Fy 16 Med-surg: RN Annual Education Policy/Procedure/Protocol Quiz

2.

When would you notify the organ procurement agency?

When death is imminent.
When death is likely in 3 to 4 days.
At least 6 hours after death has occured.
Twenty-four hours before death is to occur.

Correct Answer

A. When death is imminent.

Explanation

CPM 00-14-16. T drive- All CPMs—type “Organ” in the search box

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3.

The following are nurses’ actions in the event of a blood transfusion reaction except:

Notify physician.
Notify blood bank
Collect 2 seven ml lavender tubes of blood from distant site from the transfusion.
Label the tubes as immediate.

Correct Answer

A. Collect 2 seven ml lavender tubes of blood from distant site from the transfusion.

Explanation

CPM 113-13-01. T drive- All CPMs—type “blood transfusion ” in the search box

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4.

Because CIWA-Ar is a nurse driven policy, no order is needed to initiate the protocol.

True
False

Correct Answer

A. False

Explanation

T drive---Clincal Guildlines and Protocols--Protocols--Alcohol Dextoxicfication Protocol

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5.

What is the minimum CIWA-Ar score that should be treated?

> 6
> 8
>10
> 12

Correct Answer

A. > 8

Explanation

T drive---Clincal Guildlines and Protocols--Protocols--Alcohol Dextoxicfication Protocol

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6.

When can the CIWA-AR protocol be discontiuned?

CIWA-AR score of less than 4 for three consecutive times
CIWA-AR score of less than 6 for three consecutive times
CIWA-AR score of less than 8 for three consecutive times
CIWA-AR score of less than 10 for three consecutive times

Correct Answer

A. CIWA-AR score of less than 8 for three consecutive times

Explanation

T drive---Clincal Guildlines and Protocols--Protocols--Alcohol Dextoxicfication Protocol

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7.

When admitting a SCI patient, what primary care intervention needs to be addressed in the hospital and continued on same home schedule?

Assess bowel daily home routine care
Assess bladder daily home routine care
Assess bowel and bladder daily routine home care
Assess daily routine bathing home care

Correct Answer

A. Assess bowel and bladder daily routine home care

Explanation

CPG 12-2013 Spinal Cord Injury Treatment Guidelines for Physicians and Nurses. Located on the T drive--Clinical Guidelines and Protocols---Clinical Practice and Guidelines. Type "spinal" in the search box.

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8.

What would you do if your SCI patient was showing symptoms of autonomic dysreflexia?

A. Sit patient upright
B. Take patient's B/P
C. Seek to eliminate the cause
A, B, & C
Only A & C

Correct Answer

A. A, B, & C

Explanation

CPG 12-2013 Spinal Cord Injury Treatment Guidelines for Physicians and Nurses. Located on the T drive--Clinical Guidelines and Protocols---Clinical Practice and Guidelines. Type "spinal" in the search box.

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9.

What are the signs and symptoms of blood transfusion reaction? (Select all that apply).

Fever
Flushing of skin
Chills
Dizzness

Correct Answer(s)

A. Fever
A. Flushing of skin
A. Chills
A. Dizzness

Explanation

CPM 113-13-01. T drive---All CPMs, type "blood transfusion" in search box

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10.

What type of specimen is required for a type and cross match?

One 7 ml lavender top blood tube with a yellow armband sticker
One 7 ml green top blood tube with a yellow armband sticker
One 7 ml yellow top blood tube with a yellow armband sticker
One 7 ml brown top blood tube with a yellow armband sticker

Correct Answer

A. One 7 ml lavender top blood tube with a yellow armband sticker

Explanation

CPM 113-13-01. T drive---All CPMs, type "blood transfusion" in search box

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11.

The following interventions are to be performed in the event that an inpatient suffer a Fall, check all that apply:

ROM
Neuro checks
Report to the Patient Safety Hotline
Peripheral pulses in all extermities

Correct Answer(s)

A. ROM
A. Neuro checks
A. Report to the Patient Safety Hotline

Explanation

CPM 118-13-18 Assessment and Care of Patients-Residents at Risk for Falls. Locsatedon the T drive--All CPMs--type "falls" in the search box.

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12.

I pledge to demonstrate the core values of the American Nurses Association code of ethics by upholding the standards of honesty and integrity. By answering yes, you certify that you are the person taking this test.

Yes
No

Correct Answer

A. Yes

Explanation

The given statement indicates that the person is pledging to uphold the core values of the American Nurses Association code of ethics, specifically honesty and integrity. By selecting "Yes," the person is affirming their commitment to these values and certifying that they are the one taking the test.

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13.

When a patient on the unit shows signs and symptoms of a stroke, according to the stroke protocol, which of the following interventions should you perform, check all that apply:

EKG
Vital signs every 30 minutes
Start oxygen, titrate to keep greater than 95%
Order non-contrast CT scan

Correct Answer(s)

A. EKG
A. Start oxygen, titrate to keep greater than 95%
A. Order non-contrast CT scan

Explanation

Nursing Protocol Signs and Symptoms of Acute Ischemia Stroke

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14.

Continuous IV medication infusions that require titration based on vital signs are not approved for administration on the inpatient medical-surgical nursing units.

True
False

Correct Answer

A. True

Explanation

CPM 118-13-41

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15.

After obtaining tubes of blood for type and cross match, verification is to be done at the bedside, but labeling can be done at the beside or at the nurse’s station with two RNs verifies.

True
False

Correct Answer

A. False

Explanation

Blood Transfusions: CPM 113-13-01. T drive---all CPMS—type the word “blood transfusion” in the search box.

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16.

Medication that is scheduled for every 8 hour will be administered within plus or minus 2 hours of scheduled times unless otherwise noted by the provider.

True
False

Correct Answer

A. False

Explanation

CPM 118-14-42 (Nursing)

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17.

Mr. Smith is to receive two units of Packed RBCs, the correct procedure for identifying Mr. Smith is:

Ask the patient his first and last name and the last four digits of his social security number
Ask the patient his first and last name and the last six digits of his social security number
Ask the patient his first and last name and his date of date of birth
Ask the patient his first and last name and his full social security number

Correct Answer

A. Ask the patient his first and last name and his full social security number

Explanation

The correct procedure for identifying Mr. Smith is to ask the patient his first and last name and his full social security number. This ensures a more accurate and secure identification process, as the full social security number is a unique identifier for an individual. Asking for the last four or six digits of the social security number may not provide enough information to accurately identify the patient, as there could be multiple individuals with the same last four or six digits. Additionally, asking for the patient's date of birth may not be as reliable, as there could be individuals with the same name and date of birth.

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18.

What blood glucose reading warrants initiating the hypoglycemia protocol:

Less than 50
Less than 60
Less than 70
Less than 80

Correct Answer

A. Less than 70

Explanation

Hypoglycemia-Hyperglycemia Protocol; this policy is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "hypoglycemia" and this will bring up the policy.

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19.

Your patient has a blood sugar that warrants you initiating the hypoglycemia protocol; where would you document your interventions:

CPRS general note
CPRS 24 hour assessment note
CPRS hypoglycemia/hyperglycemia protocol note
CPRS addendum to the 24 hour assessment note

Correct Answer

A. CPRS hypoglycemia/hyperglycemia protocol note

Explanation

Hypoglycemia-Hyperglycemia Protocol; this policy is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "hypoglycemia" and this will bring up the policy.

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Fy 16 Med-surg: RN Annual Education Policy/Procedure/Protocol Quiz

Who is the organ procurement agency for RHJ VAMC?

Quiz Preview

When would you notify the organ procurement agency?

The following are nurses’ actions in the event of a blood transfusion reaction except:

Because CIWA-Ar is a nurse driven policy, no order is needed to initiate the protocol.

What is the minimum CIWA-Ar score that should be treated?

When can the CIWA-AR protocol be discontiuned?

When admitting a SCI patient, what primary care intervention needs to be addressed in the hospital and continued on same home schedule?

What would you do if your SCI patient was showing symptoms of autonomic dysreflexia?

What are the signs and symptoms of blood transfusion reaction? (Select all that apply).

What type of specimen is required for a type and cross match?

The following interventions are to be performed in the event that an inpatient suffer a Fall, check all that apply:

I pledge to demonstrate the core values of the American Nurses Association code of ethics by upholding the standards of honesty and integrity. By answering yes, you certify that you are the person taking this test.

When a patient on the unit shows signs and symptoms of a stroke, according to the stroke protocol, which of the following interventions should you perform, check all that apply:

Continuous IV medication infusions that require titration based on vital signs are not approved for administration on the inpatient medical-surgical nursing units.

After obtaining tubes of blood for type and cross match, verification is to be done at the bedside, but labeling can be done at the beside or at the nurse’s station with two RNs verifies.

Medication that is scheduled for every 8 hour will be administered within plus or minus 2 hours of scheduled times unless otherwise noted by the provider.

Mr. Smith is to receive two units of Packed RBCs, the correct procedure for identifying Mr. Smith is:

What blood glucose reading warrants initiating the hypoglycemia protocol:

Your patient has a blood sugar that warrants you initiating the hypoglycemia protocol; where would you document your interventions: