PROPHECY GENERAL ICU A RN V3 QUESTIONS & ANSWERS, DISTINCTION LEVEL ASSIGNMENT/ FALL 2023

One of your patients coded but is now stabilized and you are catching up on
charting. The step-down unit calls to get report on your other patient who is
to be transfered. The nurses near you do not appear busy. How should you
prioritize your time?
Correct Ans- Give report and ask the nurses to prepare the patient for
transfer.
Your patient was intubated but still has oral medications on their list of
medications. How should you ensure they receive their medications?
Correct Ans- Ask the provider to update the route of administration.
What laboratory value should you monitor closely if your patient is vomiting
coffee ground emesis?
Correct Ans- Hemoglobin
What ECG finding is indicative of hyperkalema?
Correct Ans- peaked T wave
You witness a patient that is not assigned to you fall out of bed and begin
crying for help but you do not see the assigned nurse to assist the patient.
What should you do first?
Correct Ans- Check on the patient's status and call for assistance.
When assessing for fever in your intubated patient, placement of the
thermometer in which area would be most accurate?
Correct Ans- Pulmonary artery or bladder
Your patient has just completed IV potassium replacement. When should you
collect their repeat potassium level?
Correct Ans- 30-60 min
Your patient is receiving an antiarrhythmic agent. Which of the following
assessment parameters is the MOST important for you to evaluate?
Correct Ans- ECG
Your patient is undergoing a weaning trial from the ventilator. Fifteen minutes
into the trial the patient's heart rate increases to 140 bpm and they start to
grab at their oxygen and IV tubing. What should you do NEXT?
Correct Ans- C. Stop weaning and rest the patient
While assessing a patient just admitted to the hospital, he admits to drinking
12 cans of beer a day, with the last drink being right before admission. What is
the expected onset of delirium tremens?
Correct Ans- Within 48-72 hours
You have administered a pain medication that has a half-life of 120 minutes,
onset of action 6 min, tmax of 15 minutes, and is mostly excreted in the uring.
when can the patient expect the medication to start working
Correct Ans- 6 minutes
A lethargic but oriented patient is being admitted for sepsis and their family
member is in the waiting area. Their belonging include a ring, cell phone, and
wallet. The patient asks if they can keep the ring on and phone at bedside.
What is your BEST response?
Correct Ans- It is best if your family takes your belongings.
What is a significant complication of imaging studies performed with iv
contrast
Correct Ans- Acute kidney injury
What respiratory support would an alert patient with an acute COPD
exacerbatiobn likely receive FIRST?
Correct Ans- Bipap
Your intubated and unresponsive patient is scheduled for surgery in the
morning. Who is the most appropriate person to make decisions for your
patient?
Correct Ans- The healthcare POA
When administering a titratable infusion what information must you check on
the medication IV bag to confirm the correct dose is being administered?
Correct Ans- Concentration
Your patient has a known baseline heart rate of around 45. The ECG monitor
keeps alarming when the heart rate decreases below 50. Their vital signs are
stable. What would you do?
Correct Ans- A. Adjust the alarm parameters
How is dopamine usually administered in the icu when given intravenously
Correct Ans- Titratable continous infusion
Which of the following can be given through an enteral feeding tube?
Correct Ans- Immediate release pills
When donning an N-95 mask, how should you secure the nose?
Correct Ans- Fit the nose piece with both hands
What type of medication is used in the critical care setting to help manage the
symptoms of alcohol withdrawal?
Correct Ans- Benzodiazepines
While admitting a patient with a history of IV drug use, what precautions
should you take?
Correct Ans- Carefully inspect items for presence of sharps.
Your patient is intubated and begins to cough up clear mucous inside their
ETT. What should you do NEXT?
Correct Ans- A. Instill normal saline to lavage ETT*WRONG*
B. Sit the patient up to 30 degrees in bed *wrong*
C. Inspect their oral cavity and suction mouth
D. Provide 100% oxygenation and prepare to suction
What is a complication of long term TPN?
Correct Ans- Liver injury
Which assessment establishes baseline hand perfusion before an ABG
puncture or arterial line placement?
Correct Ans- Allen Test
You find the concentration of an IV medication bag that is hanging and
infusing into your patient does not match the concentration in the order. What
should you do NEXT?
Correct Ans- Stop the infusion
Your patient has a right chest tube that was placed after thoracotomy. They
report that is very painful when they cough and request cough medicing. What
should you do?
Correct Ans- Teach them to splint their right side when coughing and give
pain medicine
Your patient had an unplanned self-extubation. They are now alert and sitting
up. Their pulse oximetry is 98% on 4 liters face mask. What action should you
prioritize?
Correct Ans- A. Inspecting the oral cavity
B. Checking blood pressure and the heart rate*WRONG
C. Administering an albuterol nebulizer
D. Performing an ordered STAT ABG *WRONG