SCF NURSING LEVEL 1 FINAL EXAM REVIEW
30 y.o. pt with terminal cancer doesnt want to have chemo or radiation. Her mother
says, "ignore her, she doesnt know what shes saying, tell the dr we want to start
treatment now." Whys this wrong? - ANSWER-autonomy is associated with
allowing/enabling pt to make their own decisions about healthcare
doing rounds, you enter a pt room and see the pt and chaplain praying. the pt asks you
to come pray with them even though you do not partake in the same religious beliefs.
what makes you go pray with them? - ANSWER-put of respect for pt spirituality
fellow nursing student is anxious and doesnt know why we need to learn all our
antibiotics there are so many! You advise them to focus on prototypes, why? -
ANSWER-prototype drug serves as a model or reference for other drugs in same class
with similar structure, mechanism of action, mode of action, and potential side effects
new grad nurse is administering iv dilaudid to sleeping pt. new nurse tells you hat the pt
asked to be given their meds right when it was due regardless of sleep status. whats
wrong with this? - ANSWER-opioids can cause respiratory depression and low BP.
need to assess pt consciousness, respiratory rate and BP. nurse must also perform 10
right of med admin
new nurse asks pt, "do you have any discomfort when I press on your abdomen like
this? Now I am just going to take a listen to your belly for bowel sounds." Whys this
wrong? - ANSWER-physical manipulation of abdomen may change bowel sounds. must
auscultate before palpation to make sure you listen t undisturbed bowel sounds
new nurse gives pt morning meds and tells them that digoxin helps to reduce high BP.
what does it really do? - ANSWER-treats HF and a fib by helping heart beast stronger
with a more regular rhythm
new nurse is admitting a new pt. she turns to you and says, "this part of the admission is
asking for me to ask about the pt spiritual wellbeing. what should i ask?" - ANSWER-
what are your beliefs and attitudes around spirituality and spiritual care; what are some
of your spiritual care practices ; what makes your life feel meaningful; do your spiritual
beliefs assist you in managing situations that arise during illness
new pt is agitated and angry and often lashes out at you verbally, despite attempts to
care for them/ meet needs. what do you do? - ANSWER-stay calm. be polite but firm
and set limits for their behavior. be aware of body language and maintain appropriate
distance. allow patient to vent feelings and listen to their concerns. find reason behind
behavior and show understanding
notice a tech removing their PPE after coming out of a contact room (c. diff) and then
using hand sanitizer before answering another call light. Whats wrong with this? -
ANSWER-wash hands to prevent spread of c. diff
, nurse gives disharge order to pt. nurse says, "you will give yourself Lovenox injections
for 21 days. the box will have instructions, dont worry its easy." What should the nurse
have done instead? - ANSWER-its up to nurse to assess pt learning needs. use teach
back method
nurse is calling report on pt who is being transferred to rehab center. she says, "I have a
pt coming to you soon who has just had their hip replaced. I changed the dressing, so
thats all good. They have had a BM, so thats also good. DO you have any questions?"
Whys this so horribly wrong - ANSWER-use SBAR to communicate with healthcare
team
nurse uses a 5/8 inch needle to give 6mg dose of morphine to an obese pt via vastus
lateralis muscle. what should be used instead? - ANSWER-1.5 inch needle for women
>200 lbs or men >260 lbs
patient asks you to explain why his oral dose of dilaudid is so much larger than his iv
dose. why is this? - ANSWER-first pass effect
Patient on unit has been taking vancomycin PO for C. Diff infection and reports vaginal
itching and burning. A new nurse tells the patient she should be tested for and STI
asap. Why doesnt she need the testing? - ANSWER-antibiotics disturb normal
microbiome and puts pt at risk for superinfection. Strong antibiotics can lead to vaginal
yeast infection (vaginal candidiasis)
post op pt is on normal saline at 125ml/hr. you hear crackles in his lungs, his o2sat is
90% on 2 liters nasal cannula and breathing is labored (short of breath) Pulses are
bounding. What do you do? - ANSWER-stop iv and notify physician
pot op hip arthroplasty points to IS and says, "the girl just told me to use this gadget to
prevent pneumonia. why should I worry about pneumonia if I just came in to have my
hip replaced?" What do you tell him? - ANSWER-post op pt are at risk for respiratory
complications . encourage pt to take precautions to minimize risk. (remember fluid
builds up if pt just sits!!)
pt asks why they are on both senna and mirilax. what do you tell them? - ANSWER-
senna is a stimulant laxative and mirilax is osmotic and draws water to soften stool
Pt has gastroenteritis, and the new nurse tells them that their medication dose may
need to be reduced because of impaired GI metabolism. Why is this wrong? -
ANSWER-liver is primary site of drug metabolism
pt just returned from hemodialysis and needs to use the BR. patient gets as far as
sitting at the side of the bed when they tell you they feel very dizzy and lightheaded.
why is this and what should they do? - ANSWER-pt who went through dialysis are at
risk for hemodialysis because of fast volume removal. pt BP should be assessed to
30 y.o. pt with terminal cancer doesnt want to have chemo or radiation. Her mother
says, "ignore her, she doesnt know what shes saying, tell the dr we want to start
treatment now." Whys this wrong? - ANSWER-autonomy is associated with
allowing/enabling pt to make their own decisions about healthcare
doing rounds, you enter a pt room and see the pt and chaplain praying. the pt asks you
to come pray with them even though you do not partake in the same religious beliefs.
what makes you go pray with them? - ANSWER-put of respect for pt spirituality
fellow nursing student is anxious and doesnt know why we need to learn all our
antibiotics there are so many! You advise them to focus on prototypes, why? -
ANSWER-prototype drug serves as a model or reference for other drugs in same class
with similar structure, mechanism of action, mode of action, and potential side effects
new grad nurse is administering iv dilaudid to sleeping pt. new nurse tells you hat the pt
asked to be given their meds right when it was due regardless of sleep status. whats
wrong with this? - ANSWER-opioids can cause respiratory depression and low BP.
need to assess pt consciousness, respiratory rate and BP. nurse must also perform 10
right of med admin
new nurse asks pt, "do you have any discomfort when I press on your abdomen like
this? Now I am just going to take a listen to your belly for bowel sounds." Whys this
wrong? - ANSWER-physical manipulation of abdomen may change bowel sounds. must
auscultate before palpation to make sure you listen t undisturbed bowel sounds
new nurse gives pt morning meds and tells them that digoxin helps to reduce high BP.
what does it really do? - ANSWER-treats HF and a fib by helping heart beast stronger
with a more regular rhythm
new nurse is admitting a new pt. she turns to you and says, "this part of the admission is
asking for me to ask about the pt spiritual wellbeing. what should i ask?" - ANSWER-
what are your beliefs and attitudes around spirituality and spiritual care; what are some
of your spiritual care practices ; what makes your life feel meaningful; do your spiritual
beliefs assist you in managing situations that arise during illness
new pt is agitated and angry and often lashes out at you verbally, despite attempts to
care for them/ meet needs. what do you do? - ANSWER-stay calm. be polite but firm
and set limits for their behavior. be aware of body language and maintain appropriate
distance. allow patient to vent feelings and listen to their concerns. find reason behind
behavior and show understanding
notice a tech removing their PPE after coming out of a contact room (c. diff) and then
using hand sanitizer before answering another call light. Whats wrong with this? -
ANSWER-wash hands to prevent spread of c. diff
, nurse gives disharge order to pt. nurse says, "you will give yourself Lovenox injections
for 21 days. the box will have instructions, dont worry its easy." What should the nurse
have done instead? - ANSWER-its up to nurse to assess pt learning needs. use teach
back method
nurse is calling report on pt who is being transferred to rehab center. she says, "I have a
pt coming to you soon who has just had their hip replaced. I changed the dressing, so
thats all good. They have had a BM, so thats also good. DO you have any questions?"
Whys this so horribly wrong - ANSWER-use SBAR to communicate with healthcare
team
nurse uses a 5/8 inch needle to give 6mg dose of morphine to an obese pt via vastus
lateralis muscle. what should be used instead? - ANSWER-1.5 inch needle for women
>200 lbs or men >260 lbs
patient asks you to explain why his oral dose of dilaudid is so much larger than his iv
dose. why is this? - ANSWER-first pass effect
Patient on unit has been taking vancomycin PO for C. Diff infection and reports vaginal
itching and burning. A new nurse tells the patient she should be tested for and STI
asap. Why doesnt she need the testing? - ANSWER-antibiotics disturb normal
microbiome and puts pt at risk for superinfection. Strong antibiotics can lead to vaginal
yeast infection (vaginal candidiasis)
post op pt is on normal saline at 125ml/hr. you hear crackles in his lungs, his o2sat is
90% on 2 liters nasal cannula and breathing is labored (short of breath) Pulses are
bounding. What do you do? - ANSWER-stop iv and notify physician
pot op hip arthroplasty points to IS and says, "the girl just told me to use this gadget to
prevent pneumonia. why should I worry about pneumonia if I just came in to have my
hip replaced?" What do you tell him? - ANSWER-post op pt are at risk for respiratory
complications . encourage pt to take precautions to minimize risk. (remember fluid
builds up if pt just sits!!)
pt asks why they are on both senna and mirilax. what do you tell them? - ANSWER-
senna is a stimulant laxative and mirilax is osmotic and draws water to soften stool
Pt has gastroenteritis, and the new nurse tells them that their medication dose may
need to be reduced because of impaired GI metabolism. Why is this wrong? -
ANSWER-liver is primary site of drug metabolism
pt just returned from hemodialysis and needs to use the BR. patient gets as far as
sitting at the side of the bed when they tell you they feel very dizzy and lightheaded.
why is this and what should they do? - ANSWER-pt who went through dialysis are at
risk for hemodialysis because of fast volume removal. pt BP should be assessed to
