Nursing Care 2 Flashcards
What organ clears the blood of alcohol, drugs and other harmful substances?
A. Liver
B. Kidneys
C. Pancreas
D. Gallbladder
A. Liver
A medication prescription of 25 mg/kg/day TDS. The patient weighs 10 kg what is the correct amount for each dose?
83.3mg
A patient has just told you they had a fall earlier in the shift. What should you do first?
A. Report to the doctor straight away
B. Assess the patient for any injuries then monitor for the next 24 hours
C. Do neurological observations and if normal don’t do anything else
D. Document that they had a fall
A. Report to the doctor straight away
An alcoholic patient who was admitted is going through withdrawal and is shaking, nauseated and clammy. After taking their vital signs, what is your next step?
A. Report to the physician straight away
B. Start the alcohol withdrawal scope
C. If vital signs are ok do nothing
D. Administer IVF
A. Report to the physician straight away
A child presents with a sore throat, what is the first thing you do?
A. Swab their throat and give AB’s
B. Lymph node assessment and palpate neck
C. Check vitals
D. Get more history and background
D. Get more history and background
A patient is post-op from an adenoidectomy and tonsillectomy and is internally bleeding. What are the signs of internal bleeding?
A. Increased respirations and increased pulse
B. Increased respirations and decreased pulse
C. Decreased respirations and decreased pulse
D. Decreased respirations and increased pulse
D. Decreased respirations and increased pulse
A 7-year-old presents to ED with acute exacerbated asthma. Which of the following is the most concerning sign?
A. Coughs when given a bronchodilator
B. Unable to speak in full sentences
C. Oxygen saturating 98% on 2L of oxygen
B. Unable to speak in full sentences
A police officer arrives at the ward and asks to interview a patient who was involved in an accident. What is your response?
A. Tell the officer they can interview the patient once they are discharged from the hospital
B. Tell the officer the patient is very sick right now, but what can I do to help?
C. Take the officer to the patient for an interview.
D. Tell the officer to go away
B. Tell the officer the patient is very sick right now, but what can I do to help?
Vaccines are required to be…
A. Stored away from sunlight and does not require refrigeration
B. Refrigerated if it is a liquid solution
C. Refrigerated at 2-8 degrees
D. Refrigerated for a while at 5 degrees
C. Refrigerated at 2-8 degrees
A MH patient is sitting in the lounge room naked. What should you do?
A. Send the patient to their room
B. Ask other service users to leave the lounge to give the patient privacy
C. Cover the patient and take them to their room
D. Tell patient if they want their PRN medication
C. Cover the patient and take them to their room
You witness a nurse humiliate a patient. After ensuring the patient is okay, what must you do?
A. Tell the nurse their behaviour was unacceptable, then report to the charge nurse or manager.
B. Tell the nurse their behaviour was unacceptable, if this continues you will have to report it to the nurse or manager.
C. Tell the nurse their behaviour was unacceptable and that they should inform the charge nurse.
D. Don’t do anything as the patient must have been in the wrong.
A. Tell the nurse their behaviour was unacceptable, then report to the charge nurse or manager.
A nurse has made a public Facebook page about “anti-vaccination”. She has stated she is a nurse.
A. This is wrong as nurses should not undermine public health
B. This is right as nurses can have their own personal views
C. Share it and add your own comment
D. Report this to the nursing council
A. This is wrong as nurses should not undermine public health
You have received a handover from the night staff. What is your priority?
A. A patient who is going for mega surgery later in the morning
B. A post-op patient with oozing wound
C. A post-op patient who is transferring to another hospital
D. A patient who had difficulty breathing the shift before
D. A patient who had difficulty breathing the shift before
Signs of abuse on a child you are caring for are:
A. A 1 cm laceration on the forehead
B. A haematoma on the child’s head
C. Several marks on the child’s back
D. small bruise on their lower extremity
C. Several marks on the child’s back
A patient with bipolar disorder is pacing up and down and is very distressed. What is the most appropriate action?
A. Tell the patient they need to stop what they are doing
B. Take the patient to a quiet empty room till they calm down
C. Ask the patient what is concerning them
D. Ask the patient if they want their antidepressant
C. Ask the patient what is concerning them
The mother of a patient who is under the MHA asks you who can release them from the MHA.
A. Responsible clinician
B. Registered nurse
C. Judge
D. Themselves
A. Responsible clinician
A patient is to have an urgent blood transfusion. You notice the initials of the blood type on the blood bag is different to what is given on the patient’s chart. What is the right action?
A. Give blood but watch for any reactions
B. Withhold the transfusion and document the error in notes
C. Withhold the transfusion and call the blood bank for another bag
D. Inform the charge nurse whether you should give it or withhold
C. Withhold the transfusion and call the blood bank for another bag
The patient was given morphine sulphate. What is the most important action?
A. Come back every shift to check the IV site
B. Assess the patient’s heart rate
C. Observe the patient’s blood pressure
D. Document all medications given and time given in patient’s notes
B. Assess the patient’s heart rate
You suspect a patient has DVT. What is the reason for your clinical manifestation?
A. Cold and pale painful calf
B. Obvious limp and weakness on the left leg
C. Red and swollen painful calf
C. Red and swollen painful calf
An EN is working with you. You delegate tasks to EN. What must you do as an RN?
A. Follow up with EN
B. Ensure tasks are done satisfactorily
C. Note down the tasks then check if all tasks have been done
D. You do not need to check as EN is responsible enough.
B. Ensure tasks are done satisfactorily
Patient with depression asks you if they could be left alone to sleep. What must you check as the nurse?
A. Ask the patient if are they feeling suicidal or planning to take their life
B. Check when the last time they talked to family and friends
C. Check if they have eaten their meals
D. Do nothing and leave them to sleep
A. Ask the patient if are they feeling suicidal or planning to take their life
A patient is being prepared for their surgery. What is the role of the nurse in this situation?
A. Check if consent forms are signed
B. Check the patient’s understanding of the surgery
C. Gain consent from the patient
B. Check the patient’s understanding of the surgery
You notice a box of controlled drugs is missing from the medication room. What is the most important action?
A. Report to your charge nurse immediately
B. Ask every nurse if they have taken it
C. Report to the house officer immediately
D. Report to the pharmacist immediately
A. Report to your charge nurse immediately
A patient has been admitted to the ED. You notice they are losing consciousness. What is your immediate action?
A. Assess responsiveness then call for help
B. Administer oxygen
C. Commence CPR
A. Assess responsiveness then call for help
Your patient, who is a voluntary admission to a mental health unit, leaves the following day without telling anyone. Legally, what is required by staff:
A. Provide care for him at home
B. Re-admit him under a compulsory order
C. Get police to bring him in to sign a statement
D. Do nothing, the patient has right to leave health care at any time
D. Do nothing, the patient has right to leave health care at any time
A pregnant woman at 30 weeks’ gestation exhibits a rise in her baseline systolic blood pressure of 32mmHg, a weight gain of 4 kgs since last week and difficulty removing rings she normally wears. This is suggestive of:
A. Gestational hypertension
B. Pre-eclampsia
C. Eclampsia
D. Elevated liver enzymes
The primary pathophysiologic basis for the clinical manifestations of pregnancy-induced hypertension (PIH) is:
A. Fluid retention related to excessive salt intake
B. Ineffective excretion of fluid by the kidneys
C. Cardiac decompensation
D. Ineffective dilation of the vascular network to accommodate the expanding blood volume of pregnancy
D. Ineffective dilation of the vascular network to accommodate the expanding blood volume of pregnancy
Which measure would be least effective in relieving the signs and symptoms of mild pre-eclampsia?
A. Low salt diet
B. Period of bed rest
C. Balance diet with protein
D. Relaxation techniques
A. Low salt diet
A woman with severe pre-eclampsia is being monitored for assessment findings indicative of cerebral oedema and vasospasm. Which of the following would you NOT expect to find?
A. Hypotonic deep tendon reflexes
B. Headache
C. Vision changes including burring and spots before the eyes
D. Insomnia
A. Hypotonic deep tendon reflexes
The symptoms of cerebral oedema and vasospasm can include headache, vision changes including blurring and spots before the eyes, and insomnia. These symptoms are due to increased pressure in the brain and reduced blood flow.
Newly expectant parents, ask the nurse how they can prepare their 3-year-old preschool daughter for the new baby. All of the following would be useful except:
A. Tell the child about the pregnancy as soon as a mother begins to look pregnant
B. Arrange for a few sleepovers with the person who will care for the child at the time of the birth
C. Transfer their child to her new room and bed just before the expected birth of the baby
D. Introduce their child to preschool as soon as possible
C. Transfer their child to her new room and bed just before the expected birth of the baby