50 FREE Questions and Answers

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What are the correct math answers?

3000 ml
125 ml
0.5 ml
360 ml
12 - 13 gtts per minute
17 - 18 gtts per minute
21 gtts per minute
31 gtts per minute
Decrease the flow rate by 50gtt/min

Rationale: Proper calculations ensure safe and accurate drug and fluid administration

What is the correct response to something unusual, possibly requiring physician intervention?

Gather vitals and assessment data, complete an SBAR, finally contact the physician

Rationale: Gathering relevant data before contacting the physician ensures effective communication and informed decision making

What is the most common dietary recommendation for pregnant women?

Regular diet with an additional 300 - 400 calories per day

Rationale: Pregnant women need an additional 300 - 400 calories daily to support fetal growth

If D5W is added to a blood transfusion, what will occur?

Hemolysis (breaking down of erythrocytes)

Rationale: D5W (dextrose 5% in water) can cause hemolysis (breakdown of red blood cells) when used with blood products

What is a typical setup of a blood transfusion?

Normal saline and blood with a Y-tube

Rationale: Blood transfusions are typically administered with normal saline and blood using a Y-tube setup to ensure compatibility and reduce clotting

If back pain, hives, chills, edema, or increased temperature, is moderate during a blood transfusion, what intervention should take place?

Continue to monitor

Rationale: Moderate symptoms should be monitored closely as they can indicate a developing reaction

If back pain, hives, chills, edema, or increased temperature, is NOT moderate during a blood transfusion, what intervention should take place?

Stop the blood transfusion, and report to physician

Rationale: Severe symptoms can indicate a serious transfusion reaction and require immediate interventioN

How many hours is blood acceptable to hang for?

4 hours. Anything more and bacterial growth can occur

Rationale: Blood can hang for up to 4 hours. After this, bacterial growth increases, posing an infection risk

What intervention is necessary if the physician orders blood to be hung for 5 hours or more?

Clarify with the physician, and remind them that bacterial growth occurs after 4 hours

Rationale: Blood should not hang for more than 4 hours to prevent bacterial growth. The physician should be reminded of this guideline

What is the most common blood infusion rate (in hours)?

2 - 3 hours at 100 - 150 ml per hour

Rationale: Blood is commonly infused over 2 - 3 hours at a rate of 100 - 150 mL per hour to ensure safe administration

If the MAR directs to give blood and antibiotics, which are given first?

Give antibiotic, and then blood

Rationale: Administering antibiotics first ensures that any potential infection is treated before transfusing blood, reducing the risk of complication

How long should a patient be monitored after a blood transfusion has been started?

5 - 15 minutes

Rationale: The first 5 - 15 minutes of a transfusion are critical for detecting immediate reactions

What keywords in REX PN answers always point towards an incorrect answer?

Answers with absolutes. Answers which include words like “always, never, or must, etc.

Rationale: Absolutist language is often incorrect in exam questions because it leaves no room for exceptions or nuances that are common in healthcare scenarios

How many nurses are needed to check before a blood transfusion?

2. At least 1 RN must be present. 2 RN’s can check, or 1 RN and 1 LPN but 2 LPN’s is not permitted

Rationale: Ensuring the correct blood product is administered requires verification by two healthcare professionals to prevent transfusion errors

What are the 4 types of blood transfusion reactions?

Circulatory overload (onset 1 - 2 hours caused by rapid fluid infusion)
Febrile (onset 30 min caused by increased leucocytes and thrombocytes)
Anaphylactic (onset 5 - 15 min caused by allergy to blood phenotype)
Bacterial (onset 2 hours if contamination is present in transfused blood)

Rationale: Understanding different types of transfusion reactions allows for quick identification and appropriate interventions

What is the most common treatment for chronic obstructive pulmonary disease?

Oxygen therapy 2L/minute or less. Must keep patient between hypoxic and hypercapnic. Constantly monitor oxygen saturation. Partial pressure of oxygen saturation (Pao2) should be >60 and arterial oxygen saturation (Sao2) should be >90% because of chronic carbon dioxide retention

Rationale: Careful oxygen administration is essential in COPD to avoid oxygen toxicity and maintain appropriate oxygen and carbon dioxide levels in the blooD

What is the correct method to administer a Fentanyl patch?

Press the edges around the entire patch to make sure adherence is correct and sign patch with initials and time/date stamp. Cover with plastic if patient needs to take bath or shower

Rationale: Ensuring the patch is securely adhered prevents improper dosing. Signing the patch with initials and a date/time stamp ensures proper monitoring, and covering it for bathing protects it from water exposure

How should a wound be cleansed?

Proximal to distal using the midline, nearside, and far side method

Rationale: Cleansing a wound from proximal to distal (from the center outward) reduces the risk of contaminating the clean areas of the wound

What is recommended for a patient with postural drainage?

More fluids

Rationale: Increased fluid intake helps thin secretions and improve drainage for patients undergoing postural drainage therapy

What is the correct method to take the blood pressure of a patient who has undergone a mastectomy?

Administer analgesic if possible before starting the procedure and take the blood pressure on the arm opposite of the mastectomy (if only one breast removed) while elevating the arm

Rationale: Taking the blood pressure on the unaffected side prevents lymphedema and other complications in the arm of the affected side

What are common symptoms of systemic lupus erythematosus?

Joint pain, loss of eyebrow or eyelash hair, and photosensitivity

Rationale: Systemic lupus erythematosus (SLE) can affect multiple body systems, with common symptoms including joint pain, loss of hair, and photosensitivity due to the autoimmune nature of the disease

What is the most common symptom of systemic lupus erythematosus?

Butterfly rash on the face. Encourage sunscreen

Rationale: The butterfly shaped rash on the face is a hallmark sign of SLE, and patients should be advised to use sunscreen to avoid exacerbating the photosensitivity associated with this disease

What is the correct intervention for a patient who has increased intracranial pressure?

Elevate the head of the bed 30 – 40 degrees into the Semi-Fowler’s position (some physicians will request Reverse Trendelenburg bed positioning), allowing fluid to shunt away from the cranium and hold the head from going side to side (common response to the pain) as if left unnoticed this is fatal

Rationale: Elevating the head of the bed to 30 - 40 degrees promotes venous drainage from the brain, helping to reduce intracranial pressure. Keeping the head midline helps prevent obstruction of venous outflow

What are the most common symptoms of multiple sclerosis?

Decreased sensation to pain and heat (take special note during bath or shower if redness occurs with no pain response by patient)

Rationale: MS affects nerve conduction, resulting in decreased sensation to pain and heat, which can be particularly dangerous

When is an LPN intervention most important?

During anaphylactic shock. Left untreated is 100% fatal

Rationale: Anaphylactic shock is a medical emergency that is 100% fatal if untreated. LPN intervention is crucial to administer epinephrine and other immediate treatment

How is an abdominal assessment performed?

Inspection, auscultation, percussion, and palpation (in that exact order)

Rationale: The correct sequence for abdominal assessment prevents altering bowel sounds that might be caused by palpation or percussion

How is a respiratory assessment performed?

Inspection, palpation, percussion, and auscultation (in that exact order)

Rationale: The respiratory assessment involves inspecting for abnormalities, palpating for tenderness or deformities, percussing to assess air in the lungs, and auscultating to check breath sounds

How is post mortem care performed?

Place patient in a supine position with legs straight and arms beside torso. Place dentures in mouth (try to close mouth and eyes if possible, although often not), change any soiled linens, brush hair, and place a pillow under the patients head for family viewing

Rationale: The goal of post mortem care is to prepare the body respectfully and in a way that offers comfort to the family

What is physiological jaundice?

A type of jaundice which DOES NOT occur within 24 hours of newborn infant birth, but rather anytime post 24 hours of newborn infant birth. Physiological jaundice typically lasts 2 weeks in duration. Phototherapy intervention is required if the infant’s bilirubin levels are >18-21 mg/dL. Genitals and eyes must be covered during phototherapy. Reposition newborn infant Q2H

Rationale: Physiological jaundice occurs after 24 hours of birth, often lasting up to 2 weeks. It results from the normal breakdown of red blood cells. Phototherapy is used if bilirubin levels are elevated

What is the correct method to assess for dehydration in a child?

Assess mucous membranes

Rationale: Assessing mucous membranes (such as the mouth and lips) for dryness is an effective method to check for dehydration in children

What is the correct method to assess for dehydration in an infant?

Assess the anterior and posterior fontanels for depression

Rationale: In infants, the anterior and posterior fontanels should be assessed. A sunken fontanel indicates dehydration

When do the anterior and posterior fontanels close?

Anterior (diamond shaped) closes at 18 months. Posterior (almond shaped) closes at 2 - 3 months

Rationale: The closure of fontanels is important in monitoring an infant’s development and assessing for signs of abnormal intracranial pressure

What is the correct method to chart?

Use FOCAL. Factual, organized, concise, accurate, and legible

Rationale: FOCAL ensures that charting is clear, concise, and accurately reflects the patient's condition and care

What is the correct dosage for Nitroglycerine spray?

0.3 - 0.4 mg administered up to 3 times every 5 minutes under the tongue. Do not spray in the back of the mouth. If not effective, angina is not the root problem, MI should be expected, and the physician must be notified

Rationale: Nitroglycerine spray should be administered sublingually (under the tongue) for rapid absorption. Spraying in the back of the mouth is ineffective. Repeated doses can be given at 5 minute intervals

When should a tracheostomy dressing be changed?

Tracheostomy change should occur once per shift. Always keep obturator nearby (in case of emergency)

Rationale: Regular dressing changes prevent infection, and keeping the obturator nearby ensures quick action in case of accidental decannulation

What is the best method to prepare for a suspected MI?

Check the crash cart is fully stocked, and clear the hallway in the event that a code blue is called

Rationale: A fully stocked crash cart and a clear hallway ensure readiness for emergencies like a myocardial infarction

What is the best intervention for a broken piece of equipment?

Put an "out of order " sign on the equipment, and create a requisition for maintenance to fix

Rationale: Clearly labeling broken equipment and submitting a maintenance requisition ensures patient safety and proper handling

What is the correct way to deal with acuity?

Level of risk (chest pains before constipation)
Unknown factors (pre-existing conditions like diabetes)
Routine care (perianal care, ambulation, etc.)
Scheduled appointments (administrations, and discharges)

Rationale: Managing acuity in healthcare prioritizes immediate risks, considering both known and unknown factors, and addressing routine and scheduled tasks after urgent needs are met

How is the Apgar scale scored?

A: Appearance (color all pink, color pink and/or blue, or color blue and/or pale)
P: Pulse (>100, <100, or absent)
G: Grimace (cough, grimace, or no response)
A: Activity (flexed, flaccid, or limp)
R: Respirations (strong cry, weak cry, or absent)

8 – 10 is an ideal situation
4 – 7 requires intervention
0 – 3 requires a full resuscitation

Rationale: The APGAR score assesses a newborn’s condition at birth, evaluating appearance, pulse, grimace, activity, and respiration

How does the fetal heart rate system work?

Accelerations – Oxygen (infant is well oxygenated) GOOD
Variable deceleration – Cord compression (changing position alleviates) GOOD
Early deceleration – Head compression (deceleration mirror the contractions) GOOD
Late deceleration – Placental utero insufficiency (decreased perfusion) BAD

Rationale: Fetal heart rate patterns give important information about the well being of the fetus during labor. Variable decelerations, early decelerations, and accelerations are reassuring, while late decelerations indicate a problem with placental blood flow

What is the most important thing to obtain before starting a blood transfusion?

ID bracelet confirmation and patient consent (in that order)

Rationale: Confirming patient identification and obtaining consent ensures that the right blood is transfused to the correct patient, reducing the risk of transfusion errors

How does the rule of 9’s work for burns?

Head and neck – 9%
Upper extremities – 9% each (18% for both)
Lower extremities – 9% each (18% for both)
Front chest – 18%
Back chest – 18%
Genitalia – 1%

Rationale: The rule of 9’s is a system used to estimate the percentage of body surface area affected by burns, aiding in fluid resuscitation and treatment planning for burn patients

What are the 12 cranial nerves and what do they control (including type of sensory)?

I – Olfactory (smell) SOMATIC
II – Optic (sight) SOMATIC
III – Oculomotor (external eye muscles) MOTOR
IV – Trochlear (external eye muscles) MOTOR
V – Trigeminal (chewing and facial sensation) BOTH
VI – Abducent (lateral eye movement) MOTOR
VII – Facial (muscles of facial expression, taste buds, blinking, fingers and toes) BOTH
VIII – Vestibulocochlear (sound and balance) SOMATIC
IX – Glossopharyngeal (taste and swallowing) BOTH
X – Vagus (organs in the chest and abdomen) BOTH
XI – Accessory (neck muscles) MOTOR
XII – Hypoglossal (tongue and neck muscles) MOTOR

Rationale: These are the 12 cranial nerves that control various sensory and motor functions related to sight, smell, taste, movement, and other critical processes in the body

What are the most important things to check before administering a blood transfusion?

Blood type and Rh compatibility of the patient

Rationale: Verifying blood type and Rh compatibility prevents hemolytic reactions

What intervention is necessary if a hypoglycemic patient is found conscious but drowsy and nauseous?

Glucagon tabs (usually between 3 - 6 tabs)

Rationale: Administering glucagon tabs raises blood glucose levels in a conscious patient

What intervention is necessary if a hypoglycemic patient is found UNconscious?

Glucagon IV is started

Rationale: IV glucagon or dextrose is administered in emergencies to raise blood glucose in an unconscious patient

What is Reye syndrome?

Common condition presenting in children with fever after Acetylsalicylic Acid administration. Symptoms include persistent vomiting and nausea

Rationale: Reye syndrome is associated with aspirin use in children recovering from viral infections, presenting as vomiting and altered mental status

What procedure is necessary if unfamiliar with a disease (e.g. fetal alcohol syndrome)?

Leave the patients room, read about the disease, and check facility protocol, procedure, and policy

Rationale: Healthcare providers must familiarize themselves with a condition before treating a patient to ensure proper care

What effect does any drug (especially antibiotics) have if taken too frequently?

Accumulative effect

Rationale: Repeated use of drugs, especially antibiotics, can lead to an accumulative effect, increasing the risk of toxicity

What is a common symptom of arterial insufficiency?

The extremity is cold to the touch and pedal pulses are not felt