RN Adult Medical Surgical Online Practice
2023-2024 A NGN. All Questions & Correct
Answers. Graded A+
0530:
Client is awake and alert.
Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated
for bruit. Lung sounds clear upon auscultation; client denies shortness of breath.
No peripheral edema noted; capillary refill is less than 3 seconds; +2 bilateral
pedal and radial pulses.
AVF access prepared and cannulated twice with no difficulty. Lines are taped and
secured; treatment is initiated.0600:
Client is reading a book. Access is visible, and lines are secure. Client reports no
discomfort or pain.0630:
Client reports feeling warm, nauseated, and lightheaded; appears restless and
slightly confused. - ANSPerform a 12-lead ECG is not indicated.
Place the client in Trendelenburg position is indicated.
,Administer a 0.9% sodium chloride 200 mL IV bolus is indicated.
Apply oxygen at 2 L/min via nasal cannula is indicated
Notify the provider immediately is indicated
Obtain the client's blood glucose level is not indicated.
1000:Client presents to the ED with visual disturbances, expressive aphasia, and
numbness and tingling of the lips. Manifestations started about 30 min ago. Client
reports flashing lights in their vision, especially on the right side.
Client's partner states the client had some difficulty with finding words when
speaking.
Client is alert and oriented x 3 and appears anxious. No facial drooping noted.
Right hand grasp is weaker than left. Client denies pain. - ANSHand grasps is
consistent with migraine, stroke, and meningitis.
Numbness is consistent with migraine and stroke.
,Aphasia is consistent with migraine and stroke.
Visual changes are consistent with migraine, stroke, and meningitis.
Family history is consistent with migraine and stroke.
1800:
Emergency medical team removed client's shirt at the scene and initiated 18-
gauge IV therapy in the right antecubital space.
Client has full-thickness burns over the upper half of the chest and both forearms;
partial-thickness burns are present on the client's face and neck.
Sinus tachycardia, pulses to brachial extremities palpable. 1+ edema to upper
extremities.
Respirations even, labored with scattered rhonchi. Soot noted to the client's
mouth and nose. Oxygen 40% via face tent applied.
Hypoactive bowel sounds.
16 French indwelling urinary catheter inserted with return of 250 mL of yellow
urine.
, Lactated Ringer's infusing to right antecubital. Provider preparing to insert right
femoral central line catheter.
1830:
Client's voice is becoming hoarse and reports difficulty swallowing. Wheezes
present to upper lobes bilaterally. Provider notified. Client positioned upright,
oxygen via face tent. Blood collected - ANSDuring the emergent phase of burn
care, the client is at risk for developing
hypovolemia
and
respiratory failure
.
1NGN
000:Client presents to the ED with visual disturbances, expressive aphasia, and
numbness and tingling of the lips. Manifestations started about 30 min ago. Client
reports flashing lights in their vision, especially on the right side.
Client's partner states the client had some difficulty with finding words when
speaking.
2023-2024 A NGN. All Questions & Correct
Answers. Graded A+
0530:
Client is awake and alert.
Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated
for bruit. Lung sounds clear upon auscultation; client denies shortness of breath.
No peripheral edema noted; capillary refill is less than 3 seconds; +2 bilateral
pedal and radial pulses.
AVF access prepared and cannulated twice with no difficulty. Lines are taped and
secured; treatment is initiated.0600:
Client is reading a book. Access is visible, and lines are secure. Client reports no
discomfort or pain.0630:
Client reports feeling warm, nauseated, and lightheaded; appears restless and
slightly confused. - ANSPerform a 12-lead ECG is not indicated.
Place the client in Trendelenburg position is indicated.
,Administer a 0.9% sodium chloride 200 mL IV bolus is indicated.
Apply oxygen at 2 L/min via nasal cannula is indicated
Notify the provider immediately is indicated
Obtain the client's blood glucose level is not indicated.
1000:Client presents to the ED with visual disturbances, expressive aphasia, and
numbness and tingling of the lips. Manifestations started about 30 min ago. Client
reports flashing lights in their vision, especially on the right side.
Client's partner states the client had some difficulty with finding words when
speaking.
Client is alert and oriented x 3 and appears anxious. No facial drooping noted.
Right hand grasp is weaker than left. Client denies pain. - ANSHand grasps is
consistent with migraine, stroke, and meningitis.
Numbness is consistent with migraine and stroke.
,Aphasia is consistent with migraine and stroke.
Visual changes are consistent with migraine, stroke, and meningitis.
Family history is consistent with migraine and stroke.
1800:
Emergency medical team removed client's shirt at the scene and initiated 18-
gauge IV therapy in the right antecubital space.
Client has full-thickness burns over the upper half of the chest and both forearms;
partial-thickness burns are present on the client's face and neck.
Sinus tachycardia, pulses to brachial extremities palpable. 1+ edema to upper
extremities.
Respirations even, labored with scattered rhonchi. Soot noted to the client's
mouth and nose. Oxygen 40% via face tent applied.
Hypoactive bowel sounds.
16 French indwelling urinary catheter inserted with return of 250 mL of yellow
urine.
, Lactated Ringer's infusing to right antecubital. Provider preparing to insert right
femoral central line catheter.
1830:
Client's voice is becoming hoarse and reports difficulty swallowing. Wheezes
present to upper lobes bilaterally. Provider notified. Client positioned upright,
oxygen via face tent. Blood collected - ANSDuring the emergent phase of burn
care, the client is at risk for developing
hypovolemia
and
respiratory failure
.
1NGN
000:Client presents to the ED with visual disturbances, expressive aphasia, and
numbness and tingling of the lips. Manifestations started about 30 min ago. Client
reports flashing lights in their vision, especially on the right side.
Client's partner states the client had some difficulty with finding words when
speaking.
