CAPA/CPAN Exam with Accurate Solutions
Nursing Process - correct answer-Assessment-
cv cv cv cv
gathering info/data; asking questions to gather this info/data cv cv cv cv cv cv cv
Diagnosis
Identification of Outcomes cv cv
Planning-
future tense; patient is subject, achieve overall goal Implementa
cv cv cv cv cv cv cv cv
tion- nurse is subject, present tense.
cv cv cv cv cv
Evaluation
DNR vs AND - correct answer-
cv cv cv cv cv
DNR can WITHHOLD Palliative care AND includes it
cv cv cv cv cv cv cv
Ethical Principles - correct answer-Autonomy-
cv cv cv cv
freedom of action chosen by individual Beneficence- doing good
cv cv cv cv cv cv cv cv
Nonmaleficence-
do no harm Justice-
cv cv cv cv
duty to be fair to all people Veracity-
cv cv cv cv cv cv cv cv
truthfullness or accuracy Fidelity-
cv cv cv cv
loyal or faithful
cv cv cv
Biot's respirations - correct answer-
cv cv cv cv
rapid gasps followed by apnea Usually brain insults (ex. traumas)
cv cv cv cv cv cv cv cv cv
=Increase ICP cv
Cheyne-Stokes respiration - correct answer- cv cv cv cv
gradual increase and then decrease in breathing followed by apnea
cv cv cv cv cv cv cv cv cv
Increase ICP cv
usually Cardiac problems cv cv
Kussmaul's breathing pattern - correct answer- cv cv cv cv cv
tachypnea and hyperpnea ex. DKA, metabolic acidosis patients cv cv cv cv cv cv cv
Statutory Law - correct answer- cv cv cv cv
legislative acts declaring, commanding, or prohibiting something cv cv cv cv cv cv
written laws where you can go and reference it ex.
cv cv cv cv cv cv cv cv cv
driving over the speed limit
cv cv cv cv cv
Common Law - correct answer- cv cv cv cv
patient bill of rights derived from principles rather than rule
cv cv cv cv cv cv cv cv cv
s and regulations
cv cv
,Civil Law - correct answer- cv cv cv cv
Based on rules and regulations Court action lawsuits (most co
cv cv cv cv cv cv cv cv cv
mmon)
Wrong doing cv
Tort Law - correct answer- cv cv cv cv
wrongful doing involves compensation to those wro cv c v cv cv cv cv
ngfully injured assault/battery/negligence; alarm sil
cv cv cv cv
encing
Criminal Law - correct answer-Harmful or offensive to society as a whole
cv cv cv cv cv cv cv cv cv cv cv
ex. practicing nursing/medicine without a license; harming patients on purpose
cv cv cv cv cv cv cv cv cv
Informed consent** - correct answer- cv cv cv cv
Consent obtained after the patient has been fully informed by the physician about the risks
cv cv cv cv cv cv cv cv cv cv cv cv cv cv cv
and benefits of the treatment, alternatives, and consequences of no treatment
cv cv cv cv cv cv cv cv cv cv
*can be withdrawn at any time; even at the last second
cv cv cv cv cv cv cv cv cv cv
*If signing after narcotic/benzo given-must wait at least 1/2 the half-life of the drug
cv cv cv cv cv cv cv cv cv cv cv cv cv
*Is the patient knowledgeable, willing, competent
cv cv cv cv cv
Informed Consent (cont)** - correct answer- cv cv cv cv cv
Competent to Sign: legal adult, minors with parent/guardian, emancipated minor (married or cv cv cv cv cv cv cv cv cv cv cv
in armed forces).
cv cv cv
Exceptions: pt is unable to give consent and is a threat to life/emergent (IMPLIED CONSENT cv cv cv cv cv cv cv cv cv cv cv cv cv cv
)
**Must have documentation of emergency in staff notes
cv cv cv cv cv cv cv
**Malpractice - correct answer- cv cv cv
Elements needed to claim medical malpractice: Duty owed patient cv cv cv cv cv cv cv cv
Breach of duty owed patient Causat cv cv cv cv cv
ion - cv
most difficult to prove Injury/Damag
cv cv cv cv cv
es
Intentional Torts - correct answer- cv cv cv cv
Violating patient rights; No actual harm necessary. 3 most common: cv cv cv cv cv cv cv cv cv
Assault-
place person in fear of being touched Battery-
cv cv cv cv cv cv cv
Touch without permission cv cv
False imprisonment-unjustified detention cv cv
Intentional Quasi Torts - correct answer- cv cv cv cv cv
No intent to injure or cause distress to another person.
cv cv cv cv cv cv cv cv cv
Ex: Patient abandonment, defamation of character, invasion of privacy, breach of confidenti
cv cv cv cv cv cv cv cv cv cv cv
ality
**Staffing Ratios - correct answer- cv cv cv cv
Staffing ratios see pg. 864 ISO patients 1:1 cv cv cv cv cv cv cv
Peds <8 yo unconscious = 1:1 regardless of parent.
cv cv cv cv cv cv cv cv
( if they have parent and stable you can have another patient)
cv cv cv cv cv cv cv cv cv cv cv
,1:1 New phase 1 admission (fresh out of OR), unstable hemodynamically, unstable airw
cv cv cv cv cv cv cv cv cv cv cv cv
ay
PreAdmission - correct answer--usually phone call is done 2 weeks prior to surgery cv cv cv cv cv cv cv cv cv cv cv cv
-written instructions should be at 5th grade level
cv cv cv cv cv cv cv
-Med Rec starts at 1st PAT visit when MD decided pt needs surgery
cv cv cv cv cv cv cv cv cv cv cv cv
Med History (AntiCoags) - correct answer-
cv cv cv cv cv
*AntiCoag therapy, NSAIDs, Aspirin should be stopped cv cv cv cv cv cv
Aspirin-stopped up to 7 days prior cv cv cv cv cv
Coumadin-
stopped 5 days prior (coags taken immediately before surgery) Dipyridamole
cv cv cv cv cv cv cv cv cv cv
(Persantine)- stopped 2 days prior cv cv cv cv
*Interfere with plt function: Indomethacin, tricyclic antidepressants, phenothiazines, fur
cv cv cv cv cv cv cv cv
osemide, steroids cv
Med Rec (Held vs. Taken Day of Surgery) - correct answer-
cv cv cv cv cv cv cv cv cv cv
Held Day of: Diuretics, insulin, oral hypoglycemic, MAOI antidepressants
cv cv cv cv cv cv cv cv
Taken Day of: cv cv
Cardiac,antihypertensives cv cv
Beta Blockers cv
CaChannelBlockers A
cv cv cv
nticonvulsants Chronic cv cv
Pain Meds cv
Herbals/Supplements - correct answer- cv cv cv
Decreases BP: Black Cohosh Increases BP: ginseg, ephedra, licorice cv cv cv cv cv cv cv cv
Steroids: echinacea, licorice may decrease effect Increase
cv cv cv cv cv cv c
AntiCoag(More Bleeding):
v cv
-Ginko*, feverfew, garlic, ginger, ginseng, Vit E, fish oil, saw palmetto
cv cv cv cv cv cv cv cv cv cv
Decreases AntiCoag (more clotting) cv cv cv
-
St John's wort*, ginseng, green tea (
cv cv cv cv cv cv
more risk for DVT, PE, MI, Strokes)
cv cv cv cv cv cv
Barbituates and benzos cv cv
Increases Effect: St johns wart (prolongs emergence) Decreas cv cv cv cv cv cv cv
es Effect: sarsaparillae
cv cv
Diagnostic Tests: CBC Labs - correct answer-Indications for this test: cv cv cv cv cv cv cv cv cv
, Infections autoimmun cv
ediseases alcohol abu
cv cv cv
se
blood disorders (anemia, coagulopathies, chronic disease states) Expecte
cv cv cv cv cv cv cv
d large EBL or recent significant blood loss.
cv cv cv cv cv cv cv
Diagnostic Tests: BMP vs CMP Labs - correct answer- cv cv cv cv cv cv cv cv
Indications for this test: BMP: cv cv cv cv
ChronicRenalFailure cv cv cv
HTN
Heart Disease cv
any disease with potential fluid/electrolyte disturbance COPD
cv cv cv cv cv cv cv
or OSA cv
CMP:
Chronic renal or liver disease (Liver function tests) Malnutritioncv cv cv cv cv cv cv cv c
(albumin)
v
Usually ordered for Addiction patients (usually have low albumin levels) Ca
cv cv cv cv cv cv cv cv cv cv
level (ionized "free floating calcium")
cv cv cv cv cv
More Diagnostic Tests - correct answer- cv cv cv cv cv
ECG/EKG: any cardiac hx patient cv cv cv cv
Hx of CVA or TIA DM cv cv cv cv cv
Smokerlongterm P cv cv cv
V disease cv
Pregnancy Test: cv
Females of childbearing age cv cv cv
(1st to last menses +1 year WITHOUT breakthrough bleeding)
cv cv cv cv cv cv cv cv
Fasting Blood Glucose: cv cv
ALL diabetic patients unless electrolytes ordered
cv cv cv cv cv
More Diagnostic Tests (Cont.) - correct answer-
cv cv cv cv cv cv
Blood Bank: Patient pre-donated cv cv cv
Large EBL cv
CXR:
if there are s/sx of cardiac or pulm disease
cv cv cv cv cv cv cv cv
PFT (Pulm function tests): cv cv cv
Pulm surgery (thoracic surgeries), CABG cv cv cv cv
OSA- ASA OSA Checklist - correct answer- cv cv cv cv cv cv
Preop Assessment Tools: Yes to <3 = low risk for OSA
cv cv cv cv cv cv cv cv cv cv
Nursing Process - correct answer-Assessment-
cv cv cv cv
gathering info/data; asking questions to gather this info/data cv cv cv cv cv cv cv
Diagnosis
Identification of Outcomes cv cv
Planning-
future tense; patient is subject, achieve overall goal Implementa
cv cv cv cv cv cv cv cv
tion- nurse is subject, present tense.
cv cv cv cv cv
Evaluation
DNR vs AND - correct answer-
cv cv cv cv cv
DNR can WITHHOLD Palliative care AND includes it
cv cv cv cv cv cv cv
Ethical Principles - correct answer-Autonomy-
cv cv cv cv
freedom of action chosen by individual Beneficence- doing good
cv cv cv cv cv cv cv cv
Nonmaleficence-
do no harm Justice-
cv cv cv cv
duty to be fair to all people Veracity-
cv cv cv cv cv cv cv cv
truthfullness or accuracy Fidelity-
cv cv cv cv
loyal or faithful
cv cv cv
Biot's respirations - correct answer-
cv cv cv cv
rapid gasps followed by apnea Usually brain insults (ex. traumas)
cv cv cv cv cv cv cv cv cv
=Increase ICP cv
Cheyne-Stokes respiration - correct answer- cv cv cv cv
gradual increase and then decrease in breathing followed by apnea
cv cv cv cv cv cv cv cv cv
Increase ICP cv
usually Cardiac problems cv cv
Kussmaul's breathing pattern - correct answer- cv cv cv cv cv
tachypnea and hyperpnea ex. DKA, metabolic acidosis patients cv cv cv cv cv cv cv
Statutory Law - correct answer- cv cv cv cv
legislative acts declaring, commanding, or prohibiting something cv cv cv cv cv cv
written laws where you can go and reference it ex.
cv cv cv cv cv cv cv cv cv
driving over the speed limit
cv cv cv cv cv
Common Law - correct answer- cv cv cv cv
patient bill of rights derived from principles rather than rule
cv cv cv cv cv cv cv cv cv
s and regulations
cv cv
,Civil Law - correct answer- cv cv cv cv
Based on rules and regulations Court action lawsuits (most co
cv cv cv cv cv cv cv cv cv
mmon)
Wrong doing cv
Tort Law - correct answer- cv cv cv cv
wrongful doing involves compensation to those wro cv c v cv cv cv cv
ngfully injured assault/battery/negligence; alarm sil
cv cv cv cv
encing
Criminal Law - correct answer-Harmful or offensive to society as a whole
cv cv cv cv cv cv cv cv cv cv cv
ex. practicing nursing/medicine without a license; harming patients on purpose
cv cv cv cv cv cv cv cv cv
Informed consent** - correct answer- cv cv cv cv
Consent obtained after the patient has been fully informed by the physician about the risks
cv cv cv cv cv cv cv cv cv cv cv cv cv cv cv
and benefits of the treatment, alternatives, and consequences of no treatment
cv cv cv cv cv cv cv cv cv cv
*can be withdrawn at any time; even at the last second
cv cv cv cv cv cv cv cv cv cv
*If signing after narcotic/benzo given-must wait at least 1/2 the half-life of the drug
cv cv cv cv cv cv cv cv cv cv cv cv cv
*Is the patient knowledgeable, willing, competent
cv cv cv cv cv
Informed Consent (cont)** - correct answer- cv cv cv cv cv
Competent to Sign: legal adult, minors with parent/guardian, emancipated minor (married or cv cv cv cv cv cv cv cv cv cv cv
in armed forces).
cv cv cv
Exceptions: pt is unable to give consent and is a threat to life/emergent (IMPLIED CONSENT cv cv cv cv cv cv cv cv cv cv cv cv cv cv
)
**Must have documentation of emergency in staff notes
cv cv cv cv cv cv cv
**Malpractice - correct answer- cv cv cv
Elements needed to claim medical malpractice: Duty owed patient cv cv cv cv cv cv cv cv
Breach of duty owed patient Causat cv cv cv cv cv
ion - cv
most difficult to prove Injury/Damag
cv cv cv cv cv
es
Intentional Torts - correct answer- cv cv cv cv
Violating patient rights; No actual harm necessary. 3 most common: cv cv cv cv cv cv cv cv cv
Assault-
place person in fear of being touched Battery-
cv cv cv cv cv cv cv
Touch without permission cv cv
False imprisonment-unjustified detention cv cv
Intentional Quasi Torts - correct answer- cv cv cv cv cv
No intent to injure or cause distress to another person.
cv cv cv cv cv cv cv cv cv
Ex: Patient abandonment, defamation of character, invasion of privacy, breach of confidenti
cv cv cv cv cv cv cv cv cv cv cv
ality
**Staffing Ratios - correct answer- cv cv cv cv
Staffing ratios see pg. 864 ISO patients 1:1 cv cv cv cv cv cv cv
Peds <8 yo unconscious = 1:1 regardless of parent.
cv cv cv cv cv cv cv cv
( if they have parent and stable you can have another patient)
cv cv cv cv cv cv cv cv cv cv cv
,1:1 New phase 1 admission (fresh out of OR), unstable hemodynamically, unstable airw
cv cv cv cv cv cv cv cv cv cv cv cv
ay
PreAdmission - correct answer--usually phone call is done 2 weeks prior to surgery cv cv cv cv cv cv cv cv cv cv cv cv
-written instructions should be at 5th grade level
cv cv cv cv cv cv cv
-Med Rec starts at 1st PAT visit when MD decided pt needs surgery
cv cv cv cv cv cv cv cv cv cv cv cv
Med History (AntiCoags) - correct answer-
cv cv cv cv cv
*AntiCoag therapy, NSAIDs, Aspirin should be stopped cv cv cv cv cv cv
Aspirin-stopped up to 7 days prior cv cv cv cv cv
Coumadin-
stopped 5 days prior (coags taken immediately before surgery) Dipyridamole
cv cv cv cv cv cv cv cv cv cv
(Persantine)- stopped 2 days prior cv cv cv cv
*Interfere with plt function: Indomethacin, tricyclic antidepressants, phenothiazines, fur
cv cv cv cv cv cv cv cv
osemide, steroids cv
Med Rec (Held vs. Taken Day of Surgery) - correct answer-
cv cv cv cv cv cv cv cv cv cv
Held Day of: Diuretics, insulin, oral hypoglycemic, MAOI antidepressants
cv cv cv cv cv cv cv cv
Taken Day of: cv cv
Cardiac,antihypertensives cv cv
Beta Blockers cv
CaChannelBlockers A
cv cv cv
nticonvulsants Chronic cv cv
Pain Meds cv
Herbals/Supplements - correct answer- cv cv cv
Decreases BP: Black Cohosh Increases BP: ginseg, ephedra, licorice cv cv cv cv cv cv cv cv
Steroids: echinacea, licorice may decrease effect Increase
cv cv cv cv cv cv c
AntiCoag(More Bleeding):
v cv
-Ginko*, feverfew, garlic, ginger, ginseng, Vit E, fish oil, saw palmetto
cv cv cv cv cv cv cv cv cv cv
Decreases AntiCoag (more clotting) cv cv cv
-
St John's wort*, ginseng, green tea (
cv cv cv cv cv cv
more risk for DVT, PE, MI, Strokes)
cv cv cv cv cv cv
Barbituates and benzos cv cv
Increases Effect: St johns wart (prolongs emergence) Decreas cv cv cv cv cv cv cv
es Effect: sarsaparillae
cv cv
Diagnostic Tests: CBC Labs - correct answer-Indications for this test: cv cv cv cv cv cv cv cv cv
, Infections autoimmun cv
ediseases alcohol abu
cv cv cv
se
blood disorders (anemia, coagulopathies, chronic disease states) Expecte
cv cv cv cv cv cv cv
d large EBL or recent significant blood loss.
cv cv cv cv cv cv cv
Diagnostic Tests: BMP vs CMP Labs - correct answer- cv cv cv cv cv cv cv cv
Indications for this test: BMP: cv cv cv cv
ChronicRenalFailure cv cv cv
HTN
Heart Disease cv
any disease with potential fluid/electrolyte disturbance COPD
cv cv cv cv cv cv cv
or OSA cv
CMP:
Chronic renal or liver disease (Liver function tests) Malnutritioncv cv cv cv cv cv cv cv c
(albumin)
v
Usually ordered for Addiction patients (usually have low albumin levels) Ca
cv cv cv cv cv cv cv cv cv cv
level (ionized "free floating calcium")
cv cv cv cv cv
More Diagnostic Tests - correct answer- cv cv cv cv cv
ECG/EKG: any cardiac hx patient cv cv cv cv
Hx of CVA or TIA DM cv cv cv cv cv
Smokerlongterm P cv cv cv
V disease cv
Pregnancy Test: cv
Females of childbearing age cv cv cv
(1st to last menses +1 year WITHOUT breakthrough bleeding)
cv cv cv cv cv cv cv cv
Fasting Blood Glucose: cv cv
ALL diabetic patients unless electrolytes ordered
cv cv cv cv cv
More Diagnostic Tests (Cont.) - correct answer-
cv cv cv cv cv cv
Blood Bank: Patient pre-donated cv cv cv
Large EBL cv
CXR:
if there are s/sx of cardiac or pulm disease
cv cv cv cv cv cv cv cv
PFT (Pulm function tests): cv cv cv
Pulm surgery (thoracic surgeries), CABG cv cv cv cv
OSA- ASA OSA Checklist - correct answer- cv cv cv cv cv cv
Preop Assessment Tools: Yes to <3 = low risk for OSA
cv cv cv cv cv cv cv cv cv cv