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iRationale: iMorphine ican icause irespiratory idepression iif igiven itoo imuch. iAlso iyou
should iALWAYS iASSESS ithe ipatient ifirst iwhen ia imed ierror iis iperformed ito imake
i
sure imed ierror idoesn‟t iput ithe iclient‟s ihealth iin irisk.
i
4. A inurse iis ipreparing ito iadminister idiphenhydramine i20 img iorally ito ia i6-year-old ichild iwho
has idifficulty iswallowing ipills. iAvailable iis idiphenhydramine i12.5 img/5 imL ioral isyrup. iWhich
i
i of ithe ifollowing iimages ishows ithe icorrect i# iof imL ithe inurse ishould iadminister? i(Round ithe
i answer ito ithe inearest iwhole inumber.)
Click ion ithe isyringe ithat ihas i8 imL iof imed.
20 img ix i(5mL/12.5mg) i= i8 imL
5. A inurse iis icaring ifor ia i6-year-old ichild iwho ihas ia inew iprescription ifor icefoxitin i80
i mg/kg/day iadministered iintravenously ievery i6 ihour. iThe ichild iweighs i20 ikg. iHow imuch
i cefoxitin ishould ithe inurse iadminister iwith ieach idose? i(Round ithe ianswer ito ithe inearest iwhole
number. iUse ia ileading izero iif iit iapplies. iDo inot iuse ia itrailing izero.)
i
So iit isays ieach idose ifor ithe ifinal ianswer, ibut iwe iare igiven i80 img/kg/day.
80 i x i20 i= i1600 i/ i4 i(dose iis igiven ievery i6 ihours ia iday) i=400 img
iRationale: i80 img ix i20 ikg i= i1,600 i i1,600/4 ix iday i(q6h) i= i400 img
6. A inurse iis ipreparing ito iadminister iIV ifluids ito ia iclient. iThe inurse inotes isparks iwhen iplugging
in ithe iIV ipump. iWhich iof ithe ifollowing iactions ishould ithe inurse itake ifirst?
i
a. Label ithe ipump iwith ia idefective iequipment isticker.
b. Unplug ithe ipump.
c. Obtain ia ireplacement ipump.
d. Notified ithe ibiomedical idepartment ito ifix ithe ipump.
iRationale: iPrioritization iquestion. iYOU iWILL iFIRST iUNPLUG ithe iIV ipump ito iavoid
causing ia ifire.
i
7. A inurse iis icaring ifor ia iclient iwho ihas ia isurgical iwound. iWhich iof ithe ifollowing ilaboratory
values iplaces ithe iclient iat irisk ifor ipoor iwound ihealing?
i
a. Serum ialbumin i3 ig/dL
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b. Total ilymphocyte icount i2400 imm3
c. HCT i42%
d. HGB i16g/dL
iRationale: iAlbumin iin ilow. iNormal irange iis i3.5 ito i5.5 ig/dL. iLow ialbumin iplaces ithe
client iat irisk iforpoor iwound ihealing. iThe iother ilab ivalues iare iwithin inormal ilimits.
i
8. A inurse iis ipreparing ito icheck ia iclient's iblood ipressure. iWhich iof ithe ifollowing iactions ishould
the inurse itake? iChapter i27 iVitals isigns ipage i244
i
a. Apply ithe icuff iabove ithe iclient‟s iantecubital ifossa.
b. Use ia icuff iwith ia iwidth ithat iis iabout i60% iof ithe iclient's iarm icircumference. i- iwidth iof ithe
cuff ishould ibe i40 i% iof iarm icircumference
i
c. How ithe iclients isit iwith ihis iarm iresting iabove ithe ilevel iof ihis iheart. i- iMUST iBE iAT
HEART iLEVEL
i
d. Release ithe ipressure ion ithe iclient's iarm i5 ito i6 imm iper isecond. i- ipressure irelease ishould
not ibe imore ithan i2 ito i3 imm ihg iper isecond
i
iRationale: iATI iFUNDA isays i40% iof ithe iarm icircumference ipg. i139. iRelease ithe
i pressure ino ifaster ithan i2 ito i3 imm iHg iper isecond. iApply ithe iBP icuff i2.5 icm i(1 iin) iabove
i the iantecubital ispace iwith ithe ibrachial iartery iin iline iwith ithe imarking ion ithe icuff.Apply
i the iBP icuff i2.5 icm i(1 iin) iabove ithe iantecubital ispace iwith ithe ibrachial iartery iin iline iwith
the imarking ion ithe icuff.
i
9. A inurse iis ipreparing ito iperform inasal itracheal isuctioning ifor ia iclient. iWhich iof ithe ifollowing
is ian iappropriate iaction ifor ithe inurse ito itake? iChapter i53 iAirway imanagement ipage i563
i
a. Hold ithe isuction icatheter iwith ithe iclean inon-dominant ihand.
b. Apply isuctioning ifor i20 ito i30 iseconds.- i10 i-15 iseconds iis ithe imaximum.
c. Place ithe icatheter iin ia ilocation ithat iis iclean iand idry ifor ilater iuse inew iline.- iNEVER
EVER iREUSE iTHE iSUCTION iCATHETER i. iyou ithrow iit iaway iafter ibeing iused.
i
d. Use isurgical iasepsis iwhen iperforming ithe iprocedure.- ibook isay imedical iasepsis
which iis imaybe ithe isame ithing i.
i
Rationale: isterile itechnique ifor itrachea
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Rationale: iATI iFUNDA. iPG. i316 iUse isurgical iasepsis ifor iall itypes iof isuctioning. iNo
longer ithan i10-15 iseconds ito iavoid ihypoxemia
i
10. A inurse iis idocumenting iclient icare. iWhich iof ithe ifollowing iabbreviations ishould ithe inurse
i use?ati ibook iwas inot ithorough iso ii ihad ito igo ion idifferent isites ifor icharts i- inot iconfident iwith ithis,
please idouble icheck.
i
a. “SS” ifor isliding iscale
b. “BRP” ifor ibathroom iprivileges
c. “OJ” ifor iorange ijuice- ido inot
d. “SQ” ifor isubcutaneous- ido inot
11. MISSING
12. A inurse iis icollecting iA iblood ipressure ireading ifrom ia iclient iwho iis isitting iin ia ichair iperiod
i the inurse idetermines ithat ithe iclients iBP iis i158/96 immhg. iwhich iof ithe ifollowing iactions ishould
the inurse itake?
i
a. Ensure ithat ithe iwidth iof ithe iBP icuff iis i50% iof ithe iclient‟s iupper iarm icircumference. iIt
says i40%
i
b. Reposition ithe iclient iSupine iand irecheck iher iBP. iBP. i→ iORTHOSTATIC
HYPOTENSION
i
c. Recheck ithe iclients iBP iand iher iother iarm ifor icomparison.
d. Request ithat ianother inurse icheck ithe i ithe iclients iBP iin i30 iminutes. i→ i15 iminutes
13. A inurse iis icaring ifor ia iclient iwho ihas ileft ilower iatelectasis. iin iwhich iof ithe ifollowing
positions ishould ithe inurse iplace ithe iclient ifor ipostural idrainage? iChapter i53 iAirway
i
Management ipage i562
i
e. Supine iand ilow-Fowler's iposition
f. Right ilateral iin iTrendelenburg iposition
g. Side ilying iwith ithe iright iside iof ithe ichest ielevated
h. Prone iwith ipillows iunder ithe iextremities
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Downloaded by: jameslewis |
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iRationale: iMorphine ican icause irespiratory idepression iif igiven itoo imuch. iAlso iyou
should iALWAYS iASSESS ithe ipatient ifirst iwhen ia imed ierror iis iperformed ito imake
i
sure imed ierror idoesn‟t iput ithe iclient‟s ihealth iin irisk.
i
4. A inurse iis ipreparing ito iadminister idiphenhydramine i20 img iorally ito ia i6-year-old ichild iwho
has idifficulty iswallowing ipills. iAvailable iis idiphenhydramine i12.5 img/5 imL ioral isyrup. iWhich
i
i of ithe ifollowing iimages ishows ithe icorrect i# iof imL ithe inurse ishould iadminister? i(Round ithe
i answer ito ithe inearest iwhole inumber.)
Click ion ithe isyringe ithat ihas i8 imL iof imed.
20 img ix i(5mL/12.5mg) i= i8 imL
5. A inurse iis icaring ifor ia i6-year-old ichild iwho ihas ia inew iprescription ifor icefoxitin i80
i mg/kg/day iadministered iintravenously ievery i6 ihour. iThe ichild iweighs i20 ikg. iHow imuch
i cefoxitin ishould ithe inurse iadminister iwith ieach idose? i(Round ithe ianswer ito ithe inearest iwhole
number. iUse ia ileading izero iif iit iapplies. iDo inot iuse ia itrailing izero.)
i
So iit isays ieach idose ifor ithe ifinal ianswer, ibut iwe iare igiven i80 img/kg/day.
80 i x i20 i= i1600 i/ i4 i(dose iis igiven ievery i6 ihours ia iday) i=400 img
iRationale: i80 img ix i20 ikg i= i1,600 i i1,600/4 ix iday i(q6h) i= i400 img
6. A inurse iis ipreparing ito iadminister iIV ifluids ito ia iclient. iThe inurse inotes isparks iwhen iplugging
in ithe iIV ipump. iWhich iof ithe ifollowing iactions ishould ithe inurse itake ifirst?
i
a. Label ithe ipump iwith ia idefective iequipment isticker.
b. Unplug ithe ipump.
c. Obtain ia ireplacement ipump.
d. Notified ithe ibiomedical idepartment ito ifix ithe ipump.
iRationale: iPrioritization iquestion. iYOU iWILL iFIRST iUNPLUG ithe iIV ipump ito iavoid
causing ia ifire.
i
7. A inurse iis icaring ifor ia iclient iwho ihas ia isurgical iwound. iWhich iof ithe ifollowing ilaboratory
values iplaces ithe iclient iat irisk ifor ipoor iwound ihealing?
i
a. Serum ialbumin i3 ig/dL
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b. Total ilymphocyte icount i2400 imm3
c. HCT i42%
d. HGB i16g/dL
iRationale: iAlbumin iin ilow. iNormal irange iis i3.5 ito i5.5 ig/dL. iLow ialbumin iplaces ithe
client iat irisk iforpoor iwound ihealing. iThe iother ilab ivalues iare iwithin inormal ilimits.
i
8. A inurse iis ipreparing ito icheck ia iclient's iblood ipressure. iWhich iof ithe ifollowing iactions ishould
the inurse itake? iChapter i27 iVitals isigns ipage i244
i
a. Apply ithe icuff iabove ithe iclient‟s iantecubital ifossa.
b. Use ia icuff iwith ia iwidth ithat iis iabout i60% iof ithe iclient's iarm icircumference. i- iwidth iof ithe
cuff ishould ibe i40 i% iof iarm icircumference
i
c. How ithe iclients isit iwith ihis iarm iresting iabove ithe ilevel iof ihis iheart. i- iMUST iBE iAT
HEART iLEVEL
i
d. Release ithe ipressure ion ithe iclient's iarm i5 ito i6 imm iper isecond. i- ipressure irelease ishould
not ibe imore ithan i2 ito i3 imm ihg iper isecond
i
iRationale: iATI iFUNDA isays i40% iof ithe iarm icircumference ipg. i139. iRelease ithe
i pressure ino ifaster ithan i2 ito i3 imm iHg iper isecond. iApply ithe iBP icuff i2.5 icm i(1 iin) iabove
i the iantecubital ispace iwith ithe ibrachial iartery iin iline iwith ithe imarking ion ithe icuff.Apply
i the iBP icuff i2.5 icm i(1 iin) iabove ithe iantecubital ispace iwith ithe ibrachial iartery iin iline iwith
the imarking ion ithe icuff.
i
9. A inurse iis ipreparing ito iperform inasal itracheal isuctioning ifor ia iclient. iWhich iof ithe ifollowing
is ian iappropriate iaction ifor ithe inurse ito itake? iChapter i53 iAirway imanagement ipage i563
i
a. Hold ithe isuction icatheter iwith ithe iclean inon-dominant ihand.
b. Apply isuctioning ifor i20 ito i30 iseconds.- i10 i-15 iseconds iis ithe imaximum.
c. Place ithe icatheter iin ia ilocation ithat iis iclean iand idry ifor ilater iuse inew iline.- iNEVER
EVER iREUSE iTHE iSUCTION iCATHETER i. iyou ithrow iit iaway iafter ibeing iused.
i
d. Use isurgical iasepsis iwhen iperforming ithe iprocedure.- ibook isay imedical iasepsis
which iis imaybe ithe isame ithing i.
i
Rationale: isterile itechnique ifor itrachea
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, Stuvia.com - The Marketplace to Buy and Sell your Study Material
Rationale: iATI iFUNDA. iPG. i316 iUse isurgical iasepsis ifor iall itypes iof isuctioning. iNo
longer ithan i10-15 iseconds ito iavoid ihypoxemia
i
10. A inurse iis idocumenting iclient icare. iWhich iof ithe ifollowing iabbreviations ishould ithe inurse
i use?ati ibook iwas inot ithorough iso ii ihad ito igo ion idifferent isites ifor icharts i- inot iconfident iwith ithis,
please idouble icheck.
i
a. “SS” ifor isliding iscale
b. “BRP” ifor ibathroom iprivileges
c. “OJ” ifor iorange ijuice- ido inot
d. “SQ” ifor isubcutaneous- ido inot
11. MISSING
12. A inurse iis icollecting iA iblood ipressure ireading ifrom ia iclient iwho iis isitting iin ia ichair iperiod
i the inurse idetermines ithat ithe iclients iBP iis i158/96 immhg. iwhich iof ithe ifollowing iactions ishould
the inurse itake?
i
a. Ensure ithat ithe iwidth iof ithe iBP icuff iis i50% iof ithe iclient‟s iupper iarm icircumference. iIt
says i40%
i
b. Reposition ithe iclient iSupine iand irecheck iher iBP. iBP. i→ iORTHOSTATIC
HYPOTENSION
i
c. Recheck ithe iclients iBP iand iher iother iarm ifor icomparison.
d. Request ithat ianother inurse icheck ithe i ithe iclients iBP iin i30 iminutes. i→ i15 iminutes
13. A inurse iis icaring ifor ia iclient iwho ihas ileft ilower iatelectasis. iin iwhich iof ithe ifollowing
positions ishould ithe inurse iplace ithe iclient ifor ipostural idrainage? iChapter i53 iAirway
i
Management ipage i562
i
e. Supine iand ilow-Fowler's iposition
f. Right ilateral iin iTrendelenburg iposition
g. Side ilying iwith ithe iright iside iof ithe ichest ielevated
h. Prone iwith ipillows iunder ithe iextremities
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