test question!

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So the question asked, what is the FIRST thing the nurse should do if the dressing on a patient who is one day post op abdominal surgery, is saturated in bright red blood. Answers were between a) alert the physician. B) assess the wound. C) take vitals.

Opions??? My first thought was risk of evisceration...

Please excuse grammar in this post; i'm typing from my phone.:-)

Thanks!!!!

I never said YOU said anything. I also never said that the question the OP posted was a bad question. I said I could see DEPENDING ON HOW IT WAS WORDED, that calling the MD would be the first thing. There's more than 1 way to word a question, and have a different answer be correct. but once again, I never said you said anything. And like I said, real world vs. school world will be different. The "you" I mention is a generalized you, not you.

My apologies for misunderstanding, typing on a forum is an inexact form of communication and when you quoted my post, then used the word "you" I interpreted that as me and not a general you.

I never said or implied you called the OP question a bad question...I just said that's the question we've been talking about.

Of course a question could have a different answer depending on how it's worded, that seem pretty obvious....however, we were (as we all need to do on the NCLEX) dealing with the question as it was worded, not as it could be worded.

Since we were dealing with an actual question....and not discussing a type of question, it seemed like saying to call the Doc just confuses folks. As I said earlier, focusing on the mechanics of a question (ie someone should always/never choose call the Doc if that's an option) seems to be a complete waste of time and focusing on the question, in question (so to speak) is a far more productive use of time.

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Specializes in Cath Lab/ ICU.

For this question, I would check vitals first.

Assess wound next

Call MD last.

If the VS are stable, then the Tx is going to be different than if their BP is 80/40 and HR is 120. And what you going to tell the MD..."wound is bleeding" AND..... You NEED to assess your pt before you call. They need to know your judgement...

FWIW, in my nursing school, we were told that notifying the MD was almost NEVER the correct answer. The NCLEX wants to know what you will do as a nurse, not what you have the MD do...

In the ICU, I would hit the VS button as I assess my pt (color, pain, diaphoretic?) and as I assessed the wound. That would take about 1 min. Then I'd ask the clerk to page the MD.

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Since we were dealing with an actual question....and not discussing a type of question, it seemed like saying to call the Doc just confuses folks. As I said earlier, focusing on the mechanics of a question (ie someone should always/never choose call the Doc if that's an option) seems to be a complete waste of time and focusing on the question, in question (so to speak) is a far more productive use of time.

Yes then, answer to the actual question is vital signs as we stated.

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Specializes in CNA.
I can see it because how is taking vitals gonna fix the problem? While you got get your stuff to get the vitals, sit there getting the vitals, etc..patient is bleeding and/or dying. It depends on how it's worded

Sounds like a good way to get yelled at by the MD.

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Sounds like a good way to get yelled at by the MD.

Which? Callin the doc without vitals, or getting vitals while your patient dies a little more?

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Which? Callin the doc without vitals, or getting vitals while your patient dies a little more?

You keep speaking about taking vitals like it takes hours....just how long are you thinking it takes to take a BP and a pulse?

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Mi Vida Loca, can you give me any info about the handout your instructor gave you for answering questions. I am struggling with answering these questions and need help. I'm not gettin it from my instructor. Thanks

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You keep speaking about taking vitals like it takes hours....just how long are you thinking it takes to take a BP and a pulse?

Takes me about 47 minutes, maybe 46 on a good day. :sniff:

I asked him a question to clarify something...

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Specializes in Emergency Dept. Trauma. Pediatrics.
Mi Vida Loca, can you give me any info about the handout your instructor gave you for answering questions. I am struggling with answering these questions and need help. I'm not gettin it from my instructor. Thanks

It's 6 pages small print typing. The lady that wrote it used to do something with NCLEX, helped write questions or review on the board or something, I don't remember what her role was. Now she tutors nursing students. anyway, maybe I can scan it and email it to you in a PDF format. She said though to use it to focus on NCLEX boards since school can sometimes be different. I will type out everything said on a question very similar to this one she had on a handout though. I have to leave for an appointment and it's a lot to type out, so I will do it when I return in a few hours. My instructor who is also my adviser gave it to me, she got it from the lady.

In school, I would have picked the vitals answer. But I am 3 months away from taking my boards so I am trying to get best prepared for the actual NCLEX.

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I will also add that on our exam, the amount of blood on the dressing was an area measuring 6 cm. If that makes a difference.

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Specializes in Cath Lab/ ICU.
You keep speaking about taking vitals like it takes hours....just how long are you thinking it takes to take a BP and a pulse?

I know, right?

I just can't imagine calling the doc and not having any valid information about why you're calling.

I'm a nurse, I have a brain. I've assessed my pt. Maybe it's something I can handle on my own, maybe the doc needs to know right now, or maybe they just need to know sometime today.

Either way-->I'm assessing MY pt, and doing my job of caring for my pt before anything else.

And in the ICU, the Drs expect nothing less...

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Specializes in Infusion.

It's one thing if the patient who had abdominal surgery said that she felt a "pop" and something "give way" when she reached over to retrieve something off her bed table. It's different when you get a question about 6cm of red blood on a dressing. One is an emergency and the other isn't an emergency unless you have some other indications that the patient is hemorrhaging. I say, take a BP and pulse and you'll have a better idea. If the patient feels the pop and giving way, the surgeon needs to prep for emergency surgery.

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