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WHAT ARE THE CORRECT MATH ANSWERS?
3000 ml
125 ml
0.5 ml
360 ml
12 - 13 gtts per minute
17 - 18 gtts per minute
21 gtts per minute
31 gtts per minute
Decrease the flow rate by 50gtt/min
125 ml
0.5 ml
360 ml
12 - 13 gtts per minute
17 - 18 gtts per minute
21 gtts per minute
31 gtts per minute
Decrease the flow rate by 50gtt/min
WHAT IS THE CORRECT RESPONSE TO SOMETHING UNUSUAL, POSSIBLY REQUIRING PHYSICIAN INTERVENTION?
Gather vitals and assessment data, complete an SBAR, finally contact the physician
WHAT IS THE MOST COMMON DIETARY RECOMMENDATION FOR PREGNANT WOMEN?
Regular diet with an additional 300 - 400 calories per day
IF D5W IS ADDED TO A BLOOD TRANSFUSION, WHAT WILL OCCUR?
Hemolysis (breaking down of erythrocytes)
WHAT IS A TYPICAL SETUP OF A BLOOD TRANSFUSION?
Normal saline and blood with a Y-tube
IF BACK PAIN, HIVES, CHILLS, EDEMA, OR INCREASED TEMPERATURE, IS MODERATE DURING A BLOOD TRANSFUSION, WHAT INTERVENTION SHOULD TAKE PLACE?
Continue to monitor
IF BACK PAIN, HIVES, CHILLS, EDEMA, OR INCREASED TEMPERATURE, IS NOT MODERATE DURING A BLOOD TRANSFUSION, WHAT INTERVENTION SHOULD TAKE PLACE?
Stop the blood transfusion, and report to physician
HOW MANY HOURS IS BLOOD ACCEPTABLE TO HANG FOR?
4 hours. Anything more and bacterial growth can occur
WHAT INTERVENTION IS NECESSARY IF THE PHYSICIAN ORDERS BLOOD TO BE HUNG FOR 5 HOURS OR MORE?
Clarify with the physician, and remind them that bacterial growth occurs after 4 hours
WHAT IS THE MOST COMMON BLOOD INFUSION RATE (IN HOURS)?
2 - 3 hours at 100 - 150 ml per hour
IF THE MAR DIRECTS TO GIVE BLOOD AND ANTIBIOTICS, WHICH ARE GIVEN FIRST?
Give antibiotic, and then blood
HOW LONG SHOULD A PATIENT BE MONITORED AFTER A BLOOD TRANSFUSION HAS BEEN STARTED?
5 - 15 minutes
WHAT IS THE MOST IMPORTANT THING TO OBTAIN BEFORE STARTING A BLOOD TRANSFUSION?
ID bracelet confirmation and patient consent (in that order)
HOW MANY NURSES ARE NEEDED TO CHECK BEFORE A BLOOD TRANSFUSION?
2. At least 1 RN must be present. 2 RN’s can check, or 1 RN and 1 LPN but 2 LPN’s is not permitted
WHAT ARE THE 4 TYPES OF BLOOD TRANSFUSION REACTIONS?
Circulatory overload (onset 1 - 2 hours caused by rapid fluid infusion)
Febrile (onset 30 min caused by increased leucocytes and thrombocytes)
Anaphylactic (onset 5 - 15 min caused by allergy to blood phenotype)
Bacterial (onset 2 hours if contamination is present in transfused blood)
Febrile (onset 30 min caused by increased leucocytes and thrombocytes)
Anaphylactic (onset 5 - 15 min caused by allergy to blood phenotype)
Bacterial (onset 2 hours if contamination is present in transfused blood)
WHAT ARE THE MOST IMPORTANT THINGS TO CHECK BEFORE ADMINISTERING A BLOOD TRANSFUSION?
Blood type and Rh compatibility of the patient
WHAT IS THE CORRECT METHOD TO ADMINISTER A FENTANYL PATCH?
Distal to proximal
HOW SHOULD A WOUND BE CLEANSED?
Proximal to distal using the midline, nearside, and far side method
WHAT IS RECOMMENDED FOR A PATIENT WITH POSTURAL DRAINAGE?
More fluids
WHAT IS THE CORRECT METHOD TO TAKE THE BLOOD PRESSURE OF A PATIENT WHO HAS UNDERGONE A MASTECTOMY?
Administer analgesic if possible before starting the procedure and take the blood pressure on the arm opposite of the mastectomy (if only one breast removed) while elevating the arm
WHAT ARE COMMON SYMPTOMS OF SYSTEMIC LUPUS ERYTHEMATOSUS?
Joint pain, loss of eyebrow or eyelash hair, and photosensitivity
WHAT IS THE MOST COMMON SYMPTOM OF SYSTEMIC LUPUS ERYTHEMATOSUS?
Butterfly rash on the face. Encourage sunscreen
WHAT IS THE CORRECT INTERVENTION FOR A PATIENT WHO HAS INCREASED INTRACRANIAL PRESSURE?
Elevate the head of the bed 30 – 40 degrees into the Semi-Fowler’s position (some physicians will request Reverse Trendelenburg bed positioning), allowing fluid to shunt away from the cranium and hold the head from going side to side (common response to the pain) as if left unnoticed this is fatal
WHAT ARE THE MOST COMMON SYMPTOMS OF MULTIPLE SCLEROSIS?
Decreased sensation to pain and heat (take special note during bath or shower if redness occurs with no pain response by patient)
WHEN IS AN RPN INTERVENTION MOST IMPORTANT?
During anaphylactic shock. Left untreated is 100% fatal
HOW IS AN ABDOMINAL ASSESSMENT PERFORMED?
Inspection, auscultation, percussion, and palpation (in that exact order)
HOW IS A RESPIRATORY ASSESSMENT PERFORMED?
Inspection, palpation, percussion, and auscultation (in that exact order)
HOW IS POST-MORTEM CARE PERFORMED?
Place patient in a supine position with legs straight and arms beside torso. Place dentures in mouth (try to close mouth and eyes if possible, although often not), change any soiled linens, brush hair, and place a pillow under the patients head for family viewing
WHAT IS PHYSIOLOGICAL JAUNDICE? |
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A type of jaundice which DOES NOT occur within 24 hours of newborn infant birth, but rather anytime post 24 hours of newborn infant birth. Physiological jaundice typically lasts 2 weeks in duration. Phototherapy intervention is required if the infant’s bilirubin levels are >18-21 mg/dL. Genitals and eyes must be covered during phototherapy. Reposition newborn infant Q2H
WHAT IS THE CORRECT METHOD TO ASSESS FOR DEHYDRATION IN A CHILD?
Assess mucous membranes
WHAT IS THE CORRECT METHOD TO ASSESS FOR DEHYDRATION IN AN INFANT?
Assess the anterior and posterior fontanels for depression
WHEN DO THE ANTERIOR AND POSTERIOR FONTANELS CLOSE?
Anterior (diamond shaped) closes at 18 months. Posterior (almond shaped) closes at 2 - 3 months
WHAT IS THE CORRECT METHOD TO CHART?
Use FOCAL. Factual, organized, concise, accurate, and legible
WHAT IS THE CORRECT DOSAGE FOR NITROGLYCERINE SPRAY?
0.3 - 0.4 mg administered up to 3 times every 5 minutes under the tongue. Do not spray in the back of the mouth. If not effective, angina is not the root problem, MI should be expected, and the physician must be notified
WHEN SHOULD A TRACHEOSTOMY DRESSING BE CHANGED?
Tracheostomy change should occur once per shift. Always keep obturator nearby (in case of emergency)
WHAT IS THE BEST METHOD TO PREPARE FOR A SUSPECTED MI?
Check the crash cart is fully stocked, and clear the hallway in the event that a code blue is called
WHAT IS THE BEST INTERVENTION FOR A BROKEN PIECE OF EQUIPMENT?
Put an "out of order " sign on the equipment, and create a requisition for maintenance to fix
What is the correct way to deal with acuity?
Level of risk (chest pains before constipation)
Unknown factors (pre-existing conditions like diabetes)
Routine care (perianal care, ambulation, etc.)
Scheduled appointments (administrations, and discharges)
Unknown factors (pre-existing conditions like diabetes)
Routine care (perianal care, ambulation, etc.)
Scheduled appointments (administrations, and discharges)
How is the Apgar scale scored?
A: Appearance (color all pink, color pink and/or blue, or color blue and/or pale)
P: Pulse (>100, <100, or absent)
G: Grimace (cough, grimace, or no response)
A: Activity (flexed, flaccid, or limp)
R: Respirations (strong cry, weak cry, or absent)
8 – 10 is an ideal situation
4 – 7 requires intervention
0 – 3 requires a full resuscitation
P: Pulse (>100, <100, or absent)
G: Grimace (cough, grimace, or no response)
A: Activity (flexed, flaccid, or limp)
R: Respirations (strong cry, weak cry, or absent)
8 – 10 is an ideal situation
4 – 7 requires intervention
0 – 3 requires a full resuscitation
How does the fetal heart rate system work?
Accelerations – Oxygen (infant is well oxygenated) GOOD
Variable deceleration – Cord compression (changing position alleviates) GOOD
Early deceleration – Head compression (deceleration mirror the contractions) GOOD
Late deceleration – Placental utero insufficiency (decreased perfusion) BAD
Variable deceleration – Cord compression (changing position alleviates) GOOD
Early deceleration – Head compression (deceleration mirror the contractions) GOOD
Late deceleration – Placental utero insufficiency (decreased perfusion) BAD
What keywords in rpnce answers always point towards an incorrect answer?
Answers with absolutes. Answers which include words like “always, never, or must, etc.
How does the rule of 9’s work for burns?
Head and neck – 9%
Upper extremities – 9% each (18% for both)
Lower extremities – 9% each (18% for both)
Front chest – 18%
Back chest – 18%
Genitalia – 1%
Upper extremities – 9% each (18% for both)
Lower extremities – 9% each (18% for both)
Front chest – 18%
Back chest – 18%
Genitalia – 1%
What are the 12 cranial nerves and what do they control (including type of sensory)?
I – Olfactory (smell) SOMATIC
II – Optic (sight) SOMATIC
III – Oculomotor (external eye muscles) MOTOR
IV – Trochlear (external eye muscles) MOTOR
V – Trigeminal (chewing and facial sensation) BOTH
VI – Abducent (lateral eye movement) MOTOR
VII – Facial (muscles of facial expression, taste buds, blinking, fingers and toes) BOTH
VIII – Vestibulocochlear (sound and balance) SOMATIC
IX – Glossopharyngeal (taste and swallowing) BOTH
X – Vagus (organs in the chest and abdomen) BOTH
XI – Accessory (neck muscles) MOTOR
XII – Hypoglossal (tongue and neck muscles) MOTOR
II – Optic (sight) SOMATIC
III – Oculomotor (external eye muscles) MOTOR
IV – Trochlear (external eye muscles) MOTOR
V – Trigeminal (chewing and facial sensation) BOTH
VI – Abducent (lateral eye movement) MOTOR
VII – Facial (muscles of facial expression, taste buds, blinking, fingers and toes) BOTH
VIII – Vestibulocochlear (sound and balance) SOMATIC
IX – Glossopharyngeal (taste and swallowing) BOTH
X – Vagus (organs in the chest and abdomen) BOTH
XI – Accessory (neck muscles) MOTOR
XII – Hypoglossal (tongue and neck muscles) MOTOR
What is the most common treatment for chronic obstructive pulmonary disease?
Oxygen therapy 2L/minute or less. Must keep patient between hypoxic and hypercapnic. Constantly monitor oxygen saturation. Partial pressure of oxygen saturation (Pao2) should be >60 and arterial oxygen saturation (Sao2) should be >90% because of chronic carbon dioxide retention
WHAT INTERVENTION IS NECESSARY IF A HYPOGLYCEMIC PATIENT IS FOUND CONSCIOUS BUT DROWSY AND NAUSEOUS?
Glucagon tabs (usually between 3 - 6 tabs)
WHAT INTERVENTION IS NECESSARY IF A HYPOGLYCEMIC PATIENT IS FOUND UNCONSCIOUS?
Glucagon IV is started
WHAT IS REYE SYNDROME?
Common condition presenting in children with fever after Acetylsalicylic Acid administration. Symptoms include persistent vomiting and nausea
WHAT PROCEDURE IS NECESSARY IF UNFAMILIAR WITH A DISEASE (E.G. FETAL ALCOHOL SYNDROME)?
Leave the patients room, read about the disease, and check facility protocol, procedure, and policy
WHAT EFFECT DOES ANY DRUG (ESPECIALLY ANTIBIOTICS) HAVE IF TAKEN TOO FREQUENTLY?
Accumulative effect
WHAT IS A COMMON SYMPTOM OF ARTERIAL INSUFFICIENCY?
The extremity is cold to the touch and pedal pulses are not felt
