You are about to handover patient care to your on-coming nurse colleague. Which patient
requires the most immediate attention?
1.) 62 year-old man with COPD who has just completed his scheduled bronchodilator
2.) 68 year-old woman with type 2 diabetes who had CVA 2 days ago
3.) 72 year-old woman with history of asthma with HR 90 and is due for her beta-blocker
4.) 48 year-old man admitted with cellulitis of his right hand after a construction accident,
currently on IV antibiotics, with a temperature of 101.8 - ANSWER 4
Cellulitis is serious infection, involving swelling of subcutaneous tissue, fluid displacement
due to 3rd spacing. What else would you assess?
You have just received change of shift report. Which patient should you assess first?
a. 62 year-old man who is scheduled for a cardiac cath, and is ready to be transported now
b. 58 year-old woman with COPD with an O2 saturation of 92% on 2 liters of O2, who is
scheduled to be discharged home on O2
c. 36 year-old man admitted with an exacerbation of asthma with RR 36 at rest, and whose
wheezing has diminished
d. 72 year-old woman with history of asthma with HR 90 and is due for her beta-blocker -
ANSWER C
RR 36 and diminished wheezing indicative of respiratory distress and needs prompt atten-
tion
You are assigned to care for a 58 year-old man who is scheduled for a cardiac angiogram dur-
ing your shift. What actions should you take? Check all that apply.
1-Explain that the patient will receive short-acting anesthesia
1
,2-Review the patient's allergies, specifically checking to see if he has an allergy to contrast
dye
3-Inform the patient that his wife should stay at home until the procedure is finished, as
family members often distract the team in the cath lab
4-Review and reconcile his medications. Confirm that he did not take his warfarin
5-Check the patient's most recent labs paying particular attention to the PT INR - AN-
SWER 2, 4, 5
Contrast dyes contain iodine and allergy could lead to anaphylactic response; might receive
light sedation but needs to be awake and able to follow directions
A 62 year-old man, who is s/p coronary artery bypass surgery, is about to be transferred
from the ICU to the cardiac stepdown unit. What is the most effective way for the ICU (re-
porting) nurse and cardiac stepdown (receiving) nurse to ensure that essential patient infor-
mation is conveyed?
1- A face-to-face verbal report with both nurses present in a quiet room
2- The ICU nurse will provide an audio-recorded report for future reference and documenta-
tion
3- The ICU nurse will document essential transfer information in the patient's medical record
4- The ICU nurse will accompany the patient to the stepdown unit and provide a face-to-face
report, using a unit-approved, standardized guide - ANSWER 4
What is the most common outcome associated with poorly managed hospital discharge? -
ANSWER Adverse Drug events
You are the nurse preparing to discharge a 46 year-old man with hypertension who was
started on chlorothiazide. You ask the patient to share with you his understanding of his new
medication. Which of the following statements indicates your teaching has been effective?
Select all that apply.
1- I will weigh myself every day at the same time.
2- I will notify Charles, the nurse practitioner in my primary care doctor's office if I gain 3
pounds or more, have increased swelling in my feet and ankles, or feel more tired than
usual.
2
, 3- I will reduce my medication if I feel very thirsty or dizzy.
4- I will wear sunscreen if I will be out in the sun for a long period of time.
5- If I want to drink alcohol, I will wait and take my medication right before I go to bed. - AN-
SWER 1, 2, 4
The nurse is tracking data on a group of patients with heart failure, who have been dis-
charged from the unit where you work and are now being followed in clinic. What is the best
indicator that the nursing interventions of monitoring and teaching have been effective?
1- Eighty-five percent of patients have not gained weight
2- Seventy-five percent of family caregivers have reported watching an educational DVD
3- Five percent of patients have been readmitted to the hospital in the last 90 days
4- Eighty percent report that they are taking their medications - ANSWER 3
All are important but lower resource utilization is best indicator and one used by accrediting
agencies, payors, etc.
The following should NOT be used to reduce pressure, as it may increase friction injuries:
A) rolled towels
B) convoluted foam mattress overlay
C) foam pads
D) viscoelastic overlay - ANSWER A
Rolled towels and sheets should not be used and may negate pressure-reducing function of
other pads
An adult Jehovah's' Witness patient is hemorrhaging and might die without transfusions, but
he refused blood products prior to surgery. The correct procedure is?
A) use volume replacement and fractionated blood cells only, as permitted by the religion
B) contact family and ask permission
C) ask legal authorities to grant permission
D) give transfusions because the patient may die - ANSWER ANSWER: A
3
requires the most immediate attention?
1.) 62 year-old man with COPD who has just completed his scheduled bronchodilator
2.) 68 year-old woman with type 2 diabetes who had CVA 2 days ago
3.) 72 year-old woman with history of asthma with HR 90 and is due for her beta-blocker
4.) 48 year-old man admitted with cellulitis of his right hand after a construction accident,
currently on IV antibiotics, with a temperature of 101.8 - ANSWER 4
Cellulitis is serious infection, involving swelling of subcutaneous tissue, fluid displacement
due to 3rd spacing. What else would you assess?
You have just received change of shift report. Which patient should you assess first?
a. 62 year-old man who is scheduled for a cardiac cath, and is ready to be transported now
b. 58 year-old woman with COPD with an O2 saturation of 92% on 2 liters of O2, who is
scheduled to be discharged home on O2
c. 36 year-old man admitted with an exacerbation of asthma with RR 36 at rest, and whose
wheezing has diminished
d. 72 year-old woman with history of asthma with HR 90 and is due for her beta-blocker -
ANSWER C
RR 36 and diminished wheezing indicative of respiratory distress and needs prompt atten-
tion
You are assigned to care for a 58 year-old man who is scheduled for a cardiac angiogram dur-
ing your shift. What actions should you take? Check all that apply.
1-Explain that the patient will receive short-acting anesthesia
1
,2-Review the patient's allergies, specifically checking to see if he has an allergy to contrast
dye
3-Inform the patient that his wife should stay at home until the procedure is finished, as
family members often distract the team in the cath lab
4-Review and reconcile his medications. Confirm that he did not take his warfarin
5-Check the patient's most recent labs paying particular attention to the PT INR - AN-
SWER 2, 4, 5
Contrast dyes contain iodine and allergy could lead to anaphylactic response; might receive
light sedation but needs to be awake and able to follow directions
A 62 year-old man, who is s/p coronary artery bypass surgery, is about to be transferred
from the ICU to the cardiac stepdown unit. What is the most effective way for the ICU (re-
porting) nurse and cardiac stepdown (receiving) nurse to ensure that essential patient infor-
mation is conveyed?
1- A face-to-face verbal report with both nurses present in a quiet room
2- The ICU nurse will provide an audio-recorded report for future reference and documenta-
tion
3- The ICU nurse will document essential transfer information in the patient's medical record
4- The ICU nurse will accompany the patient to the stepdown unit and provide a face-to-face
report, using a unit-approved, standardized guide - ANSWER 4
What is the most common outcome associated with poorly managed hospital discharge? -
ANSWER Adverse Drug events
You are the nurse preparing to discharge a 46 year-old man with hypertension who was
started on chlorothiazide. You ask the patient to share with you his understanding of his new
medication. Which of the following statements indicates your teaching has been effective?
Select all that apply.
1- I will weigh myself every day at the same time.
2- I will notify Charles, the nurse practitioner in my primary care doctor's office if I gain 3
pounds or more, have increased swelling in my feet and ankles, or feel more tired than
usual.
2
, 3- I will reduce my medication if I feel very thirsty or dizzy.
4- I will wear sunscreen if I will be out in the sun for a long period of time.
5- If I want to drink alcohol, I will wait and take my medication right before I go to bed. - AN-
SWER 1, 2, 4
The nurse is tracking data on a group of patients with heart failure, who have been dis-
charged from the unit where you work and are now being followed in clinic. What is the best
indicator that the nursing interventions of monitoring and teaching have been effective?
1- Eighty-five percent of patients have not gained weight
2- Seventy-five percent of family caregivers have reported watching an educational DVD
3- Five percent of patients have been readmitted to the hospital in the last 90 days
4- Eighty percent report that they are taking their medications - ANSWER 3
All are important but lower resource utilization is best indicator and one used by accrediting
agencies, payors, etc.
The following should NOT be used to reduce pressure, as it may increase friction injuries:
A) rolled towels
B) convoluted foam mattress overlay
C) foam pads
D) viscoelastic overlay - ANSWER A
Rolled towels and sheets should not be used and may negate pressure-reducing function of
other pads
An adult Jehovah's' Witness patient is hemorrhaging and might die without transfusions, but
he refused blood products prior to surgery. The correct procedure is?
A) use volume replacement and fractionated blood cells only, as permitted by the religion
B) contact family and ask permission
C) ask legal authorities to grant permission
D) give transfusions because the patient may die - ANSWER ANSWER: A
3
