Final

Question 1

For a patient with a STEMI, why would they need oxygen?

Answer 1

Oxygen supplements the air, supports organ function, and helps to relieve angina.

Question 2

How does a nitroglycerin drip work for a patient with a STEMI?

Answer 2

It dilates small vessels to increase perfusion.

Question 3

What is the purpose of an oral anticoagulant for a STEMI patient?

Answer 3

It makes the blood thin to reduce the risk of clots.

Question 4

What is the effect of a beta blocker (e.g., propranolol) on a patient with a STEMI?

Answer 4

It decreases chest pain, decreases the heart rate, and helps prevent further damage.

Question 5

What is the main priority for a patient with stable angina?

Answer 5

To promote oxygenation and decrease chest pain.

Question 6

What is the goal of treatment for a hypertensive emergency?

Answer 6

Stabilization of blood pressure within 24-48 hours.

Question 7

What does the DASH diet stand for, and what kinds of foods are included?

Answer 7

DASH stands for Dietary Approaches to Stop Hypertension. It includes low salt, fish, poultry, fresh fruit, fat-free yogurt, fresh vegetables, broccoli, and grilled chicken.

Question 8

What is the first thing to do for a patient with unstable angina who comes to the ED with chest pains?

Answer 8

Place them on an EKG.

Question 9

A patient with angina is sent home on a calcium channel blocker. What are key education points for this patient?

Answer 9

They cannot have grapefruit juice, should learn to check their pulse daily, keep follow-up appointments, and call 911 if chest pains occur. They also cannot be on a beta blocker or digoxin, as it could cause them to “bottom out” due to effects on electrical conduction.

Question 10

What types of foods are included in a heart-healthy diet?

Answer 10

Lean proteins (like grilled salmon or chicken), fiber, healthy fats (like olive oil), and antioxidants. The diet should be lower in saturated fats, refined carbohydrates, and sodium.

Question 11

For a COPD patient on high-flow oxygen, what assessment finding would require immediate intervention?

Answer 11

CO2 retention, which would present as confusion and restlessness.

Question 12

What should you do for a COPD patient in bed who starts to have a high respiratory rate, tachycardia, and an oxygen saturation of 87%?

Answer 12

Sit them up to get pressure off their chest and promote lung expansion.

Question 13

What is the best action to take for a Jehovah’s Witness patient who needs blood?

Answer 13

Educate the patient and offer fluids or alternative methods.

Question 14

What are the most significant complications for a patient with Obstructive Sleep Apnea (OSA)?

Answer 14

Hypertension, chronic fatigue, stroke risk, and risk of type 2 diabetes. Cognitive function is also a concern.

Question 15

What is the most significant risk for a patient with obesity?

Answer 15

Osteoarthritis, due to pressure on the joints.

Question 16

What is a key education point for a patient with mitral valve stenosis?

Answer 16

Avoid activities that increase their heart rate.

Question 17

What is your priority for a patient with critical leg ischemia whose leg is cool, pale, and they are complaining of pain?

Answer 17

Make sure they get their pain medication.

Question 18

What defines brain death, and what are the parameters for diagnosing it?

Answer 18

Brain death is the irreversible loss of all brain function, including the brain stem. The patient has no brain activity at all, which can be confirmed with an EEG.

Question 19

What is the ethical issue surrounding organ donation for a brain-dead patient?

Answer 19

The patient must be kept on life support, which raises the question of when a person is considered dead, as they are being kept alive for the purpose of organ donation.

Question 20

What are the steps for giving blood to a patient with a GI bleed?

Answer 20

Get a blood type match, obtain consent, and then follow hospital protocol for taking vitals after hanging the blood.

Question 21

A public health nurse is looking at a patient with Hepatitis A who works in a restaurant. What is the plan of action?

Answer 21

Track down people who ate at the restaurant, get them tested, give them a vaccine within 14 days, and an immunoglobulin injection.

Question 22

What diet modification is recommended for a patient with chronic constipation?

Answer 22

Increase fiber

Question 23

What are the bowel patterns during an ulcerative colitis exacerbation?

Answer 23

Bloody stools, 10-15 a day.

Question 24

An end-of-life patient with a hospice consult has elevated heart and respiratory rates. What should you tell the family?

Answer 24

That the elevated heart and respiratory rates are expected and normal, and that they will go down as the patient gets closer to the end of life.

Question 25

What is PAD, and what should you do if you cannot feel a pulse in a patient with it?

Answer 25

PAD stands for Peripheral Artery Disease. If you cannot feel a pulse, you should get a Doppler.

Question 26

A patient with PAD smokes 2 packs a day. What education is needed?

Answer 26

The patient needs to be educated to stop smoking because it can cause or worsen PAD.

Question 27

What is a good low-sodium diet for a patient with heart failure?

Answer 27

A diet of whole foods that are low in sodium, such as grilled salmon and sweet potatoes.

Question 28

What medications and restrictions are prescribed for a patient in heart failure?

Answer 28

Medications would include a beta blocker and a diuretic. The patient will also have fluid and sodium restrictions.

Question 29

What is the priority after a patient has had a TEE (Transesophageal Echocardiogram)?

Answer 29

Gag reflex. Monitor for signs of aspiration, such as a dropped O2 saturation, or a change in respiratory status.

Question 30

For infective carditis, what diagnostic test would you monitor to determine the appropriate antibiotic?

Answer 30

A blood culture to identify the organism.

Question 31

What are the bowel patterns and other symptoms of Crohn's disease?

Answer 31

Non-bloody, loose stools. They will have mouth ulcerations, and in the rectal area, they may have anal fissures and bleeding. They may also present with abdominal cramping/pain on the right side,

Question 32

What three medications are typically in a comfort pack/kit for an end-of-life patient?

Answer 32

Morphine: for pain relief and to decrease respiratory drive. Ativan (Lorazepam): to decrease anxiety and agitation and promote calmness. Atropine: to decrease secretions.

Question 33

A patient with a diverticulitis exacerbation has no bowel sounds on assessment. What is the priority nursing action?

Answer 33

Call the doctor and prepare for surgery.

Question 34

A patient with a colostomy is on a PCA pump for pain. What ostomy-related findings would you report to the physician?

Answer 34

A reportable finding would be a stoma that is a very dark red or purple. If the patient is still complaining of pain at an 8/10, that should also be reported to the physician.

Question 35

What is the goal of care for a patient with chronic pain and depression who can no longer do activities they enjoy, such as biking or golfing?

Answer 35

To help them control their pain so they can resume the activities they want to do.

Question 36

On assessment of a patient with an AV fistula, their arm is cold and they complain of pain. What is the immediate nursing action?

Answer 36

Call the doctor, as there is a circulation issue.

Question 37

A Type 1 diabetic patient is admitted with DKA. What is the first priority?

Answer 37

Look at fluid balance and adjust as needed to maintain hydration, correct acidosis, and correct imbalances before treating the blood sugar.

Question 38

What kind of pain scale should be used for a severe dementia patient who cannot verbalize their pain from a bowel obstruction?

Answer 38

The Pain AD Scale, which evaluates the patient based on behaviors.

Question 39

A patient is on medication for TB. How do you know the treatment is successful?

Answer 39

By monitoring a blood culture.

Question 40

What does the methylprednisolone test for Cushing's syndrome involve?

Answer 40

A dose of dexamethasone is given orally around 1100, and a plasma cortisone level is drawn the next day around 0800.

Question 41

What would you anticipate doing for a patient in Addison's crisis?

Answer 41

Anticipate blood sugar checks, IV fluids, and monitoring blood pressure.

Question 42

An older adult patient has fallen and suffered a hip fracture. What signs and symptoms should be monitored when giving a lot of pain medication?

Answer 42

Signs of drug toxicity.

Question 43

For a newly diagnosed HIV patient, what is the priority test?

Answer 43

A TB test.

Question 44

What are the expected vital signs of a patient with chronic pain?

Answer 44

Heart rate, blood pressure, and pulse rate may still be normal.

Question 45

A patient is on a sustained-release pain medicine every 12 hours but is still having pain. What is the next step?

Answer 45

Get an immediate-release medication ordered.

Question 46

What is the diet for a patient with end-stage renal disease who is on dialysis?

Answer 46

A low-sodium and high-protein diet (once dialysis has started).

Question 47

How does glyburide work?

Answer 47

It stimulates beta cells to increase insulin.

Question 48

What are two common medications for gout?

Answer 48

Allopurinol and colchicine.

Question 49

What is the goal for a patient with Rheumatoid Arthritis (RA)?

Answer 49

To increase/maintain range of motion (ROM) and limit joint stress.

Question 50

How would you educate a patient who does not want to take methotrexate for RA?

Answer 50

That it will slow down the progression and the earlier they start it the better

Question 51

What is the clinical manifestation for a patient with a migraine who has visual disturbances?

Answer 51

Aura

Question 52

A patient is taking Triptans for migraine headaches. What conditions would contraindicate the use of this medication?

Answer 52

Hypertension, seizures, angina, and PVD (Peripheral Vascular Disease).

Question 53

When is the best time to assess for tremors in a patient with Parkinson's?

Answer 53

When they are at rest.

Question 54

What is a common long-term side effect for a patient taking Sinemet?

Answer 54

Dyskinesia

Question 55

A patient with myasthenia gravis is reporting shortness of breath and difficulty speaking. What are you concerned about, and what should you do?

Answer 55

You are concerned about their ability to maintain an airway. You should assess their respiration, as they may end up on a ventilator.

Question 56

A patient with ALS is experiencing increased fatigue, coughing, and shallow breathing. What is the nursing action?

Answer 56

Assess their respiration, as they may end up on a ventilator.

Question 57

In the acute phase of a stroke, what vital sign indicates the body is trying to increase blood flow?

Answer 57

Increased blood pressure (hypertension).

Question 58

What types of patients are at the highest risk for a thrombolytic stroke?

Answer 58

Patients with hypertension and diabetes.

Question 59

What are common signs and symptoms of a lupus patient?

Answer 59

Butterfly rash, joint pain, swelling, fever, and photosensitivity.

Question 59

A patient with osteoarthritis is on a lot of medications. What should be a primary concern?

Answer 59

Be cautious of drug interactions.

Question 59

What equipment should be in the room for a patient on seizure precautions?

Answer 59

An Ambu bag, valve mask, suction setup, simple nasal cannula, and padded side rails to decrease the risk of head injury.

Question 60

What can trigger an exacerbation in a newly diagnosed MS patient?

Answer 60

Childbirth, infection, a change in climate/temperature, live virus vaccines, stress, trauma, and smoking.

Question 60

How do you assess an AV graft?

Answer 60

Auscultate for a bruit and palpate for a thrill, and assess pulses.

Question 61

What does RICE stand for in the care plan for a patient with osteoarthritis?

Answer 61

Rest, Ice, Compression, Elevation.