Two weeks after passing the NCLEX RN I had an interview on a NEURO/TELE/STROKE floor at a Trauma hospital. I was nervous but an insider told me that because im a new grad, more than likely, I wouldn't be asked any clinical questions--THEY WERE WRONG. The nurse manager was difficult, with good reason--people's lives would be in my hands (But I was discouraged because I don't think I got a fair chance). So anyway, he basically gave me a 4 patient scenario, told me to prioritize them and then asked what my interventions would be one by one--all while throwing curveballs and adding in things as I answered:
Pt with new onset confusion.
I would assess Pt’s level of consciousness, Pt is not AAO at all (doesn’t even know name), check vital signs, Pts BP is 220/110, also check glucose because hypoglycemia or hyperglycemia and stroke can mimic one another. Perform neuro assessment, Pt has left sided weakness, also request CT for stroke. DO NOT LOWER BP—can make stroke worse. Give oxygen and NS, maintain normal temp. Administer TPA. Cardiac monitoring
Pt extubated two days ago and now has difficulty breathing
-First patient I would see based off of ABCs. I would assess patient, check breath sounds and O2 Sat. Pt is having such difficulty breathing that he cannot speak, has wheezes or rhonchi. I would check the MAR and admin Bronchodilator STAT. Recheck patient’s condition to assess improvement.
Pt in the hallway and just waving to get your attention
-Last patient to see. Pt is in no imminent danger or distress.
Pt who had normal sinus rhythm, then went into V-Tach, and is now back to normal sinus rhythm
-Assess Pt, check for pulse. There is no pulse. Immediately start high quality CPR. Pt’s heart is beating on monitor but blood isn’t being pumped through body. You want to maintain circulation through body. Defibrillate, Check MAR and administer epinephrine.
He also asked these questions before the clinical questions:
Why do you want to work here?
Tell us about one mistake you made and how you corrected it.
What did you do to improve customer service or STARN rating?
Tell us about a conflict you had with a patient or patient’s family and how you handled it.
What made you choose nursing as a career path?