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Progressive Care RN A 2024 /////Progressive Care RN A 2024 ////EXAM///EXAM////EXAM///

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Progressive Care RN A 2024 You ii want ii to ii assess ii for ii jugular ii vein ii distention ii (JVD). ii What ii position ii would ii be ii BEST? ii- ii ii ii Position ii patient ii on ii their ii back ii with ii head ii of ii bed ii at ii 30 ii to ii 45 ii degrees. ii ii ii Your ii patient ii with ii triple ii cardiac ii bypass ii surgery ii is ii post-op ii day ii 3. ii Chest ii tubes ii have ii been ii removed. ii They ii suddenly ii report ii palpitations. ii Their ii blood ii pressure ii is ii 130/76 ii and ii heart ii rate ii is ii 140 ii bpm. ii What ii would ii you ii do ii NEXT? ii- ii ii ii Perform ii a ii bedside ii EKG ii ii ii Your ii patient ii has ii a ii history ii of ii renal ii insufficiency. ii What ii class ii of ii analgesics ii would ii MOST ii likely ii be ii contraindicated ii for ii them? ii- ii ii ii Nonsteroidal ii anti-inflammatory ii medications ii ii ii Your ii patient ii is ii acutely ii ill. ii What ii route ii of ii medication ii administration ii would ii likely ii be ii LEAST ii effective? ii- ii ii ii Intramuscular ii ii ii You ii are ii working ii with ii the ii code ii team ii to ii resuscitate ii a ii patient ii in ii ventricular ii fibrillation. ii Chest ii compressions ii are ii ongoing ii and ii the ii patient ii has ii been ii shocked ii twice. ii What ii emergency ii medication, ii if ii any, ii would ii you ii administer ii at ii this ii juncture? ii- ii ii ii Epinephrine ii (Adrenaline) ii 1 ii mg ii IV ii ii ii Your ii patient ii is ii on ii anticoagulant ii medication. ii You ii are ii discharging ii them ii and ii provide ii patient ii education. Which ii statement ii by ii your ii patient ii indicates ii an ii understanding ii of ii the ii education? ii- ii ii ii I ii will ii not ii take ii ibuprofen ii (Motrin®) ii every ii day ii ii ii Your ii non-verbal ii patient ii is ii alert. ii What ii type ii of ii pain ii assessment ii would ii be ii appropriate? ii- ii ii ii • ii Visual ii pain ii scale • ii Verbal ii descriptive ii scale • ii Vital ii signs ii assessment ii to ii approximate ii pain • ii Behavioral ii pain ii scale ii (Wrong) ii ii ii Your ii patient ii has ii returned ii from ii the ii cath ii lab ii post ii angioplasty. ii Upon ii assessment ii you ii note ii a ii large ii hematoma ii at ii the ii sheath ii site. ii What ii would ii be ii your ii immediate ii action? ii- ii ii ii Apply ii manual ii pressure ii to ii the ii site ii and ii call ii for ii help. ii ii ii Your ii patient ii has ii new ii onset ii seizures. ii They ii ask ii you ii what ii they ii should ii know ii about ii taking ii levetiracetam ii (Keppra®). ii What ii would ii be ii your ii BEST ii response? ii- ii ii ii Common ii side ii effects ii are ii fatigue ii and ii depression ii ii ii Your ii patient ii with ii cardiac ii bypass ii surgery ii is ii post-op ii day ii 2. ii The ii nursing ii assistant ii reports ii that ii your ii patient ii has ii a ii temp ii of ii 101.3°F ii and ii blood ii pressure ii of ii 82/56. ii Their ii urine ii output ii has ii decreased ii to ii less ii than ii 30 ii mL ii in ii the ii past ii 4 ii hours. ii You ii suspect ii a ii post-surgery ii complication. ii After ii calling ii the ii physician ii you ii receive ii orders ii for ii STAT ii CBC, ii CMP, ii and ii coagulation ii test. ii What ii results ii would ii you ii expect ii to ii see ii after ii these ii labs ii are ii completed? ii- ii ii ii WBC ii greater ii than ii 19,000 This study source was downloaded by from on :56:35 GMT -05:00 CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM ii ii ii What ii is ii an ii adequate ii amount ii of ii urine ii output? ii- ii ii ii 30 ii mL/hr ii ii ii Your ii patient ii has ii left ii ventricular ii failure. ii What ii clinical ii manifestations ii would ii you ii expect ii to ii see? ii- ii ii ii Dyspnea, ii distant ii heart ii sounds, ii bilateral ii crackles ii ii ii You ii are ii caring ii for ii your ii patient ii with ii an ii order ii for ii furosemide ii (Lasix®) ii 80 ii mg ii BID. ii What ii would ii be ii your ii MOST ii appropriate ii action? ii- ii ii ii Call ii provider ii to ii clarify ii the ii order. ii ii ii Your ii patient ii is ii in ii cardiac ii arrest. ii Chest ii compressions ii are ii being ii performed. ii Capnography ii indicates ii the ii end-tidal ii CO2 ii is ii 18 ii mmg. ii What ii do ii the ii capnography ii results ii indicate ii about ii the ii chest ii compressions? ii- ii ii ii No ii changes. ii These ii are ii high ii quality ii compressions. ii ii ii What ii is ii required ii before ii making ii a ii report ii of ii elder ii abuse? ii- ii ii ii Suspicion ii of ii abuse ii ii ii You ii receive ii your ii patient ii with ii pneumonia ii from ii the ii ED. ii Antibiotics ii and ii steroids ii have ii been ii initiated ii by ii the ii provider. ii The ii patient ii reports ii abdominal ii pain ii and ii has ii a ii large ii loose ii bowel ii movement. ii They ii inform ii you ii this ii is ii their ii third ii bowel ii movement ii in ii the ii last ii two ii hours. ii What ii would ii you ii do ii FIRST? ii- ii ii ii Initiate ii enteric ii contact ii isolation ii precautions ii for ii possible ii C. ii diff ii ii ii Your ii patient ii has ii developed ii sepsis ii from ii an ii indwelling ii urinary ii catheter. ii What ii would ii be ii your ii PRIORITY ii intervention? ii- ii ii ii Remove ii catheter. ii ii ii Your ii patient ii is ii in ii third ii degree ii heart ii block. ii What ii treatment ii would ii you ii MOST ii likely ii expect ii to ii be ii implemented? ii- ii ii ii Pacemaker ii ii ii What ii are ii 2 ii nursing ii interventions ii to ii prevent ii venous ii thromboembolism? ii- ii ii ii • ii Adequate ii hydration ii and ii early ii mobilization. • ii Hemodynamic ii monitoring ii and ii early ii mobilization. ii (Wrong) • ii Adequate ii hydration ii and ii encouraging ii a ii steady ii amount ii of ii green ii leafy ii vegetables ii in ii diet. • ii Hemodynamic ii monitoring ii and ii encouraging ii a ii steady ii amount ii of ii green ii leafy ii vegetables ii in ii diet. ii ii ii Your ii patient ii is ii post ii left ii pneumonectomy. ii They ii have ii a ii chest ii tube ii in ii place ii for ii drainage. ii What ii would ii be ii a ii PRIORITY ii in ii your ii care? ii- ii ii ii Encourage ii patient ii to ii cough ii and ii deep ii breathe ii ii ii What ii is ii the ii reversal ii agent ii for ii benzodiazepines? ii- ii ii ii Flumazenil ii (Romazicon) ii ii ii Your ii patient ii is ii on ii a ii patient-controlled ii analgesia ii (PCA) ii pump ii infusing ii morphine. ii They ii are ii not ii getting ii relief. ii What ii would ii be ii your ii FIRST ii intervention? ii- ii ii ii Obtain ii order ii from ii provider ii for ii an ii additional ii dose. This study source was downloaded by from on :56:35 GMT -05:00 CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM ii ii ii Which ii finding ii would ii assist ii in ii the ii diagnosis ii of ii deep ii vein ii thrombosis? ii- ii ii ii Positive ii D dimer ii ii ii What ii is ii the ii MOST ii common ii symptom ii of ii syndrome ii of ii inappropriate ii antidiuretic ii hormone ii secretion ii (SIADH)? ii- ii ii ii Fluid ii retention ii ii ii Your ii patient ii has ii nephrotoxicity. ii At ii discharge ii what ii education ii would ii be ii MOST ii important ii for ii you ii to ii provide? ii- ii ii ii • ii Establish ii an ii exercise ii routine. • ii Implement ii smoking ii cessation. • ii Review ii your ii medications ii with ii the ii primary ii care ii provider. • ii Create ii a ii meal ii plan ii to ii maintain ii kidney ii health. ii (Wrong) ii ii ii Which ii patient ii would ii you ii ask ii about ii the ii language ii they ii would ii prefer ii to ii use ii for ii communication ii purposes? ii- ii ii ii A ii patient ii who ii is ii newly ii admitted ii ii ii Upon ii arrival ii to ii the ii ED ii a ii patient's ii lab ii results ii indicate ii a ii BNP ii of ii 2000. ii They ii are ii transferred ii to ii the ii PCU. What ii treatment ii plan ii would ii you ii expect ii from ii the ii attending ii provider? ii- ii ii ii Furosemide ii (Lasix®) ii 40 ii mg ii IV ii BID ii ii ii Your ii patient ii reports ii chest ii pain. ii Which ii lab ii orders ii would ii you ii anticipate ii the ii provider ii ordering? ii- ii ii ii Troponin ii ii ii A ii patient ii presents ii with ii blood ii pressure ii of ii 90/60, ii creatinine ii of ii 3.0, ii and ii decreased ii urinary ii output. ii What ii is ii a ii possible ii cause ii for ii these ii findings? ii- ii ii ii Acute ii kidney ii injury ii ii ii You ii want ii to ii help ii your ii patient ii wean ii from ii the ii BiPap. ii You ii are ii collaborating ii with ii the ii healthcare ii team. What ii is ii a ii sign ii that ii your ii patient ii is ii fatiguing ii and ii you ii would ii communicate ii to ii the ii respiratory ii therapy ii team? ii- ii ii ii Increased ii PaCO2 ii ii ii What ii is ii an ii effective ii nursing ii intervention ii for ii reducing ii central ii line-associated ii bloodstream ii infections ii (CLABSIs)? ii- ii ii ii Perform ii a ii daily ii assessment ii of ii line ii necessity. ii ii ii You ii are ii administering ii 1 ii unit ii of ii packed ii red ii blood ii cells ii (PRBC) ii to ii your ii patient. ii They ii develop ii shortness ii of ii breath, ii tachycardia, ii and ii distended ii jugular ii veins ii in ii the ii first ii 15 ii minutes ii of ii PRBC ii administration. ii What ii type ii of ii transfusion ii reaction ii are ii they ii likely ii experiencing? ii- ii ii ii • ii Transfusion ii related ii hemolytic ii reaction ii (Wrong) • ii Septic ii transfusion ii reaction • ii Transfusion ii related ii fluid ii overload • ii Anaphylaxis ii ii ii When ii should ii the ii trough ii for ii vancomycin ii (Firvanq®) ii be ii measured? ii- ii ii ii Immediately ii before ii the ii next ii scheduled ii dose This study source was downloaded by from on :56:35 GMT -05:00 CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM ii ii ii What ii are ii PRIMARY ii goals ii in ii diabetic ii ketoacidosis ii therapy? ii- ii ii ii Correct ii fluid ii deficit ii and ii replace ii potassium. ii ii ii Your ii patient ii is ii receiving ii an ii amiodarone ii (Pacerone®) ii drip. ii When ii would ii you ii reduce ii the ii dose ii from ii 1 ii mg/mL ii to ii 0.5 ii mg/mL? ii- ii ii ii After ii 6 ii hours ii ii ii You ii walk ii into ii your ii patient's ii room. ii You ii notice ii that ii the ii chest ii tube ii collection ii chamber ii has ii been ii knocked ii over ii onto ii its ii side. ii There ii appears ii to ii be ii drainage ii dispersed ii throughout ii the ii chambers. ii What ii would ii you ii do ii NEXT? ii- ii ii ii Replace ii chamber ii with ii a ii new ii one. ii ii ii Your ii patient ii is ii experiencing ii left-sided ii weakness ii from ii a ii meningioma. ii What ii would ii be ii the ii MOST ii likely ii treatment ii for ii their ii brain ii tumor? ii- ii ii ii Surgical ii resection ii ii ii Your ii coworker ii mistakenly ii gives ii 2 ii units ii of ii insulin ii to ii a ii patient. ii The ii patient ii is ii stabilized ii and ii the ii provider ii is ii informed. ii What ii would ii be ii your ii NEXT ii step? ii- ii ii ii Create ii an ii incident ii report ii ii ii Your ii patient ii had ii an ii IVC ii filter ii placed ii 2 ii days ii ago. ii They ii start ii to ii complain ii of ii sharp ii pain ii in ii the ii chest, ii shortness ii of ii breath, ii anxiety, ii and ii heart ii palpitations. ii What ii would ii you ii do ii NEXT? ii- ii ii ii Notify ii provider ii and ii prepare ii for ii a ii CT ii scan. ii ii ii What ii ethical ii principle ii is ii the ii foundation ii of ii end-of-life ii care? ii- ii ii ii Patient ii autonomy ii ii ii What ii is ii the ii importance ii of ii proper ii cuff ii inflation ii for ii tracheostomy ii tubes? ii- ii ii ii • ii To ii decrease ii the ii flow ii of ii supplemental ii oxygen. ii (Wrong) • ii To ii facilitate ii mechanical ii ventilation. • ii To ii prepare ii the ii patient ii for ii extubation. • ii To ii allow ii the ii patient ii to ii speak. ii ii ii What ii are ii the ii MOST ii common ii causes ii of ii acute ii onset ii pancreatitis? ii- ii ii ii Alcoholism ii and ii gallstones ii ii ii Your ii patient ii has ii an ii upper ii GI ii bleed. ii They ii have ii a ii hemoglobin ii of ii 6.1 ii g/dL. ii What ii order ii would ii you ii perform FIRST? ii- ii ii ii Prepare ii to ii administer ii 2 ii units ii PRBCs. ii ii ii Your ii patient ii is ii on ii the ii midday ii schedule ii for ii hemodialysis. ii They ii have ii 100 ii mg ii metoprolol ii XL ii (Toprol®) ii ordered ii for ii this ii morning. ii Their ii blood ii pressure ii is ii 150/98. ii What ii would ii be ii your ii MOST ii appropriate ii action? ii- ii ii ii Hold ii the ii metoprolol ii because ii of ii the ii upcoming ii dialysis. ii ii ii What ii would ii be ii your ii BEST ii method ii for ii dressing ii a ii venous ii stasis ii ulcer? ii- ii ii ii Use ii gauze ii wrap ii covered ii by ii a ii compression ii bandage ii ii ii What ii would ii you ii check ii before ii administering ii digoxin ii (Lanoxin®)? ii- ii ii ii Apical ii pulse This study source was downloaded by from on :56:35 GMT -05:00 CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROO

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Progressive Care RN A 2024
You want to assess for jugular vein distention (JVD). What position would be BEST? -
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


Position patient on their back with head of bed at 30 to 45 degrees.
ii ii ii ii ii ii ii ii ii ii ii ii ii ii




Your patient with triple cardiac bypass surgery is post-op day 3. Chest tubes have been
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii removed. They suddenly report palpitations. Their blood pressure is 130/76 and heart
ii ii ii ii ii ii ii ii ii ii ii


ii rate is 140 bpm. What would you do NEXT? - Perform a bedside EKG
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii




Your patient has a history of renal insufficiency. What class of analgesics would MOST
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii likely be contraindicated for them? - Nonsteroidal anti-inflammatory medications
ii ii ii ii ii ii ii ii ii ii




Your patient is acutely ill. What route of medication administration would likely be
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii LEAST effective? - Intramuscular ii ii ii ii ii




You are working with the code team to resuscitate a patient in ventricular fibrillation.
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii Chest compressions are ongoing and the patient has been shocked twice. What
ii ii ii ii ii ii ii ii ii ii ii


ii emergency medication, if any, would you administer at this juncture? - Epinephrine
ii ii ii ii ii ii ii ii ii ii ii ii ii


ii (Adrenaline) 1 mg IV ii ii ii




Your patient is on anticoagulant medication. You are discharging them and provide
ii ii ii ii ii ii ii ii ii ii ii ii ii ii


patient education.
ii ii


Which statement by your patient indicates an understanding of the education? - I will not
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


take ibuprofen (Motrin®) every day
ii ii ii ii ii




Your non-verbal patient is alert. What type of pain assessment would be appropriate? -
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


• Visual pain scale
ii ii ii ii ii


• Verbal descriptive scale
ii ii ii


• Vital signs assessment to approximate pain
ii ii ii ii ii ii


• Behavioral pain scale (Wrong)
ii ii ii ii




Your patient has returned from the cath lab post angioplasty. Upon assessment you
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii note a large hematoma at the sheath site. What would be your immediate action? -
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii Apply manual pressure to the site and call for help.
ii ii ii ii ii ii ii ii ii




Your patient has new onset seizures. They ask you what they should know about taking
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii levetiracetam (Keppra®). What would be your BEST response? - Common side effects ii ii ii ii ii ii ii ii ii ii ii ii ii


ii are fatigue and depression
ii ii ii




Your patient with cardiac bypass surgery is post-op day 2. The nursing assistant
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii reports that your patient has a temp of 101.3°F and blood pressure of 82/56. Their urine
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii output has decreased to less than 30 mL in the past 4 hours. You suspect a post-surgery
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii complication. After calling the physician you receive orders for STAT CBC, CMP, and ii ii ii ii ii ii ii ii ii ii ii ii


ii coagulation test. What results would you expect to see after these labs are completed? -
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii ii WBC greater than 19,000 ii ii ii




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ii ii ii What is an adequate amount of urine output? - 30 mL/hr
ii ii ii ii ii ii ii ii ii ii ii ii




Your patient has left ventricular failure. What clinical manifestations would you expect
ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii to see? - Dyspnea, distant heart sounds, bilateral crackles
ii ii ii ii ii ii ii ii ii ii




You are caring for your patient with an order for furosemide (Lasix®) 80 mg BID. What
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii would be your MOST appropriate action? - Call provider to clarify the order.
ii ii ii ii ii ii ii ii ii ii ii ii ii ii




Your patient is in cardiac arrest. Chest compressions are being performed.
ii ii ii ii ii ii ii ii ii ii ii ii ii


ii Capnography indicates the end-tidal CO2 is 18 mmg. What do the capnography results ii ii ii ii ii ii ii ii ii ii ii ii


ii indicate about the chest compressions? - No changes. These are high quality
ii ii ii ii ii ii ii ii ii ii ii ii ii


ii compressions.

ii ii ii What is required before making a report of elder abuse? - Suspicion of abuse
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii




You receive your patient with pneumonia from the ED. Antibiotics and steroids have
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii been initiated by the provider. The patient reports abdominal pain and has a large loose
ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii bowel movement. They inform you this is their third bowel movement in the last two
ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii hours. What would you do FIRST? - Initiate enteric contact isolation precautions for
ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii possible C. diff ii ii




Your patient has developed sepsis from an indwelling urinary catheter. What would be
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii your PRIORITY intervention? - Remove catheter.
ii ii ii ii ii ii ii




Your patient is in third degree heart block. What treatment would you MOST likely
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii expect to be implemented? - Pacemaker ii ii ii ii ii ii ii




What are 2 nursing interventions to prevent venous thromboembolism? - • Adequate
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


hydration and early mobilization.
ii ii ii ii


• Hemodynamic monitoring and early mobilization. (Wrong)
ii ii ii ii ii ii


• Adequate hydration and encouraging a steady amount of green leafy vegetables in diet.
ii ii ii ii ii ii ii ii ii ii ii ii ii


• Hemodynamic monitoring and encouraging a steady amount of green leafy vegetables
ii ii ii ii ii ii ii ii ii ii ii


in diet.
ii ii




Your patient is post left pneumonectomy. They have a chest tube in place for drainage.
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii What would be a PRIORITY in your care? - Encourage patient to cough and deep
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii breathe

ii ii ii What is the reversal agent for benzodiazepines? - Flumazenil (Romazicon)
ii ii ii ii ii ii ii ii ii ii ii




Your patient is on a patient-controlled analgesia (PCA) pump infusing morphine. They
ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii are not getting relief. What would be your FIRST intervention? - Obtain order from
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii


ii provider for an additional dose. ii ii ii ii




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