Lecture twelve- MOC

Question 1

4 rules of prioritization

Answer 1

#1 acute beats chronic; acute is the higher priority
#2 fresh postop (12hrs) beats med/other surgical
#3 unstable beats stable
#4 more vital the organ the higher the priority (the organ in the modifying phrase

Question 2

unstable pt characteristics

Answer 2

• acute illness
• general anesthesia
• postop <12hrs
• lab abnormalities of c/d lvls
• “not ready for discharge”
• “newly admitted/dx”
• admitted less than 24hrs ago
• changing/changed assessments
• experiencing unexpected s/s of a disease

Question 3

stable pt characteristics

Answer 3

• chronic illness
• postop >12hrs
• local/regional anesthesia
• lab abnormalities a/b lvl
• “ready for discharge”
• admitted longer than 24hrs ago
• unchanged assessments
• experiencing typical/expected s/s of disease

Question 4

4 things that are ALWAYS unstable

Answer 4

1. hemmorhage
2. high fever >105
3. hypoglycemia
4. pulseless/breathless

Question 5

three things that result in a black tag in an unwitnessed accident triage

Answer 5

1. pulseless
2. breathless
3. fixed/dilated pupils

Question 6

organ vitality order

Answer 6

1. brain
2. lungs
3. heart
4. liver
5. kidneys
6. pancreas

Question 7

what should the rn NOT delegate to the lvn

Answer 7

• starting an IV
• hanging/mixing IV meds
• Pushin IV meds
• blood admin
• central line care
• planning care
• form/dev teaching
• unstable pt care
• the first of ANYTHING
• assessments
• can only maintain ivs*

Question 8

what should the rn NOT delegate to the UAP

Answer 8

• charting about a pt; they can only chart what they did
• med admin; the can only give barrier topical OTC meds
• assessments; only vitals/accuchecks
• treatments; only enemas
• evaluation

Question 9

UAPS only

Answer 9

implement

Question 10

when handling staff ask

Answer 10

1. is it illegal
   2 is it causing harm
2. is it just simply inappropriate

Question 11

heart auscultation APETM

Answer 11

Apical 2nd R
Pulmonic 2nd L
Erbs point 3rd L
Tricuspid 4th L
Mitral/Bicuspid 5th midclavicular
"try before you buy"

Question 12

Psych when you have no clue

Answer 12

“the nurse will examine own feelings”

“Establish a trusting relationship”

Question 13

Nutrition when you have no clue

Answer 13

• chicken
• fish
• no meds in food

Question 14

Pharm when you have no clue

Answer 14

SE

if you know the drug but dont know the side effects pick the side effect in the same body system!

Question 15

Never push K+ ___

Answer 15

IV

Question 16

if you have no idea what the drug is (PO)

Answer 16

choose a GI SE

Question 17

never tell a child a drug is ___

Answer 17

candy

Question 18

OB when you have no clue

Answer 18

check FHR

Question 19

MEDSURG when you have no clue #1 assessment

Answer 19

LOC

Question 20

MEDSURG when you have no clue #1 intervention

Answer 20

estb an airway

Question 21

PEDS growth/dev always give the child

Answer 21

more time to grow

Question 22

PEDS norm, older, easier

Answer 22

Norm- always say its normal when in doubt
Older- if you narrow it down to two ages go with the older
Easier- when in doubt pick the easier task

Question 23

rule out

Answer 23

absolutes

Question 24

if two answers say the same thing,

Answer 24

neither is right

Question 25

if two answers are opposite,

Answer 25

one is probably right

Question 26

umbrella; look for

Answer 26

the answer that is more global

Question 27

suspension meds shake well before

Answer 27

giving

Question 28

sesame street rule LAST RESORT

Answer 28

” 3 of these things belong together on is just not the same” pick the outlier

Question 29

if there is an answer you’ve never seen before

Answer 29

DONT PICK IT