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Questions and Answers
What is the systolic and diastolic range that qualifies as Stage I Hypertension?
What is the systolic and diastolic range that qualifies as Stage I Hypertension?
- 110-119 mmHg systolic and 60-79 mmHg diastolic
- 130-139 mmHg systolic and 80-89 mmHg diastolic
- 120-129 mmHg systolic and 60-79 mmHg diastolic (correct)
- 100-119 mmHg systolic and 50-60 mmHg diastolic
How much water should the nurse instill into the NGT as ordered?
How much water should the nurse instill into the NGT as ordered?
- 60 mL (correct)
- 15 mL
- 30 mL
- 90 mL
What is the total input and output the nurse should record based on the given information?
What is the total input and output the nurse should record based on the given information?
- Input: 1550 cc and output: 730 cc
- Input: 1110 cc and output: 1020 cc
- Input: 1350 cc and output: 1020 cc (correct)
- Input: 960 cc and output: 440 cc
Which urine output measurement corresponds to the total voided amount by Jermaine?
Which urine output measurement corresponds to the total voided amount by Jermaine?
What stage of adaptation does Hans Selye's theory suggest for Royette's physiological response after cutting his finger?
What stage of adaptation does Hans Selye's theory suggest for Royette's physiological response after cutting his finger?
What does a BUN level of 22 mg/dL indicate in a patient’s assessment?
What does a BUN level of 22 mg/dL indicate in a patient’s assessment?
Which of the following liquids does not contribute to Jermaine's total input as recorded?
Which of the following liquids does not contribute to Jermaine's total input as recorded?
How much liquid stool did Jermaine have during his assessment?
How much liquid stool did Jermaine have during his assessment?
Which food item contains the highest amount of iron per area of meat?
Which food item contains the highest amount of iron per area of meat?
Which nursing procedure does NOT require sterile technique?
Which nursing procedure does NOT require sterile technique?
What is an early sign of hypoxia that a nurse should be aware of?
What is an early sign of hypoxia that a nurse should be aware of?
What board exam rating may allow a nurse to practice nursing?
What board exam rating may allow a nurse to practice nursing?
Which option is NOT a means of earning CPD units under RA 10912?
Which option is NOT a means of earning CPD units under RA 10912?
How many units per hour can a nurse earn for being a resource person or keynote speaker under the CPD law of RA 10912?
How many units per hour can a nurse earn for being a resource person or keynote speaker under the CPD law of RA 10912?
Which of the following is an incorrect pairing of CPD unit earning activities?
Which of the following is an incorrect pairing of CPD unit earning activities?
Which of the following statements best describes a research statement?
Which of the following statements best describes a research statement?
Which vital sign assessment indicates cardiogenic shock?
Which vital sign assessment indicates cardiogenic shock?
What position is best for performing oral care on an unconscious client?
What position is best for performing oral care on an unconscious client?
If a nurse notes that a client is no longer experiencing difficulty breathing, cough, and is afebrile after pneumonia treatment, which step of the nursing process does this reflect?
If a nurse notes that a client is no longer experiencing difficulty breathing, cough, and is afebrile after pneumonia treatment, which step of the nursing process does this reflect?
What is the priority intervention for clients with burns during the emergent phase?
What is the priority intervention for clients with burns during the emergent phase?
For a 31-year-old female client admitted for severe dehydration, what level is the nurse likely to expect for the hematocrit?
For a 31-year-old female client admitted for severe dehydration, what level is the nurse likely to expect for the hematocrit?
When assessing a client, which position is contraindicated for optimal breathing?
When assessing a client, which position is contraindicated for optimal breathing?
What is the normal expected heart rate range for a resting adult?
What is the normal expected heart rate range for a resting adult?
Which of the following blood pressure readings suggests adequate circulation?
Which of the following blood pressure readings suggests adequate circulation?
What is the nurse’s priority action to prevent complications during suctioning?
What is the nurse’s priority action to prevent complications during suctioning?
At what time will a patient's infusion of NSS end if there are 250 ml left to infuse at a flow rate of 25 gtts/min with a drop factor of 10?
At what time will a patient's infusion of NSS end if there are 250 ml left to infuse at a flow rate of 25 gtts/min with a drop factor of 10?
What therapeutic effect is achieved by prescribing bedrest?
What therapeutic effect is achieved by prescribing bedrest?
In assessing the patient's abdomen, which sequence of physical examination is correctly ordered?
In assessing the patient's abdomen, which sequence of physical examination is correctly ordered?
In which component of the problem-oriented medical record will the nurse find the doctor's orders?
In which component of the problem-oriented medical record will the nurse find the doctor's orders?
A client receiving heparin therapy should be routinely assessed for which sign?
A client receiving heparin therapy should be routinely assessed for which sign?
During which point of the client’s hospital stay does rehabilitation typically begin?
During which point of the client’s hospital stay does rehabilitation typically begin?
What is the significance of using clean technique during procedures?
What is the significance of using clean technique during procedures?
What sound should a nurse expect upon percussion of the lung fields in a healthy patient?
What sound should a nurse expect upon percussion of the lung fields in a healthy patient?
What should be the initial nursing action when giving gastrostomy feeding?
What should be the initial nursing action when giving gastrostomy feeding?
For a burn client, which route is the most effective for administering pain medication?
For a burn client, which route is the most effective for administering pain medication?
At what time should the nurse replace a client's TPN if there is 300cc remaining at 6 am and the TPN was started at 12 noon the previous day?
At what time should the nurse replace a client's TPN if there is 300cc remaining at 6 am and the TPN was started at 12 noon the previous day?
What is the best nursing action to verify tube placement in a client receiving enteral feeding?
What is the best nursing action to verify tube placement in a client receiving enteral feeding?
Which term describes how accurately an instrument measures what it is intended to measure?
Which term describes how accurately an instrument measures what it is intended to measure?
What might indicate a fluid and electrolyte imbalance in a patient?
What might indicate a fluid and electrolyte imbalance in a patient?
What could be a potential complication of not properly managing a gastrostomy tube?
What could be a potential complication of not properly managing a gastrostomy tube?
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Study Notes
Fluid and Electrolyte Imbalance
- Serum calcium levels can be critical in assessing hydration and nutritional status; a level of 1.8 mEq/L is noted.
- BUN (Blood Urea Nitrogen) of 22 mg/dL may indicate dehydration or renal dysfunction.
- Albumin levels at 5.0 g/dL suggest good nutritional status; low levels could indicate malnutrition or liver disease.
- Urinary creatinine output of 360 mg in a 24-hour period reflects kidney function and hydration status.
Blood Pressure and Hypertension
- Stage I Hypertension is categorized as a systolic BP between 130-139 mmHg and diastolic BP between 80-89 mmHg.
- Important for nurses to provide accurate education regarding blood pressure classifications.
Nutritional Management via NGT
- NGT (nasogastric tube) feeding requires flushing with normal saline to prevent obstructions; a flush of 2 oz is standard.
- Essential to maintain proper nutritional intake and to prevent tube blockage.
Nursing Techniques for Interventions
- Administer antibiotics prior to suctioning to prevent infection in patients with dysrhythmias.
- Use clean technique for procedures such as suctioning to minimize infection risk.
Nursing Assessments
- Evaluate intravenous fluid administration and calculate the expected end time based on flow rates and drop factors.
- The expected end time for IV fluid depends on the rate of infusion and current volume remaining in the bag.
Patient Positioning for Procedures
- Positioning for thoracentesis involves having the patient supine with head of bed elevated at 30 degrees.
- For oral care in unconscious patients, a semi-Fowler’s position with the head turned to the side is preferred to prevent aspiration.
Pain Assessment and Management
- Pain medication for burn patients is ideally administered IV for better absorption and faster action.
- Be vigilant for signs of potential complications, such as bleeding from injuries.
Laboratory Expectations
- Hematocrit levels in dehydration may range significantly; a common expectation could be around 40%.
Adaptation Stages in Physiological Responses
- Selye's stages of adaptation provide a framework for understanding how individuals cope physiologically after injuries.
- The alarm stage indicates initial responses to stressors, while the resistance stage reflects adaptation.
TPN and Nutrition Management
- Monitoring of TPN (Total Parenteral Nutrition) is critical; clients may have a set volume needing replacement as per timing of infusion initiation.
Food and Nutrition
- Foods high in iron include lean red meats and pork liver; essential for assessing dietary intake in anemic patients.
Communication of Results
- Use of tables and graphs can effectively convey study results and aid understanding in nursing reports.
Continuing Professional Development (CPD)
- Under RA 10912, various activities can earn CPD units; formal learning, self-directed learning, and non-formal learning are valid methods for earning credits.
- License renewal for nurses requires appropriate CPD units to ensure continued professional competence.
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