Basic Concepts (Q)

Questions

SITUATION 1

Mr. A is a 65-year-old male who lives in a nursing facility, is admitted to your unit for diarrhea and dehydration from an unknown cause. For a few days now, he complains of nausea which has caused him to have a decrease in appetite. The patient has a history of right-sided stroke and urinary incontinence with a stage 2 pressure ulcer at his coccyx which according to him is not healing well. He said that at his residence, he spends the majority of his time in bed because once he goes to his wheelchair, he feels pain from his coccyx.

Question 1

Name 4 factors that increase Mr. A’s risk of pressure ulcer: see answers

Question 2

Apart from aseptic technique, what else do you recommend the LPN to do during dressing change to improve wound healing on Mr. A's pressure ulcer at his coccyx? Identify four (4) see answers

SITUATION 2

Mr. X, 83 years of age, who is a new patient in the nursing home where you work. In your initial evaluation, you notice that he is thin and dehydrated. Upon admission, his Braden scale is 16.

Question 1

Apart from alternating the patient’s position every two hours. How can you reduce pressure in the areas that are prone for pressure ulcer? Identify three (3). see answers

SITUATION 3

Mr. B, age 75, who is living in a home care facility, known to have heart failure and has a history of fall.

Around 22:00, the orderly found him lying on the floor. You note that the bed is at the lowest position and that the rails are lowered. The orderly assists you to put Mr. B back to bed. His physical examination and vital signs are normal. The patient stated that he wanted to go to the bathroom and everything was so dark, when he stood up to look for his eyeglasses, he felt dizzy that’s why he fell on the floor.

MEDICATIONS:

Lasix 20mg (furosemide)
Digoxin 500mcg (lanoxin)
Lopressor 25mg (metoprolol)
Lipitor 10 mg (atorvastatin)
Nitroglycerin patch 0.4mg
Capoten 6.25mg (captopril)

Question 1

Identify three (3) clinical administrative interventions you must carry out after what happened to Mr. B? see answers

Question 2

What are the possible factors that contribute to Mr. B’s fall? Identify three (3). see answers

Question 3

In a brief sentence, explain what is "Post-Fall Syndrome"? see answers

Question 4

The physician orders a CT scan with IV contrast. When you checked the patient's chart, what important finding should you report to the physician?

SITUATION 4

You review the arterial blood gas results of a patient and note the following: pH- 7.45, PCO2- 30, and HCO3- 22.

Question 1

You have analyzed these results which indicating what condition? see answers

Question 2

You're caring for a patient with a nasogastric tube that is attached to low suction. You monitor the patient closely, knowing that the client is at risk for which acid-base disorder? see answers

Question 3

Based on your answer in question number 2, what do you expect will happen to the patient's ABG result: see answers

PH = Normal, High, Low

PCO2 = Normal, High, Low

HCO3 = Normal, High, Low

SITUATION 5

You're a nurse who is instructing the parents of a 2-year-old child with iron deficiency anemia regarding the administration of a liquid oral iron supplement.

Question 1

What instructions should you tell the parents? see answers

Question 2

What other instruction should you tell them after the administration of the medication? see answers

Question 3

The mother asks you if it is possible to add the iron supplement to the formula for easier administration.

Yes or No? Justify. see answers

SITUATION 6

Mrs. X, 63-year-old, is soon to be discharged home using crutches or a wheelchair. She lives alone with her three cats.

Question 1

What assessment parameter is most important when you’re doing your initial home visit? see answers

SITUATION 7

Mrs. D has been hospitalized for a hemicolectomy. She requires assistance to wash and get out of bed, and prefer a PAB woman to take care of her. Mrs. D's record says that she is an alcoholic and comes from a center for abused women.

Question 1

What type of information may the nurse give to the team members responsible for Mrs. D's care? see answers

SITUATION 8

Mr. T has just learned that he has prostate cancer and must undergo a prostate resection. He has signed his consent form for the operation. A few hours later, after a few telephone conversations with friends, he begins to question his decision. He is worried about the after-effects. He says, "I didn't think it would turn my whole life upside down. I'd like to wait and think about other possibilities."

Question 1

What is your responsibility if the patient will refuse care or treatment? see answers

SITUATION 9

Mr. J needs relief from pain that he rates at moderate to severe. The medical prescription is an opiate subcutaneous.

Question 1

What requirement applies to the handling of narcotics in a health care institution? see answers

SITUATION 10

Mrs. L's violent behavior represents an imminent danger to the other patients. She intimidates patients and there is a risk that she will become violent. Measures have already been taken to prevent the violence from escalating but in vain.

Question1

Is it justifiable to administer the appropriate medication PRN? YES or NO. If yes, why? And what will you do after administering the medication? see answers

SITUATION 11

While ambulating in the hallway, a patient suddenly complains of extreme dizziness. You’ve been alert that the patient is about to fall or having a syncopal episode.

Question 1

What should you do? see answers

SITUATION 12

Mr. C, age 33, underwent appendectomy 36 hours ago. At 20:00, he rings the bell and tells you that his stomach hurts a lot. He rates the pain at 7/10, feels nauseous and bloated. His abdomen is distended. He has not had any bowel movement since his surgery. His vitals are within normal limits.

Question 1

What problem do you suspect? see answers

Question 2

Regarding the assessment of Mr. C’s clinical condition, what else must you check to complete your abdominal examination? see answers

SITUATION 13

Mrs. E is admitted to your unit after a transfer from another hospital. She has a Foley catheter and a colostomy. The MD suspects the patient has MRSA. As a precaution, you set her up in a private room to maintain isolation.

Question 1

What type of isolation is it? see answer

Question 2

Name 4 precautions that should be implemented to prevent the spread of MRSA? see answer

Question 3

How to obtain a sample to proceed the screening process of MRSA? Identify three (3). see answer

SITUATION 14

Ms. F is an 18-year-old female who has come to the clinic requesting a prescription for Levonorgestrel (“Plan B”). At her previous visit, she received antibiotics for her Chlamydia.

Question 1

After unprotected sexual intercourse, at least how many days are allowed for Ms. F for her to take the pill to be effective? see answer

Question 2

Identify other two (2) priority questions you should ask Ms. F before giving her Levonorgestrel, apart from asking the day of her last sexual intercourse. see answer

SITUATION 15

Mrs. H, 72-year-old, is admitted to the hospital for right hip fracture following a fall at home. This morning she had a total right hip replacement. When she returned from OR, while transferring the patient from the stretcher to bed, you see that her dressing are soaked in bright red blood. The urinary catheter is draining very little clear urine. She has IV Ringer's Lactate infusing to her right antecubital. Mrs. H has a pale face and appears diaphoretic. His BP is 100/60, HR: 80bpm regular, RR: 16 rpm.

Question 1

What is your priority nursing action? Justify your answer: see answer

SITUATION 16

Mr. G, age 54, was admitted to the surgical unit yesterday for a 2nd-degree chemical burn on his right arm. The patient has a dressing on his right arm to be changed every morning. Yesterday, when you changed his dressing he was complaining of pain at 7/10 on a pain scale and was taking Acetaminophen 325mg. He also has a prescription of Tylenol #3 1 tablet PO q 3-4h PRN. The dressing is due to be changed at 9:00.

Question 1

When do you suggest he will take Tylenol #3? Give the rationale for your answer. see answer

Time:

Rationale:

Question 2

Mr. G asks you, "Why it would be better for me to take the Tylenol #3 rather than his regular Acetaminophen?" What would be your response? see answer

SITUATION 17

Before the change of shift (3:15pm) the previous nurse administers morphine sulfate 4 mg IV to a patient for treatment of severe pain. Your initial assessment to the patient are: Pain is unrelieved after 15 minutes (3:30pm); the patient is drowsy; RR-10/min, PR-93/min, BP-110/70 mmHg.

Question 1

Which of your following assessments require immediate nursing intervention? see answer

See Answers