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SCF Nursing Level 1 Final review game Questions And Answers Graded A+

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You (charge nurse) are auditing units nursing care plans. The goal/outcome states, "patient may be able to finally get out of bed and do some walking." What is wrong? - Must be SMART pt with dementia hasnt touched bedside water, and he only has 100ml of dark, amber colored urine in foley bag since beginning of your shift. what do you need to do? - dementia pt may forget to drink if they forget or dont recognize thirst. may need encouragement to drink or iv fluids You overhear a nurse asking an LPN to perform an admission assessment and complete the paperwork on a new floor arrival. Why is this wrong? - Scope of practice: LPN may not perform an initial admission assessment Your pt has left sided weakness, where do you place bedside commode? - strong side (right) or left side at foot of bed Pt has gastroenteritis, and the new nurse tells them that their medication dose may need to be reduced because of impaired GI metabolism. Why is this wrong? - liver is primary site of drug metabolism You (charge nurse) are auditing units nursing care plans. The documentation says, "patient said he felt tired and had some pain. BP was low so I told PT to leave patient alone." What is wrong? - Must be SMART Patient on unit has been taking vancomycin PO for C. Diff infection and reports vaginal itching and burning. A new nurse tells the patient she should be tested for and STI asap. Why doesnt she need the testing? - antibiotics disturb normal microbiome and puts pt at risk for superinfection. Strong antibiotics can lead to vaginal yeast infection (vaginal candidiasis) 30 y.o. pt with terminal cancer doesnt want to have chemo or radiation. Her mother says, "ignore her, she doesnt know what shes saying, tell the dr we want to start treatment now." Whys this wrong? - autonomy is associated with allowing/enabling pt to make their own decisions about healthcarept who has bilateral mastectomy is very upset and anxious. She fears her husband will no longer find her attractive and that he will leave her for another woman. What do you do? - therapeutic communication- encourage to express her feelings more pt takes dilaudid 0.5mg IV q4 hour for pain, but pain is not under good control. Provider will put in order to double pt dosage. Phramacy finalizes the order and the dose is dilaudid 10mg IV q4 for pain. What do you do? - discuss dose with provider when confirming pt identity, the new nurse asks the patient if she is Jane smith? what should she have asked instead? - confirm name and date of birth patient asks you to explain why his oral dose of dilaudid is so much larger than his iv dose. why is this? - first pass effect you assess a toddler and drop your clipboard. the mom is startled, but the kid doesnt flinch. what may be the issue? - developmental delay in kids Your pregnant patient (1st tri) asks you if she can take her DHE migraine medicine. You find this medicine is considered pregnancy class X. What would you advise this patient? - Avoid pregnancy class X. 1) nonmedicinal= hydration, caffeine, magnesium, 2) medicinal= Tylenol you need to assess pt pain level, but they are aphasic and cannot verbally communicate. what can you use? - pain scale (faces) post op pt is on normal saline at 125ml/hr. you hear crackles in his lungs, his o2sat is 90% on 2 liters nasal cannula and breathing is labored (short of breath) Pulses are bounding. What do you do? - stop iv and notify physician pt with HF has shortness of breath, fatigue, stomach bloating, and swollen feet. BMP shows sodium of 126 meq/l. whats the issue and how do we resolve it? - volume overload with dilutional hypervolemic hyponatremia from congestion. treat with fluid restriction and loop diureticsyou receive order for FOBT. you put a cup in commode and inform UAP that you need a stool sample for testing. later, the uap gives you the cup with solid brown stool to send to the lab for testing. whys this wrong? - FOBT used to detect presence of blood in stool. need to smear sample onto card for testing pt with liver cirrhosis wants a disposable razor to shave. why is this a bad idea? - cirrhosis means increased risk for bleeding in people with chronic liver disease due to decreased platelet production and decrease production of vitamin k. cannot clot and he is at risk to bleed out, no razor your 82 y.o. pt only eats a fraction of her food. she says the food doesnt taste flavorful or remotely good anymore. she also has no appetite. why? - taste buds decrease in age an the remaining ones shrink. mouth has less saliva and can affect the taste. offer smaller portions with more vitamins/ minerals; good oral hygiene; nutritional supplements and flavor enhancers pt requested to be boosted up in bed, but the family is trying to lift the patient up in bed under her arms. why dont you do this? - can harm pt shoulders and can cause shearing force to skin. need 2 people to boost you (charge nurse) see a new nurse is uncomfortable about taking care of pt wearing a hijab. the nurse states she doesnt know anything about the Muslim religion or their cultural practices and shes afraid she may offend the pt or their family. what should you know when caring for someone of another religion? - awareness, acceptance, asking. be aware of own bias/perceptions/ assumptions. accept cultural differences. ask pt if there are cultural/religious practices you need to know in order to respect and support their needs new pt is agitated and angry and often lashes out at you verbally, despite attempts to care for them/ meet needs. what do you do? - stay calm. be polite but firm and set limits for their behavior. be aware of body language and maintain appropriate distance. allow patient to vent feelings and listen to their concerns. find reason behind behavior and show understanding you need to speak to middle schoolers about healthy life choices. what is the best way to prevent an STI? - abstinence pt with severe blood loss anemia refuses to consent to blood transfusion unless they know that the donor did not get the covid vaccine. what do you tell them? - the donor must remain anonymous,blood product labels do not report vaccine status, or info pertaining to demographic factors. pt has right to refuse transfusion you have an elderly pt with a terminal illness. pt expresses the desire to die peacefully without aggressive interventions. family opposes and wants "everything medically possible" to save the pt life. what do you do? - engage in open and compassionate communication with pt and the family about the pt medical condition. BE THE PT ADVOCATE. seek assistance of ethics committee when warranted pt asks why they are on both senna and mirilax. what do you tell them? - senna is a stimulant laxative and mirilax is osmotic and draws water to soften stool new grad nurse is administering iv dilaudid to sleeping pt. new nurse tells you hat the pt asked to be given their meds right when it was due regardless of sleep status. whats wrong with this? - opioids can cause respiratory depression and low BP. need to assess pt consciousness, respiratory rate and BP. nurse must also perform 10 right of med admin

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Uploaded on
August 10, 2024
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Written in
2024/2025
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Exam (elaborations)
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SCF Nursing Level 1 Final review game
You (charge nurse) are auditing units nursing care plans. The goal/outcome states, "patient may be able
to finally get out of bed and do some walking." What is wrong? - Must be SMART



pt with dementia hasnt touched bedside water, and he only has 100ml of dark, amber colored urine in
foley bag since beginning of your shift. what do you need to do? - dementia pt may forget to drink
if they forget or dont recognize thirst. may need encouragement to drink or iv fluids



You overhear a nurse asking an LPN to perform an admission assessment and complete the paperwork
on a new floor arrival. Why is this wrong? - Scope of practice: LPN may not perform an initial
admission assessment



Your pt has left sided weakness, where do you place bedside commode? - strong side (right) or
left side at foot of bed



Pt has gastroenteritis, and the new nurse tells them that their medication dose may need to be reduced
because of impaired GI metabolism. Why is this wrong? - liver is primary site of drug metabolism




You (charge nurse) are auditing units nursing care plans. The documentation says, "patient said he felt
tired and had some pain. BP was low so I told PT to leave patient alone." What is wrong? - Must
be SMART



Patient on unit has been taking vancomycin PO for C. Diff infection and reports vaginal itching and
burning. A new nurse tells the patient she should be tested for and STI asap. Why doesnt she need the
testing? - antibiotics disturb normal microbiome and puts pt at risk for superinfection. Strong
antibiotics can lead to vaginal yeast infection (vaginal candidiasis)



30 y.o. pt with terminal cancer doesnt want to have chemo or radiation. Her mother says, "ignore her,
she doesnt know what shes saying, tell the dr we want to start treatment now." Whys this wrong? -
autonomy is associated with allowing/enabling pt to make their own decisions about healthcare

, pt who has bilateral mastectomy is very upset and anxious. She fears her husband will no longer find her
attractive and that he will leave her for another woman. What do you do? - therapeutic
communication- encourage to express her feelings more



pt takes dilaudid 0.5mg IV q4 hour for pain, but pain is not under good control. Provider will put in order
to double pt dosage. Phramacy finalizes the order and the dose is dilaudid 10mg IV q4 for pain. What do
you do? - discuss dose with provider



when confirming pt identity, the new nurse asks the patient if she is Jane smith? what should she have
asked instead? - confirm name and date of birth



patient asks you to explain why his oral dose of dilaudid is so much larger than his iv dose. why is this? -
first pass effect



you assess a toddler and drop your clipboard. the mom is startled, but the kid doesnt flinch. what may
be the issue? - developmental delay in kids

Your pregnant patient (1st tri) asks you if she can take her DHE migraine medicine. You find this medicine
is considered pregnancy class X. What would you advise this patient? - Avoid pregnancy class X. 1)
nonmedicinal= hydration, caffeine, magnesium, 2) medicinal= Tylenol



you need to assess pt pain level, but they are aphasic and cannot verbally communicate. what can you
use? - pain scale (faces)



post op pt is on normal saline at 125ml/hr. you hear crackles in his lungs, his o2sat is 90% on 2 liters
nasal cannula and breathing is labored (short of breath) Pulses are bounding. What do you do? -
stop iv and notify physician



pt with HF has shortness of breath, fatigue, stomach bloating, and swollen feet. BMP shows sodium of
126 meq/l. whats the issue and how do we resolve it? - volume overload with dilutional
hypervolemic hyponatremia from congestion. treat with fluid restriction and loop diuretics

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