NUR242 skills UPDATED ACTUAL Exam
Questions and CORRECT Answers
what are the 7 safety checks - CORRECT ANSWER - 1. call bell within reach
2. are the suction + O2 equipment functioning
3. can patient access their mobility aids
4. check all tubes & lines
5. have med charts been reviewed
6. check allergies
7. has ADDs score + observations been reviewed and are they normal
IVAB - CORRECT ANSWER -
how can IV medications be administered - CORRECT ANSWER - 1. bolus/injection
2. infusion for larger doses
considerations for IV infusions - CORRECT ANSWER - - ensure correct diluent
(h2o/saline)
-consider fluid restricitons + should be charted on fluid treatment chart
- use smallest gauge needle to enter rubber port to avoid making large bore for bacteria &
leakage
- invert bag back/forth at least 10 times
what do you do if this is your patients first dose of IV medication - CORRECT
ANSWER - observe closely during administration and for a minimum of 5 minutes post
administration
- if any reaction stop immediately
- check on patient 15 minutes post administration
,what to do if administration has been delayed for over an hour - CORRECT ANSWER --
discuss if its appropriate to retain preparation
- discard the preparation and make a new one
which solutions may not have additives added to it - CORRECT ANSWER - - blood,
albumin, blood products
- total parental nutrition
- intralipids
- dextrans
considerations before administering IV medication - CORRECT ANSWER - - check and
verbally ask for allergies
- check and ensure label for adverse drug reactions
- ensure patency with saline flush
CATHETERISATION - CORRECT ANSWER -
what is the purpose of catheterisation (2) - CORRECT ANSWER - 1. to monitor UO
2. provide bladder drainage
5 indications for a catheter - CORRECT ANSWER - 1. during & post surgery
2. acute urinary retention
3. chronic urinary retention
4. irrigation of bladder
5. minimising distress and discomfort during end of life care
contraindications of a catheter (2) - CORRECT ANSWER - - blood at meatus
- suspected urethral trauma
, what are the 2 types of catheter - CORRECT ANSWER - 1. 2-way IDC (inflation +
drainage)
2. 3-way IDC (inflation + irrigation + drainage)
female catheter size recommendations - CORRECT ANSWER - - 12/14 gauge
- length: IDC-27cm, IMC-16cm
male catheter size recommendations - CORRECT ANSWER - - 16 gauge
- length: IDC-44cm, IMC-40cm
important consideration regarding urine output - CORRECT ANSWER - if <100 in 3
hours activate medical emergency
considerations in the process of inserting an IDC (regarding infection control) - CORRECT
ANSWER - - thorough hand hygiene to avoid introducing bacteria to patient
-aseptic technique + don sterile gloves
insertion considerations (3 points regarding the balloon) - CORRECT ANSWER - - only
inflate balloon with sterile water if there is urine drainage
- when urine is flowing, advance catheter another 6-8cm then inflate
- if there is pain during balloon inflation = it could be in the urethra rather than in bladder
drainage bag considerations - CORRECT ANSWER - - bag should be below level of
bladder
(urinary reflux is associated with infection, having bag in this position prevents back flow)
when should you measure urine output and what are 3 urine output considerations - CORRECT
ANSWER - - measure UO after 15 minutes and at 1 hour
Questions and CORRECT Answers
what are the 7 safety checks - CORRECT ANSWER - 1. call bell within reach
2. are the suction + O2 equipment functioning
3. can patient access their mobility aids
4. check all tubes & lines
5. have med charts been reviewed
6. check allergies
7. has ADDs score + observations been reviewed and are they normal
IVAB - CORRECT ANSWER -
how can IV medications be administered - CORRECT ANSWER - 1. bolus/injection
2. infusion for larger doses
considerations for IV infusions - CORRECT ANSWER - - ensure correct diluent
(h2o/saline)
-consider fluid restricitons + should be charted on fluid treatment chart
- use smallest gauge needle to enter rubber port to avoid making large bore for bacteria &
leakage
- invert bag back/forth at least 10 times
what do you do if this is your patients first dose of IV medication - CORRECT
ANSWER - observe closely during administration and for a minimum of 5 minutes post
administration
- if any reaction stop immediately
- check on patient 15 minutes post administration
,what to do if administration has been delayed for over an hour - CORRECT ANSWER --
discuss if its appropriate to retain preparation
- discard the preparation and make a new one
which solutions may not have additives added to it - CORRECT ANSWER - - blood,
albumin, blood products
- total parental nutrition
- intralipids
- dextrans
considerations before administering IV medication - CORRECT ANSWER - - check and
verbally ask for allergies
- check and ensure label for adverse drug reactions
- ensure patency with saline flush
CATHETERISATION - CORRECT ANSWER -
what is the purpose of catheterisation (2) - CORRECT ANSWER - 1. to monitor UO
2. provide bladder drainage
5 indications for a catheter - CORRECT ANSWER - 1. during & post surgery
2. acute urinary retention
3. chronic urinary retention
4. irrigation of bladder
5. minimising distress and discomfort during end of life care
contraindications of a catheter (2) - CORRECT ANSWER - - blood at meatus
- suspected urethral trauma
, what are the 2 types of catheter - CORRECT ANSWER - 1. 2-way IDC (inflation +
drainage)
2. 3-way IDC (inflation + irrigation + drainage)
female catheter size recommendations - CORRECT ANSWER - - 12/14 gauge
- length: IDC-27cm, IMC-16cm
male catheter size recommendations - CORRECT ANSWER - - 16 gauge
- length: IDC-44cm, IMC-40cm
important consideration regarding urine output - CORRECT ANSWER - if <100 in 3
hours activate medical emergency
considerations in the process of inserting an IDC (regarding infection control) - CORRECT
ANSWER - - thorough hand hygiene to avoid introducing bacteria to patient
-aseptic technique + don sterile gloves
insertion considerations (3 points regarding the balloon) - CORRECT ANSWER - - only
inflate balloon with sterile water if there is urine drainage
- when urine is flowing, advance catheter another 6-8cm then inflate
- if there is pain during balloon inflation = it could be in the urethra rather than in bladder
drainage bag considerations - CORRECT ANSWER - - bag should be below level of
bladder
(urinary reflux is associated with infection, having bag in this position prevents back flow)
when should you measure urine output and what are 3 urine output considerations - CORRECT
ANSWER - - measure UO after 15 minutes and at 1 hour
