Progressive Care RN A Exam

Which of the following medications is MOST commonly indicated for patients with CHF? - Ace inhibitors A patient was involved in a motor vehicle accident and CAT scan results reveal a right sided SDH. What would be an expected neurological assessment finding in this patient? - Dilated right pupil What is the most common symptom of SIADH? - Fluid retention Upon arrival to the unit, you receive report on four PCU patients. Which patient should you attend to FIRST? - A patient complaining of shortness of breathe on continuous BiPAP with a BP of 189/109 Of the following patients, which one would you see FIRST? - A 30 year suicidal female that took an unknown number of alprazolam with an O2 saturation of 85% You are caring for a patient with new onset atrial fibrillation with a blood pressure of 80/60. Which of the following treatment options is MOST appropriate? - Electrical cardioversion Which of the following supplemental medications is frequently ordered in conjunction with furosemide? - Potassium Which of the following positions is the BEST way to assess for JVD? - Position the patient on his/her back with the head of bed 30-45 degrees Your patient is on the midday schedule for hemodialysis. He has 100 mg of metoprolol XL ordered for this morning and his blood pressure if 150/98. Which of the following would be an appropriate action? - Hold the metoprolol because of the upcoming dialysis You walk into your patient's room and notice that the chest tube collection chamber has been knocked over on the floor. There appears to be drainage dispersed throughout the chambers. What should you do NEXT? - Replace the chamber with a new one Your patient is complaining of nausea, vomiting, and diarrhea. His blood pressure is 89/55, heart rate is 122 bpm, and the temperature is 100.8 F. What condition is this patient most likely experiencing? - Hypovolemic shock You are caring for a patient with a chest tube that has become dislodged. Which of the following would you do FIRST? - Cover the insertion site immediately with Vaseline gauze A 78 year old male is admitted from the ED for syncope with ground level fall. You note his heart rate is 50 and the patient is confused. His daughter states she thinks he has dementia but he has not been diagnosed yet. Blood pressure is stable. What order do you anticipate? - Stat head CT A patient with an upper GI bleed has a hgb of 6.1 g/dL. Which of the following orders should you do FIRST? - Prepare to administer 2 units PRBCs Which of the following should be checked before administering digoxin? - Apical pulse A patient with a history of acute seizure activity of unknown etiology is admitted to the PCU from the ED. Which of the following orders would you expect to receive from the admitting provider? - Levetiracetam (Keppra) 500 mg IV every 12 hours and seizure precautions You are caring for a patient post left pneumonectomy with a chest tube in place for drainage. Which of the following is a priority in caring for this patient? - Encourage the patient to cough and deep breathe You are caring for a patient with an order for "furosemide 80 mg BID". Which of the following actions is the MOST appropriate? - Call the provider to clarify the order You are caring for a patient with a Do Not Resuscitate (DNR) order. The patient goes into cardiac arrest and the patient's daughter states "Do whatever you can to save my dad." Which of the following is the BEST response? - Follow the patient's wishes and honor the DNR You are educating your patient about reducing sodium intake. You know that the patient understands when they make the statement: - "I will avoid canned food because it's salty" The trough for vancomycin is measured: - Immediately before the next scheduled dose You are delegating wound care to a LPN. The LPN states that she has never performed this type of wound care before. Which of the following components of delegation have you neglected? - Competency You are caring for a patient in third degree heart block. Which of the following treatment options will MOST likely be implemented? - Pacemaker You are assigned a patient who recently traveled outside of the United States. He has a fever of 101.9 F and excessive diarrhea. You suspect he may have been exposed to Ebola. What type of PPE would you expect to use? - High level PPE Which of the following patients would you see FIRST? - A 57 year old male complaining of worsening chest tightness You enter a patient's room and notice the telemetry box on the bed and the IV on the floor connected to running IV fluids. You last saw the patient 1 hour ago. Who should be notified immediately? - Charge nurse A patient is admitted for a NSTEMI and ST depression is noted in leads II, III, and AVF. Two hours after admission you notice the patient now has ST elevation in each of those leads. What should you do NEXT? - Administer O2 and morphine 2mg IV??? An 18 year old female is admitted from PACU after a cholecystectomy. She has a 22 gauge peripheral IV in her left hand and is due to void. She had morphine 8 mg and Zofran 4 mg in recovery, and is complaining of nausea. She has Phenergan 50 mg IV every 6 hours/PRN. What should you do first? - Start a new IV line in the antecubital region or obtain an order for Phenergan IM A patient is on strict I&Os with an indwelling urinary catheter. 4 hours into your shift you notice that there is a total of 50 mL of urine in the bag. You notify the provider because you recognize that adequate urine output should be: - 30 mL/hr A co-worker administered a narcotic earlier in the shift, but failed to get a witness for the portion of medication that was wasted. The co-worker asks that you sign off as the witness. What is the BEST response? - Refuse to witness the waste and ask the co-worker to notify the charge nurse