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Relias/Prophecy general ICU RN A v3 Updated
2025. Verified Questions and Correct Answers.
Graded A
A code is initiated and the second nurse is observed not following ACLS protocol. What is the BEST action to take? โ ANS Stop the nurse immediately and institute ACLS protocol A lethargic but oriented patient is being admitted for sepsis and their family member is in the waiting area. Their belonging includes 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? โ ANS It is best if your family takes your belongings. After turning a patient with CVP monitoring what should you do to ensure accuracy of the CVP reading? โ ANS Zero the line at phlebostatic axis 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?
- ANS Within 24 hours of admission to the ICU
Besides the white blood cells, what laboratory value is used in the diagnosis of sepsis? โ ANS Lactic acid During cardiogenic shock what temporary intervention might be ordered to improve perfusion until definitive treatment is provided? โ ANS Inotropic infusion During the first hour of tPA infusion, how frequently should you monitor blood pressure? - ANSEvery 15 minutes For a patient with septic shock, What would you monitor to objectively determine the effectiveness and need to titrate a dobutamine infusion. - ANSScVo How is dopamine usually administered in the ICU when given intravenously? - ANSTitratable continuous infusion In a patient with septic shock, after fluid administration which of the following findings is MOST suggestive of the need to start a vasopressor? - ANSMean arterial pressure 40-50 mmHg 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
What information do you need from the provider to setup a cerebral intraventricular drainage system? - ANSMaximum ICP What information is MOST important for you to confirm in smart IV pump settings? - ANSWeight What is a complication of long term TPN? - ANSLiver injury What is a significant complication of imaging studies performed with IV contrast? - ANSAcute kidney injury What is an effective way to evaluate for cyanosis in a person of color? - ANSCheck inner eyelids What is the BEST way to determine a STEMI? - ANS12 Lead ECG What is the normal cardiovascular response to early sepsis? - ANSIncreased cardiac output What IV sedative would MOST likely be ordered for a non-intubated patient? - ANSDexmedetomidine (Precedex)
What laboratory value should you monitor closely if your patient is vomiting coffee ground emesis? - ANSHemoglobin What MUST you confirm before removing a cervical spine collar? - ANSPresence of active order to remove What order is included in the pre-procedural checklist for patients at risk for acute kidney injury who are to receive IV contrast? - ANSPre-hydration with IV Fluids What respiratory support would an alert patient with an acute COPD exacerbation likely receive FIRST? - ANSBiPAP What type of medication is used in the critical care setting to help manage the symptoms of alcohol withdrawal? - ANSBenzodiazepines What ventilator adjustment do you expect when your patient's ABG is pH 7.40, PaCO2 112, BICARB 22? - ANSDecrease in FiO
Which of the following actions complies with ventilator acquired pneumonia (VAP) prevention protocols? - ANSKeep head of bed 30-45 degrees Which of the following can be given through an enteral feeding tube? - ANSImmediate release pills Which of the following diets would be BEST for a patient with renal failure? - ANSLow sodium, Low potassium and moderate protein Which of the following is a priority for the bedside nurse when a patient gets inpatient hemodialysis? - ANSMaintaining adequate blood pressure Which of the following should you do if your patient suddenly becomes diaphoretic, anxious, tachycardic, and has clammy skin? - ANSCheck their glucose Which of the following signs or symptoms indicates a patient might not be tolerating the extubation? - ANSThe patient is coughing and has tachycardia While admitting a patient with a history of IV drug use, what precautions should you take? - ANSCarefully inspect items for presence of sharps.
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? - ANSWithin 48-72 hours 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? - ANSConfirm with the off-going nurse if this is a known situation. 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? - ANSPlace a new ID bracelet on the patient's wrist while confirming perfusion to the hand You are caring for a patient with diabetic ketoacidosis with suspected sepsis. You have the following tasks to complete: Draw blood cultures, check blood glucose, administer antibiotic, insert urinary catheter, and check urine for glucose. Which task should you complete FIRST? - ANSDraw blood culture You are caring for an underweight, older adult who is intubated, sedated, and septic. You have implemented turning every 2 hours. While inspecting the
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? - ANSCheck on the patient's status and call for assistance. 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? - ANSContact the ICU intensivist or specialist assigned to the case Your intubated and unresponsive patient is scheduled for surgery in the morning. Who is the most appropriate person to make decisions for your patient? - ANSThe healthcare POA Your patient begins to choke and a code blue is called. The provider is unsuccessful at removing the object and is unable to place the ETT. You would expect to prepare for what type of procedure? - ANSSurgical airway 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? - ANSInspecting the oral cavity
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? - ANSAdjust the alarm parameters Your patient has a right chest tube that was placed after thoracotomy. They report that is very painful when they cough and request cough medicine. What should you do? - ANSTeach them to splint their right side when coughing and give pain medicine Your patient has just completed IV potassium replacement. When should you collect their repeat potassium level? - ANS30-60 min Your patient is intubated and begins to cough up clear mucous inside their ETT. What should you do NEXT? - ANSProvide 100% oxygenation and prepare to suction Your patient is intubated with an ETT and sedated without spontaneous movements when the ventilator alarms with a high-pressure warning. The ventilator tubing is free and unkinked. What should you do NEXT? - ANSProvide 100% oxygen and prepare to suction the patient
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? - ANSPulmonary embolism
