{"id":110011,"date":"2023-07-25T21:19:26","date_gmt":"2023-07-25T21:19:26","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=110011"},"modified":"2023-07-25T21:19:31","modified_gmt":"2023-07-25T21:19:31","slug":"medical-surgical-rn-a-prophecy-test-relias-learning-answered-2023","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/07\/25\/medical-surgical-rn-a-prophecy-test-relias-learning-answered-2023\/","title":{"rendered":"Medical-Surgical RN A Prophecy Test \/ Relias Learning Answered 2023."},"content":{"rendered":"\n

\"\"<\/p>\n\n\n\n

Medical-Surgical RN A Prophecy Relias Test, Answered<\/p>\n\n\n\n

1.2 milligrams is equal to how many micrograms?<\/p>\n\n\n\n

– 1200 mcg<\/p>\n\n\n\n

Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure<\/p>\n\n\n\n

effective drain function?<\/p>\n\n\n\n

– Compress the drain, then plug the bulb to establish suction<\/p>\n\n\n\n

Your male patient complains of discomfort while inflating the balloon during insertion<\/p>\n\n\n\n

of an indwelling urinary catheter. What would be the MOST appropriate action?<\/p>\n\n\n\n

– Deflate the balloon, advance the catheter further, then reinflate the balloon<\/p>\n\n\n\n

Your patient has symptomatic anemia but is refusing a blood transfusion for religious<\/p>\n\n\n\n

reason. What is an appropriate response?<\/p>\n\n\n\n

– Respect his wishes and notify the provider<\/p>\n\n\n\n

Your patient is admitted with diverticulitis. What type of diet do you expect to be<\/p>\n\n\n\n

ordered for the patient?<\/p>\n\n\n\n

– broth, jello, soft fruit no skin,<\/p>\n\n\n\n

You were hired to work the medical unit and when you arrive at work the charge<\/p>\n\n\n\n

nurse has assigned you to the post-surgical unit since they are understaffed. Which is<\/p>\n\n\n\n

the MOST appropriate action?<\/p>\n\n\n\n

– Report to the post-surgical unit.<\/p>\n\n\n\n

What is a proton pump inhibitor, such as pantoprazole (Protonix) used for?<\/p>\n\n\n\n

– Acid Reduction<\/p>\n\n\n\n

Which adaptive equipment would be MOST appropriate to use for a severely<\/p>\n\n\n\n

contracted patient who is unable to bear weight when transferring from the bed to the<\/p>\n\n\n\n

chair?<\/p>\n\n\n\n

– Patient lift (e.g., Hoyer)<\/p>\n\n\n\n

Which tool should you use to assess pain in you 80-year-old patient with severe<\/p>\n\n\n\n

dementia?<\/p>\n\n\n\n

– PAINAD scale<\/p>\n\n\n\n

Your patient is admitted from the ED with failure to thrive and advanced dementia.<\/p>\n\n\n\n

You note he is extremely underweight, appears unbathed for some time, and has a<\/p>\n\n\n\n

\"\"<\/p>\n\n\n\n

stage 4 pressure injury to his coccyx. You were told in report that he lives at home<\/p>\n\n\n\n

with family members. What should you do?<\/p>\n\n\n\n

– Notify the charge nurse and social worker of your concerns.<\/p>\n\n\n\n

Your 85-year-old patient with atrial fibrillation fell at home 3 days ago. You notice<\/p>\n\n\n\n

she has been having several episodes of acute confusion since being admitted to your<\/p>\n\n\n\n

unit. What is the MOST important order you should anticipate from the provider?<\/p>\n\n\n\n

– Stat CT of head<\/p>\n\n\n\n

Your patient has a temp of 102.3 F, HR 122, and has had 15 mL of urine from the<\/p>\n\n\n\n

indwelling urinary catheter in the last 2 hours. What is your patient MOST likely<\/p>\n\n\n\n

experiencing.<\/p>\n\n\n\n

– Sepsis<\/p>\n\n\n\n

What type of personal protective equipment (PPE) is applied prior to entering a room<\/p>\n\n\n\n

for a patient with C. diff?<\/p>\n\n\n\n

– Gown and gloves<\/p>\n\n\n\n

Your patient continues to pull at their IV site located in their left forearm despite<\/p>\n\n\n\n

verbal reminders and increased observation. The nursing assistant recommends using<\/p>\n\n\n\n

soft mitt restraints on the patient. What is your recommendation?<\/p>\n\n\n\n

– Request an order for soft mitts as they are the least restrictive<\/p>\n\n\n\n

Your patient was admitted for a hypertensive crisis and has a history of HTN,<\/p>\n\n\n\n

Parkinson’s disease, depression, and alcohol use. On his second hospitalized day, you<\/p>\n\n\n\n

notice he is more anxious and restless than his baseline. What would be your FIRST<\/p>\n\n\n\n

nursing intervention?<\/p>\n\n\n\n

– Ask the patient when his last drink of alcohol was.<\/p>\n\n\n\n

What is the BEST indication of an acute neurological problem?<\/p>\n\n\n\n

– Change in level of consciousness<\/p>\n\n\n\n

While in a supine position your patient states, “I’m tired and cannot catch my breath.”<\/p>\n\n\n\n

Physical assessment reveals jugular vein distention and a third heart sound (S3). These<\/p>\n\n\n\n

symptoms are indicative of what condition?<\/p>\n\n\n\n

– Heart failure<\/p>\n\n\n\n

Your new admission presents with a cough, unintentional weight loss, frequent night<\/p>\n\n\n\n

sweats, and bloody sputum. What type of isolation precautions should you initiate, if<\/p>\n\n\n\n

any?<\/p>\n\n\n\n

– Airborne precautions<\/p>\n\n\n\n

\"\"<\/p>\n\n\n\n

Patients with diabetes are at high risk for complications from damage to what body<\/p>\n\n\n\n

areas?<\/p>\n\n\n\n

– Nerve and kidney damage<\/p>\n\n\n\n

If your patient with a known history of diabetes is displaying symptoms of<\/p>\n\n\n\n

diaphoresis, cool skin, lethargy, and shakiness. What is your first action?<\/p>\n\n\n\n

– Check the patient’s blood glucose level.<\/p>\n\n\n\n

Your patient tells you, “I hope I don’t die, but if I do I don’t want to be brought back.?<\/p>\n\n\n\n

You notice on her chart and wrist band that she is a full code. What would be the<\/p>\n\n\n\n

MOST appropriate action?<\/p>\n\n\n\n

– Discuss code status with the patient and follow up with provider to ensure the<\/p>\n\n\n\n

medical record reflects her wishes.<\/p>\n\n\n\n

Your coworker posted photos on social media from a birthday party they had for her<\/p>\n\n\n\n

in the unit breakroom. What should be your NEXT course of action?<\/p>\n\n\n\n

– No action is necessary because no PHI was displayed.<\/p>\n\n\n\n

Your new patient understands very limited English. How should you communicate<\/p>\n\n\n\n

with them when completing the admission assessment?<\/p>\n\n\n\n

– Use the organization’s interpreter services.<\/p>\n\n\n\n

You are caring for a patient with a history of diabetes mellitus. You walk into the<\/p>\n\n\n\n

room and find the patient lethargic and diaphoretic. What is your first action?<\/p>\n\n\n\n

– Obtain capillary blood glucose level.<\/p>\n\n\n\n

Your patient is 4 hours post open appendectomy and has not voided yet. You note his<\/p>\n\n\n\n

lower abdomen is distended. What should you do NEXT?<\/p>\n\n\n\n

– Perform a bladder scan<\/p>\n\n\n\n

A patient with peritonitis presents with tachycardia, hypotension, and dehydration.<\/p>\n\n\n\n

What other assessment finding would you anticipate as part of your physical<\/p>\n\n\n\n

assessment?<\/p>\n\n\n\n

– Severe abdominal pain or rebound tenderness<\/p>\n\n\n\n

What is the EARLIEST sign indicating increased intracranial pressure (ICP)?<\/p>\n\n\n\n

– Level of consciousness<\/p>\n\n\n\n

In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes<\/p>\n\n\n\n

checking for: – Paresthesia and paralysis<\/p>\n\n\n\n

\"\"<\/p>\n\n\n\n

You received a report on a patient that sustained a right hemisphere CVA 48 hours<\/p>\n\n\n\n

ago. What do you expect the patient to exhibit?<\/p>\n\n\n\n

– Left sided weakness of the leg, arm, and face.<\/p>\n\n\n\n

You are ordered to give digoxin (Lanoxin). Your patients vital signs are: BP 130\/70,<\/p>\n\n\n\n

Temp 97.9F, HR 52, RR 16, O2 Sat 100% on room air. What should you do NEXT?<\/p>\n\n\n\n

– Hold digoxin (Lanoxin) and call the provider<\/p>\n\n\n\n

Upon entry to your patient’s room, you find her sitting in High Fowler’s position and<\/p>\n\n\n\n

complaining of shortness of breath. Her respiratory rate is 34 breaths\/min and O2 sat<\/p>\n\n\n\n

is 84%. Which mode of oxygen delivery would MOST likely reverse these<\/p>\n\n\n\n

symptoms?<\/p>\n\n\n\n

– Non-rebreather mask<\/p>\n\n\n\n

Your patient is on contact precautions for active MRSA. What proper PPE should you<\/p>\n\n\n\n

use before entering the room?<\/p>\n\n\n\n

– Gown and gloves<\/p>\n\n\n\n

Your patient recently had a G-tube placed and intermittent enteral feedings have been<\/p>\n\n\n\n

initiated. What symptoms may indicate intolerance to the feedings?<\/p>\n\n\n\n

– Vomiting and diarrhea<\/p>\n\n\n\n

Upon entering your patient’s room, you note that they are having a seizure. What is<\/p>\n\n\n\n

your FIRST action?<\/p>\n\n\n\n

– Position the patient on their side to maintain the airway.<\/p>\n\n\n\n

Your 18-year-old female patient was admitted with dehydration secondary to anorexia<\/p>\n\n\n\n

nervosa. During your assessment you note she has a flat affect and says, “I just want<\/p>\n\n\n\n

to die. I’m tired of my life.” What should be your FIRST intervention?<\/p>\n\n\n\n

– Stay with the patient and ask fi she has a plan to carry out this wish.<\/p>\n\n\n\n

Your patient has a non-productive cough and presence of secretions in his<\/p>\n\n\n\n

tracheostomy. Prior to suctioning the patient, what should you do FIRST?<\/p>\n\n\n\n

– Hyperoxygenate patient.<\/p>\n\n\n\n

Your patient takes 5 mg of warfarn (Coumadin\/Jantoven) dailyand reports having<\/p>\n\n\n\n

black colored stool today. What do you most likely suspect?<\/p>\n\n\n\n

– Gastrointestinal bleeding<\/p>\n\n\n\n

\"\"<\/p>\n\n\n\n

Your new patient was admitted with blunt force trauma to the abdomen following a<\/p>\n\n\n\n

motor vehicle accident (MVA). A NG tube is in place for decompression; however,<\/p>\n\n\n\n

you note during the assessment that the stomach is rigid and hard during palpation.<\/p>\n\n\n\n

What condition do you suspect?<\/p>\n\n\n\n

– Hemorrhage<\/p>\n\n\n\n

Which of the following nursing diagnoses is MOST important for a patient with<\/p>\n\n\n\n

chronic obstructive pulmonary disease (COPD)?<\/p>\n\n\n\n

– Impaired gas exchange<\/p>\n\n\n\n

You have a patient going for dialysis. Their medications include lisinopril (Prinivil),<\/p>\n\n\n\n

ondansetron (Zofran), famotidine (Pepcid), and atorvastatin (Lipitor). Which<\/p>\n\n\n\n

medication would you possibly hold and seek clarification?<\/p>\n\n\n\n

– famotidine (Pepcid)<\/p>\n\n\n\n

What is an early symptom that the patient is developing a complication of heart<\/p>\n\n\n\n

failure?<\/p>\n\n\n\n

– Edema in the legs and feet<\/p>\n\n\n\n

Black and tarry colored stools are CLASSIC symptoms of what condition?<\/p>\n\n\n\n

– Bleeding gastric ulcer<\/p>\n\n\n\n

You have 4 patients who have high priority needs. One needs to go to surgery, one<\/p>\n\n\n\n

needs STAT lab draws from a PICC line, another has chest pain rated 8\/10, and<\/p>\n\n\n\n

another needs toileting. Which patient should you tend to FIRST?<\/p>\n\n\n\n

– The patient with chest pain<\/p>\n\n\n\n

Your patient with Hepatitis C exhibits signs of jaundice and a distended abdomen.<\/p>\n\n\n\n

What procedure would you anticipate being performed by the provider at the bedside<\/p>\n\n\n\n

for this patient?<\/p>\n\n\n\n

– Paracentesis<\/p>\n\n\n\n

What is clubbing of the fingers MOST likely associated with?<\/p>\n\n\n\n

– Chronic oxygen deficiency<\/p>\n\n\n\n

A patient on warfarin (Coumadin\/Jantoven) has an INR of 6. Which medication would<\/p>\n\n\n\n

you anticipate administering?<\/p>\n\n\n\n

– Vitamin K<\/p>\n\n\n\n

\"\"<\/p>\n\n\n\n

To reduce the risk of infection and phlebitis in an adult patient with a peripheral IV,<\/p>\n\n\n\n

what is the MINIMUM duration the catheter should remain in place before ROUTINE<\/p>\n\n\n\n

replacement?<\/p>\n\n\n\n

– 72 hours<\/p>\n\n\n\n

You are caring for a patient post lobectomy with a chest tube in place for drainage.<\/p>\n\n\n\n

What is a priority in care for this patient?<\/p>\n\n\n\n

– Encourage the patient to cough and deep breathe.<\/p>\n\n\n\n

What patient population is the pneumococcal vaccine, PPSV23 indicated for?<\/p>\n\n\n\n

– Adults aged 65 years and older<\/p>\n\n\n\n

Your patient with stave IV terminal lung cancer continues to experience increasing<\/p>\n\n\n\n

pain as each day passes. What would you anticipate the provider ordering for this<\/p>\n\n\n\n

patient?<\/p>\n\n\n\n

– Palliative care consult<\/p>\n\n\n\n

The provider gives you a telephone order to explain a surgical procedure to your<\/p>\n\n\n\n

patient and obtain surgical consent. How should you respond?<\/p>\n\n\n\n

– Inform the provider that explaining the procedure is outside the nurse’s scope of<\/p>\n\n\n\n

practice.<\/p>\n\n\n\n

The patient has diltiazem HCl (Cardizem CD) ordered and is requesting the capsule be<\/p>\n\n\n\n

mixed into her morning yogurt. How should you respond?<\/p>\n\n\n\n

– “Sorry, it is a slow-release medication that cannot be opened or crushed.”<\/p>\n\n\n\n

Your 72-year-old male patient is admitted for colon cancer related complications and<\/p>\n\n\n\n

has a history of CHF, stroke, and a recent knee replacement. Based on your patient’s<\/p>\n\n\n\n

risk assessment, you determine he is at risk for venous thromboembolism (VTE).<\/p>\n\n\n\n

What is an appropriate VTE prophylaxis order for this patient?<\/p>\n\n\n\n

– Enoxaparin (Lovenox) once daily and intermittent pneumatic compressions (IPC)<\/p>\n\n\n\n

You receive a provider’s order that is not consistent with evidence-based practice.<\/p>\n\n\n\n

What is your FIRST step?<\/p>\n\n\n\n

– Clarify the order with the provider.<\/p>\n\n\n\n

When would sucralfate (Carafate) 4 times daily be scheduled for?<\/p>\n\n\n\n

– 1 hour before meals and at bedtime<\/p>\n\n\n\n

Your patient’s morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18.<\/p>\n\n\n\n

What blood product do you expect to administer?<\/p>\n\n\n\n

Recommended for you<\/h3>\n\n\n\n

Document continues below<\/p>\n\n\n\n