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PROPHECY EMERGENCY DEPARTMENT RN exam solution 2024, Exams of Medicine

PROPHECY EMERGENCY DEPARTMENT RN exam solution 2024

Typology: Exams

2023/2024

Available from 03/24/2024

johnrays
johnrays 🇬🇧

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PROPHECY EMERGENCY DEPARTMENT
RN exam solution 2024
What is the proper procedure for testing visual acuity? - ANS>> *BOTH WRONG*
1) Test the affected eye first, then the unaffected eye without corrective lenses
2) Test the unaffected eye first, then the affected eye with corrective lenses when
available
A 22-year-old man with sickle cell disease is brought into the ED by Campus Police
from his local university. He is complaining of increasing pain to his bilateral lower
extremities, consistent with his past sickle cell pain crisis. Which intervention would you
expect the provider to order? - ANS>> *BOTH WRONG*
1) Oral hydrocodone
2) Intravenous acetaminophen
TPA would be contraindicated for which of the following patients? - ANS>> WRONG
1) 67 year old with symptom onset 3 hours ago
A 24 year old female, who has recently received methotrexate for a tubal pregnancy,
presents to the ED with severe abdominal pain. What would be the PRIORITY nursing
intervention? - ANS>> *BOTH WRONG*
1) Administer pain medication and fluids as ordered
2) Prepare for a pelvic exam and assess for vaginal bleeding
A 3 year old boy with a history of hydrocephalus with a cerebral shunt arrives to the ED
with a fever of 102.0°F, an enlarged abdomen, tachycardia and hypotension. The
patient is mildly lethargic, however is cooperative with the ED staff. Immediate treatment
for this child should include: - ANS>> *BOTH WRONG*
1) Removal of the shunt
2) Draining the shunt
When caring for a patient who has received a massive blood transfusion, monitoring
which of the following lab results is a top priority? - ANS>> *BOTH WRONG*
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PROPHECY EMERGENCY DEPARTMENT

RN exam solution 2024

What is the proper procedure for testing visual acuity? - ANS>> BOTH WRONG

  1. Test the affected eye first, then the unaffected eye without corrective lenses
  2. Test the unaffected eye first, then the affected eye with corrective lenses when available A 22-year-old man with sickle cell disease is brought into the ED by Campus Police from his local university. He is complaining of increasing pain to his bilateral lower extremities, consistent with his past sickle cell pain crisis. Which intervention would you expect the provider to order? - ANS>> BOTH WRONG
  3. Oral hydrocodone
  4. Intravenous acetaminophen TPA would be contraindicated for which of the following patients? - ANS>> WRONG
  5. 67 year old with symptom onset 3 hours ago A 24 year old female, who has recently received methotrexate for a tubal pregnancy, presents to the ED with severe abdominal pain. What would be the PRIORITY nursing intervention? - ANS>> BOTH WRONG
  6. Administer pain medication and fluids as ordered
  7. Prepare for a pelvic exam and assess for vaginal bleeding A 3 year old boy with a history of hydrocephalus with a cerebral shunt arrives to the ED with a fever of 102.0°F, an enlarged abdomen, tachycardia and hypotension. The patient is mildly lethargic, however is cooperative with the ED staff. Immediate treatment for this child should include: - ANS>> BOTH WRONG
  8. Removal of the shunt
  9. Draining the shunt When caring for a patient who has received a massive blood transfusion, monitoring which of the following lab results is a top priority? - ANS>> BOTH WRONG
  1. B-type natriuretic peptide
  2. Hematocrit count What medication would you anticipate administering to a six month old having an active tonic-clonic seizure? - ANS>> BOTH WRONG
  3. Phenobarbital 2)Phenytoin Patient presents to the ED with a snake bite that occurred 30 minutes ago. The snake was identified as a poisonous rattlesnake. What medication would you expect the physician to order for this patient? - ANS>> CroFab Crotalidae Polyvalent Immune Fab (Ovine) A 26 year old male with a history of asthma presents to the ED with dyspnea, audible expiratory wheezes, substernal retractions, accessory muscle use, with BP-145/72, HR
  • 26, RR-32, O2 Sat 88% on room air. What is the FIRST treatment of choice for this patient? - ANS>> Give albuterol and atrovent nebulizer with oxygen A 40-year-old man presents to the ED with shortness of breath and a headache, after being sprayed by pesticides while working on a farm. What is the FIRST nursing intervention? - ANS>> Decontaminate the patient according to hospital procedure Four patients are being transported to the ED after a severe collision between a train and two motor vehicles. Which of the following patients should be triaged for FIRST treatment? - ANS>> 26-year-old with respiratory distress and open chest wound A 53 year old female with a history of sarcoidosis presents to the ED after being rescued by firefighters from her burning apartment. She is currently alert and oriented, BP-115/78, HR-110, RR- 24, T-100.4 F, oxygen saturation 97% on room air. She is currently only complaining of a headache and her carboxyhemoglobin is 13%. What is the MOST appropriate nursing intervention? - ANS>> Place on high-flow non- rebreather A 28 year old, obsterical patient presents at 38 weeks gestation status post motor vehicle collision. Upon arrival via EMS, you note she is on a backboard and c-collar is in place. What is the immediate nursing intervention for this patient? - ANS>> Place patient in left tilt position A 36 year old male presents to the ED with an amputated hand. What should you do FIRST? - ANS>> Apply direct pressure to extremity

A 26-year-old woman presents with severe eye pain, photophobia, and the sensation of sand in her right eye. She is a contact lens wearer and states that she frequently leaves them in overnight. Which of the following is indicated for this patient? - ANS>> Slit lamp exam using fluorescein staining A 28-year old male patient presents with severe dysuria and white, foul smelling drainage from his penis. The symptoms have lasted about one month and have become progressively worse over the last few days. On exam, the patient is noted to have a petechial rash to his bilateral upper extremities. The patient's signs and symptoms are consistent with which of the following? - ANS>> Disseminated gonorrhea Which of the following would be the FIRST fluid of choice for a patient in hypovolemic shock secondary to hemorrhaging? - ANS>> PRBCs RhoGAM would be administered to a pregnant patient for which of the following reasons

  • ANS>> To prevent an RH- negative mother from forming antibodies to RH- positive fetal blood A pediatric patient was brought in by EMS for seizure activity. The patient is post ictal on arrival. During assessment, the patient begins to have convulsions with body stiffening, jerking motions of legs and arms, loss of consciousness and loss of bladder control. What is your PRIORITY nursing intervention? - ANS>> Lay patient on side to avoid injury and protect airway A 54 yr old male with a history of non-insulin dependent diabetes, presents to the ED with new onset of confusion, weakness, lethargy and nausea with frequent large volume urine output. Vital signs are BP-102/54, HR-115, RR-12, T- 97.4 and oxygen saturation is 97% on room air. Blood glucose is 725 mg/dl. pH is 7.40. What diagnosis would you expect to see for this patient? - ANS>> Hyperosmolar hyperglycemic state Your patient arrives hypotensive and tachycardic after a motorcycle collision. His pelvis is unstable upon palpation and a portable pelvic film reveals an open book pelvic fracture. What immediate intervention should you expect? - ANS>> Pelvic sheeting or placement of a commercial pelvic binder A nurse is at end of their shift and has been dealing with a difficult and unruly patient. The nurse threatens to place the patient in restraints without justification. This is an example of: - ANS>> Assault Your patient is an 84-year-old man who presents to the ED with increasing forgetfulness, restlessness, and anxiety, which has become progressively worse over the past 2 months. The patient feels well and is independent with his ADLs but will forget where he placed things. The head CT, labs and ECG are all normal. The diagnosis is likely dementia. Which of the following is correct about dementia? - ANS>>

There is progressive deterioration in cognition and/or behavior without altered consciousness Which of the following fractures is highly associated with child abuse? - ANS>> Spiral leg fracture of the tibia in an 8 month old You enter a patient's room and notice the chest tube has become dislodged from the patient's chest and is hanging off the bed. The primary intervention is to: - ANS>> Cover the chest tube site with 4x4 dressing and taping only 3 sides of the dressing An 18 year old female presents to ED unresponsive via private car. Her friends state that she has overdosed on hydrocodone. BP- 80/40, HR- 58, RR- 8, O2 sat 86% on room air. You expect an order for which of the following medications? - ANS>> Naltrexone (Narcan) A patient with a tension pnuemothorax should have a needle decompression catheter placed - ANS>> IN the 2nd intercostal space, midclavicular line An intubated patient becomes extremely agitated and the ventilator begins to alarm. What should you do FIRST? - ANS>> Check the ventilator tubing for disconnection Which of the following is a responsibility of the nurse collecting forensic evidence during the care of a sexual assault patient? - ANS>> Maintaining the evidence chain of custody A 26 year old male presents to the ED with an alcohol level of 225 mg/dl. The patient also consumed an unmeasured amount of benzodiazepines, is positive for THC and opiates. An eye witness states that the patient also consumed bleach while intoxicated. What is the next most important step to take in order to ensure proper treatment for this patient? - ANS>> Call the Poison Control Center for toxic ingestion recommendations A 38 week pregnant patient presents to the ED in active labor. The patient states she has not had any prenatal care. The fetal heart rate is assessed to be 85 beats per minute. What is the PRIORITY nursing intervention? - ANS>> Have the patient lay on her left side and place patient on high flow oxygen A patient arrives to the ED intubated and decompressed on the left side status post gunshot wound to the chest. During the primary survey, the endotracheal tube placement is confirmed but breath sounds ae noted to be absent on the right. A right- sided chest tube is place with immediate return of 500 ml or blood. Which of the following would you perform FIRST? - ANS>> Transfuse 2 unite of uncrossmatched red blood cells

and complains of pain to the left arm. The patient has seatbelt marks across the chest. What is your priority assessment for this patient? - ANS>> Assess the patient for signs of possible airway and respiratory compromise A 38-year old man with a history of schizophrenia arrives at this emergency department reporting that he is being monitored and plotted against by his neighbors through his television. He appears mildly agitated and suspicious. He reports he has blocked the people working against him by putting aluminum foil over TV and over the doors and windows. He left his apartment because he suddenly feared they would retaliate. This patient is demonstrating which of the following psychotic symptom? - ANS>> Persecutory delusions You are caring for a patient who has decided to discontinue treatment. You recognize that the patient is competent to make this decision. What action should you take NEXT?

  • ANS>> Comply with the patient wishes and ensure proper documentation of refusal The physician orders a heparin infusion of 900 units/hr. Heparin is prepared 25, units in 500 ml of D5W. The pump should be set to deliver ___ mL/hr. - ANS>> 18 You are caring for a patient in second-degree AV block type 2 with a heart rate of 30, BP - 86/62 and with an altered mental status. IV access attempts have been unsuccessful, and the patient becomes unresponsive. What is the PRIORITY nursing intervention? - ANS>> Begin transcutaneous pacemaker During CPR in progress, the physician calls for a pulse check. The monitor shows a change from the previously recorded rhythm. Which of the following would indicate the need for a shock? - ANS>> V-fib A patient with severe pre-eclampsia is sent to the ED by her OB/GYN. The OB/GYN called ahead and instructs the charge nurse to start the patient on a magnesium drip. You notice signs of magnesium toxicity including hypotension, bradypnea, loss of reflexes and decreased urinary output. Which of the following is the antidote used to treat magnesium toxicity? - ANS>> Calcium gluconate IV Which of the following statements from a patient exhibits a good understanding of discharge instructions after being diagnosed with trichomoniasis and given a prescription for metronidazole? - ANS>> I will avoid alcohol consumption while taking my medication Hypoparathyroidism tends to cause which of the following electrolyte imbalance? - ANS>> Hypocalcemia A 48-year old woman presents to the ED with nausea, vomiting, RUQ, and a fever (T- 101 F). The physician states that she has a positive Murphy's sign. Considering these

symptoms and assessment findings, the patient is MOST likely experiencing: - ANS>> Cholecystitis What would you anticipate as part of the plan of care for a patient diagnosed with pancreatitis? - ANS>> Maintain NPO status Interpret the acid-base abnormality: ph 7.56, PaCO2- 24 mm Hg, HCO3 - 23 mEq/L,PO2 93 - ANS>> Respiratory alkalosis A 79 year old male from a nursing home presents to the ED with complaints of severe diarrhea ongoing for more than 3 days. C-difficile is suspected. Education for visitors should include: - ANS>> Wash hands with soap and water You are delegating wound care to a licensed practical nurse. The LPN states she has never performed this type of wound care before. What component of delegation have you neglected? - ANS>> Competency A 46-year old patient presents with complaint of palpitations beginning 1 hour prior to presentation. He reports excessive caffeine intake over the past 24 hours. A 12-lead EKG has been contained and shows a narrow complex tachycardia at a rate of 200 BPM. His skin is cool and clammy. The patient's blood pressure is 110/50. The physician has attempted vagal maneuvers with the patient by asking him to bear down without effect. An intravenous line has been established. What is the NEXT priority intervention? - ANS>> Place defibrillator/pacing electrode pads on his chest and prepare to administer adenosine