Prophecy general ICU A V3 Questions & Answers, Distinction Level Assignment Has everything.

Prophecy general ICU A V3 Questions & Answers; Fall 2023. One of your patients coded but is now stabilized and you are catching up on charting. The step-down unit calls to get report on your other patient who is to be transfered. The nurses near you do not appear busy. How should you prioritize your time? Your patient was intubated but still has oral medications on their list of medications. How should you ensure they receive their medications? What laboratory value should you monitor closely if your patient is vomiting coffee ground emesis? What ECG finding is indicative of hyperkalema? You witness a patient that is not assigned to you fall out of bed and begin crying for help but you do not see the assigned nurse to assist the patient. What should you do first? When assessing for fever in your intubated patient, placement of the thermometer in which area would be most accurate? Your patient has just completed IV potassium replacement. When should you collect their repeat potassium level? Your patient is receiving an antiarrhythmic agent. Which of the following assessment parameters is the MOST important for you to evaluate? Your patient is undergoing a weaning trial from the ventilator. Fifteen minutes into the trial the patient's heart rate increases to 140 bpm and they start to grab at their oxygen and IV tubing. What should you do NEXT? While assessing a patient just admitted to the hospital, he admits to drinking 12 cans of beer a day, with the last drink being right before admission. What is the expected onset of delirium tremens? You have administered a pain medication that has a half-life of 120 minutes, onset of action 6 min, tmax of 15 minutes, and is mostly excreted in the uring. when can the patient expect the medication to start working A lethargic but oriented patient is being admitted for sepsis and their family member is in the waiting area. Their belonging include a ring, cell phone, and wallet. The patient asks if they can keep the ring on and phone at bedside. What is your BEST response? What is a significant complication of imaging studies performed with iv contrast What respiratory support would an alert patient with an acute COPD exacerbatiobn likely receive FIRST? Your intubated and unresponsive patient is scheduled for surgery in the morning. Who is the most appropriate person to make decisions for your patient? When administering a titratable infusion what information must you check on the medication IV bag to confirm the correct dose is being administered? Your patient has a known baseline heart rate of around 45. The ECG monitor keeps alarming when the heart rate decreases below 50. Their vital signs are stable. What would you do? How is dopamine usually administered in the icu when given intravenously Which of the following can be given through an enteral feeding tube? When donning an N-95 mask, how should you secure the nose? What type of medication is used in the critical care setting to help manage the symptoms of alcohol withdrawal? While admitting a patient with a history of IV drug use, what precautions should you take? Your patient is intubated and begins to cough up clear mucous inside their ETT. What should you do NEXT? Correct Ans- A. Instill normal saline to lavage ETT B. Sit the patient up to 30 degrees in bed C. Inspect their oral cavity and suction mouth D. Provide 100% oxygenation and prepare to suction What is a complication of long term TPN? Which assessment establishes baseline hand perfusion before an ABG puncture or arterial line placement? You find the concentration of an IV medication bag that is hanging and infusing into your patient does not match the concentration in the order. What should you do NEXT? Your patient has a right chest tube that was placed after thoracotomy. They report that is very painful when they cough and request cough medicing. What should you do? Your patient had an unplanned self-extubation. They are now alert and sitting up. Their pulse oximetry is 98% on 4 liters face mask. What action should you prioritize? - A. Inspecting the oral cavity B. Checking blood pressure and the heart rate C. Administering an albuterol nebulizer D. Performing an ordered STAT ABG Your are admitting a patient who is sedated and intubated directly from the operating room after a major surgery. The anesthesia provider connects the patient to the ventilator in the ICU room and leaves before entering orders for the patient's ventilatory settings. How should you proceed? For a patient with septic shock, What would you monitor to objectively determine the effectiveness and need to titrate a dobutamine infusion. Which of the following actions complies with ventilator acquired pneumonia (VAP) prevention protocols? What assessment tool is needed for a patient who has uncomplicated retrosternal hemorrhage? Which condition may cause increased effects from a medication that is mostly metabolized by the liver? An intubated patient with a GCS of 3 is admitted to the ICU from the ER after being found down for an unknown amount of time at home. The CT scan reveals profuse cerebral edema. When is the BEST time to notify organ donation services? What order is included in the pre-procedural checklist for patients at risk for acute kidney injury who are to receive IV contrast? Your patient is intubated with an ETT and sedated without spontaneous monements when the ventilator alarms with a high-pressure warning. The ventilator tubing is free and unkinked. What should you do NEXT? Your postoperative patient suddenly becomes dyspneic, clutches their chest and their Sp02 drops to 89% the patient has a swollen left calf. what condition do you suspect? What IV sedative would MOST likely be ordered for a non-intubated patient? What is the normal cardiovasculat response to early sepsis? You have just received report on Patient A and Patient B. Patient A is intubated, sedated, and on a vasoactive infusion to keep their BP greater than 110 mmHg systolic on an arterial line. Patient B was extubated an hour ago and has a scheduled glucose check due in 1 hour. What is your PRIORITY action? Which of the following diets would be BEST for a patient with renal failure? Your patient on a furosemide infusion has a positive daily fluid balance, new bilateral crackles on auscultation and has gained weight since admission. What action should you take? What ventilator adjustment do you expect when your patient's ABG is pH 7.40, PaCO2 112, BICARB 22? What information do you need from the provider to setup a cerebral intraventricular drainage system? After turning a patient with CVP monitoring what should you do to ensure accuracy of the CVP reading? In a patient with septic shock, after fluid administration which of the following findings is MOST suggestive of the need to start a vasopressor? Your patient's family does not want to tell the patient of their life-threatening diagnosis and pleads with you not to let the patient know. What is the MOST appropriate response? What is the BEST way to determine a STEMI? What condition does the Confusion Assessment Method for ICU (CAM-ICU) detect? You are caring for an underweight, older adult who is intubated, sedated, and septic. You have implemented turning every 2 hours. While inspectingthe patient's back you notice bony prominences with intact but reddened skin. What should youinclude in the plan of care? You are to administer 1 mg of morphine IV but it only comes in a 2 mg vial. How should you proceed? The provider has ordered 2 units of FFP to be transfused. Your patient's religious beliefs prevent them from accepting blood products. What is your BEST response? During cardiogenic shock what temporary intervention might be ordered to improve perfusion until definitive treatment is provided? While reviewing your patient's EHR prior to receiving report, you notice that their documented urine output for the past 24 hours is 600ml. What would be the MOST important action to take for this patient? You are caring for a confused patient with edema who has large swollen wrist. You find that someone has taped their ID bracelet to the side of the bed. How should you secure their ID bracelet? You are caring for a patient with diabetic ketoacidosis with suspected sepsis. You have the following tasks to complete: Draw blood cultures, checkblood glucose, administer antibiotic, insert urinary catheter, and check urine for glucose. Which task should you complete FIRST? A code is initiated and the second nurse is observed not following ACLS protocol. What is the BEST actionsto take? During the first hour of tPA infusion, how frequently should you monitor blood pressure? Which of the following is a priority for the bedside nurse when a patient gets inpatient hemodialysis? What MUST you confirm before removing a cervical spine collar? Which of the following signs or symptoms indicates a patient might not be tolerating the extubation? Which age group is MORE likely to experence a