Progressive Care RN A 2025

You want to assess for jugular vein distention (JVD). What position would be BEST? - Position patient on their back with head of bed at 30 to 45 degrees. Your patient with triple cardiac bypass surgery is post-op day 3. Chest tubes have been removed. They suddenly report palpitations. Their blood pressure is 130/76 and heart rate is 140 bpm. What would you do NEXT? - Perform a bedside EKG Your patient has a history of renal insufficiency. What class of analgesics would MOST likely be contraindicated for them? - Nonsteroidal anti-inflammatory medications Your patient is acutely ill. What route of medication administration would likely be LEAST effective? - Intramuscular You are working with the code team to resuscitate a patient in ventricular fibrillation. Chest compressions are ongoing and the patient has been shocked twice. What emergency medication, if any, would you administer at this juncture? - Epinephrine (Adrenaline) 1 mg IV Your patient is on anticoagulant medication. You are discharging them and provide patient education. Which statement by your patient indicates an understanding of the education? - I will not take ibuprofen (Motrin®) every day Your non-verbal patient is alert. What type of pain assessment would be appropriate? - • Visual pain scale • Verbal descriptive scale • Vital signs assessment to approximate pain • Behavioral pain scale (Wrong) Your patient has returned from the cath lab post angioplasty. Upon assessment you note a large hematoma at the sheath site. What would be your immediate action? - Apply manual pressure to the site and call for help. Your patient has new onset seizures. They ask you what they should know about taking levetiracetam (Keppra®). What would be your BEST response? - Common side effects are fatigue and depression Your patient with cardiac bypass surgery is post-op day 2. The nursing assistant reports that your patient has a temp of 101.3°F and blood pressure of 82/56. Their urine output has decreased to less than 30 mL in the past 4 hours. You suspect a post-surgery complication. After calling the physician you receive orders for STAT CBC, CMP, and coagulation test. What results would you expect to see after these labs are completed? - WBC greater than 19,000 What is an adequate amount of urine output? - 30 mL/hr Your patient has left ventricular failure. What clinical manifestations would you expect to see? - Dyspnea, distant heart sounds, bilateral crackles You are caring for your patient with an order for furosemide (Lasix®) 80 mg BID. What would be your MOST appropriate action? - Call provider to clarify the order. Your patient is in cardiac arrest. Chest compressions are being performed. Capnography indicates the end-tidal CO2 is 18 mmg. What do the capnography results indicate about the chest compressions? - No changes. These are high quality compressions. What is required before making a report of elder abuse? - Suspicion of abuse You receive your patient with pneumonia from the ED. Antibiotics and steroids have been initiated by the provider. The patient reports abdominal pain and has a large loose bowel movement. They inform you this is their third bowel movement in the last two hours. What would you do FIRST? - Initiate enteric contact isolation precautions for possible C. diff Your patient has developed sepsis from an indwelling urinary catheter. What would be your PRIORITY intervention? - Remove catheter. Your patient is in third degree heart block. What treatment would you MOST likely expect to be implemented? - Pacemaker What are 2 nursing interventions to prevent venous thromboembolism? - • Adequate hydration and early mobilization. • Hemodynamic monitoring and early mobilization. (Wrong) • Adequate hydration and encouraging a steady amount of green leafy vegetables in diet. • Hemodynamic monitoring and encouraging a steady amount of green leafy vegetables in diet. Your patient is post left pneumonectomy. They have a chest tube in place for drainage. What would be a PRIORITY in your care? - Encourage patient to cough and deep breathe What is the reversal agent for benzodiazepines? - Flumazenil (Romazicon) Your patient is on a patient-controlled analgesia (PCA) pump infusing morphine. They are not getting relief. What would be your FIRST intervention? - Obtain order from provider for an additional dose. Which finding would assist in the diagnosis of deep vein thrombosis? - Positive D-dimer What is the MOST common symptom of syndrome of inappropriate antidiuretic hormone secretion (SIADH)? - Fluid retention Your patient has nephrotoxicity. At discharge what education would be MOST important for you to provide? - • Establish an exercise routine. • Implement smoking cessation. • Review your medications with the primary care provider. • Create a meal plan to maintain kidney health. (Wrong) Which patient would you ask about the language they would prefer to use for communication purposes? - A patient who is newly admitted Upon arrival to the ED a patient's lab results indicate a BNP of 2000. They are transferred to the PCU. What treatment plan would you expect from the attending provider? - Furosemide (Lasix®) 40 mg IV BID Your patient reports chest pain. Which lab orders would you anticipate the provider ordering? - Troponin A patient presents with blood pressure of 90/60, creatinine of 3.0, and decreased urinary output. What is a possible cause for these findings? - Acute kidney injury