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

SITUATION I

After the change of shift, you are assigned to care for the following patients. Which patient should you attend first and so on, prioritize your answers by putting a number on the line provided.see answer

 

___A. A 68-year-old patient whom a sterile sputum must be sent to the laboratory.

___B. A 57-year-old with COPD and a pulse oximetry reading from the previous shift of 90% saturation.

___C. A 72-year-old with pneumonia who needs to be started on intravenous antibiotics.

___D. A 51-year-old with asthma who complains of shortness of breath after using a bronchodilator inhaler.

 

SITUATION II

You have a patient with Chronic Obstructive Pulmonary Disease (COPD). You're a charge nurse and you're working with LPN, PAB, and a nurse. Which of the following tasks are best to delegate to them?see answer

1. Assisting the patient to sit up on the side of the bed.

2. Instructing the patient to cough effectively.

3. Teaching the patient to use incentive spirometry.

4. Auscultation of breath sounds every 4 hours.

5. Administer Ciprofloxacin 500mg PO.

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Put the number of your answer in the box. Note: Don't repeat your answer.

 

 

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SITUATION III

An 89-year-old female patient is admitted to the hospital with a diagnosis of bacterial pneumonia. While obtaining the patient's health history, you learn that the patient has osteoarthritis, follows a vegetarian diet, and is very concerned with cleanliness.see answer

 

Question 1:

What would be the most likely predisposing factor of her pneumonia? 

1. _____________________________________________________________________________________________________________________________.

 

SITUATION IV

You are caring for a patient admitted to the hospital with the diagnosis of active tuberculosis.see answer

 

Question 1:

You are aware that the diagnosis was confirmed by what test?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION V

You're  teaching a pregnant patient who smokes and asks you, "What will be the effects of smoking on my pregnancy?"

see answer

Question 1:

Identify at least two effects of smoking on pregnancy?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

SITUATION VI

The LPN tells you that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort.see answer

 

Question 1:

What interventions should you suggest to improve the patient's comfort for this problem?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

SITUATION VII

Patient A, 17-year-old, female, who has a history of asthma presents to the Emergency Room (ER) with acute shortness of breath. The patient has taken her prescribed Albuterol at home with no relief of symptoms. Auscultation reveals decreased breath sounds with inspiratory and expiratory wheezing and the patient  is coughing up a small amount of white sputum . SaO2 is 93% on room air.see answer

MEDICATIONS:

Fluticasone 1 puff BID

Albuterol 2 puffs BID

 

Question 1:

Identify five (4) other possible signs and symptoms you must check to complete your assessment on patient A’s worsening respiratory condition?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

4. _____________________________________________________________________________________________________________________________.

 

Question 2:

Apart from taking into account the proper use of the inhaler, how will you administer her medications to get its maximum effect?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

Question 3:

After administering her medications and notifying the physician about the patient’s condition. Identify three (3) nursing interventions you will do while waiting for the physician to arrive?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

Question 4:

Identify three (3) discharge teachings the patient should do to prevent asthma attack when doing her activities

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

SITUATION VIII

You are working as a public health nurse in a community clinic. Mrs. B is a 33-year-old Hispanic woman comes to the clinic to be tested for Mantoux test (PPD or TST).see answer

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Question 1:

You've instructed the patient to come back to the clinic for how many days to read her test result?

1. _____________________________________________________________________________________________________________________________.

 

The result of her tests came out and confirmed that the patient has latent tuberculosis, therefore her physician decided to put her on Isoniazid (INH) as prophylaxis for nine months.

 

Question 2:

 What test do you expect the physician will order before Mrs. B starts her treatment of Isoniazid (INH)

1. _____________________________________________________________________________________________________________________________.

 

SITUATION IX

Mrs. C is a 69-year-old, resident in a long-term care facility who is very hesitant to get a flu vaccine. She states that she has been healthy and never been sick by flu before. You really want to help her understand the importance of flu vaccine without influencing her decision.see answer

 

Question 1:

Explain to Mrs. C why it is important for her to get vaccinated against the flu? Identify two:

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

 

Question 2:

The patient states, “I heard that there are side-effects of flu vaccine and that’s another reason why I really don’t like to receive it”. Identify two (2) possible side-effects of the vaccine and its interventions to reassure the patient’s concern

 

 

 

 

 

 

Twenty-four hours later after her vaccination, you notice that Mrs. C has red eyes, facial edema, and is complaining of sore- throat and cough.

 

Question 3:  

What do you suspect is happening to the patient?

1. _____________________________________________________________________________________________________________________________.

 

Question 4:

Identify three (3) nursing interventions that you will do for Mrs. C?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

4. _____________________________________________________________________________________________________________________________.

 

Question 5:

What is the most common complication of influenza?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION X

A 12-year-old female patient with asthma comes to the clinic for regular check-up accompanied by her mother today.

PRESCRIBED MEDICATIONS:

Fluticasone (Flovent) 125 mcg 2 puffs.

Salbutamol (Ventolin) 0.4 ml in 3ml NS q2h by nebulisation.

Ipratropium bromide (Atrovent) 36 mcg 2 puffs.

see answer

Question 1:

The mother asks you, "Why my child becomes more restless and won't go to sleep since they started the prescribed medications?". What would be your response?

1. _____________________________________________________________________________________________________________________________.

 

Question 2:

She also asks, “I am concern with the effect of corticosteroids on my daughter’s growth”. What would be your response to reassure the patient's mother? Identify two.

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

 

SITUATION XI

Mrs. D who has a history of HIV infection and was recently diagnosed with Congestive Heart Failure (CHF) arrive in the Emergency Room (ER) complaining of shortness of breath. While doing your blood works, you incidentally prick yourself with the needle that you used for the patient.see answer

 

Question 1:

Identify three (3) interventions you must do with this incident

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

 

SITUATION XII

Question 1:

A female client with interstitial lung disease is prescribed prednisone (Deltasone), to control her inflammation. During client teaching, the nurse stresses the importance of taking prednisone exactly as prescribed and cautions against discontinuing the drug abruptly. A client who discontinues prednisone abruptly may experience:see answer

1. _____________________________________________________________________________________________________________________________.

 

SITUATION XIII

A male adult client with cystic fibrosis is admitted to an acute care facility with an acute respiratory infection. Prescribed respiratory treatment includes chest physiotherapy every morning.see answer

 

Question 1:

When should the nurse perform this procedure?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION XIV

Question 1:

Before weaning a male client from a ventilator, what assessment parameter is most important for the nurse to review?

see answer

1. _____________________________________________________________________________________________________________________________.

 

SITUATION XV

A 4-year-old patient with asthma is being treated with corticosteroids.see answer

 

Question 1:

What should you monitor for this patient?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION XVI

A female client is suspected of having a pulmonary embolus.see answer

 

Question 1:

You assessed the client, knowing that what lung sound is a common clinical manifestation of pulmonary embolism?

1. _____________________________________________________________________________________________________________________________.

 

SITUATION XVII

Prioritize them for care in order of the severity of their condition:see answer

___1. A 35-year-old man complaining of severe intermittent cramps with three episodes of watery diarrhea 2 hours after eating.

___2. An 11-year-old boy with a low-grade fever, right lower quadrant tenderness, nausea, and anorexia for the past 2 days.

___3. A 40-year-old woman with moderate right upper quadrant pain who has vomited small amounts of yellow bile and whose symptoms have worsened over the past week.

___4. A 65-year-old man with a pulsating abdominal mass and sudden onset of “tearing” pain in the abdomen and flank within the past hour.

___5. A 23-year-old woman complaining of dizziness and severe left lower quadrant pain who reports she is possibly pregnant.

___6. A 50-year-old woman who complains of gnawing mid epigastric pain that is worse between meals and during the night.