NUR 185 Final Exam Term 4 |2023/2024
Patient with CHF, what lab value would you pay attention to? - ANSW- Potassium
Patient with stroke and R sided vision loss. You plan to do which of the following? -
ANSW- Teach the patient to scan the environment
Patient with bowl tumor. Which diagnostic test would confirm the malignancy? - ANSW-
Biopsy
Patient getting Antineoplastic (Chemo). What would you include in their plan of care? -
ANSW- Consult the physicians before getting immunizations
Patient has upper GI bleeding and in moderate distress. What is your first priority? -
ANSW- Obtain and evaluate vital signs
You have a patient with pulmonary edema about to be discharged. What would you tell
them to manage and prevent complications? - ANSW- Daily weights
You have given patient benedryl and then educate the patient on this medication. Which
statement indicates need for further teaching? - ANSW- I can still take my sleeping pill
with my benedryl
The nurse is caring for patient with terminal cancer and close to death. What is the
priority intervention for this patient? - ANSW- Provide emotional support for loved ones
(Answer D)
Patient with chronic vertigo. Teaching them about preventions of exacerbations or
injury. What would you educate the patient on? - ANSW- Turn your head slowly to
minimize vertigo.
Teaching a patient how to use a walker. What statement would the nurse question? -
ANSW- Be certain there is a 45 degree angle of flexion at the elbow to ensure
adequate length of the walker
You have a patient from the OR following hip replacement. Patient is in bed in high-
fowlers. Skin is pale, cold, and clammy. What actions would you take at this time? -
ANSW- Check the blood pressure.
You have 4 patients in long-term care facility. Which patient would be priority? - ANSW-
29 year old patient with down syndrome. 1 week post op temp of 101, pulse 110,
shivering.
, You have a patient on the coumadin 3MG a day. INR today is 1.2 (low). What order
would you carry out? - ANSW- Give 5MG coumadin today (to offset the imbalance)
Caring for diabetic patient who just took shower. HR is 70, skin is warm and dry. You
take their BS and it is 42. What would you do? - ANSW- Go get a new glucose test
and recheck.
You have a patient that just vomited coffee ground emesis. 350 ML on the floor.
(indicative of GI bleed) on the cardiac floor on heparin drip. What are you going to do? -
ANSW- Stop the heparin drip, give vitals, and provide emotional support (one answer)
A patient has started on a new med and developed hives and angioedema. This is their
3rd dose of medication and states "I did have some itching with the second dose". What
would the nurse do now? - ANSW- Give the patient a dose of EPI IM stat per physician
order.
What are burn patients at high risk for? - ANSW- High risk for sepsis (that is all you
need to know)
Anytime you are at risk for infections - ANSW- Tetanus is good for up to 10 years
You have a patient getting gentamicin (geromycin) IV. What lab from this morning are
you going to be concerned about? - ANSW- Creatinine of 5.1
What acronym would you use for a fire extinguisher? - ANSW- PASS (Point AIM,
squeeze, sweep)
You are giving med to G tube patient. What would concern you the most? - ANSW-
Purulent drainage
Nurse notices a trashcan with papers caught on fire. You will do what action first? -
ANSW- Grab an ABC fire extinguisher and aim at the base of the fire.
Patient admitted to ED with chest pain. They have several coronary artery risk factors.
What will you implement? - ANSW- EKG within 10 minutes and give chewable aspirin
if they are not allergic.
You gave a patient morphine 1 hour ago. You are most concerned about which
assessment? - ANSW- BP of 94/60 pulse ox of 88, patient is lethargic.
You have a patient who had an MI. Which lab are greatest concern to the nurse? -
ANSW- Sodium of 133 and magnesium of 1.3
You go into a patient's room and there is a fire in the corner. The ambulatory patient is
asleep. What are you going to do? - ANSW- Wake up the patient up and get them out
of the room as quickly as possible.
Patient with CHF, what lab value would you pay attention to? - ANSW- Potassium
Patient with stroke and R sided vision loss. You plan to do which of the following? -
ANSW- Teach the patient to scan the environment
Patient with bowl tumor. Which diagnostic test would confirm the malignancy? - ANSW-
Biopsy
Patient getting Antineoplastic (Chemo). What would you include in their plan of care? -
ANSW- Consult the physicians before getting immunizations
Patient has upper GI bleeding and in moderate distress. What is your first priority? -
ANSW- Obtain and evaluate vital signs
You have a patient with pulmonary edema about to be discharged. What would you tell
them to manage and prevent complications? - ANSW- Daily weights
You have given patient benedryl and then educate the patient on this medication. Which
statement indicates need for further teaching? - ANSW- I can still take my sleeping pill
with my benedryl
The nurse is caring for patient with terminal cancer and close to death. What is the
priority intervention for this patient? - ANSW- Provide emotional support for loved ones
(Answer D)
Patient with chronic vertigo. Teaching them about preventions of exacerbations or
injury. What would you educate the patient on? - ANSW- Turn your head slowly to
minimize vertigo.
Teaching a patient how to use a walker. What statement would the nurse question? -
ANSW- Be certain there is a 45 degree angle of flexion at the elbow to ensure
adequate length of the walker
You have a patient from the OR following hip replacement. Patient is in bed in high-
fowlers. Skin is pale, cold, and clammy. What actions would you take at this time? -
ANSW- Check the blood pressure.
You have 4 patients in long-term care facility. Which patient would be priority? - ANSW-
29 year old patient with down syndrome. 1 week post op temp of 101, pulse 110,
shivering.
, You have a patient on the coumadin 3MG a day. INR today is 1.2 (low). What order
would you carry out? - ANSW- Give 5MG coumadin today (to offset the imbalance)
Caring for diabetic patient who just took shower. HR is 70, skin is warm and dry. You
take their BS and it is 42. What would you do? - ANSW- Go get a new glucose test
and recheck.
You have a patient that just vomited coffee ground emesis. 350 ML on the floor.
(indicative of GI bleed) on the cardiac floor on heparin drip. What are you going to do? -
ANSW- Stop the heparin drip, give vitals, and provide emotional support (one answer)
A patient has started on a new med and developed hives and angioedema. This is their
3rd dose of medication and states "I did have some itching with the second dose". What
would the nurse do now? - ANSW- Give the patient a dose of EPI IM stat per physician
order.
What are burn patients at high risk for? - ANSW- High risk for sepsis (that is all you
need to know)
Anytime you are at risk for infections - ANSW- Tetanus is good for up to 10 years
You have a patient getting gentamicin (geromycin) IV. What lab from this morning are
you going to be concerned about? - ANSW- Creatinine of 5.1
What acronym would you use for a fire extinguisher? - ANSW- PASS (Point AIM,
squeeze, sweep)
You are giving med to G tube patient. What would concern you the most? - ANSW-
Purulent drainage
Nurse notices a trashcan with papers caught on fire. You will do what action first? -
ANSW- Grab an ABC fire extinguisher and aim at the base of the fire.
Patient admitted to ED with chest pain. They have several coronary artery risk factors.
What will you implement? - ANSW- EKG within 10 minutes and give chewable aspirin
if they are not allergic.
You gave a patient morphine 1 hour ago. You are most concerned about which
assessment? - ANSW- BP of 94/60 pulse ox of 88, patient is lethargic.
You have a patient who had an MI. Which lab are greatest concern to the nurse? -
ANSW- Sodium of 133 and magnesium of 1.3
You go into a patient's room and there is a fire in the corner. The ambulatory patient is
asleep. What are you going to do? - ANSW- Wake up the patient up and get them out
of the room as quickly as possible.
