Updated 2025 Questions With Complete
Answers
Woman in labor (un-reassuring FHR) - VERIFIED ANSWERS-(late decels, decreased
variability, fetal bradycardia, etc) Turn pt on Left side, give O2, stop pitocin, Increase IV
fluids!
Tube feeding with decreased LOC - VERIFIED ANSWERS-Pt on Right side (promotes
emptying of the stomach) Head of bed elevated (prevent aspiration)
Decrease deep tendon reflex - VERIFIED ANSWERS-hypermagnesium
After lumbar puncture and oil based myelogram - VERIFIED ANSWERS-pt is flat
SUPINE (prevent headache and leaking of CSF)
Pt with heat stroke - VERIFIED ANSWERS-flat with legs elevated
during Continuous Bladder Irrigation (CBI) - VERIFIED ANSWERS-catheter is taped to
the thigh. leg must be kept straight.
After Myringotomy - VERIFIED ANSWERS-position on the side of AFFECTED ear,
allows drainage.
Myringotomy - VERIFIED ANSWERS-surgical incision into the eardrum, to relieve
pressure or drain fluid.
After Cateract surgery - VERIFIED ANSWERS-pt sleep on UNAFFECTED side with a
night shield for *1-4 weeks*
after Thyroidectomy - VERIFIED ANSWERS-low or semi-fowler's position, support
head, neck and shoulders.
Infant with Spina Bifida - VERIFIED ANSWERS-Prone so that sac does not rupture
Buck's Traction (skin) - VERIFIED ANSWERS-elevate foot of bed for counter traction
After total hip replacement - VERIFIED ANSWERS-don't sleep on side of surgery, don't
flex hip more than 45-60 degress, don't elevate Head Of Bed more than 45 degrees.
Maintain hip abduction by separating thighs with pillows.
,Prolapsed cord - VERIFIED ANSWERS-Knee to chest or Trendelenburg
oxygen 8 to 10 L
Cleft Lip - VERIFIED ANSWERS-position on back or in infant seat to prevent trauma to
the suture line. while feeding hold in upright position.
To prevent dumping syndrome - VERIFIED ANSWERS-(post operative ulcer/stomach
surgeries) eat in reclining position. Lie down after meals for 20-30 min. also restrict
fluids during meals, low CHO and fiber diet. small, frequent meals.
AKA (above knee amputation) - VERIFIED ANSWERS-elevate for first 24 hours on
pillow. position prone daily to maintain hip extension.
BKA (below knee amputation) - VERIFIED ANSWERS-foot of bed elevated for first 24
hours. position prone to provide hip extension.
detached retina - VERIFIED ANSWERS-area of detachment should be in the
dependent position
dependent position - VERIFIED ANSWERS-supported
administration of enema - VERIFIED ANSWERS-pt should be left side lying (Sim's) with
knee flexed.
supratentorial - VERIFIED ANSWERS-(incision behind hairline on forhead) e
After supratentorial surgery - VERIFIED ANSWERS-elevate HOB 30-40 degrees
Pre-albumin levels - VERIFIED ANSWERS-3.5-5.0 indicates malnutrition which leads to
poor wound healing
infratentorial - VERIFIED ANSWERS-(incision at the nape of neck)
After infratentorial surgery - VERIFIED ANSWERS-position pt flat and lateral on either
side.
During internal radiation - VERIFIED ANSWERS-on bed rest while implant in place
Autonomic Dysreflexia/Hyperreflexia - VERIFIED ANSWERS-S/S pounding headache,
profuse sweating, nasal congestion, chills, bradycardia, hypertension. Place client in
sitting position (elevate HOB) FIRST!
Shock
increase heart rate
increase respirations
, decrease blood pressures - VERIFIED ANSWERS-bedrest with extremities elevated 20
degrees. knees straight, head slightly elevated (modified Trendelenberg)
Head Injury - VERIFIED ANSWERS-elevate HOB 30 degrees to decrease ICP
Peritoneal Dialysis (when outflow is inadequate) - VERIFIED ANSWERS-turn pt from
side to side BEFORE checking for kinks in tubing
Lumbar Puncture - VERIFIED ANSWERS-After the procedure, the pt should be supine
for 4-12 hours as prescribed.
Myesthenia Gravis - VERIFIED ANSWERS-worsens with exercise and improves with
rest
Myesthenia Gravis - VERIFIED ANSWERS-a positive reaction to Tensilon---will improve
symptoms
Cholinergic Crisis - VERIFIED ANSWERS-Caused by excessive medication ---stop
giving Tensilon...will make it worse.
Liver biopsy (prior) - VERIFIED ANSWERS-must have lab results for prothrombin time
Myxedema/ hypothyroidism - VERIFIED ANSWERS-slowed physical and mental
function, sensitivity to cold, dry skin and hair.
Grave's Disease/ hyperthyroidism - VERIFIED ANSWERS-accelerated physical and
mental function. Sensitivity to heat. Fine/soft hair.
Thyroid storm - VERIFIED ANSWERS-increased temp, pulse and HTN
Post-Thyroidectomy - VERIFIED ANSWERS-semi-fowler's. Prevent neck
flexion/hyperextension. Trach at bedside
Hypo-parathyroid - VERIFIED ANSWERS-CATS---Convulsions, Arrhythmias, Tetany,
Spasms, Stridor. (decreased calcium) give high calcium, low phosphorus diet
Hyper-parathyroid - VERIFIED ANSWERS-fatigue, muscle weakness, renal calculi,
back and joint pain (increased calcium) give a low calcium high phosphorous diet
Hypovolemia - VERIFIED ANSWERS-increased temp, rapid/weak pulse, increase
respiration, hypotension, anxiety. Urine specific gravity >1.030
Hypervolemia - VERIFIED ANSWERS-bounding pulse, SOB, dyspnea, rales/crackles,
peripheral edema, HTN, urine specific gravity <1.010. semi fowler's