RN COMP PRACTICE 2023 A
QUESTIONS WITH [A GRADED]
ANSWERS
NGN:wlWhatwlassessmentwlfindingswlarewlconsistentwlwithwlCrohn'swldisease,wlulcerativew
lcolitis,wlorwlperitonitis?
Temperaturewl(100F)
Weightwl(-9.7wllbs)
Albuminwllevelwl(2.4)
WBCwl(14)
Bowelwlpatternwl(freq.wlloosewlstools)
Abdominalwlpainwllocationwl(RLQ)
Heartwlratewl(105)wl-wlANS--Temperature:wlCrohn's,wlUCwl&wlperitonitis.wl
-Elevationwlcanwloccurwlwithwlallwlthreewlduewltowlinflammationwlandwlinfection.wl
Weight:wlCrohn'swl&wlUC.wl
-UnintendedwlweightwllosswlcanwloccurwlduewltowlmalabsorptionwlinwlthewlGIwltract.wl
Bowelwlpattern:wlCrohn's.
-
Ifwlthewlpatientwlreportedwltherewlwaswlbloodwlinwlthewlstool,wlitwlwouldwlbewlUC.wlCrohn'swl
doesn'twlcausewltarrywlstools.wl
WBC:wlCrohn's,wlUCwl&wlperitonitis.
-Elevationwlcanwloccurwlduewltowlinflammationwlandwlinfection.wl
Heartwlrate:wlperitonitis.wl
-Tachycardiawlcanwloccurwlduewltowlinflammation,wlinfection,wlandwldehydration.wl
Albuminwllevel:wlCrohn'swl&wlUC.wl
-
BecausewlofwlthewlmalabsorptionwlinwlthewlGIwltract,wlthewlbodywlisn'twlreceivingwlenoughwl
protein.wl
Abdominalwlpainwllocation:wlCrohn's.wl
-
BecausewlitwliswlinwlthewlRLQ,wlitwliswlmorewlconsistentwlwithwlCrohn's.wlWithwlpatientswltha
twlhavewlperitonitis,wltheywlexperiencewlgeneralizedwlabd.wlpainwlthatwlradiateswltowlthewlsh
oulderwlandwlback.
,NGN:wlWhatwlassessmentwlfindingswlcanwlindicatewlawltransfusionwlreactionwlinwlawlpatient
wlreceivingwlblood?
Urinewloutputwl(150mLwlofwlclear,wlyellow)
Skinwl(pale,wlcoolwlandwldry)
Anxiety
Vitalwlsignswl(withinwlnormalwlrange)
Headache
Backwlpainwl-wlANS--Backwlpain,wlheadachewl&wlanxiety.wl
HemolyticwlreactionwlS/
S:wlbackwlpain,wlheadache,wlanxiety,wlfever,wlchills,wlchestwlpain,wltachycardia,wldyspnea,
wlhypotension.
NGN:wlPatientwlarriveswlwithwlpalpitations,wldifficultywlbreathing,wlandwlreportswlfeelingwlfai
nt.wlReportswlconstipationwlandwljointwlpainwlforwlx2wldays.wlInwlchildhood,wlpatientwlexperi
encedwlphysicalwlabuse,wlandwlemotionallywldetachedwlparents.wlReportswlnervousnesswl
andwlonlywlleavingwlhomewlwhenwlnecessary.wl
PMH:wlfreq.wlhospitalwlvisitswlduewltowlheadacheswlandwlGIwldistress.wl
Bowtie:wl-wlANS--Condition:wlsomaticwlsymptomwldisorderwl
-duewltowlphysicalwlinactivitywl&wljointwlpain
Interventions:wlMonitorwlphysicalwlmanifestationswl&wlassesswlforwlpresencewlofwl2ndwlgai
nswlfromwltheirwlillness
-
disorderwliswlcharacterizedwlbywlthewlpresencewlofwlotherwlrealwlmanifestationswllikewldizzi
ness,wlnausea,wlbackwlpain,wlandwljointwlpain.wl
Monitor:wlVitalwlsignswl&wlpain.
NGN:wlWhatwlactionswlshouldwlthewlnursewltakewlwhenwlherwlpediwlpatientwliswlexhibitingwl
symptomswlofwlanwlallergicwlreaction?
Administerwl0.9%wlNSwlIV
AdministerwlepiwlIM
Monitorwlurinewloutputwlq2hrs
DCwlsupplementalwloxygen
Monitorwlvitalwlsignswlfrequently
DCwlIVwlmedicationwl-wlANS--Administerwl0.9%wlNSwlIV
AdministerwlepiwlIM
Monitorwlvitalwlsignswlfrequently
DCwlIVwlmedication
,-
NursewlshouldwlDCwlthewlRocephinwlandwlgivewlIVwlNSwltowlhelpwlrestorewlfluidswlbecause
wlfluidwlshiftswlcanwloccurwlquicklywlduringwlawlreaction.wlAdministeringwlepiwlIMwliswlthewlfir
stwllinewlofwltherapywlforwlanaphylacticwlreactionswlbecausewlitwlconstrictswlbloodwlvesselsw
landwldilateswlbronchioles.wlMonitoringwlvitalwlsingswlfrequentlywlwillwlallowwlthewlnursewlto
wlmonitorwlforwlsignswlofwlshock.
NGN:wlWhatwl5wlactionswlshouldwlthewlnursewlplanwltowltakewlwithwlawlpatientwlexperiencin
gwlhallucinations,wlfollowingwlalcoholwlwithdrawal?
Administerwlthiamine
Maintainwlawllow-stimulationwlenvironmentwl
Administerwlchlordiazepoxide
Initiatewlseizurewlprecautions
PerformwlawlCIWA-Ar
Administerwldisulfiramwl-wlANS--Administerwlthiamine
Maintainwlawllow-stimulationwlenvironmentwl
Administerwlchlordiazepoxide
Initiatewlseizurewlprecautions
PerformwlawlCIWA-Ar
-
Nursewlshouldwlplanwlinterventionswlthatwlkeepwlthewlpatientwlsafewlandwltreatwlthewlphysic
alwlmanifestationswlofwlwithdrawal.wlUsewlthewlCIWA-
Arwltowldeterminewlthewlseveritywlofwlthewlwithdrawal.wlWithdrawalwlseizureswlcanwloccurwl
12-
24hrswlafterwlcessationwlofwlalcoholwluse,wlthereforewlinitiatewlseizurewlprecautionswltowlpr
eventwlinjury.wlAdministerwlchlordiazepoxidewl(awlbenzodiazepine)wlandwlplacewlpatientwli
nwlawllow-
stimwlenvironmentwltowldecreasewlagitationwlandwlthewlriskwlforwlseizures.wlAdministeringwl
thiaminewlcanwlpreventwlWernickewlsyndrome.
NGN:wlAwlpost-
opwlpatientwliswlexperiencingwlrightwllowerwlextremitywlpainwlandwlitching,wlfollowingwlanwle
mergentwlappy.wlReportswlrightwllowerwlextremitywlpainwlthatwlhaswlbeenwlintermittentwlforw
lx2wlmonths.wl
Assessment:wlBilatwllowerwlextremitieswlwarmwltowltouch,wlpedalwlpulseswl2+wlbilat.wlSpide
rwlveinswlnoted.wlDistendedwlveinswlnotedwlonwlrightwllowerwlextremity.wlVitalwlsignswlarewl
withinwlnormalwllimits.wl
Bowtie:wl-wlANS--Condition:wlVaricosewlveins.
-duewltowledemawl&wlpruritiswl
Interventions:wlElevatewlextremitywl&wlapplywlcompressionwlstockings
-towlpromotewlvenouswlreturnwl&wlcirculation
, Monitor:wlPruritiswl&wledema
NGN:wlWhichwlassessmentwlfindingswlrequirewlanwlimmediatewlfollow-
upwlinwlawlschizophrenicwlpatient?
Hyperactivewlbowelwlsoundswlx4
LastwlHCPwlappointmentwlwaswl6wlmonthswlago
ClientwlAOwlx2
Agitated
Speechwldisorganized
Involuntarywltonguewlmovementwlandwlfootwltremor
Increasewlinwlurinationwlandwlonewlepisodewlofwlincontinence
Familywlc/owlincreasedwlagitationwlandwldelusionswl-wlANS--
Involuntarywltonguewlmovementwlandwlfootwltremor
Frequentwlurinationwlandwlincontinence
Increasewlinwlagitation
-Patientwliswlexperiencingwltardivewldyskinesia
Awlhomewlhealthwlnursewliswlevaluationwlawlschool-
agewlchildwlwhowlhaswlcysticwlfibrosis.wlThewlnursewlshouldwlinitiatewlawlrequestwlforwlawlhig
h-
frequencywlchestwlcompressionwlvestwlinwlresponsewltowlwhichwlofwlthewlfollowingwlparentw
lstatements?
A.wl"Mywlchildwldoesn'twllikewltowlsitwlstillwlforwlnebulizerwltreatments."
B.wl"Iwlthinkwlthatwlmywlchildwlhaswlbeenwlrunningwlawlfeverwloverwlthewllastwlcouplewlofwlda
ys."
C.wl"Mywlchildwlonlywlhaswlawlsmallwlamountwlofwlmucuswlafterwlpercussionwltherapy."
D.wl"Iwlamwlconcernedwlaboutwlmywlchild'swlfuturewlparticipationwlinwlteamwlsports."wl-
wlANS--
C.wl"Mywlchildwlhaswlonlywlawlsmallwlamountwlofwlmucuswlafterwlpercussionwltherapy."
-Thewlnursewlshouldwlrecommendwlawlhigh-
frequencywlvestwlforwlawlchildwlwhowlhaswlinadequatewlresultswlfromwlotherwlairwaywlcleara
ncewltherapywltechniques.wlOlderwlchildrenwloftenwlrequirewlotherwltechniqueswlinwladditio
nwltowlpercussionwlandwlposturalwldrainagewltowlachievewladequatewlmucuswlexpectoratio
n.
-
Thewlnursewlshouldwlteachwlthewlparentwltechniqueswlforwladministrationwlforwlnebulizerwltr
eatmentswltowlthewlchild.wl
-Thewlnursewlshouldwlfollow-
upwlonwlreportswlofwlfever,wlaswlthiswlcouldwlindicatewlawlpulmonarywlinfection.
QUESTIONS WITH [A GRADED]
ANSWERS
NGN:wlWhatwlassessmentwlfindingswlarewlconsistentwlwithwlCrohn'swldisease,wlulcerativew
lcolitis,wlorwlperitonitis?
Temperaturewl(100F)
Weightwl(-9.7wllbs)
Albuminwllevelwl(2.4)
WBCwl(14)
Bowelwlpatternwl(freq.wlloosewlstools)
Abdominalwlpainwllocationwl(RLQ)
Heartwlratewl(105)wl-wlANS--Temperature:wlCrohn's,wlUCwl&wlperitonitis.wl
-Elevationwlcanwloccurwlwithwlallwlthreewlduewltowlinflammationwlandwlinfection.wl
Weight:wlCrohn'swl&wlUC.wl
-UnintendedwlweightwllosswlcanwloccurwlduewltowlmalabsorptionwlinwlthewlGIwltract.wl
Bowelwlpattern:wlCrohn's.
-
Ifwlthewlpatientwlreportedwltherewlwaswlbloodwlinwlthewlstool,wlitwlwouldwlbewlUC.wlCrohn'swl
doesn'twlcausewltarrywlstools.wl
WBC:wlCrohn's,wlUCwl&wlperitonitis.
-Elevationwlcanwloccurwlduewltowlinflammationwlandwlinfection.wl
Heartwlrate:wlperitonitis.wl
-Tachycardiawlcanwloccurwlduewltowlinflammation,wlinfection,wlandwldehydration.wl
Albuminwllevel:wlCrohn'swl&wlUC.wl
-
BecausewlofwlthewlmalabsorptionwlinwlthewlGIwltract,wlthewlbodywlisn'twlreceivingwlenoughwl
protein.wl
Abdominalwlpainwllocation:wlCrohn's.wl
-
BecausewlitwliswlinwlthewlRLQ,wlitwliswlmorewlconsistentwlwithwlCrohn's.wlWithwlpatientswltha
twlhavewlperitonitis,wltheywlexperiencewlgeneralizedwlabd.wlpainwlthatwlradiateswltowlthewlsh
oulderwlandwlback.
,NGN:wlWhatwlassessmentwlfindingswlcanwlindicatewlawltransfusionwlreactionwlinwlawlpatient
wlreceivingwlblood?
Urinewloutputwl(150mLwlofwlclear,wlyellow)
Skinwl(pale,wlcoolwlandwldry)
Anxiety
Vitalwlsignswl(withinwlnormalwlrange)
Headache
Backwlpainwl-wlANS--Backwlpain,wlheadachewl&wlanxiety.wl
HemolyticwlreactionwlS/
S:wlbackwlpain,wlheadache,wlanxiety,wlfever,wlchills,wlchestwlpain,wltachycardia,wldyspnea,
wlhypotension.
NGN:wlPatientwlarriveswlwithwlpalpitations,wldifficultywlbreathing,wlandwlreportswlfeelingwlfai
nt.wlReportswlconstipationwlandwljointwlpainwlforwlx2wldays.wlInwlchildhood,wlpatientwlexperi
encedwlphysicalwlabuse,wlandwlemotionallywldetachedwlparents.wlReportswlnervousnesswl
andwlonlywlleavingwlhomewlwhenwlnecessary.wl
PMH:wlfreq.wlhospitalwlvisitswlduewltowlheadacheswlandwlGIwldistress.wl
Bowtie:wl-wlANS--Condition:wlsomaticwlsymptomwldisorderwl
-duewltowlphysicalwlinactivitywl&wljointwlpain
Interventions:wlMonitorwlphysicalwlmanifestationswl&wlassesswlforwlpresencewlofwl2ndwlgai
nswlfromwltheirwlillness
-
disorderwliswlcharacterizedwlbywlthewlpresencewlofwlotherwlrealwlmanifestationswllikewldizzi
ness,wlnausea,wlbackwlpain,wlandwljointwlpain.wl
Monitor:wlVitalwlsignswl&wlpain.
NGN:wlWhatwlactionswlshouldwlthewlnursewltakewlwhenwlherwlpediwlpatientwliswlexhibitingwl
symptomswlofwlanwlallergicwlreaction?
Administerwl0.9%wlNSwlIV
AdministerwlepiwlIM
Monitorwlurinewloutputwlq2hrs
DCwlsupplementalwloxygen
Monitorwlvitalwlsignswlfrequently
DCwlIVwlmedicationwl-wlANS--Administerwl0.9%wlNSwlIV
AdministerwlepiwlIM
Monitorwlvitalwlsignswlfrequently
DCwlIVwlmedication
,-
NursewlshouldwlDCwlthewlRocephinwlandwlgivewlIVwlNSwltowlhelpwlrestorewlfluidswlbecause
wlfluidwlshiftswlcanwloccurwlquicklywlduringwlawlreaction.wlAdministeringwlepiwlIMwliswlthewlfir
stwllinewlofwltherapywlforwlanaphylacticwlreactionswlbecausewlitwlconstrictswlbloodwlvesselsw
landwldilateswlbronchioles.wlMonitoringwlvitalwlsingswlfrequentlywlwillwlallowwlthewlnursewlto
wlmonitorwlforwlsignswlofwlshock.
NGN:wlWhatwl5wlactionswlshouldwlthewlnursewlplanwltowltakewlwithwlawlpatientwlexperiencin
gwlhallucinations,wlfollowingwlalcoholwlwithdrawal?
Administerwlthiamine
Maintainwlawllow-stimulationwlenvironmentwl
Administerwlchlordiazepoxide
Initiatewlseizurewlprecautions
PerformwlawlCIWA-Ar
Administerwldisulfiramwl-wlANS--Administerwlthiamine
Maintainwlawllow-stimulationwlenvironmentwl
Administerwlchlordiazepoxide
Initiatewlseizurewlprecautions
PerformwlawlCIWA-Ar
-
Nursewlshouldwlplanwlinterventionswlthatwlkeepwlthewlpatientwlsafewlandwltreatwlthewlphysic
alwlmanifestationswlofwlwithdrawal.wlUsewlthewlCIWA-
Arwltowldeterminewlthewlseveritywlofwlthewlwithdrawal.wlWithdrawalwlseizureswlcanwloccurwl
12-
24hrswlafterwlcessationwlofwlalcoholwluse,wlthereforewlinitiatewlseizurewlprecautionswltowlpr
eventwlinjury.wlAdministerwlchlordiazepoxidewl(awlbenzodiazepine)wlandwlplacewlpatientwli
nwlawllow-
stimwlenvironmentwltowldecreasewlagitationwlandwlthewlriskwlforwlseizures.wlAdministeringwl
thiaminewlcanwlpreventwlWernickewlsyndrome.
NGN:wlAwlpost-
opwlpatientwliswlexperiencingwlrightwllowerwlextremitywlpainwlandwlitching,wlfollowingwlanwle
mergentwlappy.wlReportswlrightwllowerwlextremitywlpainwlthatwlhaswlbeenwlintermittentwlforw
lx2wlmonths.wl
Assessment:wlBilatwllowerwlextremitieswlwarmwltowltouch,wlpedalwlpulseswl2+wlbilat.wlSpide
rwlveinswlnoted.wlDistendedwlveinswlnotedwlonwlrightwllowerwlextremity.wlVitalwlsignswlarewl
withinwlnormalwllimits.wl
Bowtie:wl-wlANS--Condition:wlVaricosewlveins.
-duewltowledemawl&wlpruritiswl
Interventions:wlElevatewlextremitywl&wlapplywlcompressionwlstockings
-towlpromotewlvenouswlreturnwl&wlcirculation
, Monitor:wlPruritiswl&wledema
NGN:wlWhichwlassessmentwlfindingswlrequirewlanwlimmediatewlfollow-
upwlinwlawlschizophrenicwlpatient?
Hyperactivewlbowelwlsoundswlx4
LastwlHCPwlappointmentwlwaswl6wlmonthswlago
ClientwlAOwlx2
Agitated
Speechwldisorganized
Involuntarywltonguewlmovementwlandwlfootwltremor
Increasewlinwlurinationwlandwlonewlepisodewlofwlincontinence
Familywlc/owlincreasedwlagitationwlandwldelusionswl-wlANS--
Involuntarywltonguewlmovementwlandwlfootwltremor
Frequentwlurinationwlandwlincontinence
Increasewlinwlagitation
-Patientwliswlexperiencingwltardivewldyskinesia
Awlhomewlhealthwlnursewliswlevaluationwlawlschool-
agewlchildwlwhowlhaswlcysticwlfibrosis.wlThewlnursewlshouldwlinitiatewlawlrequestwlforwlawlhig
h-
frequencywlchestwlcompressionwlvestwlinwlresponsewltowlwhichwlofwlthewlfollowingwlparentw
lstatements?
A.wl"Mywlchildwldoesn'twllikewltowlsitwlstillwlforwlnebulizerwltreatments."
B.wl"Iwlthinkwlthatwlmywlchildwlhaswlbeenwlrunningwlawlfeverwloverwlthewllastwlcouplewlofwlda
ys."
C.wl"Mywlchildwlonlywlhaswlawlsmallwlamountwlofwlmucuswlafterwlpercussionwltherapy."
D.wl"Iwlamwlconcernedwlaboutwlmywlchild'swlfuturewlparticipationwlinwlteamwlsports."wl-
wlANS--
C.wl"Mywlchildwlhaswlonlywlawlsmallwlamountwlofwlmucuswlafterwlpercussionwltherapy."
-Thewlnursewlshouldwlrecommendwlawlhigh-
frequencywlvestwlforwlawlchildwlwhowlhaswlinadequatewlresultswlfromwlotherwlairwaywlcleara
ncewltherapywltechniques.wlOlderwlchildrenwloftenwlrequirewlotherwltechniqueswlinwladditio
nwltowlpercussionwlandwlposturalwldrainagewltowlachievewladequatewlmucuswlexpectoratio
n.
-
Thewlnursewlshouldwlteachwlthewlparentwltechniqueswlforwladministrationwlforwlnebulizerwltr
eatmentswltowlthewlchild.wl
-Thewlnursewlshouldwlfollow-
upwlonwlreportswlofwlfever,wlaswlthiswlcouldwlindicatewlawlpulmonarywlinfection.
