PROGRESSIVE CARE RN A 2024
(RELIAS?) QUESTIONS AND ANSWERS
Youqwantqtoqassessqforqjugularqveinqdistentionq(JVD).qWhatqpositionqwouldqbeq
BEST?q-qans-
Positionqpatientqonqtheirqbackqwithqheadqofqbedqatq30qtoq45qdegrees.
Yourqpatientqwithqtripleqcardiacqbypassqsurgeryqisqpost-
opqdayq3.qChestqtubesqhaveqbeenqremoved.qTheyqsuddenlyqreportqpalpitations.q
Theirqbloodqpressureqisq130/76qandqheartqrateqisq140qbpm.qWhatqwouldqyouqd
oqNEXT?q-qans-PerformqaqbedsideqEKG
Yourqpatientqhasqaqhistoryqofqrenalqinsufficiency.qWhatqclassqofqanalgesicsqwoul
dqMOSTqlikelyqbeqcontraindicatedqforqthem?q-qans-Nonsteroidalqanti-
inflammatoryqmedications
Yourqpatientqisqacutelyqill.qWhatqrouteqofqmedicationqadministrationqwouldqlikelyq
beqLEASTqeffective?q-qans-Intramuscular
Youqareqworkingqwithqtheqcodeqteamqtoqresuscitateqaqpatientqinqventricularqfibril
lation.qChestqcompressionsqareqongoingqandqtheqpatientqhasqbeenqshockedqtwic
e.qWhatqemergencyqmedication,qifqany,qwouldqyouqadministerqatqthisqjuncture?q-
qans-Epinephrineq(Adrenaline)q1qmgqIV
Yourqpatientqisqonqanticoagulantqmedication.qYouqareqdischargingqthemqandqpro
videqpatientqeducation.
Whichqstatementqbyqyourqpatientqindicatesqanqunderstandingqofqtheqeducation?q-
qans-Iqwillqnotqtakeqibuprofenq(Motrin®)qeveryqday
Yourqnon-
verbalqpatientqisqalert.qWhatqtypeqofqpainqassessmentqwouldqbeqappropriate?q-
qans-•qVisualqpainqscale
•qVerbalqdescriptiveqscale
•qVitalqsignsqassessmentqtoqapproximateqpain
•qBehavioralqpainqscaleq(Wrong)
, Yourqpatientqhasqreturnedqfromqtheqcathqlabqpostqangioplasty.qUponqassessment
qyouqnoteqaqlargeqhematomaqatqtheqsheathqsite.qWhatqwouldqbeqyourqimmedia
teqaction?q-qans-Applyqmanualqpressureqtoqtheqsiteqandqcallqforqhelp.
Yourqpatientqhasqnewqonsetqseizures.qTheyqaskqyouqwhatqtheyqshouldqknowqa
boutqtakingqlevetiracetamq(Keppra®).qWhatqwouldqbeqyourqBESTqresponse?q-
qans-Commonqsideqeffectsqareqfatigueqandqdepression
Yourqpatientqwithqcardiacqbypassqsurgeryqisqpost-
opqdayq2.qTheqnursingqassistantqreportsqthatqyourqpatientqhasqaqtempqofq101.3
°Fqandqbloodqpressureqofq82/56.qTheirqurineqoutputqhasqdecreasedqtoqlessqthan
q30qmLqinqtheqpastq4qhours.qYouqsuspectqaqpost-
surgeryqcomplication.qAfterqcallingqtheqphysicianqyouqreceiveqordersqforqSTATqC
BC,qCMP,qandqcoagulationqtest.qWhatqresultsqwouldqyouqexpectqtoqseeqafterqth
eseqlabsqareqcompleted?q-qans-WBCqgreaterqthanq19,000
Whatqisqanqadequateqamountqofqurineqoutput?q-qans-30qmL/hr
Yourqpatientqhasqleftqventricularqfailure.qWhatqclinicalqmanifestationsqwouldqyouq
expectqtoqsee?q-qans-Dyspnea,qdistantqheartqsounds,qbilateralqcrackles
Youqareqcaringqforqyourqpatientqwithqanqorderqforqfurosemideq(Lasix®)q80qmgq
BID.qWhatqwouldqbeqyourqMOSTqappropriateqaction?q-qans-
Callqproviderqtoqclarifyqtheqorder.
Yourqpatientqisqinqcardiacqarrest.qChestqcompressionsqareqbeingqperformed.qCap
nographyqindicatesqtheqend-
tidalqCO2qisq18qmmg.qWhatqdoqtheqcapnographyqresultsqindicateqaboutqtheqche
stqcompressions?q-qans-Noqchanges.qTheseqareqhighqqualityqcompressions.
Whatqisqrequiredqbeforeqmakingqaqreportqofqelderqabuse?q-qans-
Suspicionqofqabuse
YouqreceiveqyourqpatientqwithqpneumoniaqfromqtheqED.qAntibioticsqandqsteroids
qhaveqbeenqinitiatedqbyqtheqprovider.qTheqpatientqreportsqabdominalqpainqandqh
asqaqlargeqlooseqbowelqmovement.qTheyqinformqyouqthisqisqtheirqthirdqbowelqm
ovementqinqtheqlastqtwoqhours.qWhatqwouldqyouqdoqFIRST?q-qans-
InitiateqentericqcontactqisolationqprecautionsqforqpossibleqC.qdiff
Yourqpatientqhasqdevelopedqsepsisqfromqanqindwellingqurinaryqcatheter.qWhatqw
ouldqbeqyourqPRIORITYqintervention?q-qans-Removeqcatheter.
Yourqpatientqisqinqthirdqdegreeqheartqblock.qWhatqtreatmentqwouldqyouqMOSTqli
kelyqexpectqtoqbeqimplemented?q-qans-Pacemaker
(RELIAS?) QUESTIONS AND ANSWERS
Youqwantqtoqassessqforqjugularqveinqdistentionq(JVD).qWhatqpositionqwouldqbeq
BEST?q-qans-
Positionqpatientqonqtheirqbackqwithqheadqofqbedqatq30qtoq45qdegrees.
Yourqpatientqwithqtripleqcardiacqbypassqsurgeryqisqpost-
opqdayq3.qChestqtubesqhaveqbeenqremoved.qTheyqsuddenlyqreportqpalpitations.q
Theirqbloodqpressureqisq130/76qandqheartqrateqisq140qbpm.qWhatqwouldqyouqd
oqNEXT?q-qans-PerformqaqbedsideqEKG
Yourqpatientqhasqaqhistoryqofqrenalqinsufficiency.qWhatqclassqofqanalgesicsqwoul
dqMOSTqlikelyqbeqcontraindicatedqforqthem?q-qans-Nonsteroidalqanti-
inflammatoryqmedications
Yourqpatientqisqacutelyqill.qWhatqrouteqofqmedicationqadministrationqwouldqlikelyq
beqLEASTqeffective?q-qans-Intramuscular
Youqareqworkingqwithqtheqcodeqteamqtoqresuscitateqaqpatientqinqventricularqfibril
lation.qChestqcompressionsqareqongoingqandqtheqpatientqhasqbeenqshockedqtwic
e.qWhatqemergencyqmedication,qifqany,qwouldqyouqadministerqatqthisqjuncture?q-
qans-Epinephrineq(Adrenaline)q1qmgqIV
Yourqpatientqisqonqanticoagulantqmedication.qYouqareqdischargingqthemqandqpro
videqpatientqeducation.
Whichqstatementqbyqyourqpatientqindicatesqanqunderstandingqofqtheqeducation?q-
qans-Iqwillqnotqtakeqibuprofenq(Motrin®)qeveryqday
Yourqnon-
verbalqpatientqisqalert.qWhatqtypeqofqpainqassessmentqwouldqbeqappropriate?q-
qans-•qVisualqpainqscale
•qVerbalqdescriptiveqscale
•qVitalqsignsqassessmentqtoqapproximateqpain
•qBehavioralqpainqscaleq(Wrong)
, Yourqpatientqhasqreturnedqfromqtheqcathqlabqpostqangioplasty.qUponqassessment
qyouqnoteqaqlargeqhematomaqatqtheqsheathqsite.qWhatqwouldqbeqyourqimmedia
teqaction?q-qans-Applyqmanualqpressureqtoqtheqsiteqandqcallqforqhelp.
Yourqpatientqhasqnewqonsetqseizures.qTheyqaskqyouqwhatqtheyqshouldqknowqa
boutqtakingqlevetiracetamq(Keppra®).qWhatqwouldqbeqyourqBESTqresponse?q-
qans-Commonqsideqeffectsqareqfatigueqandqdepression
Yourqpatientqwithqcardiacqbypassqsurgeryqisqpost-
opqdayq2.qTheqnursingqassistantqreportsqthatqyourqpatientqhasqaqtempqofq101.3
°Fqandqbloodqpressureqofq82/56.qTheirqurineqoutputqhasqdecreasedqtoqlessqthan
q30qmLqinqtheqpastq4qhours.qYouqsuspectqaqpost-
surgeryqcomplication.qAfterqcallingqtheqphysicianqyouqreceiveqordersqforqSTATqC
BC,qCMP,qandqcoagulationqtest.qWhatqresultsqwouldqyouqexpectqtoqseeqafterqth
eseqlabsqareqcompleted?q-qans-WBCqgreaterqthanq19,000
Whatqisqanqadequateqamountqofqurineqoutput?q-qans-30qmL/hr
Yourqpatientqhasqleftqventricularqfailure.qWhatqclinicalqmanifestationsqwouldqyouq
expectqtoqsee?q-qans-Dyspnea,qdistantqheartqsounds,qbilateralqcrackles
Youqareqcaringqforqyourqpatientqwithqanqorderqforqfurosemideq(Lasix®)q80qmgq
BID.qWhatqwouldqbeqyourqMOSTqappropriateqaction?q-qans-
Callqproviderqtoqclarifyqtheqorder.
Yourqpatientqisqinqcardiacqarrest.qChestqcompressionsqareqbeingqperformed.qCap
nographyqindicatesqtheqend-
tidalqCO2qisq18qmmg.qWhatqdoqtheqcapnographyqresultsqindicateqaboutqtheqche
stqcompressions?q-qans-Noqchanges.qTheseqareqhighqqualityqcompressions.
Whatqisqrequiredqbeforeqmakingqaqreportqofqelderqabuse?q-qans-
Suspicionqofqabuse
YouqreceiveqyourqpatientqwithqpneumoniaqfromqtheqED.qAntibioticsqandqsteroids
qhaveqbeenqinitiatedqbyqtheqprovider.qTheqpatientqreportsqabdominalqpainqandqh
asqaqlargeqlooseqbowelqmovement.qTheyqinformqyouqthisqisqtheirqthirdqbowelqm
ovementqinqtheqlastqtwoqhours.qWhatqwouldqyouqdoqFIRST?q-qans-
InitiateqentericqcontactqisolationqprecautionsqforqpossibleqC.qdiff
Yourqpatientqhasqdevelopedqsepsisqfromqanqindwellingqurinaryqcatheter.qWhatqw
ouldqbeqyourqPRIORITYqintervention?q-qans-Removeqcatheter.
Yourqpatientqisqinqthirdqdegreeqheartqblock.qWhatqtreatmentqwouldqyouqMOSTqli
kelyqexpectqtoqbeqimplemented?q-qans-Pacemaker