I didn't do so well on my last med-surg II exam last week. I was able to review my test today to see what I missed and why. On nearly every single one I missed, I was able to narrow it down to two possibilities and I missed nearly every time. So frustrating!
Anyway, here are a few questions. Now, I don't have them written word-for-word here but I think I got the gist of them.
Patient begins to receive TPN. It is important for the nurse to
A: check blood sugars Q4h
B: check serum albumin
I chose - check serum albumin. I always underline what I think are key words in the question and I underlined "begins to receive" so my rationale was that we would want to know the serum albumin levels at the beginning of this treatment to establish the patient's baseline.
The doctor inserts 2 chest tubes connected with a Y-connector in a patient with a hemothorax. When monitoring placement, the nurse will be most concerned about:
A: a large air leak in water-seal chamber
b: 400ml of blood in collection chamber
The correct answer was B. I chose A because the question reads, "when monitoring for PLACEMENT..." In my head, I'm thinking, "this question is asking about the placement of the tube, not what is coming out of it."
Last one... and I didn't have time to write much of this one...
A patient has been recently intubated and is on mechanical ventilation and a monitor that reads continuous arterial O2. The highest nursing priority is:
A: suction Q4h and PRN
B: monitor VS and breath sounds Q30-60 minutes.
The correct answer was B. I wish I had had the time to write all of this question because I'm sure I'm missing a vital piece of info but my rationale for A was that in a lecture, a teacher said that these vents have alarms that sound when either breathing has stopped or there is a kink in tubing, etc. and I'm asking myself if monitoring breath sounds every 30 minutes is realistic so I rule out B.
Clearly, respiratory stuff is NOT my cup of tea and I really need some help with this area. I got a solid A in med-surg I last semester but I am really struggling in this class so far.
2 - I work on a med-surg floor and I have a pt on TPN nearly every time I work and we don't do q4h blood sugar checks. We do it HC and HS and that's it. We don't check throughout the night.
Always remember that your tests take place in a magical NCLEX world where only one thing can be done at a time and you always have enough time to do everything.
I haven't done respiratory yet, so I can't really answer the chest tube question but I can give my theory on how to analyze the question. In the real world, the 400 mL might have been from the whole shift; in NCLEX-land the nurse suddenly found the blood.
Guest 360983
357 Posts
Always remember that your tests take place in a magical NCLEX world where only one thing can be done at a time and you always have enough time to do everything.
I haven't done respiratory yet, so I can't really answer the chest tube question but I can give my theory on how to analyze the question. In the real world, the 400 mL might have been from the whole shift; in NCLEX-land the nurse suddenly found the blood.