to restore cardiac output and tissue oxygenation.
Question 5: A patient with heart failure is receiving digoxin 0.25 mg IV daily.
Before administering the medication, the nurse reviews the patient's latest
laboratory results in the Epic EHR. Which laboratory value requires the nurse to
hold the medication and notify the provider?
A. Serum sodium of 138 mEq/L.
B. Serum potassium of 3.1 mEq/L.
C. Serum creatinine of 0.9 mg/dL.
D. Digoxin trough level of 1.2 ng/mL.
CORRECT ANSWER: B. Serum potassium of 3.1 mEq/L.
Rationale: Hypokalemia (normal 3.5-5.0 mEq/L) increases the risk of digoxin
toxicity by enhancing digoxin binding to the myocardium, which can precipitate
life-threatening dysrhythmias. The nurse should hold the digoxin and request a
potassium replacement order. The other values are within normal limits or
therapeutic ranges.
Question 6: A patient with a closed head injury is being monitored in the neuro-
ICU. The nurse notes that the patient's Glasgow Coma Scale (GCS) score has
decreased from 14 to 9 over the past two hours, and the right pupil is now 5 mm
and non-reactive, compared to the left pupil which is 3 mm and reactive. What
is the nurse's priority action?
A. Elevate the head of the bed to 45 degrees and apply a cold compress to the
forehead.
B. Perform a comprehensive neurological assessment and document the
findings in the flowsheet.
C. Notify the neurosurgery provider immediately and prepare the patient for an
emergent CT scan.
D. Administer a prescribed PRN dose of IV mannitol and recheck the pupils in 30
minutes.
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