Prophecy health medical surgical RN A (Latest 2022/2023)

Prophecy health medical surgical RN A Which adaptive equipment would be most appropriate to use for a severely contracted patient who is unable to bear weight when transferring from bed to chair Patient Lift example hoyer What lab values are expected to be in a patient with end stage renal disease on hemodialysis BUN 32, CREATNINE 8.32 Your 85 year old patient with atrial fibrillation fell at home 3 days ago. You notice she has been having several episodes of acute confusion since being admitted to your unit. What is the most important order you should anticipate from the provider? You're? Hold wayfaring (coumadin) for the next 48 hours Your new admission presents with a cough, unintentional weight loss, frequent knot sweats, and bloody sputum. What type of isolation precautions should you initiate, if any? Airborne precautions Upon entering your patient's room you note that they are having a seizure. What is your 1st action? Position the patient on their side to maintain the airway You find your coworker looking through your patient's medical record.. She States how is Mr. Smith doing? He is my best friend's dad. We are so worried about him. What is the best course of action? Tell her you cannot give her information and report her actions to your manager. Your male patient complaints of discomfort while inflating the balloon during insertion of a endwelling urinary catheter. What would be the most appropriate action? Deflate the balloon, advance the catheter further, then reinflate the balloon. Your patient takes regular insulin and NPH twice A-day for glucose control. What times should the patient be taught to be alert for signs of hypoglycemia? Is late afternoon and early morning What is a proton pump inhibitor, such as pantoprazole (protonix) used for? Reduce gastric acid secretion Your patient has a non productive cough and presence of secretions in his tracheostomy. Prior to sectioning the patient, what should you do 1st? Hyperoxygenate patient dietary teaching for a patient with chronic renal failure should include choices that are: Low potassium, low protein, moderate fat Which of the following nursing diagnosis is most important for a patient with chronic obstructive pulmonary disease(COPD) Impaired gas exchange Your patient is admitted from the ED with failure to thrive and advanced dementia. You note he is extremely underweight, appears unbathed for some time, and has a stage 4 pressure injury to his coccyx. You were told in report that he lives at home with family members. What should you do? Notify the charge nurse and social worker of your concerns. You have a patient going for dialysis. There are medications include Lisinopril(prinivil), ondansetron (zofran), famotidine(pepcid) and atorvastatin(lipitor). Which medication would you possibly hold and seek clarification? LISINOPRIL(PRINIVIL) What is the best indication of an acute neurological problem? Change in level of consciousness Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? Clear liquids Which tool should you use to assess pain in your 80 year old patient with severe dementia? ? Your post op patient has a Jackson - Pratt drain in place. how do you ensure effective drain function? Compress the drain, then plug the bulb to establish suction. Is a patient with peritonitis Presents with tachycardia, hypotension , and dehydration. What other assessment finding would you anticipate as part of your physical assessment? Severe abdominal pain or rebound tenderness Your patient with a known history of diabetes is displaying symptoms of diaphoresis, Cool skin, lethargy, And shakiness. What is your 1st action? Check the patient's blood glucose level a patient on warfarin(Coumadin/jantoven) has an INR of 6. Which medication would you anticipate administering? Vitamin K While in a supine position your patient States" I'm tired and cannot catch my breath". Physical assessment reveals juggler vein distention and a 3rd heart sound(S3). These symptoms are indicative of what condition? Heart failure Upon entry to your patient's room, you find her sitting in high Fowler's Position and complaining of shortness of breath. Her respiratory rate is 34 breaths/minute And 02 sat is 84%. Which mode of oxygen delivery would most likely reverse the symptoms? Non rebreather mask Your patient continues to pull at their iv located in their left forearm despite verbal reminders And increased observation. The nursing assistant recommends using soft mitt Restraints on the patient. What is your recommendation? Request and order for soft mitts As they are the least restrictive.. What is an early symptom that a patient is developing a complication of heart failure? Edema in the legs and feet You were hired to work the medical unit and when you arrive at work the charge nurse has assigned you to the post surgical unit since they are under staffed. Which is the most appropriate action? Report to the post surgical unit What type of personal protective equipment(Ppe) Is applied prior to entering a room for a patient with with C diff? Gown and gloves When would sucralfate(Carafate) 4 times daily be scheduled for? 1 hour before meals and at bedtime Your new patient was admitted with Blunt force trauma to the abdomen Following a motor vehicle accident. A NG Tube is in place for decompression, however, you note during the assessment that the stomach is rigid and hard during palpation. What condition do you suspect. Hemorrhage What is clubbing of the fingers most likely associated with? Chronic oxygen deficiency Is your patient with hepatitis C Exhibits signs of jaundice and a distended abdomen. What procedure would you anticipate being performed by the provider at the bedside for this patient? Paracentesis Is the provider gives you a telephone order to explain a surgical procedure to your patient and obtain surgical consent. How should you respond? Inform the provider that explaining the procedure is outside the nurse's scope of practice. You're patient Recently had a G Tube Placed and interminent enteral Feedings have been initiated. What symptoms may indicate intolerance to the feedings? Vomiting and diarrhea You are caring for a patient post lobotomy With a chest tube in place for drainage. What is a priority in caring for this patient? Encourage the patient to cough and deep breathe. Your new patient understands very limited English. How should you communicate with them when completing the admission assessment? Use the organizations interpreter services You are ordered to give Digoxin(lanoxin). Your patience vital signs are BP 130/75, temp 97.9F, HR 52, RR 16, o2 sat 100% on room air. What should you do next? HOLD DIGOXIN AND CALL PROVIDER Your patient tells you I hope I don't die, but if I do I don't want to be brought back. You notice on her chart and wrist band that she is a full code. What would be the most appropriate action? Discuss code status with the patient and follow up with the provider to ensure the medical record reflects her wishes What are the most common causes of acute onset pancreatitis? Alcoholism and gallstones Your 18 year old female patient was admitted with dehydration secondary to anorexia nervosa. During your assessment you note she has a flat effect and says" I just want to die, I'm tired of my life ". What should be your 1st intervention? Stay with the patient and ask if she has a plan to carry out this wish A patient with diabetes who is receiving peritoneal dialysis Is at risk for which of the following? ? To reduce the risk of infection and phlebotomy in an adult patient with a peripherL IV, What is the minimum duration the catheter should remain in place before routine replacement. 72 hours Your patient was admitted for a hypertensive crisis and has a history of HTN. Parkinson disease, depression and alcohol use. On his 2nd hospitalized day, you notice he is more anxious and restless than his baseline. What would be your 1st nursing intervention? Ask the patient when his last drink of alcohol was Black and tarry Colored stools are classic symptoms of what condition? Bleeding gastric ulcer In addition to pain, pallor, and pulselssness, a neurovascular assessment Also includes checking for Parasthesia and paralysis After scrolling through your social media, you notice a coworker posted a photo with a patient from your unit. What is the most appropriate action to take? Report the situation to the hospital compliance officer. Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18. What blood product do you expect to administer? PRBCs What medication is contraindicated In a patient with A hemorrhagic CVA? Heparin Your patient appears dusky colored and you cannot palpate a pulse. What is the 1st thing you should do? Initiate a code per facility protocol and begin CPR Your 68 year old patient is a is a Type one diabetic with a history of schizophrenia And exhibit signs and symptoms of tardiness dyskinesia. Is what long term medication is associated with signs and symptoms of tardive dyskinesia? Chlorpromazine(thorazine) You received a report on a patient that sustained a right hemisphere CVA 48 hours ago. What do you expect the patient to exhibit? Lift sided weakness of the leg, arm, and face and face You have 4 patients who have high priority needs. One needs to go to surgery, 1 needs stat lab draws From a PICC line, Another has chest pain rated 8/10 And another needs toileting. Which patient should you tend to 1st? The patient with chest pain Your coworker posted photos on social media from a birthday party they had for her in the unit break room. What should be your next course of action? No action is necessary because no PHI was displayed. Is your patient with stage IV Terminal lung cancer continues to experience increasing pain as each day passes. What would you anticipate the provider ordering for this patient? Palliative care consult Your 72 Year old male patient is admitted for colon cancer Related complications and has a history of CHF, stroke and a recent Knee replacement.Based on your patient's risk assessment,You determine he is at risk for Venous thromboembolism (VTE) What is an appropriate VTE prophylaxis prophylaxis order for this patient? Enoxaparin(Lovenox) once daily and intermittent pneumatic compressions(IPC) 1.2 Milligrams is equal to how many micrograms 1200 mcg Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? Gown and gloves You are caring for a patient with history of diabetes mellitus. You walk into the room and find the patient lethargic and diaphoretic. What is your 1st action? Obtain capillary blood glucose level Your patient has symptomatic anemia but is refusing a blood transfusion for religious reasons. What is an appropriate response? Respect his wishes and notify the provider Your patient has a temp of 102.3 F, HR 122, and has had 15ml of urine from the indwelling urinary catheter in the last 2 hours. What is your patient most likely experiencing? ? Patients with diabetes are at a high risk for complications for damage in what body areas? Nerve and kidney damage Your patient is 4 hours post open appendectomy Anne has not voided yet. You note his lower abdomen is distended. What should you do next? Perform a bladder scan You receive a provider's order that is not consistent with evidence based practice.What is your 1st step? Clarify the order with the provider Is what is the earliest sign indicating increased intracranial pressure(ICP)? Level of consciousness What patient population is the pneumococcal vaccine PPSV23 indicated for? Adults aged 65 years and older Your patient takes 5 mg of warfarin(coumadin) day and reports having black cored stool today. What do you most likely suspect? Gastrointestinal bleeding Failed to capture question Failed to capture answer Failed to capture question Failed to capture answer