Free Registered Nurse: Reduction of Risk Potential Questions and Answers — Questions and Answers

Question 1: At the local clinic, the healthcare provider is seeing four patients. Which of these people needs to have their risk for iron deficiency anemia identified by the healthcare professional?

The patient who follows a strict vegan diet.
The woman of childbearing age, reported a craving for ice. (Correct answer)
The patient with diagnosis of chronic renal failure.
The obese patient with a history of gastric bypass surgery.

Correct answer: The woman of childbearing age, reported a craving for ice.

Pica, which is a craving for non-nutritive substances like ice (pagophagia), dirt, or clay, is a classic symptom of iron deficiency anemia. While other patients listed may have risk factors for anemia, the reported craving for ice in a woman of childbearing age is a strong indicator specifically for iron deficiency anemia and warrants immediate investigation.

Question 2: Monitoring the patient's vital signs is crucial when a healthcare professional is treating a patient with a cardiac dysrhythmia.

hemoglobin and hematocrit
PT and INR
BUN and creatinine
sodium, potassium, and calcium (Correct answer)

Correct answer: sodium, potassium, and calcium

Electrolytes such as sodium, potassium, and calcium play critical roles in cardiac function, particularly in the electrical conduction system and myocardial contractility. Imbalances in these electrolytes can lead to various cardiac dysrhythmias. Therefore, monitoring their levels is crucial when caring for a patient with a cardiac dysrhythmia to guide treatment and prevent further complications.

Question 3: A patient arrives to the emergency room with a headache, disorientation, and a blood pressure of 180/130 mmHg. Which other observation supports the diagnosis of a hypertensive emergency?

Jaundice
Urinary retention
Retinopathy (Correct answer)
Bradycardia

Correct answer: Retinopathy

A hypertensive emergency is defined by severe hypertension (blood pressure typically >180/120 mmHg) accompanied by acute target organ damage. Retinopathy, which involves damage to the blood vessels in the retina, is a direct and visible sign of such acute end-organ damage caused by dangerously high blood pressure. This finding confirms the severity of the patient's condition and the need for immediate intervention.

Question 4: Which of the following would a healthcare professional anticipate when analyzing the arterial blood gases (ABGs) of a patient with a 20-year history of chronic bronchitis?

Metabolic acidosis, uncompensated
Respiratory alkalosis, uncompensated
Respiratory acidosis, compensated (Correct answer)
Metabolic alkalosis, compensated

Correct answer: Respiratory acidosis, compensated

Chronic bronchitis leads to impaired gas exchange in the lungs, causing the body to retain carbon dioxide (CO2). This CO2 retention results in an elevated PaCO2 and a decreased pH, indicating respiratory acidosis. Over a 20-year history, the kidneys would have compensated by retaining bicarbonate (HCO3-), bringing the pH back towards a normal range, thus classifying it as compensated respiratory acidosis.

Question 5: The healthcare provider would most likely anticipate finding during an evaluation of a patient with acute bleeding

tachycardia (Correct answer)
nausea
hypotension
jaundice

Correct answer: tachycardia

In acute bleeding, the body's initial compensatory mechanism for decreased blood volume and oxygen delivery is to increase the heart rate. Tachycardia helps maintain cardiac output and tissue perfusion in an attempt to counteract the blood loss. Hypotension would typically be a later sign, indicating that the body's compensatory mechanisms are failing.

Question 6: On your floor is a 50-year-old patient who is blind and deaf. What is your primary duty to this patient as the charge nurse?

Continually update the patient on the social environment.
Let others know about the patient's deficits.
Provide a secure environment for the patient. (Correct answer)
Communicate with your supervisor about your patient safety concerns.

Correct answer: Provide a secure environment for the patient.

For a patient who is both blind and deaf, their ability to perceive and react to their surroundings is severely compromised, making them highly vulnerable to injury. Therefore, the primary duty of the charge nurse is to ensure a secure and safe environment to prevent falls, accidents, and disorientation. While communication and informing others are important, physical safety takes precedence.

Question 7: A new patient can't take care of their oral hygiene. What guidance should the nurse provide the nurse's assistant out of the following list?

"Rinse the patient's mouth with mouthwash a few times during your shift."
"Use a soft toothbrush to brush the patient's teeth after every meal." (Correct answer)
"Use a soft foam applicator to swab the tongue, gums, and lips every 2 hours."
"Check the entire mouth each time oral hygiene is done and document your observations."

Correct answer: "Use a soft toothbrush to brush the patient's teeth after every meal."

For a patient unable to perform their own oral hygiene, regular and thorough cleaning is essential to prevent plaque buildup, cavities, and gum disease. Using a soft toothbrush after every meal effectively removes food particles and bacteria from the teeth and gums. This method provides more comprehensive cleaning than just rinsing or swabbing, promoting better oral health.

Question 8: The nurse should initially check the patient's ________ when evaluating a patient in the post-anesthesia care unit (PACU).

respiratory status (Correct answer)
level of pain
ability to move
level of consciousness

Correct answer: respiratory status

In the Post-Anesthesia Care Unit (PACU), the patient's respiratory status is the most critical initial assessment. Anesthesia can depress the respiratory drive and airway reflexes, making patients vulnerable to airway obstruction, hypoventilation, and hypoxemia. Ensuring a patent airway and adequate breathing is paramount to prevent life-threatening complications before addressing other concerns.

Question 9: For several days, your home health patient has been throwing up. She is currently resting in bed when you arrive. Her eyes are lifeless, and she is pale and listless. She is concerned as well. What is the most likely scenario?

Congestive heart failure
Hypovolemic shock (Correct answer)
Multiple sclerosis
Fecal impaction

Correct answer: Hypovolemic shock

The patient's symptoms of prolonged vomiting, paleness, listlessness, lifeless eyes, and concern strongly suggest significant fluid and electrolyte loss. These are classic signs of hypovolemia, which, if severe enough, can lead to hypovolemic shock due to inadequate tissue perfusion. The body is struggling to maintain circulation due to severe fluid depletion.

Question 10: A 7-year-old girl's bone marrow biopsy will be assisted by a pediatric nurse. The procedure will be done while under conscious sedation. What role does the nurse play primarily?

Documentation of the entire process
Communication with the child's parents
Monitoring the child during the procedures (Correct answer)
Application of the topical anesthetic ointment

Correct answer: Monitoring the child during the procedures

During conscious sedation, the pediatric nurse's primary responsibility is to continuously monitor the child's vital signs, respiratory status, oxygen saturation, and level of consciousness. This vigilant monitoring ensures the child's safety, detects any adverse reactions to the sedation, and allows for prompt intervention if complications arise. Other tasks, while important, are secondary to direct patient monitoring.

Question 11: A client with amyotrophic lateral sclerosis (ALS) suffers dysphagia, according to a home health nurse. What is the nurse's main worry?

The client is at risk for oral infections.
The client will be prone to drooling.
The client will have difficulty speaking.
The client is at risk for aspiration. (Correct answer)

Correct answer: The client is at risk for aspiration.

Dysphagia, or difficulty swallowing, is a common and serious symptom in patients with Amyotrophic Lateral Sclerosis (ALS) due to progressive muscle weakness. The main concern with dysphagia is the high risk of aspiration, where food or liquids enter the airway instead of the esophagus, which can lead to aspiration pneumonia, choking, and respiratory distress. This poses a significant threat to the patient's health and safety.

Question 12: A patient is admitted to the ICU after falling from a ladder and being diagnosed with traumatic brain damage (TBI). He is becoming more restless, the nurse notices, and his right arm is becoming weaker. He also reports feeling sick. What is the BEST thing the nurse can do right away?

Administer oxygen by face mask.
Measure the patient's blood pressure.
Elevate the head of the bed to 30 degrees. (Correct answer)
Increase the IV rate and call the physician.

Correct answer: Elevate the head of the bed to 30 degrees.

The patient's increasing restlessness, arm weakness, and nausea following a traumatic brain injury are concerning signs that suggest a potential increase in intracranial pressure (ICP). Elevating the head of the bed to 30 degrees promotes venous drainage from the brain, which can help to reduce ICP and is a crucial immediate nursing intervention to prevent further neurological damage.

Question 13: After discovering his two-year-old son next to an empty aspirin bottle, the father brings him to the emergency room. While unconscious, the youngster is breathing. What will the nurse do right away?

Notify Family Service authorities of child abuse.
Insert a nasogastric tube (NGT) to prepare for lavage. (Correct answer)
Provide education regarding accidental overdose.
Prepare to intubate the child for respiratory support.

Correct answer: Insert a nasogastric tube (NGT) to prepare for lavage.

In an unconscious child with suspected aspirin overdose, the immediate priority after ensuring airway and breathing is to prevent further absorption of the toxic substance. Inserting a nasogastric tube (NGT) allows for gastric lavage or administration of activated charcoal, which are critical interventions to remove the aspirin from the stomach and minimize systemic absorption. This is a life-saving measure to reduce the drug's effects.

Question 14: The 49-year-old pedestrian is taken to the emergency room following an automobile and pedestrian collision. Internal bleeding and a femur fracture are the two diagnosis made by the ED doctor. The nurse tries to get in touch with the next of kin for permission when surgery is recommended. What is the correct procedure for obtaining this client's consent?

Adult child, spouse, parent, sibling
Parent, spouse, adult child, sibling
Spouse, adult child, parent, sibling (Correct answer)
Sibling, parent, spouse, adult child

Correct answer: Spouse, adult child, parent, sibling

When a patient is incapacitated and unable to provide consent, the legal hierarchy for obtaining informed consent typically prioritizes the closest legal and emotional relationships. The order generally follows as: spouse, then adult child, followed by parent, and finally sibling. This hierarchy reflects the presumed wishes and legal authority of family members in making medical decisions.

Question 15: When Nurse John arrives for his shift, he observes that Nurse Jane has an alcoholic odor and slurs her speech. What is Nurse John supposed to do?

Report his observation to the charge nurse. (Correct answer)
Document his findings in an incident report.
Tell Nurse Jane she should go home.
Assist Nurse Jane with her patient care.

Correct answer: Report his observation to the charge nurse.

Patient safety is the paramount concern in healthcare. A nurse exhibiting signs of alcohol impairment poses a significant risk to patient care and safety. The appropriate action is to immediately report the observation to the charge nurse or supervisor, who is responsible for addressing such situations, ensuring patient safety, and following institutional policies regarding impaired staff.

Question 16: An evaluation of a patient who underwent extensive abdominal surgery five days ago is being done by the nurse. When the client coughed, the client claimed to feel a "pop where my operation was." The nurse examines the area and observes that the borders of the wound have split at the point of the incision. What should the nurse start by doing?

Administer a cough suppressant medication STAT.
Notify the health care provider (HCP). (Correct answer)
Stress the importance of splinting when coughing.
Apply an antibiotic ointment and sterile dressing.

Correct answer: Notify the health care provider (HCP).

The patient's description of a 'pop' and the observation of wound dehiscence (separation of wound edges) after extensive abdominal surgery is a serious complication. The nurse's initial action must be to notify the healthcare provider (HCP) immediately, as this condition requires prompt medical evaluation and potential surgical intervention. While supporting the wound and applying a sterile dressing are important, medical notification is the priority.

Free Registered Nurse: Reduction of Risk Potential Questions and Answers

At the local clinic, the healthcare provider is seeing four patients.
Which of these people needs to have their risk for iron deficiency anemia identified by the healthcare professional?