RN101
Home of the Registered Nurses (RN) and
Licensed Practical Nurses (LPN)

SITUATION I

Mr. B is a 50-year-old male patient who suffered from ulcerative colitis, underwent a permanent ileostomy one week ago. He's still finding hard to participate in his ileostomy care and told you that the smell is disgusting.see answer

 

Question 1:

Identify five (4) recommendations you will teach him to prevent offensive odor?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

4. _____________________________________________________________________________________________________________________________.

 

Question 2:

After two weeks of taking methylprednisolone, the patient asks you, "Why long-term corticosteroid treatment should not be stopped abruptly?". What is your response?

1. _____________________________________________________________________________________________________________________________.

 

Mr. B who is managing his ileostomy well now. He reports sudden onset of abdominal cramps, vomiting, and watery discharge from the ileostomy.

 

Question 3:

What do you suspect is the problem?

1. _____________________________________________________________________________________________________________________________.

 

Question 4:

What is your intervention?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION II

You find a 21-year-old patient crying in her room who has had an ileostomy. The patient explains to you, "I'm upset because I know I won't be able to have children now that I have an ileostomy."see answer

 

Question 1:

What would be your best response?

1. _____________________________________________________________________________________________________________________________.

 

Question 2:

The patient told you that she loves sports and would like to continue doing it. Apart from advising her to change her bag before activity and covering it well, what other recommendations you will suggest to her regarding the choice of sports that she likes?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

Question 3:

The patient asks you if she can still do swimming.  What would be your advice to her?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

SITUATION III

Mr. X, 55- year-old male patient with a history of diabetes mellitus and duodenal ulcer is admitted due to chronic pancreatitis. He states, “Every morning, I regularly have a beer as an eye-opener and I love to eat fast food specifically Chinese cuisine because I don't have time to cook."  He lives alone in an apartment and works in a factory.see answer

 

Question 1:

What factors the patient should be modified to reduce recurrences of his pancreatitis?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

SITUATION IV

You’re performing an abdominal assessment to a patient with suspected appendicitis. You have already inspected the skin on the abdomen and auscultated it.see answer

 

Question 1:

You will perform what abdominal assessment next?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION V

You are monitoring a patient admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The patient begins to complain of increased abdominal pain and begins to vomit. On assessment, you note that the abdomen is distended and bowel sounds are diminished.see answer

 

Question 1:

What do you suspect is happening? What is your appropriate intervention?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION VI

You are assisting a patient to ambulate following a bowel resection for diverticulitis. Suddenly, the patient complains of sharp abdominal pain. When you assess the patient, you determine that the wound has eviscerated. You stay with the patient and immediately call for assistance.see answer

 

Question 1:

Identify two (2) priority nursing interventions you will do while you wait for the surgeon to arrive.

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

SITUATION VII

Mr. C, age 56, male Canadian,  who has a history of alcoholism is admitted to your unit due to liver cirrhosis.see answer

 

Question 1:

The health care provider orders lactulose for the patient who is at risk for hepatic encephalopathy. You will monitor for effectiveness of this medication for this patient by assessing what?

1. _____________________________________________________________________________________________________________________________.

 

Question 2:

As a nurse, what are your interventions or teachings to prevent the development of hepatic encephalopathy? Identify three (3)

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

Question 3:

When caring for a patient with liver disease, you recognize the need to prevent bleeding resulting from altered clotting factors and rupture of varices. What are your nursing interventions to achieve these outcomes?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

SITUATION VIII

A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L.see answer

 

Question 1:

What do you think is the reason that has attributed to these findings?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION IX

Mr. D is a 58-year-old man is admitted to your unit, stated that he has recently been waking up in the middle of the night due to abdominal pain. According to the patient, this has been happening several nights a week and each time he eats something the pain will start to disappear.see answer

 

Question 1:

What do you suspect is happening to the patient

1. _____________________________________________________________________________________________________________________________.

 

Mr. D’s condition got worse. Surgical management (gastroduodenostomy [Billroth I]) was done to him. A few days later, the patient is recovering well after his surgery. When you go to see the patient,  you notice that he is diaphoretic and states that he feels nauseous, and feels full after he drinks the milk brought by his wife.

 

Question 2:

What do you suspect is happening in relation to patient’s symptoms?

1. _____________________________________________________________________________________________________________________________.

 

Question 3:

You reassure  Mr. D that this is common because of his surgery. To prevent this from happening, you advise him to avoid foods high in salt, carbohydrates, large meals, dairy products and stress. Identify three (3) things you should include in your teachings apart from those mentioned?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

SITUATION X

Question1:

A  male patient with hepatitis B is being discharged in two days. What information should you include in the discharge teaching  plan instructions regarding  his sexual relationship?see answer

1. _____________________________________________________________________________________________________________________________.

 

SITUATION XI

A 36-year-old African American who is newly diagnosed with hepatitis A, who is a father of two children. The patient has no smoking history but drinks alcohol occasionally at home.see answer

 

Question 1:

How will you evaluate the patient for jaundice? Identify three (3).

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

Question 1:

The family of the patient asks you what they can do to prevent becoming ill themselves. What will be your most appropriate response?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION XII

A patient has been admitted to the emergency department with severe left upper quadrant pain.see answer

 

PROGRESS NOTE:

 2015/12/22 16:30

Received patient lying on bed complaining of severe left upper quadrant pain 8/10 on pain scale radiating to the back. N/V noted and febrile (39˚oral) other V/S stable. Lab results as follows: glucose 462 mg/dL, WBC 14000, lipase 214 units/L.-----------------------------------------------------------------------------------------------------------------------Jim Briant E. Banusan_Rn--------------------------------

 

Question 1:

What interventions  should the nurse expect to include in the patient's plan of care based on his progress note?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

SITUATION XIII

You're providing postoperative care for a client who has undergone a laparoscopic cholecystectomy. The patient rings the call bell and is complaining of right shoulder pain.see answer

 

Question 1:

What do you suspect is the cause of the patient's pain?

1. _____________________________________________________________________________________________________________________________.

 

Question 2:

Apart from giving analgesia, identify two things that will help relieve the patient's shoulder pain?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

SITUATION XIV

The nurse is caring for a patient who has been experiencing severe diarrhea. The patient has been permitted to resume oral intake.see answer

 

Question 1:

What foods may be introduced to aid in thickening the stools?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

SITUATION XV

An elderly patient has been admitted to the acute care facility for observation and to rule out the presence of a gastric ulcer.see answer

 

Question 1:

What manifestation is most likely to provide support for the diagnosis?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION XVI

Question 1:

When a patient experiences an exacerbation of Crohn's disease, the priority pharmacologic treatment would be administration of:see answer

1. _____________________________________________________________________________________________________________________________.