ANSWERS
1 day post op following ilioconduit. What do you need to report to the RN
immediately? correct answer Abdominal pain and rigidity, Low abd. Discomfort
with 26 ml/hr urinary output.
Aware that elderly patient is at risk for falls. What do you implement? correct
answer Bed rails up at all times.
Caring for newly intubated patient getting mechanical ventilation. Pt.'s wife was
not at hosp. when this occurred. Wife appears angry and states "What have you
all done to him?" What would be your response as a nurse? correct answer
Explain to the patient why the patient had to be intubated, continue to update
patient's wife on condition and plan of care, I'm sorry that you walked in on him
like that, I understand this must have been very frightening.
Caring for patient at outpatient. Hgb 10.1 c/o abdominal pain. Occult blood test at
home. What would you educate on in patient plan of care? correct answer
Educate patient on high fiber diet and no red meat before test.
Caring for patient with hx of diarrhea. Weight loss, bloating, run labs on them.
Which to report potassium-5.1 WBC 10.8 Sodium 146 Hgb-9.1. ? correct answer
HgB
Caring for patient with IBS. Last 4 hours pt. had 6 liquid bowel movements.
Requesting the lomotial. Vitals are 98.9 pul 98 resp 20 bp 164-96. Med given.
What should be highest priority. correct answer Monitor BP and urinary output.
, Caring for pt. who is intubated and receiving mechanical ventilation. What action
by the nurse would decrease the patient's incidence of developing ventilator
associated pneumonia? correct answer Put head of bed at 30-45 degrees.
Confused patient trying to remove all their lines. Apply wrist restraints. What
action will you take? correct answer Assess patient at least once every hour.
Discharging patient with Vicodin. Recognize further teaching is needed when
patient states what? correct answer I can continue to drive my son to work
everyday.
DOPE correct answer Displaced
Obstruction
Pulmonary
Equipment
Elderly patient with new colostomy starting home care instructions. What should
you take into consideration for this patient? correct answer Cost of the supplies,
evaluation of the patient's visual ability to care for the colostomy, evaluation of
patient's ability to understand the instructions for the colostomy.
HH nurse visiting patient with diabetes. What situation requires the nurse to
implement safety intervention? correct answer Grandchildren fold laundry and
place baskets by the bedroom door.
Important strategy you should implement that promoted healing with pressure
ulcers? correct answer Increase protein.